Achieving Robustness to Uncertainty for Financial Decision-making

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

Barnum, George M.; Van Buren, Kendra L.; Hemez, Francois M.

2014-01-10

This report investigates the concept of robustness analysis to support financial decision-making. Financial models, that forecast future stock returns or market conditions, depend on assumptions that might be unwarranted and variables that might exhibit large fluctuations from their last-known values. The analysis of robustness explores these sources of uncertainty, and recommends model settings such that the forecasts used for decision-making are as insensitive as possible to the uncertainty. A proof-of-concept is presented with the Capital Asset Pricing Model. The robustness of model predictions is assessed using info-gap decision theory. Info-gaps are models of uncertainty that express the “distance,” or gapmore » of information, between what is known and what needs to be known in order to support the decision. The analysis yields a description of worst-case stock returns as a function of increasing gaps in our knowledge. The analyst can then decide on the best course of action by trading-off worst-case performance with “risk”, which is how much uncertainty they think needs to be accommodated in the future. The report also discusses the Graphical User Interface, developed using the MATLAB® programming environment, such that the user can control the analysis through an easy-to-navigate interface. Three directions of future work are identified to enhance the present software. First, the code should be re-written using the Python scientific programming software. This change will achieve greater cross-platform compatibility, better portability, allow for a more professional appearance, and render it independent from a commercial license, which MATLAB® requires. Second, a capability should be developed to allow users to quickly implement and analyze their own models. This will facilitate application of the software to the evaluation of proprietary financial models. The third enhancement proposed is to add the ability to evaluate multiple models simultaneously. When two models reflect past data with similar accuracy, the more robust of the two is preferable for decision-making because its predictions are, by definition, less sensitive to the uncertainty.« less

Dual conception of risk in the Iowa Gambling Task: effects of sleep deprivation and test-retest gap.

PubMed

Singh, Varsha

2013-01-01

Risk in the Iowa Gambling Task (IGT) is often understood in terms of intertemporal choices, i.e., preference for immediate outcomes in favor of delayed outcomes is considered risky decision making. According to behavioral economics, healthy decision makers are expected to refrain from choosing the short-sighted immediate gain because, over time (10 trials of the IGT), the immediate gains result in a long term loss (net loss). Instead decision makers are expected to maximize their gains by choosing options that, over time (10 trials), result in delayed or long term gains (net gain). However, task choices are sometimes made on the basis of the frequency of reward and punishment such that frequent rewards/infrequent punishments are favored over infrequent rewards/frequent punishments. The presence of these two attributes (intertemporality and frequency of reward) in IGT decision making may correspond to the emotion-cognition dichotomy and reflect a dual conception of risk. Decision making on the basis of the two attributes was tested under two conditions: delay in retest and sleep deprivation. An interaction between sleep deprivation and time delay was expected to attenuate the difference between the two attributes. Participants were 40 male university students. Analysis of the effects of IGT attribute type (intertemporal vs. frequency of reinforcement), sleep deprivation (sleep deprivation vs. no sleep deprivation), and test-retest gap (short vs. long delay) showed a significant within-subjects effect of IGT attribute type thus confirming the difference between the two attributes. Sleep deprivation had no effect on the attributes, but test-retest gap and the three-way interaction between attribute type, test-retest gap, and sleep deprivation were significantly different. Post-hoc tests revealed that sleep deprivation and short test-retest gap attenuated the difference between the two attributes. Furthermore, the results showed an expected trend of increase in intertemporal decision making at retest suggesting that intertemporal decision making benefited from repeated task exposure. The present findings add to understanding of the emotion-cognition dichotomy. Further, they show an important time-dependent effect of a universally experienced constraint (sleep deprivation) on decision making. It is concluded that risky decision making in the IGT is contingent on the attribute under consideration and is affected by factors such as time elapsed and constraint experienced before the retest.

Analysis of Stakeholder-Defined Needs in Northeast U.S. Coastal Communities to Determine Gaps in Research Informing Coastal Resilience Planning

NASA Astrophysics Data System (ADS)

Molino, G. D.; Kenney, M. A.; Sutton-Grier, A.; Penn, K.

2017-12-01

The impacts of climate change on our coastlines are increasing pressure on communities, ecosystems, infrastructure, and state-to-local economies in the northeastern United States (U.S.). As a result of current or imminent risk of acute and chronic hazards, local, state and regional entities have taken steps to identify and address vulnerabilities to climate change. Decisions to increase coastal infrastructure resilience and grey, green, and cultural infrastructure solutions requires physical, natural, and social science that is useful for decision-making and effective science translation mechanisms. Despite the desire to conduct or fund science that meets the needs of communities, there has been no comprehensive analysis to determine stakeholder-defined research needs. To address this gap, this study conducts a stakeholder needs analysis in northeast U.S. coastal communities to determine gaps in information and translation processes supporting coastal resilience planning. Documents were sourced from local, state, and regional organizations in both the public and private sectors, using the northeast region defined by the third National Climate Assessment. Modeled after Dilling et al. (2015), a deductive coding schema was developed that categorized documents using specific search terms such as "Location and condition of infrastructure" and "Proactive planning". A qualitative document analysis was then executed using NVivo to formally identify patterns and themes present in stakeholder surveys, workshop proceedings, and reports. Initial stakeholder priorities centered around incorporation of climate science into planning and decision making regarding vulnerabilities of infrastructure, enhanced emergency planning and response, and communication of key information.

Groundwater Remediation using Bayesian Information-Gap Decision Theory

NASA Astrophysics Data System (ADS)

O'Malley, D.; Vesselinov, V. V.

2016-12-01

Probabilistic analyses of groundwater remediation scenarios frequently fail because the probability of an adverse, unanticipated event occurring is often high. In general, models of flow and transport in contaminated aquifers are always simpler than reality. Further, when a probabilistic analysis is performed, probability distributions are usually chosen more for convenience than correctness. The Bayesian Information-Gap Decision Theory (BIGDT) was designed to mitigate the shortcomings of the models and probabilistic decision analyses by leveraging a non-probabilistic decision theory - information-gap decision theory. BIGDT considers possible models that have not been explicitly enumerated and does not require us to commit to a particular probability distribution for model and remediation-design parameters. Both the set of possible models and the set of possible probability distributions grow as the degree of uncertainty increases. The fundamental question that BIGDT asks is "How large can these sets be before a particular decision results in an undesirable outcome?". The decision that allows these sets to be the largest is considered to be the best option. In this way, BIGDT enables robust decision-support for groundwater remediation problems. Here we apply BIGDT to in a representative groundwater remediation scenario where different options for hydraulic containment and pump & treat are being considered. BIGDT requires many model runs and for complex models high-performance computing resources are needed. These analyses are carried out on synthetic problems, but are applicable to real-world problems such as LANL site contaminations. BIGDT is implemented in Julia (a high-level, high-performance dynamic programming language for technical computing) and is part of the MADS framework (http://mads.lanl.gov/ and https://github.com/madsjulia/Mads.jl).

SOUTHWEST REGIONAL GAP ANALYSIS PROJECT: THE SECOND GENERATION

EPA Science Inventory

The project goal of providing useful information to the regional, state, and community stakeholders to assist them in understanding the environment, setting priorities, and making important decisions relative to conservation and sustainable resource management.

Pedestrian temporal and spatial gap acceptance at mid-block street crossing in developing world.

PubMed

Pawar, Digvijay S; Patil, Gopal R

2015-02-01

Most of the midblock pedestrian crossings on urban roads in India are uncontrolled; wherein the high degree of discretion in pedestrians' behavior while crossing the traffic stream, has made the situation complex to analyze. Vehicles do not yield to pedestrians, even though the traffic laws give priority to pedestrians over motorized vehicles at unsignalized pedestrian crossings. Therefore, a pedestrian has to decide if an available gap is safe or not for crossing. This paper aims to investigate pedestrian temporal and spatial gap acceptance for midblock street crossings. Field data were collected using video camera at two midblock pedestrian crossings. The data extraction in laboratory resulted in 1107 pedestrian gaps. Available gaps, pedestrians' decision, traffic volume, etc. were extracted from the videos. While crossing a road with multiple lanes, rolling gap acceptance behavior was observed. Using binary logit analysis, six utility models were developed, three each for temporal and spatial gaps. The 50th percentile temporal and spatial gaps ranged from 4.1 to 4.8s and 67 to 79 m respectively, whereas the 85th percentile temporal and spatial gaps ranged from 5 to 5.8s and 82 to 95 m respectively. These gap values were smaller than that reported in the studies in developed countries. The speed of conflicting vehicle was found to be significant in spatial gap but not in temporal gap acceptance. The gap acceptance decision was also found to be affected by the type of conflicting vehicles. The insights from this study can be used for the safety and performance evaluation of uncontrolled midblock street crossings in developing countries. Copyright © 2014 Elsevier Ltd and National Safety Council. All rights reserved.

Robust climate policies under uncertainty: a comparison of robust decision making and info-gap methods.

PubMed

Hall, Jim W; Lempert, Robert J; Keller, Klaus; Hackbarth, Andrew; Mijere, Christophe; McInerney, David J

2012-10-01

This study compares two widely used approaches for robustness analysis of decision problems: the info-gap method originally developed by Ben-Haim and the robust decision making (RDM) approach originally developed by Lempert, Popper, and Bankes. The study uses each approach to evaluate alternative paths for climate-altering greenhouse gas emissions given the potential for nonlinear threshold responses in the climate system, significant uncertainty about such a threshold response and a variety of other key parameters, as well as the ability to learn about any threshold responses over time. Info-gap and RDM share many similarities. Both represent uncertainty as sets of multiple plausible futures, and both seek to identify robust strategies whose performance is insensitive to uncertainties. Yet they also exhibit important differences, as they arrange their analyses in different orders, treat losses and gains in different ways, and take different approaches to imprecise probabilistic information. The study finds that the two approaches reach similar but not identical policy recommendations and that their differing attributes raise important questions about their appropriate roles in decision support applications. The comparison not only improves understanding of these specific methods, it also suggests some broader insights into robustness approaches and a framework for comparing them. © 2012 RAND Corporation.

Reconciling uncertain costs and benefits in bayes nets for invasive species management

USGS Publications Warehouse

Burgman, M.A.; Wintle, B.A.; Thompson, C.A.; Moilanen, A.; Runge, M.C.; Ben-Haim, Y.

2010-01-01

Bayes nets are used increasingly to characterize environmental systems and formalize probabilistic reasoning to support decision making. These networks treat probabilities as exact quantities. Sensitivity analysis can be used to evaluate the importance of assumptions and parameter estimates. Here, we outline an application of info-gap theory to Bayes nets that evaluates the sensitivity of decisions to possibly large errors in the underlying probability estimates and utilities. We apply it to an example of management and eradication of Red Imported Fire Ants in Southern Queensland, Australia and show how changes in management decisions can be justified when uncertainty is considered. ?? 2009 Society for Risk Analysis.

Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM).

PubMed

Balneaves, Lynda G; Truant, Tracy L O; Kelly, Mary; Verhoef, Marja J; Davison, B Joyce

2007-08-01

The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies. Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process. The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together. Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.

Capacity Building on the Use of Earth Observation for Bridging the Gaps between Science and Policy

NASA Astrophysics Data System (ADS)

Thapa, R. B.; Bajracharya, B.

2017-12-01

Although the geospatial technologies and Earth observation (EO) data are getting more accessible, lack of skilled human resources and institutional capacities are the major hurdles in the effective applications in Hindu Kush Himalayan (HKH) region. Designing efficient and cost effective capacity building (CB) programs fitting needs by different users on the use of EO information for decision making will provide options in bridging the gaps in the region. This paper presents the strategies adopted by SERVIR-HKH as an attempt to strengthen the capacity of governments and development stakeholders in the region. SERVIR-HKH hub plays vital role in CB on EO applications by bringing together the leading scientists from the Globe and the key national institutions and stakeholders in the region. We conducted country consultation workshops in Afghanistan, Bangladesh, Pakistan, and Nepal to identify national priorities, requirements and the capacity of the institutions to utilize EO information in decision making. The need assessments were focused on four thematic areas of SERVIR where capacity gaps in utilization of EO data in policy decisions were identified in thirteen key service areas. Geospatial capacities in GIT infrastructure, data, and human resources were varied. Linking EO information to policy decision is mostly lacking. Geospatial data sharing provision among the institutions in the region is poor. We developed a capacity building strategy for HKH region which bridges the gaps in a coordinated manner through customized training programs, institutional strengthening, coordination and regional cooperation. Using the strategy, we conducted training on FEWS NET remote sensing products for agro-climatological analysis, which focused on technical interpretation and analysis of the remote sensing and modeled products, eg, CHIRPS, RFE2, CHIRTS, GFS, NDVI, GeoCLIM and GeoGLAM. Scientists from USGS FEWS NET program delivered the training to mid-level managers and decision makers. We also carried out on-the-job trainings on wheat mapping using multi-sensor EO data for co-development of methodologies and implementation on sustainable basis. In this presentation, we will also present the lesson learned from capacity building efforts at SERVIR-HKH and how we envision the best practices for other SERVIR hubs.

Evidence-based medicine, the research-practice gap, and biases in medical and surgical decision making in dermatology.

PubMed

Eaglstein, William H

2010-10-01

The objectives of this article are to promote a better understanding of a group of biases that influence therapeutic decision making by physicians/dermatologists and to raise the awareness that these biases contribute to a research-practice gap that has an impact on physicians and treatment solutions. The literature included a wide range of peer-reviewed articles dealing with biases in decision making, evidence-based medicine, randomized controlled clinical trials, and the research-practice gap. Bias against new therapies, bias in favor of indirect harm or omission, and bias against change when multiple new choices are offered may unconsciously affect therapeutic decision making. Although there is no comprehensive understanding or theory as to how choices are made by physicians, recognition of certain cognition patterns and their associated biases will help narrow the research-practice gap and optimize decision making regarding therapeutic choices.

Info-gap management of public health Policy for TB with HIV-prevalence and epidemiological uncertainty

PubMed Central

2012-01-01

Background Formulation and evaluation of public health policy commonly employs science-based mathematical models. For instance, epidemiological dynamics of TB is dominated, in general, by flow between actively and latently infected populations. Thus modelling is central in planning public health intervention. However, models are highly uncertain because they are based on observations that are geographically and temporally distinct from the population to which they are applied. Aims We aim to demonstrate the advantages of info-gap theory, a non-probabilistic approach to severe uncertainty when worst cases cannot be reliably identified and probability distributions are unreliable or unavailable. Info-gap is applied here to mathematical modelling of epidemics and analysis of public health decision-making. Methods Applying info-gap robustness analysis to tuberculosis/HIV (TB/HIV) epidemics, we illustrate the critical role of incorporating uncertainty in formulating recommendations for interventions. Robustness is assessed as the magnitude of uncertainty that can be tolerated by a given intervention. We illustrate the methodology by exploring interventions that alter the rates of diagnosis, cure, relapse and HIV infection. Results We demonstrate several policy implications. Equivalence among alternative rates of diagnosis and relapse are identified. The impact of initial TB and HIV prevalence on the robustness to uncertainty is quantified. In some configurations, increased aggressiveness of intervention improves the predicted outcome but also reduces the robustness to uncertainty. Similarly, predicted outcomes may be better at larger target times, but may also be more vulnerable to model error. Conclusions The info-gap framework is useful for managing model uncertainty and is attractive when uncertainties on model parameters are extreme. When a public health model underlies guidelines, info-gap decision theory provides valuable insight into the confidence of achieving agreed-upon goals. PMID:23249291

Info-gap management of public health Policy for TB with HIV-prevalence and epidemiological uncertainty.

PubMed

Ben-Haim, Yakov; Dacso, Clifford C; Zetola, Nicola M

2012-12-19

Formulation and evaluation of public health policy commonly employs science-based mathematical models. For instance, epidemiological dynamics of TB is dominated, in general, by flow between actively and latently infected populations. Thus modelling is central in planning public health intervention. However, models are highly uncertain because they are based on observations that are geographically and temporally distinct from the population to which they are applied. We aim to demonstrate the advantages of info-gap theory, a non-probabilistic approach to severe uncertainty when worst cases cannot be reliably identified and probability distributions are unreliable or unavailable. Info-gap is applied here to mathematical modelling of epidemics and analysis of public health decision-making. Applying info-gap robustness analysis to tuberculosis/HIV (TB/HIV) epidemics, we illustrate the critical role of incorporating uncertainty in formulating recommendations for interventions. Robustness is assessed as the magnitude of uncertainty that can be tolerated by a given intervention. We illustrate the methodology by exploring interventions that alter the rates of diagnosis, cure, relapse and HIV infection. We demonstrate several policy implications. Equivalence among alternative rates of diagnosis and relapse are identified. The impact of initial TB and HIV prevalence on the robustness to uncertainty is quantified. In some configurations, increased aggressiveness of intervention improves the predicted outcome but also reduces the robustness to uncertainty. Similarly, predicted outcomes may be better at larger target times, but may also be more vulnerable to model error. The info-gap framework is useful for managing model uncertainty and is attractive when uncertainties on model parameters are extreme. When a public health model underlies guidelines, info-gap decision theory provides valuable insight into the confidence of achieving agreed-upon goals.

Modeling pedestrian gap crossing index under mixed traffic condition.

PubMed

Naser, Mohamed M; Zulkiple, Adnan; Al Bargi, Walid A; Khalifa, Nasradeen A; Daniel, Basil David

2017-12-01

There are a variety of challenges faced by pedestrians when they walk along and attempt to cross a road, as the most recorded accidents occur during this time. Pedestrians of all types, including both sexes with numerous aging groups, are always subjected to risk and are characterized as the most exposed road users. The increased demand for better traffic management strategies to reduce the risks at intersections, improve quality traffic management, traffic volume, and longer cycle time has further increased concerns over the past decade. This paper aims to develop a sustainable pedestrian gap crossing index model based on traffic flow density. It focusses on the gaps accepted by pedestrians and their decision for street crossing, where (Log-Gap) logarithm of accepted gaps was used to optimize the result of a model for gap crossing behavior. Through a review of extant literature, 15 influential variables were extracted for further empirical analysis. Subsequently, data from the observation at an uncontrolled mid-block in Jalan Ampang in Kuala Lumpur, Malaysia was gathered and Multiple Linear Regression (MLR) and Binary Logit Model (BLM) techniques were employed to analyze the results. From the results, different pedestrian behavioral characteristics were considered for a minimum gap size model, out of which only a few (four) variables could explain the pedestrian road crossing behavior while the remaining variables have an insignificant effect. Among the different variables, age, rolling gap, vehicle type, and crossing were the most influential variables. The study concludes that pedestrians' decision to cross the street depends on the pedestrian age, rolling gap, vehicle type, and size of traffic gap before crossing. The inferences from these models will be useful to increase pedestrian safety and performance evaluation of uncontrolled midblock road crossings in developing countries. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Professional Development to Improve Accommodations Decisions--A Review of the Literature. Synthesis Report 84

ERIC Educational Resources Information Center

Hodgson, Jennifer R.; Lazarus, Sheryl S.; Thurlow, Martha L.

2011-01-01

Teachers play an important role in making decisions about students' accommodations for instruction and assessment. Although teachers are a significant part of the decision-making process, "gaps" in teachers' accommodations knowledge are well documented. Some of these gaps may be due to challenges in providing teacher professional…

Analysis of driver merging behavior at lane drops on freeways.

DOT National Transportation Integrated Search

2013-12-01

Lane changing assistance systems advise drivers on safe gaps for making mandatory lane changes at lane drops. In this : study, such a system was developed using a Bayes classifier and a decision tree to model lane changes. Detailed vehicle : trajecto...

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 analysis to complete diagnostic research by closing the gap between test characteristics and cost-effectiveness.

PubMed

Schaafsma, Joanna D; van der Graaf, Yolanda; Rinkel, Gabriel J E; Buskens, Erik

2009-12-01

The lack of a standard methodology in diagnostic research impedes adequate evaluation before implementation of constantly developing diagnostic techniques. We discuss the methodology of diagnostic research and underscore the relevance of decision analysis in the process of evaluation of diagnostic tests. Overview and conceptual discussion. Diagnostic research requires a stepwise approach comprising assessment of test characteristics followed by evaluation of added value, clinical outcome, and cost-effectiveness. These multiple goals are generally incompatible with a randomized design. Decision-analytic models provide an important alternative through integration of the best available evidence. Thus, critical assessment of clinical value and efficient use of resources can be achieved. Decision-analytic models should be considered part of the standard methodology in diagnostic research. They can serve as a valid alternative to diagnostic randomized clinical trials (RCTs).

Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology.

PubMed

Krieger, Janice L; Krok-Schoen, Jessica L; Dailey, Phokeng M; Palmer-Wackerly, Angela L; Schoenberg, Nancy; Paskett, Electra D; Dignan, Mark

2017-07-01

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients ( N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed.

Decision technologies and the independent professional: the future's challenge to learning and leadership

PubMed Central

Dowie, J.

2001-01-01

Most references to "leadership" and "learning" as sources of quality improvement in medical care reflect an implicit commitment to the decision technology of "clinical judgement". All attempts to sustain this waning decision technology by clinical guidelines, care pathways, "evidence based practice", problem based curricula, and other stratagems only increase the gap between what is expected of doctors in today's clinical situation and what is humanly possible, hence the morale, stress, and health problems they are increasingly experiencing. Clinical guidance programmes based on decision analysis represent the coming decision technology, and proactive adaptation will produce independent doctors who can deliver excellent evidence based and preference driven care while concentrating on the human aspects of the therapeutic relation, having been relieved of the unbearable burdens of knowledge and information processing currently laid on them. History is full of examples of the incumbents of dominant technologies preferring to die than to adapt, and medicine needs both learning and leadership if it is to avoid repeating this mistake. Key Words: decision technology; clinical guidance programmes; decision analysis PMID:11700381

What Explains the Gender Gap in Financial Literacy? The Role of Household Decision Making.

PubMed

Fonseca, Raquel; Mullen, Kathleen J; Zamarro, Gema; Zissimopoulos, Julie

2012-01-01

Using newly collected data from the RAND American Life Panel, we examine potential explanations for the gender gap in financial literacy, including the role of marriage and who within a couple makes the financial decisions. Blinder-Oaxaca decomposition reveals the majority of the gender gap in financial literacy is not explained by differences in the characteristics of men and women-but rather differences in coefficients, or how literacy is produced. We find that financial decision making of couples is not centralized in one spouse although it is sensitive to the relative education level of spouses.

What Explains the Gender Gap in Financial Literacy? The Role of Household Decision Making

PubMed Central

FONSECA, RAQUEL; MULLEN, KATHLEEN J.; ZAMARRO, GEMA; ZISSIMOPOULOS, JULIE

2012-01-01

Using newly collected data from the RAND American Life Panel, we examine potential explanations for the gender gap in financial literacy, including the role of marriage and who within a couple makes the financial decisions. Blinder–Oaxaca decomposition reveals the majority of the gender gap in financial literacy is not explained by differences in the characteristics of men and women—but rather differences in coefficients, or how literacy is produced. We find that financial decision making of couples is not centralized in one spouse although it is sensitive to the relative education level of spouses. PMID:23049140

Robust evaluation of time series classification algorithms for structural health monitoring

NASA Astrophysics Data System (ADS)

Harvey, Dustin Y.; Worden, Keith; Todd, Michael D.

2014-03-01

Structural health monitoring (SHM) systems provide real-time damage and performance information for civil, aerospace, and mechanical infrastructure through analysis of structural response measurements. The supervised learning methodology for data-driven SHM involves computation of low-dimensional, damage-sensitive features from raw measurement data that are then used in conjunction with machine learning algorithms to detect, classify, and quantify damage states. However, these systems often suffer from performance degradation in real-world applications due to varying operational and environmental conditions. Probabilistic approaches to robust SHM system design suffer from incomplete knowledge of all conditions a system will experience over its lifetime. Info-gap decision theory enables nonprobabilistic evaluation of the robustness of competing models and systems in a variety of decision making applications. Previous work employed info-gap models to handle feature uncertainty when selecting various components of a supervised learning system, namely features from a pre-selected family and classifiers. In this work, the info-gap framework is extended to robust feature design and classifier selection for general time series classification through an efficient, interval arithmetic implementation of an info-gap data model. Experimental results are presented for a damage type classification problem on a ball bearing in a rotating machine. The info-gap framework in conjunction with an evolutionary feature design system allows for fully automated design of a time series classifier to meet performance requirements under maximum allowable uncertainty.

Racial Labor Market Gaps: The Role of Abilities and Schooling Choices

ERIC Educational Resources Information Center

Urzua, Sergio

2008-01-01

This paper studies the relationship between abilities, schooling choices, and black-white differentials in labor market outcomes. The analysis is based on a model of endogenous schooling choices. Agents' schooling decisions are based on expected future earnings, family background, and unobserved abilities. Earnings are also determined by…

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

Lockwood, Jr., Neil; McLellan, Jason G; Crossley, Brian

The Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams Project, commonly known as the Joint Stock Assessment Project (JSAP) is a management tool using ecosystem principles to manage artificial fish assemblages and native fish in altered environments existing in the Columbia River System above Chief Joseph and Grand Coulee Dams (blocked area). The three-phase approach of this project will enhance the fisheries resources of the blocked area by identifying data gaps, filling data gaps with research, and implementing management recommendations based on research results. The Blocked Area fisheries information housed in a central location will allow managersmore » to view the entire system while making decisions, rather than basing management decisions on isolated portions of the system. The JSAP (NWPPC program measure 10.8B.26) is designed and guided jointly by fisheries managers in the blocked area and the Columbia Basin blocked area management plan (1998). The initial year of the project (1997) identified the need for a central data storage and analysis facility, coordination with the StreamNet project, compilation of blocked area fisheries information, and a report on the ecological condition of the Spokane River System. These needs were addressed in 1998 by acquiring a central location with a data storage and analysis system, coordinating a pilot project with StreamNet, compiling fisheries distribution data throughout the blocked area, identifying data gaps based on compiled information, and researching the ecological condition of the Spokane River. In order to ensure that any additional information collected throughout the life of this project will be easily stored and manipulated by the central storage facility, it was necessary to develop standardized methodologies between the JSAP fisheries managers. The use of common collection and analytical tools is essential to the process of streamlining joint management decisions. In 1999 and 2000 the project began to address some of the identified data gaps, throughout the blocked area, with a variety of newly developed sampling projects, as well as, continuing with ongoing data collection of established projects.« less

Ontology based decision system for breast cancer diagnosis

NASA Astrophysics Data System (ADS)

Trabelsi Ben Ameur, Soumaya; Cloppet, Florence; Wendling, Laurent; Sellami, Dorra

2018-04-01

In this paper, we focus on analysis and diagnosis of breast masses inspired by expert concepts and rules. Accordingly, a Bag of Words is built based on the ontology of breast cancer diagnosis, accurately described in the Breast Imaging Reporting and Data System. To fill the gap between low level knowledge and expert concepts, a semantic annotation is developed using a machine learning tool. Then, breast masses are classified into benign or malignant according to expert rules implicitly modeled with a set of classifiers (KNN, ANN, SVM and Decision Tree). This semantic context of analysis offers a frame where we can include external factors and other meta-knowledge such as patient risk factors as well as exploiting more than one modality. Based on MRI and DECEDM modalities, our developed system leads a recognition rate of 99.7% with Decision Tree where an improvement of 24.7 % is obtained owing to semantic analysis.

Who Am I to Decide Whether This Person Is to Die Today? Physicians' Life-or-Death Decisions for Elderly Critically Ill Patients at the Emergency Department-ICU Interface: A Qualitative Study.

PubMed

Fassier, Thomas; Valour, Elizabeth; Colin, Cyrille; Danet, François

2016-07-01

We explored physicians' perceptions of and attitudes toward triage and end-of-life decisions for elderly critically ill patients at the emergency department (ED)-ICU interface. This was a qualitative study with thematic analysis of data collected through semistructured interviews (15 emergency physicians and 9 ICU physicians) and nonparticipant observations (324 hours, 8 units, in 2 hospitals in France). Six themes emerged: (1) Physicians revealed a representation of elderly patients that comprised both negative and positive stereotypes, and expressed the concept of physiologic age. (2) These age-related factors influenced physicians' decisionmaking in resuscitate/not resuscitate situations. (3) Three main communication patterns framed the decisions: interdisciplinary decisions, decisions by 2 physicians on their own, and unilateral decisions by 1 physician; however, some physicians avoided decisions, facing uncertainty and conflicts. (4) Conflicts and communication gaps occurred at the ED-ICU interface and upstream of the ED-ICU interface. (5) End-of-life decisions were perceived as more complex in the ED, in the absence of family or of information about elderly patients' end-of-life preferences, and when there was conflict with relatives, time pressure, and a lack of training in end-of-life decisionmaking. (6) During decisionmaking, patients' safety and quality of care were potentially compromised by delayed or denied intensive care and lack of palliative care. These qualitative findings highlight the cognitive heuristics and biases, interphysician conflicts, and communication gaps influencing physicians' triage and end-of-life decisions for elderly critically ill patients at the ED-ICU interface and suggest strategies to improve these decisions. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Merging building maintainability and sustainability assessment: A multicriteria decision making approach

NASA Astrophysics Data System (ADS)

Asmone, A. S.; Chew, M. Y. L.

2018-02-01

Accurately predicting maintainability has been a challenge due to the complex nature of buildings, yet it is an important research area with a rising necessity. This paper explores the use of multicriteria decision making approach for merging maintainability and sustainability elements into building grading systems to attain long-term sustainability in the building industry. The paper conducts a systematic literature review on multicriteria decision analysis approach and builds on the existing knowledge of maintainability to achieve this. A conceptual framework is developed to bridge the gap between building operations and maintenance with green facilities management by forecasting green maintainability at the design stage.

Health social workers sources of knowledge for decision making in practice.

PubMed

McDermott, Fiona; Henderson, Annabel; Quayle, Carol

2017-10-01

This article presents findings from research examining knowledge social workers in a health network in Victoria, Australia identified as informing their decision-making. Data for 13 patients, and in-depth interviews with six social workers who worked with these patients, were studied. A thematic analysis of interviews revealed that participants identified reliance on past experience and contextual/situational information as underpinning their decisions, demonstrating their commitment to person-in-environment perspectives. However, despite the availability of a repository of empirical evidence, no respondent made use of this. This study provided insight into health practitioners' sources of knowledge, highlighting gaps and areas for further exploration.

GAP Analysis Bulletin Number 15

USGS Publications Warehouse

Maxwell, Jill; Gergely, Kevin; Aycrigg, Jocelyn; Canonico, Gabrielle; Davidson, Anne; Coffey, Nicole

2008-01-01

The Mission of the Gap Analysis Program (GAP) is to promote conservation by providing broad geographic information on biological diversity to resource managers, planners, and policy makers who can use the information to make informed decisions. As part of the National Biological Information Infrastructure (NBII) ?a collaborative program to provide increased access to data and information on the nation?s biological resources--GAP data and analytical tools have been used in hundreds of applications: from basic research to comprehensive state wildlife plans; from educational projects in schools to ecoregional assessments of biodiversity. The challenge: keeping common species common means protecting them BEFORE they become threatened. To do this on a state or regional basis requires key information such as land cover descriptions, predicted distribution maps for native animals, and an assessment of the level of protection currently given to those plants and animals. GAP works cooperatively with Federal, state, and local natural resource professionals and academics to provide this kind of information. GAP activities focus on the creation of state and regional databases and maps that depict patterns of land management, land cover, and biodiversity. These data can be used to identify ?gaps? in conservation--instances where an animal or plant community is not adequately represented on the existing network of conservation lands. GAP is administered through the U.S. Geological Survey. Through building partnerships among disparate groups, GAP hopes to foster the kind of collaboration that is needed to address conservation issues on a broad scale. For more information, contact: John Mosesso National GAP Director 703-648-4079 Kevin Gergely National GAP Operations Manager 208-885-3565

Implementing shared decision making in federally qualified health centers, a quasi-experimental design study: the Office-Guidelines Applied to Practice (Office-GAP) program.

PubMed

Olomu, Adesuwa; Hart-Davidson, William; Luo, Zhehui; Kelly-Blake, Karen; Holmes-Rovner, Margaret

2016-08-02

Use of Shared Decision-Making (SDM) and Decision Aids (DAs) has been encouraged but is not regularly implemented in primary care. The Office-Guidelines Applied to Practice (Office-GAP) intervention is an application of a previous model revised to address guidelines based care for low-income populations with diabetes and coronary heart disease (CHD). To evaluate Office-GAP Program feasibility and preliminary efficacy on medication use, patient satisfaction with physician communication and confidence in decision in low-income population with diabetes and coronary heart disease (CHD) in a Federally Qualified Healthcare Center (FQHC). Ninety-five patients participated in an Office-GAP program. A quasi-experimental design study, over 6 months with 12-month follow-up. Office-GAP program integrates health literacy, communication skills education for patients and physicians, patient/physician decision support tools and SDM into routine care. 1) Implementation rates of planned program elements 2) Patient satisfaction with communication and confidence in decision, and 3) Medication prescription rates. We used the GEE method for hierarchical logistic models, controlling for confounding. Feasibility of the Office-GAP program in the FQHC setting was established. We found significant increase in use of Aspirin/Plavix, statin and beta-blocker during follow-up compared to baseline: Aspirin OR 1.5 (95 % CI: 1.1, 2.2) at 3-months, 1.9 (1.3, 2.9) at 6-months, and 1.8 (1.2, 2.8) at 12-months. Statin OR 1.1 (1.0, 1.3) at 3-months and 1.5 (1.1, 2.2) at 12-months; beta-blocker 1.8 (1.1, 2.9) at 6-months and 12-months. Program elements were consistently used (≥ 98 % clinic attendance at training and tool used). Patient satisfaction with communication and confidence in decision increased. The use of Office-GAP program to teach SDM and use of DAs in real time was demonstrated to be feasible in FQHCs. It has the potential to improve satisfaction with physician communication and confidence in decisions and to improve medication use. The Office-GAP program is a brief, efficient platform for delivering patient and provider education in SDM and could serve as a model for implementing guideline based care for all chronic diseases in outpatient clinical settings. Further evaluation is needed to establish feasibility outside clinical study, reach, effectiveness and cost-effectiveness of this approach.

Interim analysis: A rational approach of decision making in clinical trial.

PubMed

Kumar, Amal; Chakraborty, Bhaswat S

2016-01-01

Interim analysis of especially sizeable trials keeps the decision process free of conflict of interest while considering cost, resources, and meaningfulness of the project. Whenever necessary, such interim analysis can also call for potential termination or appropriate modification in sample size, study design, and even an early declaration of success. Given the extraordinary size and complexity today, this rational approach helps to analyze and predict the outcomes of a clinical trial that incorporate what is learned during the course of a study or a clinical development program. Such approach can also fill the gap by directing the resources toward relevant and optimized clinical trials between unmet medical needs and interventions being tested currently rather than fulfilling only business and profit goals.

Personalized Surgical Risk Assessment Using Population-Based Data Analysis

ERIC Educational Resources Information Center

AbuSalah, Ahmad Mohammad

2013-01-01

The volume of information generated by healthcare providers is growing at a relatively high speed. This tremendous growth has created a gap between knowledge and clinical practice that experts say could be narrowed with the proper use of healthcare data to guide clinical decisions and tools that support rapid information availability at the…

Wide Area Recovery and Resiliency Program (WARRP) Biological Attack Response and Recovery: End to End Medical Countermeasure Distribution and Dispensing Processes

DTIC Science & Technology

2012-04-24

compliance (Figure 3). This sensitivity analysis shows that public compliance is likely the most important consideration in saving lives. If the... public complies, medication effectiveness and POD throughput are the next two most important factors. Figure 3. Sensitivity Analysis ...government decision makers to the public . The number of gaps identified in this analysis is overwhelming, and improving the outcomes of the end-to

Mapping moderate-scale land-cover over very large geographic areas within a collaborative framework: A case study of the Southwest Regional Gap Analysis Project (SWReGAP)

USGS Publications Warehouse

Lowry, J.; Ramsey, R.D.; Thomas, K.; Schrupp, D.; Sajwaj, T.; Kirby, J.; Waller, E.; Schrader, S.; Falzarano, S.; Langs, L.; Manis, G.; Wallace, C.; Schulz, K.; Comer, P.; Pohs, K.; Rieth, W.; Velasquez, C.; Wolk, B.; Kepner, W.; Boykin, K.; O'Brien, L.; Bradford, D.; Thompson, B.; Prior-Magee, J.

2007-01-01

Land-cover mapping efforts within the USGS Gap Analysis Program have traditionally been state-centered; each state having the responsibility of implementing a project design for the geographic area within their state boundaries. The Southwest Regional Gap Analysis Project (SWReGAP) was the first formal GAP project designed at a regional, multi-state scale. The project area comprises the southwestern states of Arizona, Colorado, Nevada, New Mexico, and Utah. The land-cover map/dataset was generated using regionally consistent geospatial data (Landsat ETM+ imagery (1999-2001) and DEM derivatives), similar field data collection protocols, a standardized land-cover legend, and a common modeling approach (decision tree classifier). Partitioning of mapping responsibilities amongst the five collaborating states was organized around ecoregion-based "mapping zones". Over the course of 21/2 field seasons approximately 93,000 reference samples were collected directly, or obtained from other contemporary projects, for the land-cover modeling effort. The final map was made public in 2004 and contains 125 land-cover classes. An internal validation of 85 of the classes, representing 91% of the land area was performed. Agreement between withheld samples and the validated dataset was 61% (KHAT = .60, n = 17,030). This paper presents an overview of the methodologies used to create the regional land-cover dataset and highlights issues associated with large-area mapping within a coordinated, multi-institutional management framework. ?? 2006 Elsevier Inc. All rights reserved.

The multiple resource inventory decision-making process

Treesearch

Victor A. Rudis

1993-01-01

A model of the multiple resource inventory decision-making process is presented that identifies steps in conducting inventories, describes the infrastructure, and points out knowledge gaps that are common to many interdisciplinary studies.Successful efforts to date suggest the need to bridge the gaps by sharing elements, maintain dialogue among stakeholders in multiple...

Faulty judgment, expert opinion, and decision-making capacity.

PubMed

Silberfeld, M; Checkland, D

1999-08-01

An assessment of decision-making capacity is the accepted procedure for determining when a person is not competent. An inferential gap exists between the criteria for capacity specific abilities and the legal requirements to understand relevant information and appreciate the consequences of a decision. This gap extends to causal influences on a person's capacity to decide. Using a published case of depression, we illustrate that assessors' uses of diagnostic information is frequently not up to the task of bridging this inferential gap in a justifiable way. We then describe cases of faulty judgement which challenge the understanding of diagnostic causal influences. These cases help to clarify the nature of the expertise required for capacity assessments. In practice, the requirements of decision-making capacity are often abandoned to other considerations due to a lack of requisite expertise. The legal policy supporting decision-making capacity as a means to protective intervention is justified only if the requisite expertise is developed. We propose the requisite expertise to be developed in the long term as a distinct multidisciplinary endeavour.

Analysis of Automated Aircraft Conflict Resolution and Weather Avoidance

NASA Technical Reports Server (NTRS)

Love, John F.; Chan, William N.; Lee, Chu Han

2009-01-01

This paper describes an analysis of using trajectory-based automation to resolve both aircraft and weather constraints for near-term air traffic management decision making. The auto resolution algorithm developed and tested at NASA-Ames to resolve aircraft to aircraft conflicts has been modified to mitigate convective weather constraints. Modifications include adding information about the size of a gap between weather constraints to the routing solution. Routes that traverse gaps that are smaller than a specific size are not used. An evaluation of the performance of the modified autoresolver to resolve both conflicts with aircraft and weather was performed. Integration with the Center-TRACON Traffic Management System was completed to evaluate the effect of weather routing on schedule delays.

Shared decision-making in the paediatric field: a literature review and concept analysis.

PubMed

Park, Eun Sook; Cho, In Young

2017-09-13

The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field. The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for child's health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising child's health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care. This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field. © 2017 Nordic College of Caring Science.

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

PubMed

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

2017-01-01

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

An Ecobehavioral Analysis of Child Academic Engagement: Implications for Preschool Children Not Responding to Instructional Intervention

ERIC Educational Resources Information Center

Greenwood, Charles R.; Beecher, Constance; Atwater, Jane; Petersen, Sarah; Schiefelbusch, Jean; Irvin, Dwight

2018-01-01

A gap exists in the information needed to make intervention decisions with preschool children who are unresponsive to instructional intervention. "Multi-Tiered System of Supports/Response to Intervention" (MTSS/RTI) progress monitoring is helpful in indicating when an intervention change is needed but provides little information on what…

Looking beyond the forest: Using harvest plots, gap analysis, and expert consultations to assess effectiveness, engage stakeholders, and inform policy.

PubMed

Burns, J; Polus, S; Brereton, L; Chilcott, J; Ward, S E; Pfadenhauer, L M; Rehfuess, E A

2018-03-01

We describe a combination of methods for assessing the effectiveness of complex interventions, especially where substantial heterogeneity with regard to the population, intervention, comparison, outcomes, and study design of interest is expected. We applied these methods in a recent systematic review of the effectiveness of reinforced home-based palliative care (rHBPC) interventions, which included home-based care with an additional and explicit component of lay caregiver support. We first summarized the identified evidence, deemed inappropriate for statistical pooling, graphically by creating harvest plots. Although very useful as a tool for summary and presentation of overall effectiveness, such graphical summary approaches may obscure relevant differences between studies. Thus, we then used a gap analysis and conducted expert consultations to look beyond the aggregate level at how the identified evidence of effectiveness may be explained. The goal of these supplemental methods was to step outside of the conventional systematic review and explore this heterogeneity from a broader perspective, based on the experience of palliative care researchers and practitioners. The gap analysis and expert consultations provided valuable input into possible underlying explanations in the evidence, which could be helpful in the further adaptation and testing of existing rHBPC interventions or the development and evaluation of new ones. We feel that such a combination of methods could prove accessible, understandable, and useful in informing decisions and could thus help increase the relevance of systematic reviews to the decision-making process. Copyright © 2017 John Wiley & Sons, Ltd.

Social modulation of decision-making: a cross-species review

PubMed Central

van den Bos, Ruud; Jolles, Jolle W.; Homberg, Judith R.

2013-01-01

Taking decisions plays a pivotal role in daily life and comprises a complex process of assessing and weighing short-term and long-term costs and benefits of competing actions. Decision-making has been shown to be affected by factors such as sex, age, genotype, and personality. Importantly, also the social environment affects decisions, both via social interactions (e.g., social learning, cooperation and competition) and social stress effects. Although everyone is aware of this social modulating role on daily life decisions, this has thus far only scarcely been investigated in human and animal studies. Furthermore, neuroscientific studies rarely discuss social influence on decision-making from a functional perspective such as done in behavioral ecology studies. Therefore, the first aim of this article is to review the available data of the influence of the social context on decision-making both from a causal and functional perspective, drawing on animal and human studies. Also, there is currently still a gap between decision-making in real life where influences of the social environment are extensive, and decision-making as measured in the laboratory, which is often done without any (deliberate) social influences. However, methods are being developed to bridge this gap. Therefore, the second aim of this review is to discuss these methods and ways in which this gap can be increasingly narrowed. We end this review by formulating future research questions. PMID:23805092

Affordability Engineering: Bridging the Gap Between Design and Cost

NASA Technical Reports Server (NTRS)

Reeves, J. D.; DePasquale, Dominic; Lim, Evan

2010-01-01

Affordability is a commonly used term that takes on numerous meanings depending on the context used. Within conceptual design of complex systems, the term generally implies comparisons between expected costs and expected resources. This characterization is largely correct, but does not convey the many nuances and considerations that are frequently misunderstood and underappreciated. In the most fundamental sense, affordability and cost directly relate to engineering and programmatic decisions made throughout development programs. Systems engineering texts point out that there is a temporal aspect to this relationship, for decisions made earlier in a program dictate design implications much more so than those made during latter phases. This paper explores affordability engineering and its many sub-disciplines by discussing how it can be considered an additional engineering discipline to be balanced throughout the systems engineering and systems analysis processes. Example methods of multidisciplinary design analysis with affordability as a key driver will be discussed, as will example methods of data visualization, probabilistic analysis, and other ways of relating design decisions to affordability results.

Incorporating uncertainty in watershed management decision-making: A mercury TMDL case study

USGS Publications Warehouse

Labiosa, W.; Leckie, J.; Shachter, R.; Freyberg, D.; Rytuba, J.; ,

2005-01-01

Water quality impairment due to high mercury fish tissue concentrations and high mercury aqueous concentrations is a widespread problem in several sub-watersheds that are major sources of mercury to the San Francisco Bay. Several mercury Total Maximum Daily Load regulations are currently being developed to address this problem. Decisions about control strategies are being made despite very large uncertainties about current mercury loading behavior, relationships between total mercury loading and methyl mercury formation, and relationships between potential controls and mercury fish tissue levels. To deal with the issues of very large uncertainties, data limitations, knowledge gaps, and very limited State agency resources, this work proposes a decision analytical alternative for mercury TMDL decision support. The proposed probabilistic decision model is Bayesian in nature and is fully compatible with a "learning while doing" adaptive management approach. Strategy evaluation, sensitivity analysis, and information collection prioritization are examples of analyses that can be performed using this approach.

Effects of major-road vehicle speed and driver age and gender on left-turn gap acceptance.

PubMed

Yan, Xuedong; Radwan, Essam; Guo, Dahai

2007-07-01

Because the driver's gap-acceptance maneuver is a complex and risky driving behavior, it is a highly concerned topic for traffic safety and operation. Previous studies have mainly focused on the driver's gap acceptance decision itself but did not pay attention to the maneuver process and driving behaviors. Using a driving simulator experiment for left-turn gap acceptance at a stop-controlled intersection, this study evaluated the effects of major traffic speed and driver age and gender on gap acceptance behaviors. The experiment results illustrate relationships among drivers' left-turn gap decision, driver's acceleration rate, steering action, and the influence of the gap-acceptance maneuver on the vehicles in the major traffic stream. The experiment results identified an association between high crash risk and high traffic speed at stop-controlled intersections. The older drivers, especially older female drivers, displayed a conservative driving attitude as a compensation for reduced driving ability, but also showed to be the most vulnerable group for the relatively complex driving maneuvers.

Robustness of risk maps and survey networks to knowledge gaps about a new invasive pest

Treesearch

Denys Yemshanov; Frank H. Koch; Yakov Ben-Haim; William D. Smith

2010-01-01

In pest risk assessment it is frequently necessary to make management decisions regarding emerging threats under severe uncertainty. Although risk maps provide useful decision support for invasive alien species, they rarely address knowledge gaps associated with the underlying risk model or how they may change the risk estimates. Failure to recognize uncertainty leads...

Development and implementation of a clinical and business intelligence system for the Florida health data warehouse.

PubMed

AlHazme, Raed H; Rana, Arif M; De Lucca, Michael

2014-01-01

To develop and implement a Clinical and Business Intelligence (CBI) system for the Florida Health Data Warehouse (FHDW) in order to bridge the gap between Florida's healthcare stakeholders and the health data archived in FHWD. A gap analysis study has been conducted to evaluate the technological divide between the relevant users and FHWD health data, which is maintained by the Broward Regional Health Planning Council (BRHPC). The study revealed a gap between the health care data and the decision makers that utilize the FHDW data. To bridge the gap, a CBI system was proposed, developed and implemented by BRHPC as a viable solution to address this issue, using the System Development Life Cycle methodology. The CBI system was successfully implemented and yielded a number of positive outcomes. In addition to significantly shortening the time required to analyze the health data for decision-making processes, the solution also provided end-users with the ability to automatically track public health parameters. A large amount of data is collected and stored by various health care organizations at the local, state, and national levels. If utilized properly, such data can go a long way in optimizing health care services. CBI systems provide health care organizations with valuable insights for improving patient care, tracking trends for medical research, and for controlling costs. The CBI system has been found quite effective in bridging the gap between Florida's healthcare stake holders and FHDW health data. Consequently, the solution has improved in the planning and coordination of health care services for the state of Florida.

Using Critical Policy Analysis to Examine Competing Discourses in Zero Tolerance Legislation: Do We Really Want to Leave No Child Behind?

ERIC Educational Resources Information Center

Kennedy-Lewis, Brianna L.

2014-01-01

The increasing use of zero tolerance discipline policies in the USA has led to a "discipline gap," in which minoritized students receive harsher and more frequent suspensions and expulsions than their peers from dominant cultural and socioeconomic backgrounds. Though disciplinary decisions are made by educators at the school level,…

The Success of Linear Bootstrapping Models: Decision Domain-, Expertise-, and Criterion-Specific Meta-Analysis

PubMed Central

Kaufmann, Esther; Wittmann, Werner W.

2016-01-01

The success of bootstrapping or replacing a human judge with a model (e.g., an equation) has been demonstrated in Paul Meehl’s (1954) seminal work and bolstered by the results of several meta-analyses. To date, however, analyses considering different types of meta-analyses as well as the potential dependence of bootstrapping success on the decision domain, the level of expertise of the human judge, and the criterion for what constitutes an accurate decision have been missing from the literature. In this study, we addressed these research gaps by conducting a meta-analysis of lens model studies. We compared the results of a traditional (bare-bones) meta-analysis with findings of a meta-analysis of the success of bootstrap models corrected for various methodological artifacts. In line with previous studies, we found that bootstrapping was more successful than human judgment. Furthermore, bootstrapping was more successful in studies with an objective decision criterion than in studies with subjective or test score criteria. We did not find clear evidence that the success of bootstrapping depended on the decision domain (e.g., education or medicine) or on the judge’s level of expertise (novice or expert). Correction of methodological artifacts increased the estimated success of bootstrapping, suggesting that previous analyses without artifact correction (i.e., traditional meta-analyses) may have underestimated the value of bootstrapping models. PMID:27327085

Are normally sighted, visually impaired, and blind pedestrians accurate and reliable at making street crossing decisions?

PubMed

Hassan, Shirin E

2012-05-04

The purpose of this study is to measure the accuracy and reliability of normally sighted, visually impaired, and blind pedestrians at making street crossing decisions using visual and/or auditory information. Using a 5-point rating scale, safety ratings for vehicular gaps of different durations were measured along a two-lane street of one-way traffic without a traffic signal. Safety ratings were collected from 12 normally sighted, 10 visually impaired, and 10 blind subjects for eight different gap times under three sensory conditions: (1) visual plus auditory information, (2) visual information only, and (3) auditory information only. Accuracy and reliability in street crossing decision-making were calculated for each subject under each sensory condition. We found that normally sighted and visually impaired pedestrians were accurate and reliable in their street crossing decision-making ability when using either vision plus hearing or vision only (P > 0.05). Under the hearing only condition, all subjects were reliable (P > 0.05) but inaccurate with their street crossing decisions (P < 0.05). Compared to either the normally sighted (P = 0.018) or visually impaired subjects (P = 0.019), blind subjects were the least accurate with their street crossing decisions under the hearing only condition. Our data suggested that visually impaired pedestrians can make accurate and reliable street crossing decisions like those of normally sighted pedestrians. When using auditory information only, all subjects significantly overestimated the vehicular gap time. Our finding that blind pedestrians performed significantly worse than either the normally sighted or visually impaired subjects under the hearing only condition suggested that they may benefit from training to improve their detection ability and/or interpretation of vehicular gap times.

Are Normally Sighted, Visually Impaired, and Blind Pedestrians Accurate and Reliable at Making Street Crossing Decisions?

PubMed Central

Hassan, Shirin E.

2012-01-01

Purpose. The purpose of this study is to measure the accuracy and reliability of normally sighted, visually impaired, and blind pedestrians at making street crossing decisions using visual and/or auditory information. Methods. Using a 5-point rating scale, safety ratings for vehicular gaps of different durations were measured along a two-lane street of one-way traffic without a traffic signal. Safety ratings were collected from 12 normally sighted, 10 visually impaired, and 10 blind subjects for eight different gap times under three sensory conditions: (1) visual plus auditory information, (2) visual information only, and (3) auditory information only. Accuracy and reliability in street crossing decision-making were calculated for each subject under each sensory condition. Results. We found that normally sighted and visually impaired pedestrians were accurate and reliable in their street crossing decision-making ability when using either vision plus hearing or vision only (P > 0.05). Under the hearing only condition, all subjects were reliable (P > 0.05) but inaccurate with their street crossing decisions (P < 0.05). Compared to either the normally sighted (P = 0.018) or visually impaired subjects (P = 0.019), blind subjects were the least accurate with their street crossing decisions under the hearing only condition. Conclusions. Our data suggested that visually impaired pedestrians can make accurate and reliable street crossing decisions like those of normally sighted pedestrians. When using auditory information only, all subjects significantly overestimated the vehicular gap time. Our finding that blind pedestrians performed significantly worse than either the normally sighted or visually impaired subjects under the hearing only condition suggested that they may benefit from training to improve their detection ability and/or interpretation of vehicular gap times. PMID:22427593

EVA Suit Studies: Human Forward Contamination Project

NASA Technical Reports Server (NTRS)

Rucker, Michelle

2017-01-01

Background: NASA Strategic Knowledge Gap B5: Forward Contamination for Mars. Issue: we have knowledge gaps!: Whether / how microbes are released from crewed pressure systems. Why do we care?: Informs Mars operational concepts - How to protect the science; Informs architecture decisions - How “open” Environmental Control and Life Support (ECLS) systems are; Informs landing site selection decisions - How close we can land / operate to where life may be present. Project goal: get some data to fill in these gaps: Data will help determine whether we’re ready to go to Mars, or if we need to change our systems or operational designs.

Case based reasoning in criminal intelligence using forensic case data.

PubMed

Ribaux, O; Margot, P

2003-01-01

A model that is based on the knowledge of experienced investigators in the analysis of serial crime is suggested to bridge a gap between technology and methodology. Its purpose is to provide a solid methodology for the analysis of serial crimes that supports decision making in the deployment of resources, either by guiding proactive policing operations or helping the investigative process. Formalisation has helped to derive a computerised system that efficiently supports the reasoning processes in the analysis of serial crime. This novel approach fully integrates forensic science data.

PRIORITIES FOR HEALTH ECONOMIC METHODOLOGICAL RESEARCH: RESULTS OF AN EXPERT CONSULTATION.

PubMed

Tordrup, David; Chouaid, Christos; Cuijpers, Pim; Dab, William; van Dongen, Johanna Maria; Espin, Jaime; Jönsson, Bengt; Léonard, Christian; McDaid, David; McKee, Martin; Miguel, José Pereira; Patel, Anita; Reginster, Jean-Yves; Ricciardi, Walter; Rutten-van Molken, Maureen; Rupel, Valentina Prevolnik; Sach, Tracey; Sassi, Franco; Waugh, Norman; Bertollini, Roberto

2017-01-01

The importance of economic evaluation in decision making is growing with increasing budgetary pressures on health systems. Diverse economic evidence is available for a range of interventions across national contexts within Europe, but little attention has been given to identifying evidence gaps that, if filled, could contribute to more efficient allocation of resources. One objective of the Research Agenda for Health Economic Evaluation project is to determine the most important methodological evidence gaps for the ten highest burden conditions in the European Union (EU), and to suggest ways of filling these gaps. The highest burden conditions in the EU by Disability Adjusted Life Years were determined using the Global Burden of Disease study. Clinical interventions were identified for each condition based on published guidelines, and economic evaluations indexed in MEDLINE were mapped to each intervention. A panel of public health and health economics experts discussed the evidence during a workshop and identified evidence gaps. The literature analysis contributed to identifying cross-cutting methodological and technical issues, which were considered by the expert panel to derive methodological research priorities. The panel suggests a research agenda for health economics which incorporates the use of real-world evidence in the assessment of new and existing interventions; increased understanding of cost-effectiveness according to patient characteristics beyond the "-omics" approach to inform both investment and disinvestment decisions; methods for assessment of complex interventions; improved cross-talk between economic evaluations from health and other sectors; early health technology assessment; and standardized, transferable approaches to economic modeling.

Perceptional gaps among women, husbands and family members about intentions for birthplace: a cross-sectional study 1

PubMed Central

Shimpuku, Yoko; Madeni, Frida Elikana; Horiuchi, Shigeko; Leshabari, Sebalda Charles

2017-01-01

ABSTRACT Objective: women are more likely to give birth at a health facility when their families agree with the birthplace. However, in rural areas of Tanzania, women are often marginalized from decision-making. This study predicted birthplace intention and identified factors to reduce perceptional gaps among pregnant women, husbands and family members. Method: explanatory cross-sectional survey was conducted in three villages in North Eastern Tanzania. Participants were 138 pregnant women and their families who answered the Birth Intention Questionnaire (BIQ), measuring knowledge, attitude, perceived behavioral control, subjective norms and intention for birthplace. Descriptive analysis, ANOVA, Chi-square, and multiple linear regression was used to analyze the data. Results: the regression model showed that knowledge, perceived behavioral control, and subjective norms predicted intention for birthplace (R2 = .28). While 81% of pregnant women thought their husbands were decision-makers for their birth, only 38% of husbands and 37% of family members agreed. Pregnant women had significantly lower scores on the item “I will prepare for childbirth with my family” compared with husbands (p < .01) and other family members (p < .001). Conclusion: providing evidence-based birth preparation and reducing the identified perceptual gaps may enhance women’s intention to deliver at health facilities. PMID:28146180

Assessing Option Grid® practicability and feasibility for facilitating shared decision making: An exploratory study.

PubMed

Tsulukidze, Maka; Grande, Stuart W; Gionfriddo, Michael R

2015-07-01

To assess the feasibility of Option Grids(®)for facilitating shared decision making (SDM) in simulated clinical consultations and explore clinicians' views on their practicability. We used mixed methods approach to analyze clinical consultations using the Observer OPTION instrument and thematic analysis for follow-up interviews with clinicians. Clinicians achieved high scores on information sharing and low scores on preference elicitation and integration. Four themes were identified: (1) Barriers affect practicability of Option Grids(®); (2) Option Grids(®) facilitate the SDM process; (3) Clinicians are aware of the gaps in their practice of SDM; (4) Training and ongoing feedback on the optimal use of Option Grids(®) are necessary. Use of Option Grids(®) by clinicians with background knowledge in SDM did not facilitate optimal levels of competency on the SDM core concepts of preference elicitation and integration. Future research must evaluate the impact of training on the use of Option Grids(®), and explore how best to help clinicians bridge the gap between knowledge and action. Clinicians proficiently imparting information in simulations struggled to elicit and integrate patient preferences - understanding this gap and developing strategies to close it are the next steps for implementing SDM into clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Narrowing the Achievement Gap in a (Re) Segregated Urban School District: Research, Policy and Practice. The Achievement Gap, Research, Practice, and Policy

ERIC Educational Resources Information Center

Ikpa, Vivian W.; McGuire, C. Kent

2009-01-01

The interplay between sociopolitical forces and economic agendas becomes apparent when one examines the June 28, 2007 United States Supreme Court Decision, Parents Involved In Community Schools v. Seattle School District . In a reversal of the 1954 Brown Decision, the United States Supreme Court ruled that public schools could not use race as a…

Information Engineering and Workflow Design in a Clinical Decision Support System for Colorectal Cancer Screening in Iran.

PubMed

Maserat, Elham; Seied Farajollah, Seiede Sedigheh; Safdari, Reza; Ghazisaeedi, Marjan; Aghdaei, Hamid Asadzadeh; Zali, Mohammad Reza

2015-01-01

Colorectal cancer is a major cause of morbidity and mortality throughout the world. Colorectal cancer screening is an optimal way for reducing of morbidity and mortality and a clinical decision support system (CDSS) plays an important role in predicting success of screening processes. DSS is a computer-based information system that improves the delivery of preventive care services. The aim of this article was to detail engineering of information requirements and work flow design of CDSS for a colorectal cancer screening program. In the first stage a screening minimum data set was determined. Developed and developing countries were analyzed for identifying this data set. Then information deficiencies and gaps were determined by check list. The second stage was a qualitative survey with a semi-structured interview as the study tool. A total of 15 users and stakeholders' perspectives about workflow of CDSS were studied. Finally workflow of DSS of control program was designed by standard clinical practice guidelines and perspectives. Screening minimum data set of national colorectal cancer screening program was defined in five sections, including colonoscopy data set, surgery, pathology, genetics and pedigree data set. Deficiencies and information gaps were analyzed. Then we designed a work process standard of screening. Finally workflow of DSS and entry stage were determined. A CDSS facilitates complex decision making for screening and has key roles in designing optimal interactions between colonoscopy, pathology and laboratory departments. Also workflow analysis is useful to identify data reconciliation strategies to address documentation gaps. Following recommendations of CDSS should improve quality of colorectal cancer screening.

Armored Family of Vehicles (AFV). Phase 1 Report. Book 3. Volumes 5 thru 8

DTIC Science & Technology

1987-08-31

tactical mobility /agility, tactical and strategic deployability, rapid repair/replacement of damaged or destroyed equipment, lethality, reduced...Mover (CEM). (15) Combat Mobility Vehicle (CMV). (16) Combat Gap Crosser (CGC). (17) Combat Excavator (CEX). (18) Mine Dispensing Vehicle (MDV). (19...economic decision analysis (IAW AR 700-XX, AR 700-127 and AR 700-17) and consideration of mobilization requirements. 7. Transportability

Reasoned Decision Making Without Math? Adaptability and Robustness in Response to Surprise.

PubMed

Smithson, Michael; Ben-Haim, Yakov

2015-10-01

Many real-world planning and decision problems are far too uncertain, too variable, and too complicated to support realistic mathematical models. Nonetheless, we explain the usefulness, in these situations, of qualitative insights from mathematical decision theory. We demonstrate the integration of info-gap robustness in decision problems in which surprise and ignorance are predominant and where personal and collective psychological factors are critical. We present practical guidelines for employing adaptable-choice strategies as a proxy for robustness against uncertainty. These guidelines include being prepared for more surprises than we intuitively expect, retaining sufficiently many options to avoid premature closure and conflicts among preferences, and prioritizing outcomes that are steerable, whose consequences are observable, and that do not entail sunk costs, resource depletion, or high transition costs. We illustrate these concepts and guidelines with the example of the medical management of the 2003 SARS outbreak in Vietnam. © 2015 Society for Risk Analysis.

HIV-related stigma acting as predictors of unemployment of people living with HIV/AIDS.

PubMed

Liu, Ying; Canada, Kelli; Shi, Kan; Corrigan, Patrick

2012-01-01

Obtaining employment is an important part of recovery for many people living with HIV/AIDS (PLHA). However, this population often faces barriers in their attempt to reenter the workplace. One potential barrier lies in the decision-making of employers. Little is known about what influences employers' decision to hire PLHA. The current paper addresses this gap with findings from 156 quantitative interviews with employers across Chicago, Beijing, and Hong Kong regarding the hiring of people with HIV/AIDS. Hierarchical regression analysis showed that both fear of contagion and perceived incompetence are important factors in employers' decision to interview even after controlling for variables related to the employers' business size, their education level, and the provision of health benefits. These two variables accounted for 42% of the variance in employers' decision to interview. Implications of these findings are considered for better understanding of HIV-related employment stigma and further intervention for employing PLHA.

Needs and challenges for assessing the environmental impacts of engineered nanomaterials (ENMs)

PubMed Central

Romero-Franco, Michelle; Godwin, Hilary A; Bilal, Muhammad

2017-01-01

The potential environmental impact of nanomaterials is a critical concern and the ability to assess these potential impacts is top priority for the progress of sustainable nanotechnology. Risk assessment tools are needed to enable decision makers to rapidly assess the potential risks that may be imposed by engineered nanomaterials (ENMs), particularly when confronted by the reality of limited hazard or exposure data. In this review, we examine a range of available risk assessment frameworks considering the contexts in which different stakeholders may need to assess the potential environmental impacts of ENMs. Assessment frameworks and tools that are suitable for the different decision analysis scenarios are then identified. In addition, we identify the gaps that currently exist between the needs of decision makers, for a range of decision scenarios, and the abilities of present frameworks and tools to meet those needs. PMID:28546894

Development and Implementation of a Clinical and Business Intelligence System for the Florida Health Data Warehouse

PubMed Central

AlHazme, Raed H.; Rana, Arif M.; De Lucca, Michael

2014-01-01

Objective To develop and implement a Clinical and Business Intelligence (CBI) system for the Florida Health Data Warehouse (FHDW) in order to bridge the gap between Florida’s healthcare stakeholders and the health data archived in FHWD. Materials and Methods A gap analysis study has been conducted to evaluate the technological divide between the relevant users and FHWD health data, which is maintained by the Broward Regional Health Planning Council (BRHPC). The study revealed a gap between the health care data and the decision makers that utilize the FHDW data. To bridge the gap, a CBI system was proposed, developed and implemented by BRHPC as a viable solution to address this issue, using the System Development Life Cycle methodology. Results The CBI system was successfully implemented and yielded a number of positive outcomes. In addition to significantly shortening the time required to analyze the health data for decision-making processes, the solution also provided end-users with the ability to automatically track public health parameters. Discussion A large amount of data is collected and stored by various health care organizations at the local, state, and national levels. If utilized properly, such data can go a long way in optimizing health care services. CBI systems provide health care organizations with valuable insights for improving patient care, tracking trends for medical research, and for controlling costs. Conclusion The CBI system has been found quite effective in bridging the gap between Florida’s healthcare stake holders and FHDW health data. Consequently, the solution has improved in the planning and coordination of health care services for the state of Florida. PMID:25379128

Needs assessment for business strategies of anesthesiology groups' practices.

PubMed

Scurlock, Corey; Dexter, Franklin; Reich, David L; Galati, Maria

2011-07-01

Progress has been made in understanding strategic decision making influencing anesthesia groups' operating room business practices. However, there has been little analysis of the remaining gaps in our knowledge. We performed a needs assessment to identify unsolved problems in anesthesia business strategy based on Porter's Five Forces Analysis. The methodology was a narrative literature review. We found little previous investigation for 2 of the 5 forces (threat of new entrants and bargaining power of suppliers), modest understanding for 1 force (threat of substitute products or services), and substantial understanding for 2 forces (bargaining power of customers and jockeying for position among current competitors). Additional research in strategic decisions influencing anesthesia groups should focus on the threat of new entrants, bargaining power of suppliers, and the threat of substitute products or services.

A Techno-Economic Look at SiC WBG from Wafer to Motor Drive

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

Bench Reese, Samantha R; Horowitz, Kelsey A; Remo, Timothy W

Techno-economic analysis helps benchmark and deliver supply chain and manufacturing insights that can be leveraged by decision-makers to inform investment strategies, policy, and other decisions to promote economic growth and competitiveness. Silicon Carbide (SiC) wide-band gap (WBG) technologies is poised to be an integral contributor to the clean energy economy. We use bottoms-up regional manufacturing cost models to show SiC power electronics, manufactured in volume, could result in final product cost parity with those manufactured with silicon. The models are further leveraged to show innovation pathways to lower cost and potentially expanded technology adoption.

Linking ecosystem characteristics to final ecosystem services for public policy.

PubMed

Wong, Christina P; Jiang, Bo; Kinzig, Ann P; Lee, Kai N; Ouyang, Zhiyun

2015-01-01

Governments worldwide are recognising ecosystem services as an approach to address sustainability challenges. Decision-makers need credible and legitimate measurements of ecosystem services to evaluate decisions for trade-offs to make wise choices. Managers lack these measurements because of a data gap linking ecosystem characteristics to final ecosystem services. The dominant method to address the data gap is benefit transfer using ecological data from one location to estimate ecosystem services at other locations with similar land cover. However, benefit transfer is only valid once the data gap is adequately resolved. Disciplinary frames separating ecology from economics and policy have resulted in confusion on concepts and methods preventing progress on the data gap. In this study, we present a 10-step approach to unify concepts, methods and data from the disparate disciplines to offer guidance on overcoming the data gap. We suggest: (1) estimate ecosystem characteristics using biophysical models, (2) identify final ecosystem services using endpoints and (3) connect them using ecological production functions to quantify biophysical trade-offs. The guidance is strategic for public policy because analysts need to be: (1) realistic when setting priorities, (2) attentive to timelines to acquire relevant data, given resources and (3) responsive to the needs of decision-makers. © 2014 The Authors. Ecology Letters published by John Wiley & Sons Ltd and CNRS.

Linking ecosystem characteristics to final ecosystem services for public policy

PubMed Central

Wong, Christina P; Jiang, Bo; Kinzig, Ann P; Lee, Kai N; Ouyang, Zhiyun

2015-01-01

Governments worldwide are recognising ecosystem services as an approach to address sustainability challenges. Decision-makers need credible and legitimate measurements of ecosystem services to evaluate decisions for trade-offs to make wise choices. Managers lack these measurements because of a data gap linking ecosystem characteristics to final ecosystem services. The dominant method to address the data gap is benefit transfer using ecological data from one location to estimate ecosystem services at other locations with similar land cover. However, benefit transfer is only valid once the data gap is adequately resolved. Disciplinary frames separating ecology from economics and policy have resulted in confusion on concepts and methods preventing progress on the data gap. In this study, we present a 10-step approach to unify concepts, methods and data from the disparate disciplines to offer guidance on overcoming the data gap. We suggest: (1) estimate ecosystem characteristics using biophysical models, (2) identify final ecosystem services using endpoints and (3) connect them using ecological production functions to quantify biophysical trade-offs. The guidance is strategic for public policy because analysts need to be: (1) realistic when setting priorities, (2) attentive to timelines to acquire relevant data, given resources and (3) responsive to the needs of decision-makers. PMID:25394857

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.

Public perceptions and information gaps in solar energy in Texas

NASA Astrophysics Data System (ADS)

Rai, Varun; Beck, Ariane L.

2015-07-01

Studying the behavioral aspects of the individual decision-making process is important in identifying and addressing barriers in the adoption of residential solar photovoltaic (PV). However, there is little systematic research focusing on these aspects of residential PV in Texas, an important, large, populous state, with a range of challenges in the electricity sector including increasing demand, shrinking reserve margins, constrained water supply, and challenging emissions reduction targets under proposed federal regulations. This paper aims to address this gap through an empirical investigation of a new survey-based dataset collected in Texas on solar energy perceptions and behavior. The results of this analysis offer insights into the perceptions and motivations influencing intentions and behavior toward solar energy in a relatively untapped market and help identify information gaps that could be targeted to alleviate key barriers to adopting solar, thereby enabling significant emissions reductions in the residential sector in Texas.

RH-LLW Disposal Facility Project CD-2/3 to Design/Build Proposal Reconciliation Report

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

Annette L. Schafer

2012-06-01

A reconciliation plan was developed and implemented to address potential gaps and responses to gaps between the design/build vendor proposals and the Critical Decision-2/3 approval request package for the Remote-Handled Low Level Waste Disposal Facility Project. The plan and results of the plan implementation included development of a reconciliation team comprised of subject matter experts from Battelle Energy Alliance and the Department of Energy Idaho Operations Office, identification of reconciliation questions, reconciliation by the team, identification of unresolved/remaining issues, and identification of follow-up actions and subsequent approvals of responses. The plan addressed the potential for gaps to exist in themore » following areas: • Department of Energy Order 435.1, “Radioactive Waste Management,” requirements, including the performance assessment, composite analysis, monitoring plan, performance assessment/composite analysis maintenance plan, and closure plan • Environmental assessment supporting the National Environmental Policy Act • Nuclear safety • Safeguards and security • Emplacement operations • Requirements for commissioning • General project implementation. The reconciliation plan and results of the plan implementation are provided in a business-sensitive project file. This report provides the reconciliation plan and non-business sensitive summary responses to identified gaps.« less

Can Carbon Nanomaterials Improve CZTS Photovoltaic Devices? Evaluation of Performance and Impacts Using Integrated Life-Cycle Assessment and Decision Analysis.

PubMed

Scott, Ryan P; Cullen, Alison C; Fox-Lent, Cate; Linkov, Igor

2016-10-01

In emergent photovoltaics, nanoscale materials hold promise for optimizing device characteristics; however, the related impacts remain uncertain, resulting in challenges to decisions on strategic investment in technology innovation. We integrate multi-criteria decision analysis (MCDA) and life-cycle assessment (LCA) results (LCA-MCDA) as a method of incorporating values of a hypothetical federal acquisition manager into the assessment of risks and benefits of emerging photovoltaic materials. Specifically, we compare adoption of copper zinc tin sulfide (CZTS) devices with molybdenum back contacts to alternative devices employing graphite or graphene instead of molybdenum. LCA impact results are interpreted alongside benefits of substitution including cost reductions and performance improvements through application of multi-attribute utility theory. To assess the role of uncertainty we apply Monte Carlo simulation and sensitivity analysis. We find that graphene or graphite back contacts outperform molybdenum under most scenarios and assumptions. The use of decision analysis clarifies potential advantages of adopting graphite as a back contact while emphasizing the importance of mitigating conventional impacts of graphene production processes if graphene is used in emerging CZTS devices. Our research further demonstrates that a combination of LCA and MCDA increases the usability of LCA in assessing product sustainability. In particular, this approach identifies the most influential assumptions and data gaps in the analysis and the areas in which either engineering controls or further data collection may be necessary. © 2016 Society for Risk Analysis.

From Population Databases to Research and Informed Health Decisions and Policy.

PubMed

Machluf, Yossy; Tal, Orna; Navon, Amir; Chaiter, Yoram

2017-01-01

In the era of big data, the medical community is inspired to maximize the utilization and processing of the rapidly expanding medical datasets for clinical-related and policy-driven research. This requires a medical database that can be aggregated, interpreted, and integrated at both the individual and population levels. Policymakers seek data as a lever for wise, evidence-based decision-making and information-driven policy. Yet, bridging the gap between data collection, research, and policymaking, is a major challenge. To bridge this gap, we propose a four-step model: (A) creating a conjoined task force of all relevant parties to declare a national program to promote collaborations; (B) promoting a national digital records project, or at least a network of synchronized and integrated databases, in an accessible transparent manner; (C) creating an interoperative national research environment to enable the analysis of the organized and integrated data and to generate evidence; and (D) utilizing the evidence to improve decision-making, to support a wisely chosen national policy. For the latter purpose, we also developed a novel multidimensional set of criteria to illuminate insights and estimate the risk for future morbidity based on current medical conditions. Used by policymakers, providers of health plans, caregivers, and health organizations, we presume this model will assist transforming evidence generation to support the design of health policy and programs, as well as improved decision-making about health and health care, at all levels: individual, communal, organizational, and national.

Robust CO2 Injection: Application of Bayesian-Information-Gap Decision Theory

NASA Astrophysics Data System (ADS)

Grasinger, M.; O'Malley, D.; Vesselinov, V. V.; Karra, S.

2015-12-01

Carbon capture and sequestration has the potential to reduce greenhouse gasemissions. However, care must be taken when choosing a site for CO2 seques-tration to ensure that the CO2 remains sequestered for many years, and thatthe environment is not harmed in any way. Making a rational decision be-tween potential sites for sequestration is not without its challenges because, asin the case of many environmental and subsurface problems, there is a lot ofuncertainty that exists. A method for making decisions under various typesand severities of uncertainty, Bayesian-Information-Gap Decision Theory (BIGDT), is presented. BIG DT was coupled with a numerical model for CO2 wellinjection and the resulting framework was then applied to a problem of selectingbetween two potential sites for CO2 sequestration. The results of the analysisare presented, followed by a discussion of the decision process.

Identifying the institutional decision process to introduce decentralized sanitation in the city of Kunming (China).

PubMed

Medilanski, Edi; Chuan, Liang; Mosler, Hans-Joachim; Schertenleib, Roland; Larsen, Tove A

2007-05-01

We conducted a study of the institutional barriers to introducing urine source separation in the urban area of Kunming, China. On the basis of a stakeholder analysis, we constructed stakeholder diagrams showing the relative importance of decision-making power and (positive) interest in the topic. A hypothetical decision-making process for the urban case was derived based on a successful pilot project in a periurban area. All our results were evaluated by the stakeholders. We concluded that although a number of primary stakeholders have a large interest in testing urine source separation also in an urban context, most of the key stakeholders would be reluctant to this idea. However, the success in the periurban area showed that even a single, well-received pilot project can trigger the process of broad dissemination of new technologies. Whereas the institutional setting for such a pilot project is favorable in Kunming, a major challenge will be to adapt the technology to the demands of an urban population. Methodologically, we developed an approach to corroborate a stakeholder analysis with the perception of the stakeholders themselves. This is important not only in order to validate the analysis but also to bridge the theoretical gap between stakeholder analysis and stakeholder involvement. We also show that in disagreement with the assumption of most policy theories, local stakeholders consider informal decision pathways to be of great importance in actual policy-making.

Identifying the Institutional Decision Process to Introduce Decentralized Sanitation in the City of Kunming (China)

NASA Astrophysics Data System (ADS)

Medilanski, Edi; Chuan, Liang; Mosler, Hans-Joachim; Schertenleib, Roland; Larsen, Tove A.

2007-05-01

We conducted a study of the institutional barriers to introducing urine source separation in the urban area of Kunming, China. On the basis of a stakeholder analysis, we constructed stakeholder diagrams showing the relative importance of decision-making power and (positive) interest in the topic. A hypothetical decision-making process for the urban case was derived based on a successful pilot project in a periurban area. All our results were evaluated by the stakeholders. We concluded that although a number of primary stakeholders have a large interest in testing urine source separation also in an urban context, most of the key stakeholders would be reluctant to this idea. However, the success in the periurban area showed that even a single, well-received pilot project can trigger the process of broad dissemination of new technologies. Whereas the institutional setting for such a pilot project is favorable in Kunming, a major challenge will be to adapt the technology to the demands of an urban population. Methodologically, we developed an approach to corroborate a stakeholder analysis with the perception of the stakeholders themselves. This is important not only in order to validate the analysis but also to bridge the theoretical gap between stakeholder analysis and stakeholder involvement. We also show that in disagreement with the assumption of most policy theories, local stakeholders consider informal decision pathways to be of great importance in actual policy-making.

LEVEL OF COMPETENCIES OF FAMILY PHYSICIANS IN KOSOVO FROM DIFFERENT PERSPECTIVES.

PubMed

Bojaj, Gazmend; Skeraj, Fitim; Czabanowska, Katarzyna; Burazeri, Genc

2016-10-01

The aim of this analysis was to compare the level of self-perceived competencies of primary health care physicians in Kosovo with patients' viewpoint, as well as the necessary (required) level of such competencies from decision-makers' standpoint. Three cross-sectional studies were carried out in Kosovo in 2013 including: i) a representative sample of 1340 primary health care users aged ≥18 years (49% men; overall mean age: 50.5±17.9 years; response rate: 89%); ii) a representative sample of 597 primary health care physicians (49% men; overall mean age: 46.0±9.4 years; response rate: 90%), and; iii) a nationwide representative sample of 100 decision-makers operating at different primary health care institutions or public health agencies in Kosovo (63% men; mean age: 47.7±5.7 years). A structured self-administered questionnaire (consisting of 37 items) was used in the three surveys in order to assess physicians' competencies regarding different domains of the quality of health care. There was a significant gap in the level of self-perceived physicians' competencies and patients' perspective in transitional Kosovo. Furthermore, there was a gap in the level of self-perceived physicians' competencies and the necessary (required) level of physicians' competencies from decision-makers perspective which was less evident in Prishtina, but considerable in the other regions of Kosovo. Our analysis provides valuable evidence about the level of competencies of primary health care physicians in Kosovo from different stakeholders' perspectives. There is an urgent need for continuous professional development of family physicians in post-war Kosovo.

The Zika Virus Outbreak in Brazil: Knowledge Gaps and Challenges for Risk Reduction.

PubMed

Garcia Serpa Osorio-de-Castro, Claudia; Silva Miranda, Elaine; Machado de Freitas, Carlos; Rochel de Camargo, Kenneth; Cranmer, Hilarie Hartel

2017-06-01

We analyzed uncertainties and complexities of the Zika virus outbreak in Brazil, and we discuss risk reduction for future emergencies. We present the public health situation in Brazil and concurrent determinants of the epidemic and the knowledge gaps that persist despite building evidence from research, making public health decisions difficult. Brazil has adopted active measures, but producing desired outcomes may be uncertain because of partial or unavailable information. Reducing population group vulnerabilities and acting on environmental issues are medium- to long-term measures. Simultaneously dealing with information gaps, uncontrolled disease spread, and vulnerabilities is a new risk scenario and must be approached decisively to face emerging biothreats.

Bayesian-information-gap decision theory with an application to CO 2 sequestration

DOE PAGES

O'Malley, D.; Vesselinov, V. V.

2015-09-04

Decisions related to subsurface engineering problems such as groundwater management, fossil fuel production, and geologic carbon sequestration are frequently challenging because of an overabundance of uncertainties (related to conceptualizations, parameters, observations, etc.). Because of the importance of these problems to agriculture, energy, and the climate (respectively), good decisions that are scientifically defensible must be made despite the uncertainties. We describe a general approach to making decisions for challenging problems such as these in the presence of severe uncertainties that combines probabilistic and non-probabilistic methods. The approach uses Bayesian sampling to assess parametric uncertainty and Information-Gap Decision Theory (IGDT) to addressmore » model inadequacy. The combined approach also resolves an issue that frequently arises when applying Bayesian methods to real-world engineering problems related to the enumeration of possible outcomes. In the case of zero non-probabilistic uncertainty, the method reduces to a Bayesian method. Lastly, to illustrate the approach, we apply it to a site-selection decision for geologic CO 2 sequestration.« less

Minding the Cyber-Physical Gap: Model-Based Analysis and Mitigation of Systemic Perception-Induced Failure.

PubMed

Mordecai, Yaniv; Dori, Dov

2017-07-17

The cyber-physical gap (CPG) is the difference between the 'real' state of the world and the way the system perceives it. This discrepancy often stems from the limitations of sensing and data collection technologies and capabilities, and is inevitable at some degree in any cyber-physical system (CPS). Ignoring or misrepresenting such limitations during system modeling, specification, design, and analysis can potentially result in systemic misconceptions, disrupted functionality and performance, system failure, severe damage, and potential detrimental impacts on the system and its environment. We propose CPG-Aware Modeling & Engineering (CPGAME), a conceptual model-based approach to capturing, explaining, and mitigating the CPG. CPGAME enhances the systems engineer's ability to cope with CPGs, mitigate them by design, and prevent erroneous decisions and actions. We demonstrate CPGAME by applying it for modeling and analysis of the 1979 Three Miles Island 2 nuclear accident, and show how its meltdown could be mitigated. We use ISO-19450:2015-Object Process Methodology as our conceptual modeling framework.

The invisibility of fisheries in the process of hydropower development across the Amazon.

PubMed

Doria, Carolina Rodrigues da Costa; Athayde, Simone; Marques, Elineide E; Lima, Maria Alice Leite; Dutka-Gianelli, Jynessa; Ruffino, Mauro Luis; Kaplan, David; Freitas, Carlos E C; Isaac, Victoria N

2018-05-01

We analyze the invisibility of fisheries and inadequacy of fishers' participation in the process of hydropower development in the Amazon, focusing on gaps between legally mandated and actual outcomes. Using Ostrom's institutional design principles for assessing common-pool resource management, we selected five case studies from Brazilian Amazonian watersheds to conduct an exploratory comparative case-study analysis. We identify similar problems across basins, including deficiencies in the dam licensing process; critical data gaps; inadequate stakeholder participation; violation of human rights; neglect of fishers' knowledge; lack of organization and representation by fishers' groups; and lack of governmental structure and capacity to manage dam construction activities or support fishers after dam construction. Fishers have generally been marginalized or excluded from decision-making regarding planning, construction, mitigation, compensation, and monitoring of the social-ecological impacts of hydroelectric dams. Addressing these deficiencies will require concerted investments and efforts by dam developers, government agencies and civil society, and the promotion of inter-sectorial dialogue and cross-scale participatory planning and decision-making that includes fishers and their associations.

New institutional mechanisms to bridge the information gap between climate science and public policy decisions

NASA Astrophysics Data System (ADS)

Rogers, W.; Gulledge, J. M.

2010-12-01

Many decision makers lack actionable scientific information needed to prepare for future challenges associated with climate change. Although the scope and quality of available scientific information has increased dramatically in recent years, this information does not always reach - or is not presented in a form that is useful to - decision makers who need it. The producer (i.e. scientists) community tends to be stovepiped, even though consumers (i.e. decision makers) often need interdisciplinary science and analysis. Consumers, who may also be stovepiped in various agencies or subject areas, may lack familiarity with or access to these separate communities, as well as the tools or time to navigate scientific information and disciplines. Closing the communication gap between these communities could be facilitated by institutionalizing processes designed for this purpose. We recommend a variety of mainstreaming policies within the consumer community, as well as mechanisms to generate a strong demand signal that will resonate more strongly with the producer community. We also recommend institutional reforms and methods of incentivizing policy-oriented scientific analysis within the producer community. Our recommendations focus on improving information flow to national security and foreign policy decision makers, but many are relevant to public policy writ large. Recommendations for Producers 1. The scientific community should formally encourage collaborations between natural and social scientists and reward publications in interdisciplinary outlets Incentives could include research funding and honorary awards recognizing service to public policy. 2. Academic merit review should reward research grants and publications targeted at interdisciplinary and/or policy-oriented audiences. Reforms of merit review may require new policies and engaged institutional leadership. Recommendations for Consumers 1. Congress should amend Title VI of the National Defense Education Act to encourage the development of multidisciplinary educational programs on the national security implications of climate change. 2. Federal agencies should establish funding programs to encourage producers to provide scientific information tailored to consumer needs. 3. The Department of State should appoint climate advisors to serve within the regional bureaus and on the policy and planning staff. 4. Federal agencies, the Department of Education, and the National Science Foundation should develop programs to stimulate new interdisciplinary research partnerships and training of a new generation of interdisciplinary climate change risk thinkers, assessors and managers. 5. Federal agencies should encourage Senior Executive Service decision makers to participate in science policy certi¬fication workshops and include science and technology policy as a core curricu¬lum component of the SES Federal Candidate Development Program. These recommendations are described in detail in a report published by the Center for a New American Security: Rogers, W. and J. Gulledge (2010) Lost in Translation: Closing the Gap Between Climate Science and National Security Policy (available online: http://cnas.org/node/4391)

Evidence-based decision-making 7: Knowledge translation.

PubMed

Manns, Braden J

2015-01-01

There is a significant gap between what is known and what is implemented by key stakeholders in practice (the evidence to practice gap). The primary purpose of knowledge translation is to address this gap, bridging evidence to clinical practice. The knowledge to action cycle is one framework for knowledge translation that integrates policy-makers throughout the research cycle. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). After identification of the problem, knowledge creation is undertaken, depicted at the center of the cycle as a funnel. Knowledge inquiry is at the wide end of the funnel, and moving down the funnel, the primary data is synthesized into knowledge products in the form of educational materials, guidelines, decision aids, or clinical pathways. The remaining components of the knowledge to action cycle refer to the action of applying the knowledge that has been created. This includes adapting knowledge to local context, assessing barriers to knowledge use, selecting, tailoring implementing interventions, monitoring knowledge use, evaluating outcomes, and sustaining knowledge use. Each of these steps is connected by bidirectional arrows and ideally involves healthcare decision-makers and key stakeholders at each transition.

Understanding Adherence and Prescription Patterns Using Large-Scale Claims Data.

PubMed

Bjarnadóttir, Margrét V; Malik, Sana; Onukwugha, Eberechukwu; Gooden, Tanisha; Plaisant, Catherine

2016-02-01

Advanced computing capabilities and novel visual analytics tools now allow us to move beyond the traditional cross-sectional summaries to analyze longitudinal prescription patterns and the impact of study design decisions. For example, design decisions regarding gaps and overlaps in prescription fill data are necessary for measuring adherence using prescription claims data. However, little is known regarding the impact of these decisions on measures of medication possession (e.g., medication possession ratio). The goal of the study was to demonstrate the use of visualization tools for pattern discovery, hypothesis generation, and study design. We utilized EventFlow, a novel discrete event sequence visualization software, to investigate patterns of prescription fills, including gaps and overlaps, utilizing large-scale healthcare claims data. The study analyzes data of individuals who had at least two prescriptions for one of five hypertension medication classes: ACE inhibitors, angiotensin II receptor blockers, beta blockers, calcium channel blockers, and diuretics. We focused on those members initiating therapy with diuretics (19.2%) who may have concurrently or subsequently take drugs in other classes as well. We identified longitudinal patterns in prescription fills for antihypertensive medications, investigated the implications of decisions regarding gap length and overlaps, and examined the impact on the average cost and adherence of the initial treatment episode. A total of 790,609 individuals are included in the study sample, 19.2% (N = 151,566) of whom started on diuretics first during the study period. The average age was 52.4 years and 53.1% of the population was female. When the allowable gap was zero, 34% of the population had continuous coverage and the average length of continuous coverage was 2 months. In contrast, when the allowable gap was 30 days, 69% of the population showed a single continuous prescription period with an average length of 5 months. The average prescription cost of the period of continuous coverage ranged from US$3.44 (when the maximum gap was 0 day) to US$9.08 (when the maximum gap was 30 days). Results were less impactful when considering overlaps. This proof-of-concept study illustrates the use of visual analytics tools in characterizing longitudinal medication possession. We find that prescription patterns and associated prescription costs are more influenced by allowable gap lengths than by definitions and treatment of overlap. Research using medication gaps and overlaps to define medication possession in prescription claims data should pay particular attention to the definition and use of gap lengths.

Planning and design of a knowledge based system for green manufacturing management

NASA Astrophysics Data System (ADS)

Kamal Mohd Nawawi, Mohd; Mohd Zuki Nik Mohamed, Nik; Shariff Adli Aminuddin, Adam

2013-12-01

This paper presents a conceptual design approach to the development of a hybrid Knowledge Based (KB) system for Green Manufacturing Management (GMM) at the planning and design stages. The research concentrates on the GMM by using a hybrid KB system, which is a blend of KB system and Gauging Absences of Pre-requisites (GAP). The hybrid KB/GAP system identifies all potentials elements of green manufacturing management issues throughout the development of this system. The KB system used in the planning and design stages analyses the gap between the existing and the benchmark organizations for an effective implementation through the GAP analysis technique. The proposed KBGMM model at the design stage explores two components, namely Competitive Priority and Lean Environment modules. Through the simulated results, the KBGMM System has identified, for each modules and sub-module, the problem categories in a prioritized manner. The System finalized all the Bad Points (BP) that need to be improved to achieve benchmark implementation of GMM at the design stage. The System provides valuable decision making information for the planning and design a GMM in term of business organization.

Decision Support Systems (DSSs) For Contaminated Land Management - Gaps And Challenges

EPA Science Inventory

A plethora of information is available when considering decision support systems for risk-based management of contaminated land. Broad issues of what is contaminated land, what is a brownfield, and what is remediation are discussed in EU countries and the U.S. Making decisions ...

What can the rangeland decision-making survey do for you?

USDA-ARS?s Scientific Manuscript database

Every day, rangeland managers make complicated decisions to balance multiple outcomes. The complex nature of ranch decision-making is not well understood by scientists, policy makers or the general public. To fill this gap, the Wyoming Stock Growers Association has partnered with the Agricultural Re...

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

Phreatophytic land-cover map of the northern and central Great Basin Ecoregion: California, Idaho, Nevada, Utah, Oregon, and Wyoming

USGS Publications Warehouse

Mathie, Amy M.; Welborn, Toby L.; Susong, David D.; Tumbusch, Mary L.

2011-01-01

Increasing water use and changing climate in the Great Basin of the western United States are likely affecting the distribution of phreatophytic vegetation in the region. Phreatophytic plant communities that depend on groundwater are susceptible to natural and anthropogenic changes to hydrologic flow systems. The purpose of this report is to document the methods used to create the accompanying map that delineates areas of the Great Basin that have the greatest potential to support phreatophytic vegetation. Several data sets were used to develop the data displayed on the map, including Shrub Map (a land-cover data set derived from the Regional Gap Analysis Program) and Gap Analysis Program (GAP) data sets for California and Wyoming. In addition, the analysis used the surface landforms from the U.S. Geological Survey (USGS) Global Ecosystems Mapping Project data to delineate regions of the study area based on topographic relief that are most favorable to support phreatophytic vegetation. Using spatial analysis techniques in a GIS, phreatophytic vegetation classes identified within Shrub Map and GAP were selected and compared to the spatial distribution of selected landforms in the study area to delineate areas of phreatophyte vegetation. Results were compared to more detailed studies conducted in selected areas. A general qualitative description of the data and the limitations of the base data determined that these results provide a regional overview but are not intended for localized studies or as a substitute for detailed field analysis. The map is intended as a decision-support aide for land managers to better understand, anticipate, and respond to ecosystem changes in the Great Basin.

Exploring Institutional Mechanisms for Scientific Input into the Management Cycle of the National Protected Area Network of Peru: Gaps and Opportunities.

PubMed

López-Rodríguez, M D; Castro, H; Arenas, M; Requena-Mullor, J M; Cano, A; Valenzuela, E; Cabello, J

2017-12-01

Understanding how to improve decision makers' use of scientific information across their different scales of management is a core challenge for narrowing the gap between science and conservation practice. Here, we present a study conducted in collaboration with decision makers that aims to explore the functionality of the mechanisms for scientific input within the institutional setting of the National Protected Area Network of Peru. First, we analyzed institutional mechanisms to assess the scientific information recorded by decision makers. Second, we developed two workshops involving scientists, decision makers and social actors to identify barriers to evidence-based conservation practice. Third, we administered 482 questionnaires to stakeholders to explore social perceptions of the role of science and the willingness to collaborate in the governance of protected areas. The results revealed that (1) the institutional mechanisms did not effectively promote the compilation and application of scientific knowledge for conservation practice; (2) six important barriers hindered scientific input in management decisions; and (3) stakeholders showed positive perceptions about the involvement of scientists in protected areas and expressed their willingness to collaborate in conservation practice. This collaborative research helped to (1) identify gaps and opportunities that should be addressed for increasing the effectiveness of the institutional mechanisms and (2) support institutional changes integrating science-based strategies for strengthening scientific input in decision-making. These insights provide a useful contextual orientation for scholars and decision makers interested in conducting empirical research to connect scientific inputs with operational aspects of the management cycle in other institutional settings around the world.

Exploring Institutional Mechanisms for Scientific Input into the Management Cycle of the National Protected Area Network of Peru: Gaps and Opportunities

NASA Astrophysics Data System (ADS)

López-Rodríguez, M. D.; Castro, H.; Arenas, M.; Requena-Mullor, J. M.; Cano, A.; Valenzuela, E.; Cabello, J.

2017-12-01

Understanding how to improve decision makers' use of scientific information across their different scales of management is a core challenge for narrowing the gap between science and conservation practice. Here, we present a study conducted in collaboration with decision makers that aims to explore the functionality of the mechanisms for scientific input within the institutional setting of the National Protected Area Network of Peru. First, we analyzed institutional mechanisms to assess the scientific information recorded by decision makers. Second, we developed two workshops involving scientists, decision makers and social actors to identify barriers to evidence-based conservation practice. Third, we administered 482 questionnaires to stakeholders to explore social perceptions of the role of science and the willingness to collaborate in the governance of protected areas. The results revealed that (1) the institutional mechanisms did not effectively promote the compilation and application of scientific knowledge for conservation practice; (2) six important barriers hindered scientific input in management decisions; and (3) stakeholders showed positive perceptions about the involvement of scientists in protected areas and expressed their willingness to collaborate in conservation practice. This collaborative research helped to (1) identify gaps and opportunities that should be addressed for increasing the effectiveness of the institutional mechanisms and (2) support institutional changes integrating science-based strategies for strengthening scientific input in decision-making. These insights provide a useful contextual orientation for scholars and decision makers interested in conducting empirical research to connect scientific inputs with operational aspects of the management cycle in other institutional settings around the world.

Bridging the Gap Between NASA Earth Observations and Decision Makers Through the NASA Develop National Program

NASA Astrophysics Data System (ADS)

Remillard, C. M.; Madden, M.; Favors, J.; Childs-Gleason, L.; Ross, K. W.; Rogers, L.; Ruiz, M. L.

2016-06-01

The NASA DEVELOP National Program bridges the gap between NASA Earth Science and society by building capacity in both participants and partner organizations that collaborate to conduct projects. These rapid feasibility projects highlight the capabilities of satellite and aerial Earth observations. Immersion of decision and policy makers in these feasibility projects increases awareness of the capabilities of Earth observations and contributes to the tools and resources available to support enhanced decision making. This paper will present the DEVELOP model, best practices, and two case studies, the Colombia Ecological Forecasting project and the Miami-Dade County Ecological Forecasting project, that showcase the successful adoption of tools and methods for decision making. Through over 90 projects each year, DEVELOP is always striving for the innovative, practical, and beneficial use of NASA Earth science data.

The construct-behavior gap in behavioral decision research: A challenge beyond replicability.

PubMed

Regenwetter, Michel; Robinson, Maria M

2017-10-01

Behavioral decision research compares theoretical constructs like preferences to behavior such as observed choices. Three fairly common links from constructs to behavior are (1) to tally, across participants and decision problems, the number of choices consistent with one predicted pattern of pairwise preferences; (2) to compare what most people choose in each decision problem against a predicted preference pattern; or (3) to enumerate the decision problems in which two experimental conditions generate a 1-sided significant difference in choice frequency 'consistent' with the theory. Although simple, these theoretical links are heuristics. They are subject to well-known reasoning fallacies, most notably the fallacy of sweeping generalization and the fallacy of composition. No amount of replication can alleviate these fallacies. On the contrary, reiterating logically inconsistent theoretical reasoning over and again across studies obfuscates science. As a case in point, we consider pairwise choices among simple lotteries and the hypotheses of overweighting or underweighting of small probabilities, as well as the description-experience gap. We discuss ways to avoid reasoning fallacies in bridging the conceptual gap between hypothetical constructs, such as, for example, "overweighting" to observable pairwise choice data. Although replication is invaluable, successful replication of hard-to-interpret results is not. Behavioral decision research stands to gain much theoretical and empirical clarity by spelling out precise and formally explicit theories of how hypothetical constructs translate into observable behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Setting the most robust effluent level under severe uncertainty: application of information-gap decision theory to chemical management.

PubMed

Yokomizo, Hiroyuki; Naito, Wataru; Tanaka, Yoshinari; Kamo, Masashi

2013-11-01

Decisions in ecological risk management for chemical substances must be made based on incomplete information due to uncertainties. To protect the ecosystems from the adverse effect of chemicals, a precautionary approach is often taken. The precautionary approach, which is based on conservative assumptions about the risks of chemical substances, can be applied selecting management models and data. This approach can lead to an adequate margin of safety for ecosystems by reducing exposure to harmful substances, either by reducing the use of target chemicals or putting in place strict water quality criteria. However, the reduction of chemical use or effluent concentrations typically entails a financial burden. The cost effectiveness of the precautionary approach may be small. Hence, we need to develop a formulaic methodology in chemical risk management that can sufficiently protect ecosystems in a cost-effective way, even when we do not have sufficient information for chemical management. Information-gap decision theory can provide the formulaic methodology. Information-gap decision theory determines which action is the most robust to uncertainty by guaranteeing an acceptable outcome under the largest degree of uncertainty without requiring information about the extent of parameter uncertainty at the outset. In this paper, we illustrate the application of information-gap decision theory to derive a framework for setting effluent limits of pollutants for point sources under uncertainty. Our application incorporates a cost for reduction in pollutant emission and a cost to wildlife species affected by the pollutant. Our framework enables us to settle upon actions to deal with severe uncertainty in ecological risk management of chemicals. Copyright © 2013 Elsevier Ltd. All rights reserved.

Auditory Gap-in-Noise Detection Behavior in Ferrets and Humans

PubMed Central

2015-01-01

The precise encoding of temporal features of auditory stimuli by the mammalian auditory system is critical to the perception of biologically important sounds, including vocalizations, speech, and music. In this study, auditory gap-detection behavior was evaluated in adult pigmented ferrets (Mustelid putorius furo) using bandpassed stimuli designed to widely sample the ferret’s behavioral and physiological audiogram. Animals were tested under positive operant conditioning, with psychometric functions constructed in response to gap-in-noise lengths ranging from 3 to 270 ms. Using a modified version of this gap-detection task, with the same stimulus frequency parameters, we also tested a cohort of normal-hearing human subjects. Gap-detection thresholds were computed from psychometric curves transformed according to signal detection theory, revealing that for both ferrets and humans, detection sensitivity was worse for silent gaps embedded within low-frequency noise compared with high-frequency or broadband stimuli. Additional psychometric function analysis of ferret behavior indicated effects of stimulus spectral content on aspects of behavioral performance related to decision-making processes, with animals displaying improved sensitivity for broadband gap-in-noise detection. Reaction times derived from unconditioned head-orienting data and the time from stimulus onset to reward spout activation varied with the stimulus frequency content and gap length, as well as the approach-to-target choice and reward location. The present study represents a comprehensive evaluation of gap-detection behavior in ferrets, while similarities in performance with our human subjects confirm the use of the ferret as an appropriate model of temporal processing. PMID:26052794

[Hospital self-management policy in Chile: perceptions of decision-makers].

PubMed

Méndez, Claudio A; Miranda, Christian; Torres, M Cristina; Márquez, Myriam

2013-01-01

To learn the perceptions of decision-makers concerning the imple-men-t-ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia and the Hospital San José de Osorno from August 2010 to December 2011. A convenience sample of 26 decision-makers was selected. The 26 interviews were recorded and transcribed verbatim. The information was analyzed using inductive content analysis. The interviewees consider the concept of self-management to be determined by autonomy in decision-making about resource allocation and the financing of health service delivery in the hospitals. They also stated that human resources and financing policies should be included to improve the implementation stage. They related weaknesses with the lack of organizational capabilities and managerial skills in the health teams implementing the changes. Conceptually, the hospital self-management policy is based on financial autonomy, and implementation is affected by persistent capacity gaps in policy design.

Leveraging human decision making through the optimal management of centralized resources

NASA Astrophysics Data System (ADS)

Hyden, Paul; McGrath, Richard G.

2016-05-01

Combining results from mixed integer optimization, stochastic modeling and queuing theory, we will advance the interdisciplinary problem of efficiently and effectively allocating centrally managed resources. Academia currently fails to address this, as the esoteric demands of each of these large research areas limits work across traditional boundaries. The commercial space does not currently address these challenges due to the absence of a profit metric. By constructing algorithms that explicitly use inputs across boundaries, we are able to incorporate the advantages of using human decision makers. Key improvements in the underlying algorithms are made possible by aligning decision maker goals with the feedback loops introduced between the core optimization step and the modeling of the overall stochastic process of supply and demand. A key observation is that human decision-makers must be explicitly included in the analysis for these approaches to be ultimately successful. Transformative access gives warfighters and mission owners greater understanding of global needs and allows for relationships to guide optimal resource allocation decisions. Mastery of demand processes and optimization bottlenecks reveals long term maximum marginal utility gaps in capabilities.

Planning water supply under uncertainty - benefits and limitations of RDM, Info-Gap, economic optimization and many-objective optimization

NASA Astrophysics Data System (ADS)

Matrosov, E.; Padula, S.; Huskova, I.; Harou, J. J.

2012-12-01

Population growth and the threat of drier or changed climates are likely to increase water scarcity world-wide. A combination of demand management (water conservation) and new supply infrastructure is often needed to meet future projected demands. In this case system planners must decide what to implement, when and at what capacity. Choices can range from infrastructure to policies or a mix of the two, culminating in a complex planning problem. Decision making under uncertainty frameworks can be used to help planners with this planning problem. This presentation introduces, applies and compares four decision making under uncertainty frameworks. The application is to the Thames basin water resource system which includes the city of London. The approaches covered here include least-economic cost capacity expansion optimization (EO), Robust Decision Making (RDM), Info-Gap Decision Theory (Info-gap) and many-objective evolutionary optimization (MOEO). EO searches for the least-economic cost program, i.e. the timing, sizing, and choice of supply-demand management actions/upgrades which meet projected water demands. Instead of striving for optimality, the RDM and Info-gap approaches help build plans that are robust to 'deep' uncertainty in future conditions. The MOEO framework considers multiple performance criteria and uses water systems simulators as a function evaluator for the evolutionary algorithm. Visualizations show Pareto approximate tradeoffs between multiple objectives. In this presentation we detail the application of each framework to the Thames basin (including London) water resource planning problem. Supply and demand options are proposed by the major water companies in the basin. We apply the EO method using a 29 year time horizon and an annual time step considering capital, operating (fixed and variable), social and environmental costs. The method considers all plausible combinations of supply and conservation schemes and capacities proposed by water companies and generates the least-economic cost annual plan. The RDM application uses stochastic simulation under a weekly time-step and regret analysis to choose a candidate strategy. We then use a statistical cluster algorithm to identify future states of the world under which the strategy is vulnerable. The method explicitly considers the effects of uncertainty in supply, demands and energy price on multiple performance criteria. The Info-gap approach produces robustness and opportuneness plots that show the performance of different plans under the most dire and favorable sets of future conditions. The same simulator, supply and demand options and uncertainties are considered as in the RDM application. The MOEO application considers many more combinations of supply and demand options while still employing a simulator that enables a more realistic representation of the physical system and operating rules. A computer cluster is employed to ease the computational burden. Visualization software allows decision makers to interactively view tradeoffs in many dimensions. Benefits and limitations of each framework are discussed and recommendations for future planning in the basin are provided.

Communication as a Strategic Activity (Invited)

NASA Astrophysics Data System (ADS)

Fischhoff, B.

2010-12-01

Effective communication requires preparation. The first step is explicit analysis of the decisions faced by audience members, in order to identify the facts essential to their choices. The second step is assessing their current beliefs, in order to identify the gaps in their understanding, as well as their natural ways of thinking. The third step is drafting communications potentially capable of closing those gaps, taking advantage of the relevant behavioral science. The fourth step is empirically evaluating those communications, refining them as necessary. The final step is communicating through trusted channels, capable of getting the message out and receiving needed feedback. Executing these steps requires a team involving subject matter experts (for ensuring that the science is right), decision analysts (for identifying the decision-critical facts), behavioral scientists (for designing and evaluating messages), and communication specialists (for creating credible channels). Larger organizations should be able to assemble those teams and anticipate their communication needs. However, even small organizations, individuals, or large organizations that have been caught flat-footed can benefit from quickly assembling informal teams, before communicating in ways that might undermine their credibility. The work is not expensive, but does require viewing communication as a strategic activity, rather than an afterthought. The talk will illustrate the science base, with a few core research results; note the risks of miscommunication, with a few bad examples; and suggest the opportunities for communication leadership, focusing on the US Food and Drug Administration.

Taking the Pulse of a Large Marine Ecosystem: An Inventory and Gap Analysis of Long-Term Recovery Monitoring Efforts in the Gulf of Mexico

NASA Astrophysics Data System (ADS)

Robbins, C.; Baldera, A.; Spies, R.; Love, M. S.

2016-02-01

Discharges of hydrocarbons into a large marine ecosystem can cause acute and sub-lethal effects, resulting in a recovery of populations or habitats that could take years, even decades. Recovery from oil spill impacts is complicated by the vagaries of a dynamic marine ecosystem. A major challenge and need is establishing and sustaining an interdisciplinary monitoring and research program capable of tracking oil spill impacts and resource recovery within the context of an ever changing, chronically stressed ecosystem. Ocean Conservancy undertook an assessment to identify and prioritize data collection activities for tracking the recovery of species and habitats impacted by the BP oil disaster in the Gulf of Mexico. We inventoried more than 700 discrete monitoring efforts in the Gulf, identified gaps in coverage for priority species, habitats and ecosystem drivers in space and time and mapped the footprints of active monitoring activities for ease of communication. We will present an overview of our methods and findings from the inventory and gap analysis and discuss how scientists and resource managers can integrate these tools into study plans or adapt restoration decisions based on recovery trajectories or changes in ocean conditions.

Clinical decision support tools for osteoporosis disease management: a systematic review of randomized controlled trials.

PubMed

Kastner, Monika; Straus, Sharon E

2008-12-01

Studies indicate a gap between evidence and clinical practice in osteoporosis management. Tools that facilitate clinical decision making at the point of care are promising strategies for closing these practice gaps. To systematically review the literature to identify and describe the effectiveness of tools that support clinical decision making in osteoporosis disease management. Medline, EMBASE, CINAHL, and EBM Reviews (CDSR, DARE, CCTR, and ACP J Club), and contact with experts in the field. Randomized controlled trials (RCTs) in any language from 1966 to July 2006 investigating disease management interventions in patients at risk for osteoporosis. Outcomes included fractures and bone mineral density (BMD) testing. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. Of 1,246 citations that were screened for relevance, 13 RCTs met the inclusion criteria. Reported study quality was generally poor. Meta-analysis was not done because of methodological and clinical heterogeneity; 77% of studies included a reminder or education as a component of their intervention. Three studies of reminders plus education targeted to physicians and patients showed increased BMD testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67). A physician reminder plus a patient risk assessment strategy found reduced fractures [RR 0.58, 95% confidence interval (CI) 0.37 to 0.90] and increased osteoporosis therapy (RR 2.44, CI 1.43 to 4.17). Multi-component tools that are targeted to physicians and patients may be effective for supporting clinical decision making in osteoporosis disease management.

Understanding cognitive processes behind acceptance or refusal of phase I trials.

PubMed

Pravettoni, Gabriella; Mazzocco, Ketti; Gorini, Alessandra; Curigliano, Giuseppe

2016-04-01

Participation in phase I trials gives patients the chance to obtain control over their disease by trying an experimental therapy. The patients' vulnerability, the informed consent process aiming at understanding the purpose and potential benefits of the phase I trial, and the complexity of the studies may impact the patient's final decision. Emotionally difficult health conditions may induce patients to succumb to cognitive biases, allocating attention only on a part of the provided information. Filling the gap in patients' information process can foster the implementation of strategies to help physicians tailor clinical trials' communication providing personalized support and tailored medical information around patients' need, so avoiding cognitive biases in patients and improving informed shared decision quality. The aim of the present review article focuses on the analysis of cognitive and psychological factors that affect patients' decision to participate or not to early phase clinical trials. Copyright © 2016. Published by Elsevier Ireland Ltd.

A Practical Approach to Address Uncertainty in Stakeholder Deliberations.

PubMed

Gregory, Robin; Keeney, Ralph L

2017-03-01

This article addresses the difficulties of incorporating uncertainty about consequence estimates as part of stakeholder deliberations involving multiple alternatives. Although every prediction of future consequences necessarily involves uncertainty, a large gap exists between common practices for addressing uncertainty in stakeholder deliberations and the procedures of prescriptive decision-aiding models advanced by risk and decision analysts. We review the treatment of uncertainty at four main phases of the deliberative process: with experts asked to describe possible consequences of competing alternatives, with stakeholders who function both as individuals and as members of coalitions, with the stakeholder committee composed of all stakeholders, and with decisionmakers. We develop and recommend a model that uses certainty equivalents as a theoretically robust and practical approach for helping diverse stakeholders to incorporate uncertainties when evaluating multiple-objective alternatives as part of public policy decisions. © 2017 Society for Risk Analysis.

Bridging the gap between health and non-health investments: moving from cost-effectiveness analysis to a return on investment approach across sectors of economy.

PubMed

Sendi, Pedram

2008-06-01

When choosing from a menu of treatment alternatives, the optimal treatment depends on the objective function and the assumptions of the model. The classical decision rule of cost-effectiveness analysis may be formulated via two different objective functions: (i) maximising health outcomes subject to the budget constraint or (ii) maximising the net benefit of the intervention with the budget being determined ex post. We suggest a more general objective function of (iii) maximising return on investment from available resources with consideration of health and non-health investments. The return on investment approach allows to adjust the analysis for the benefits forgone by alternative non-health investments from a societal or subsocietal perspective. We show that in the presence of positive returns on non-health investments the decision-maker's willingness to pay per unit of effect for a treatment program needs to be higher than its incremental cost-effectiveness ratio to be considered cost-effective.

Missing Data and Influential Sites: Choice of Sites for Phylogenetic Analysis Can Be As Important As Taxon Sampling and Model Choice

PubMed Central

Shavit Grievink, Liat; Penny, David; Holland, Barbara R.

2013-01-01

Phylogenetic studies based on molecular sequence alignments are expected to become more accurate as the number of sites in the alignments increases. With the advent of genomic-scale data, where alignments have very large numbers of sites, bootstrap values close to 100% and posterior probabilities close to 1 are the norm, suggesting that the number of sites is now seldom a limiting factor on phylogenetic accuracy. This provokes the question, should we be fussy about the sites we choose to include in a genomic-scale phylogenetic analysis? If some sites contain missing data, ambiguous character states, or gaps, then why not just throw them away before conducting the phylogenetic analysis? Indeed, this is exactly the approach taken in many phylogenetic studies. Here, we present an example where the decision on how to treat sites with missing data is of equal importance to decisions on taxon sampling and model choice, and we introduce a graphical method for illustrating this. PMID:23471508

Mads.jl

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

Vesselinov, Velimir; O'Malley, Daniel; Lin, Youzuo

2016-07-01

Mads.jl (Model analysis and decision support in Julia) is a code that streamlines the process of using data and models for analysis and decision support. It is based on another open-source code developed at LANL and written in C/C++ (MADS; http://mads.lanl.gov; LA-CC-11- 035). Mads.jl can work with external models of arbitrary complexity as well as built-in models of flow and transport in porous media. It enables a number of data- and model-based analyses including model calibration, sensitivity analysis, uncertainty quantification, and decision analysis. The code also can use a series of alternative adaptive computational techniques for Bayesian sampling, Monte Carlo,more » and Bayesian Information-Gap Decision Theory. The code is implemented in the Julia programming language, and has high-performance (parallel) and memory management capabilities. The code uses a series of third party modules developed by others. The code development will also include contributions to the existing third party modules written in Julia; this contributions will be important for the efficient implementation of the algorithm used by Mads.jl. The code also uses a series of LANL developed modules that are developed by Dan O'Malley; these modules will be also a part of the Mads.jl release. Mads.jl will be released under GPL V3 license. The code will be distributed as a Git repo at gitlab.com and github.com. Mads.jl manual and documentation will be posted at madsjulia.lanl.gov.« less

Balancing emotion and cognition: a case for decision aiding in conservation efforts.

PubMed

Wilson, Robyn S

2008-12-01

Despite advances in the quality of participatory decision making for conservation, many current efforts still suffer from an inability to bridge the gap between science and policy. Judgment and decision-making research suggests this gap may result from a person's reliance on affect-based shortcuts in complex decision contexts. I examined the results from 3 experiments that demonstrate how affect (i.e., the instantaneous reaction one has to a stimulus) influences individual judgments in these contexts and identified techniques from the decision-aiding literature that help encourage a balance between affect-based emotion and cognition in complex decision processes. In the first study, subjects displayed a lack of focus on their stated conservation objectives and made decisions that reflected their initial affective impressions. Value-focused approaches may help individuals incorporate all the decision-relevant objectives by making the technical and value-based objectives more salient. In the second study, subjects displayed a lack of focus on statistical risk and again made affect-based decisions. Trade-off techniques may help individuals incorporate relevant technical data, even when it conflicts with their initial affective impressions or other value-based objectives. In the third study, subjects displayed a lack of trust in decision-making authorities when the decision involved a negatively affect-rich outcome (i.e., a loss). Identifying shared salient values and increasing procedural fairness may help build social trust in both decision-making authorities and the decision process.

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

PubMed

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

2007-05-01

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

Evidence development and publication planning: strategic process.

PubMed

Wittek, Michael R; Jo Williams, Mary; Carlson, Angeline M

2009-11-01

A number of decisions in the health care field rely heavily on published clinical evidence. A systematic approach to evidence development and publication planning is required to develop a portfolio of evidence that includes at minimum information on efficacy, safety, durability of effect, quality of life, and economic outcomes. The approach requires a critical assessment of available literature, identification of gaps in the literature, and a strategic plan to fill the gaps to ensure the availability of evidence demanded for clinical decisions, coverage/payment decisions and health technology assessments. The purpose of this manuscript is to offer a six-step strategic process leading to a portfolio of evidence that meets the informational needs of providers, payers, and governmental agencies concerning patient access to a therapy.

Location choices for climate change and transportation decision making.

DOT National Transportation Integrated Search

2015-01-01

This research aims to fill the gap in the knowledge between residential location decisions and : preferences and the resulting travel outcomes. In this first phase, the revealed connections between : residential choices and travel patterns are examin...

Impacts of Maximizing Tendencies on Experience-Based Decisions.

PubMed

Rim, Hye Bin

2017-06-01

Previous research on risky decisions has suggested that people tend to make different choices depending on whether they acquire the information from personally repeated experiences or from statistical summary descriptions. This phenomenon, called as a description-experience gap, was expected to be moderated by the individual difference in maximizing tendencies, a desire towards maximizing decisional outcome. Specifically, it was hypothesized that maximizers' willingness to engage in extensive information searching would lead maximizers to make experience-based decisions as payoff distributions were given explicitly. A total of 262 participants completed four decision problems. Results showed that maximizers, compared to non-maximizers, drew more samples before making a choice but reported lower confidence levels on both the accuracy of knowledge gained from experiences and the likelihood of satisfactory outcomes. Additionally, maximizers exhibited smaller description-experience gaps than non-maximizers as expected. The implications of the findings and unanswered questions for future research were discussed.

Methodology for determination and use of the no-escape envelope of an air-to-air-missile

NASA Technical Reports Server (NTRS)

Neuman, Frank

1988-01-01

A large gap exists between optimal control and differential-game theory and their applications. The purpose of this paper is to show how this gap may be bridged. Missile-avoidance of realistically simulated infrared heat-seeking, fire-and-forget missile is studied. In detailed simulations, sweeping out the discretized initial condition space, avoidance methods based on pilot experience are combined with those based on simplified optimal control analysis to derive an approximation to the no-escape missile envelopes. The detailed missile equations and no-escape envelopes were then incorporated into an existing piloted simulation of air-to-air combat to generate missile firing decisions as well as missile avoidance commands. The use of these envelopes was found to be effective in both functions.

The influence of management and environment on local health department organizational structure and adaptation: a longitudinal network analysis.

PubMed

Keeling, Jonathan W; Pryde, Julie A; Merrill, Jacqueline A

2013-01-01

The nation's 2862 local health departments (LHDs) are the primary means for assuring public health services for all populations. The objective of this study is to assess the effect of organizational network analysis on management decisions in LHDs and to demonstrate the technique's ability to detect organizational adaptation over time. We conducted a longitudinal network analysis in a full-service LHD with 113 employees serving about 187,000 persons. Network survey data were collected from employees at 3 times: months 0, 8, and 34. At time 1 the initial analysis was presented to LHD managers as an intervention with information on evidence-based management strategies to address the findings. At times 2 and 3 interviews documented managers' decision making and events in the task environment. Response rates for the 3 network analyses were 90%, 97%, and 83%. Postintervention (time 2) results showed beneficial changes in network measures of communication and integration. Screening and case identification increased for chlamydia and for gonorrhea. Outbreak mitigation was accelerated by cross-divisional teaming. Network measurements at time 3 showed LHD adaptation to H1N1 and budget constraints with increased centralization. Task redundancy increased dramatically after National Incident Management System training. Organizational network analysis supports LHD management with empirical evidence that can be translated into strategic decisions about communication, allocation of resources, and addressing knowledge gaps. Specific population health outcomes were traced directly to management decisions based on network evidence. The technique can help managers improve how LHDs function as organizations and contribute to our understanding of public health systems.

Evaluation of the Effectiveness of Stormwater Decision Support Tools for Infrastructure Selection and the Barriers to Implementation

NASA Astrophysics Data System (ADS)

Spahr, K.; Hogue, T. S.

2016-12-01

Selecting the most appropriate green, gray, and / or hybrid system for stormwater treatment and conveyance can prove challenging to decision markers across all scales, from site managers to large municipalities. To help streamline the selection process, a multi-disciplinary team of academics and professionals is developing an industry standard for selecting and evaluating the most appropriate stormwater management technology for different regions. To make the tool more robust and comprehensive, life-cycle cost assessment and optimization modules will be included to evaluate non-monetized and ecosystem benefits of selected technologies. Initial work includes surveying advisory board members based in cities that use existing decision support tools in their infrastructure planning process. These surveys will qualify the decisions currently being made and identify challenges within the current planning process across a range of hydroclimatic regions and city size. Analysis of social and other non-technical barriers to adoption of the existing tools is also being performed, with identification of regional differences and institutional challenges. Surveys will also gage the regional appropriateness of certain stormwater technologies based off experiences in implementing stormwater treatment and conveyance plans. In additional to compiling qualitative data on existing decision support tools, a technical review of components of the decision support tool used will be performed. Gaps in each tool's analysis, like the lack of certain critical functionalities, will be identified and ease of use will be evaluated. Conclusions drawn from both the qualitative and quantitative analyses will be used to inform the development of the new decision support tool and its eventual dissemination.

Assessing land-use impacts on biodiversity using an expert systems tool

USGS Publications Warehouse

Crist, P.J.; Kohley, T.W.; Oakleaf, J.

2000-01-01

Habitat alteration, in the form of land-use development, is a leading cause of biodiversity loss in the U.S. and elsewhere. Although statutes in the U.S. may require consideration of biodiversity in local land-use planning and regulation, local governments lack the data, resources, and expertise to routinely consider biotic impacts that result from permitted land uses. We hypothesized that decision support systems could aid solution of this problem. We developed a pilot biodiversity expert systems tool (BEST) to test that hypothesis and learn what additional scientific and technological advancements are required for broad implementation of such a system. BEST uses data from the U.S. Geological Survey's Gap Analysis Program (GAP) and other data in a desktop GIS environment. The system provides predictions of conflict between proposed land uses and biotic elements and is intended for use at the start of the development review process. Key challenges were the development of categorization systems that relate named land-use types to ecological impacts, and relate sensitivities of biota to ecological impact levels. Although the advent of GAP and sophisticated desktop GIS make such a system feasible for broad implementation, considerable ongoing research is required to make the results of such a system scientifically sound, informative, and reliable for the regulatory process. We define a role for local government involvement in biodiversity impact assessment, the need for a biodiversity decision support system, the development of a prototype system, and scientific needs for broad implementation of a robust and reliable system.

Robustness of risk maps and survey networks to knowledge gaps about a new invasive pest.

PubMed

Yemshanov, Denys; Koch, Frank H; Ben-Haim, Yakov; Smith, William D

2010-02-01

In pest risk assessment it is frequently necessary to make management decisions regarding emerging threats under severe uncertainty. Although risk maps provide useful decision support for invasive alien species, they rarely address knowledge gaps associated with the underlying risk model or how they may change the risk estimates. Failure to recognize uncertainty leads to risk-ignorant decisions and miscalculation of expected impacts as well as the costs required to minimize these impacts. Here we use the information gap concept to evaluate the robustness of risk maps to uncertainties in key assumptions about an invading organism. We generate risk maps with a spatial model of invasion that simulates potential entries of an invasive pest via international marine shipments, their spread through a landscape, and establishment on a susceptible host. In particular, we focus on the question of how much uncertainty in risk model assumptions can be tolerated before the risk map loses its value. We outline this approach with an example of a forest pest recently detected in North America, Sirex noctilio Fabricius. The results provide a spatial representation of the robustness of predictions of S. noctilio invasion risk to uncertainty and show major geographic hotspots where the consideration of uncertainty in model parameters may change management decisions about a new invasive pest. We then illustrate how the dependency between the extent of uncertainties and the degree of robustness of a risk map can be used to select a surveillance network design that is most robust to knowledge gaps about the pest.

Minding the Cyber-Physical Gap: Model-Based Analysis and Mitigation of Systemic Perception-Induced Failure

PubMed Central

2017-01-01

The cyber-physical gap (CPG) is the difference between the ‘real’ state of the world and the way the system perceives it. This discrepancy often stems from the limitations of sensing and data collection technologies and capabilities, and is inevitable at some degree in any cyber-physical system (CPS). Ignoring or misrepresenting such limitations during system modeling, specification, design, and analysis can potentially result in systemic misconceptions, disrupted functionality and performance, system failure, severe damage, and potential detrimental impacts on the system and its environment. We propose CPG-Aware Modeling & Engineering (CPGAME), a conceptual model-based approach to capturing, explaining, and mitigating the CPG. CPGAME enhances the systems engineer’s ability to cope with CPGs, mitigate them by design, and prevent erroneous decisions and actions. We demonstrate CPGAME by applying it for modeling and analysis of the 1979 Three Miles Island 2 nuclear accident, and show how its meltdown could be mitigated. We use ISO-19450:2015—Object Process Methodology as our conceptual modeling framework. PMID:28714910

Wide area restoration following biological contamination

NASA Astrophysics Data System (ADS)

Yang, Lynn; Hibbard, Wilthea; Edwards, Donna; Franco, David; Fruetel, Julie; Tucker, Mark; Einfeld, Wayne; Knowlton, Robert; Brown, Gary; Brockmann, John; Greenwalt, Robert; Miles, Robin; Raber, Ellen; Carlsen, Tina; Krauter, Paula; Dillon, Michael; MacQueen, Don; Intrepido, Tony; Hoppes, Bill; Wilson, Wendy; Mancieri, Sav

2008-04-01

Current understanding of how to restore a wide area that has been contaminated following a large biological attack is limited. The Department of Homeland Security and Department of Defense are executing a four-year collaborative program named the Interagency Biological Restoration Demonstration (IBRD) program. This program is aimed at developing technologies, methods, plans and policies necessary to restore a wide area, including military installations and critical infrastructures, in the event of a large outdoor aerosol release of anthrax. The IBRD program partner pilot city is the Seattle Urban Area to include Fort Lewis, WA and McChord Air Force Base. A front-end systems analysis was conducted as part of IBRD, to: 1) assess existing technologies and processes for wide area restoration; from this, 2) develop an "as-is" decision framework for wide area restoration; and 3) identify and prioritize capability gaps. Qualitative assessments and quantitative analyses, including sensitivity, timeline and case study analyses, were conducted to evaluate existing processes and rank capability gaps. This paper describes the approach and results from this front-end systems analysis.

Human and Robotic Mission to Small Bodies: Mapping, Planning and Exploration

NASA Technical Reports Server (NTRS)

Neffian, Ara V.; Bellerose, Julie; Beyer, Ross A.; Archinal, Brent; Edwards, Laurence; Lee, Pascal; Colaprete, Anthony; Fong, Terry

2013-01-01

This study investigates the requirements, performs a gap analysis and makes a set of recommendations for mapping products and exploration tools required to support operations and scientific discovery for near- term and future NASA missions to small bodies. The mapping products and their requirements are based on the analysis of current mission scenarios (rendezvous, docking, and sample return) and recommendations made by the NEA Users Team (NUT) in the framework of human exploration. The mapping products that sat- isfy operational, scienti c, and public outreach goals include topography, images, albedo, gravity, mass, density, subsurface radar, mineralogical and thermal maps. The gap analysis points to a need for incremental generation of mapping products from low (flyby) to high-resolution data needed for anchoring and docking, real-time spatial data processing for hazard avoidance and astronaut or robot localization in low gravity, high dynamic environments, and motivates a standard for coordinate reference systems capable of describing irregular body shapes. Another aspect investigated in this study is the set of requirements and the gap analysis for exploration tools that support visualization and simulation of operational conditions including soil interactions, environment dynamics, and communications coverage. Building robust, usable data sets and visualisation/simulation tools is the best way for mission designers and simulators to make correct decisions for future missions. In the near term, it is the most useful way to begin building capabilities for small body exploration without needing to commit to specific mission architectures.

Experiencing biodiversity as a bridge over the science-society communication gap.

PubMed

Meinard, Yves; Quétier, Fabien

2014-06-01

Drawing on the idea that biodiversity is simply the diversity of living things, and that everyone knows what diversity and living things mean, most conservation professionals eschew the need to explain the many complex ways in which biodiversity is understood in science. On many biodiversity-related issues, this lack of clarity leads to a communication gap between science and the general public, including decision makers who must design and implement biodiversity policies. Closing this communication gap is pivotal to the ability of science to inform sound environmental decision making. To address this communication gap, we propose a surrogate of biodiversity for communication purposes that captures the scientific definition of biodiversity yet can be understood by nonscientists; that is, biodiversity as a learning experience. The prerequisites of this or any other biodiversity communication surrogate are that it should have transdisciplinary relevance; not be measurable; be accessible to a wide audience; be usable to translate biodiversity issues; and understandably encompass biodiversity concepts. Biodiversity as a learning experience satisfies these prerequisites and is philosophically robust. More importantly, it can effectively contribute to closing the communication gap between biodiversity science and society at large. © 2013 Society for Conservation Biology.

Clinical Decision Support Tools for Osteoporosis Disease Management: A Systematic Review of Randomized Controlled Trials

PubMed Central

Straus, Sharon E.

2008-01-01

BACKGROUND Studies indicate a gap between evidence and clinical practice in osteoporosis management. Tools that facilitate clinical decision making at the point of care are promising strategies for closing these practice gaps. OBJECTIVE To systematically review the literature to identify and describe the effectiveness of tools that support clinical decision making in osteoporosis disease management. DATA SOURCES Medline, EMBASE, CINAHL, and EBM Reviews (CDSR, DARE, CCTR, and ACP J Club), and contact with experts in the field. REVIEW METHODS Randomized controlled trials (RCTs) in any language from 1966 to July 2006 investigating disease management interventions in patients at risk for osteoporosis. Outcomes included fractures and bone mineral density (BMD) testing. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. RESULTS Of 1,246 citations that were screened for relevance, 13 RCTs met the inclusion criteria. Reported study quality was generally poor. Meta-analysis was not done because of methodological and clinical heterogeneity; 77% of studies included a reminder or education as a component of their intervention. Three studies of reminders plus education targeted to physicians and patients showed increased BMD testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67). A physician reminder plus a patient risk assessment strategy found reduced fractures [RR 0.58, 95% confidence interval (CI) 0.37 to 0.90] and increased osteoporosis therapy (RR 2.44, CI 1.43 to 4.17). CONCLUSION Multi-component tools that are targeted to physicians and patients may be effective for supporting clinical decision making in osteoporosis disease management. Electronic supplementary material The online version of this article (doi:10.1007/s11606-008-0812-9) contains supplementary material, which is available to authorized users. PMID:18836782

Bridging the age gap in breast cancer: evaluation of decision support interventions for older women with operable breast cancer: protocol for a cluster randomised controlled trial

PubMed Central

Collins, Karen; Reed, Malcolm; Lifford, Kate; Burton, Maria; Edwards, Adrian; Ring, Alistair; Brain, Katherine; Harder, Helena; Robinson, Thompson; Cheung, Kwok Leung; Morgan, Jenna; Audisio, Riccardo; Ward, Susan; Richards, Paul; Martin, Charlene; Chater, Tim; Pemberton, Kirsty; Nettleship, Anthony; Murray, Christopher; Walters, Stephen; Bortolami, Oscar; Armitage, Fiona; Leonard, Robert; Gath, Jacqui; Revell, Deirdre; Green, Tracy; Wyld, Lynda

2017-01-01

Introduction While breast cancer outcomes are improving steadily in younger women due to advances in screening and improved therapies, there has been little change in outcomes among the older age group. It is inevitable that comorbidities/frailty rates are higher, which may increase the risks of some breast cancer treatments such as surgery and chemotherapy, many older women are healthy and may benefit from their use. Adjusting treatment regimens appropriately for age/comorbidity/frailty is variable and largely non-evidence based, specifically with regard to rates of surgery for operable oestrogen receptor-positive disease and rates of chemotherapy for high-risk disease. Methods and analysis This multicentre, parallel group, pragmatic cluster randomised controlled trial (RCT) (2015-18) reported here is nested within a larger ongoing ‘Age Gap Cohort Study’ (2012-18RP-PG-1209-10071), aims to evaluate the effectiveness of a complex intervention of decision support interventions to assist in the treatment decision making for early breast cancer in older women. The interventions include two patient decision aids (primary endocrine therapy vs surgery/antioestrogen therapy and chemotherapy vs no chemotherapy) and a clinical treatment outcomes algorithm for clinicians. Ethics and dissemination National and local ethics committee approval was obtained for all UK participating sites. Results from the trial will be submitted for publication in international peer-reviewed scientific journals. IRAS reference 115550. Trial registration number European Union Drug Regulating Authorities Clinical Trials (EudraCT) number 2015-004220-61;Pre-results. Sponsor's Protocol Code Number Sheffield Teaching Hospitals STH17086. ISRCTN 32447*. PMID:28760787

Risky Decision Making in a Laboratory Driving Task Is Associated with Health Risk Behaviors during Late Adolescence but Not Adulthood

ERIC Educational Resources Information Center

Kim-Spoon, Jungmeen; Kahn, Rachel; Deater-Deckard, Kirby; Chiu, Pearl; Steinberg, Laurence; King-Casas, Brooks

2016-01-01

Adolescence is characterized by increasing incidence of health risk behaviors, including experimentation with drugs and alcohol. To fill the gap in our understanding of the associations between risky decision-making and health risk behaviors, we investigated associations between laboratory-based risky decision-making using the Stoplight task and…

Antibiotic prescribing for acute lower respiratory tract infections (LRTI) – guideline adherence in the German primary care setting: An analysis of routine data

PubMed Central

Pelzl, Steffen; Szecsenyi, Joachim; Laux, Gunter

2017-01-01

Objectives Antibiotic overprescribing in primary care has major impacts on the development of antibiotic resistance. The objective of this study is to provide insight in antibiotics prescriptions for patients suffering from cough, acute bronchitis or community acquired pneumonia in primary care. Methods Data from 2009 to 2013 of electronic health records of 12,880 patients in Germany were obtained from a research database. The prescription of antibiotics for acute lower respiratory tract infections was compared to the national S3 guideline cough from the German Society of General Practitioners and Family Medicine. Results Antibiotics were prescribed in 41% of consultations. General practitioners’ decision of whether or not to prescribe an antibiotic was congruent with the guideline in 52% of consultations and the antibiotic choice congruence was 51% of antibiotic prescriptions. Hence, a congruent prescribing decision and a prescription of recommendation was found in only 25% of antibiotic prescriptions. Split by diagnosis we found that around three quarters of antibiotics prescribed for cough (73%) and acute bronchitis (78%) were not congruent to the guidelines. In contrast to that around one quarter of antibiotics prescribed for community acquired pneumonia (28%) were not congruent to the guidelines. Conclusions Our results show that there is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent. This gap could be closed by periodic quality circles on antibiotic prescribing for GPs. PMID:28350820

Antibiotic prescribing for acute lower respiratory tract infections (LRTI) - guideline adherence in the German primary care setting: An analysis of routine data.

PubMed

Kraus, Eva Maria; Pelzl, Steffen; Szecsenyi, Joachim; Laux, Gunter

2017-01-01

Antibiotic overprescribing in primary care has major impacts on the development of antibiotic resistance. The objective of this study is to provide insight in antibiotics prescriptions for patients suffering from cough, acute bronchitis or community acquired pneumonia in primary care. Data from 2009 to 2013 of electronic health records of 12,880 patients in Germany were obtained from a research database. The prescription of antibiotics for acute lower respiratory tract infections was compared to the national S3 guideline cough from the German Society of General Practitioners and Family Medicine. Antibiotics were prescribed in 41% of consultations. General practitioners' decision of whether or not to prescribe an antibiotic was congruent with the guideline in 52% of consultations and the antibiotic choice congruence was 51% of antibiotic prescriptions. Hence, a congruent prescribing decision and a prescription of recommendation was found in only 25% of antibiotic prescriptions. Split by diagnosis we found that around three quarters of antibiotics prescribed for cough (73%) and acute bronchitis (78%) were not congruent to the guidelines. In contrast to that around one quarter of antibiotics prescribed for community acquired pneumonia (28%) were not congruent to the guidelines. Our results show that there is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent. This gap could be closed by periodic quality circles on antibiotic prescribing for GPs.

IMPROVED SCIENCE AND DECISION SUPPORT FOR MANAGING WATERSHED NUTRIENT LOADS

EPA Science Inventory

The proposed research addresses two critical gaps in the TMDL process: (1) the inadequacy of presently existing receiving water models to accurately simulate nutrient-sediment-water interactions and fixed plants; and (2) the lack of decision-oriented optimization f...

Factors that influence case managers' resource allocation decisions in pediatric home care: an ethnographic study.

PubMed

Fraser, Kimberly D; Estabrooks, Carole; Allen, Marion; Strang, Vicki

2009-03-01

Case managers make decisions that directly affect the amount and type of services home care clients receive and subsequently affect the overall available health care resources of home care programs. A recent systematic review of the literature identified significant knowledge gaps with respect to resource allocation decision-making in home care. Using Spradley's methodology, we designed an ethnographic study of a children's home care program in Western Canada. The sample included 11 case managers and program leaders. Data sources included interviews, card sorts, and participant observation over a 5-month period. Data analyses included open coding, domain, taxonomic, and componential analysis. One of the key findings was a taxonomy of factors that influence case manager resource allocation decisions. The factors were grouped into one of four main categories: system-related, home care program-related, family related, or client-related. Family related factors have not been previously reported as influencing case manager resource allocation decision-making and nor has the team's role been reported as an influencing factor. The findings of this study are examined in light of Daniels and Sabin's Accountability for Reasonableness framework, which may be useful for future knowledge development about micro-level resource allocation theory.

Comparative evaluation of three proliferation markers, Ki-67, TOP2A, and RacGAP1, in bronchopulmonary neuroendocrine neoplasms: Issues and prospects.

PubMed

Neubauer, Elisa; Wirtz, Ralph M; Kaemmerer, Daniel; Athelogou, Maria; Schmidt, Lydia; Sänger, Jörg; Lupp, Amelie

2016-07-05

The classification of bronchopulmonary neuroendocrine neoplasms (BP-NEN) into four tumor entities (typical carcinoids (TC), atypical carcinoids (AC), small cell lung cancers (SCLC), large cell neuroendocrine lung carcinomas (LCNEC)) is difficult to perform accurately, but important for prognostic statements and therapeutic management decisions. In this regard, we compared the expression of three proliferation markers, Ki-67, Topoisomerase II alpha (TOP2A), and RacGAP1, in a series of tumor samples from 104 BP-NEN patients (24 TC, 21 AC, 52 SCLC, 7 LCNEC) using different evaluation methods (immunohistochemistry (IHC): Average evaluation, Hotspot evaluation, digital image analysis; RT-qPCR).The results indicated that all three markers had increased protein and mRNA expression with poorer differentiation and correlated well with each other, as well as with grading, staging, and poor survival. Compared with Ki-67 and TOP2A, RacGAP1 allowed for a clearer prognostic statement. The cut-off limits obtained for Ki-67-Average (IHC) were TC-AC 1.5, AC-SCLC 19, and AC-LCNEC 23.5. The Hotspot evaluation generated equal to higher, the digital image analysis generally lower between-entity cut-off limits.All three markers enabled a clear-cut differentiation between the BP-NEN entities, and all methods evaluated were suitable for marker assessment. However, to define optimal cut-off limits, the Ki-67 evaluation methods should be standardized. RacGAP1 appeared to be a new marker with great potential.

Making the Case for the Outlier: Researcher Reflections of an African-American Female Deputy Superintendent Who Decided to Close the Achievement Gap

ERIC Educational Resources Information Center

Beard, Karen Stansberry

2012-01-01

This article presents researcher reflections of a case study of a Black female deputy superintendent who made the value-driven decision to close the achievement gap in her district. I posit that she is an outlier because she is Black and female in a predominantly white male field of practice, she effectively closed the achievement gap through her…

Finance organizations, decisions and emotions.

PubMed

Pixley, Jocelyn

2002-03-01

Analyses of global financial markets are dominated by atomized models of decision-making and behavioural psychology ('exuberance' or 'panic'). In contrast, this paper argues that overwhelmingly, finance organizations rather than 'individuals' make decisions, and routinely use emotions in formulating expectations. Keynes introduced emotion (business confidence and animal spirits) but in economics, emotion remains individualistic and irrational. Luhmann's system theory lies at the other extreme, where emotions like trust and confidence are central variables, functional in the reduction of complexity in sub-systems like the economy. The gap between irrational emotions aggregated to 'herd' behaviour in economics, and 'system trust' applied to finance and money as a 'medium of communication' in sociology, remains largely unfilled. This paper argues that while organizations cannot be said to 'think' or 'feel', they are rational and emotional, because impersonal trust, confidence and their contrary emotions are unavoidable in decision-making due to fundamental uncertainty. These future-oriented emotions are prevalent within and between organizations in the financial sector, primarily in generating expectations. The dynamic of corporate activities of tense and ruthless struggle is a more plausible level of analysis than either financial 'manias' in aggregate or 'system trust'.

The Value of Information in Decision-Analytic Modeling for Malaria Vector Control in East Africa.

PubMed

Kim, Dohyeong; Brown, Zachary; Anderson, Richard; Mutero, Clifford; Miranda, Marie Lynn; Wiener, Jonathan; Kramer, Randall

2017-02-01

Decision analysis tools and mathematical modeling are increasingly emphasized in malaria control programs worldwide to improve resource allocation and address ongoing challenges with sustainability. However, such tools require substantial scientific evidence, which is costly to acquire. The value of information (VOI) has been proposed as a metric for gauging the value of reduced model uncertainty. We apply this concept to an evidenced-based Malaria Decision Analysis Support Tool (MDAST) designed for application in East Africa. In developing MDAST, substantial gaps in the scientific evidence base were identified regarding insecticide resistance in malaria vector control and the effectiveness of alternative mosquito control approaches, including larviciding. We identify four entomological parameters in the model (two for insecticide resistance and two for larviciding) that involve high levels of uncertainty and to which outputs in MDAST are sensitive. We estimate and compare a VOI for combinations of these parameters in evaluating three policy alternatives relative to a status quo policy. We find having perfect information on the uncertain parameters could improve program net benefits by up to 5-21%, with the highest VOI associated with jointly eliminating uncertainty about reproductive speed of malaria-transmitting mosquitoes and initial efficacy of larviciding at reducing the emergence of new adult mosquitoes. Future research on parameter uncertainty in decision analysis of malaria control policy should investigate the VOI with respect to other aspects of malaria transmission (such as antimalarial resistance), the costs of reducing uncertainty in these parameters, and the extent to which imperfect information about these parameters can improve payoffs. © 2016 Society for Risk Analysis.

WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries.

PubMed

Keynejad, Roxanne C; Dua, Tarun; Barbui, Corrado; Thornicroft, Graham

2018-02-01

Despite mental, neurological and substance use (MNS) disorders being highly prevalent, there is a worldwide gap between service need and provision. WHO launched its Mental Health Gap Action Programme (mhGAP) in 2008, and the Intervention Guide (mhGAP-IG) in 2010. mhGAP-IG provides evidence-based guidance and tools for assessment and integrated management of priority MNS disorders in low and middle-income countries (LMICs), using clinical decision-making protocols. It targets a non-specialised primary healthcare audience, but has also been used by ministries, non-governmental organisations and academics, for mental health service scale-up in 90 countries. This review aimed to identify evidence to date for mhGAP-IG implementation in LMICs. We searched MEDLINE, Embase, PsycINFO, Web of Knowledge/Web of Science, Scopus, CINAHL, LILACS, SciELO/Web of Science, Cochrane, Pubmed databases and Google Scholar for studies reporting evidence, experience or evaluation of mhGAP-IG in LMICs, in any language. Data were extracted from included papers, but heterogeneity prevented meta-analysis. We conducted a systematic review of evidence to date, of mhGAP-IG implementation and evaluation in LMICs. Thirty-three included studies reported 15 training courses, 9 clinical implementations, 3 country contextualisations, 3 economic models, 2 uses as control interventions and 1 use to develop a rating scale. Our review identified the importance of detailed reports of contextual challenges in the field, alongside detailed protocols, qualitative studies and randomised controlled trials. The mhGAP-IG literature is substantial, relative to other published evaluations of clinical practice guidelines: an important contribution to a neglected field. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

New Directions in Health Risk Assessment: A REACH for the Future?

EPA Science Inventory

Health risk assessments have been used to support many decisions in the US to reduce risks from pollutant exposures. These decisions have been highly successful in protecting public health despite uncertainty due to gaps in knowledge and methodological limitations. In recent yea...

Decision Support for Renewal of Wastewater Collection and Water Distribution Systems

EPA Science Inventory

The objective of this study was to identify the current decision support methodologies, models and approaches being used for determining how to rehabilitate or replace underground utilities; identify the critical gaps of these current models through comparison with case history d...

A Pilot Study of Pedestrians with Visual Impairments Detecting Traffic Gaps and Surges Containing Hybrid Vehicles

PubMed Central

Emerson, Robert Wall; Naghshineh, Koorosh; Hapeman, Julie; Wiener, William

2010-01-01

The increasing number of hybrid and quiet internal combustion engine vehicles may impact the travel abilities of pedestrians who are blind. Pedestrians who rely on auditory cues for structuring their travel may face challenges in making crossing decisions in the presence of quiet vehicles. This article describes results of initial studies looking at the crossing decisions of pedestrians who are blind at an uncontrolled crossing (no traffic control) and a light controlled intersection. The presence of hybrid vehicles was a factor in each situation. At the uncontrolled crossing, Toyota hybrids were most difficult to detect but crossing decisions were made more often in small gaps ended by a Honda hybrid. These effects were seen only at speed under 20 mph. At the light controlled intersection, parallel surges of traffic were most difficult to detect when made up only of a Ford Escape hybrid. Results suggest that more controlled studies of vehicle characteristics impacting crossing decisions of pedestrians who are blind are warranted. PMID:21379367

A Pilot Study of Pedestrians with Visual Impairments Detecting Traffic Gaps and Surges Containing Hybrid Vehicles.

PubMed

Emerson, Robert Wall; Naghshineh, Koorosh; Hapeman, Julie; Wiener, William

2011-03-01

The increasing number of hybrid and quiet internal combustion engine vehicles may impact the travel abilities of pedestrians who are blind. Pedestrians who rely on auditory cues for structuring their travel may face challenges in making crossing decisions in the presence of quiet vehicles. This article describes results of initial studies looking at the crossing decisions of pedestrians who are blind at an uncontrolled crossing (no traffic control) and a light controlled intersection. The presence of hybrid vehicles was a factor in each situation. At the uncontrolled crossing, Toyota hybrids were most difficult to detect but crossing decisions were made more often in small gaps ended by a Honda hybrid. These effects were seen only at speed under 20 mph. At the light controlled intersection, parallel surges of traffic were most difficult to detect when made up only of a Ford Escape hybrid. Results suggest that more controlled studies of vehicle characteristics impacting crossing decisions of pedestrians who are blind are warranted.

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

PubMed

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

2016-07-01

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

Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial.

PubMed

Brownson, Ross C; Allen, Peg; Jacob, Rebekah R; deRuyter, Anna; Lakshman, Meenakshi; Reis, Rodrigo S; Yan, Yan

2017-11-30

Although practitioners in state health departments are ideally positioned to implement evidence-based interventions, few studies have examined how to build their capacity to do so. The objective of this study was to explore how to increase the use of evidence-based decision-making processes at both the individual and organization levels. We conducted a 2-arm, group-randomized trial with baseline data collection and follow-up at 18 to 24 months. Twelve state health departments were paired and randomly assigned to intervention or control condition. In the 6 intervention states, a multiday training on evidence-based decision making was conducted from March 2014 through March 2015 along with a set of supplemental capacity-building activities. Individual-level outcomes were evidence-based decision making skills of public health practitioners; organization-level outcomes were access to research evidence and participatory decision making. Mixed analysis of covariance models was used to evaluate the intervention effect by accounting for the cluster randomized trial design. Analysis was performed from March through May 2017. Participation 18 to 24 months after initial training was 73.5%. In mixed models adjusted for participant and state characteristics, the intervention group improved significantly in the overall skill gap (P = .01) and in 6 skill areas. Among the 4 organizational variables, only access to evidence and skilled staff showed an intervention effect (P = .04). Tailored and active strategies are needed to build capacity at the individual and organization levels for evidence-based decision making. Our study suggests several dissemination interventions for consideration by leaders seeking to improve public health practice.

The challenge of predicting problematic chemicals using a decision analysis tool: Triclosan as a case study.

PubMed

Perez, Angela L; Gauthier, Alison M; Ferracini, Tyler; Cowan, Dallas M; Kingsbury, Tony; Panko, Julie

2017-01-01

Manufacturers lack a reliable means for determining whether a chemical will be targeted for deselection from their supply chain. In this analysis, 3 methods for determining whether a specific chemical (triclosan) would meet the criteria necessary for being targeted for deselection are presented. The methods included a list-based approach, use of a commercially available chemical assessment software tool run in 2 modes, and a public interest evaluation. Our results indicated that triclosan was included on only 6 of the lists reviewed, none of which were particularly influential in chemical selection decisions. The results from the chemical assessment tool evaluations indicated that human and ecological toxicity for triclosan is low and received scores indicating that the chemical would be considered of low concern. However, triclosan's peak public interest tracked several years in advance of increased regulatory scrutiny of this chemical suggesting that public pressure may have been influential in deselection decisions. Key data gaps and toxicity endpoints not yet regulated such as endocrine disruption potential or phototoxicity, but that are important to estimate the trajectory for deselection of a chemical, are discussed. Integr Environ Assess Manag 2017;13:198-207. © 2016 SETAC. © 2016 SETAC.

Using Combined Marine Spatial Planning Tools and Observing System Experiments to define Gaps in the Emerging European Ocean Observing System.

NASA Astrophysics Data System (ADS)

Nolan, G.; Pinardi, N.; Vukicevic, T.; Le Traon, P. Y.; Fernandez, V.

2016-02-01

Ocean observations are critical to providing accurate ocean forecasts that support operational decision making in European open and coastal seas. Observations are available in many forms from Fixed platforms e.g. Moored Buoys and tide gauges, underway measurements from Ferrybox systems, High Frequency radars and more recently from underwater Gliders and profiling floats. Observing System Simulation Experiments have been conducted to examine the relative contribution of each type of platform to an improvement in our ability to accurately forecast the future state of the ocean with HF radar and Gliders showing particular promise in improving model skill. There is considerable demand for ecosystem products and services from today's ocean observing system and biogeochemical observations are still relatively sparse particularly in coastal and shelf seas. There is a need to widen the techniques used to assess the fitness for purpose and gaps in the ocean observing system. As well as Observing System Simulation Experiments that quantify the effect of observations on the overall model skill we present a gap analysis based on (1) Examining where high model skill is required based on a marine spatial planning analysis of European seas i.e where does activity take place that requires more accurate forecasts? and (2) assessing gaps based on the capacity of the observing system to answer key societal challenges e.g. site suitability for aquaculture and ocean energy, oil spill response and contextual oceanographic products for fisheries and ecosystems. The broad based analysis will inform the development of the proposed European Ocean Observing System as a contribution to the Global Ocean Observing System (GOOS).

Making Invasion models useful for decision makers; incorporating uncertainty, knowledge gaps, and decision-making preferences

Treesearch

Denys Yemshanov; Frank H Koch; Mark Ducey

2015-01-01

Uncertainty is inherent in model-based forecasts of ecological invasions. In this chapter, we explore how the perceptions of that uncertainty can be incorporated into the pest risk assessment process. Uncertainty changes a decision maker’s perceptions of risk; therefore, the direct incorporation of uncertainty may provide a more appropriate depiction of risk. Our...

Aging and consumer decision making

PubMed Central

Carpenter, Stephanie M.; Yoon, Carolyn

2013-01-01

Research on consumer decision making and aging is especially important for fostering a better understanding of ways to maintain consumer satisfaction and high decision quality across the life span. We provide a review of extant research on the effects of normal aging on cognition and decision processes and how these age-related processes are influenced by task environment, meaningfulness of the task, and consumer expertise. We consider how research centered on these topics generates insights about changes in consumption decisions that occur with aging and identify a number of gaps and directions for future research. PMID:22360794

Informed decision-making in elective major vascular surgery: analysis of 145 surgeon-patient consultations.

PubMed

Etchells, Edward; Ferrari, Michel; Kiss, Alex; Martyn, Nikki; Zinman, Deborah; Levinson, Wendy

2011-06-01

Prior studies show significant gaps in the informed decision-making process, a central goal of surgical care. These studies have been limited by their focus on low-risk decisions, single visits rather than entire consultations, or both. Our objectives were, first, to rate informed decision-making for major elective vascular surgery based on audiotapes of actual physician-patient conversations and, second, to compare ratings of informed decision-making for first visits to ratings for multiple visits by the same patient over time. We prospectively enrolled patients for whom vascular surgical treatment was a potential option at a tertiary care outpatient vascular surgery clinic. We audio-taped all surgeon-patient conversations, including multiple visits when necessary, until a decision was made. Using an existing method, we evaluated the transcripts for elements of decision-making, including basic elements (e.g., an explanation of the clinical condition), intermediate elements (e.g., risks and benefits) and complex elements (e.g., uncertainty around the decision). We analyzed 145 surgeon-patient consultations. Overall, 45% of consultations contained complex elements, whereas 23% did not contain the basic elements of decision-making. For the 67 consultations that involved multiple visits, ratings were significantly higher when evaluating all visits (50% complex elements) compared with evaluating only the first visit (33% complex elements, p < 0.001.) We found that 45% of consultations contained complex elements, which is higher than prior studies with similar methods. Analyzing decision-making over multiple visits yielded different results than analyzing decision-making for single visits.

Food Security as a Constraint on National Policy Decision Making in the Arab Region: A Case Study on Food Security in Sudan

DTIC Science & Technology

2009-04-17

12 Food Shortage alld The Killg of Egypt Visioll ----------------------------------------------------------- 13 Arab Security Gap ...intervention widened the gap in the value of food commodities in the Arab countries among investors and farmers. 5. Reduction in food production due to drought...seeds and also conduct pre-harvest crop assessments to identify agricultural and livestock gaps among the Sudanese2o. On the other hand, the UN

Judgment and decision making.

PubMed

Fischhoff, Baruch

2010-09-01

The study of judgment and decision making entails three interrelated forms of research: (1) normative analysis, identifying the best courses of action, given decision makers' values; (2) descriptive studies, examining actual behavior in terms comparable to the normative analyses; and (3) prescriptive interventions, helping individuals to make better choices, bridging the gap between the normative ideal and the descriptive reality. The research is grounded in analytical foundations shared by economics, psychology, philosophy, and management science. Those foundations provide a framework for accommodating affective and social factors that shape and complement the cognitive processes of decision making. The decision sciences have grown through applications requiring collaboration with subject matter experts, familiar with the substance of the choices and the opportunities for interventions. Over the past half century, the field has shifted its emphasis from predicting choices, which can be successful without theoretical insight, to understanding the processes shaping them. Those processes are often revealed through biases that suggest non-normative processes. The practical importance of these biases depends on the sensitivity of specific decisions and the support that individuals have in making them. As a result, the field offers no simple summary of individuals' competence as decision makers, but a suite of theories and methods suited to capturing these sensitivities. Copyright © 2010 John Wiley & Sons, Ltd. For further resources related to this article, please visit the WIREs website. Copyright © 2010 John Wiley & Sons, Ltd.

30 CFR 585.705 - When must I use a Certified Verification Agent (CVA)?

Code of Federal Regulations, 2014 CFR

2014-07-01

... with your SAP under § 585.610(a)(9), COP under § 585.626(b)(20), or GAP under § 585.645(c)(5). (1) BOEM... decision on your SAP, COP, or GAP. (2) If BOEM does not waive the requirement for a CVA, you may file an...

30 CFR 585.705 - When must I use a Certified Verification Agent (CVA)?

Code of Federal Regulations, 2013 CFR

2013-07-01

... with your SAP under § 585.610(a)(9), COP under § 585.626(b)(20), or GAP under § 585.645(c)(5). (1) BOEM... decision on your SAP, COP, or GAP. (2) If BOEM does not waive the requirement for a CVA, you may file an...

Aiming at Narrowing Social Gaps in Israel through a Special Program of Everyman's University.

ERIC Educational Resources Information Center

Guri, Sarah

The philosophy and implementation of the Community Leaders Project at Everyman's University (EU), the Open University of Israel, are discussed. The project is designed to narrow social gaps in Israel by upgrading the educational level of disadvantaged populations and by developing indigeneous leadership for decision-making in the most…

Minding the Gap: Investing in a Skilled Manufacturing Workforce

ERIC Educational Resources Information Center

Richard, Alan

2015-01-01

Advanced manufacturing is growing and thriving in the United States. Companies are in great need of reliable employees who can communicate well, effectively make decisions, and are interested in long-term careers with opportunity for advancement. Employers have identified a need for a more robust talent pipeline to narrow America's skills gap--a…

Symmetry in cold-to-hot and hot-to-cold valuation gaps.

PubMed

Fisher, Geoffrey; Rangel, Antonio

2014-01-01

Individuals commonly mispredict their future preferences when they make decisions in a visceral state different from their anticipated state at consumption. In the research reported here, we asked subjects to bid on different foods while exogenously varying their hunger levels at the time of decision and at the time of consumption. This procedure allowed us to test whether cold-to-hot and hot-to-cold gaps are symmetric in size and driven by similar mechanisms. We found that the effect size was symmetric: Hungry subjects overbid 20¢ for a snack they would eat later when they were satiated, and satiated subjects underbid 19¢ for a snack they would eat later when they were hungry. Furthermore, we found evidence that these gaps were driven by symmetric mechanisms that operate on the evaluation of visceral features of food, such as taste, as opposed to more cognitive features, such as healthiness.

An approach to and web-based tool for infectious disease outbreak intervention analysis

NASA Astrophysics Data System (ADS)

Daughton, Ashlynn R.; Generous, Nicholas; Priedhorsky, Reid; Deshpande, Alina

2017-04-01

Infectious diseases are a leading cause of death globally. Decisions surrounding how to control an infectious disease outbreak currently rely on a subjective process involving surveillance and expert opinion. However, there are many situations where neither may be available. Modeling can fill gaps in the decision making process by using available data to provide quantitative estimates of outbreak trajectories. Effective reduction of the spread of infectious diseases can be achieved through collaboration between the modeling community and public health policy community. However, such collaboration is rare, resulting in a lack of models that meet the needs of the public health community. Here we show a Susceptible-Infectious-Recovered (SIR) model modified to include control measures that allows parameter ranges, rather than parameter point estimates, and includes a web user interface for broad adoption. We apply the model to three diseases, measles, norovirus and influenza, to show the feasibility of its use and describe a research agenda to further promote interactions between decision makers and the modeling community.

Collaboration and co-production of climate knowledge: lessons from a network on the front-line

NASA Astrophysics Data System (ADS)

Kettle, N.

2016-12-01

The science-practice gap is broadly considered a major barrier to the production and application of decision-relevant science. This study uses a social network analysis, based on 126 interviews, to analyze the roles and network ties among climate scientists, service providers, and decision makers in Alaska. Our research highlights the importance of key actors and significant differences in bonding and bridging ties across roles - structural characteristics that provide a basis for informing recommendations to build adaptive capacity and support the co-production of knowledge. Our findings also illustrate that some individuals in the network engage in multiple roles, suggesting that conceptualizing the science-practice interface as consisting of "producers" and "consumers" oversimplifies how individuals engage in climate science, services, and decision making. This research supports the notion that the development and use of climate information is a networked phenomenon. It also emphasizes the importance of centralized individuals who are capable of engaging in multiple roles for the transition of knowledge action.

Using health technology assessment to identify gaps in evidence and inform study design for comparative effectiveness research.

PubMed

Tunis, Sean R; Turkelson, Charles

2012-12-01

Health technology assessment (HTA) is primarily used as a tool to ensure that clinical and policy decisions are made with the benefit of a systematic analysis of all completed research. This article describes the progress and potential for HTA reports to improve the quality and relevance of future research and to better serve the information needs of patients, clinicians, payers, and other decision makers. We conducted a review of the current published literature and working papers describing past, ongoing, and future initiatives that rely on HTA reports to identify gaps in evidence and improve the design of future research. Although still in a developmental stage, significant progress is under way to improve methods for using HTA reports for the systematic identification of research gaps, prioritization of future research, and improvement of study designs. Several well-defined frameworks have been developed to assist those who produce HTA to become more effective in these additional domains of work. A recurring element of this work is the importance of meaningfully involving stakeholders in the process of defining future research needs and designing studies to address them. Patients, clinicians, and payers are important audiences for completed research and are now recognized as serving an important role in determining what future research is needed. There are substantial opportunities to improve the quality, relevance, and efficiency of clinical research. Recent efforts are beginning to demonstrate the potential to build on the work invested in developing HTA reports to provide a roadmap toward these objectives.

Assessment of Gaps in Care and the Development of a Care Pathway for Anemia in Patients with Inflammatory Bowel Diseases.

PubMed

Hou, Jason K; Gasche, Christoph; Drazin, Noam Z; Weaver, Sarah Alandra; Ehrlich, Orna G; Oberai, Ridhima; Zapala, Sophie; Siegel, Corey A; Melmed, Gil

2017-01-01

Anemia is a common complication among patients with inflammatory bowel diseases (IBD) and is associated with high rates of IBD-related complications, resource utilization, and impaired quality of life. Despite practice guidelines for anemia in patients with IBD, gaps remain in the perceptions of anemia among health care providers. The aims of this study were to identify gaps in care and to develop a care pathway for anemia in patients with IBD. The Crohn's & Colitis Foundation of America anemia care pathway was developed by a committee using principles of cognitive task analysis. Focus groups of providers of patients with IBD were performed to identify domains of perceptions and management decisions for anemia and IBD. Knowledge elicitation from subject experts in anemia was conducted using case-based scenarios of patients with IBD and anemia to determine decision-making branch points. The care pathway was modified in an iterative fashion to encompass clinical presentations of anemia in IBD and potential barriers to the recognition, management, and follow-up of anemia. Variations were observed in how providers define iron deficiency, thresholds for treatment of anemia, and route of iron therapy. A care pathway for anemia incorporating the World Health Organization definition of anemia, universal hemoglobin and ferritin screening, evaluation of iron stores using ferritin and transferrin saturation, management of anemia based on adequacy of iron stores, and follow-up was developed. The authors identified domains of how providers perceive and manage patients with IBD and anemia, and developed a care pathway to align clinical practices with guideline recommendations.

Bayesian approaches for Integrated Water Resources Management. A Mediterranean case study.

NASA Astrophysics Data System (ADS)

Gulliver, Zacarías; Herrero, Javier; José Polo, María

2013-04-01

This study presents the first steps of a short-term/mid-term analysis of the water resources in the Guadalfeo Basin, Spain. Within the basin the recent construction of the Rules dam has required the development of specific management tools and structures for this water system. The climate variability and the high water demand requirements for agriculture irrigation and tourism in this region may cause different controversies in the water management planning process. During the first stages of the study a rigorous analysis of the Water Framework Directive results was done in order to implement the legal requirements and the solutions for the gaps identified by the water authorities. In addition, the stakeholders and water experts identified the variables and geophysical processes for our specific water system case. These particularities need to be taken into account and are required to be reflected in the final computational tool. For decision making process purposes in a mid-term scale, a bayesian network has been used to quantify uncertainty which also provides a structure representation of probabilities, actions-decisions and utilities. On one hand by applying these techniques it is possible the inclusion of decision rules generating influence diagrams that provides clear and coherent semantics for the value of making an observation. On the other hand the utility nodes encode the stakeholders preferences which are measured on a numerical scale, choosing the action that maximizes the expected utility [MEU]. Also this graphical model allows us to identify gaps and project corrective measures, for example, formulating associated scenarios with different event hypotheses. In this sense conditional probability distributions of the seasonal water demand and waste water has been obtained between the established intervals. This fact will give to the regional water managers useful information for future decision making process. The final display is very visual and allows the user to understand quickly the model and the causal relationships between the existing nodes and variables. The input data were collected from the local monitoring networks and the unmonitored data has been generated with a physically based spatially distributed hydrological model WiMMed, which is validated and calibrated. For short-term purposes, pattern analysis has been applied for the management of extreme events scenarios, techniques as Bayesian Neural Networks (BNN) or Gaussian Processes (GP) giving accuracy on the predictions.

Influence of an Intermediate Option on the Description-Experience Gap and Information Search

PubMed Central

Sharma, Neha; Debnath, Shoubhik; Dutt, Varun

2018-01-01

Research shows that people tend to overweight small probabilities in description and underweight them in experience, thereby leading to a different pattern of choices between description and experience; a phenomenon known as the Description-Experience (DE) gap. However, little is known on how the addition of an intermediate option and contextual framing influences the DE gap and people’s search strategies. This paper tests the effects of an intermediate option and contextual framing on the DE gap and people’s search strategies, where problems require search for information before a consequential choice. In the first experiment, 120 participants made choice decisions across investment problems that differed in the absence or presence of an intermediate option. Results showed that adding an intermediate option did not reduce the DE gap on the maximizing option across a majority of problems. There were a large majority of choices for the intermediate option. Furthermore, there was an increase in switching between options due to the presence of the intermediate option. In the second experiment, 160 participants made choice decisions in problems like those presented in experiment 1; however, problems lacked the investment framing. Results replicated findings from the first experiment and showed a similar DE gap on the maximizing option in a majority of problems in both the absence and presence of the intermediate option. Again, there were a large majority of choices for the intermediate option. Also, there was an increase in switching between options due to the presence of the intermediate option. Meta-analyses revealed that the absence or presence of the intermediate option created certain differences in the strength of frequency and recency processes. Also, a single natural-mean heuristic model was able to account for the experimental results across both experiments. We discuss implications of our findings to consequential decisions made after information search. PMID:29643821

Influence of an Intermediate Option on the Description-Experience Gap and Information Search.

PubMed

Sharma, Neha; Debnath, Shoubhik; Dutt, Varun

2018-01-01

Research shows that people tend to overweight small probabilities in description and underweight them in experience, thereby leading to a different pattern of choices between description and experience; a phenomenon known as the Description-Experience (DE) gap. However, little is known on how the addition of an intermediate option and contextual framing influences the DE gap and people's search strategies. This paper tests the effects of an intermediate option and contextual framing on the DE gap and people's search strategies, where problems require search for information before a consequential choice. In the first experiment, 120 participants made choice decisions across investment problems that differed in the absence or presence of an intermediate option. Results showed that adding an intermediate option did not reduce the DE gap on the maximizing option across a majority of problems. There were a large majority of choices for the intermediate option. Furthermore, there was an increase in switching between options due to the presence of the intermediate option. In the second experiment, 160 participants made choice decisions in problems like those presented in experiment 1; however, problems lacked the investment framing. Results replicated findings from the first experiment and showed a similar DE gap on the maximizing option in a majority of problems in both the absence and presence of the intermediate option. Again, there were a large majority of choices for the intermediate option. Also, there was an increase in switching between options due to the presence of the intermediate option. Meta-analyses revealed that the absence or presence of the intermediate option created certain differences in the strength of frequency and recency processes. Also, a single natural-mean heuristic model was able to account for the experimental results across both experiments. We discuss implications of our findings to consequential decisions made after information search.

Funding gap for immunization across 94 low- and middle-income countries.

PubMed

Ozawa, Sachiko; Grewal, Simrun; Portnoy, Allison; Sinha, Anushua; Arilotta, Richard; Stack, Meghan L; Brenzel, Logan

2016-12-07

Novel vaccine development and production has given rise to a growing number of vaccines that can prevent disease and save lives. In order to realize these health benefits, it is essential to ensure adequate immunization financing to enable equitable access to vaccines for people in all communities. This analysis estimates the full immunization program costs, projected available financing, and resulting funding gap for 94 low- and middle-income countries over five years (2016-2020). Vaccine program financing by country governments, Gavi, and other development partners was forecasted for vaccine, supply chain, and service delivery, based on an analysis of comprehensive multi-year plans together with a series of scenario and sensitivity analyses. Findings indicate that delivery of full vaccination programs across 94 countries would result in a total funding gap of $7.6 billion (95% uncertainty range: $4.6-$11.8 billion) over 2016-2020, with the bulk (98%) of the resources required for routine immunization programs. More than half (65%) of the resources to meet this funding gap are required for service delivery at $5.0 billion ($2.7-$8.4 billion) with an additional $1.1 billion ($0.9-$2.7 billion) needed for vaccines and $1.5 billion ($1.1-$2.0 billion) for supply chain. When viewed as a percentage of total projected costs, the funding gap represents 66% of projected supply chain costs, 30% of service delivery costs, and 9% of vaccine costs. On average, this funding gap corresponds to 0.2% of general government expenditures and 2.3% of government health expenditures. These results suggest greater need for country and donor resource mobilization and funding allocation for immunizations. Both service delivery and supply chain are important areas for further resource mobilization. Further research on the impact of advances in service delivery technology and reductions in vaccine prices beyond this decade would be important for efficient investment decisions for immunization. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Development of a high-resolution binational vegetation map of the Santa Cruz River riparian corridor and surrounding watershed, southern Arizona and northern Sonora, Mexico

USGS Publications Warehouse

Wallace, Cynthia S.A.; Villarreal, Miguel L.; Norman, Laura M.

2011-01-01

This report summarizes the development of a binational vegetation map developed for the Santa Cruz Watershed, which straddles the southern border of Arizona and the northern border of Sonora, Mexico. The map was created as an environmental input to the Santa Cruz Watershed Ecosystem Portfolio Model (SCWEPM) that is being created by the U.S. Geological Survey for the watershed. The SCWEPM is a map-based multicriteria evaluation tool that allows stakeholders to explore tradeoffs between valued ecosystem services at multiple scales within a participatory decision-making process. Maps related to vegetation type and are needed for use in modeling wildlife habitat and other ecosystem services. Although detailed vegetation maps existed for the U.S. side of the border, there was a lack of consistent data for the Santa Cruz Watershed in Mexico. We produced a binational vegetation classification of the Santa Cruz River riparian habitat and watershed vegetation based on NatureServe Terrestrial Ecological Systems (TES) units using Classification And Regression Tree (CART) modeling. Environmental layers used as predictor data were derived from a seasonal set of Landsat Thematic Mapper (TM) images (spring, summer, and fall) and from a 30-meter digital-elevation-model (DEM) grid. Because both sources of environmental data are seamless across the international border, they are particularly suited to this binational modeling effort. Training data were compiled from existing field data for the riparian corridor and data collected by the NM-GAP (New Mexico Gap Analysis Project) team for the original Southwest Regional Gap Analysis Project (SWReGAP) modeling effort. Additional training data were collected from core areas of the SWReGAP classification itself, allowing the extrapolation of the SWReGAP mapping into the Mexican portion of the watershed without collecting additional training data.

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

ERIC Educational Resources Information Center

Fosmire, Michael

2017-01-01

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

Prioritizing Health: A Systematic Approach to Scoping Determinants in Health Impact Assessment.

PubMed

McCallum, Lindsay C; Ollson, Christopher A; Stefanovic, Ingrid L

2016-01-01

The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of health impact assessment (HIA), the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical) for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted, including both primary and gray literature. A total of 10 HIA scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors, such as impact, public concern, and data availability, to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

WILDLIFE HEALTH 2.0: BRIDGING THE KNOWLEDGE-TO-ACTION GAP.

PubMed

Stephen, Craig

2017-01-01

The unprecedented threats to the health and sustainability of wildlife populations are inspiring conversations on the need to change the way knowledge is generated, valued, and used to promote action to protect wildlife health. Wildlife Health 2.0 symbolizes the need to investigate how to improve connections between research expertise and policy or practices to protect wildlife health. Two imperatives drive this evolution: 1) growing frustrations that research is inadequately being used to inform management decisions and 2) the realization that scientific certainty is context specific for complex socioecologic issues, such as wildlife health. Failure to appreciate the unpredictability of complex systems or to incorporate ethical and cultural dimensions of decisions has limited the contribution of research to decision making. Wildlife health can draw from scholarship in other fields, such as public health and conservation, to bridge the knowledge-to-action gap. Efforts to integrate science into decisions are more likely to be effective when they enhance relevance, credibility, and legitimacy of information for people who will make or be affected by management decisions. A Wildlife Health 2.0 agenda is not a rejection of the current research paradigm but rather a call to expand our areas of inquiry to ensure that the additional contextual understanding is generated to help decision makers make good choices.

The Development of a Humanitarian Health Ethics Analysis Tool.

PubMed

Fraser, Veronique; Hunt, Matthew R; de Laat, Sonya; Schwartz, Lisa

2015-08-01

Introduction Health care workers (HCWs) who participate in humanitarian aid work experience a range of ethical challenges in providing care and assistance to communities affected by war, disaster, or extreme poverty. Although there is increasing discussion of ethics in humanitarian health care practice and policy, there are very few resources available for humanitarian workers seeking ethical guidance in the field. To address this knowledge gap, a Humanitarian Health Ethics Analysis Tool (HHEAT) was developed and tested as an action-oriented resource to support humanitarian workers in ethical decision making. While ethical analysis tools increasingly have become prevalent in a variety of practice contexts over the past two decades, very few of these tools have undergone a process of empirical validation to assess their usefulness for practitioners. A qualitative study consisting of a series of six case-analysis sessions with 16 humanitarian HCWs was conducted to evaluate and refine the HHEAT. Participant feedback inspired the creation of a simplified and shortened version of the tool and prompted the development of an accompanying handbook. The study generated preliminary insight into the ethical deliberation processes of humanitarian health workers and highlighted different types of ethics support that humanitarian workers might find helpful in supporting the decision-making process.

Close the Gap: A Multiple Case Study about the Decision-Making Process of Administrators in Ohio Districts

ERIC Educational Resources Information Center

Guthrie, Tammy Reutzel

2017-01-01

Research has identified evidenced-based practices and programs that are successful for increasing the learning outcomes of students with disabilities which in turn helps narrow the achievement gap between the student subgroup and non-disabled peers. Employing the identified practices has produced inconsistent results and led to a closer…

Caring Decisions: The Development of a Written Resource for Parents Facing End-of-Life Decisions

PubMed Central

Gillam, Lynn; Hynson, Jenny; Sullivan, Jane; Cossich, Mary; Wilkinson, Dominic

2015-01-01

Abstract Background: Written resources in adult intensive care have been shown to benefit families facing end of life (EoL) decisions. There are few resources for parents making EoL decisions for their child and no existing resources addressing ethical issues. The Caring Decisions handbook and website were developed to fill these gaps. Aim: We discuss the development of the resources, modification after reviewer feedback and findings from initial pilot implementation. Design: A targeted literature review-to identify resources and factors that impact on parental EoL decision-making; development phase-guided by the literature and the researchers' expertise; consultation process-comprised a multi-disciplinary panel of experts and parents; pilot evaluation study-hard-copy handbook was distributed as part of routine care at an Australian Children's Hospital. Setting/Participants: Twelve experts and parents formed the consultation panel. Eight parents of children with life-limiting conditions and clinicians were interviewed in the pilot study. Results: Numerous factors supporting/impeding EoL decisions were identified. Caring Decisions addressed issues identified in the literature and by the multidisciplinary research team. The consultation panel provided overwhelmingly positive feedback. Pilot study parents found the resources helpful and comforting. Most clinicians viewed the resources as very beneficial to parents and identified them as ideal for training purposes. Conclusions: The development of the resources addressed many of the gaps in existing resources. The consultation process and the pilot study suggest these resources could be of significant benefit to parents and clinicians. PMID:26418215

Does a better model yield a better argument? An info-gap analysis

NASA Astrophysics Data System (ADS)

Ben-Haim, Yakov

2017-04-01

Theories, models and computations underlie reasoned argumentation in many areas. The possibility of error in these arguments, though of low probability, may be highly significant when the argument is used in predicting the probability of rare high-consequence events. This implies that the choice of a theory, model or computational method for predicting rare high-consequence events must account for the probability of error in these components. However, error may result from lack of knowledge or surprises of various sorts, and predicting the probability of error is highly uncertain. We show that the putatively best, most innovative and sophisticated argument may not actually have the lowest probability of error. Innovative arguments may entail greater uncertainty than more standard but less sophisticated methods, creating an innovation dilemma in formulating the argument. We employ info-gap decision theory to characterize and support the resolution of this problem and present several examples.

Importance x dissatisfaction = a formula for managerial action.

PubMed

Carson, Kerry D; Carson, Paula Phillips; Fontenot, Gwen; Toma, Alfred G

2005-01-01

Management should not only survey employees about their satisfaction with an issue but should also inquire about how important that issue is to them. If the issue is very important to employees and they are very dissatisfied, then management action may be urgent. However, if staff members are dissatisfied with an issue that is unimportant to them, then no management action may be required. Rank ordering the items by importance and then subtracting satisfaction from importance to get a performance-gap score is insufficient. The decision maker still may have to use intuition to determine which items have priority. Rather than gap analysis, it is better to multiply the importance score by the dissatisfaction score. This will yield a clear rank order of the issues to which the management must attend. The authors used the multiplicative method with a health care organization. These results are analyzed, and management actions are recommended.

On the relation between economic bubbles and effort gaps between sellers and buyers: An experimental study

PubMed Central

Kauffmann, Amitay; Ashby, Nathaniel J. S.; Zahavi, Gal

2017-01-01

Economic bubbles are an empirical puzzle because they do not readily fit the notion of an efficient market. We argue that bubbles are associated with a conflict and a gap in the allocation of effort during negotiation by sellers and buyers. We examined 21 experimental asset markets where in one condition players could buy and sell and in the other they could either buy or sell. The results indicated that when making concurrent buying and selling decisions the mean number of asks for sellers was 71% higher than the number of bids for buyers. Similar findings emerge in a re-analysis of data from Lei et al. (2001). Importantly, bubbles only emerged in markets where the number of asks was larger than that of bids. These findings indicate that bubbles are associated with increased negotiation effort when acting as a seller and diminished effort when acting as a buyer. PMID:29228034

Comparative evaluation of three proliferation markers, Ki-67, TOP2A, and RacGAP1, in bronchopulmonary neuroendocrine neoplasms: Issues and prospects

PubMed Central

Neubauer, Elisa; Wirtz, Ralph M.; Kaemmerer, Daniel; Athelogou, Maria; Schmidt, Lydia; Sänger, Jörg; Lupp, Amelie

2016-01-01

The classification of bronchopulmonary neuroendocrine neoplasms (BP-NEN) into four tumor entities (typical carcinoids (TC), atypical carcinoids (AC), small cell lung cancers (SCLC), large cell neuroendocrine lung carcinomas (LCNEC)) is difficult to perform accurately, but important for prognostic statements and therapeutic management decisions. In this regard, we compared the expression of three proliferation markers, Ki-67, Topoisomerase II alpha (TOP2A), and RacGAP1, in a series of tumor samples from 104 BP-NEN patients (24 TC, 21 AC, 52 SCLC, 7 LCNEC) using different evaluation methods (immunohistochemistry (IHC): Average evaluation, Hotspot evaluation, digital image analysis; RT-qPCR). The results indicated that all three markers had increased protein and mRNA expression with poorer differentiation and correlated well with each other, as well as with grading, staging, and poor survival. Compared with Ki-67 and TOP2A, RacGAP1 allowed for a clearer prognostic statement. The cut-off limits obtained for Ki-67-Average (IHC) were TC-AC 1.5, AC-SCLC 19, and AC-LCNEC 23.5. The Hotspot evaluation generated equal to higher, the digital image analysis generally lower between-entity cut-off limits. All three markers enabled a clear-cut differentiation between the BP-NEN entities, and all methods evaluated were suitable for marker assessment. However, to define optimal cut-off limits, the Ki-67 evaluation methods should be standardized. RacGAP1 appeared to be a new marker with great potential. PMID:27259241

Aiding alternatives assessment with an uncertainty-tolerant hazard scoring method.

PubMed

Faludi, Jeremy; Hoang, Tina; Gorman, Patrick; Mulvihill, Martin

2016-11-01

This research developed a single-score system to simplify and clarify decision-making in chemical alternatives assessment, accounting for uncertainty. Today, assessing alternatives to hazardous constituent chemicals is a difficult task-rather than comparing alternatives by a single definitive score, many independent toxicological variables must be considered at once, and data gaps are rampant. Thus, most hazard assessments are only comprehensible to toxicologists, but business leaders and politicians need simple scores to make decisions. In addition, they must balance hazard against other considerations, such as product functionality, and they must be aware of the high degrees of uncertainty in chemical hazard data. This research proposes a transparent, reproducible method to translate eighteen hazard endpoints into a simple numeric score with quantified uncertainty, alongside a similar product functionality score, to aid decisions between alternative products. The scoring method uses Clean Production Action's GreenScreen as a guide, but with a different method of score aggregation. It provides finer differentiation between scores than GreenScreen's four-point scale, and it displays uncertainty quantitatively in the final score. Displaying uncertainty also illustrates which alternatives are early in product development versus well-defined commercial products. This paper tested the proposed assessment method through a case study in the building industry, assessing alternatives to spray polyurethane foam insulation containing methylene diphenyl diisocyanate (MDI). The new hazard scoring method successfully identified trade-offs between different alternatives, showing finer resolution than GreenScreen Benchmarking. Sensitivity analysis showed that different weighting schemes in hazard scores had almost no effect on alternatives ranking, compared to uncertainty from data gaps. Copyright © 2016 Elsevier Ltd. All rights reserved.

Predictors of responses to organizational wrongdoing: a study of intentions of management accountants.

PubMed

Casal, Jose C; Bogui, Frederic B

2008-08-01

It has been proposed that employees aware of organizational wrongdoing face two decisions: whether or not to blow the whistle and whether or not to leave their organizations. Of these only the decision to blow the whistle has received attention, leaving a gap in knowledge; thus, a survey of 330 management accountants was analyzed to examine potential predictors of intended responses to organizational wrongdoing. Analysis of ratings indicated that intent to leave increased with seriousness of wrongdoing and expected retaliation for whistleblowing and decreased with expected effectiveness of whistleblowing. Intent to stay and blow the whistle increased with expected effectiveness of whistleblowing and role responsibility for reporting and decreased with expected retaliation for whistleblowing; intent to leave and blow the whistle increased with expected effectiveness of whistleblowing and role responsibility for reporting.

IT investments can add business value.

PubMed

Williams, Terry G

2002-05-01

Investment in information technology (IT) is costly, but necessary to enable healthcare organizations to improve their infrastructure and achieve other improvement initiatives. Such an investment is even more costly, however, if the technology does not appropriately enable organizations to perform business processes that help them accomplish their mission of providing safe, high-quality care cost-effectively. Before committing to a costly IT investment, healthcare organizations should implement a decision-making process that can help them choose, implement, and use technology that will provide sustained business value. A seven-step decision-making process that can help healthcare organizations achieve this result involves performing a gap analysis, assessing and aligning organizational goals, establishing distributed accountability, identifying linked organizational-change initiatives, determining measurement methods, establishing appropriate teams to ensure systems are integrated with multidisciplinary improvement methods, and developing a plan to accelerate adoption of the IT product.

Bridging the gap between uncertainty analysis for complex watershed models and decision-making for watershed-scale water management

NASA Astrophysics Data System (ADS)

Zheng, Y.; Han, F.; Wu, B.

2013-12-01

Process-based, spatially distributed and dynamic models provide desirable resolutions to watershed-scale water management. However, their reliability in solving real management problems has been seriously questioned, since the model simulation usually involves significant uncertainty with complicated origins. Uncertainty analysis (UA) for complex hydrological models has been a hot topic in the past decade, and a variety of UA approaches have been developed, but mostly in a theoretical setting. Whether and how a UA could benefit real management decisions remains to be critical questions. We have conducted a series of studies to investigate the applicability of classic approaches, such as GLUE and Markov Chain Monte Carlo (MCMC) methods, in real management settings, unravel the difficulties encountered by such methods, and tailor the methods to better serve the management. Frameworks and new algorithms, such as Probabilistic Collocation Method (PCM)-based approaches, were also proposed for specific management issues. This presentation summarize our past and ongoing studies on the role of UA in real water management. Challenges and potential strategies to bridge the gap between UA for complex models and decision-making for management will be discussed. Future directions for the research in this field will also be suggested. Two common water management settings were examined. One is the Total Maximum Daily Loads (TMDLs) management for surface water quality protection. The other is integrated water resources management for watershed sustainability. For the first setting, nutrients and pesticides TMDLs in the Newport Bay Watershed (Orange Country, California, USA) were discussed. It is a highly urbanized region with a semi-arid Mediterranean climate, typical of the western U.S. For the second setting, the water resources management in the Zhangye Basin (the midstream part of Heihe Baisn, China), where the famous 'Silk Road' came through, was investigated. The Zhangye Basin has a Gobi-oasis system typical of the western China, with extensive agriculture in its oasis.

[Effects of forest gap size on the growth and form quality of Taxus wallichina var. mairei in Cunninghamia lanceolata forests].

PubMed

Ou, Jian de; Wu, Zhi Zhuang; Luo, Ning

2016-10-01

In order to clarify the effects of forest gap size on the growth and stem form quality of Taxus wallichina var. mairei and effectiveness of the precious timbers cultivation, 25 sample plots in Cunninghamia lanceolata forest gaps were established in Mingxi County, Fujian Province, China to determine the indices of the growth, stem form and branching indices of T. wallichina var. mairei seedlings. The relationships between the gap size and growth, stem form and branching were investigated. The 25 sample plots were located at five microhabitats which were classified based on gap size as follows: Class1, 2, 3, 4 and 5, which had a gap size of 25-50 m 2 , 50-75 m 2 , 75-100 m 2 , 100-125 m 2 and 125-150 m 2 , respectively. The evaluation index system of precious timbers was built by using hierarchical analysis. The 5 classes of forest gaps were evaluated comprehensively by using the multiobjective decision making method. The results showed that gap size significantly affected 11 indices, i.e., height, DBH, crown width, forking rate, stem straightness, stem fullness, taperingness, diameter height ratio, height under living branch, interval between branches, and max-branch base diameter. Class1and 2 both significantly promoted the growth of height, DBH and crown width, and both significantly inhibited forking rate and taperingness, and improved stem straightness. Class2 significantly improved stem fullness and diameter height ratio. Class1and 2 significantly improved height under living branch and reduced max-branch base diameter. Class 1 significantly increased interval between branches. Class1and2 significantly improved the comprehensive evaluation score of precious timbers. This study suggested that controlled cutting intensity could be used to create forest gaps of 25-75 m 2 , which improved the precious timber cultivating process of T. wallichina var. mairei in C. lanceolata forests.

"Know What to Do If You Encounter a Flash Flood": Mental Models Analysis for Improving Flash Flood Risk Communication and Public Decision Making.

PubMed

Lazrus, Heather; Morss, Rebecca E; Demuth, Julie L; Lazo, Jeffrey K; Bostrom, Ann

2016-02-01

Understanding how people view flash flood risks can help improve risk communication, ultimately improving outcomes. This article analyzes data from 26 mental models interviews about flash floods with members of the public in Boulder, Colorado, to understand their perspectives on flash flood risks and mitigation. The analysis includes a comparison between public and professional perspectives by referencing a companion mental models study of Boulder-area professionals. A mental models approach can help to diagnose what people already know about flash flood risks and responses, as well as any critical gaps in their knowledge that might be addressed through improved risk communication. A few public interviewees mentioned most of the key concepts discussed by professionals as important for flash flood warning decision making. However, most interviewees exhibited some incomplete understandings and misconceptions about aspects of flash flood development and exposure, effects, or mitigation that may lead to ineffective warning decisions when a flash flood threatens. These include important misunderstandings about the rapid evolution of flash floods, the speed of water in flash floods, the locations and times that pose the greatest flash flood risk in Boulder, the value of situational awareness and environmental cues, and the most appropriate responses when a flash flood threatens. The findings point to recommendations for ways to improve risk communication, over the long term and when an event threatens, to help people quickly recognize and understand threats, obtain needed information, and make informed decisions in complex, rapidly evolving extreme weather events such as flash floods. © 2015 Society for Risk Analysis.

Multi-criteria decision-making for flood risk management: a survey of the current state of the art

NASA Astrophysics Data System (ADS)

Madruga de Brito, Mariana; Evers, Mariele

2016-04-01

This paper provides a review of multi-criteria decision-making (MCDM) applications to flood risk management, seeking to highlight trends and identify research gaps. A total of 128 peer-reviewed papers published from 1995 to June 2015 were systematically analysed. Results showed that the number of flood MCDM publications has exponentially grown during this period, with over 82 % of all papers published since 2009. A wide range of applications were identified, with most papers focusing on ranking alternatives for flood mitigation, followed by risk, hazard, and vulnerability assessment. The analytical hierarchy process (AHP) was the most popular method, followed by Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS), and Simple Additive Weighting (SAW). Although there is greater interest in MCDM, uncertainty analysis remains an issue and was seldom applied in flood-related studies. In addition, participation of multiple stakeholders has been generally fragmented, focusing on particular stages of the decision-making process, especially on the definition of criteria weights. Therefore, addressing the uncertainties around stakeholders' judgments and endorsing an active participation in all steps of the decision-making process should be explored in future applications. This could help to increase the quality of decisions and the implementation of chosen measures.

Development of a program theory for shared decision-making: a realist review protocol.

PubMed

Groot, Gary; Waldron, Tamara; Carr, Tracey; McMullen, Linda; Bandura, Lori-Ann; Neufeld, Shelley-May; Duncan, Vicky

2017-06-17

The practicality of applying evidence to healthcare systems with the aim of implementing change is an ongoing challenge for practitioners, policy makers, and academics. Shared decision- making (SDM), a method of medical decision-making that allows a balanced relationship between patients, physicians, and other key players in the medical decision process, is purported to improve patient and system outcomes. Despite the oft-mentioned benefits, there are gaps in the current literature between theory and implementation that would benefit from a realist approach given the value of this methodology to analyze complex interventions. In this protocol, we outline a study that will explore: "In which situations, how, why, and for whom does SDM between patients and health care providers contribute to improved decision making?" A seven step iterative process will be described including preliminary theory development, establishment of a search strategy, selection and appraisal of literature, data extraction, analysis and synthesis of extracted results from literature, and formation of a revised program theory with the input of patients, physicians, nurse navigators, and policy makers from a stakeholder session. The goal of the realist review will be to identify and refine a program theory for SDM through the identification of mechanisms which shape the characteristics of when, how, and why SDM will, and will not, work. PROSPERO CRD42017062609.

Demonstration of a modelling-based multi-criteria decision analysis procedure for prioritisation of occupational risks from manufactured nanomaterials.

PubMed

Hristozov, Danail; Zabeo, Alex; Alstrup Jensen, Keld; Gottardo, Stefania; Isigonis, Panagiotis; Maccalman, Laura; Critto, Andrea; Marcomini, Antonio

2016-11-01

Several tools to facilitate the risk assessment and management of manufactured nanomaterials (MN) have been developed. Most of them require input data on physicochemical properties, toxicity and scenario-specific exposure information. However, such data are yet not readily available, and tools that can handle data gaps in a structured way to ensure transparent risk analysis for industrial and regulatory decision making are needed. This paper proposes such a quantitative risk prioritisation tool, based on a multi-criteria decision analysis algorithm, which combines advanced exposure and dose-response modelling to calculate margins of exposure (MoE) for a number of MN in order to rank their occupational risks. We demonstrated the tool in a number of workplace exposure scenarios (ES) involving the production and handling of nanoscale titanium dioxide, zinc oxide (ZnO), silver and multi-walled carbon nanotubes. The results of this application demonstrated that bag/bin filling, manual un/loading and dumping of large amounts of dry powders led to high emissions, which resulted in high risk associated with these ES. The ZnO MN revealed considerable hazard potential in vivo, which significantly influenced the risk prioritisation results. In order to study how variations in the input data affect our results, we performed probabilistic Monte Carlo sensitivity/uncertainty analysis, which demonstrated that the performance of the proposed model is stable against changes in the exposure and hazard input variables.

Dysfunctions of decision-making and cognitive control as transdiagnostic mechanisms of mental disorders: advances, gaps, and needs in current research.

PubMed

Goschke, Thomas

2014-01-01

Disadvantageous decision-making and impaired volitional control over actions, thoughts, and emotions are characteristics of a wide range of mental disorders such as addiction, eating disorders, depression, and anxiety disorders and may reflect transdiagnostic core mechanisms and possibly vulnerability factors. Elucidating the underlying neurocognitive mechanisms is a precondition for moving from symptom-based to mechanism-based disorder classifications and ultimately mechanism-targeted interventions. However, despite substantial advances in basic research on decision-making and cognitive control, there are still profound gaps in our current understanding of dysfunctions of these processes in mental disorders. Central unresolved questions are: (i) to which degree such dysfunctions reflect transdiagnostic mechanisms or disorder-specific patterns of impairment; (ii) how phenotypical features of mental disorders relate to dysfunctional control parameter settings and aberrant interactions between large-scale brain systems involved in habit and reward-based learning, performance monitoring, emotion regulation, and cognitive control; (iii) whether cognitive control impairments are consequences or antecedent vulnerability factors of mental disorders; (iv) whether they reflect generalized competence impairments or context-specific performance failures; (v) whether not only impaired but also chronic over-control contributes to mental disorders. In the light of these gaps, needs for future research are: (i) an increased focus on basic cognitive-affective mechanisms underlying decision and control dysfunctions across disorders; (ii) longitudinal-prospective studies systematically incorporating theory-driven behavioural tasks and neuroimaging protocols to assess decision-making and control dysfunctions and aberrant interactions between underlying large-scale brain systems; (iii) use of latent-variable models of cognitive control rather than single tasks; (iv) increased focus on the interplay of implicit and explicit cognitive-affective processes; (v) stronger focus on computational models specifying neurocognitive mechanisms underlying phenotypical expressions of mental disorders. Copyright © 2013 John Wiley & Sons, Ltd.

Practicing What You Preach: Achieving Unity of Effort and Unified Action During Domestic Response Operations

DTIC Science & Technology

2007-05-10

planners will also benefit from experiencing the regimented military decision - making process and working with experienced operational planners. This...picture of the disaster area for the senior decision -makers, duplication of efforts, gaps in addressing requests for assistance, and the inefficient...Guard Atlantic Area. Interview by author, 25 March 2007. Mr. Doane stated that the JTF operated “in a vacuum” and “outside the inter-agency decision

Responding to Nonwords in the Lexical Decision Task: Insights from the English Lexicon Project

ERIC Educational Resources Information Center

Yap, Melvin J.; Sibley, Daragh E.; Balota, David A.; Ratcliff, Roger; Rueckl, Jay

2015-01-01

Researchers have extensively documented how various statistical properties of words (e.g., word frequency) influence lexical processing. However, the impact of lexical variables on nonword decision-making performance is less clear. This gap is surprising, because a better specification of the mechanisms driving nonword responses may provide…

An Exploration of Factors Influencing Effective Teachers' Decisions to Remain in Urban School Settings

ERIC Educational Resources Information Center

Grizzle, Alison L.

2010-01-01

Existing problems identified in the literature on teacher retention and resilience include (a) a gap in understanding factors influencing urban teacher retention; (b) lack of clarity on multiple factors swaying teachers' decisions to remain despite challenges; (c) overlapping definitions of teacher retention, attrition, and resilience; and (d)…

Developing Decision-Making Skills for Socio-Scientific Issues

ERIC Educational Resources Information Center

Lee, Yeung Chung

2007-01-01

The ability to make informed decisions on science-related social issues is considered an important attribute of scientific literacy. Literature to inform science educators how to bridge the gap between rhetoric and practice--and to assist them in developing this attribute in their students--burgeons. In view of the great diversity of…

Reluctant to Change: Self-Enhancing Responses to Diverging Performance Measures

ERIC Educational Resources Information Center

Audia, Pino G.; Brion, Sebastien

2007-01-01

Although there is extensive evidence that past performance influences the propensity to make changes, research on how decision makers respond to diverging performance measures has been sparse. This paper addresses this gap in an experimental and a field study in which we examine how decision makers respond to the ambiguity introduced by two…

Mind the Gap: A Case Study of Values-Based Decision Making in a Nonprofit Organization

ERIC Educational Resources Information Center

Craft, Jana L.

2013-01-01

Using an exploratory case study approach, this research examined the consistency between espoused and enacted values within a large nonprofit organization known as an ethical leader in the human services industry. This research explored ethical business culture, ethical decision making, deontological and utilitarian moral paradigms and learning…

Uncovering Beliefs about the Role of Faith in Curriculum Decisions: A Vignette Approach

ERIC Educational Resources Information Center

Stevens, Carla R.

2014-01-01

Accessing and assessing the controlling beliefs of teachers about the role of faith in curriculum decisions is an essential first step in efforts to address the gap between the faith integration mission of Christian schools and actual practices (Boerema, 2011). Without intervention, teachers' beliefs about teaching--shaped by early classroom…

Preparing Students for Front-Line Management: Non-Routine Day-to-Day Decisions

ERIC Educational Resources Information Center

Clydesdale, Greg; Tan, John

2009-01-01

Purpose: This paper attempts to reduce the gap between management education and practice. It emphasises day-to-day decisions that middle and lower level managers make. The purpose is to provide an education framework embodying a flexible approach to interpretation and solution creation, suitable for situations of ambiguity and uncertainty.…

Perception, Interpretation and Decision Making: Understanding Gaps between Competence and Performance--A Commentary

ERIC Educational Resources Information Center

Mason, John

2016-01-01

This papers comments on the contributions of "ZDM Mathematics Education" dedicated to the theme "Perception, interpretation and decision making: understanding the missing link between competence and performance". The papers within this issue are brought together under the perspective of the stated aims of this issue, and then…

Gaps of Decision Support Models for Pipeline Renewal and Recommendations for Improvement

EPA Science Inventory

In terms of the development of software for decision support for pipeline renewal, more attention to date has been paid to the development of asset management models that help an owner decide on which portions of a system to prioritize needed actions. There has been much less w...

GAPS OF DECISION SUPPORT MODELS FOR PIPELINE RENEWAL AND RECOMMENDATIONS FOR IMPROVEMENT (SLIDE)

EPA Science Inventory

In terms of the development of software for decision support for pipeline renewal, more attention to date has been paid to the development of asset management models that help an owner decide on which portions of a system to prioritize needed actions. There has been much less wor...

Equality bias impairs collective decision-making across cultures

PubMed Central

Mahmoodi, Ali; Bang, Dan; Olsen, Karsten; Zhao, Yuanyuan Aimee; Shi, Zhenhao; Broberg, Kristina; Safavi, Shervin; Han, Shihui; Nili Ahmadabadi, Majid; Frith, Chris D.; Roepstorff, Andreas; Rees, Geraint; Bahrami, Bahador

2015-01-01

We tend to think that everyone deserves an equal say in a debate. This seemingly innocuous assumption can be damaging when we make decisions together as part of a group. To make optimal decisions, group members should weight their differing opinions according to how competent they are relative to one another; whenever they differ in competence, an equal weighting is suboptimal. Here, we asked how people deal with individual differences in competence in the context of a collective perceptual decision-making task. We developed a metric for estimating how participants weight their partner’s opinion relative to their own and compared this weighting to an optimal benchmark. Replicated across three countries (Denmark, Iran, and China), we show that participants assigned nearly equal weights to each other’s opinions regardless of true differences in their competence—even when informed by explicit feedback about their competence gap or under monetary incentives to maximize collective accuracy. This equality bias, whereby people behave as if they are as good or as bad as their partner, is particularly costly for a group when a competence gap separates its members. PMID:25775532

Equality bias impairs collective decision-making across cultures.

PubMed

Mahmoodi, Ali; Bang, Dan; Olsen, Karsten; Zhao, Yuanyuan Aimee; Shi, Zhenhao; Broberg, Kristina; Safavi, Shervin; Han, Shihui; Nili Ahmadabadi, Majid; Frith, Chris D; Roepstorff, Andreas; Rees, Geraint; Bahrami, Bahador

2015-03-24

We tend to think that everyone deserves an equal say in a debate. This seemingly innocuous assumption can be damaging when we make decisions together as part of a group. To make optimal decisions, group members should weight their differing opinions according to how competent they are relative to one another; whenever they differ in competence, an equal weighting is suboptimal. Here, we asked how people deal with individual differences in competence in the context of a collective perceptual decision-making task. We developed a metric for estimating how participants weight their partner's opinion relative to their own and compared this weighting to an optimal benchmark. Replicated across three countries (Denmark, Iran, and China), we show that participants assigned nearly equal weights to each other's opinions regardless of true differences in their competence-even when informed by explicit feedback about their competence gap or under monetary incentives to maximize collective accuracy. This equality bias, whereby people behave as if they are as good or as bad as their partner, is particularly costly for a group when a competence gap separates its members.

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.

Reconciling Scale Mismatch in Water Governance, Hydro-climatic Processes and Infrastructure Systems of Water Supply in Las Vegas

NASA Astrophysics Data System (ADS)

Garcia, M. E.; Alarcon, T.; Portney, K.; Islam, S.

2013-12-01

Water resource systems are a classic example of a common pool resource due to the high cost of exclusion and the subtractability of the resource; for common pool resources, the performance of governance systems primarily depends on how well matched the institutional arrangements and rules are to the biophysical conditions and social norms. Changes in water governance, hydro-climatic processes and infrastructure systems occur on disparate temporal and spatial scales. A key challenge is the gap between current climate change model resolution, and the spatial and temporal scale of urban water supply decisions. This gap will lead to inappropriate management policies if not mediated through a carefully crafted decision making process. Traditional decision support and planning methods (DSPM) such as classical decision analysis are not equipped to deal with a non-static climate. While emerging methods such as decision scaling, robust decision making and real options are designed to deal with a changing climate, governance systems have evolved under the assumption of a static climate and it is not clear if these methods are well suited to the existing governance regime. In our study, these questions are contextualized by examining an urban water utility that has made significant changes in policy to adapt to changing conditions: the Southern Nevada Water Authority (SNWA) which serves metropolitan Las Vegas. Like most desert cities, Las Vegas exists because of water; the artesian springs of the Las Vegas Valley once provided an ample water supply for Native Americans, ranchers and later a small railroad city. However, population growth has increased demands far beyond local supplies. The area now depends on the Colorado River for the majority of its water supply. Natural climate variability with periodic droughts has further challenged water providers; projected climate changes and further population growth will exacerbate these challenges. Las Vegas is selected as a case study due to the combined challenges of population growth and climate change, common in the arid west, and due its cooperative institutional response to these challenges, unprecedented in the arid west. To begin to disentangle this question we have analyzed the institutional arrangements and rules which govern water decision making in the Las Vegas Valley and evaluated the existing DSPM used by the SNWA and partner utilities. Presented here are the preliminary results from an ongoing project.

A conceptual framework for understanding the perspectives on the causes of the science-practice gap in ecology and conservation.

PubMed

Bertuol-Garcia, Diana; Morsello, Carla; N El-Hani, Charbel; Pardini, Renata

2018-05-01

Applying scientific knowledge to confront societal challenges is a difficult task, an issue known as the science-practice gap. In Ecology and Conservation, scientific evidence has been seldom used directly to support decision-making, despite calls for an increasing role of ecological science in developing solutions for a sustainable future. To date, multiple causes of the science-practice gap and diverse approaches to link science and practice in Ecology and Conservation have been proposed. To foster a transparent debate and broaden our understanding of the difficulties of using scientific knowledge, we reviewed the perceived causes of the science-practice gap, aiming to: (i) identify the perspectives of ecologists and conservation scientists on this problem, (ii) evaluate the predominance of these perspectives over time and across journals, and (iii) assess them in light of disciplines studying the role of science in decision-making. We based our review on 1563 sentences describing causes of the science-practice gap extracted from 122 articles and on discussions with eight scientists on how to classify these sentences. The resulting process-based framework describes three distinct perspectives on the relevant processes, knowledge and actors in the science-practice interface. The most common perspective assumes only scientific knowledge should support practice, perceiving a one-way knowledge flow from science to practice and recognizing flaws in knowledge generation, communication, and/or use. The second assumes that both scientists and decision-makers should contribute to support practice, perceiving a two-way knowledge flow between science and practice through joint knowledge-production/integration processes, which, for several reasons, are perceived to occur infrequently. The last perspective was very rare, and assumes scientists should put their results into practice, but they rarely do. Some causes (e.g. cultural differences between scientists and decision-makers) are shared with other disciplines, while others seem specific to Ecology and Conservation (e.g. inadequate research scales). All identified causes require one of three general types of solutions, depending on whether the causal factor can (e.g. inadequate research questions) or cannot (e.g. scientific uncertainty) be changed, or if misconceptions (e.g. undervaluing abstract knowledge) should be solved. The unchanged predominance of the one-way perspective over time may be associated with the prestige of evidence-based conservation and suggests that debates in Ecology and Conservation lag behind trends in other disciplines towards bidirectional views ascribing larger roles to decision-makers. In turn, the two-way perspective seems primarily restricted to research traditions historically isolated from mainstream conservation biology. All perspectives represented superficial views of decision-making by not accounting for limits to human rationality, complexity of decision-making contexts, fuzzy science-practice boundaries, ambiguity brought about by science, and different types of knowledge use. However, joint knowledge-production processes from the two-way perspective can potentially allow for democratic decision-making processes, explicit discussions of values and multiple types of science use. To broaden our understanding of the interface and foster productive science-practice linkages, we argue for dialogue among different research traditions within Ecology and Conservation, joint knowledge-production processes between scientists and decision-makers and interdisciplinarity across Ecology, Conservation and Political Science in both research and education. © 2017 Cambridge Philosophical Society.

Child Pedestrians' Judgments of Safe Crossing Gaps at Three Different Vehicle Approach Speeds: A Preliminary Study.

ERIC Educational Resources Information Center

Connelly, Marie L.; And Others

1996-01-01

Judgments made by four children between seven and nine years of age regarding the safety of crossing a road in front of an approaching vehicle were studied. All participants consistently allowed smaller safety gaps as vehicle speeds increased, and three children often made potentially dangerous decisions at high vehicle speeds. (Author/PB)

The Arf GAP CNT-2 regulates the apoptotic fate in C. elegans asymmetric neuroblast divisions.

PubMed

Singhvi, Aakanksha; Teuliere, Jerome; Talavera, Karla; Cordes, Shaun; Ou, Guangshuo; Vale, Ronald D; Prasad, Brinda C; Clark, Scott G; Garriga, Gian

2011-06-07

During development, all cells make the decision to live or die. Although the molecular mechanisms that execute the apoptotic program are well defined, less is known about how cells decide whether to live or die. In C. elegans, this decision is linked to how cells divide asymmetrically [1, 2]. Several classes of molecules are known to regulate asymmetric cell divisions in metazoans, yet these molecules do not appear to control C. elegans divisions that produce apoptotic cells [3]. We identified CNT-2, an Arf GTPase-activating protein (GAP) of the AGAP family, as a novel regulator of this type of neuroblast division. Loss of CNT-2 alters daughter cell size and causes the apoptotic cell to adopt the fate of its sister cell, resulting in extra neurons. CNT-2's Arf GAP activity is essential for its function in these divisions. The N terminus of CNT-2, which contains a GTPase-like domain that defines the AGAP class of Arf GAPs, negatively regulates CNT-2's function. We provide evidence that CNT-2 regulates receptor-mediated endocytosis and consider the implications of its role in asymmetric cell divisions. Copyright © 2011 Elsevier Ltd. All rights reserved.

Susceptibility to social pressure following ventromedial prefrontal cortex damage

PubMed Central

Rusch, Michelle L.; Dawson, Jeffrey D.; Rizzo, Matthew; Anderson, Steven W.

2015-01-01

Social pressure influences human behavior including risk taking, but the psychological and neural underpinnings of this process are not well understood. We used the human lesion method to probe the role of ventromedial prefrontal cortex (vmPFC) in resisting adverse social pressure in the presence of risk. Thirty-seven participants (11 with vmPFC damage, 12 with brain damage outside the vmPFC and 14 without brain damage) were tested in driving simulator scenarios requiring left-turn decisions across oncoming traffic with varying time gaps between the oncoming vehicles. Social pressure was applied by a virtual driver who honked aggressively from behind. Participants with vmPFC damage were more likely to select smaller and potentially unsafe gaps under social pressure, while gap selection by the comparison groups did not change under social pressure. Participants with vmPFC damage also showed prolonged elevated skin conductance responses (SCR) under social pressure. Comparison groups showed similar initial elevated SCR, which then declined prior to making left-turn decisions. The findings suggest that the vmPFC plays an important role in resisting explicit and immediately present social pressure with potentially negative consequences. The vmPFC appears to contribute to the regulation of emotional responses and the modulation of decision making to optimize long-term outcomes. PMID:25816815

Review Article: Multi-criteria decision making for flood risk management: a survey of the current state-of-the-art

NASA Astrophysics Data System (ADS)

de Brito, M. M.; Evers, M.

2015-11-01

This paper provides a review of Multi-Criteria Decision Making (MCDM) applications to flood risk management, seeking to highlight trends and identify research gaps. Totally, 128 peer-reviewed papers published from 1995 to June 2015 were systematically analysed and classified into the following application areas: (1) ranking of alternatives for flood mitigation, (2) reservoir flood control, (3) susceptibility, (4) hazard, (5) vulnerability, (6) risk, (7) coping capacity, and (8) emergency management. Additionally, the articles were categorized based on the publication year, MCDM method, whether they were or were not carried out in a participatory process, and if uncertainty and sensitivity analysis were performed. Results showed that the number of flood MCDM publications has exponentially grown during this period, with over 82 % of all papers published since 2009. The Analytical Hierarchy Process (AHP) was the most popular technique, followed by Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS), and Simple Additive Weighting (SAW). Although there is greater interest on MCDM, uncertainty analysis remains an issue and is seldom applied in flood-related studies. In addition, participation of multiple stakeholders has been generally fragmented, focusing on particular stages of the decision-making process, especially on the definition of criteria weights. Based on the survey, some suggestions for further investigation are provided.

A Decision Analysis Tool for Climate Impacts, Adaptations, and Vulnerabilities

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

Omitaomu, Olufemi A; Parish, Esther S; Nugent, Philip J

Climate change related extreme events (such as flooding, storms, and drought) are already impacting millions of people globally at a cost of billions of dollars annually. Hence, there are urgent needs for urban areas to develop adaptation strategies that will alleviate the impacts of these extreme events. However, lack of appropriate decision support tools that match local applications is limiting local planning efforts. In this paper, we present a quantitative analysis and optimization system with customized decision support modules built on geographic information system (GIS) platform to bridge this gap. This platform is called Urban Climate Adaptation Tool (Urban-CAT). Formore » all Urban-CAT models, we divide a city into a grid with tens of thousands of cells; then compute a list of metrics for each cell from the GIS data. These metrics are used as independent variables to predict climate impacts, compute vulnerability score, and evaluate adaptation options. Overall, the Urban-CAT system has three layers: data layer (that contains spatial data, socio-economic and environmental data, and analytic data), middle layer (that handles data processing, model management, and GIS operation), and application layer (that provides climate impacts forecast, adaptation optimization, and site evaluation). The Urban-CAT platform can guide city and county governments in identifying and planning for effective climate change adaptation strategies.« less

Analytic and heuristic processing influences on adolescent reasoning and decision-making.

PubMed

Klaczynski, P A

2001-01-01

The normative/descriptive gap is the discrepancy between actual reasoning and traditional standards for reasoning. The relationship between age and the normative/descriptive gap was examined by presenting adolescents with a battery of reasoning and decision-making tasks. Middle adolescents (N = 76) performed closer to normative ideals than early adolescents (N = 66), although the normative/descriptive gap was large for both groups. Correlational analyses revealed that (1) normative responses correlated positively with each other, (2) nonnormative responses were positively interrelated, and (3) normative and nonnormative responses were largely independent. Factor analyses suggested that performance was based on two processing systems. The "analytic" system operates on "decontextualized" task representations and underlies conscious, computational reasoning. The "heuristic" system operates on "contextualized," content-laden representations and produces "cognitively cheap" responses that sometimes conflict with traditional norms. Analytic processing was more clearly linked to age and to intelligence than heuristic processing. Implications for cognitive development, the competence/performance issue, and rationality are discussed.

Laboratory Studies on Surface Sampling of Bacillus anthracis Contamination: Summary, Gaps, and Recommendations

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

Piepel, Gregory F.; Amidan, Brett G.; Hu, Rebecca

2011-11-28

This report summarizes previous laboratory studies to characterize the performance of methods for collecting, storing/transporting, processing, and analyzing samples from surfaces contaminated by Bacillus anthracis or related surrogates. The focus is on plate culture and count estimates of surface contamination for swab, wipe, and vacuum samples of porous and nonporous surfaces. Summaries of the previous studies and their results were assessed to identify gaps in information needed as inputs to calculate key parameters critical to risk management in biothreat incidents. One key parameter is the number of samples needed to make characterization or clearance decisions with specified statistical confidence. Othermore » key parameters include the ability to calculate, following contamination incidents, the (1) estimates of Bacillus anthracis contamination, as well as the bias and uncertainties in the estimates, and (2) confidence in characterization and clearance decisions for contaminated or decontaminated buildings. Gaps in knowledge and understanding identified during the summary of the studies are discussed and recommendations are given for future studies.« less

Assessing what to address in science communication.

PubMed

Bruine de Bruin, Wändi; Bostrom, Ann

2013-08-20

As members of a democratic society, individuals face complex decisions about whether to support climate change mitigation, vaccinations, genetically modified food, nanotechnology, geoengineering, and so on. To inform people's decisions and public debate, scientific experts at government agencies, nongovernmental organizations, and other organizations aim to provide understandable and scientifically accurate communication materials. Such communications aim to improve people's understanding of the decision-relevant issues, and if needed, promote behavior change. Unfortunately, existing communications sometimes fail when scientific experts lack information about what people need to know to make more informed decisions or what wording people use to describe relevant concepts. We provide an introduction for scientific experts about how to use mental models research with intended audience members to inform their communication efforts. Specifically, we describe how to conduct interviews to characterize people's decision-relevant beliefs or mental models of the topic under consideration, identify gaps and misconceptions in their knowledge, and reveal their preferred wording. We also describe methods for designing follow-up surveys with larger samples to examine the prevalence of beliefs as well as the relationships of beliefs with behaviors. Finally, we discuss how findings from these interviews and surveys can be used to design communications that effectively address gaps and misconceptions in people's mental models in wording that they understand. We present applications to different scientific domains, showing that this approach leads to communications that improve recipients' understanding and ability to make informed decisions.

The Multifold Relationship between Memory and Decision Making: An Individual-Differences Study

ERIC Educational Resources Information Center

Del Missier, Fabio; Mäntylä, Timo; Hansson, Patrik; Bruine de Bruin, Wändi; Parker, Andrew M.; Nilsson, Lars-Göran

2013-01-01

Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 and 80 years of age, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory,…

76 FR 5820 - Record of Decision for the General Management Plan for the Cumberland Gap National Historical...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

...: Pursuant to the National Environmental Policy Act of 1969, the National Park Service (NPS) announces the... Historical Park in Kentucky, Tennessee, and Virginia. On September 13, 2010, the Regional Director, Southeast....F.R. 1506.6. The responsible official for this Record of Decision is the Regional Director...

Decision Making behind the Use of Metacognitive Pedagogy within Education Methodology Coursework: An Exploratory Case Study

ERIC Educational Resources Information Center

Stokes, Andria Hilvitz

2011-01-01

Recent Department of Education Reports identify a need for changes in pre-service teacher education to help close the continuance of the achievement gap. The purpose of this qualitative study is to identify the professor decision making about metacognitive pedagogical theory within preparation of preservice education programs. The study included…

Factors that Influence STEM-Promising Females' Decision to Attend a Non Research-Intensive Undergraduate Institution

ERIC Educational Resources Information Center

Miller, Roxanne Greitz; Hurlock, Ashley J.

2017-01-01

Non research-intensive institutions of higher education are effective at narrowing STEM gender gaps in major selection and persistence to degree completion, yet the decision to attend such a setting is likely seen as counterintuitive when such institutions typically have lower levels of research, financial resources, and total student enrollments…

Towards a Context-Aware Proactive Decision Support Framework

DTIC Science & Technology

2013-11-15

initiative that has developed text analytic technology that crosses the semantic gap into the area of event recognition and representation. The...recognizing operational context, and techniques for recognizing context shift. Additional research areas include: • Adequately capturing users...Universal Interaction Context Ontology [12] might serve as a foundation • Instantiating formal models of decision making based on information seeking

Physicians' intentions and use of three patient decision aids

PubMed Central

Graham, Ian D; Logan, Jo; Bennett, Carol L; Presseau, Justin; O'Connor, Annette M; Mitchell, Susan L; Tetroe, Jacqueline M; Cranney, Ann; Hebert, Paul; Aaron, Shawn D

2007-01-01

Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270) returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80%) also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians (<60%) felt the decision aid would improve the quality of patient visits or be easily implemented into practice and very few (27%) felt that the decision aid would save time. Physicians' intentions to use the decision aid were related to their comfort with offering it to patients, the decision aid topic, and the perceived ease of implementing it into practice. While 54% of the surveyed physicians indicated they would use the decision aid, less than a third followed through with this intention. Conclusion Despite strong support for the format, content, and quality of patient decision aids, and physicians' stated intentions to adopt them into clinical practice, most did not use them within three months of completing the survey. There is a wide gap between intention and behaviour. Further research is required to study the determinants of this intention-behaviour gap and to develop interventions aimed at barriers to physicians' use of decision aids. PMID:17617908

CDC Grand Rounds: Modeling and Public Health Decision-Making.

PubMed

Fischer, Leah S; Santibanez, Scott; Hatchett, Richard J; Jernigan, Daniel B; Meyers, Lauren Ancel; Thorpe, Phoebe G; Meltzer, Martin I

2016-12-09

Mathematical models incorporate various data sources and advanced computational techniques to portray real-world disease transmission and translate the basic science of infectious diseases into decision-support tools for public health. Unlike standard epidemiologic methods that rely on complete data, modeling is needed when there are gaps in data. By combining diverse data sources, models can fill gaps when critical decisions must be made using incomplete or limited information. They can be used to assess the effect and feasibility of different scenarios and provide insight into the emergence, spread, and control of disease. During the past decade, models have been used to predict the likelihood and magnitude of infectious disease outbreaks, inform emergency response activities in real time (1), and develop plans and preparedness strategies for future events, the latter of which proved invaluable during outbreaks such as severe acute respiratory syndrome and pandemic influenza (2-6). Ideally, modeling is a multistep process that involves communication between modelers and decision-makers, allowing them to gain a mutual understanding of the problem to be addressed, the type of estimates that can be reliably generated, and the limitations of the data. As models become more detailed and relevant to real-time threats, the importance of modeling in public health decision-making continues to grow.

Barriers to participation in mental health research: findings from the Genetics and Psychosis (GAP) Study.

PubMed

Woodall, Anna; Howard, Louise; Morgan, Craig

2011-01-01

The aim of this study was to investigate why people with a first episode of psychosis choose or decline to participate in mental health research, using a qualitative study design. Participants were recruited via referrals from the Genetics and Psychosis (GAP) study. A total of 26 individuals with a first-episode of psychosis (nine of whom declined participation in the GAP study and 17 who participated) were individually interviewed and asked about their attitudes towards mental health research participation. Thematic analysis of interview transcripts was used to determine dominant themes and sub-themes on what constituted barriers and facilitators to participation. Reasons for research participation identified included a desire to help others, curiosity, and positive experiences with clinicians. Decisions to participate or not were also influenced by practical issues, including the timing of the approach, researchers' communication skills and whether individuals had concerns that it may be potentially harmful to their health. Other barriers to participation included patients' conceptualizations of mental health problems and the influence of other inpatients. Information on barriers and facilitators to recruitment in mental health research could inform recruitment strategies, thereby maximizing recruitment rates and minimizing the risk of selection biases.

Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study.

PubMed

Ellen, Moriah E; Léon, Grégory; Bouchard, Gisèle; Ouimet, Mathieu; Grimshaw, Jeremy M; Lavis, John N

2014-12-05

Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitate the use of research evidence in health system decision-making. Factors influencing the implementation of such supports remain poorly described in the literature. Identifying the barriers to and facilitators of different interventions is essential for implementation of effective, context-specific, supports for evidence-informed decision-making (EIDM) in health systems. The purpose of this study was to identify (a) barriers and facilitators to implementing supports for EIDM in Canadian health-care organizations, (b) views about emerging development of supports for EIDM, and (c) views about the priorities to bridge the gaps in the current mix of supports that these organizations have in place. This qualitative study was conducted in three types of health-care organizations (regional health authorities, hospitals, and primary care practices) in two Canadian provinces (Ontario and Quebec). Fifty-seven in-depth semi-structured telephone interviews were conducted with senior managers, library managers, and knowledge brokers from health-care organizations that have already undertaken strategic initiatives in knowledge translation. The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. Limited resources (i.e., money or staff), time constraints, and negative attitudes (or resistance) toward change were the most frequently identified barriers to implementing supports for EIDM. Genuine interest from health system decision-makers, notably their willingness to invest money and resources and to create a knowledge translation culture over time in health-care organizations, was the most frequently identified facilitator to implementing supports for EIDM. The most frequently cited views about emerging development of supports for EIDM were implementing accessible and efficient systems to support the use of research in decision-making (e.g., documentation and reporting tools, communication tools, and decision support tools) and developing and implementing an infrastructure or position where the accountability for encouraging knowledge use lies. The most frequently stated priorities for bridging the gaps in the current mix of supports that these organizations have in place were implementing technical infrastructures to support research use and to ensure access to research evidence and establishing formal or informal ties to researchers and knowledge brokers outside the organization who can assist in EIDM. These results provide insights on the type of practical implementation imperatives involved in supporting EIDM.

Modeling Sustainment Investment

DTIC Science & Technology

2015-05-01

Requests Strategy Staffing Training & Process Funding sustainment capacity sustainment performance gap Bandwagon Effect R1 Limits to Growth B1...Mellon University sustainment capacity sustainment performance gap Bandwagon Effect R1 Limits to Growth B1 S Work Smarter B3 Work Bigger B2 desired... effects of decisions and • Suggests how to prevent problems before they become too expensive. Next: A sample piece of the simulation model

Learning from hackers: open-source clinical trials.

PubMed

Dunn, Adam G; Day, Richard O; Mandl, Kenneth D; Coiera, Enrico

2012-05-02

Open sharing of clinical trial data has been proposed as a way to address the gap between the production of clinical evidence and the decision-making of physicians. A similar gap was addressed in the software industry by their open-source software movement. Here, we examine how the social and technical principles of the movement can guide the growth of an open-source clinical trial community.

Optimizing an immersion ESL curriculum using analytic hierarchy process.

PubMed

Tang, Hui-Wen Vivian

2011-11-01

The main purpose of this study is to fill a substantial knowledge gap regarding reaching a uniform group decision in English curriculum design and planning. A comprehensive content-based course criterion model extracted from existing literature and expert opinions was developed. Analytical hierarchy process (AHP) was used to identify the relative importance of course criteria for the purpose of tailoring an optimal one-week immersion English as a second language (ESL) curriculum for elementary school students in a suburban county of Taiwan. The hierarchy model and AHP analysis utilized in the present study will be useful for resolving several important multi-criteria decision-making issues in planning and evaluating ESL programs. This study also offers valuable insights and provides a basis for further research in customizing ESL curriculum models for different student populations with distinct learning needs, goals, and socioeconomic backgrounds. Copyright © 2011 Elsevier Ltd. All rights reserved.

Adherence to infection prevention and control guidelines: A vignette-based study of decision-making and risk-taking in young adults with cystic fibrosis.

PubMed

Bowmer, Grace; Latchford, Gary; Duff, Alistair; Denton, Miles; Dye, Louise; Lawton, Clare; Lee, Tim

2017-01-01

Balancing cystic fibrosis (CF) care with demands of normal life is associated with decreased adherence to infection prevention and control (IPC) guidelines. Adults with CF, aged 18-25years, were invited to participate via UK CF Trust social media platforms. An online survey evaluated participants' decision-making in nine clinician-rated vignettes and assessed the perceived influence of infection-related information sources. Participants (n=87, mean 21.4years [SD=2.45]; 75% female) were less likely to engage in the high-risk scenarios, although demonstrated greater awareness of cross-infection than environmental risks. Associations between risk-perception and willingness to participate in five vignette-based hypothetical activities were significant (p<0.05). Thematic analysis emphasised influences of past experience and a need to achieve good quality of life. Knowledge gaps were evident. People with CF make decisions that discriminate between risk-levels but are not always based on robust knowledge. They also show some inclination towards engaging in risky behaviours. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

An approach to and web-based tool for infectious disease outbreak intervention analysis

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

Daughton, Ashlynn R.; Generous, Nicholas; Priedhorsky, Reid

Infectious diseases are a leading cause of death globally. Decisions surrounding how to control an infectious disease outbreak currently rely on a subjective process involving surveillance and expert opinion. However, there are many situations where neither may be available. Modeling can fill gaps in the decision making process by using available data to provide quantitative estimates of outbreak trajectories. Effective reduction of the spread of infectious diseases can be achieved through collaboration between the modeling community and public health policy community. However, such collaboration is rare, resulting in a lack of models that meet the needs of the public healthmore » community. Here we show a Susceptible-Infectious-Recovered (SIR) model modified to include control measures that allows parameter ranges, rather than parameter point estimates, and includes a web user interface for broad adoption. We apply the model to three diseases, measles, norovirus and influenza, to show the feasibility of its use and describe a research agenda to further promote interactions between decision makers and the modeling community.« less

An approach to and web-based tool for infectious disease outbreak intervention analysis

DOE PAGES

Daughton, Ashlynn R.; Generous, Nicholas; Priedhorsky, Reid; ...

2017-04-18

Infectious diseases are a leading cause of death globally. Decisions surrounding how to control an infectious disease outbreak currently rely on a subjective process involving surveillance and expert opinion. However, there are many situations where neither may be available. Modeling can fill gaps in the decision making process by using available data to provide quantitative estimates of outbreak trajectories. Effective reduction of the spread of infectious diseases can be achieved through collaboration between the modeling community and public health policy community. However, such collaboration is rare, resulting in a lack of models that meet the needs of the public healthmore » community. Here we show a Susceptible-Infectious-Recovered (SIR) model modified to include control measures that allows parameter ranges, rather than parameter point estimates, and includes a web user interface for broad adoption. We apply the model to three diseases, measles, norovirus and influenza, to show the feasibility of its use and describe a research agenda to further promote interactions between decision makers and the modeling community.« less

Integration of different data gap filling techniques to facilitate ...

EPA Pesticide Factsheets

Data gap filling techniques are commonly used to predict hazard in the absence of empirical data. The most established techniques are read-across, trend analysis and quantitative structure-activity relationships (QSARs). Toxic equivalency factors (TEFs) are less frequently used data gap filling techniques which are applied to estimate relative potencies for mixtures of chemicals that contribute to an adverse outcome through a common biological target. For example, The TEF approach has been used for dioxin-like effects comparing individual chemical activity to that of the most toxic dioxin: 2,3,7,8-tetrachlorodibenzo-p-dioxin. The aim of this case study was to determine whether integration of two data gap filling techniques: QSARs and TEFs improved the predictive outcome for the assessment of a set of polychlorinated biphenyl (PCB) congeners and their mixtures. PCBs are associated with many different adverse effects, including their potential for neurotoxicity, which is the endpoint of interest in this study. The dataset comprised 209 PCB congeners, out of which 87 altered in vitro Ca(2+) homeostasis from which neurotoxic equivalency values (NEQs) were derived. The preliminary objective of this case study was to develop a QSAR model to predict NEQ values for the 122 untested PCB congeners. A decision tree model was developed using the number of position specific chlorine substitutions on the biphenyl scaffold as a fingerprint descriptor. Three different positiona

Improving the evidence base for better comparative effectiveness research.

PubMed

Brophy, James M

2015-09-01

The last 20 years has documented that the evidence base for informed clinical decision-making is often suboptimal. It is hoped that high-quality comparative effectiveness research may fill these knowledge gaps. Implicit in these changing paradigms is the underlying assumption that the published evidence, when available, is valid. It is posited here that this assumption is sometimes questionable. However, several recent methods that may improve the design and analysis of comparative effectiveness research have appeared and are discussed here. Examples from the cardiology literature are provided, but it is believed the highlighted principles are applicable to other branches of medicine.

Applications of a broad-spectrum tool for conservation and fisheries analysis: aquatic gap analysis

USGS Publications Warehouse

McKenna, James E.; Steen, Paul J.; Lyons, John; Stewart, Jana S.

2009-01-01

Natural resources support all of our social and economic activities, as well as our biological existence. Humans have little control over most of the physical, biological, and sociological conditions dictating the status and capacity of natural resources in any particular area. However, the most rapid and threatening influences on natural resources typically are anthropogenic overuse and degradation. In addition, living natural resources (i.e., organisms) do not respect political boundaries, but are aware of their optimal habitat and environmental conditions. Most organisms have wider spatial ranges than the jurisdictional boundaries of environmental agencies that deal with them; even within those jurisdictions, information is patchy and disconnected. Planning and projecting effects of ecological management are difficult, because many organisms, habitat conditions, and interactions are involved. Conservation and responsible resource use involves wise management and manipulation of the aspects of the environment and biological communities that can be effectively changed. Tools and data sets that provide new insights and analysis capabilities can enhance the ability of resource managers to make wise decisions and plan effective, long-term management strategies. Aquatic gap analysis has been developed to provide those benefits. Gap analysis is more than just the assessment of the match or mis-match (i.e., gaps) between habitats of ecological value and areas with an appropriate level of environmental protection (e.g., refuges, parks, preserves), as the name suggests. Rather, a Gap Analysis project is a process which leads to an organized database of georeferenced information and previously available tools to examine conservation and other ecological issues; it provides a geographic analysis platform that serves as a foundation for aquatic ecological studies. This analytical tool box allows one to conduct assessments of all habitat elements within an area of interest. Aquatic gap analysis naturally focuses on aquatic habitats. The analytical tools are largely based on specification of the species-habitat relations for the system and organism group of interest (Morrison et al. 2003; McKenna et al. 2006; Steen et al. 2006; Sowa et al. 2007). The Great Lakes Regional Aquatic Gap Analysis (GLGap) project focuses primarily on lotic habitat of the U.S. Great Lakes drainage basin and associated states and has been developed to address fish and fisheries issues. These tools are unique because they allow us to address problems at a range of scales from the region to the stream segment and include the ability to predict species specific occurrence or abundance for most of the fish species in the study area. The results and types of questions that can be addressed provide better global understanding of the ecological context within which specific natural resources fit (e.g., neighboring environments and resources, and large and small scale processes). The geographic analysis platform consists of broad and flexible geospatial tools (and associated data) with many potential applications. The objectives of this article are to provide a brief overview of GLGap methods and analysis tools, and demonstrate conservation and planning applications of those data and tools. Although there are many potential applications, we will highlight just three: (1) support for the Eastern Brook Trout Joint Venture (EBTJV), (2) Aquatic Life classification in Wisconsin, and (3) an educational tool that makes use of Google Earth (use of trade or product names does not imply endorsement by the U.S. Government) and Internet accessibility.

Universal coverage with insecticide-treated nets - applying the revised indicators for ownership and use to the Nigeria 2010 malaria indicator survey data.

PubMed

Kilian, Albert; Koenker, Hannah; Baba, Ebenezer; Onyefunafoa, Emmanuel O; Selby, Richmond A; Lokko, Kojo; Lynch, Matthew

2013-09-10

Until recently only two indicators were used to evaluate malaria prevention with insecticide-treated nets (ITN): "proportion of households with any ITN" and "proportion of the population using an ITN last night". This study explores the potential of the expanded set of indicators recommended by the Roll Back Malaria Monitoring and Evaluation Reference Group (MERG) for comprehensive analysis of universal coverage with ITN by applying them to the Nigeria 2010 Malaria Indicator Survey data. The two additional indicators of "proportion of households with at least one ITN for every two people" and "proportion of population with access to an ITN within the household" were calculated as recommended by MERG. Based on the estimates for each of the four ITN indicators three gaps were calculated: i) households with no ITN, ii) households with any but not enough ITN, iii) population with access to ITN not using it. In addition, coverage with at least one ITN at community level was explored by applying Lot Quality Assurance Sampling (LQAS) decision rules to the cluster level of the data. All outcomes were analysed by household background characteristics and whether an ITN campaign had recently been done. While the proportion of households with any ITN was only 42% overall, it was 75% in areas with a recent mass campaign and in these areas 66% of communities had coverage of 80% or better. However, the campaigns left a considerable intra-household ownership gap with 66% of households with any ITN not having enough for every family member. In contrast, the analysis comparing actual against potential use showed that ITN utilization was good overall with only 19% of people with access not using the ITN, but with a significant difference between the North, where use was excellent (use gap 11%), and the South (use gap 36%) indicating the need for enhanced behaviour change communication. The expanded ITN indicators to assess universal coverage provide strong tools for a comprehensive system effectiveness analysis that produces clear, actionable evidence of progress as well as the need for specific additional interventions clearly differentiating between gaps in ownership and use.

Bridging the Gap between Human Judgment and Automated Reasoning in Predictive Analytics

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

Sanfilippo, Antonio P.; Riensche, Roderick M.; Unwin, Stephen D.

2010-06-07

Events occur daily that impact the health, security and sustainable growth of our society. If we are to address the challenges that emerge from these events, anticipatory reasoning has to become an everyday activity. Strong advances have been made in using integrated modeling for analysis and decision making. However, a wider impact of predictive analytics is currently hindered by the lack of systematic methods for integrating predictive inferences from computer models with human judgment. In this paper, we present a predictive analytics approach that supports anticipatory analysis and decision-making through a concerted reasoning effort that interleaves human judgment and automatedmore » inferences. We describe a systematic methodology for integrating modeling algorithms within a serious gaming environment in which role-playing by human agents provides updates to model nodes and the ensuing model outcomes in turn influence the behavior of the human players. The approach ensures a strong functional partnership between human players and computer models while maintaining a high degree of independence and greatly facilitating the connection between model and game structures.« less

Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention--convened meeting.

PubMed

Broussard, Cheryl S; Frey, Meghan T; Hernandez-Diaz, Sonia; Greene, Michael F; Chambers, Christina D; Sahin, Leyla; Collins Sharp, Beth A; Honein, Margaret A

2014-09-01

To address information gaps that limit informed clinical decisions on medication use in pregnancy, the Centers for Disease Control and Prevention (CDC) solicited expert input on a draft prototype outlining a systematic approach to evaluating the quality and strength of existing evidence for associated risks. The draft prototype outlined a process for the systematic review of available evidence and deliberations by a panel of experts to inform clinical decision making for managing health conditions in pregnancy. At an expert meeting convened by the CDC in January 2013, participants divided into working groups discussed decision points within the prototype. This report summarizes their discussions of best practices for formulating an expert review process, developing evidence summaries and treatment guidance, and disseminating information. There is clear recognition of current knowledge gaps and a strong collaboration of federal partners, academic experts, and professional organizations willing to work together toward safer medication use during pregnancy. Published by Elsevier Inc.

Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention—convened meeting

PubMed Central

Broussard, Cheryl S.; Frey, Meghan T.; Hernandez-Diaz, Sonia; Greene, Michael F.; Chambers, Christina D.; Sahin, Leyla; Collins Sharp, Beth A.; Honein, Margaret A.

2015-01-01

To address information gaps that limit informed clinical decisions on medication use in pregnancy, the Centers for Disease Control and Prevention (CDC) solicited expert input on a draft prototype outlining a systematic approach to evaluating the quality and strength of existing evidence for associated risks. The draft prototype outlined a process for the systematic review of available evidence and deliberations by a panel of experts to inform clinical decision making for managing health conditions in pregnancy. At an expert meeting convened by the CDC in January 2013, participants divided into working groups discussed decision points within the prototype. This report summarizes their discussions of best practices for formulating an expert review process, developing evidence summaries and treatment guidance, and disseminating information. There is clear recognition of current knowledge gaps and a strong collaboration of federal partners, academic experts, and professional organizations willing to work together toward safer medication use during pregnancy. PMID:24881821

Emotion-affected decision making in human simulation.

PubMed

Zhao, Y; Kang, J; Wright, D K

2006-01-01

Human modelling is an interdisciplinary research field. The topic, emotion-affected decision making, was originally a cognitive psychology issue, but is now recognized as an important research direction for both computer science and biomedical modelling. The main aim of this paper is to attempt to bridge the gap between psychology and bioengineering in emotion-affected decision making. The work is based on Ortony's theory of emotions and bounded rationality theory, and attempts to connect the emotion process with decision making. A computational emotion model is proposed, and the initial framework of this model in virtual human simulation within the platform of Virtools is presented.

Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

PubMed

Schemann, K; Gillespie, J A; Toribio, J-A L M L; Ward, M P; Dhand, N K

2014-10-01

Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder participation in emergency disease management and preparedness for future EAD incursions. © 2012 Blackwell Verlag GmbH.

Current understanding of decision-making in adolescents with cancer: A narrative systematic review

PubMed Central

Day, Emma; Jones, Louise; Langner, Richard; Bluebond-Langner, Myra

2016-01-01

Background: Policy guidance and bioethical literature urge the involvement of adolescents in decisions about their healthcare. It is uncertain how roles and expectations of adolescents, parents and healthcare professionals influence decision-making and to what extent this is considered in guidance. Aims: To identify recent empirical research on decision-making regarding care and treatment in adolescent cancer: (1) to synthesise evidence to define the role of adolescents, parents and healthcare professionals in the decision-making process and (2) to identify gaps in research. Design: A narrative systematic review of qualitative, quantitative and mixed-methods research. We adopted a textual approach to synthesis, using a theoretical framework of interactionism to interpret findings. Data Sources: The databases MEDLINE, PsycINFO, SCOPUS, EMBASE and CINHAL were searched from 2001 through May 2015 for publications on decision-making for adolescents (13–19 years) with cancer. Results: Twenty-eight articles were identified. Adolescents and parents initially find it difficult to participate in decision-making due to a lack of options in the face of protocol-driven care. Parent and adolescent preferences for information and response to loss of control vary between individuals and over time. No studies indicate parental or adolescent preference for a high degree of independence in decision-making. Conclusion: Striving to make parents and adolescents fully informed or urge them towards more independence than they prefer may add to distress and confusion. This may interfere with their ability to participate in their preferred way in decisions about care and treatment. Future research should include analysis of on-ground interactions among parents, adolescents and clinicians across the trajectory. PMID:27160700

Merging Air Quality and Public Health Decision Support Systems

NASA Astrophysics Data System (ADS)

Hudspeth, W. B.; Bales, C. L.

2003-12-01

The New Mexico Air Quality Mapper (NMAQM) is a Web-based, open source GIS prototype application that Earth Data Analysis Center is developing under a NASA Cooperative Agreement. NMAQM enhances and extends existing data and imagery delivery systems with an existing Public Health system called the Rapid Syndrome Validation Project (RSVP). RSVP is a decision support system operating in several medical and public health arenas. It is evolving to ingest remote sensing data as input to provide early warning of human health threats, especially those related to anthropogenic atmospheric pollutants and airborne pathogens. The NMAQM project applies measurements of these atmospheric pollutants, derived from both remotely sensed data as well as from in-situ air quality networks, to both forecasting and retrospective analyses that influence human respiratory health. NMAQM provides a user-friendly interface for visualizing and interpreting environmentally-linked epidemiological phenomena. The results, and the systems made to provide the information, will be applicable not only to decision-makers in the public health realm, but also to air quality organizations, demographers, community planners, and other professionals in information technology, and social and engineering sciences. As an accessible and interactive mapping and analysis application, it allows environment and health personnel to study historic data for hypothesis generation and trend analysis, and then, potentially, to predict air quality conditions from daily data acquisitions. Additional spin off benefits to such users include the identification of gaps in the distribution of in-situ monitoring stations, the dissemination of air quality data to the public, and the discrimination of local vs. more regional sources of air pollutants that may bear on decisions relating to public health and public policy.

Urban High School Students' Perspectives about Sexual Health Decision-Making: The Role of School Culture and Identity

ERIC Educational Resources Information Center

Brotman, Jennie S.; Mensah, Felicia Moore

2013-01-01

Studies across fields such as science education, health education, health behavior, and curriculum studies identify a persistent gap between the aims of the school curriculum and its impact on students' thinking and acting about the real-life decisions that affect their lives. The present study presents a different story from this predominant…

Virtual Close Quarter Battle (CQB) Graphical Decision Trainer

DTIC Science & Technology

2002-09-01

leave a gap in what would traditionally be thought of as an ideal locomotion device. Research has shown that the introduction of vestibular cues in...NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS VIRTUAL CLOSE QUARTER BATTLE (CQB) GRAPHICAL DECISION TRAINER by Jordan Reece...including suggestions for reducing this burden, to Washington headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson

Making Meaning out of Human/Animal: Scientific Competition of Classifications in the Spanish Legislature

ERIC Educational Resources Information Center

Mitchell, Ross

2010-01-01

In the summer of 2008, the Spanish legislature resolved to grant great apes (though not all simians) basic human rights. While the decision to grant such rights came about largely through the lobbying efforts of the Great Ape Project (GAP), the decision has potential reverberations throughout the scientific world and beyond in its implications for…

Implementation of a Tool to Enhance Evidence-Informed Decision Making in Public Health: Identifying Barriers and Facilitating Factors

ERIC Educational Resources Information Center

van der Heide, Iris; van der Noordt, Maaike; Proper, Karin I.; Schoemaker, Casper; van den Berg, Matthijs; Hamberg-van Reenen, Heleen H.

2016-01-01

One of the barriers regarding evidence-informed decision making is the gap between the needs of policy makers and the ways researchers present evidence. This pilot study evaluates the barriers and facilitators to the implementation of a tool to enhance transparent and unambiguous communication on scientific evidence by knowledge workers.…

Experiences of surgical continence management approaches for cloacal anomalies: a qualitative analysis based on 6 women.

PubMed

Liao, L-M; Baker, E; Boyle, M E; Woodhouse, C R J; Creighton, S M

2014-10-01

The aim of this qualitative study was to gain insight into health care experiences of young women diagnosed with cloacal anomalies, with a special focus on continence management. Qualitative analysis of one-to-one interviews. A tertiary center for congenital anomalies of the urogenital tract in London. Six women aged 16 to 24 with cloacal anomalies. Tape-recorded one-to-one semi-stuctured interviews with a skilled interviewer. The taped interviews were transcribed and analyzed verbatim using interpretative phenomenological analysis according to the research question. Organizing themes across all of the accounts were identified. Two organizing themes concerning our research interests are summarized. The first theme Personal Agency in the Hands of Experts focuses on the interviewees' appreciation of their life-saving surgical care and their involvement in treatment decisions. The second theme Compromises and Trade-Offs focuses on what it was like to live with the more traditional versus the more advanced continence methods. Reliability emerged as a key priority in terms of continence treatment outcome. Gratitude may have interfered with the women's honest communications during treatment decision and evaluation consultations. A more developed approach to communication about the complex interventions proposed, founded on a nuanced understanding of users perspectives, can enhance informed decision making about continence management approaches. Despite these specific gaps, the interviewees were appreciative of their care and optimistic about life. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Potential uses of Bayesian networks as tools for synthesis of systematic reviews of complex interventions.

PubMed

Stewart, G B; Mengersen, K; Meader, N

2014-03-01

Bayesian networks (BNs) are tools for representing expert knowledge or evidence. They are especially useful for synthesising evidence or belief concerning a complex intervention, assessing the sensitivity of outcomes to different situations or contextual frameworks and framing decision problems that involve alternative types of intervention. Bayesian networks are useful extensions to logic maps when initiating a review or to facilitate synthesis and bridge the gap between evidence acquisition and decision-making. Formal elicitation techniques allow development of BNs on the basis of expert opinion. Such applications are useful alternatives to 'empty' reviews, which identify knowledge gaps but fail to support decision-making. Where review evidence exists, it can inform the development of a BN. We illustrate the construction of a BN using a motivating example that demonstrates how BNs can ensure coherence, transparently structure the problem addressed by a complex intervention and assess sensitivity to context, all of which are critical components of robust reviews of complex interventions. We suggest that BNs should be utilised to routinely synthesise reviews of complex interventions or empty reviews where decisions must be made despite poor evidence. Copyright © 2013 John Wiley & Sons, Ltd.

Evaluating a Modular Decision Support Application for Colorectal Cancer Screening

PubMed Central

Diiulio, Julie B.; Borders, Morgan R.; Sushereba, Christen E.; Saleem, Jason J.; Haverkamp, Donald; Imperiale, Thomas F.

2017-01-01

Summary Background There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. Objective To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing. Methods We leveraged two evaluation formats, online and in-person, to obtain feedback from a range primary care clinicians and obtain comparative data. Both the online and in-person evaluations used mock patient data to simulate challenging patient scenarios. Primary care clinicians responded to a series of colorectal cancer-related questions about each patient and made recommendations for screening. We collected data on performance, perceived workload, and usability. Key elements of Decision-Centered Design include evaluation in the context of realistic, challenging scenarios and measures designed to explore impact on cognitive performance. Results Comparison of means revealed increases in accuracy, efficiency, and usability and decreases in perceived mental effort and workload when using the Screening and Surveillance App. Conclusion The results speak to the benefits of using the Decision-Centered Design approach in the analysis, design, and evaluation of Health Information Technology. Furthermore, the Screening and Surveillance App shows promise for filling decision support gaps in current electronic health records. PMID:28197619

Incorporating geodiversity into conservation decisions.

PubMed

Comer, Patrick J; Pressey, Robert L; Hunter, Malcolm L; Schloss, Carrie A; Buttrick, Steven C; Heller, Nicole E; Tirpak, John M; Faith, Daniel P; Cross, Molly S; Shaffer, Mark L

2015-06-01

In a rapidly changing climate, conservation practitioners could better use geodiversity in a broad range of conservation decisions. We explored selected avenues through which this integration might improve decision making and organized them within the adaptive management cycle of assessment, planning, implementation, and monitoring. Geodiversity is seldom referenced in predominant environmental law and policy. With most natural resource agencies mandated to conserve certain categories of species, agency personnel are challenged to find ways to practically implement new directives aimed at coping with climate change while retaining their species-centered mandate. Ecoregions and ecological classifications provide clear mechanisms to consider geodiversity in plans or decisions, the inclusion of which will help foster the resilience of conservation to climate change. Methods for biodiversity assessment, such as gap analysis, climate change vulnerability analysis, and ecological process modeling, can readily accommodate inclusion of a geophysical component. We adapted others' approaches for characterizing landscapes along a continuum of climate change vulnerability for the biota they support from resistant, to resilient, to susceptible, and to sensitive and then summarized options for integrating geodiversity into planning in each landscape type. In landscapes that are relatively resistant to climate change, options exist to fully represent geodiversity while ensuring that dynamic ecological processes can change over time. In more susceptible landscapes, strategies aiming to maintain or restore ecosystem resilience and connectivity are paramount. Implementing actions on the ground requires understanding of geophysical constraints on species and an increasingly nimble approach to establishing management and restoration goals. Because decisions that are implemented today will be revisited and amended into the future, increasingly sophisticated forms of monitoring and adaptation will be required to ensure that conservation efforts fully consider the value of geodiversity for supporting biodiversity in the face of a changing climate. © 2015 Society for Conservation Biology.

Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

PubMed

Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-11-16

Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

Mind the Gap

PubMed Central

Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-01-01

Summary Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical work-flow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation. PMID:27847961

Gap analysis: synergies and opportunities for effective nursing leadership.

PubMed

Davis-Ajami, Mary Lynn; Costa, Linda; Kulik, Susan

2014-01-01

Gap analysis encompasses a comprehensive process to identify, understand, address, and bridge gaps in service delivery and nursing practice. onducting gap analysis provides structure to information gathering and the process of finding sustainable solutions to important deficiencies. Nursing leaders need to recognize, measure, monitor, and execute on feasible actionable solutions to help organizations make adjustments to address gaps between what is desired and the actual real-world conditions contributing to the quality chasm in health care. Gap analysis represents a functional and comprehensive tool to address organizational deficiencies. Using gap analysis proactively helps organizations map out and sustain corrective efforts to close the quality chasm. Gaining facility in gap analysis should help the nursing profession's contribution to narrowing the quality chasm.

Value Focused Thinking for Nation Building in Afghanistan: A Regional Perspective

DTIC Science & Technology

2012-03-01

Force Instructions/ Orders). Using existing policy documents is known as the “gold standard” and yields the most defendable final decisions. They are...Integrated Gap , characterized by unstable leadership and absence from international trade. The Core can be sub-divided into Old Core (North America...Western Europe, Japan, and Australia) and New Core (China, India, South Africa, Brazil, Argentina, Chile and Russia). The Disconnected Gap includes the

Susceptibility to social pressure following ventromedial prefrontal cortex damage.

PubMed

Chen, Kuan-Hua; Rusch, Michelle L; Dawson, Jeffrey D; Rizzo, Matthew; Anderson, Steven W

2015-11-01

Social pressure influences human behavior including risk taking, but the psychological and neural underpinnings of this process are not well understood. We used the human lesion method to probe the role of ventromedial prefrontal cortex (vmPFC) in resisting adverse social pressure in the presence of risk. Thirty-seven participants (11 with vmPFC damage, 12 with brain damage outside the vmPFC and 14 without brain damage) were tested in driving simulator scenarios requiring left-turn decisions across oncoming traffic with varying time gaps between the oncoming vehicles. Social pressure was applied by a virtual driver who honked aggressively from behind. Participants with vmPFC damage were more likely to select smaller and potentially unsafe gaps under social pressure, while gap selection by the comparison groups did not change under social pressure. Participants with vmPFC damage also showed prolonged elevated skin conductance responses (SCR) under social pressure. Comparison groups showed similar initial elevated SCR, which then declined prior to making left-turn decisions. The findings suggest that the vmPFC plays an important role in resisting explicit and immediately present social pressure with potentially negative consequences. The vmPFC appears to contribute to the regulation of emotional responses and the modulation of decision making to optimize long-term outcomes. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Understanding Decision-Making in Specialized Domestic Violence Courts: Can Contemporary Theoretical Frameworks Help Guide These Decisions?

PubMed

Pinchevsky, Gillian M

2016-05-22

This study fills a gap in the literature by exploring the utility of contemporary courtroom theoretical frameworks-uncertainty avoidance, causal attribution, and focal concerns-for explaining decision-making in specialized domestic violence courts. Using data from two specialized domestic violence courts, this study explores the predictors of prosecutorial and judicial decision-making and the extent to which these factors are congruent with theoretical frameworks often used in studies of court processing. Findings suggest that these theoretical frameworks only partially help explain decision-making in the courts under study. A discussion of the findings and implications for future research is provided. © The Author(s) 2016.

Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority

PubMed Central

2011-01-01

Objectives The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement. PMID:21756357

Women's autonomy in health care decision-making in developing countries: a synthesis of the literature.

PubMed

Osamor, Pauline E; Grady, Christine

2016-01-01

Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women's autonomy in developing countries describe the relationship between women's autonomy and their health care decision-making, and identify sociodemographic factors that influence women's autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women's decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries' national health surveys. Most studies examined women's autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women's health care decision-making autonomy. Gaps in existing literature regarding women's autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance.

Women’s autonomy in health care decision-making in developing countries: a synthesis of the literature

PubMed Central

Osamor, Pauline E; Grady, Christine

2016-01-01

Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women’s autonomy in developing countries describe the relationship between women’s autonomy and their health care decision-making, and identify sociodemographic factors that influence women’s autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women’s decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries’ national health surveys. Most studies examined women’s autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women’s health care decision-making autonomy. Gaps in existing literature regarding women’s autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance. PMID:27354830

Applying Advanced Analytical Approaches to Characterize the Impact of Specific Clinical Gaps and Profiles on the Management of Rheumatoid Arthritis.

PubMed

Ruiz-Cordell, Karyn D; Joubin, Kathy; Haimowitz, Steven

2016-01-01

The goal of this study was to add a predictive modeling approach to the meta-analysis of continuing medical education curricula to determine whether this technique can be used to better understand clinical decision making. Using the education of rheumatologists on rheumatoid arthritis management as a model, this study demonstrates how the combined methodology has the ability to not only characterize learning gaps but also identify those proficiency areas that have the greatest impact on clinical behavior. The meta-analysis included seven curricula with 25 activities. Learners who identified as rheumatologists were evaluated across multiple learning domains, using a uniform methodology to characterize learning gains and gaps. A performance composite variable (called the treatment individualization and optimization score) was then established as a target upon which predictive analytics were conducted. Significant predictors of the target included items related to the knowledge of rheumatologists and confidence concerning 1) treatment guidelines and 2) tests that measure disease activity. In addition, a striking demographic predictor related to geographic practice setting was also identified. The results demonstrate the power of advanced analytics to identify key predictors that influence clinical behaviors. Furthermore, the ability to provide an expected magnitude of change if these predictors are addressed has the potential to substantially refine educational priorities to those drivers that, if targeted, will most effectively overcome clinical barriers and lead to the greatest success in achieving treatment goals.

Objective assessment of plaster cast quality in pediatric distal forearm fractures: Is there an optimal index?

PubMed

Labronici, Pedro José; Ferreira, Leonardo Termis; Dos Santos Filho, Fernando Claudino; Pires, Robinson Esteves Santos; Gomes, Davi Coutinho Fonseca Fernandes; da Silva, Luiz Henrique Penteado; Gameiro, Vinicius Schott

2017-02-01

Several so-called casting indices are available for objective evaluation of plaster cast quality. The present study sought to investigate four of these indices (gap index, padding index, Canterbury index, and three-point index) as compared to a reference standard (cast index) for evaluation of plaster cast quality after closed reduction of pediatric displaced distal forearm fractures. Forty-three radiographs from patients with displaced distal forearm fractures requiring manipulation were reviewed. Accuracy, sensitivity, specificity, false-positive probability, false-negative probability, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were calculated for each of the tested indices. Comparison among indices revealed diagnostic agreement in only 4.7% of cases. The strongest correlation with the cast index was found for the gap index, with a Spearman correlation coefficient of 0.94. The gap index also displayed the best agreement with the cast index, with both indices yielding the same result in 79.1% of assessments. When seeking to assess plaster cast quality, the cast index and gap index should be calculated; if both indices agree, a decision on quality can be made. If the cast and gap indices disagree, the padding index can be calculated as a tiebreaker, and the decision based on the most frequent of the three results. Calculation of the three-point index and Canterbury index appears unnecessary. Copyright © 2016 Elsevier Ltd. All rights reserved.

Geospatial decision support systems for societal decision making

USGS Publications Warehouse

Bernknopf, R.L.

2005-01-01

While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the GDSS have demonstrated the benefits of utilizing science for policy decisions. Investment in science reduces decision-making uncertainty and reducing that uncertainty has economic value.

Priority setting and implementation in a centralized health system: a case study of Kerman province in Iran.

PubMed

Khayatzadeh-Mahani, Akram; Fotaki, Marianna; Harvey, Gillian

2013-08-01

The question of how priority setting processes work remains topical, contentious and political in every health system across the globe. It is particularly acute in the context of developing countries because of the mismatch between needs and resources, which is often compounded by an underdeveloped capacity for decision making and weak institutional infrastructures. Yet there is limited research into how the process of setting and implementing health priorities works in developing countries. This study aims to address this gap by examining how a national priority setting programme works in the centralized health system of Iran and what factors influence its implementation at the meso and micro levels. We used a qualitative case study approach, incorporating mixed methods: in-depth interviews at three levels and a textual analysis of policy documents. The data analysis showed that the process of priority setting is non-systematic, there is little transparency as to how specific priorities are decided, and the decisions made are separated from their implementation. This is due to the highly centralized system, whereby health priorities are set at the macro level without involving meso or micro local levels or any representative of the public. Furthermore, the two main benefit packages are decided by different bodies (Ministry of Health and Medical Education and Ministry of Welfare and Social Security) and there is no co-ordination between them. The process is also heavily influenced by political pressure exerted by various groups, mostly medical professionals who attempt to control priority setting in accordance with their interests. Finally, there are many weaknesses in the implementation of priorities, resulting in a growing gap between rural and urban areas in terms of access to health services.

Comprehensive evaluation of liver resection procedures: surgical mind development through cognitive task analysis.

PubMed

Ho, Cheng-Maw; Wakabayashi, Go; Yeh, Chi-Chuan; Hu, Rey-Heng; Sakaguchi, Takanori; Hasegawa, Yasushi; Takahara, Takeshi; Nitta, Hiroyuki; Sasaki, Akira; Lee, Po-Huang

2018-01-01

Liver resection is a complex procedure for trainee surgeons. Cognitive task analysis (CTA) facilitates understanding and decomposing tasks that require a great proportion of mental activity from experts. Using CTA and video-based coaching to compare liver resection by open and laparoscopic approaches, we decomposed the task of liver resection into exposure (visual field building), adequate tension made at the working plane (which may change three-dimensionally during the resection process), and target processing (intervention strategy) that can bridge the gap from the basic surgical principle. The key steps of highly-specialized techniques, including hanging maneuvers and looping of extra-hepatic hepatic veins, were shown on video by open and laparoscopic approaches. Familiarization with laparoscopic anatomical orientation may help surgeons already skilled at open liver resection transit to perform laparoscopic liver resection smoothly. Facilities at hand (such as patient tolerability, advanced instruments, and trained teams of personnel) can influence surgical decision making. Application of the rationale and realizing the interplay between the surgical principles and the other paramedical factors may help surgeons in training to understand the mental abstractions of experienced surgeons, to choose the most appropriate surgical strategy effectively at will, and to minimize the gap.

Policy impacts of ecosystem services knowledge

PubMed Central

Posner, Stephen M.; McKenzie, Emily; Ricketts, Taylor H.

2016-01-01

Research about ecosystem services (ES) often aims to generate knowledge that influences policies and institutions for conservation and human development. However, we have limited understanding of how decision-makers use ES knowledge or what factors facilitate use. Here we address this gap and report on, to our knowledge, the first quantitative analysis of the factors and conditions that explain the policy impact of ES knowledge. We analyze a global sample of cases where similar ES knowledge was generated and applied to decision-making. We first test whether attributes of ES knowledge themselves predict different measures of impact on decisions. We find that legitimacy of knowledge is more often associated with impact than either the credibility or salience of the knowledge. We also examine whether predictor variables related to the science-to-policy process and the contextual conditions of a case are significant in predicting impact. Our findings indicate that, although many factors are important, attributes of the knowledge and aspects of the science-to-policy process that enhance legitimacy best explain the impact of ES science on decision-making. Our results are consistent with both theory and previous qualitative assessments in suggesting that the attributes and perceptions of scientific knowledge and process within which knowledge is coproduced are important determinants of whether that knowledge leads to action. PMID:26831101

Effects of a computerized cardiac teletriage decision support system on nurse performance: results of a controlled human factors experiment using a mid-fidelity prototype.

PubMed

Somoza, Kirsten Carroll; Momtahan, Kathryn; Lindgaard, Gitte

2007-01-01

A gap exists in cardiac care between known best practices and the actual level of care administered. To help bridge this gap, a proof of concept interface for a PDA-based decision support system (DSS) was designed for cardiac care nurses engaged in teletriage. This interface was developed through a user-centered design process. Quality of assessment, quality of recommendations, and number of questions asked were measured. Cardiac floor nurses' assessment quality performance, but not their recommendation quality performance, improved with the DSS. Nurses asked more questions with the DSS than without it, and these additional questions were predominantly classifiable as essential or beneficial to a good assessment. The average participant satisfaction score with the DSS was above neutral.

Esophageal motor disorders: how to bridge the gap between advanced diagnostic tools and paucity of therapeutic modalities?

PubMed

Clarke, John O; Pandolfino, John E

2012-07-01

High-resolution manometry has added significantly to our current understanding of esophageal motor function by providing improved detail and a data analysis paradigm that is more akin to an imaging format. Esophageal pressure topography provides a seamless dynamic representation of the pressure profile through the entire esophagus and thus, is able to eliminate movement artifact and also assess intrabolus pressure patterns as a surrogate for bolus transit mechanics. This has led to improved identification of anatomic landmarks and measurement of important physiological parameters (esophagogastric junction relaxation, distal latency, and contractile integrity). This research has bridged the gap into clinical practice by defining physiologically relevant phenotypes that may have prognostic significance and improve treatment decisions in achalasia, spasm, and hypercontractile disorders. However, more work is needed in determining the etiology of symptom generation in the context of normal or trivial motor dysfunction. This research will require new techniques to assess visceral hypersensitivity and alterations in central modulation of pain and discomfort.

A review of citizen science and community-based environmental monitoring: issues and opportunities.

PubMed

Conrad, Cathy C; Hilchey, Krista G

2011-05-01

Worldwide, decision-makers and nongovernment organizations are increasing their use of citizen volunteers to enhance their ability to monitor and manage natural resources, track species at risk, and conserve protected areas. We reviewed the last 10 years of relevant citizen science literature for areas of consensus, divergence, and knowledge gaps. Different community-based monitoring (CBM) activities and governance structures were examined and contrasted. Literature was examined for evidence of common benefits, challenges, and recommendations for successful citizen science. Two major gaps were identified: (1) a need to compare and contrast the success (and the situations that induce success) of CBM programs which present sound evidence of citizen scientists influencing positive environmental changes in the local ecosystems they monitor and (2) more case studies showing use of CBM data by decision-makers or the barriers to linkages and how these might be overcome. If new research focuses on these gaps, and on the differences of opinions that exist, we will have a much better understanding of the social, economic, and ecological benefits of citizen science.

Children’s Safety Initiative: A National Assessment of Pediatric Educational Needs amongEmergency Medical Services Providers

PubMed Central

Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

2014-01-01

Objective Emergency Medical Services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps most likely to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. Methods The Children’s Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care including physicians, nurses and pre-hospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them “highly likely” (likert-type score 7–10 out of 10) to contribute to safety events. Results There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents; EMT-Basics/first responders were 22% and physicians 11.4%. The top educational priorities identified in the final round of the survey include: pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform and advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseos access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. Conclusions This is the first large-scale Delphi survey related to pediatric pre-hospital education. Our results provide foundational information related to the educational needs of pre-hospital providers. Medical directors and educators can use the results to shape future curricular development. PMID:25296191

Children's safety initiative: a national assessment of pediatric educational needs among emergency medical services providers.

PubMed

Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

2015-01-01

Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them "highly likely" (Likert-type score 7-10 out of 10) to contribute to safety events. There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents, EMT-basics/first responders were 22%, and physicians 11.4%. The top educational priorities identified in the final round of the survey include pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform an advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseous access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. This is the first large-scale Delphi survey related to pediatric prehospital education. Our results provide foundational information related to the educational needs of prehospital providers. Medical directors and educators can use the results to shape future curricular development.

Future Water Management in the South Platte River Basin: Impacts of Hydraulic Fracturing, Population, Agriculture, and Climate Change in a Semi-Arid Region.

NASA Astrophysics Data System (ADS)

Walker, E. L.; Hogue, T. S.; Anderson, A. M.; Read, L.

2015-12-01

In semi-arid basins across the world, the gap between water supply and demand is growing due to climate change, population growth, and shifts in agriculture and unconventional energy development. Water conservation efforts among residential and industrial water users, recycling and reuse techniques and innovative regulatory frameworks for water management strive to mitigate this gap, however, the extent of these strategies are often difficult to quantify and not included in modeling water allocations. Decision support systems (DSS) are purposeful for supporting water managers in making informed decisions when competing demands create the need to optimize water allocation between sectors. One region of particular interest is the semi-arid region of the South Platte River basin in northeastern Colorado, where anthropogenic and climatic effects are expected to increase the gap between water supply and demand in the near future. Specifically, water use in the South Platte is impacted by several high-intensity activities, including unconventional energy development, i.e. hydraulic fracturing, and large withdrawals for agriculture; these demands are in addition to a projected population increase of 100% by 2050. The current work describes the development of a DSS for the South Platte River basin, using the Water Evaluation and Planning system software (WEAP) to explore scenarios of how variation in future water use in the energy, agriculture, and municipal sectors will impact water allocation decisions. Detailed data collected on oil and gas water use in the Niobrara shale play will be utilized to predict future sector use. We also employ downscaled climate projections for the region to quantify the potential range of water availability in the basin under each scenario, and observe whether or not, and to what extent, climate may impact management decisions at the basin level.

Applying a Data Stewardship Maturity Matrix to the NOAA Observing System Portfolio Integrated Assessment Process

NASA Astrophysics Data System (ADS)

Peng, G.; Austin, M.

2017-12-01

Identification and prioritization of targeted user community needs are not always considered until after data has been created and archived. Gaps in data curation and documentation in the data production and delivery phases limit data's broad utility specifically for decision makers. Expert understanding and knowledge of a particular dataset is often required as a part of the data and metadata curation process to establish the credibility of the data and support informed decision-making. To enhance curation practices, content from NOAA's Observing System Integrated Assessment (NOSIA) Value Tree, NOAA's Data Catalog/Digital Object Identifier (DOI) projects (collection-level metadata) have been integrated with Data/Stewardship Maturity Matrices (data and stewardship quality information) focused on assessment of user community needs. This results in user focused evidence based decision making tools created by NOAA's National Environmental Satellite, Data, and Information Service (NESDIS) through identification and assessment of data content gaps related to scientific knowledge and application to key areas of societal benefit. Through enabling user need feedback from the beginning of data creation through archive allows users to determine the quality and value of data that is fit for purpose. Data gap assessment and prioritization are presented in a user-friendly way using the data stewardship maturity matrices as measurement of data management quality. These decision maker tools encourages data producers and data providers/stewards to consider users' needs prior to data creation and dissemination resulting in user driven data requirements increasing return on investment. A use case focused on need for NOAA observations linked societal benefit will be used to demonstrate the value of these tools.

Data-to-Decisions S&T Priority Initiative

DTIC Science & Technology

2011-11-08

Context Mapping − Track Performance Model  Multi-Source Tracking − Track Fusion − Track through Gaps − Move-Stop-Move  Performance Based ...Decisions S&T Priority Initiative Dr. Carey Schwartz PSC Lead Office of Naval Research NDIA Disruptive Technologies Conference November 8-9, 2011...PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Office of Naval Research ,875 North Randolph Street , Arlington,VA,2217 8. PERFORMING ORGANIZATION REPORT

Social Science and the Courts: Challenges and Strategies for Bridging Gaps between Law and Research

ERIC Educational Resources Information Center

Morgan, Julie Margetta; Pullin, Diana

2010-01-01

Social scientists collect vital information that bears on issues of education policy. When the courts are faced with an opportunity to make a decision that shapes education, judges need access to high-quality research, but they must also be convinced that it can be useful in their decision making. This article approaches the question of how social…

Science in Society: Bridging the gap to connect science to decision makers

NASA Astrophysics Data System (ADS)

Jones, L.; Bwarie, J.; Pearce, I.

2016-12-01

The gap between science and decision making in our society can be large and multi-faceted, involving communication, process, cultural and even subconscious differences. In sweeping generalization, scientists reject anecdotes, focus on uncertainty and details, and expect conflict as part of the scientific process, while non-scientists respond to stories, want certainty and the big picture, and see conflict as a reason to reject the message. Bridging this gap often requires ongoing collaboration to find the intersection of three independent domains: what science can provide, the technical information decision makers need to make the most effective choices and what information decision makers need to motivate action. For ten years, the USGS has experimented with improving the usefulness of its science through the SAFRR (Science Application for Risk Reduction) Project and its predecessor, the Multi Hazards Demonstration Project in Southern California. Through leading and participating in these activities, we have recognized 3 steps that have been essential to successful partnerships between scientists and decision makers. First, determining what makes for a successful product cannot be done in isolation by either scientists or users. The users may want something science cannot produce (e.g., accurate short-term earthquake predictions), while the scientists can fail to see that the product they know how to make may not be relevant to the decisions that need to be made. Real discussions with real exchange and absorption of information on both sides makes for the most useful products. Second, most scientific results need work beyond what belongs in a journal to create a product that can be used. This is not just a different style of communication, but analyses that focus on the community's local questions rather than on scientific advances. Third, probabilities of natural hazards almost never motivate action to mitigate. The probabilities are usually low on human time scales and focus on the uncertainty, conveying a strong message that the hazard may not happen. Presenting the hazard as absolutely certain to occur, just on an unknown time scale is scientifically identical, but conveys a very different emotional message.

Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector.

PubMed

van Dongen, Johanna M; Tompa, Emile; Clune, Laurie; Sarnocinska-Hart, Anna; Bongers, Paulien M; van Tulder, Maurits W; van der Beek, Allard J; van Wier, Marieke F

2013-06-03

Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers' knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer's costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers. Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this.

Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector

PubMed Central

2013-01-01

Background Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. Methods An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers’ knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. Results The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer’s costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers. Conclusions Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this. PMID:23731570

A Decision Support System for Identifying and Ranking Critical Habitat Parcels on and in the Vicinity of Department of Defense Installations

DTIC Science & Technology

2011-01-01

27 FIGURE 17. SIMULATED MOVEMENT OF MALE FLOATERS ACROSS A LANDSCAPE...effect of forest gaps larger than 150 m on both juvenile female forays and movement of floater females. Finally, we incorporated jumping by allowing...a portion of floater females to cross gaps of any size. Description of Model Changes Both high and low-level model modifications to the original

What Matters in Recruiting Public Health Employees: Considerations for Filling Workforce Gaps.

PubMed

Yeager, Valerie A; Wisniewski, Janna M; Amos, Kathleen; Bialek, Ron

2015-12-01

We examined factors that influence the decision to join the public health workforce. In this cross-sectional study, we used 2010 secondary data representing 6939 public health workers. Factors influencing the decision to take jobs in public health were significantly associated with specific previous employment settings. Respondents generally rated organizational factors as more influential than personal factors in terms of their decision to work in governmental public health. Leaders should consider tailoring recruitment efforts to maximize job uptake and enhance the potential for long-term retention.

Factors affecting decision making about fertility preservation after cancer diagnosis: a qualitative study.

PubMed

Peddie, V L; Porter, M A; Barbour, R; Culligan, D; MacDonald, G; King, D; Horn, J; Bhattacharya, S

2012-08-01

To increase our understanding of factors underlying the decision to store gametes after the diagnosis of cancer. Qualitative interview study. Andrology, Haematology, and Oncology Departments of a Scottish teaching hospital, and patients' own homes. Sixteen men and 18 women aged 17-49 years recently diagnosed with cancer; 15 health professionals concerned in cancer care. Audio-recorded semi-structured interviews were transcribed verbatim and analysed thematically. Topics included perceptions of diagnosis; prognosis; future reproductive choices; priorities; quality of information received; communication and decisions made about future reproductive choices; and the role of partners, family, friends and healthcare professionals. Professional interviews examined their role in decision making and that of protocols and guidelines, together with information emerging from patient interview analysis. Themes identified following analysis of interview transcripts. The primary barriers to pursuing fertility preservation were the way in which information was provided and the 'urgent need for treatment' conveyed by staff. Survival was always viewed as paramount, with future fertility secondary. Sperm banking was viewed as 'part and parcel' of oncology care, and the majority of men quickly stored sperm as 'insurance' against future infertility. Few women were afforded the opportunity to discuss their options, reflecting clinicians' reservations about the experimental nature of egg and ovarian tissue cryopreservation, and the need for partner involvement in embryo storage. Significant gaps in the information provided to young women diagnosed with cancer suggest the need for an early appointment with a fertility expert. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Neural Systems Underlying Individual Differences in Intertemporal Decision-making.

PubMed

Elton, Amanda; Smith, Christopher T; Parrish, Michael H; Boettiger, Charlotte A

2017-03-01

Excessively choosing immediate over larger future rewards, or delay discounting (DD), associates with multiple clinical conditions. Individual differences in DD likely depend on variations in the activation of and functional interactions between networks, representing possible endophenotypes for associated disorders, including alcohol use disorders (AUDs). Numerous fMRI studies have probed the neural bases of DD, but investigations of large-scale networks remain scant. We addressed this gap by testing whether activation within large-scale networks during Now/Later decision-making predicts individual differences in DD. To do so, we scanned 95 social drinkers (18-40 years old; 50 women) using fMRI during hypothetical choices between small monetary amounts available "today" or larger amounts available later. We identified neural networks engaged during Now/Later choice using independent component analysis and tested the relationship between component activation and degree of DD. The activity of two components during Now/Later choice correlated with individual DD rates: A temporal lobe network positively correlated with DD, whereas a frontoparietal-striatal network negatively correlated with DD. Activation differences between these networks predicted individual differences in DD, and their negative correlation during Now/Later choice suggests functional competition. A generalized psychophysiological interactions analysis confirmed a decrease in their functional connectivity during decision-making. The functional connectivity of these two networks negatively correlates with alcohol-related harm, potentially implicating these networks in AUDs. These findings provide novel insight into the neural underpinnings of individual differences in impulsive decision-making with potential implications for addiction and related disorders in which impulsivity is a defining feature.

What Is Robustness?: Problem Framing Challenges for Water Systems Planning Under Change

NASA Astrophysics Data System (ADS)

Herman, J. D.; Reed, P. M.; Zeff, H. B.; Characklis, G. W.

2014-12-01

Water systems planners have long recognized the need for robust solutions capable of withstanding deviations from the conditions for which they were designed. Faced with a set of alternatives to choose from—for example, resulting from a multi-objective optimization—existing analysis frameworks offer competing definitions of robustness under change. Robustness analyses have moved from expected utility to exploratory "bottom-up" approaches in which vulnerable scenarios are identified prior to assigning likelihoods; examples include Robust Decision Making (RDM), Decision Scaling, Info-Gap, and Many-Objective Robust Decision Making (MORDM). We propose a taxonomy of robustness frameworks to compare and contrast these approaches, based on their methods of (1) alternative selection, (2) sampling of states of the world, (3) quantification of robustness measures, and (4) identification of key uncertainties using sensitivity analysis. Using model simulations from recent work in multi-objective urban water supply portfolio planning, we illustrate the decision-relevant consequences that emerge from each of these choices. Results indicate that the methodological choices in the taxonomy lead to substantially different planning alternatives, underscoring the importance of an informed definition of robustness. We conclude with a set of recommendations for problem framing: that alternatives should be searched rather than prespecified; dominant uncertainties should be discovered rather than assumed; and that a multivariate satisficing measure of robustness allows stakeholders to achieve their problem-specific performance requirements. This work highlights the importance of careful problem formulation, and provides a common vocabulary to link the robustness frameworks widely used in the field of water systems planning.

Designing a Hydro-Economic Collaborative Computer Decision Support System: Approaches, Best Practices, Lessons Learned, and Future Trends

NASA Astrophysics Data System (ADS)

Rosenberg, D. E.

2008-12-01

Designing and implementing a hydro-economic computer model to support or facilitate collaborative decision making among multiple stakeholders or users can be challenging and daunting. Collaborative modeling is distinguished and more difficult than non-collaborative efforts because of a large number of users with different backgrounds, disagreement or conflict among stakeholders regarding problem definitions, modeling roles, and analysis methods, plus evolving ideas of model scope and scale and needs for information and analysis as stakeholders interact, use the model, and learn about the underlying water system. This presentation reviews the lifecycle for collaborative model making and identifies some key design decisions that stakeholders and model developers must make to develop robust and trusted, verifiable and transparent, integrated and flexible, and ultimately useful models. It advances some best practices to implement and program these decisions. Among these best practices are 1) modular development of data- aware input, storage, manipulation, results recording and presentation components plus ways to couple and link to other models and tools, 2) explicitly structure both input data and the meta data that describes data sources, who acquired it, gaps, and modifications or translations made to put the data in a form usable by the model, 3) provide in-line documentation on model inputs, assumptions, calculations, and results plus ways for stakeholders to document their own model use and share results with others, and 4) flexibly program with graphical object-oriented properties and elements that allow users or the model maintainers to easily see and modify the spatial, temporal, or analysis scope as the collaborative process moves forward. We draw on examples of these best practices from the existing literature, the author's prior work, and some new applications just underway. The presentation concludes by identifying some future directions for collaborative modeling including geo-spatial display and analysis, real-time operations, and internet-based tools plus the design and programming needed to implement these capabilities.

European Natural Disaster Coordination and Information System for Aviation (EUNADICS-AV)

NASA Astrophysics Data System (ADS)

Wotawa, Gerhard; Hirtl, Marcus; Arnold, Delia; Katzler-Fuchs, Susanne; Pappalardo, Gelsomina; Mona, Lucia; Sofiev, Mikhail; de Leeuw, Gerrit; Theys, Nicolas; Brenot, Hugues; Plu, Matthieu; Rockitansky, Carl-Herbert; Eschbacher, Kurt; Apituley, Arnoud; Som de Cerff, Wim

2017-04-01

Commercial aviation is one of the key infrastructures of our modern world. Even short interruptions can cause economic damages summing up to the Billion-Euro range. As evident from the past, aviation shows vulnerability with regard to natural hazards. Safe flight operations, air traffic management and air traffic control is a shared responsibility of EUROCONTROL, national authorities, airlines and pilots. All stakeholders have one common goal, namely to warrant and maintain the safety of flight crews and passengers. Currently, however, there is a significant gap in the Europe-wide availability of real time hazard measurement and monitoring information for airborne hazards describing "what, where, how much" in 3 dimensions, combined with a near-real-time European data analysis and assimilation system. This gap creates circumstances where various stakeholders in the system may base their decisions on different data and information. The H-2020 project EUNADICS-AV ("European Natural Disaster Coordination and Information System for Aviation"), started in October 2016, intends to close this gap in data and information availability, enabling all stakeholders in the aviation system to obtain fast, coherent and consistent information. The project intends to combine and harmonize data from satellite earth observation, ground based and airborne platforms, and to integrate them into state-of-the art data assimilation and analysis systems. Besides operational data sources, data from the research community are integrated as well. Hazards considered in the project include volcano eruptions, nuclear accidents and events, and forest fires. The availability of consistent and coherent data analysis fields based on all available measurements will greatly enhances our capability to respond to disasters effectively and efficiently, minimizing system downtimes and thus economic damage while maintaining the safety of millions of passengers.

Quality of Living and Dying: Pediatric Palliative Care and End-of-Life Decisions in the Netherlands.

PubMed

Brouwer, Marije; Maeckelberghe, Els; DE Weerd, Willemien; Verhagen, Eduard

2018-07-01

In 2002, The Netherlands continued its leadership in developing rules and jurisdiction regarding euthanasia and end-of-life decisions by implementing the Euthanasia Act, which allows euthanasia for patients 12 years of age and older. Subsequently, in 2005, the regulation on active ending of life for newborns was issued. However, more and more physicians and parents have stated that the age gap between these two regulations-children between 1 and 12 years old-is undesirable. These children should have the same right to end their suffering as adults and newborn infants. An extended debate on pediatric euthanasia ensued, and currently the debate is ongoing as to whether legislation should be altered in order to allow pediatric euthanasia. An emerging major question regards the active ending of life in the context of palliative care: How does a request for active ending of life relate to the care that is given to children in the palliative phase? Until now, the distinction between palliative care and end-of-life decisions continues to remain unclear, making any discussion about their mutual in- and exclusiveness hazardous at best. In this report, therefore, we aim to provide insight into the relationship between pediatric palliative care and end-of-life decisions, as understood in the Netherlands. We do so by first providing an overview of the (legal) rules and regulations regarding euthanasia and active ending of life, followed by an analysis of the relationship between these two, using the Dutch National Guidelines for Palliative Care for Children. The results of this analysis revealed two major and related features of palliative care and end-of-life decisions for children: (1) palliative care and end-of-life decisions are part of the same process, one that focuses both on quality of living and quality of dying, and (2) although physicians are seen as ultimately responsible for making end-of-life decisions, the involvement of parents and children in this decision is of the utmost importance and should be regarded as such.

A Quantitative review of relationships between Ecosystem services

NASA Astrophysics Data System (ADS)

Lee, H.; Lautenbach, S.

2014-12-01

Each decision in natural resources management can generate trade-offs with respect to the provisioning of ecosystem services (ES). If the increase of one ES happens directly or indirectly at the cost of another ES, an attempt to maximize the provision of a single ES will lead to suboptimal results. However, decisions in natural resources management are often made without considering such trade-offs, despite their crucial role toward supporting better decision-making. The research on trade-offs between ES has gained some attention in the scientific community. However, a synthesis on existing knowledge and knowledge gaps is missing so far. We aim at closing that gap by a quantitative review of recent literature on trade-offs of ES. We looked at the pairs of ES that have been studied in ~100 case studies that report on trade-offs between ES. If a case study analyzed more than one ES pair, we looked at all pairwise combinations. We categorized relationships between these pairs of ES into the categories "trade-off", "synergy" or "no-effect". Most pairs of ES had a clear association with one category: the majority of case studies that studied a specific pair of ES identified the same category of relationship between the two ES. Pairs of regulating services were typically synergetic in relationship, whereas provisioning services and regulating services typically showed a trade-off. However, for several pairs of ES we were not able to identify a dominate category of relationship. Our hypothesis is that this relates to either the scale of the analysis, the land system where the analysis took place or the method used to quantify the relationship. The number of case studies for each pair of ES was spread unevenly. This hinders the support for a conclusive statement drawn for the pairs. Our results showed further that the method used to identify the relationship between services had a strong effect on the direction of the effect. This suggests that researchers should consider their method carefully. We believe that our results are of use for the scientific community as well as for practitioners since they provide helpful information about which services to include in ES assessments. Furthermore, they allow a first check if critical trade-offs have been considered in an analysis.

Decision tree and ensemble learning algorithms with their applications in bioinformatics.

PubMed

Che, Dongsheng; Liu, Qi; Rasheed, Khaled; Tao, Xiuping

2011-01-01

Machine learning approaches have wide applications in bioinformatics, and decision tree is one of the successful approaches applied in this field. In this chapter, we briefly review decision tree and related ensemble algorithms and show the successful applications of such approaches on solving biological problems. We hope that by learning the algorithms of decision trees and ensemble classifiers, biologists can get the basic ideas of how machine learning algorithms work. On the other hand, by being exposed to the applications of decision trees and ensemble algorithms in bioinformatics, computer scientists can get better ideas of which bioinformatics topics they may work on in their future research directions. We aim to provide a platform to bridge the gap between biologists and computer scientists.

Neuroeconomics: cross-currents in research on decision-making.

PubMed

Sanfey, Alan G; Loewenstein, George; McClure, Samuel M; Cohen, Jonathan D

2006-03-01

Despite substantial advances, the question of how we make decisions and judgments continues to pose important challenges for scientific research. Historically, different disciplines have approached this problem using different techniques and assumptions, with few unifying efforts made. However, the field of neuroeconomics has recently emerged as an inter-disciplinary effort to bridge this gap. Research in neuroscience and psychology has begun to investigate neural bases of decision predictability and value, central parameters in the economic theory of expected utility. Economics, in turn, is being increasingly influenced by a multiple-systems approach to decision-making, a perspective strongly rooted in psychology and neuroscience. The integration of these disparate theoretical approaches and methodologies offers exciting potential for the construction of more accurate models of decision-making.

Active control of nano dimers response using piezoelectric effect

NASA Astrophysics Data System (ADS)

Mekkawy, Ahmed A.; Ali, Tamer A.; Badawi, Ashraf H.

2016-09-01

Nano devices can be used as building blocks for Internet of Nano-Things network devices, such as sensors/actuators, transceivers, and routers. Although nano particles response can be engineered to fit in different regimes, for such a nano particle to be used as an active nano device, its properties should be dynamically controlled. This controllability is a challenge, and there are many proposed techniques to tune nanoparticle response on the spot through a sort of control signal, wither that signal is optical (for all-optical systems) or electronic (for opto-electronic systems). This will allow the use of nano particles as nano-switches or as dynamic sensors that can pick different frequencies depending on surrounding conditions or depending on a smart decisions. In this work, we propose a piezoelectric substrate as an active control mediator to control plasmonic gaps in nano dimers. This method allows for integrating nano devices with regular electronics while communicating control signals to nano devices through applying electric signals to a piezoelectric material, in order to control the gaps between nano particles in a nano cluster. We do a full numerical study to the system, analyzing the piezoelectric control resolution (minimum gap change step) and its effect on a nanodimer response as a nanoantenna. This analysis considers the dielectric functions of materials within the visible frequencies range. The effects of different parameters, such as the piezoelectric geometrical structure and materials, on the gap control resolution and the operating frequency are studied.

Gap Analysis: Rethinking the Conceptual Foundations

DTIC Science & Technology

2008-01-30

2 Gap Analysis Background.......................................................................4 Research ...which we are intending, then there could exist a basis for gap in capability and therefore a desire to close the capability gap . What you desire...future reality that can be formulated, definitized, and established or constructed. But, Gap Analysis is not intended to close the space between the

The Office Guidelines Applied to Practice program improves secondary prevention of heart disease in Federally Qualified Healthcare Centers.

PubMed

Olomu, Adesuwa; Khan, Nazia Naz; Todem, David; Huang, Qinhua; Kumar, Esha; Holmes-Rovner, Margaret

2016-12-01

The burden of cardiovascular disease (CVD) among minority and low-income populations is well documented. This study aimed to assess the impact of patient activation and shared decision-making (SDM) on medication use through the Office-Guidelines Applied to Practice (Office-GAP) intervention in Federally Qualified Healthcare Centers (FQHCs). Patients (243) with diabetes and CHD participated in Office-GAP between October 2010 and March 2014. Two-site (FQHCs) intervention/control design. Office-GAP integrates health literacy, communication skills education for patients and physicians, decision support tools, and SDM into routine care. 1) implementation rates, 2) medication use at baseline, 3, 6, and 12 months, and 3) predictors of medication use. Logistic regression with propensity scoring assessed impact on medication use. Intervention arm had 120 and control arm had 123 patients. We found that program elements were consistently used. Compared to control, the Office-GAP program significantly improved medications use from baseline: ACEIs or ARBs at 3 months (OR 1.88, 95% CI = 1.07; 3.30, p < 0.03), 6 months (OR 2.68, 95% CI = 1.58;4.54; p < 0.01); statin at 3 months (OR 2.00, 95% CI = 0.1.22; 3.27; p < 0.05), 6 months (OR 3.05, 95% CI = 1.72; 5.43; p < 0.01), Aspirin and/or clopidogrel at 3 months OR 1.59, 95% CI = 1.02, 2.48; p < 0.05), 6 months (OR 3.67, 95% CI = 1.67; 8.08; p < 0.01). Global medication adherence was predicted only by Office-GAP intervention presence and hypertension. Office-GAP resulted in increased use of guideline-based medications for secondary CVD prevention in underserved populations. The Office-GAP program could serve as a model for implementing guideline-based care for other chronic diseases.

AN EVALUATION OF HANFORD SITE TANK FARM SUBSURFACE CONTAMINATION FY2007

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

MANN, F.M.

2007-07-10

The Tank Farm Vadose Zone (TFVZ) Project conducts activities to characterize and analyze the long-term environmental and human health impacts from tank waste releases to the vadose zone. The project also implements interim measures to mitigate impacts, and plans the remediation of waste releases from tank farms and associated facilities. The scope of this document is to report data needs that are important to estimating long-term human health and environmental risks. The scope does not include technologies needed to remediate contaminated soils and facilities, technologies needed to close tank farms, or management and regulatory decisions that will impact remediation andmore » closure. This document is an update of ''A Summary and Evaluation of Hanford Site Tank Farm Subsurface Contamination''. That 1998 document summarized knowledge of subsurface contamination beneath the tank farms at the time. It included a preliminary conceptual model for migration of tank wastes through the vadose zone and an assessment of data and analysis gaps needed to update the conceptual model. This document provides a status of the data and analysis gaps previously defined and discussion of the gaps and needs that currently exist to support the stated mission of the TFVZ Project. The first data-gaps document provided the basis for TFVZ Project activities over the previous eight years. Fourteen of the nineteen knowledge gaps identified in the previous document have been investigated to the point that the project defines the current status as acceptable. In the process of filling these gaps, significant accomplishments were made in field work and characterization, laboratory investigations, modeling, and implementation of interim measures. The current data gaps are organized in groups that reflect Components of the tank farm vadose zone conceptual model: inventory, release, recharge, geohydrology, geochemistry, and modeling. The inventory and release components address residual wastes that will remain in the tanks and tank-farm infrastructure after closure and potential losses from leaks during waste retrieval. Recharge addresses the impacts of current conditions in the tank farms (i.e. gravel covers that affect infiltration and recharge) as well as the impacts of surface barriers. The geohydrology and geochemistry components address the extent of the existing subsurface contaminant inventory and drivers and pathways for contaminants to be transported through the vadose zone and groundwater. Geochemistry addresses the mobility of key reactive contaminants such as uranium. Modeling addresses conceptual models and how they are simulated in computers. The data gaps will be used to provide input to planning (including the upcoming C Farm Data Quality Objective meetings scheduled this year).« less

Pathways to Science and Engineering Bachelor's Degrees for Men and Women.

PubMed

Legewie, Joscha; DiPrete, Thomas A

2014-02-18

Despite the striking reversal of the gender gap in educational attainment and the near-gender parity in math performance, women pursue science and engineering (S/E) degrees at much lower rates than their male peers do. Current efforts to increase the number of women in these fields focus on different life-course periods but lack a clear understanding of the importance of these periods and how orientations toward S/E fields develop over time. In this article, we examine the gendered pathways to a S/E bachelor's degree from middle school to high school and college based on a representative sample from the 1973 to 1974 birth cohort. Using a counterfactual decomposition analysis, we determine the relative importance of these different life-course periods and thereby inform the direction of future research and policy. Our findings confirm previous research that highlights the importance of early encouragement for gender differences in S/E degrees, but our findings also attest to the high school years as a decisive period for the gender gap, while challenging the focus on college in research and policy. Indeed, if female high school seniors had the same orientation toward and preparation for S/E fields as their male peers, the gender gap in S/E degrees would be closed by as much as 82 percent.

The atomic geometries of GaP(110) and ZnS(110) revisited - A structural ambiguity and its resolution

NASA Technical Reports Server (NTRS)

Duke, C. B.; Paton, A.; Kahn, A.

1984-01-01

The atomic geometries of GaP(110) and ZnS(110) are reexamined using the R-factor minimization procedure, developed for GaAs(110) and previously applied to GaSb(110), ZnTe(110), InAs(110), and AlP(110), to analyze experimental elastic low-energy electron diffraction intensities. Unlike most of the earlier cases, both GaP(110) and ZnS(110) exhibit two distinct minimum-Rx structures which cannot be distinguished by analysis of the shapes of the intensity profiles alone. One region of best-fit structures exhibits top-layer displacements normal to the surface characterized by a small bond-length-conserving, top-layer rotation (omega aproximately 2-3 deg), a small relaxation of the top layer away from the surface, and a 10 percent expansion of the top-layer bond length. The other region of best-fit structures is the conventional one: nearly bond-length-conserving rotations of omega = 26-28 deg in the top layer and a small (approximately 0.1 A) contraction of the uppermost layer spacing. This ambiguity may be removed, however, by consideration of the integrated beam intensities. The conventional region of structural parameters provides a decisively better description of the relative magnitudes of the integrated beam intensities and hence is the preferred structure.

An Alternative Methodological Approach for Cost-Effectiveness Analysis and Decision Making in Genomic Medicine.

PubMed

Fragoulakis, Vasilios; Mitropoulou, Christina; van Schaik, Ron H; Maniadakis, Nikolaos; Patrinos, George P

2016-05-01

Genomic Medicine aims to improve therapeutic interventions and diagnostics, the quality of life of patients, but also to rationalize healthcare costs. To reach this goal, careful assessment and identification of evidence gaps for public health genomics priorities are required so that a more efficient healthcare environment is created. Here, we propose a public health genomics-driven approach to adjust the classical healthcare decision making process with an alternative methodological approach of cost-effectiveness analysis, which is particularly helpful for genomic medicine interventions. By combining classical cost-effectiveness analysis with budget constraints, social preferences, and patient ethics, we demonstrate the application of this model, the Genome Economics Model (GEM), based on a previously reported genome-guided intervention from a developing country environment. The model and the attendant rationale provide a practical guide by which all major healthcare stakeholders could ensure the sustainability of funding for genome-guided interventions, their adoption and coverage by health insurance funds, and prioritization of Genomic Medicine research, development, and innovation, given the restriction of budgets, particularly in developing countries and low-income healthcare settings in developed countries. The implications of the GEM for the policy makers interested in Genomic Medicine and new health technology and innovation assessment are also discussed.

Decision support system for determining Bantuan Siswa Miskin (BSM) receivers with profile matching method

NASA Astrophysics Data System (ADS)

Situmorang, B. H.; Pibriana, E.; Tosida, E. T.

2018-03-01

Bantuan Siswa Miskin (BSM) is a National Programs aimed at eliminating the barriers of poor students participating to school by helping poor students gain access to appropriate education services, prevent dropping out of school, attract poor students back to school, assis students in providing for learning activities, support the Nine Years Basic Education (and even up to senior high school) program, as well as helping to smooth the school programs [1]. Decision Support System is made by applying Profile Matching method to assist teachers or school operators in SMP PGRI Ciasmara in selecting prospective recipients of BSM program and providing recommendations in decision making. Profile Matching is used to compare the actual data value of a profile to be assessed by the expected profile value, so that it can be known the difference of competence (also called GAP). If the resulting value of GAP is smaller then the weight of value will be greater, which means it has a greater chance to be recommended as a potential recipient of the BSM program. Decision Support System for determining BSM receivers is only choosing the right alternatives to receive BSM according to the BSM quota given to SMP PGRI Ciasmara. The right alternatives to receive this BSM is the highest ranking alternatives.

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.

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

PubMed

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

2017-12-12

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

Less power or powerless? Egocentric empathy gaps and the irony of having little versus no power in social decision making.

PubMed

Handgraaf, Michel J J; Van Dijk, Eric; Vermunt, Riël C; Wilke, Henk A M; De Dreu, Carsten K W

2008-11-01

The authors investigate the effect of power differences and associated expectations in social decision making. Using a modified ultimatum game, the authors show that allocators lower their offers to recipients when the power difference shifts in favor of the allocator. Remarkably, however, when recipients are completely powerless, offers increase. This effect is mediated by a change in framing of the situation: When the opponent is without power, feelings of social responsibility are evoked. On the recipient side, the authors show that recipients do not anticipate these higher outcomes resulting from powerlessness. They prefer more power over less, expecting higher outcomes when they are more powerful, especially when less power entails powerlessness. Results are discussed in relation to empathy gaps and social responsibility. (c) 2008 APA, all rights reserved.

Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps.

PubMed

Dvorak, Marcel F; Cheng, Christiana L; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S; White, Barry A B; Ho, Chester; Ahn, Henry; Kwon, Brian K; Christie, Sean; Noonan, Vanessa K

2017-10-15

Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds.

Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps

PubMed Central

Cheng, Christiana L.; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S.; White, Barry A.B.; Ho, Chester; Ahn, Henry; Kwon, Brian K.; Christie, Sean; Noonan, Vanessa K.

2017-01-01

Abstract Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds. PMID:28745934

Modeling of shallot supply decisions: the case of Indonesia

NASA Astrophysics Data System (ADS)

Prabawati, N. F.; Pujawan, I. N.; Widodo, E.

2018-04-01

To optimize supply chain role, the players of supply chain need to integrate its function. One of the general problems in supply chain was the unbalanced quantity of sales and quantity of supply. This paper focused on modelling a simple method to manage the gap between the demand and the supply. The gap might cause an overstock or a loss. This paper propose a buffer quantity in order to handle the gap by using import decision. The case study was about shallot supply - demand in Indonesia. In this study we model the supply decisions of shallot in Indonesia. While the demand was quite stable over time, the supply was heavily affected by the yield from the farms. The shortage could result in the government importing shallot from other countries. Hence, the government also needed to have a proper buffering mechanism in order to ensure the supply was sufficient and the price was quite stable. The initial model of this research was built by stochastic parameters and the extended model to gain pricing mechanism was built by Shapley value principal with modification. The primary variables were supply quantity, demand quantity, buffer and purchased quantity (stock needed), actual consumption, and price for three players. The validation proved that the result of price at each player presented a significant difference. Therefore, the model could be applied to decide the stock quantity needed and to keep the price stable at each player especially at the end player which would influence the market price.

What an open source clinical trial community can learn from hackers

PubMed Central

Dunn, Adam G.; Day, Richard O.; Mandl, Kenneth D.; Coiera, Enrico

2014-01-01

Summary Open sharing of clinical trial data has been proposed as a way to address the gap between the production of clinical evidence and the decision-making of physicians. Since a similar gap has already been addressed in the software industry by the open source software movement, we examine how the social and technical principles of the movement can be used to guide the growth of an open source clinical trial community. PMID:22553248

Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol

PubMed Central

Peters, Jaime L; Cooper, Chris; Buchanan, James

2015-01-01

Introduction Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests. Methods and analysis We will search electronic databases including MEDLINE, EMBASE and NHS EEDs to identify model-based economic evaluations of pharmacogenetic and pharmacogenomic tests. The search will not be limited by language or date. Title and abstract screening will be conducted independently by 2 reviewers, with screening of full texts and data extraction conducted by 1 reviewer, and checked by another. Characteristics of the decision problem, the decision model and the test evidence used to inform the model will be extracted. Specifically, we will identify the reported evidence sources for the test-related evidence used, describe the study design and how the evidence was identified. A checklist developed specifically for decision analytic models will be used to critically appraise the models described in these studies. Variations in the test evidence used in the decision models will be explored across the included studies, and we will identify gaps in the evidence in terms of both quantity and quality. Dissemination The findings of this work will be disseminated via a peer-reviewed journal publication and at national and international conferences. PMID:26560056

How to achieve benefit from mission-oriented research: lessons from the U.S. Department of Agriculture and the Naval Research Laboratory

NASA Astrophysics Data System (ADS)

Logar, N. J.

2006-12-01

Does the research performed by government mission agencies contribute to improved decision-making? Climate research within the U.S. Department of Agriculture (USDA) has the stated goal of providing "optimal benefit" to decision makers on all levels, and the meteorology division of Department of Defense's Naval Research Laboratory promises research directed towards application. Assuming that research can lead to benefit for decision makers with minimal guidance can lead to irrelevance, wasted effort, and missed opportunities. Moving beyond the assumption leads to critical consideration of processes creating climate and meteorological science. I report the results of contextual mapping, of research on decision processes, and of interviews with agency scientists and users of science to evaluate their science regimes. In the case of the USDA scientists do target stakeholders through formal and informal mechanisms, but much of the science does not find use due to institutional constraints, political considerations, and disciplinary inertia. The research results will provide options for closing these policy gaps, such as higher-level stakeholder interaction and better representation of diverse interests. I apply the economic concept of supply and demand to describe where supply of science provides decision support that matches user demand, and where science policies might miss opportunities or mischaracterize research as useful to a specific user. This analysis leads to increased understanding of how factors such as the definition of scientific problems, hierarchies in science decision-making structures, quality control mechanisms beyond peer review, distribution of participants in the knowledge production enterprise, and social accountability guide the process of producing useful information.

Ethical dilemmas concerning decision-making within health care leadership: a systematic literature review.

PubMed

Zydziūnaite, Vilma; Suominen, Tarja; Astedt-Kurki, Päivi; Lepaite, Daiva

2010-01-01

The objective was to describe the research methods and research focuses on ethical dilemmas concerning decision-making within health care leadership. The search was conducted on Medline and PubMed databases (1998-2008). The systematic review included 21 selected articles. The ethical dilemmas concerning decision-making within health care leadership are related to three levels: institutional (particular organization), political and local interface (local governmental structure), and national (professional expertise and system). The terms that are used as adequate to the term of "ethical dilemma" are the following: "continuous balancing," "result of resource allocation," "gap between professional obligations and possibilities," "ethically controversial situation," "concern about interactions," "ethical difficulty," "outcome of medical choices," "concern about society access to health care resources," "ethically difficult/challenging situation," "(the consequence of) ethical concern/ethical issue." In qualitative studies, a semi-structured interview and qualitative content analysis are the most commonly applied methods; in quantitative studies, questionnaire surveys are employed. In the research literature, there is a lack of specification according to professional qualification of health care professionals concerning ethical dilemmas by decision-making within health care management/administration. The research on ethical dilemmas in health care leadership, management, and administration should integrate data about levels at which ethical dilemmas occur and investigate ethical dilemmas as complex phenomena because those are attached to decision-making and specific nuances of health care management/administration. In this article, the presented scientific problem requires extensive scientific discussions and research on ethical dilemmas concerning decision-making within health care leadership at various levels.

Addressing gaps in the maturity of judgment literature: age differences and delinquency.

PubMed

Modecki, Kathryn Lynn

2008-02-01

Over the past decade, a majority of states have legislated to expand their capacity to try adolescents as adults [Griffin (2003). Trying and sentencing juveniles as adults: An analysis of state transfer and blended sentencing laws. Pittsburgh, PA: National Center for Juvenile Justice]. In response, researchers have investigated factors that may affect adolescent culpability [Steinberg and Scott (Am Psychol 58(12):1009-1018, 2003)]. Research on immature judgment posits that psychosocial influences on adolescent decision processes results in reduced criminal responsibility [Cauffman and Steinberg (Behav Sci Law 18(6):741-760, 2000); Scott, Reppucci, and Woolard (Law Hum Behav 19(3):221-244, 1995); Steinberg and Cauffman (Law Hum Behav 20(3):249-272, 1996)]. The current study utilizes hypothetical vignettes and standardized measures of maturity of judgment (responsibility, temperance, and perspective) to examine gaps in previous maturity of judgment findings (Cauffman and Steinberg 2000). This work suggests that adolescents (ages 14-17) display less responsibility and perspective relative to college students (ages 18-21), young-adults (ages 22-27), and adults (ages 28-40). Further, this research finds no maturity of judgment differences between delinquent and non-delinquent youth, but does find significant maturity of judgment differences between high and low delinquency male youth. Finally, results show that maturity of judgment predicts self-reported delinquency beyond the contributions of age, gender, race, education level, SES, and antisocial decision making. Implications for the juvenile justice system are discussed.

Assisting Public Organizations in Their Outsourcing Endeavors: A Decision Support Mode

NASA Technical Reports Server (NTRS)

Kremic, TIbor; Tukel, Oya

2006-01-01

There has been a tremendous growth in outsourcing practices in recent years. The public organizations in the United States have outsourced some functions and are now being compelled to outsource additional ones. While there are numerous studies that document and analyze outsourcing practices, there is limited research to guide public or governmental organizations in determining what functions to outsource. This study fills this gap by developing a decision support model for a typical public organization in determining what to outsource and how. A set of outsourcing decision factors is identified that can be used as parameters in the three integer programming formulations developed. These formulations are used as solution engines in the model. The first formulation identifies which functions are the best candidates for outsourcing given the organization's priorities. The other formulations place the functions into recommended contracts and re-assign displaced employees. Data from NASA Glenn Research Center in Ohio is used to test and analyze the model. Analysis indicates that cost and skills-related factors are the most sensitive parameters for the data tested. The model and the formulations are a relatively comprehensive package and may help guide outsourcing decisionmakers and policymakers in public organizations.

Decision Making Under Uncertainty - Bridging the Gap Between End User Needs and Science Capability

NASA Astrophysics Data System (ADS)

Verdon-Kidd, D. C.; Kiem, A.; Austin, E. K.

2012-12-01

Successful adaptation outcomes depend on decision making based on the best available climate science information. However, a fundamental barrier exists, namely the 'gap' between information that climate science can currently provide and the information that is practically useful for end users and decision makers. This study identifies the major contributing factors to the 'gap' from an Australian perspective and provides recommendations as to ways in which the 'gap' may be narrowed. This was achieved via a literature review, online survey (targeted to providers of climate information and end users of that information), workshop (where both climate scientists and end users came together to discuss key issues) and focus group. The study confirmed that uncertainty in climate science is a key barrier to adaptation. The issue of uncertainty was found to be multi-faceted, with issues identified in terms of communication of uncertainty, misunderstanding of uncertainty and the lack of tools/methods to deal with uncertainty. There were also key differences in terms of expectations for the future - most end users were of the belief that uncertainty associated with future climate projections would reduce within the next five to 10 years, however producers of climate science information were well aware that this would most likely not be the case. This is a concerning finding as end users may delay taking action on adaptation and risk planning until the uncertainties are reduced - a situation which may never eventuate or may occur after the optimal time for action. Improved communication and packaging of climate information was another key theme that was highlighted in this study. Importantly, it was made clear that improved communication is not just about more glossy brochures and presentations by climate scientists, rather there is a role for a program or group to fill this role (coined a 'knowledge broker' during the workshop and focus group). The role of the 'knowledge broker' would be to package, translate (both from end user to scientist and scientist to end user) and transform climate information. Importantly communication of uncertainty needs to be improved so that end users are aware of all the caveats and what can realistically be expected from climate science now and in the near future. Overall this study confirmed that there is indeed a 'gap' between end user's needs and science capability, particularly with respect to uncertainty, communication and packaging of climate information. This 'gap' has been a barrier to successful climate change adaptation in the past. While it is unrealistic to think we could ever close the 'gap' completely, based on the recommendations provided in this paper, it may be possible to bridge the 'gap' (or at least improve people's awareness of the 'gap'). Furthermore, the insights gained and recommendations provided from this study, while based on an Australian context, are likely to be applicable to many other regions of the world, grappling with similar issues.

A Pilot Study of Neonatologists' Decision-Making Roles in Delivery Room Resuscitation Counseling for Periviable Births.

PubMed

Tucker Edmonds, Brownsyne; McKenzie, Fatima; Panoch, Janet E; White, Douglas B; Barnato, Amber E

2016-07-01

Relatively little is known about neonatologists' roles in helping families navigate the difficult decision to attempt or withhold resuscitation for a neonate delivering at the threshold of viability. Therefore, we aimed to describe the "decision-making role" of neonatologists in simulated periviable counseling sessions. We conducted a qualitative content analysis of audio-recorded simulation encounters and post-encounter debriefing interviews collected as part of a single-center simulation study of neonatologists' resuscitation counseling practices in the face of ruptured membranes at 23 weeks gestation. We trained standardized patients to request a recommendation if the physician presented multiple treatment options. We coded each encounter for communication behaviors, applying an adapted, previously developed coding scheme to classify physicians into four decision-making roles (informative, facilitative, collaborative, or directive). We also coded post-simulation debriefing interviews for responses to the open-ended prompt: "During this encounter, what did you feel was your role in the management decision-making process?" Fifteen neonatologists (33% of the division) participated in the study; audio-recorded debriefing interviews were available for 13. We observed 9 (60%) take an informative role, providing medical information only; 2 (13%) take a facilitative role, additionally eliciting the patient's values; 3 (20%) take a collaborative role, additionally engaging the patient in deliberation and providing a recommendation; and 1 (7%) take a directive role, making a treatment decision independent of the patient. Almost all (10/13, 77%) of the neonatologists described their intended role as informative. Neonatologists did not routinely elicit preferences, engage in deliberation, or provide treatment recommendations-even in response to requests for recommendations. These findings suggest there may be a gap between policy recommendations calling for shared decision making and actual clinical practice.

ECOREGIONAL GAP ANALYSIS OF THE SOUTHWESTERN UNITED STATES: THE SOUTHWEST REGIONAL GAP ANALYSIS PROJECT FINAL REPORT

EPA Science Inventory

The Gap Analysis Program is a national program with the mission of developing key datasets needed to assess biological diversity across the nation. The primary objectives of the Gap Analysis Program are: (1) Land Cover Mapping – to map the distributions of natural communities; (2...

Concluding comments: maximizing good patient care and minimizing potential liability when considering complementary and alternative medicine.

PubMed

Gilmour, Joan; Harrison, Christine; Vohra, Sunita

2011-11-01

Our goal for this supplemental issue of Pediatrics was to consider what practitioners, parents, patients, institutions, and policy-makers need to take into account to make good decisions about using complementary and alternative medicine (CAM) to treat children and to develop guidelines for appropriate use. We began by explaining underlying concepts and principles in ethical, legal, and clinical reasoning and then used case scenarios to explore how they apply and identify gaps that remain in practice and policy. In this concluding article, we review our major findings, summarize our recommendations, and suggest further research. We focus on several key areas: practitioner and patient/parent relationships; decision-making; dispute resolution; standards of practice; hospital/health facility policies; patient safety; education; and research. Ethical principles, standards, and rules applicable when making decisions about conventional care for children apply to decision-making about CAM as well. The same is true of legal reasoning. Although CAM use has seldom led to litigation, general legal principles relied on in cases involving conventional medical care provide the starting point for analysis. Similarly, with respect to clinical decision-making, clinicians are guided by clinical judgment and the best interests of their patient. Whether a therapy is CAM or conventional, clinicians must weigh the relative risks and benefits of therapeutic options and take into account their patient's values, beliefs, and preferences. Consequently, many of our observations apply to conventional and CAM care and to both adult and pediatric patients.

Advanced Computational Framework for Environmental Management ZEM, Version 1.x

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

Vesselinov, Velimir V.; O'Malley, Daniel; Pandey, Sachin

2016-11-04

Typically environmental management problems require analysis of large and complex data sets originating from concurrent data streams with different data collection frequencies and pedigree. These big data sets require on-the-fly integration into a series of models with different complexity for various types of model analyses where the data are applied as soft and hard model constraints. This is needed to provide fast iterative model analyses based on the latest available data to guide decision-making. Furthermore, the data and model are associated with uncertainties. The uncertainties are probabilistic (e.g. measurement errors) and non-probabilistic (unknowns, e.g. alternative conceptual models characterizing site conditions).more » To address all of these issues, we have developed an integrated framework for real-time data and model analyses for environmental decision-making called ZEM. The framework allows for seamless and on-the-fly integration of data and modeling results for robust and scientifically-defensible decision-making applying advanced decision analyses tools such as Bayesian- Information-Gap Decision Theory (BIG-DT). The framework also includes advanced methods for optimization that are capable of dealing with a large number of unknown model parameters, and surrogate (reduced order) modeling capabilities based on support vector regression techniques. The framework is coded in Julia, a state-of-the-art high-performance programing language (http://julialang.org). The ZEM framework is open-source and can be applied to any environmental management site. The framework will be open-source and released under GPL V3 license.« less

A Synthesis Of Knowledge About Caregiver Decision Making Finds Gaps In Support For Those Who Care For Aging Loved Ones.

PubMed

Garvelink, Mirjam M; Ngangue, Patrice A G; Adekpedjou, Rheda; Diouf, Ndeye T; Goh, Larissa; Blair, Louisa; Légaré, France

2016-04-01

We conducted a mixed-methods knowledge synthesis to assess the effectiveness of interventions to improve caregivers' involvement in decision making with seniors, and to describe caregivers' experiences of decision making in the absence of interventions. We analyzed forty-nine qualitative, fourteen quantitative, and three mixed-methods studies. The qualitative studies indicated that caregivers had unmet needs for information, discussions of values and needs, and decision support, which led to negative sentiments after decision making. Our results indicate that there have been insufficient quantitative evaluations of interventions to involve caregivers in decision making with seniors and that the evaluations that do exist found few clinically significant effects. Elements of usual care that received positive evaluations were the availability of a decision coach and a supportive decision-making environment. Additional rigorously evaluated interventions are needed to help caregivers be more involved in decision making with seniors. Project HOPE—The People-to-People Health Foundation, Inc.

Outbreak Column 16: Cognitive errors in outbreak decision making.

PubMed

Curran, Evonne T

2015-01-01

During outbreaks, decisions must be made without all the required information. People, including infection prevention and control teams (IPCTs), who have to make decisions during uncertainty use heuristics to fill the missing data gaps. Heuristics are mental model short cuts that by-and-large enable us to make good decisions quickly. However, these heuristics contain biases and effects that at times lead to cognitive (thinking) errors. These cognitive errors are not made to deliberately misrepresent any given situation; we are subject to heuristic biases when we are trying to perform optimally. The science of decision making is large; there are over 100 different biases recognised and described. Outbreak Column 16 discusses and relates these heuristics and biases to decision making during outbreak prevention, preparedness and management. Insights as to how we might recognise and avoid them are offered.

Private behaviors for the public good: Citizens' actions and U.S. energy conservation

NASA Astrophysics Data System (ADS)

Bolsen, Toby

Why and when do individuals take political actions? Why do some, but not all, citizens make sacrifices for the sake of the public good? Outside of work on participation, political scientists have paid little attention to these questions. I seek to fill this gap by exploring the factors that drive political behaviors. I focus specifically on an important class of behaviors: actions regarding the consumption of energy. I begin by developing a theory that brings together the potentially interactive effects of individual and environmental factors that shape individuals' decisions to take action. I test predictions generated by my theory in three empirical chapters: a media content analysis, laboratory experiment, and survey experiment. The content analysis allows me to assess frames in a communication toward energy consumption, which I examine later in terms of effects. I use the theory and experiments to evaluate the impact of competing forces on attitudes toward energy conservation, willingness to pay for energy saving devices, and actual behavior (e.g., a purchasing decision and financial contribution). My results suggest a primacy of norms, which is fascinating because the impact of norms is under-studied relative to research evaluating the impact of political communications.

Use of structured decision-making to explicitly incorporate environmental process understanding in management of coastal restoration projects: Case study on barrier islands of the northern Gulf of Mexico.

PubMed

Dalyander, P Soupy; Meyers, Michelle; Mattsson, Brady; Steyer, Gregory; Godsey, Elizabeth; McDonald, Justin; Byrnes, Mark; Ford, Mark

2016-12-01

Coastal ecosystem management typically relies on subjective interpretation of scientific understanding, with limited methods for explicitly incorporating process knowledge into decisions that must meet multiple, potentially competing stakeholder objectives. Conversely, the scientific community lacks methods for identifying which advancements in system understanding would have the highest value to decision-makers. A case in point is barrier island restoration, where decision-makers lack tools to objectively use system understanding to determine how to optimally use limited contingency funds when project construction in this dynamic environment does not proceed as expected. In this study, collaborative structured decision-making (SDM) was evaluated as an approach to incorporate process understanding into mid-construction decisions and to identify priority gaps in knowledge from a management perspective. The focus was a barrier island restoration project at Ship Island, Mississippi, where sand will be used to close an extensive breach that currently divides the island. SDM was used to estimate damage that may occur during construction, and guide repair decisions within the confines of limited availability of sand and funding to minimize adverse impacts to project objectives. Sand was identified as more limiting than funds, and unrepaired major breaching would negatively impact objectives. Repairing minor damage immediately was determined to be generally more cost effective (depending on the longshore extent) than risking more damage to a weakened project. Key gaps in process-understanding relative to project management were identified as the relationship of island width to breach formation; the amounts of sand lost during breaching, lowering, or narrowing of the berm; the potential for minor breaches to self-heal versus developing into a major breach; and the relationship between upstream nourishment and resiliency of the berm to storms. This application is a prototype for using structured decision-making in support of engineering projects in dynamic environments where mid-construction decisions may arise; highlights uncertainty about barrier island physical processes that limit the ability to make robust decisions; and demonstrates the potential for direct incorporation of process-based models in a formal adaptive management decision framework. Published by Elsevier Ltd.

Use of structured decision-making to explicitly incorporate environmental process understanding in management of coastal restoration projects: Case study on barrier islands of the northern Gulf of Mexico

USGS Publications Warehouse

Dalyander, P. Soupy; Meyers, Michelle B.; Mattsson, Brady; Steyer, Gregory; Godsey, Elizabeth; McDonald, Justin; Byrnes, Mark R.; Ford, Mark

2016-01-01

Coastal ecosystem management typically relies on subjective interpretation of scientific understanding, with limited methods for explicitly incorporating process knowledge into decisions that must meet multiple, potentially competing stakeholder objectives. Conversely, the scientific community lacks methods for identifying which advancements in system understanding would have the highest value to decision-makers. A case in point is barrier island restoration, where decision-makers lack tools to objectively use system understanding to determine how to optimally use limited contingency funds when project construction in this dynamic environment does not proceed as expected. In this study, collaborative structured decision-making (SDM) was evaluated as an approach to incorporate process understanding into mid-construction decisions and to identify priority gaps in knowledge from a management perspective. The focus was a barrier island restoration project at Ship Island, Mississippi, where sand will be used to close an extensive breach that currently divides the island. SDM was used to estimate damage that may occur during construction, and guide repair decisions within the confines of limited availability of sand and funding to minimize adverse impacts to project objectives. Sand was identified as more limiting than funds, and unrepaired major breaching would negatively impact objectives. Repairing minor damage immediately was determined to be generally more cost effective (depending on the longshore extent) than risking more damage to a weakened project. Key gaps in process-understanding relative to project management were identified as the relationship of island width to breach formation; the amounts of sand lost during breaching, lowering, or narrowing of the berm; the potential for minor breaches to self-heal versus developing into a major breach; and the relationship between upstream nourishment and resiliency of the berm to storms. This application is a prototype for using structured decision-making in support of engineering projects in dynamic environments where mid-construction decisions may arise; highlights uncertainty about barrier island physical processes that limit the ability to make robust decisions; and demonstrates the potential for direct incorporation of process-based models in a formal adaptive management decision framework.

What factors hinder the decision-making process for women with cancer and contemplating fertility preservation treatment?

PubMed

Jones, Georgina; Hughes, Jane; Mahmoodi, Neda; Smith, Emily; Skull, Jonathan; Ledger, William

2017-07-01

Although fertility preservation (FP) treatment options have increased, the existing evidence suggests that many women with cancer do not feel well supported in making these decisions, but find them stressful and complex and fail to take up fertility care at this crucial time. Whilst existing reviews have all made important contributions to our understanding of the FP decision-making process, none of them examine solely and specifically these processes for women of reproductive age with a diagnosis of any cancer, leaving a gap in the knowledge base. Given the expectation that care is patient-centred, our review aims to address this gap which may be of help to those managing patients struggling to make difficult decisions in the often brief period before potentially sterilizing cancer treatment is started. Underpinning this narrative review was the question 'What factors hinder the decision-making process for women with any cancer and contemplating FP treatment?' Our objectives were to (i) assess and summarize this existing literature, (ii) identify the factors that hinder this decision-making process, (iii) explore to what extent these factors may differ for women choosing different methods of FP and (iv) make recommendations for service delivery and future research. A systematic search of the medical and social science literature from the 1 January 2005 up to the end of January 2016 was carried out using three electronic databases (Web of Science (PubMed), Ovid SP Medline and CINAHL via Ebsco). Included in the review were quantitative, qualitative and mixed-method studies. Reference lists of relevant papers were also hand searched. From the 983 papers identified, 46 papers were included. Quality assessment was undertaken using the Mixed Methods Appraisal Tool and thematic analysis was used to analyse the data. From the analysis, 6 key themes with 15 sub-themes emerged: (i) fertility information provision (lack of information, timing of the information, patient-provider communication); (ii) fear concerning the perceived risks associated with pursuing FP (delaying cancer treatment, aggravating a hormone positive cancer and consequences of a future pregnancy); (iii) non-referral from oncology (personal situation, having a hormone positive cancer, FP not a priority and transition between service issues); (iv) the dilemma (in survival mode, whether to prioritize one treatment over another); (v) personal situation (parity, relationship status) and (iv) costs (financial concerns). This review has found that a wide range of internal and external factors impact the FP decision-making process. Key external issues related to current service delivery such as the provision and timing of FP information, and lack of referral from oncology to the fertility clinic. However, internal issues such as women's fears concerning the perceived risks associated with pursuing FP also hindered decision-making but these 'risks' were typically overestimated and non-evidence based. These findings suggest that the implementation of a range of decision support interventions may be of benefit within the clinical care pathway of FP and cancer. Women would benefit from the provision of more evidence-based FP information, ideally received at cancer diagnosis, in advance of seeing a fertility specialist, for example through the implementation of patient decision aids. Healthcare professionals in both oncology and fertility services may also benefit from the implementation of training programmes and educational tools targeted at improving the communication skills needed to improve collaborative decision-making and deliver care that is patient-centred. Exploration of the current barriers, both intellectual and practical, that prevent some patients from accepting FP will help care providers to do better for their patients in the future. Finally, the extent to which a poorer prognosis and moral, ethical and religious beliefs influence the FP decision-making process also warrant further research. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Emotional balances in experimental consumer choices.

PubMed

Mengov, George; Egbert, Henrik; Pulov, Stefan; Georgiev, Kalin

2008-11-01

This paper presents an experiment, which builds a bridge over the gap between neuroscience and the analysis of economic behaviour. We apply the mathematical theory of Pavlovian conditioning, known as Recurrent Associative Gated Dipole (READ), to analyse consumer choices in a computer-based experiment. Supplier reputations, consumer satisfaction, and customer reactions are operationally defined and, together with prices, related to READ's neural dynamics. We recorded our participants' decisions with their timing, and then mapped those decisions on a sequence of events generated by the READ model. To achieve this, all constants in the differential equations were determined using simulated annealing with data from 129 people. READ predicted correctly 96% of all consumer choices in a calibration sample (n=1290), and 87% in a test sample (n=903), thus outperforming logit models. The rank correlations between self-assessed and dipole-generated consumer satisfactions were 89% in the calibration sample and 78% in the test sample, surpassing by a wide margin the best linear regression model.

Modeling approaches for characterizing and evaluating environmental exposure to engineered nanomaterials in support of risk-based decision making.

PubMed

Hendren, Christine Ogilvie; Lowry, Michael; Grieger, Khara D; Money, Eric S; Johnston, John M; Wiesner, Mark R; Beaulieu, Stephen M

2013-02-05

As the use of engineered nanomaterials becomes more prevalent, the likelihood of unintended exposure to these materials also increases. Given the current scarcity of experimental data regarding fate, transport, and bioavailability, determining potential environmental exposure to these materials requires an in depth analysis of modeling techniques that can be used in both the near- and long-term. Here, we provide a critical review of traditional and emerging exposure modeling approaches to highlight the challenges that scientists and decision-makers face when developing environmental exposure and risk assessments for nanomaterials. We find that accounting for nanospecific properties, overcoming data gaps, realizing model limitations, and handling uncertainty are key to developing informative and reliable environmental exposure and risk assessments for engineered nanomaterials. We find methods suited to recognizing and addressing significant uncertainty to be most appropriate for near-term environmental exposure modeling, given the current state of information and the current insufficiency of established deterministic models to address environmental exposure to engineered nanomaterials.

Bicycle and pedestrian data : sources, needs, & gaps

DOT National Transportation Integrated Search

2000-01-01

This report provides a review of existing sources of bicycle and pedestrian-related information, including their uses, quality, and limitations. It also includes information from a broad range of decision-makers, researchers, planners, and other user...

A Perspective from the National Consortium for Secondary STEM Schools

ERIC Educational Resources Information Center

Bonds, Crystal

2016-01-01

This article addresses the role of National Consortium for Secondary STEM Schools in the process of data-informed decision-making for both improving and addressing achievement gaps in participatory specialized STEM high schools.

Computational Linguistics in Military Operations

DTIC Science & Technology

2010-01-01

information dominance at the operational and tactical level of war in future warfare. Discussion: Mastering culture and language in a foreign country is decisive to understand the operational environment. In addition, the ability to understand and speak a foreign language is a prerequisite to achieve truly comprehension of an unfamiliar culture. Lasting operations in Afghanistan and Iraq and the necessity to breach the language gap lead to progress in the field of Machine Translation and the development of technical solutions to close the gap in the past decade. This paper

Human Factors in Intelligence, Surveillance, and Reconnaissance: Gaps for Soldiers and Technology Recommendations

DTIC Science & Technology

2014-07-01

technology work seeks to address gaps in the management, processing, and fusion of heterogeneous (i.e., soft and hard ) information to aid human decision...and bandwidth) to exploit the vast and growing amounts of data [16], [17]. There is also a broad research program on techniques for soft and hard ...Mott, G. de Mel, and T. Pham, “Integrating hard and soft information sources for D2D using controlled natural language,” in Proc. Information Fusion

Meta-modelling, visualization and emulation of multi-dimensional data for virtual production intelligence

NASA Astrophysics Data System (ADS)

Schulz, Wolfgang; Hermanns, Torsten; Al Khawli, Toufik

2017-07-01

Decision making for competitive production in high-wage countries is a daily challenge where rational and irrational methods are used. The design of decision making processes is an intriguing, discipline spanning science. However, there are gaps in understanding the impact of the known mathematical and procedural methods on the usage of rational choice theory. Following Benjamin Franklin's rule for decision making formulated in London 1772, he called "Prudential Algebra" with the meaning of prudential reasons, one of the major ingredients of Meta-Modelling can be identified finally leading to one algebraic value labelling the results (criteria settings) of alternative decisions (parameter settings). This work describes the advances in Meta-Modelling techniques applied to multi-dimensional and multi-criterial optimization by identifying the persistence level of the corresponding Morse-Smale Complex. Implementations for laser cutting and laser drilling are presented, including the generation of fast and frugal Meta-Models with controlled error based on mathematical model reduction Reduced Models are derived to avoid any unnecessary complexity. Both, model reduction and analysis of multi-dimensional parameter space are used to enable interactive communication between Discovery Finders and Invention Makers. Emulators and visualizations of a metamodel are introduced as components of Virtual Production Intelligence making applicable the methods of Scientific Design Thinking and getting the developer as well as the operator more skilled.

76 FR 37371 - Agency Information Collection: Comment Request for National Gap Analysis Program Evaluation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... Gap Analysis Program (GAP). The information collected will provide information for the Program's... DEPARTMENT OF THE INTERIOR U.S. Geological Survey [USGS--GX10RB0000SDP00] Agency Information Collection: Comment Request for National Gap Analysis Program Evaluation AGENCY: United States Geological...

Parental influences on adolescent decision making and contraceptive use.

PubMed

Commendador, Kathleen A

2010-01-01

This article reviews the literature in the area of parental and maternal influences on contraceptive decision making, thus determining future directions of research and potential interventions. A review of published literature using PubMed, CINAHL, Infotrak, Science and Technology, and Medline spanning 1980-2007 was used to gather information. Results from 35 research studies and 15 scholarly articles were included. The search terms adolescent decision making, maternal influences on adolescent contraceptive decision making, adolescent contraceptive decision making, paternal influences on adolescent decision making, and contraception were used to gather data. The literature reveals there is an association between parental communication, parenting style, and adolescent sexual activity and contraception use. Maternal communication has been shown to delay sexual intercourse and increase contraceptive use. Maternal communication has rich potential as an intervention to impact positive adolescent sexual decision making and contraception use. Gaps in the research identified were the lack of studies on the influences on parenting style and the father/adolescent influences on sexual initiation and contraceptive decision making.

Comprehensive evaluation of liver resection procedures: surgical mind development through cognitive task analysis

PubMed Central

Wakabayashi, Go; Yeh, Chi-Chuan; Hu, Rey-Heng; Sakaguchi, Takanori; Hasegawa, Yasushi; Takahara, Takeshi; Nitta, Hiroyuki; Sasaki, Akira; Lee, Po-Huang

2018-01-01

Background Liver resection is a complex procedure for trainee surgeons. Cognitive task analysis (CTA) facilitates understanding and decomposing tasks that require a great proportion of mental activity from experts. Methods Using CTA and video-based coaching to compare liver resection by open and laparoscopic approaches, we decomposed the task of liver resection into exposure (visual field building), adequate tension made at the working plane (which may change three-dimensionally during the resection process), and target processing (intervention strategy) that can bridge the gap from the basic surgical principle. Results The key steps of highly-specialized techniques, including hanging maneuvers and looping of extra-hepatic hepatic veins, were shown on video by open and laparoscopic approaches. Conclusions Familiarization with laparoscopic anatomical orientation may help surgeons already skilled at open liver resection transit to perform laparoscopic liver resection smoothly. Facilities at hand (such as patient tolerability, advanced instruments, and trained teams of personnel) can influence surgical decision making. Application of the rationale and realizing the interplay between the surgical principles and the other paramedical factors may help surgeons in training to understand the mental abstractions of experienced surgeons, to choose the most appropriate surgical strategy effectively at will, and to minimize the gap. PMID:29445607

Incapacity in Canada: review of laws and policies on research involving decisionally impaired adults.

PubMed

Wildeman, Sheila; Dunn, Laura B; Onyemelukwe, Cheluchi

2013-04-01

In Canada, as in the United States, the legal frameworks governing research involving adults incapable of providing informed consent are beset by gaps and ambiguities. In both countries, federal laws and policies relevant to the regulation of research involving decisionally incapable adults interact in complex ways with provincial or state laws. To alert researchers to these complexities and to urge law reform, this review provides a comprehensive account of the federal and provincial/ territorial legal frameworks relevant to research involving decisionally incapable adults in Canada. We identified the federal and provincial/territorial laws and policies pertinent to this review by updating previous work on substitute decision-making about research in Canada and then performing keyword searches on a Canadian legal information database (CanLii) to identify further laws of relevance. Our analysis of identified laws focused on three questions: 1) What (if any) preconditions-including permissible risk and/or benefit thresholds-are imposed on research involving persons who lack capacity to consent? 2) What provisions (if any) are in place for identification of the legally authorized representative for research decision making? and 3) What factors, if any, are stipulated as mandatory relevant considerations for the legally authorized representative's decision-making process? Across Canada, laws relating to substitute decision-making are highly variable, and often ambiguous or uncertain, on each of the matters targeted in our analysis. Researchers and research institutions should be aware of federal and provincial/territorial legal requirements for research involving persons who lack capacity to consent in Canada. The relevant governments should undertake coordinated efforts at law reform to clarify, and potentially harmonize, these requirements. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

A dataset of human decision-making in teamwork management.

PubMed

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-17

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

A dataset of human decision-making in teamwork management

PubMed Central

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-01

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members’ capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches. PMID:28094787

A dataset of human decision-making in teamwork management

NASA Astrophysics Data System (ADS)

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-01

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

Informing disinvestment with limited evidence: cobalamin deficiency in the fatigued.

PubMed

Mnatzaganian, George; Karnon, Jonathan; Moss, John R; Elshaug, Adam G; Metz, Michael; Frank, Oliver R; Hiller, Janet E

2015-01-01

Health technology reassessment and disinvestment can be difficult due to uncertainties regarding available evidence. Pathology testing to investigate cobalamin (vitamin B12) deficiency is a strong case in point. We conducted a 3-month economic evaluation of five strategies for diagnosing and treating cobalamin deficiency in adult patients hypothetically presenting with new unexplained fatigue in the primary care setting. The first consultation per patient was considered. Screening tests other than serum cobalamin were not included. A cost-effectiveness analysis was undertaken using a decision tree to represent the diagnostic / treatment pathways, with relevant cost and utility scores assigned to different stages in the evaluation process. Input parameter values were estimated from published evidence, supplemented by expert opinion, with sensitivity analysis undertaken to represent parameter uncertainty. Ordering serum vitamin B12 to assess cobalamin deficiency among patients with unexplained fatigue was not cost-effective in any patient population, irrespective of pretest prevalence of this deficiency. For patients with a pretest prevalence above 1 percent, treating all with oral vitamin B12 supplements without testing was most cost-effective, whereas watchful waiting with symptoms monitoring was most cost-effective for patients with lower pretest prevalence probabilities. Substantial evidence gaps exist for parameter estimation: questionable cobalamin deficiency levels in the fatigued; debatable treatment methods; unknown natural history of the condition. Despite this, we reveal a robust path for disinvestment decision making in the face of a paradox between the evidence required to inform disinvestment compared with its paucity in informing initial funding decisions.

Facilitators and constraints at each stage of the migration decision process.

PubMed

Kley, Stefanie

2017-10-01

Behavioural models of migration emphasize the importance of migration decision-making for the explanation of subsequent behaviour. But empirical migration research regularly finds considerable gaps between those who intend to migrate and those who actually realize their intention. This paper applies the Theory of Planned Behaviour, enriched by the Rubicon model, to test specific hypotheses about distinct effects of facilitators and constraints on specific stages of migration decision-making and behaviour. The data come from a tailor-made panel survey based on random samples of people drawn from two German cities in 2006-07. The results show that in conventional models the effects of facilitators and constraints on migration decision-making are likely to be underestimated. Splitting the process of migration decision-making into a pre-decisional and a pre-actional phase helps to avoid bias in the estimated effects of facilitators and constraints on both migration decision-making and migration behaviour.

Optimizing Decision Preparedness by Adapting Scenario Complexity and Automating Scenario Generation

NASA Technical Reports Server (NTRS)

Dunne, Rob; Schatz, Sae; Flore, Stephen M.; Nicholson, Denise

2011-01-01

Klein's recognition-primed decision (RPD) framework proposes that experts make decisions by recognizing similarities between current decision situations and previous decision experiences. Unfortunately, military personnel arQ often presented with situations that they have not experienced before. Scenario-based training (S8T) can help mitigate this gap. However, SBT remains a challenging and inefficient training approach. To address these limitations, the authors present an innovative formulation of scenario complexity that contributes to the larger research goal of developing an automated scenario generation system. This system will enable trainees to effectively advance through a variety of increasingly complex decision situations and experiences. By adapting scenario complexities and automating generation, trainees will be provided with a greater variety of appropriately calibrated training events, thus broadening their repositories of experience. Preliminary results from empirical testing (N=24) of the proof-of-concept formula are presented, and future avenues of scenario complexity research are also discussed.

To close the childhood immunization gap, we need a richer understanding of parents' decision-making.

PubMed

Corben, Paul; Leask, Julie

2016-12-01

Vaccination is widely acknowledged as one of the most successful public health interventions globally and in most high-income countries childhood vaccination coverage rates are moderately high. Yet in many instances, immunisation rates remain below aspirational targets and have shown only modest progress toward those targets in recent years, despite concerted efforts to improve uptake. In part, coverage rates reflect individual parents' vaccination attitudes and decisions and, because vaccination decision-making is complex and context-specific, it remains challenging at individual and community levels to assist parents to make positive decisions. Consequently, in the search for opportunities to improve immunisation coverage, there has been a renewed research focus on parents' decision-making. This review provides an overview of the literature surrounding parents' vaccination decision-making, offering suggestions for where efforts to increase vaccination coverage should be targeted and identifying areas for further research.

Performance needs assessment of maternal and newborn health service delivery in urban and rural areas of Osun State, South-West, Nigeria.

PubMed

Esan, Oluwaseun T; Fatusi, Adesegun O

2014-06-01

The study aimed to determine performance and compare gaps in maternal and newborn health (MNH) services in urban and rural areas of Osun State, Nigeria, to inform decisions for improved services. This study involved 14 urban and 10 rural-based randomly selected PHC facilities. Using a Performance Needs Assessment framework, desired performances were determined by key stakeholders and actual performances measured by conducting facility survey. Questionnaire interview of 143 health workers and 153 antenatal clients were done. Performance gaps were determined for the urban and rural areas and compared using Chi-square tests with SPSS version 17. PHC facilities and health workers in Osun State, Nigeria, were found to have significant gaps in MNH service performance and this was worse in the rural areas. Root cause of most of the performance gaps was poor political will of local government authorities. Improved government commitment to MNH is needful to address most of the gaps.

Embodying racism: race, rhinoplasty, and self-esteem in Venezuela.

PubMed

Gulbas, Lauren E

2013-03-01

In this article, I examine how race motivates women's decisions to undergo aesthetic rhinoplasty in Caracas, Venezuela. Through a combination of cultural domain analysis and thematic analysis of qualitative interviews, I explore how the preference for whiteness and associated facial features dovetail with the aesthetic ideals promoted by cosmetic surgeons. Rhinoplasty is offered by physicians and interpreted by patients as a resolution to body dissatisfaction and low self-esteem. The clinical ethos of objectivity established by cosmetic surgeons fails to acknowledge how perceptions of the self and body are strongly tied to racial marginalization: patients' efforts to alter the nose reveal attempts to change not only how the body looks, but how it is lived. As a result, cosmetic surgery only acts as a stop-gap measure to heighten one's self-esteem and body image.

There are big gaps in our knowledge, and thus approach, to zoo animal welfare: a case for evidence-based zoo animal management.

PubMed

Melfi, V A

2009-11-01

There are gaps in knowledge that hinder our ability within zoos to provide good animal welfare. This does not mean that zoos cannot or do not provide good welfare, only that currently this goal is hindered. Three reasons for these gaps are identified as: (1) there is an emphasis on the identification and monitoring of indicators that represent poor welfare and it is assumed that an absence of poor welfare equates to good welfare. This assumption is overly simplistic and potentially erroneous; (2) our understanding of how housing and husbandry (H&H) affects animals is limited to a small set of variables determined mostly by our anthropogenic sensitivities. Thus, we place more value on captive environmental variables like space and companionship, ignoring other factors that may have a greater impact on welfare, like climate; (3) finally, whether intentional or not, our knowledge and efforts to improve zoo animal welfare are biased to very few taxa. Most attention has been focused on mammals, notably primates, large cats, bears, and elephants, to the exclusion of the other numerous species about which very little is known. Unfortunately, the extent to which these gaps limit our ability to provide zoo animals with good welfare is exacerbated by our over reliance on using myth and tradition to determine zoo animal management. I suggest that we can fill these gaps in our knowledge and improve our ability to provide zoo animals with good welfare through the adoption of an evidence-based zoo animal management framework. This approach uses evidence gathered from different sources as a basis for making any management decisions, as good quality evidence increases the likelihood that these decisions result in good zoo animal welfare.

Gap Analysis: Rethinking the Conceptual Foundations

DTIC Science & Technology

2008-04-23

there could exist a basis for gap in capability and, therefore, a desire to close the capability gap . What one desires versus what one has is, in...Analysis is not intended to close the space between the most distant extremes or the rarest occurrences. Rather, Gap Analysis is centered on the larger...åÖÉ=======- 13 - = = Research Objectives The process of identifying needs and unsatisfied desires, or gaps in capability—in essence, the goal—is

Identification of key factors in consumers' adoption behavior of intelligent medical terminals based on a hybrid modified MADM model for product improvement.

PubMed

Liu, Yupeng; Chen, Yifei; Tzeng, Gwo-Hshiung

2017-09-01

As a new application technology of the Internet of Things (IoT), intelligent medical treatment has attracted the attention of both nations and industries through its promotion of medical informatisation, modernisation, and intelligentisation. Faced with a wide variety of intelligent medical terminals, consumers may be affected by various factors when making purchase decisions. To examine and evaluate the key influential factors (and their interrelationships) of consumer adoption behavior for improving and promoting intelligent medical terminals toward achieving set aspiration level in each dimension and criterion. A hybrid modified Multiple Attribute Decision-Making (MADM) model was used for this study, based on three components: (1) the Decision-Making Trial and Evaluation Laboratory (DEMATEL) technique, to build an influential network relationship map (INRM) at both 'dimensions' and 'criteria' levels; (2) the DEMATEL-based analytic network process (DANP) method, to determine the interrelationships and influential weights among the criteria and identify the source-influential factors; and (3) the modified Vlse Kriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method, to evaluate and improve for reducing the performance gaps to meet the consumers' needs for continuous improvement and sustainable products-development. First, a consensus on the influential factors affecting consumers' adoption of intelligent medical terminals was collected from experts' opinion in practical experience. Next, the interrelationships and influential weights of DANP among dimensions/criteria based on the DEMATEL technique were determined. Finally, two intelligent medicine bottles (AdhereTech, A 1 alternative; and Audio/Visual Alerting Pillbox, A 2 alternative) were reviewed as the terminal devices to verify the accuracy of the MADM model and evaluate its performance on each criterion for improving the total certification gaps by systematics according to the modified VIKOR method based on an INRM. In this paper, the criteria and dimensions used to improve the evaluation framework are validated. The systematic evaluation in index system is constructed on the basis of five dimensions and corresponding ten criteria. Influential weights of all criteria ranges from 0.037 to 0.152, which shows the rank of criteria importance. The evaluative framework were validated synthetically and scientifically. INRM (influential network relation map) was obtained from experts' opinion through DEMATEL technique shows complex interrelationship among factors. At the dimension level, the environmental dimension influences other dimensions the most, whereas the security dimension is most influenced by others. So the improvement order of environmental dimension is prior to security dimension. The newly constructed approach was still further validated by the results of the empirical case, where performance gap improvement strategies were analyzed for decision-makers. The modified VIKOR method was especially validated for solving real-world problems in intelligent medical terminal improvement processes. For this paper, A 1 performs better than A 2 , however, promotion mix, brand factor, and market environment are shortcomings faced by both A 1 and A 2 . In addition, A 2 should be improved in the wireless network technology, and the objective contact with a high degree of gaps. Based on the evaluation index system and the integrated model proposed here, decision-makers in enterprises can identify gaps when promoting intelligent medical terminals, from which they can get valuable advice to improve consumer adoption. Additionally, an INRM and the influential weights of DANP can be combined using the modified VIKOR method as integrated weightings to determine how to reduce gaps and provide the best improvement strategies for reaching set aspiration levels. Copyright © 2017 Elsevier B.V. All rights reserved.

Enabler for Interdisciplinary eHealthcare: A Qualitative Study.

PubMed

Yu, Dan; Poon, Simon K; Tran, Vivienne; Lam, Mary K; Hines, Monique; Brunner, Melissa; Power, Emma; Shaw, Tim; Togher, Leanne

2017-01-01

The complex relations between Health Technologies and clinical practices have been the focus of intensive research in recent years. This research represents a shift towards a holistic view where evaluation of health technologies is linked to organisational practices. In this paper, we address the gaps in existing literature regarding the holistic evaluation of e-health in clinical practice. We report the results from a qualitative study conducted to gain insight into e-health in practice within an interdisciplinary healthcare domain. Findings from this qualitative study, provides the foundation for the creation of a generic measurement model that allows for the comparative analysis of health technologies and assist in the decision-making of its stakeholders.

Confidentiality and Privacy for Smartphone Applications in Child and Adolescent Psychiatry: Unmet Needs and Practical Solutions.

PubMed

Wu, Emily; Torous, John; Hardaway, Rashad; Gutheil, Thomas

2017-01-01

This article summarizes the current literature on clinical knowledge and practical gaps regarding the confidentiality and privacy for smartphone and connected devices in child and adolescent psychiatry and offers practical solutions and consideration for the next steps for the field. Important issues to consider include disclosure of information sharing, access privilege, privacy and trust, risk and benefit analysis, and the need for standardization. Through understanding the privacy and confidentiality concerns regarding digital devices, child and adolescent psychiatrists can guide patients and parents though informed decision-making and also help shape how the field creates the next generation of these tools. Copyright © 2016 Elsevier Inc. All rights reserved.

Discursive gaps in the implementation of public health policy guidelines in India: the case of HIV testing.

PubMed

Sheikh, Kabir; Porter, John

2010-12-01

The implementation of standardized policy guidelines for care of diseases of public health importance has emerged as a subject of concern in low and middle-income countries (LMIC) globally. We conducted an empirical research study using the interpretive policy analysis approach to diagnose reasons for gaps in the implementation of national guidelines for HIV testing in Indian hospitals. Forty-six in-depth interviews were conducted with actors involved in policy implementation processes in five states of India, including practitioners, health administrators, policy-planners and donors. We found that actors' divergences from their putative roles in implementation were underpinned by their inhabitation of discrete 'systems of meaning' - frameworks for perceiving policy problems, acting and making decisions. Key gaps in policy implementation included conflicts between different actors' ideals of performance of core tasks and conformance with policy, and problems in communicating policy ideas across systems of meaning. These 'discursive' gaps were compounded by the lack of avenues for intellectual intercourse and by unaccounted interrelationships of power between implementing actors. Our findings demonstrate the importance of thinking beyond short-sighted ideals of aligning frontline practices with global policymakers' intentions. Recognising the deliberative nature of implementation, and strengthening discourse and communications between involved actors may be critical to the success of public health policies in Indian and comparable LMIC settings. Effective policy implementation in the long term also necessitates enhancing practitioners' contributions to the policy process, and equipping country public health functionaries to actualize their policy leadership roles. Copyright © 2010 Elsevier Ltd. All rights reserved.

Diagnosing climate change impacts and identifying adaptation strategies by involving key stakeholder organisations and farmers in Sikkim, India: Challenges and opportunities.

PubMed

Azhoni, Adani; Goyal, Manish Kumar

2018-06-01

Narrowing the gap between research, policy making and implementing adaptation remains a challenge in many parts of the world where climate change is likely to severely impact water security. This research aims to narrow this gap by matching the adaptation strategies being framed by policy makers to that of the perspectives of development agencies, researchers and farmers in the Himalayan state of Sikkim in India. Our case study examined the perspectives of various stakeholders for climate change impacts, current adaptation strategies, knowledge gaps and adaptation barriers, particularly in the context of implementing the Sikkim State Action Plan on Climate Change through semi-structured interviews carried out with decision makers in the Sikkim State Government, researchers, consultants, local academia, development agencies and farmers. Using Stakeholders Network Analysis tools, this research unravels the complexities of perceiving climate change impacts, identifying strategies, and implementing adaptation. While farmers are less aware about the global phenomenon of climate change impacts for water security, their knowledge of the local conditions and their close interaction with the State Government Agriculture Department provides them opportunities. Although important steps are being initiated through the Sikkim State Action Plan on Climate Change it is yet to deliver effective means of adaptation implementation and hence, strengthening the networks of close coordination between the various implementing agencies will pay dividends. Knowledge gaps and the need for capacity building identified in this research, based on the understandings of key stakeholders are highly relevant to both the research community and for informing policy. Copyright © 2018 Elsevier B.V. All rights reserved.

Checklist and Decision Support in Nutritional Care for Burned Patients

DTIC Science & Technology

2016-10-01

AD______________ AWARD NUMBER: W81XWH-12-2-0074 TITLE: Checklist and Decision Support in Nutritional Care for Burned Patients PRINCIPAL...in Nutritional Care for Burned Patients 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-2-0074 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Steven E... nutritional goals are not met in severely burned adults, 2) To find strategies to address identified gaps in feeding to incorporate into a checklist with easy

Supporting Fisheries Management by Means of Complex Models: Can We Point out Isles of Robustness in a Sea of Uncertainty?

PubMed Central

Gasche, Loïc; Mahévas, Stéphanie; Marchal, Paul

2013-01-01

Ecosystems are usually complex, nonlinear and strongly influenced by poorly known environmental variables. Among these systems, marine ecosystems have high uncertainties: marine populations in general are known to exhibit large levels of natural variability and the intensity of fishing efforts can change rapidly. These uncertainties are a source of risks that threaten the sustainability of both fish populations and fishing fleets targeting them. Appropriate management measures have to be found in order to reduce these risks and decrease sensitivity to uncertainties. Methods have been developed within decision theory that aim at allowing decision making under severe uncertainty. One of these methods is the information-gap decision theory. The info-gap method has started to permeate ecological modelling, with recent applications to conservation. However, these practical applications have so far been restricted to simple models with analytical solutions. Here we implement a deterministic approach based on decision theory in a complex model of the Eastern English Channel. Using the ISIS-Fish modelling platform, we model populations of sole and plaice in this area. We test a wide range of values for ecosystem, fleet and management parameters. From these simulations, we identify management rules controlling fish harvesting that allow reaching management goals recommended by ICES (International Council for the Exploration of the Sea) working groups while providing the highest robustness to uncertainties on ecosystem parameters. PMID:24204873

Supporting fisheries management by means of complex models: can we point out isles of robustness in a sea of uncertainty?

PubMed

Gasche, Loïc; Mahévas, Stéphanie; Marchal, Paul

2013-01-01

Ecosystems are usually complex, nonlinear and strongly influenced by poorly known environmental variables. Among these systems, marine ecosystems have high uncertainties: marine populations in general are known to exhibit large levels of natural variability and the intensity of fishing efforts can change rapidly. These uncertainties are a source of risks that threaten the sustainability of both fish populations and fishing fleets targeting them. Appropriate management measures have to be found in order to reduce these risks and decrease sensitivity to uncertainties. Methods have been developed within decision theory that aim at allowing decision making under severe uncertainty. One of these methods is the information-gap decision theory. The info-gap method has started to permeate ecological modelling, with recent applications to conservation. However, these practical applications have so far been restricted to simple models with analytical solutions. Here we implement a deterministic approach based on decision theory in a complex model of the Eastern English Channel. Using the ISIS-Fish modelling platform, we model populations of sole and plaice in this area. We test a wide range of values for ecosystem, fleet and management parameters. From these simulations, we identify management rules controlling fish harvesting that allow reaching management goals recommended by ICES (International Council for the Exploration of the Sea) working groups while providing the highest robustness to uncertainties on ecosystem parameters.

Eco-informatics for decision makers advancing a research agenda

USGS Publications Warehouse

Cushing, J.B.; Wilson, T.; Brandt, L.; Gregg, V.; Spengler, S.; Borning, A.; Delcambre, L.; Bowker, G.; Frame, M.; Fulop, J.; Hert, C.; Hovy, E.; Jones, J.; Landis, E.; Schnase, J.L.; Schweik, C.; Sonntag, W.; ,

2005-01-01

Resource managers often face significant information technology (IT) problems when integrating ecological or environmental information to make decisions. At a workshop sponsored by the NSF and USGS in December 2004, university researchers, natural resource managers, and information managers met to articulate IT problems facing ecology and environmental decision makers. Decision making IT problems were identified in five areas: 1) policy, 2) data presentation, 3) data gaps, 4) tools, and 5) indicators. To alleviate those problems, workshop participants recommended specific informatics research in modeling and simulation, data quality, information integration and ontologies, and social and human aspects. This paper reports the workshop findings, and briefly compares these with research that traditionally falls under the emerging eco-informatics rubric. ?? Springer-Verlag Berlin Heidelberg 2005.

Taking stock of decentralized disaster risk reduction in Indonesia

NASA Astrophysics Data System (ADS)

Grady, Anthony; Gersonius, Berry; Makarigakis, Alexandros

2016-09-01

The Sendai Framework, which outlines the global course on disaster risk reduction until 2030, places strong importance on the role of local government in disaster risk reduction. An aim of decentralization is to increase the influence and authority of local government in decision making. Yet, there is limited empirical evidence of the extent, character and effects of decentralization in current disaster risk reduction implementation, and of the barriers that are most critical to this. This paper evaluates decentralization in relation to disaster risk reduction in Indonesia, chosen for its recent actions to decentralize governance of DRR coupled with a high level of disaster risk. An analytical framework was developed to evaluate the various dimensions of decentralized disaster risk reduction, which necessitated the use of a desk study, semi-structured interviews and a gap analysis. Key barriers to implementation in Indonesia included: capacity gaps at lower institutional levels, low compliance with legislation, disconnected policies, issues in communication and coordination and inadequate resourcing. However, any of these barriers are not unique to disaster risk reduction, and similar barriers have been observed for decentralization in other developing countries in other public sectors.

An Overview of Power Capability Requirements for Exploration Missions

NASA Technical Reports Server (NTRS)

Davis, Jose M.; Cataldo, Robert L.; Soeder, James F.; Manzo, Michelle A.; Hakimzadeh, Roshanak

2005-01-01

Advanced power is one of the key capabilities that will be needed to achieve NASA's missions of exploration and scientific advancement. Significant gaps exist in advanced power capabilities that are on the critical path to enabling human exploration beyond Earth orbit and advanced robotic exploration of the solar system. Focused studies and investment are needed to answer key development issues for all candidate technologies before down-selection. The viability of candidate power technology alternatives will be a major factor in determining what exploration mission architectures are possible. Achieving the capabilities needed to enable the CEV, Moon, and Mars missions is dependent on adequate funding. Focused investment in advanced power technologies for human and robotic exploration missions is imperative now to reduce risk and to make informed decisions on potential exploration mission decisions beginning in 2008. This investment would begin the long lead-time needed to develop capabilities for human exploration missions in the 2015 to 2030 timeframe. This paper identifies some of the key technologies that will be needed to fill these power capability gaps. Recommendations are offered to address capability gaps in advanced power for Crew Exploration Vehicle (CEV) power, surface nuclear power systems, surface mobile power systems, high efficiency power systems, and space transportation power systems. These capabilities fill gaps that are on the critical path to enabling robotic and human exploration missions. The recommendations address the following critical technology areas: Energy Conversion, Energy Storage, and Power Management and Distribution.

Evolution of rural-urban health gaps in Morocco: 1992-2011.

PubMed

Abdesslam, Boutayeb

2012-07-27

Moroccan authorities carry out regular surveys on population and family health (NSFFP 1980, NSPH 1992, SPFH 2004, NSPFH 2011). These surveys constitute valuable resources for monitoring socio-economic and health indicators. They provide an evidence base for health decision makers to help them to optimize health strategies in order to improve the health conditions of the whole population. They also provide updated measures on geographic disparities, socio-economic inequalities and health inequity. The most recent Moroccan population and family health survey (NSPFH 2011) was carried out between November 2010 and March 2011. The final report and the database are not yet accessible, but a preliminary report was released early March 2012. This report does not allow for a complete evaluation of the present health situation in Morocco. A partial equity analysis can, however, be devoted to the comparison of health indicators especially in terms of rural-urban gaps. The 2011 survey shows that Moroccan population is in the last phase of the demographic transition. The total fertility rate decreased from 5.6 children per woman in 1980 to 2.5 per woman in 2011. The mean age of first marriage increased from 24 years for men and 17.5 years for women in 1960 to 31.5 years and 26.3 years in 2011 for men and women, respectively. The age structure shows a trend of ageing population. A comparison with the 1992 NSPH indicates that adult illiteracy has decreased from 53% in 1992 to 37.6% in 2011.During the same time period, women's access to maternal care and health services improved significantly. For instance, the proportion of deliveries assisted by skilled health personnel increased from 31% in 1992 to 73.6% in 2011. Between 1992 and 2011, neonatal, postnatal, infant and under-five mortality rates were reduced by 44%, 65%, 54% and 64%, respectively. This paper shows that average health indicators improved noticeably during the last two decades but rural-urban disparities are still a challenge for health decision makers. Socio-economic indicators, like illiteracy rate and unemployment, also demonstrate large gender inequalities. This preliminary analysis is designed to assist Moroccan health authorities to evaluate the current health situation in order to adopt cost-effective strategies that improve "health for all" and reduce the gaps between advantaged and disadvantaged populations.

Local transportation and land use coordination : tools and gaps.

DOT National Transportation Integrated Search

2010-06-01

"The effective coordination of transportation and land use planning decisions is vital to Montanas long-term economic growth and fiscal well being. Toward this end, this research project entailed a best practices study of land use and transportati...

Factors influencing parents' decision to donate their healthy infant's DNA for minimal-risk genetic research.

PubMed

Hatfield, Linda A; Pearce, Margaret M

2014-11-01

To examine factors that influence a parent's decision to donate their healthy infant's DNA for minimal-risk genetic research. Grounded theory, using semi-structured interviews conducted with 35 postpartum mother or mother-father dyads in an urban teaching hospital. Data were collected from July 2011 to January 2012. Audiorecorded semistructured interviews were conducted in private rooms with mothers or mother-father dyads 24 to 48 hr after the birth of their healthy, full-term infant. Data-driven content analysis using selected principles of grounded theory was performed. Parents' willingness to donate their healthy infant's DNA for minimal-risk pediatric genetic research emerged as a process involving three interacting components: the parents, the scientist, and the comfort of the child embedded within the context of benefit to the child. The purpose of the study and parents' perception of their commitment of time and resources determined their willingness to participate. The scientist's ability to communicate trust in the research process influenced parents' decisions. Physical discomfort of the child shaped parents' decision to donate DNA. Parental perception of a direct benefit to their child affected their willingness to discuss genetic research and its outcomes. Significant gaps and misunderstandings in parental knowledge of pediatric genetic research may affect parental willingness to donate their healthy child's DNA. Nurses knowledgeable about the decision-making process parents utilize to donate their healthy infant's DNA for minimal-risk genetic research and the factors influencing that decision are well positioned to educate parents about the role of genetics in health and illness and reassure potential research participants of the value and safeguards in pediatric genetic research. © 2014 Sigma Theta Tau International.

A conceptual model of Verbal Exchange Health Literacy

PubMed Central

Harrington, Kathleen F.; Valerio, Melissa A.

2014-01-01

Objective To address a gap in understanding of verbal exchange (oral and aural) health literacy by describing the systematic development of a verbal exchange health literacy (VEHL) definition and model which hypothesizes the role of VEHL in health outcomes. Methods Current health literacy and communication literature was systematically reviewed and combined with qualitative patient and provider data that were analyzed using a grounded theory approach. Results Analyses of current literature and formative data indicated the importance of verbal exchange in the clinical setting and revealed various factors associated with the patient-provider relationship and their characteristics that influence decision making and health behaviors. VEHL is defined as the ability to speak and listen that facilitates exchanging, understanding, and interpreting of health information for health-decision making, disease management and navigation of the healthcare system. A model depiction of mediating and influenced factors is presented. Conclusion A definition and model of VEHL is a step towards addressing a gap in health literacy knowledge and provides a foundation for examining the influence of VEHL on health outcomes. Practice Implications VEHL is an extension of current descriptions of health literacy and has implications for patient-provider communication and health decision making. PMID:24291145

Regression analysis for bivariate gap time with missing first gap time data.

PubMed

Huang, Chia-Hui; Chen, Yi-Hau

2017-01-01

We consider ordered bivariate gap time while data on the first gap time are unobservable. This study is motivated by the HIV infection and AIDS study, where the initial HIV contracting time is unavailable, but the diagnosis times for HIV and AIDS are available. We are interested in studying the risk factors for the gap time between initial HIV contraction and HIV diagnosis, and gap time between HIV and AIDS diagnoses. Besides, the association between the two gap times is also of interest. Accordingly, in the data analysis we are faced with two-fold complexity, namely data on the first gap time is completely missing, and the second gap time is subject to induced informative censoring due to dependence between the two gap times. We propose a modeling framework for regression analysis of bivariate gap time under the complexity of the data. The estimating equations for the covariate effects on, as well as the association between, the two gap times are derived through maximum likelihood and suitable counting processes. Large sample properties of the resulting estimators are developed by martingale theory. Simulations are performed to examine the performance of the proposed analysis procedure. An application of data from the HIV and AIDS study mentioned above is reported for illustration.

Evaluation of implementation viability gap funding (VGF) policy on toll road investment in Indonesia

NASA Astrophysics Data System (ADS)

Mahani, Iris; Tamin, Rizal Z.; Pribadi, Krishna S.; Wibowo, Andreas

2017-11-01

VGF policy for toll road investment in Indonesia must be reviewed. Since 2012 the Government of Indonesia (GOI) has issued viability gap funding (VGF) policy for PPP infrastructure project through ministry of finance decision (PMK) No.223/2012. One of VGF purpose is to improve the financial feasibility. In the toll road investment in Indonesia, the implementation of this policy has some problems. This study aimed to evaluate the policy by seeking implementation constraints so can be given an alternative. This research was conducted qualitatively, included aspects of implementation process VGF policy. The analysis process is based on literature study and in-depth interviews to related parties include business entity, ministry of finance, and the ministry of public works, Indonesia Toll Road Authority (BPJT) and professional societies. The literature review conducted by reviewing existing policies and best practices in countries that already practice VGF. The conclusion of this study are 1) There is a conflict of regulation in viability gap funding (VGF) for toll road investment in Indonesia; 2) If Government of Indonesia (GOI) want implement construction grant as VGF, so the regulation must improve in time limited for submission and clearly define limited given in regulation; 3) If GOI want implement partial construction as VGF, so the regulation must be improve in guideline for submission and given.

Enhancing Tissue Engineering and Regenerative Medicine Product Commercialization: The Role of Science in Regulatory Decision-Making for the TE/RM Product Development.

PubMed

Bertram, Timothy A; Johnson, Peter C; Tawil, Bill J; Van Dyke, Mark; Hellman, Kiki B

2015-10-01

TERMIS-AM Industry Committee (TERMIS-AM/IC), in collaboration with the TERMIS-Europe (EU)/IC, conducted a symposium involving the European Medicines Agency and the U.S. Food and Drug Administration (FDA) toward building an understanding of the rational basis for regulatory decision-making and providing a framework for decisions made during the evaluation of safety and efficacy of TE/RM technologies. This symposium was held in August 2012 during the TERMIS-WC in Vienna, Austria. Emerging from this international initiative by the European Union and the United States, representatives from the respective agencies demonstrated that there are ongoing interagency efforts for developing common national practices toward harmonization of regulatory requirements for the TE/RM products. To extend a broad-based understanding of the role of science in regulatory decision-making, TERMIS-AM/IC, in cooperation with the FDA, organized a symposium at the 2014 TERMIS-AM Annual Meeting, which was held in Washington, DC. This event provided insights from leaders in the FDA and TERMIS on the current status of regulatory approaches for the approved TE/RM products, the use of science in making regulatory decisions, and TE/RM technologies that are in the development pipeline to address unmet medical needs. A far-ranging discussion with FDA representatives, industrialists, physicians, regenerative medicine biologists, and tissue engineers considered the gaps in today's scientific and regulatory understanding of TE/RM technologies. The identified gaps represent significant opportunities to advance TE/RM technologies toward commercialization.

Perceptions of organ donors and willingness to donate organs upon death: a test of the prototype/willingness model.

PubMed

Hyde, Melissa K; White, Katherine M

2014-01-01

Understanding people's organ donation decisions may narrow the gap between organ supply and demand. In two studies, participants who had not recorded their posthumous organ donation decision (Study 1, N = 210; Study 2, N = 307) completed items assessing prototype/willingness model (PWM; attitude, subjective norm, donor prototype favorability and similarity, willingness) constructs. Attitude, subjective norm, and prototype similarity predicted willingness to donate. Prototype favorability and a Prototype Favorability × Similarity interaction predicted willingness (Study 2). These findings provide support for the PWM in altruistic health contexts, highlighting the importance of people's perceptions about organ donors in their donation decisions.

Perceptions of Organ Donors and Willingness to Donate Organs Upon Death: A Test of the Prototype/Willingness Model.

PubMed

Hyde, Melissa K; White, Katherine M

2014-06-09

Understanding people's organ donation decisions may narrow the gap between organ supply and demand. In two studies, participants who had not recorded their posthumous organ donation decision (Study 1 N = 210; Study 2 N = 307) completed items assessing Prototype/Willingness Model (PWM) (attitude, subjective norm, donor prototype favorability and similarity, willingness) constructs. Attitude, subjective norm, and prototype similarity predicted willingness to donate. Prototype favorability and a prototype favorability x similarity interaction predicted willingness (Study 2). These findings provide support for the PWM in altruistic health contexts, highlighting the importance of people's perceptions about organ donors in their donation decisions.

An exploratory analysis of the nature of informal knowledge underlying theories of planned action used for public health oriented knowledge translation.

PubMed

Kothari, Anita; Boyko, Jennifer A; Campbell-Davison, Andrea

2015-09-09

Informal knowledge is used in public health practice to make sense of research findings. Although knowledge translation theories highlight the importance of informal knowledge, it is not clear to what extent the same literature provides guidance in terms of how to use it in practice. The objective of this study was to address this gap by exploring what planned action theories suggest in terms of using three types of informal knowledge: local, experiential and expert. We carried out an exploratory secondary analysis of the planned action theories that informed the development of a popular knowledge translation theory. Our sample included twenty-nine (n = 29) papers. We extracted information from these papers about sources of and guidance for using informal knowledge, and then carried out a thematic analysis. We found that theories of planned action provide guidance (including sources of, methods for identifying, and suggestions for use) for using local, experiential and expert knowledge. This study builds on previous knowledge translation related work to provide insight into the practical use of informal knowledge. Public health practitioners can refer to the guidance summarized in this paper to inform their decision-making. Further research about how to use informal knowledge in public health practice is needed given the value being accorded to using informal knowledge in public health decision-making processes.

Integrating environmental gap analysis with spatial conservation prioritization: a case study from Victoria, Australia.

PubMed

Sharafi, Seyedeh Mahdieh; Moilanen, Atte; White, Matt; Burgman, Mark

2012-12-15

Gap analysis is used to analyse reserve networks and their coverage of biodiversity, thus identifying gaps in biodiversity representation that may be filled by additional conservation measures. Gap analysis has been used to identify priorities for species and habitat types. When it is applied to identify gaps in the coverage of environmental variables, it embodies the assumption that combinations of environmental variables are effective surrogates for biodiversity attributes. The question remains of how to fill gaps in conservation systems efficiently. Conservation prioritization software can identify those areas outside existing conservation areas that contribute to the efficient covering of gaps in biodiversity features. We show how environmental gap analysis can be implemented using high-resolution information about environmental variables and ecosystem condition with the publicly available conservation prioritization software, Zonation. Our method is based on the conversion of combinations of environmental variables into biodiversity features. We also replicated the analysis by using Species Distribution Models (SDMs) as biodiversity features to evaluate the robustness and utility of our environment-based analysis. We apply the technique to a planning case study of the state of Victoria, Australia. Copyright © 2012 Elsevier Ltd. All rights reserved.

Advance care planning among Colombian, Mexican, and Puerto Rican women with a cancer diagnosis.

PubMed

Carrion, Iraida V; Nedjat-Haiem, Frances R; Martinez-Tyson, Dinorah; Castañeda, Heide

2013-05-01

Limited knowledge exists pertaining to advance care planning (ACP) among Colombian, Mexican, and Puerto Rican women with a cancer diagnosis living in Central Florida, in the USA. The purpose of the study is to identify factors that facilitated the completion of ACP and decisions making patterns among the three groups of Latinas. The research method used was an exploratory qualitative in-depth open-ended semi-structured interview with a grounded theoretical approach and thematic analysis. The interviews were conducted in Spanish with a purposeful sample of 45 Latinas (15 in each group) diagnosed with cancer. A total of ten women (22 %) in the study documented at least one form of ACP. Thirty-five women identified obstacles to accessing information regarding ACP, relating this to insurance and financial factors. Among the Colombian women, one completed a living will, health care surrogate, and power of attorney (all forms of ACP), and three just a living will. Two Puerto Rican women completed all, two a living will, and one both a living will and an enduring power of attorney. Only one Mexican woman completed a living will. This study identifies a knowledge gap regarding ACP among Latina women with cancer diagnosis living in Central Florida, in the USA. Differences between the three groups exist as a result of migration/immigration history, family support, education, English language proficiency, income, knowledge gaps, and information ascertained by medical and health professionals. These differences contribute to their readiness, receptiveness, and willingness to engage in documenting a living will, a health care surrogate, and an enduring power of attorney for health decisions.

Including health in transport policy agendas: the role of health impact assessment analyses and procedures in the European experience.

PubMed Central

Dora, Carlos; Racioppi, Francesca

2003-01-01

From the mid-1990s, research began to highlight the importance of a wide range of health impacts of transport policy decisions. The Third Ministerial Conference on Environment and Health adopted a Charter on Transport, Environment and Health based on four main components: bringing awareness of the nature, magnitude and costs of the health impacts of transport into intergovernmental processes; strengthening the arguments for integration of health into transport policies by developing in-depth analysis of the evidence; developing national case studies; and engaging ministries of environment, health and transport as well as intergovernmental and nongovernmental organizations. Negotiation of the Charter was based on two converging processes: the political process involved the interaction of stakeholders in transport, health and environment in Europe, which helped to frame the issues and the approaches to respond to them; the scientific process involved an international group of experts who produced state-of- the-art reviews of the health impacts resulting from transportation activities, identifying gaps in existing knowledge and methodological tools, specifying the policy implications of their findings, and suggesting possible targets for health improvements. Health arguments were used to strengthen environmental ones, clarify costs and benefits, and raise issues of health equity. The European experience shows that HIA can fulfil the need for simple procedures to be systematically applied to decisions regarding transport strategies at national, regional and local levels. Gaps were identified concerning models for quantifying health impacts and capacity building on how to use such tools. PMID:12894322

Developing decision-relevant data and information systems for California water through listening and collaboration

NASA Astrophysics Data System (ADS)

Bales, R. C.; Bernacchi, L.; Conklin, M. H.; Viers, J. H.; Fogg, G. E.; Fisher, A. T.; Kiparsky, M.

2017-12-01

California's historic drought of 2011-2015 provided excellent conditions for researchers to listen to water-management challenges from decision makers, particularly with regard to data and information needs for improved decision making. Through the UC Water Security and Sustainability Research Initiative (http://ucwater.org/) we began a multi-year dialog with water-resources decision makers and state agencies that provide data and technical support for water management. Near-term products of that collaboration will be both a vision for a 21st-century water data and information system, and near-term steps to meet immediate legislative deadlines in a way that is consistent with the longer-term vision. While many university-based water researchers engage with state and local agencies on both science and policy challenges, UC Water's focus was on: i) integrated system management, from headwaters through groundwater and agriculture, and on ii) improved decision making through better water information systems. This focus aligned with the recognition by water leaders that fundamental changes in the way the state manages water were overdue. UC Water is focused on three "I"s: improved water information, empowering Institutions to use and to create new information, and enabling decision makers to make smart investments in both green and grey Infrastructure. Effective communication with water decision makers has led to engagement on high-priority programs where large knowledge gaps remain, including more-widespread groundwater recharge of storm flows, restoration of mountain forests in important source-water areas, governance structures for groundwater sustainability, and filling information gaps by bringing new technology to bear on measurement and data programs. Continuing engagement of UC Water researchers in public dialog around water resources, through opinion pieces, feature articles, blogs, white papers, social media, video clips and a feature documentary film have also been key to our continuing engagement. These novel partnerships are leading to decision-relevant tools and an improved integrated praxis in on-the-ground water-resources management. Our research is becoming more embedded in policies and our network remains interconnected with decision makers at multiple levels.

A Decision Support Framework for Evaluation of Engineered Nanomaterials

EPA Science Inventory

Engineered nanomaterials (ENM) are currently being developed and applied at rates that far exceed our ability to evaluate their potential for environmental or human health risks. The gap between material development and capacity for assessment grows wider every day. Transforma...

Improving Coalitions through S&T Cooperation

DTIC Science & Technology

2008-12-01

Canada Potentially disruptive technologies that could provide decisive advantage for the CF • Quantum capabilities • Autonomous intelligent systems...the gaps in the CF Strategic Capability Roadmap • Position Defence to exploit emerging or disruptive technologies • Reduce the costs of defence

Political orientation and perceptions of adolescent autonomy and judicial culpability.

PubMed

Reppucci, N Dickon; Scott, Elizabeth; Antonishak, Jill

2009-01-01

This study probed general attitudes about processing youths in adult criminal court across a range of offenses, explored attitudes about age of autonomous decision-making for several activities outside the criminal justice context, and examined the interaction between these two realms. The major finding was that adults favor adult punishment of adolescent offenders at younger ages than they favor autonomy in other decision-making contexts; the gap is widest for those who identify themselves as conservatives. 2009 John Wiley & Sons, Ltd.

Review and bibliometric analysis of published literature citing data produced by the Gap Analysis Program (GAP)

USGS Publications Warehouse

Ratz, Joan M.; Conk, Shannon J.

2014-01-01

The Gap Analysis Program (GAP) of the U.S. Geological Survey (USGS) produces geospatial datasets providing information on land cover, predicted species distributions, stewardship (ownership and conservation status), and an analysis dataset which synthesizes the other three datasets. The intent in providing these datasets is to support the conservation of biodiversity. The datasets are made available at no cost. The initial datasets were created at the state level. More recent datasets have been assembled at regional and national levels. GAP entered an agreement with the Policy Analysis and Science Assistance branch of the USGS to conduct an evaluation to describe the effect that using GAP data has on those who utilize the datasets (GAP users). The evaluation project included multiple components: a discussion regarding use of GAP data conducted with participants at a GAP conference, a literature review of publications that cited use of GAP data, and a survey of GAP users. The findings of the published literature search were used to identify topics to include on the survey. This report summarizes the literature search, the characteristics of the resulting set of publications, the emergent themes from statements made regarding GAP data, and a bibliometric analysis of the publications. We cannot claim that this list includes all publications that have used GAP data. Given the time lapse that is common in the publishing process, more recent datasets may be cited less frequently in this list of publications. Reports or products that used GAP data may be produced but never published in print or released online. In that case, our search strategies would not have located those reports. Authors may have used GAP data but failed to cite it in such a way that the search strategies we used would have located those publications. These are common issues when using a literature search as part of an evaluation project. Although the final list of publications we identified is not comprehensive, this set of publications can be considered a sufficient sample of those citing GAP data and suitable for the descriptive analyses we conducted.

The absence of wild game and fish species from the USDA National Nutrient Database for standard reference: addressing information gaps in wild caught foods.

PubMed

Tidball, Moira M; Tidball, Keith G; Curtis, Paul

2014-01-01

We highlighted gaps in nutritional data for wild game meat and wild caught fish that have a regulated harvesting season in New York State, and examined the possible role that wild game and fish play in current trends towards consumption of local, healthy meat sources. This project is part of larger study that examines family food decision-making, and explores possibilities for leveraging the locavore movement in support of consumption of wild game and fish.

Human Research Program Space Human Factors Engineering (SHFE) Standing Review Panel (SRP)

NASA Technical Reports Server (NTRS)

Wichansky, Anna; Badler, Norman; Butler, Keith; Cummings, Mary; DeLucia, Patricia; Endsley, Mica; Scholtz, Jean

2009-01-01

The Space Human Factors Engineering (SHFE) Standing Review Panel (SRP) evaluated 22 gaps and 39 tasks in the three risk areas assigned to the SHFE Project. The area where tasks were best designed to close the gaps and the fewest gaps were left out was the Risk of Reduced Safety and Efficiency dire to Inadequate Design of Vehicle, Environment, Tools or Equipment. The areas where there were more issues with gaps and tasks, including poor or inadequate fit of tasks to gaps and missing gaps, were Risk of Errors due to Poor Task Design and Risk of Error due to Inadequate Information. One risk, the Risk of Errors due to Inappropriate Levels of Trust in Automation, should be added. If astronauts trust automation too much in areas where it should not be trusted, but rather tempered with human judgment and decision making, they will incur errors. Conversely, if they do not trust automation when it should be trusted, as in cases where it can sense aspects of the environment such as radiation levels or distances in space, they will also incur errors. This will be a larger risk when astronauts are less able to rely on human mission control experts and are out of touch, far away, and on their own. The SRP also identified 11 new gaps and five new tasks. Although the SRP had an extremely large quantity of reading material prior to and during the meeting, we still did not feel we had an overview of the activities and tasks the astronauts would be performing in exploration missions. Without a detailed task analysis and taxonomy of activities the humans would be engaged in, we felt it was impossible to know whether the gaps and tasks were really sufficient to insure human safety, performance, and comfort in the exploration missions. The SRP had difficulty evaluating many of the gaps and tasks that were not as quantitative as those related to concrete physical danger such as excessive noise and vibration. Often the research tasks for cognitive risks that accompany poor task or information design addressed only part, but not all, of the gaps they were programmed to fill. In fact the tasks outlined will not close the gap but only scratch the surface in many cases. In other cases, the gap was written too broadly, and really should be restated in a more constrained way that can be addressed by a well-organized and complementary set of tasks. In many cases, the research results should be turned into guidelines for design. However, it was not clear whether the researchers or another group would construct and deliver these guidelines.

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.

Disclosing incidental findings in brain research: the rights of minors in decision-making.

PubMed

Di Pietro, Nina C; Illes, Judy

2013-11-01

MRI is used routinely in research with children to generate new knowledge about brain development. The detection of unexpected brain abnormalities (incidental findings; IFs) in these studies presents unique challenges. While key issues surrounding incidence and significance, duty of care, and burden of disclosure have been addressed substantially for adults, less empirical data and normative analyses exist for minors who participate in minimal risk research. To identify ethical concerns and fill existing gaps, we conducted a comprehensive review of papers that focused explicitly on the discovery of IFs in minors. The discourse in the 21 papers retrieved for this analysis amply covered practical issues such as informed consent and screening, difficulties in ascertaining clinical significance, the economic costs and burden of responsibility on researchers, and risks (physical or psychological). However, we found little discussion about the involvement of minors in decisions about disclosure of IFs in the brain, especially for IFs of low clinical significance. In response, we propose a framework for managing IFs that integrates practical considerations with explicit appreciation of rights along the continuum of maturity. This capacity-adjusted framework emphasizes the importance of involving competent minors and respecting their right to make decisions about disclosure. Copyright © 2013 Wiley Periodicals, Inc.

Addressing uncertainty in modelling cumulative impacts within maritime spatial planning in the Adriatic and Ionian region.

PubMed

Gissi, Elena; Menegon, Stefano; Sarretta, Alessandro; Appiotti, Federica; Maragno, Denis; Vianello, Andrea; Depellegrin, Daniel; Venier, Chiara; Barbanti, Andrea

2017-01-01

Maritime spatial planning (MSP) is envisaged as a tool to apply an ecosystem-based approach to the marine and coastal realms, aiming at ensuring that the collective pressure of human activities is kept within acceptable limits. Cumulative impacts (CI) assessment can support science-based MSP, in order to understand the existing and potential impacts of human uses on the marine environment. A CI assessment includes several sources of uncertainty that can hinder the correct interpretation of its results if not explicitly incorporated in the decision-making process. This study proposes a three-level methodology to perform a general uncertainty analysis integrated with the CI assessment for MSP, applied to the Adriatic and Ionian Region (AIR). We describe the nature and level of uncertainty with the help of expert judgement and elicitation to include all of the possible sources of uncertainty related to the CI model with assumptions and gaps related to the case-based MSP process in the AIR. Next, we use the results to tailor the global uncertainty analysis to spatially describe the uncertainty distribution and variations of the CI scores dependent on the CI model factors. The results show the variability of the uncertainty in the AIR, with only limited portions robustly identified as the most or the least impacted areas under multiple model factors hypothesis. The results are discussed for the level and type of reliable information and insights they provide to decision-making. The most significant uncertainty factors are identified to facilitate the adaptive MSP process and to establish research priorities to fill knowledge gaps for subsequent planning cycles. The method aims to depict the potential CI effects, as well as the extent and spatial variation of the data and scientific uncertainty; therefore, this method constitutes a suitable tool to inform the potential establishment of the precautionary principle in MSP.

A critical analysis of the literature and theoretical perspectives on theory-practice gap amongst newly qualified nurses within the United Kingdom.

PubMed

Monaghan, Thomas

2015-08-01

This critical analysis of the literature examines the factors and theoretical perspectives contributing to the theory-practice gap for newly qualified nurses within the United Kingdom. This article aspires to inform, guide and promote effective nursing education both academically and practically. A systematic search strategy was conducted to identify relevant literature covering the period of 2000-2014, to include only contemporary theoretical perspectives coinciding with the dearth of contemporary literature post Project 2000. The literature was systematically investigated utilising nursing research databases, the Cumulative Index of Nursing and Allied Health Literature, Allied and Complementary Medicine, the U.S. National Library of Medicine and Internurse. To satisfy the search criteria only articles conducted within the United Kingdom and written in the English language were included. Only literature including nurses and newly qualified nurses were included. To identify relevant literature a series of key words were utilised. Systematic review of the literature revealed that newly qualified nurses feel unprepared for practice, lacking confidence in their own abilities. It was also felt by newly qualified nurses that not enough time was dedicated to the production of clinical skills during their training. The use of preceptorship programmes was found to reduce the transitional stress associated with becoming a qualified nursing practitioner. Despite the increasing research being undertaken in the area of theory-practice gap there is still a need for nursing educators, practice areas and regulatory bodies to invest further in research. The effects of preceptorship and simulation exercises in particular require more research to provide regulatory bodies with enough evidence to make an informed decision as to whether their use should be mandatory. Copyright © 2015 Elsevier Ltd. All rights reserved.

Application of Life Cycle Assessment on Electronic Waste Management: A Review.

PubMed

Xue, Mianqiang; Xu, Zhenming

2017-04-01

Electronic waste is a rich source of both valuable materials and toxic substances. Management of electronic waste is one of the biggest challenges of current worldwide concern. As an effective and prevailing environmental management tool, life cycle assessment can evaluate the environmental performance of electronic waste management activities. Quite a few scientific literatures reporting life cycle assessment of electronic waste management with significant outcomes have been recently published. This paper reviewed the trends, characteristics, research gaps, and challenges of these studies providing detailed information for practitioners involved in electronic waste management. The results showed that life cycle assessment studies were most carried out in Europe, followed by Asia and North America. The research subject of the studies mainly includes monitors, waste printed circuit boards, mobile phones, computers, printers, batteries, toys, dishwashers, and light-emitting diodes. CML was the most widely used life cycle impact assessment method in life cycle assessment studies on electronic waste management, followed by EI99. Furthermore, 40% of the reviewed studies combined with other environmental tools, including life cycle cost, material flow analysis, multi-criteria decision analysis, emergy analysis, and hazard assessment which came to more comprehensive conclusions from different aspects. The research gaps and challenges including uneven distribution of life cycle assessment studies, life cycle impact assessment methods selection, comparison of the results, and uncertainty of the life cycle assessment studies were examined. Although life cycle assessment of electronic waste management facing challenges, their results will play more and more important role in electronic waste management practices.

Boundary Layer Transition Results From STS-114

NASA Technical Reports Server (NTRS)

Berry, Scott A.; Horvath, Thomas J.; Cassady, Amy M.; Kirk, Benjamin S.; Wang, K. C.; Hyatt, Andrew J.

2006-01-01

The tool for predicting the onset of boundary layer transition from damage to and/or repair of the thermal protection system developed in support of Shuttle Return to Flight is compared to the STS-114 flight results. The Boundary Layer Transition (BLT) Tool is part of a suite of tools that analyze the aerothermodynamic environment of the local thermal protection system to allow informed disposition of damage for making recommendations to fly as is or to repair. Using mission specific trajectory information and details of each damage site or repair, the expected time of transition onset is predicted to help determine the proper aerothermodynamic environment to use in the subsequent thermal and stress analysis of the local structure. The boundary layer transition criteria utilized for the tool was developed from ground-based measurements to account for the effect of both protuberances and cavities and has been calibrated against flight data. Computed local boundary layer edge conditions provided the means to correlate the experimental results and then to extrapolate to flight. During STS-114, the BLT Tool was utilized and was part of the decision making process to perform an extravehicular activity to remove the large gap fillers. The role of the BLT Tool during this mission, along with the supporting information that was acquired for the on-orbit analysis, is reviewed. Once the large gap fillers were removed, all remaining damage sites were cleared for reentry as is. Post-flight analysis of the transition onset time revealed excellent agreement with BLT Tool predictions.

Application of Life Cycle Assessment on Electronic Waste Management: A Review

NASA Astrophysics Data System (ADS)

Xue, Mianqiang; Xu, Zhenming

2017-04-01

Electronic waste is a rich source of both valuable materials and toxic substances. Management of electronic waste is one of the biggest challenges of current worldwide concern. As an effective and prevailing environmental management tool, life cycle assessment can evaluate the environmental performance of electronic waste management activities. Quite a few scientific literatures reporting life cycle assessment of electronic waste management with significant outcomes have been recently published. This paper reviewed the trends, characteristics, research gaps, and challenges of these studies providing detailed information for practitioners involved in electronic waste management. The results showed that life cycle assessment studies were most carried out in Europe, followed by Asia and North America. The research subject of the studies mainly includes monitors, waste printed circuit boards, mobile phones, computers, printers, batteries, toys, dishwashers, and light-emitting diodes. CML was the most widely used life cycle impact assessment method in life cycle assessment studies on electronic waste management, followed by EI99. Furthermore, 40% of the reviewed studies combined with other environmental tools, including life cycle cost, material flow analysis, multi-criteria decision analysis, emergy analysis, and hazard assessment which came to more comprehensive conclusions from different aspects. The research gaps and challenges including uneven distribution of life cycle assessment studies, life cycle impact assessment methods selection, comparison of the results, and uncertainty of the life cycle assessment studies were examined. Although life cycle assessment of electronic waste management facing challenges, their results will play more and more important role in electronic waste management practices.

End-of-life decision making by family caregivers of persons with advanced dementia: A literature review of decision aids.

PubMed

Xie, Bo; Berkley, Amy S; Kwak, Jung; Fleischmann, Kenneth R; Champion, Jane Dimmitt; Koltai, Kolina S

2018-01-01

To investigate existing knowledge in the literature about end-of-life decision making by family caregivers of persons with dementia, focusing on decision aids for caregivers of persons with advanced dementia, and to identify gaps in the literature that can guide future research. A literature review through systematic searches in PubMed, CINAHL Plus with Full Text, and PsycINFO was conducted in February 2018; publications with full text in English and published in the past 10 years were selected in multiple steps. The final sample included five decision aids with predominantly Caucasian participants; three of them had control groups, and three used audiovisual technology in presenting the intervention materials. No other technology was used in any intervention. Existing interventions lacked tailoring of information to caregivers' preferences for different types and amounts of information necessary to make decisions consistent with patients' values. Research is needed in exploring the use of technology in decision aids that could provide tailored information to facilitate caregivers' decision making. More diverse samples are needed.

FDT 2.0: Improving scalability of the fuzzy decision tree induction tool - integrating database storage.

PubMed

Durham, Erin-Elizabeth A; Yu, Xiaxia; Harrison, Robert W

2014-12-01

Effective machine-learning handles large datasets efficiently. One key feature of handling large data is the use of databases such as MySQL. The freeware fuzzy decision tree induction tool, FDT, is a scalable supervised-classification software tool implementing fuzzy decision trees. It is based on an optimized fuzzy ID3 (FID3) algorithm. FDT 2.0 improves upon FDT 1.0 by bridging the gap between data science and data engineering: it combines a robust decisioning tool with data retention for future decisions, so that the tool does not need to be recalibrated from scratch every time a new decision is required. In this paper we briefly review the analytical capabilities of the freeware FDT tool and its major features and functionalities; examples of large biological datasets from HIV, microRNAs and sRNAs are included. This work shows how to integrate fuzzy decision algorithms with modern database technology. In addition, we show that integrating the fuzzy decision tree induction tool with database storage allows for optimal user satisfaction in today's Data Analytics world.

Closing data gaps for LCA of food products: estimating the energy demand of food processing.

PubMed

Sanjuán, Neus; Stoessel, Franziska; Hellweg, Stefanie

2014-01-21

Food is one of the most energy and CO2-intensive consumer goods. While environmental data on primary agricultural products are increasingly becoming available, there are large data gaps concerning food processing. Bridging these gaps is important; for example, the food industry can use such data to optimize processes from an environmental perspective, and retailers may use this information for purchasing decisions. Producers and retailers can then market sustainable products and deliver the information demanded by governments and consumers. Finally, consumers are increasingly interested in the environmental information of foods in order to lower their consumption impacts. This study provides estimation tools for the energy demand of a representative set of food process unit operations such as dehydration, evaporation, or pasteurization. These operations are used to manufacture a variety of foods and can be combined, according to the product recipe, to quantify the heat and electricity demand during processing. In combination with inventory data on the production of the primary ingredients, this toolbox will be a basis to perform life cycle assessment studies of a large number of processed food products and to provide decision support to the stakeholders. Furthermore, a case study is performed to illustrate the application of the tools.

The experience of physicians in pharmacogenomic clinical decision support within eight German university hospitals.

PubMed

Hinderer, Marc; Boeker, Martin; Wagner, Sebastian A; Binder, Harald; Ückert, Frank; Newe, Stephanie; Hülsemann, Jan L; Neumaier, Michael; Schade-Brittinger, Carmen; Acker, Till; Prokosch, Hans-Ulrich; Sedlmayr, Brita

2017-06-01

The aim of this study was to assess the physicians' attitude, their knowledge and their experience in pharmacogenomic clinical decision support in German hospitals. We conducted an online survey to address physicians of 13 different medical specialties across eight German university hospitals. In total, 564 returned questionnaires were analyzed. The remaining knowledge gap, the uncertainty of test reimbursement and the physicians' lack of awareness of existing pharmacogenomic clinical decision support systems (CDSS) are the major barriers for implementing pharmacogenomic CDSS into German hospitals. Furthermore, pharmacogenomic CDSS are most effective in the form of real-time decision support for internists. Physicians in German hospitals require additional education of both genetics and pharmacogenomics. They need to be provided with access to relevant pharmacogenomic CDSS.

Cells, circuits, and choices: social influences on perceptual decision making.

PubMed

Mojzisch, Andreas; Krug, Kristine

2008-12-01

Making decisions is an integral part of everyday life. Social psychologists have demonstrated in many studies that humans' decisions are frequently and strongly influenced by the opinions of others--even in simple perceptual decisions, where, for example, participants have to judge what an image looks like. However, because the effect of other people's opinions on decision making has remained largely unaddressed by the neuroimaging and neurophysiology literature, we are only beginning to understand how social influence is integrated into the decision-making process. We put forward the thesis that by probing the neurophysiology of social influence with perceptual decision-making tasks similar to those used in the seminal work of Asch (1952, 1956), this gap could be remedied. Perceptual paradigms are already widely used to probe neuronal mechanisms of decision making in nonhuman primates. There is also increasing evidence about how nonhuman primates' behavior is influenced by observing conspecifics. The high spatial and temporal resolution of neurophysiological recordings in awake monkeys could provide insight into where and how social influence modulates decision making, and thus should enable us to develop detailed functional models of the neural mechanisms that support the integration of social influence into the decision-making process.

Community–Academic Partnership Participation

PubMed Central

Drahota, Amy; Spurgeon, Emily

2015-01-01

Community–academic partnerships (CAPs) improve the research process, outcomes, and yield benefits for the community and researchers. This exploratory study examined factors important in community stakeholders’ decision to participate in CAPs. Autism spectrum disorder (ASD) community stakeholders, previously contacted to participate in a CAP (n = 18), completed the 15-item Decision to Participate Questionnaire (DPQ). The DPQ assessed reasons for participating or declining participation in the ASD CAP. CAP participants rated networking with other providers, fit of collaboration with agency philosophy, and opportunity for future training/consultations as factors more important in their decision to participate in the ASD CAP than nonparticipants. Nonparticipants reported the number of requests to participate in research as more important in their decision to decline participation than participants. Findings reveal important factors in community stakeholders’ decision to participate in CAPs that may provide guidance on increasing community engagement in CAPs and help close the science-to-service gap. PMID:25976376

Wildfire and invasive species in the west: challenges that hinder current and future management and protection of the sagebrush-steppe ecosystem: a Gap Report

USGS Publications Warehouse

Mayer, Kenneth F.; Anderson, Pete; Chambers, Jeanne; Boyd, Chad; Christiansen, Tom; Davis, Dawn; Espinosa, Shawn; Havlina, Doug; Ielmini, Michael; Kemner, Don; Kurth, Laurie; Maestas, Jeremy; Mealor, Brian; Milesneck, Ted; Niell, Lara; Pellant, Mike; Pyke, David A.; Tague, Joe; Vernon, Jason

2013-01-01

The WG will continue to meet on a regular basis to further develop and expand this list of gaps. Additionally, the WG will offer specific options to address the identified gaps. However, the WG recommends that the FWS, possibly through the State/Federal (Western Governors Association) Sage Grouse Task Force or the National Sage-grouse Executive Oversight Committee, establish a Subcommittee to specifically review this Gap Report and develop a multi-agency approach on how to address each gap. The WG will continue to endeavor to establish a priority list and identify the “low hanging fruit” that can be addressed in the short-term to affect the listing decision. Additionally, the WG will propose a longer-term strategy. However, to successfully establish such a strategy it will take buy-in and commitment at the highest levels in federal and state governments. In an effort to provide managers an opportunity to address the most important issues this coming fiscal year, we offer the following top 5 gaps. Beyond these top 5, the WG has identified 17 additional gaps that should be evaluated by both federal and state agencies as a means to help better manage the wildfire/invasive threat in the west.

Translating reference doses into allergen management practice: challenges for stakeholders.

PubMed

Crevel, René W R; Baumert, Joseph L; Luccioli, Stefano; Baka, Athanasia; Hattersley, Sue; Hourihane, Jonathan O'B; Ronsmans, Stefan; Timmermans, Frans; Ward, Rachel; Chung, Yong-joo

2014-05-01

Risk assessment describes the impact of a particular hazard as a function of dose and exposure. It forms the foundation of risk management and contributes to the overall decision-making process, but is not its endpoint. This paper outlines a risk analysis framework to underpin decision-making in the area of allergen cross-contact. Specifically, it identifies challenges relevant to each component of the risk analysis: risk assessment (data gaps and output interpretation); risk management (clear and realistic objectives); and risk communication (clear articulation of risk and benefit). Translation of the outputs from risk assessment models into risk management measures must be informed by a clear understanding of the model outputs and their limitations. This will lead to feasible and achievable risk management objectives, grounded in a level of risk accepted by the different stakeholders, thereby avoiding potential unintended detrimental consequences. Clear, consistent and trustworthy communications actively involving all stakeholders underpin these objectives. The conclusions, integrating the perspectives of different stakeholders, offer a vision where clear, science-based benchmarks form the basis of allergen management and labelling, cutting through the current confusion and uncertainty. Finally, the paper recognises that the proposed framework must be adaptable to new and emerging evidence. Copyright © 2014 ILSI Europe. Published by Elsevier Ltd.. All rights reserved.

Advances on a Decision Analytic Approach to Exposure-Based Chemical Prioritization.

PubMed

Wood, Matthew D; Plourde, Kenton; Larkin, Sabrina; Egeghy, Peter P; Williams, Antony J; Zemba, Valerie; Linkov, Igor; Vallero, Daniel A

2018-05-11

The volume and variety of manufactured chemicals is increasing, although little is known about the risks associated with the frequency and extent of human exposure to most chemicals. The EPA and the recent signing of the Lautenberg Act have both signaled the need for high-throughput methods to characterize and screen chemicals based on exposure potential, such that more comprehensive toxicity research can be informed. Prior work of Mitchell et al. using multicriteria decision analysis tools to prioritize chemicals for further research is enhanced here, resulting in a high-level chemical prioritization tool for risk-based screening. Reliable exposure information is a key gap in currently available engineering analytics to support predictive environmental and health risk assessments. An elicitation with 32 experts informed relative prioritization of risks from chemical properties and human use factors, and the values for each chemical associated with each metric were approximated with data from EPA's CP_CAT database. Three different versions of the model were evaluated using distinct weight profiles, resulting in three different ranked chemical prioritizations with only a small degree of variation across weight profiles. Future work will aim to include greater input from human factors experts and better define qualitative metrics. © 2018 Society for Risk Analysis.

EnviroAtlas in the Classroom: New K-16 Lesson Plans that Empower Tomorrow’s Decision-Makers

EPA Pesticide Factsheets

EPA’s new suite of educational materials aims to address that knowledge gap with classroom-ready lessons that teach students about the environment’s effects on their daily lives, including their health and well-being.

Methanol as an Automotive Fuel : With Special Emphasis on Methanol-Gasoline Blends

DOT National Transportation Integrated Search

1977-04-01

This report reviews the available information on methanol as related to its potential use as an automotive fuel. Information gaps critical to assessment and future decisions are delineated and suggestions made for necessary R&D efforts. In this conte...

Involving patients in detecting quality gaps in a fragmented healthcare system: development of a questionnaire for Patients' Experiences Across Health Care Sectors (PEACS)

PubMed Central

Noest, Stefan; Ludt, Sabine; Klingenberg, Anja; Glassen, Katharina; Heiss, Friederike; Ose, Dominik; Rochon, Justine; Bozorgmehr, Kayvan; Wensing, Michel; Szecsenyi, Joachim

2014-01-01

Objective The purpose of this study was to develop and validate a generic questionnaire to evaluate experiences and reported outcomes in patients who receive treatment across a range of healthcare sectors. Design Mixed-methods design including focus groups, pretests and field test. Setting The patient questionnaire was developed in the context of a nationwide program in Germany aimed at quality improvements across the healthcare sectors. Participants For the field test, 589 questionnaires were distributed to patients via 47 general practices. Main Measurements Descriptive item analyzes non-responder analysis and factor analysis (PCA). Retest coefficients (r) calculated by correlation of sum scores of PCA factors. Quality gaps were assessed by the proportion of responders choosing a response category defined as indicating shortcomings in quality of care. Results The conceptual phase showed good content validity. Four hundred and seventy-four patients who received a range of treatment across a range of sectors were included (response rate: 80.5%). Data analysis confirmed the construct, oriented to the patient care journey with a focus on transitions between healthcare sectors. Quality gaps were assessed for the topics ‘Indication’, including shared-decision-making (6 items, 24.5–62.9%) and ‘Discharge and Transition’ (10 items; 20.7–48.2%). Retest coefficients ranged from r = 0.671 until r = 0.855 and indicated good reliability. Low ratios of item-non-response (0.8–9.3%) confirmed a high acceptance by patients. Conclusions The number of patients with complex healthcare needs is increasing. Initiatives to expand quality assurance across organizational borders and healthcare sectors are therefore urgently needed. A validated questionnaire (called PEACS 1.0) is available to measure patients' experiences across healthcare sectors with a focus on quality improvement. PMID:24758750

Possibilities and hindrances for prevention of intimate partner violence: perceptions among professionals and decision makers in a Swedish medium-sized town.

PubMed

Jakobsson, A; von Borgstede, C; Krantz, G; Spak, F; Hensing, G

2013-09-01

Intimate partner violence (IPV) is a major public health problem, but few evidence-based prevention programs have yet been implemented. This study explored the perceptions and beliefs of local-level decision makers, social and health-care professionals, and representatives from the police force regarding the possibilities and hindrances for prevention of IPV. An explorative qualitative approach was used, and participants were strategically selected for focus group discussions. The participants, 19 men and 23 women, were professionals or decision makers within health-care services, social welfare, municipal administration, the police force, local industry, and local politicians in a Swedish town of 54,000 inhabitants. The focus group discussions were audio recorded, transcribed verbatim, and thematically analyzed. A manifest content analysis was performed on the text. Preschools, schools, sports associations, workplaces, and the mass media were suggested as possible arenas for prevention measures. The proposed activities included norm building and improved social support structures. Hindrances were conceptualized as societal beliefs and attitudes, shame, silence, gender inequality, the counteracting influence of the media, and lack of resources. The participants demonstrated closeness and distance to IPV, expressed as acceptance or referral of responsibility to others regarding where and by whom prevention measures should be executed. This study gave new insights in the prevailing perceptions of professionals and decision makers of a medium-sized Swedish town, which can be a useful knowledge in future preventive work and contribute to bridge the gap between research and practice.

Identifying stakeholder-relevant climate change impacts: a case study in the Yakima River Basin, Washington, USA

USGS Publications Warehouse

Jenni, K.; Graves, D.; Hardiman, Jill M.; Hatten, James R.; Mastin, Mark C.; Mesa, Matthew G.; Montag, J.; Nieman, Timothy; Voss, Frank D.; Maule, Alec G.

2014-01-01

Designing climate-related research so that study results will be useful to natural resource managers is a unique challenge. While decision makers increasingly recognize the need to consider climate change in their resource management plans, and climate scientists recognize the importance of providing locally-relevant climate data and projections, there often remains a gap between management needs and the information that is available or is being collected. We used decision analysis concepts to bring decision-maker and stakeholder perspectives into the applied research planning process. In 2009 we initiated a series of studies on the impacts of climate change in the Yakima River Basin (YRB) with a four-day stakeholder workshop, bringing together managers, stakeholders, and scientists to develop an integrated conceptual model of climate change and climate change impacts in the YRB. The conceptual model development highlighted areas of uncertainty that limit the understanding of the potential impacts of climate change and decision alternatives by those who will be most directly affected by those changes, and pointed to areas where additional study and engagement of stakeholders would be beneficial. The workshop and resulting conceptual model highlighted the importance of numerous different outcomes to stakeholders in the basin, including social and economic outcomes that go beyond the physical and biological outcomes typically reported in climate impacts studies. Subsequent studies addressed several of those areas of uncertainty, including changes in water temperatures, habitat quality, and bioenergetics of salmonid populations.

Public health financial management competencies.

PubMed

Honoré, Peggy A; Costich, Julia F

2009-01-01

The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

Addressing the Challenges in Tonsillectomy Research to Inform Health Care Policy: A Review.

PubMed

Mandavia, Rishi; Schilder, Anne G M; Dimitriadis, Panagiotis A; Mossialos, Elias

2017-09-01

Eighty-five percent of investment in medical research has been wasted, with lack of effect on clinical practice and policy. There is increasing effort to improve the likelihood of research being used to influence clinical practice and policy. Tonsillectomy is one of the most common otorhinolaryngologic surgical procedures, and its frequency, cost, and morbidity create a clear need for evidence-based guidelines and policy. The first systematic review on tonsillectomy was conducted 40 years ago and highlighted the lack of definitive evidence for the procedure. Since that study, the body of evidence has still not been able to sufficiently inform policy. This review provides an overview of the key challenges in research to inform tonsillectomy policy and recommendations to help bridge the evidence-policy gap. The challenges in using research to inform policy can be summarized as 4 main themes: (1) non-policy-focused evidence and lack of available evidence, (2) quality of evidence, (3) communication of research findings, and (4) coordinating time frames. Researchers and decision makers should be aware of the limitations of research designs and conflicts of interest that can undermine policy decisions. Researchers must work with decision makers and patients throughout the research process to identify areas of unmet need and political priority, align research and policy time frames, and disseminate research findings. Incentives for researchers should be reorganized to promote dissemination of findings. It is important to consider why evidence gaps in tonsillectomy research have not been addressed during the past 40 years despite considerable investment in time and resources. These findings and recommendations will help produce research that is more responsive to policy gaps and more likely to result in policy changes.

Observational Study Designs for Comparative Effectiveness Research: An Alternative Approach to Close Evidence Gaps in Head-and-Neck Cancer

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

Goulart, Bernardo H.L., E-mail: bhg@uw.edu; University of Washington, Seattle, Washington; Ramsey, Scott D.

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H and N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H and N RCTs, which limits the validity of their results to the broader H and N cancer patient population seenmore » in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H and N cancer, including treatment comparisons for rare types of H and N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H and N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H and N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design.« less

Observational study designs for comparative effectiveness research: an alternative approach to close evidence gaps in head-and-neck cancer.

PubMed

Goulart, Bernardo H L; Ramsey, Scott D; Parvathaneni, Upendra

2014-01-01

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H&N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H&N RCTs, which limits the validity of their results to the broader H&N cancer patient population seen in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H&N cancer, including treatment comparisons for rare types of H&N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H&N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H&N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessing the impact of a medical librarian on identification of valid and actionable practice gaps for a continuing medical education committee.

PubMed

Bartkowiak, Barbara A; Safford, Lindsey A; Stratman, Erik J

2014-01-01

Identifying educational needs related to professional practice gaps can be a complex process for continuing medical education (CME) committees and for physicians who submit activity applications. Medical librarians possess unique skills that may be useful for identifying practice gaps relevant to CME committees. We assessed this assumption by assessing a medical librarian's contributions to practice gap identification for the Marshfield Clinic's CME Committee. We reviewed all locally relevant, locally actionable practice gaps identified annually by various stakeholders and presented to our CME Committee from 2010 to 2013. Total numbers of practice gaps identified, total categorized as actionable, and numbers of subsequent activities resulting from these gaps were calculated for each year. Medical librarian totals were compared to those of other CME committee stakeholders to determine the relative contribution. The medical librarian identified unique, actionable published practice gaps that directly contributed to CME activity planning. For each study year, contributions by the medical librarian grew, from 0 of 27 actionable gaps validated by CME Committee in 2010 to 49 of 108 (45.4%) in 2013. With the librarian's assistance, the number of valid practice gaps submitted between 2010 and 2013 by stakeholders climbed from 23 for 155 activities (14.8%) to 133 for 157 activities (84.7%). Medical librarians can provide a valuable service to CME committees by identifying valid professional practice gaps that inform decisions about educational activities aimed at improving clinical practice. Medical librarians bring into deliberations unique information, including national health policy priorities, practice gaps found in the literature, and point-of-care search engine statistics. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Of black swans and tossed coins: is the description-experience gap in risky choice limited to rare events?

PubMed

Ludvig, Elliot A; Spetch, Marcia L

2011-01-01

When faced with risky decisions, people tend to be risk averse for gains and risk seeking for losses (the reflection effect). Studies examining this risk-sensitive decision making, however, typically ask people directly what they would do in hypothetical choice scenarios. A recent flurry of studies has shown that when these risky decisions include rare outcomes, people make different choices for explicitly described probabilities than for experienced probabilistic outcomes. Specifically, rare outcomes are overweighted when described and underweighted when experienced. In two experiments, we examined risk-sensitive decision making when the risky option had two equally probable (50%) outcomes. For experience-based decisions, there was a reversal of the reflection effect with greater risk seeking for gains than for losses, as compared to description-based decisions. This fundamental difference in experienced and described choices cannot be explained by the weighting of rare events and suggests a separate subjective utility curve for experience.

Of Black Swans and Tossed Coins: Is the Description-Experience Gap in Risky Choice Limited to Rare Events?

PubMed Central

Ludvig, Elliot A.; Spetch, Marcia L.

2011-01-01

When faced with risky decisions, people tend to be risk averse for gains and risk seeking for losses (the reflection effect). Studies examining this risk-sensitive decision making, however, typically ask people directly what they would do in hypothetical choice scenarios. A recent flurry of studies has shown that when these risky decisions include rare outcomes, people make different choices for explicitly described probabilities than for experienced probabilistic outcomes. Specifically, rare outcomes are overweighted when described and underweighted when experienced. In two experiments, we examined risk-sensitive decision making when the risky option had two equally probable (50%) outcomes. For experience-based decisions, there was a reversal of the reflection effect with greater risk seeking for gains than for losses, as compared to description-based decisions. This fundamental difference in experienced and described choices cannot be explained by the weighting of rare events and suggests a separate subjective utility curve for experience. PMID:21673807

Informing the NCA: EPA's Climate Change Impact and Risk Analysis Framework

NASA Astrophysics Data System (ADS)

Sarofim, M. C.; Martinich, J.; Kolian, M.; Crimmins, A. R.

2017-12-01

The Climate Change Impact and Risk Analysis (CIRA) framework is designed to quantify the physical impacts and economic damages in the United States under future climate change scenarios. To date, the framework has been applied to 25 sectors, using scenarios and projections developed for the Fourth National Climate Assessment. The strength of this framework has been in the use of consistent climatic, socioeconomic, and technological assumptions and inputs across the impact sectors to maximize the ease of cross-sector comparison. The results of the underlying CIRA sectoral analyses are informing the sustained assessment process by helping to address key gaps related to economic valuation and risk. Advancing capacity and scientific literature in this area has created opportunity to consider future applications and strengthening of the framework. This presentation will describe the CIRA framework, present results for various sectors such as heat mortality, air & water quality, winter recreation, and sea level rise, and introduce potential enhancements that can improve the utility of the framework for decision analysis.

Assessing the conceptual clarity and evidence base of quality criteria/standards developed for evaluating decision aids

PubMed Central

McDonald, Heather; Charles, Cathy; Gafni, Amiram

2011-01-01

Abstract Context  Promoting patient participation in treatment decision making is of increasing interest to researchers, clinicians and policy makers. Decision aids (DAs) are advocated as one way to help achieve this goal. Despite their proliferation, there has been little agreement on criteria or standards for evaluating these tools. To fill this gap, an international collaboration of researchers and others interested in the development, content and quality of DAs have worked over the past several years to develop a checklist and, based on this checklist, an instrument for determining whether any given DA meets a defined set of quality criteria. Objective/Methods  In this paper, we offer a framework for assessing the conceptual clarity and evidence base used to support the development of quality criteria/standards for evaluating DAs. We then apply this framework to assess the conceptual clarity and evidence base underlying the International Patient Decision Aids Standards (IPDAS) checklist criteria for one of the checklist domains: how best to present in DAs probability information to patients on treatment benefits and risks. Conclusion  We found that some of the central concepts underlying the presenting probabilities domain were not defined. We also found gaps in the empirical evidence and theoretical support for this domain and criteria within this domain. Finally, we offer suggestions for steps that should be undertaken for further development and refinement of quality standards for DAs in the future. PMID:22050440

What incentives influence employers to engage in workplace health interventions?

PubMed

Martinsson, Camilla; Lohela-Karlsson, Malin; Kwak, Lydia; Bergström, Gunnar; Hellman, Therese

2016-08-23

To achieve a sustainable working life it is important to know more about what could encourage employers to increase the use of preventive and health promotive interventions. The objective of the study is to explore and describe the employer perspective regarding what incentives influence their use of preventive and health promotive workplace interventions. Semi-structured focus group interviews were carried out with 20 representatives from 19 employers across Sweden. The economic sectors represented were municipalities, government agencies, defence, educational, research, and development institutions, health care, manufacturing, agriculture and commercial services. The interviews were transcribed verbatim and the data were analysed using latent content analysis. Various incentives were identified in the analysis, namely: "law and provisions", "consequences for the workplace", "knowledge of worker health and workplace health interventions", "characteristics of the intervention", "communication and collaboration with the provider". The incentives seemed to influence the decision-making in parallel with each other and were not only related to positive incentives for engaging in workplace health interventions, but also to disincentives. This study suggests that the decision to engage in workplace health interventions was influenced by several incentives. There are those incentives that lead to a desire to engage in a workplace health intervention, others pertain to aspects more related to the intervention use, such as the characteristics of the employer, the provider and the intervention. It is important to take all incentives into consideration when trying to understand the decision-making process for workplace health interventions and to bridge the gap between what is produced through research and what is used in practice.

Development of a group therapy to enhance treatment motivation and decision making in severely obese patients with a comorbid mental disorder.

PubMed

Wild, Beate; Herzog, Wolfgang; Wesche, Daniela; Niehoff, Dorothea; Müller, Beat; Hain, Bernhard

2011-05-01

The prevalence rate of mental disorders in severely obese patients appears to be high. In the Department of Psychosomatic Medicine, Heidelberg, we established a short outpatient group intervention for severely obese patients with an affective, anxiety, and/or eating disorder who either are not able to make a clear decision for an intensive weight loss program or who have already decided to undergo bariatric surgery but are advised to attend a support group before surgery. The aim of the group intervention was to reduce depressive symptoms and, in indecisive patients, to enhance the motivation of the patients for engagement in further intensive treatment programs, including bariatric surgery. Descriptive data of the first two intervention groups are provided. The treatment program and topics of the group sessions are explained. Time series analysis methods are used to investigate the development of a single patient during the intervention program. Initially, 16 patients joined the group program; ten of these attended the group therapy to completion. The remaining ten patients showed clinically relevant reduction in depression levels and improvement in mental quality of life. Results of the single-case time series analysis indicate that the temporal relationship between eating behavior and depression changed during treatment. The group program, as outlined, could be a useful intervention for severely obese patients with comorbid depression, anxiety, or eating disorder. A gap in the health care system is thus bridged by this short intervention that can encourage further treatment decisions such as bariatric surgery.

Student professional suitability: lessons from how the regulator handles fitness to practise cases.

PubMed

Unsworth, John

2011-07-01

A self regulating profession, such as nursing, has to have in place systems which deal with practitioners considered unfit to practise. In addition, students studying to enter the profession may also be subject to systems to address concerns about their professional suitability. While the NMC have left it up to each Higher Education Institution (HEI) to identify the systems which should be in place for students, there is a body of case law and statutory legislation which governs how the NMC deals with fitness to practise amongst qualified nurses and midwives. This paper examines the content of fitness to practise policies in place across HEIs and compares this with how the regulator handles fitness to practise cases. Data was collected using unobtrusive methods and was analysed using content analysis. The results suggest that many HEI's policies have significant gaps which may result in challenges to decision making. In addition, the power of some Vice Chancellors to overturn fitness to practise decisions on appeals calls into question the whole notion of professional self regulation. Copyright © 2010 Elsevier Ltd. All rights reserved.

Experiences in sub-Saharan Africa with GM crop risk communication: outcome of a workshop.

PubMed

Racovita, Monica; Obonyo, Dennis Ndolo; Abdallah, Roshan; Anguzu, Robert; Bamwenda, Gratian; Kiggundu, Andrew; Maganga, Harrison; Muchiri, Nancy; Nzeduru, Chinyere; Otadoh, Jane; Rumjaun, Anwar; Suleiman, Iro; Sunil, Manjusha; Tepfer, Mark; Timpo, Samuel; van der Walt, Wynand; Kaboré-Zoungrana, Chantal; Nfor, Lilian; Craig, Wendy

2013-01-01

In tackling agricultural challenges, policy-makers in sub-Saharan Africa (SSA) have increasingly considered genetically modified (GM) crops as a potential tool to increase productivity and to improve product quality. Yet, as elsewhere in the world, the adoption of GM crops in SSA has been marked by controversy, encompassing not only the potential risks to animal and human health, and to the environment, but also other concerns such as ethical issues, public participation in decision-making, socio-economic factors and intellectual property rights. With these non-scientific factors complicating an already controversial situation, disseminating credible information to the public as well as facilitating stakeholder input into decision-making is essential. In SSA, there are various and innovative risk communication approaches and strategies being developed, yet a comprehensive analysis of such data is missing. This gap is addressed by giving an overview of current strategies, identifying similarities and differences between various country and institutional approaches and promoting a way forward, building on a recent workshop with risk communicators working in SSA.

A Multi-layer, Data-driven Advanced Reasoning Tool for Intelligent Data Mining and Analysis for Smart Grids

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

Lu, Ning; Du, Pengwei; Greitzer, Frank L.

2012-12-31

This paper presents the multi-layer, data-driven advanced reasoning tool (M-DART), a proof-of-principle decision support tool for improved power system operation. M-DART will cross-correlate and examine different data sources to assess anomalies, infer root causes, and anneal data into actionable information. By performing higher-level reasoning “triage” of diverse data sources, M-DART focuses on early detection of emerging power system events and identifies highest priority actions for the human decision maker. M-DART represents a significant advancement over today’s grid monitoring technologies that apply offline analyses to derive model-based guidelines for online real-time operations and use isolated data processing mechanisms focusing on individualmore » data domains. The development of the M-DART will bridge these gaps by reasoning about results obtained from multiple data sources that are enabled by the smart grid infrastructure. This hybrid approach integrates a knowledge base that is trained offline but tuned online to capture model-based relationships while revealing complex causal relationships among data from different domains.« less

Why decision support systems are important for medical education.

PubMed

Konstantinidis, Stathis Th; Bamidis, Panagiotis D

2016-03-01

During the last decades, the inclusion of digital tools in health education has rapidly lead to a continuously enlarging digital era. All the online interactions between learners and tutors, the description, creation, reuse and sharing of educational digital resources and the interlinkage between them in conjunction with cheap storage technology has led to an enormous amount of educational data. Medical education is a unique type of education due to accuracy of information needed, continuous changing competences required and alternative methods of education used. Nowadays medical education standards provide the ground for organising the educational data and the paradata. Analysis of such education data through education data mining techniques is in its infancy, but decision support systems (DSSs) for medical education need further research. To the best of our knowledge, there is a gap and a clear need for identifying the challenges for DSSs in medical education in the era of medical education standards. Thus, in this Letter the role and the attributes of such a DSS for medical education are delineated and the challenges and vision for future actions are identified.

Optical sensors for water quality

USGS Publications Warehouse

Pellerin, Brian A.; Bergamaschi, Brian A.

2014-01-01

Recent advancements in commercially available in situ sensors, data platforms, and new techniques for data analysis provide an opportunity to monitor water quality in rivers, lakes, and estuaries on the time scales in which changes occur. For example, measurements that capture the variability in freshwater systems over time help to assess how shifts in seasonal runoff, changes in precipitation intensity, and increased frequencies of disturbances (such as fire and insect outbreaks) affect the storage, production, and transport of carbon and nitrogen in watersheds. Transmitting these data in real-time also provides information that can be used for early trend detection, help identify monitoring gaps, and provide sciencebased decision support across a range of issues related to water quality, freshwater ecosystems, and human health.

AN APPROACH FOR DETERMINING REGIONAL LAND COVER AND SPECIES HABITAT CONSERVATION STATUS IN THE AMERICAN SOUTHWEST: THE SOUTHWEST REGIONAL GAP ANALYSIS PROJECT

EPA Science Inventory

The Gap Analysis Program (GAP) is a national interagency progranl that maps the distribution of plant communities and selected animal species and compares these distributions with land stewardship to identify biotic elements at potential risk of endangerment. GAP uses remote sens...

Development of a Policy-Relevant Child Maltreatment Research Strategy

PubMed Central

MacMillan, Harriet L; Jamieson, Ellen; Wathen, C Nadine; Boyle, Michael H; Walsh, Christine A; Omura, John; Walker, Jason M; Lodenquai, Gregory

2007-01-01

Child maltreatment is associated with a huge burden of suffering, yet there are serious gaps in knowledge about its epidemiology and approaches to intervention. This article describes the development of a proposed national research framework in child maltreatment, as requested by the Department of Justice, Canada, based on (1) a review of the literature, (2) consultation with experts, and (3) application of evaluation criteria for considering research priorities. The article identifies gaps in knowledge about child maltreatment in Canada and proposes a research agenda to make evidence-based policy decisions more likely. Although this work was driven by gaps in Canada's knowledge about child maltreatment, the international scope of the review and consultation process could make the findings useful to broader research and policy audiences. PMID:17517119

Info-gap robust-satisficing model of foraging behavior: do foragers optimize or satisfice?

PubMed

Carmel, Yohay; Ben-Haim, Yakov

2005-11-01

In this note we compare two mathematical models of foraging that reflect two competing theories of animal behavior: optimizing and robust satisficing. The optimal-foraging model is based on the marginal value theorem (MVT). The robust-satisficing model developed here is an application of info-gap decision theory. The info-gap robust-satisficing model relates to the same circumstances described by the MVT. We show how these two alternatives translate into specific predictions that at some points are quite disparate. We test these alternative predictions against available data collected in numerous field studies with a large number of species from diverse taxonomic groups. We show that a large majority of studies appear to support the robust-satisficing model and reject the optimal-foraging model.

Realia: Tools for Consumer Education Instruction

ERIC Educational Resources Information Center

Green, D. Hayden

1974-01-01

These suggestions on using realia in the classroom should augment carefully conceived strategies for teaching concepts concerning the consumer in the economy, the consumer in the marketplace, and the consumer's decision-making processes. Realia can bridge the gap between abstract subject matter and functional applications. (BP)

Application of Toxicogenomics in Decision Making in Ecological and Human Health Risk Assessment

EPA Science Inventory

Uncertainties in risk assessment arise from sparse or inadequate data including gaps in our understanding of mode of action, the exposure-dose-response pathway, cross-species toxicokinetic and toxicodynamic information, and/or exposure data. There is an expectation that toxicogen...

Digital Readiness Gaps

ERIC Educational Resources Information Center

Horrigan, John B.

2016-01-01

For many years concerns about "digital divides" centered primarily on whether people had "access" to digital technologies. Now, those worried about these issues also focus on the degree to which people succeed or struggle when they use technology to try to navigate their environments, solve problems, and make decisions. This…

Ethics of Knowing

ERIC Educational Resources Information Center

Kim, Mijung

2015-01-01

The gap between knowledge and action has become a critical concern in the discussion of participatory scientific literacy for citizenship where one's decision making and action are central to alleviate socioscientific and environmental challenges in the current society. With the emphasis of action, Hoeg, Lemelin, and Bencze suggest an activist…

[Dangers and risks of black market anabolic steroid abuse in sports --gas chromatography-mass spectrometry analyses].

PubMed

Ritsch, M; Musshoff, F

2000-03-01

Anabolic steroids have become increasingly popular among athletes even at subcompetitive or recreational level instead of extensive doping tests, educational campaigns and lethal incidents. Nowadays, the fitness boom has also produced a population of steroid users at high school level and also under non-sports practicing children. After opening the borders to East Europe an explosion of the black-market for anabolic steroids occurred. Beside the well-known side effects of anabolic steroids new problems and risks occurred due to fake drugs from the black market. This review ist subdivided into two parts: We provide a detailed review of the literature an anabolic steroids to the reader the information needed to make an informed decision an the relative risks and benefits of anabolic steroids. Secondly, we evaluated 40 "anabolic steroids" obtained from the black market using mass spectrometry or gas chromatography analysis to evaluate the real pharmacological compounds. As the results of this analysis, we found that 15 (37.5%) these drugs contained different or any pharmacological compounds as labeled. From the external packing, a differentiation between original and the fake drugs was impossible. Therefore, a large information and credibility gap concerning anabolic steroids particular those from the black market exists between the athletes and the medical and scientific communities. We believe that this gap can only be closed if both groups are be better informed about anabolic steroids.

Models, solution, methods and their applicability of dynamic location problems (DLPs) (a gap analysis for further research)

NASA Astrophysics Data System (ADS)

Seyedhosseini, Seyed Mohammad; Makui, Ahmad; Shahanaghi, Kamran; Torkestani, Sara Sadat

2016-09-01

Determining the best location to be profitable for the facility's lifetime is the important decision of public and private firms, so this is why discussion about dynamic location problems (DLPs) is a critical significance. This paper presented a comprehensive review from 1968 up to most recent on published researches about DLPs and classified them into two parts. First, mathematical models developed based on different characteristics: type of parameters (deterministic, probabilistic or stochastic), number and type of objective function, numbers of commodity and modes, relocation time, number of relocation and relocating facilities, time horizon, budget and capacity constraints and their applicability. In second part, It have been also presented solution algorithms, main specification, applications and some real-world case studies of DLPs. At the ends, we concluded that in the current literature of DLPs, distribution systems and production-distribution systems with simple assumption of the tackle to the complexity of these models studied more than any other fields, as well as the concept of variety of services (hierarchical network), reliability, sustainability, relief management, waiting time for services (queuing theory) and risk of facility disruption need for further investigation. All of the available categories based on different criteria, solution methods and applicability of them, gaps and analysis which have been done in this paper suggest the ways for future research.

Optimal bearing gap of a multiarc radial bearing in a hydrodynamically levitated centrifugal blood pump for the reduction of hemolysis.

PubMed

Kosaka, Ryo; Yasui, Kazuya; Nishida, Masahiro; Kawaguchi, Yasuo; Maruyama, Osamu; Yamane, Takashi

2014-09-01

We have developed a hydrodynamically levitated centrifugal pump as a bridge-to-decision device. The purpose of the present study is to determine the optimal bearing gap of a multiarc radial bearing in the developed blood pump for the reduction of hemolysis. We prepared eight pump models having bearing gaps of 20, 30, 40, 80, 90, 100, 180, and 250 μm. The driving conditions were set to a pressure head of 200 mm Hg and a flow rate of 4 L/min. First, the orbital radius of the impeller was measured for the evaluation of the impeller stability. Second, the hemolytic property was evaluated in an in vitro hemolysis test. As a result, the orbital radius was not greater than 15 μm when the bearing gap was between 20 and 100 μm. The relative normalized index of hemolysis (NIH) ratios in comparison with BPX-80 were 37.67 (gap: 20 μm), 0.95 (gap: 30 μm), 0.96 (gap: 40 μm), 0.82 (gap: 80 μm), 0.77 (gap: 90 μm), 0.92 (gap: 100 μm), 2.76 (gap: 180 μm), and 2.78 (gap: 250 μm). The hemolysis tended to increase at bearing gaps of greater than 100 μm due to impeller instability. When the bearing gap decreased from 30 to 20 μm, the relative NIH ratios increased significantly from 0.95 to 37.67 times (P < 0.01) due to high shear stress. We confirmed that the optimal bearing gap was determined between 30 and 100 μm in the developed blood pump for the reduction of hemolysis. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Ag2S atomic switch-based `tug of war' for decision making

NASA Astrophysics Data System (ADS)

Lutz, C.; Hasegawa, T.; Chikyow, T.

2016-07-01

For a computing process such as making a decision, a software controlled chip of several transistors is necessary. Inspired by how a single cell amoeba decides its movements, the theoretical `tug of war' computing model was proposed but not yet implemented in an analogue device suitable for integrated circuits. Based on this model, we now developed a new electronic element for decision making processes, which will have no need for prior programming. The devices are based on the growth and shrinkage of Ag filaments in α-Ag2+δS gap-type atomic switches. Here we present the adapted device design and the new materials. We demonstrate the basic `tug of war' operation by IV-measurements and Scanning Electron Microscopy (SEM) observation. These devices could be the base for a CMOS-free new computer architecture.For a computing process such as making a decision, a software controlled chip of several transistors is necessary. Inspired by how a single cell amoeba decides its movements, the theoretical `tug of war' computing model was proposed but not yet implemented in an analogue device suitable for integrated circuits. Based on this model, we now developed a new electronic element for decision making processes, which will have no need for prior programming. The devices are based on the growth and shrinkage of Ag filaments in α-Ag2+δS gap-type atomic switches. Here we present the adapted device design and the new materials. We demonstrate the basic `tug of war' operation by IV-measurements and Scanning Electron Microscopy (SEM) observation. These devices could be the base for a CMOS-free new computer architecture. Electronic supplementary information (ESI) available. See DOI: 10.1039/c6nr00690f

Robust Satisficing Decision Making for Unmanned Aerial Vehicle Complex Missions under Severe Uncertainty

PubMed Central

Ji, Xiaoting; Niu, Yifeng; Shen, Lincheng

2016-01-01

This paper presents a robust satisficing decision-making method for Unmanned Aerial Vehicles (UAVs) executing complex missions in an uncertain environment. Motivated by the info-gap decision theory, we formulate this problem as a novel robust satisficing optimization problem, of which the objective is to maximize the robustness while satisfying some desired mission requirements. Specifically, a new info-gap based Markov Decision Process (IMDP) is constructed to abstract the uncertain UAV system and specify the complex mission requirements with the Linear Temporal Logic (LTL). A robust satisficing policy is obtained to maximize the robustness to the uncertain IMDP while ensuring a desired probability of satisfying the LTL specifications. To this end, we propose a two-stage robust satisficing solution strategy which consists of the construction of a product IMDP and the generation of a robust satisficing policy. In the first stage, a product IMDP is constructed by combining the IMDP with an automaton representing the LTL specifications. In the second, an algorithm based on robust dynamic programming is proposed to generate a robust satisficing policy, while an associated robustness evaluation algorithm is presented to evaluate the robustness. Finally, through Monte Carlo simulation, the effectiveness of our algorithms is demonstrated on an UAV search mission under severe uncertainty so that the resulting policy can maximize the robustness while reaching the desired performance level. Furthermore, by comparing the proposed method with other robust decision-making methods, it can be concluded that our policy can tolerate higher uncertainty so that the desired performance level can be guaranteed, which indicates that the proposed method is much more effective in real applications. PMID:27835670

Robust Satisficing Decision Making for Unmanned Aerial Vehicle Complex Missions under Severe Uncertainty.

PubMed

Ji, Xiaoting; Niu, Yifeng; Shen, Lincheng

2016-01-01

This paper presents a robust satisficing decision-making method for Unmanned Aerial Vehicles (UAVs) executing complex missions in an uncertain environment. Motivated by the info-gap decision theory, we formulate this problem as a novel robust satisficing optimization problem, of which the objective is to maximize the robustness while satisfying some desired mission requirements. Specifically, a new info-gap based Markov Decision Process (IMDP) is constructed to abstract the uncertain UAV system and specify the complex mission requirements with the Linear Temporal Logic (LTL). A robust satisficing policy is obtained to maximize the robustness to the uncertain IMDP while ensuring a desired probability of satisfying the LTL specifications. To this end, we propose a two-stage robust satisficing solution strategy which consists of the construction of a product IMDP and the generation of a robust satisficing policy. In the first stage, a product IMDP is constructed by combining the IMDP with an automaton representing the LTL specifications. In the second, an algorithm based on robust dynamic programming is proposed to generate a robust satisficing policy, while an associated robustness evaluation algorithm is presented to evaluate the robustness. Finally, through Monte Carlo simulation, the effectiveness of our algorithms is demonstrated on an UAV search mission under severe uncertainty so that the resulting policy can maximize the robustness while reaching the desired performance level. Furthermore, by comparing the proposed method with other robust decision-making methods, it can be concluded that our policy can tolerate higher uncertainty so that the desired performance level can be guaranteed, which indicates that the proposed method is much more effective in real applications.

Memory states influence value-based decisions.

PubMed

Duncan, Katherine D; Shohamy, Daphna

2016-11-01

Using memory to guide decisions allows past experience to improve future outcomes. However, the circumstances that modulate how and when memory influences decisions are not well understood. Here, we report that the use of memories to guide decisions depends on the context in which these decisions are made. We show that decisions made in the context of familiar images are more likely to be influenced by past events than are decisions made in the context of novel images (Experiment 1), that this bias persists even when a temporal gap is introduced between the image presentation and the decision (Experiment 2), and that contextual novelty facilitates value learning whereas familiarity facilitates the retrieval and use of previously learned values (Experiment 3). These effects are consistent with neurobiological and computational models of memory, which propose that familiar images evoke a lingering "retrieval state" that facilitates the recollection of other episodic memories. Together, these experiments highlight the importance of episodic memory for decision-making and provide an example of how computational and neurobiological theories can lead to new insights into how and when different types of memories guide our choices. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The emergency patient's participation in medical decision-making.

PubMed

Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh

2016-09-01

The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.

The Multifold Relationship Between Memory and Decision Making: An Individual-differences Study

PubMed Central

Del Missier, Fabio; Mäntylä, Timo; Hansson, Patrik; Bruine de Bruin, Wändi; Parker, Andrew M.; Nilsson, Lars-Göran

2014-01-01

Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 to 80 years, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory, and semantic memory, respectively, and six main components of decision-making competence. In line with the hypotheses, working memory was positively related with the more cognitively-demanding tasks (Resistance to Framing, Applying Decision Rules, and Under/Overconfidence), whereas episodic memory was positively associated with a more experience-based judgment task (Recognizing Social Norms). Furthermore, semantic memory was positively related with two more knowledge-based decision-making tasks (Consistency in Risk Perception and Resistance to Sunk Costs). Finally, the age-related decline observed in some of the decision-making tasks was (partially or totally) mediated by the age-related decline in working memory or episodic memory. These findings are discussed in relation to the functional roles fulfilled by different memory processes in judgment and decision-making tasks. PMID:23565790

AN INTER-AGENCY APPROACH FOR DETERMINING REGIONAL LAND COVER AND SPECIES HABITAT CONSERVATION STATUS IN THE AMERICAN SOUTHWEST: THE SOUTHWEST REGIONAL GAP ANALYSIS PROJECT

EPA Science Inventory

The Gap Analysis Program (GAP) is a national inter-agency program that maps the distribution of plant communities and selected animal species and compares these distributions with land stewardship to identify biotic elements at potential risk of endangerment. GAP uses remote sens...

Development the conceptual design of Knowledge Based System for Integrated Maintenance Strategy and Operation

NASA Astrophysics Data System (ADS)

Milana; Khan, M. K.; Munive, J. E.

2014-07-01

The importance of maintenance has escalated significantly by the increasing of automation in manufacturing process. This condition switches traditional maintenance perspective of inevitable cost into the business competitive driver. Consequently, maintenance strategy and operation decision needs to be synchronized to business and manufacturing concerns. This paper shows the development of conceptual design of Knowledge Based System for Integrated Maintenance Strategy and Operation (KBIMSO). The framework of KBIMSO is elaborated to show the process of how the KBIMSO works to reach the maintenance decision. By considering the multi-criteria of maintenance decision making, the KB system embedded with GAP and AHP to support integrated maintenance strategy and operation which is novel in this area. The KBIMSO is useful to review the existing maintenance system and give reasonable recommendation of maintenance decisions in respect to business and manufacturing perspective.

Beyond the Academic Journal: Unfreezing Misconceptions About Mental Illness and Gun Violence Through Knowledge Translation to Decision-Makers.

PubMed

Horwitz, Joshua; Grilley, Anna; Kennedy, Orla

2015-06-01

In a policy arena characterized by polarized debate, such as the consideration of legal interventions to prevent gun violence, research evidence is an important tool to inform decision-making processes. However, unless the evidence is communicated to stakeholders who can influence policy decisions, the research will often remain an academic exercise with little practical impact. The Educational Fund to Stop Violence's process of "unfreezing" individual perceptions and conventional interpretations of the relationship between mental illness and gun violence, forming a consensus, and translating this knowledge to stakeholders through state discussion forums is one way to inform policy change. The recent passage of gun violence prevention legislation in California provides an example of successfully closing the knowledge translation gap between research and decision-making processes. Copyright © 2015 John Wiley & Sons, Ltd.

The use of Ethics Decision-Making Frameworks by Canadian Ethics Consultants: A Qualitative Study.

PubMed

Kaposy, Chris; Brunger, Fern; Maddalena, Victor; Singleton, Richard

2016-10-01

In this study, Canadian healthcare ethics consultants describe their use of ethics decision-making frameworks. Our research finds that ethics consultants in Canada use multi-purpose ethics decision-making frameworks, as well as targeted frameworks that focus on reaching an ethical resolution to a particular healthcare issue, such as adverse event reporting, or difficult triage scenarios. Several interviewees mention the influence that the accreditation process in Canadian healthcare organizations has on the adoption and use of such frameworks. Some of the ethics consultants we interviewed also report on their reluctance to use these tools. Limited empirical work has been done previously on the use of ethics decision-making frameworks. This study begins to fill this gap in our understanding of the work of healthcare ethics consultants. © 2016 John Wiley & Sons Ltd.

XWeB: The XML Warehouse Benchmark

NASA Astrophysics Data System (ADS)

Mahboubi, Hadj; Darmont, Jérôme

With the emergence of XML as a standard for representing business data, new decision support applications are being developed. These XML data warehouses aim at supporting On-Line Analytical Processing (OLAP) operations that manipulate irregular XML data. To ensure feasibility of these new tools, important performance issues must be addressed. Performance is customarily assessed with the help of benchmarks. However, decision support benchmarks do not currently support XML features. In this paper, we introduce the XML Warehouse Benchmark (XWeB), which aims at filling this gap. XWeB derives from the relational decision support benchmark TPC-H. It is mainly composed of a test data warehouse that is based on a unified reference model for XML warehouses and that features XML-specific structures, and its associate XQuery decision support workload. XWeB's usage is illustrated by experiments on several XML database management systems.

Training for Decisive Action: Stories of Mission Command. Collected Insights from Commanders and Leaders on their Experience at the National Training Center

DTIC Science & Technology

2014-01-01

If there is no control then friction builds into a colossal traffic jam . It takes a traffic cop that understands the susceptible points of friction...to force control back into the jam so that movement can regain momentum. My position at the BCT TAC, south of the Whale Gap, acted as an effective...him that the COEFOR would most likely rouse the IDP camp north of the Whale Gap to create a massive traffic jam . The plan took all of this into

Smart roadside initiative gap analysis : target functionality and gap analysis.

DOT National Transportation Integrated Search

2015-02-01

This document summarizes the target functionality for the Smart Roadside Initiative, as well as the operational, institutional, and technical gaps that currently impede the deployment of three of its operational scenarios (electronic mainline s...

Gaps in the Body of Knowledge of Systems Engineering

DTIC Science & Technology

2012-07-01

practices, agile development, Kanban , risk management, and decision management. This focus is being driven by the need to reduce time for delivery of...to incorporate Kanban approaches to scheduling the SE activities based on value. Rapid Fielding. In this situation, there is a short time to

Cycle-Based Budgeting Toolkit: A Primer

ERIC Educational Resources Information Center

Yan, Bo

2016-01-01

At the core, budgeting is about distributing and redistributing limited financial resources for continuous improvement. Incremental budgeting is limited in achieving the goal due to lack of connection between outcomes and budget decisions. Zero-based budgeting fills the gap, but is cumbersome to implement, especially for large urban school…

Budgeting for Efficiency and Effectiveness

ERIC Educational Resources Information Center

Pereus, Steven C.

2012-01-01

For most districts, budgeting has become a cost-cutting exercise designed to close the gap between revenues and expenses. During this process, decision makers inherently assume that existing operations are efficient and effective--an assumption that is rarely validated by facts. Cutting programs and services balances budgets but does not…

Agreement between physicians' and nurses' clinical decisions for the management of the fracture liaison service (4iFLS): the Lucky Bone™ program.

PubMed

Senay, A; Delisle, J; Raynauld, J P; Morin, S N; Fernandes, J C

2016-04-01

We determined if nurses can manage osteoporotic fractures in a fracture liaison service by asking a rheumatologist and an internist to assess their clinical decisions. Experts agreed on more than 94 % of all nurses' actions for 525 fragility fracture patients, showing that their management is efficient and safe. A major care gap exists in the investigation of bone fragility and initiation of treatment for individuals who have sustained a fragility fracture. The implementation of a fracture liaison service (FLS) managed by nurses could be the key in resolving this problem. The aim of this project was to obtain agreement between physicians' and nurses' clinical decisions and evaluate if the algorithm of care is efficient and reliable for the management of a FLS. Clinical decisions of nurses for 525 subjects in a fracture liaison service between 2010 and 2013 were assessed by two independent physicians with expertise in osteoporosis treatment. Nurses succeeded in identifying all patients at risk and needed to refer 27 % of patients to an MD. Thereby, they managed autonomously 73 % of fragility fracture patients. No needless referrals were made according to assessing physicians. Agreement between each evaluator and nurses was of >97 %. Physicians' decisions were the same in >96 %, and Gwet AC11 coefficient was of >0.960 (almost perfect level of agreement). All major comorbidities were adequately managed. High agreement between nurses' and physicians' clinical decisions indicate that the independent management by nurses of a fracture liaison service is safe and should strongly be recommended in the care of patients with a fragility fracture. This kind of intervention could help resolve the existing care gap in bone fragility care as well as the societal economic burden associated with prevention and treatment of fragility fractures.

Response to Burgman and Regan: the elephant in the rhetoric on info-gap decision theory.

PubMed

Sniedovich, Moshe

2014-01-01

The formal, rigorous assessment of IGDT in Sniedovich (2012) reveals that this theory's central pillar, namely its robustness model, is a reinvention of a well-established model of local robustness, known universally as radius of stability (circa 1960). As a matter of fact, this robustness model is a simple model derived from Wald's famous maximin paradigm (circa 1940). This means that had there been any gap in the state of the art that IGDT could have possibly presumed to fill, this gap had already been filled decades ago, well before IGDT was even contemplated. The conclusion therefore is that there is no gap in the state of the art that IGDT does fill, or can possibly fill, or is called upon to fill. Also, since IGDT is based on a definition of local robustness, the theory is unsuitable for the treatment of a severe uncertainty of the type that this theory claims to address. Therefore, since the theory claims to be particularly suitable for the treatment of a severe, unbounded uncertainty, the inevitable conclusion is that this theory constitutes a voodoo decision theory par excellence. Fig. 1 speaks for itself so that no amount of rhetoric can explain this fact away. The Letter's attempt to brush off valid, rigorous, well-documented criticism of IGDT as "... haggling over terminology ..." is yet another attempt to avoid dealing with the elephant in the IGDT room. Nothing will be gained from the use of misleading rhetorics to argue that ideas, models, techniques, approaches, etc., that go back to the 1940s and 1960s, are IGDT innovations. But more than this, what good can come of misapplications of these ideas in applied ecology and conservation biology? In the Appendix, I address a more intriguing question, namely: QUESTION 2: What could possibly be the rationale that motivated a search for a (nonexistent) gap in the state of the art for IGDT to fill?

Three-dimensional modeling and quantitative analysis of gap junction distributions in cardiac tissue.

PubMed

Lackey, Daniel P; Carruth, Eric D; Lasher, Richard A; Boenisch, Jan; Sachse, Frank B; Hitchcock, Robert W

2011-11-01

Gap junctions play a fundamental role in intercellular communication in cardiac tissue. Various types of heart disease including hypertrophy and ischemia are associated with alterations of the spatial arrangement of gap junctions. Previous studies applied two-dimensional optical and electron-microscopy to visualize gap junction arrangements. In normal cardiomyocytes, gap junctions were primarily found at cell ends, but can be found also in more central regions. In this study, we extended these approaches toward three-dimensional reconstruction of gap junction distributions based on high-resolution scanning confocal microscopy and image processing. We developed methods for quantitative characterization of gap junction distributions based on analysis of intensity profiles along the principal axes of myocytes. The analyses characterized gap junction polarization at cell ends and higher-order statistical image moments of intensity profiles. The methodology was tested in rat ventricular myocardium. Our analysis yielded novel quantitative data on gap junction distributions. In particular, the analysis demonstrated that the distributions exhibit significant variability with respect to polarization, skewness, and kurtosis. We suggest that this methodology provides a quantitative alternative to current approaches based on visual inspection, with applications in particular in characterization of engineered and diseased myocardium. Furthermore, we propose that these data provide improved input for computational modeling of cardiac conduction.

Stakeholders' participatory diagnosis of climate change impacts on subsistence agriculture in Sikkim, India, for identifying adaptation strategies

NASA Astrophysics Data System (ADS)

Azhoni, A.; Goyal, M. K.

2017-12-01

Narrowing the gap between research, policy making and implementing adaptation remains a challenge in many parts of the world where climate change is likely to severely impact subsistence agriculture. This research aims to narrow this gap by matching the adaptation strategies being framed by policy makers and perspectives of consultants and researchers which are expected to be implemented by development agencies farmers in the state of Sikkim in India. Our case study examined the framing and implementation of State Action Plan on Climate Change through semi-structured interviews carried out with decision makers in the State Government, Scientific Organisations, consultants, local academia, implementing and development agencies, and farmers for whom the adaptation strategies are targeted. Using Social Network and Stakeholder Analysis approach, this research unravels the complexities of perceiving climate change impacts, identifying adaptation strategies, and implementing climate change adaptation strategies. While farmers are less aware about the global phenomenon of climate change impacts for their subsistence livelihood, their knowledge of the local conditions and their close interaction with the State Government Agriculture Department provides them an access to new and high value crops. Although important steps are initiated through the Sikkim State Action Plan on Climate Change it is yet to deliver effective means of adaptation implementation and identifying the networks of close coordination between the various implementing agencies will likely to pay rich dividends. While Sikkim being a small and hilly state with specific contextual challenges of climate change impacts, the results from this study highlights how the internal and external networks between various types of stakeholders informs decision makers in identifying local impacts of climate change and plan adaptation strategies.

Alternatives Assessment Frameworks: Research Needs for the Informed Substitution of Hazardous Chemicals

PubMed Central

Jacobs, Molly M.; Malloy, Timothy F.; Tickner, Joel A.; Edwards, Sally

2015-01-01

Background Given increasing pressures for hazardous chemical replacement, there is growing interest in alternatives assessment to avoid substituting a toxic chemical with another of equal or greater concern. Alternatives assessment is a process for identifying, comparing, and selecting safer alternatives to chemicals of concern (including those used in materials, processes, or technologies) on the basis of their hazards, performance, and economic viability. Objectives The purposes of this substantive review of alternatives assessment frameworks are to identify consistencies and differences in methods and to outline needs for research and collaboration to advance science policy practice. Methods This review compares methods used in six core components of these frameworks: hazard assessment, exposure characterization, life-cycle impacts, technical feasibility evaluation, economic feasibility assessment, and decision making. Alternatives assessment frameworks published from 1990 to 2014 were included. Results Twenty frameworks were reviewed. The frameworks were consistent in terms of general process steps, but some differences were identified in the end points addressed. Methodological gaps were identified in the exposure characterization, life-cycle assessment, and decision–analysis components. Methods for addressing data gaps remain an issue. Discussion Greater consistency in methods and evaluation metrics is needed but with sufficient flexibility to allow the process to be adapted to different decision contexts. Conclusion Although alternatives assessment is becoming an important science policy field, there is a need for increased cross-disciplinary collaboration to refine methodologies in support of the informed substitution and design of safer chemicals, materials, and products. Case studies can provide concrete lessons to improve alternatives assessment. Citation Jacobs MM, Malloy TF, Tickner JA, Edwards S. 2016. Alternatives assessment frameworks: research needs for the informed substitution of hazardous chemicals. Environ Health Perspect 124:265–280; http://dx.doi.org/10.1289/ehp.1409581 PMID:26339778

A Multi-Objective Optimization Technique to Model the Pareto Front of Organic Dielectric Polymers

NASA Astrophysics Data System (ADS)

Gubernatis, J. E.; Mannodi-Kanakkithodi, A.; Ramprasad, R.; Pilania, G.; Lookman, T.

Multi-objective optimization is an area of decision making that is concerned with mathematical optimization problems involving more than one objective simultaneously. Here we describe two new Monte Carlo methods for this type of optimization in the context of their application to the problem of designing polymers with more desirable dielectric and optical properties. We present results of applying these Monte Carlo methods to a two-objective problem (maximizing the total static band dielectric constant and energy gap) and a three objective problem (maximizing the ionic and electronic contributions to the static band dielectric constant and energy gap) of a 6-block organic polymer. Our objective functions were constructed from high throughput DFT calculations of 4-block polymers, following the method of Sharma et al., Nature Communications 5, 4845 (2014) and Mannodi-Kanakkithodi et al., Scientific Reports, submitted. Our high throughput and Monte Carlo methods of analysis extend to general N-block organic polymers. This work was supported in part by the LDRD DR program of the Los Alamos National Laboratory and in part by a Multidisciplinary University Research Initiative (MURI) Grant from the Office of Naval Research.

Insights into water managers' perception and handling of uncertainties - a study of the role of uncertainty in practitioners' planning and decision-making

NASA Astrophysics Data System (ADS)

Höllermann, Britta; Evers, Mariele

2017-04-01

Planning and decision-making under uncertainty is common in water management due to climate variability, simplified models, societal developments, planning restrictions just to name a few. Dealing with uncertainty can be approached from two sites, hereby affecting the process and form of communication: Either improve the knowledge base by reducing uncertainties or apply risk-based approaches to acknowledge uncertainties throughout the management process. Current understanding is that science more strongly focusses on the former approach, while policy and practice are more actively applying a risk-based approach to handle incomplete and/or ambiguous information. The focus of this study is on how water managers perceive and handle uncertainties at the knowledge/decision interface in their daily planning and decision-making routines. How they evaluate the role of uncertainties for their decisions and how they integrate this information into the decision-making process. Expert interviews and questionnaires among practitioners and scientists provided an insight into their perspectives on uncertainty handling allowing a comparison of diverse strategies between science and practice as well as between different types of practitioners. Our results confirmed the practitioners' bottom up approach from potential measures upwards instead of impact assessment downwards common in science-based approaches. This science-practice gap may hinder effective uncertainty integration and acknowledgement in final decisions. Additionally, the implementation of an adaptive and flexible management approach acknowledging uncertainties is often stalled by rigid regulations favouring a predict-and-control attitude. However, the study showed that practitioners' level of uncertainty recognition varies with respect to his or her affiliation to type of employer and business unit, hence, affecting the degree of the science-practice-gap with respect to uncertainty recognition. The level of working experience was examined as a cross-cutting property of science and practice with increasing levels of uncertainty awareness and integration among more experienced researchers and practitioners. In conclusion, our study of water managers' perception and handling of uncertainties provides valuable insights for finding routines for uncertainty communication and integration into planning and decision-making processes by acknowledging the divers perceptions among producers, users and receivers of uncertainty information. These results can contribute to more effective integration of hydrological forecast and improved decisions.

Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.

PubMed

Gloyd, Stephen; Wagenaar, Bradley H; Woelk, Godfrey B; Kalibala, Samuel

2016-01-01

HIV programme data from routine health information systems (RHIS) and personal health information (PHI) provide ample opportunities for secondary data analysis. However, these data pose unique opportunities and challenges for use in health system monitoring, along with process and impact evaluations. Analyses focused on retrospective case reviews of four of the HIV-related studies published in this JIAS supplement. We identify specific opportunities and challenges with respect to the secondary analysis of RHIS and PHI data. Challenges working with both HIV-related RHIS and PHI included missing, inconsistent and implausible data; rapidly changing indicators; systematic differences in the utilization of services; and patient linkages over time and different data sources. Specific challenges among RHIS data included numerous registries and indicators, inconsistent data entry, gaps in data transmission, duplicate registry of information, numerator-denominator incompatibility and infrequent use of data for decision-making. Challenges specific to PHI included the time burden for busy providers, the culture of lax charting, overflowing archives for paper charts and infrequent chart review. Many of the challenges that undermine effective use of RHIS and PHI data for analyses are related to the processes and context of collecting the data, excessive data requirements, lack of knowledge of the purpose of data and the limited use of data among those generating the data. Recommendations include simplifying data sources, analysis and reporting; conducting systematic data quality audits; enhancing the use of data for decision-making; promoting routine chart review linked with simple patient tracking systems; and encouraging open access to RHIS and PHI data for increased use.

Changes in perception-action tuning over long time scales: How children and adults perceive and act on dynamic affordances when crossing roads.

PubMed

O'Neal, Elizabeth E; Jiang, Yuanyuan; Franzen, Lucas J; Rahimian, Pooya; Yon, Junghum Paul; Kearney, Joseph K; Plumert, Jodie M

2018-01-01

This investigation examined developmental change in how children perceive and act on dynamic affordances when crossing roads on foot. Six- to 14-year-olds and adults crossed roads with continuous cross-traffic in a large-screen, immersive pedestrian simulator. We observed change both in children's gap choices and in their ability to precisely synchronize their movement with the opening of a gap. Younger children were less discriminating than older children and adults, choosing fewer large gaps and more small gaps. Interestingly, 12-year-olds' gap choices were significantly more conservative than those of 6-, 8-, 10-, and 14-year-olds, and adults. Timing of entry behind the lead vehicle in the gap (a key measure of movement coordination) improved steadily with development, reaching adultlike levels by age 14. Coupled with their poorer timing of entry, 6-, 8-, and 10-year-olds' gap choices resulted in significantly less time to spare and more collisions than 14-year-olds and adults. Time to spare did not differ between 12-year-olds, 14-year-olds, and adults, indicating that 12-year-olds' more conservative gap choices compensated for their poorer timing of entry. The findings show that children's ability to perceive and act on dynamic affordances undergoes a prolonged period of development, and that older children appear to compensate for their poorer movement timing skills by adjusting their gap decisions to match their crossing actions. Implications for the development of perception-action tuning and road-crossing skills are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Knowledge and confidence of Australian emergency department clinicians in managing patients with mental health-related presentations: findings from a national qualitative study

PubMed Central

2013-01-01

Background Mental health related presentations are common in Australian Emergency Departments (EDs). We sought to better understand ED staff knowledge and levels of confidence in treating people with mental health related problems using qualitative methods. Methods This was a qualitative learning needs analysis of Australian emergency doctors and nurses regarding the assessment and management of mental health presentations. Participants were selected for semi-structured telephone interview using criterion-based sampling. Recruitment was via the Australasian College for Emergency Medicine and College of Emergency Nursing Australasia membership databases. Interviews were audio-recorded and transcribed verbatim. Thematic framework analysis was used to identify perceived knowledge gaps and levels of confidence among participants in assessing and managing patients attending EDs with mental health presentations. Results Thirty-six staff comprising 20 doctors and 16 nurses consented to participate. Data saturation was achieved for four major areas where knowledge gaps were reported. These were: assessment (risk assessment and assessment of mental status), management (psychotherapeutic skills, ongoing management, medication management and behaviour management), training (curriculum and rotations), and application of mental health legislation. Participants’ confidence in assessing mental health patients was affected by environmental, staff, and patient related factors. Clinicians were keen to learn more about evidence based practice to provide better care for this patient group. Areas where clinicians felt the least confident were in the effective assessment and management of high risk behaviours, providing continuity of care, managing people with dual diagnosis, prescribing and effectively managing medications, assessing and managing child and adolescent mental health, and balancing the caseload in ED. Conclusion Participants were most concerned about knowledge gaps in risk assessment, particularly for self-harming patients, violent and aggressive patients and their management, and distinguishing psychiatric from physical illness. Staff confidence was enhanced by better availability of skilled psychiatric support staff to assist in clinical decision-making for complex cases and via the provision of a safe ED environment. Strategies to enhance the care of patients with mental health presentations in Australian emergency departments should address these gaps in knowledge and confidence. PMID:23317351

The SI-Gap: How British Units Are Impeding Advances in STEM

NASA Astrophysics Data System (ADS)

Jones, M. P.; Cook, Courtney J.

2017-11-01

The United States is one of only three countries in the world that remain uncommitted to the metric system. Perhaps to policymakers the decision to hang on to miles, pounds, and gallons is one of tradition. However, as a physics teacher I have seen firsthand how growing up with U.S. Customary Units (commonly called by the pseudonym "British Units") has negatively impacted my students. Sure, they can convert between "British" and SI units; and they can effectively toggle between SI prefixes. However, they typically lack intuition regarding the values they express in SI. This is a major problem, but is by no means a criticism against them. Their disadvantage is the result of a unique learning gap that exists in the United States. I call it the SI(sī)-gap. The SI-gap not only impedes our ability as teachers to inspire students when it comes to science, technology, engineering, and mathematics (STEM); it also prevents our students from properly assessing the validity of their own results. As we shall soon see, the SI-gap carries consequences beyond the classroom. If we are to solve the problems that relate to the SI-gap, we need to reform the way we introduce SI units to the current generation of students.

Delivering Educational Services that Meet the Needs of All Students

ERIC Educational Resources Information Center

Ferretti, Ralph P.; Eisenman, Laura T.

2010-01-01

Federal policies intended to promote educational equity, especially through state accountability mechanisms, have mobilized efforts to improve outcomes for students with disabilities. Although these efforts have met with some success, achievement gaps remain. The authors argue that local cultures of teaching practices and decision making continue…

Rurality Index for Small Areas in Spain

ERIC Educational Resources Information Center

Ocana-Riola, Ricardo; Sanchez-Cantalejo, Carmen

2005-01-01

An operational definition for "rural area" is pivotal if proposals, policies and decisions aimed at optimising the distribution of resources, closing the gap on inequity between areas and raising standards of living for the least advantaged populations are to be put in place. The concept of rurality, however, is often based on…

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…

Authenticity of Mathematical Modeling

ERIC Educational Resources Information Center

Tran, Dung; Dougherty, Barbara J.

2014-01-01

Some students leave high school never quite sure of the relevancy of the mathematics they have learned. They fail to see links between school mathematics and the mathematics of everyday life that requires thoughtful decision making and often complex problem solving. Is it possible to bridge the gap between school mathematics and the mathematics in…

Conflict Management: A Gap in Business Education Curricula

ERIC Educational Resources Information Center

Lang, Matthew

2009-01-01

Conflict management is a significant and unavoidable part of a manager's role in an organization. Employees need conflict management skills to manage themselves, make decisions, and work effectively in the ever-increasing team environment of today's organizations. In the present article, the author demonstrates the disconnect between the…

75 FR 34115 - Pesticides; Availability of Updated Schedule for Registration Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... decisions for the soil fumigants, new research is underway to address current data gaps and to refine... fumigation are emerging. By moving the soil fumigants forward in registration review from 2017 to 2013, the... on transparency and sound science, including independent scientific peer review. The current atrazine...

Making DATA Work: A Process for Conducting Action Research

ERIC Educational Resources Information Center

Young, Anita; Kaffenberger, Carol

2013-01-01

This conceptual model introduces a process to help school counselors use data to drive decision making and offers examples to implement the process. A step-by-step process is offered to help school counselors and school counselor supervisors address educational issues, close achievement gaps, and demonstrate program effectiveness. To illustrate…

The Decisions We Make about Data

ERIC Educational Resources Information Center

Parsley, James F.

2004-01-01

In this article, the author suggests that leaders need to pause and ask, Is the school environment becoming one of fear and frustration with diminishing regard for personal passion, interest or creativity in teachers and students? Is it possible to narrow the achievement gap on high-stakes assessments while also fostering creativity, limitless…

Implications of the Value of Hydrologic Information to Reservoir Operations--Learning from the Past

ERIC Educational Resources Information Center

Hejazi, Mohamad Issa

2009-01-01

Closing the gap between theoretical reservoir operation and the real-world implementation remains a challenge in contemporary reservoir operations. Past research has focused on optimization algorithms and establishing optimal policies for reservoir operations. In this research, we attempt to understand operators' release decisions by investigating…

Analytic and Heuristic Processing Influences on Adolescent Reasoning and Decision-Making.

ERIC Educational Resources Information Center

Klaczynski, Paul A.

2001-01-01

Examined the relationship between age and the normative/descriptive gap--the discrepancy between actual reasoning and traditional standards for reasoning. Found that middle adolescents performed closer to normative ideals than early adolescents. Factor analyses suggested that performance was based on two processing systems, analytic and heuristic…

Attitudes Affecting Online Learning Implementation in Higher Education Institutions

ERIC Educational Resources Information Center

Mitchell, Betty; Geva-May, Iris

2009-01-01

This study explores attitudes towards and affecting online learning implementation (OLI). In recent years there has been greater acceptance of online learning (OL) by institutional decision-makers, as evidenced by higher levels of institutional involvement; nevertheless, the increase in faculty acceptance lags behind. This gap affects the…

Developing a Foreign Language Fiction Collection on a Limited Budget

ERIC Educational Resources Information Center

Bissett, Cindy

2010-01-01

Libraries have limited budgets and Collection Development Librarians can be faced with difficult decisions in the spending of their allocated funds. This paper discusses how the Tasmanian Polytechnic Launceston Campus Library discovered a gap in their collection and addressed this situation without funding. The Library wished to purchase fiction…

GAPS OF DECISION SUPPORT MODELS FOR PIPELINE RENEWAL AND RECOMMENDATIONS FOR IMPROVEMENT - Paper

EPA Science Inventory

As part of the U.S. Environmental Protection Agency (EPA)’s Aging Water Infrastructure Research Program, one key area of research pursued, in collaboration with wastewater and water utilities, was a study of the current approaches available for making rehabilitation versus replac...

The alfalfa yield gap: A review of the evidence

USDA-ARS?s Scientific Manuscript database

Knowledge of feasibly attainable crop yields is needed for many purposes, from field-scale management to national policy decisions. For alfalfa (Medicago sativa L.), the most widely used estimates of yield in the US are whole-farm reports from the National Agriculture Statistics Service, which are b...

How much is new information worth? Evaluating the financial benefit of resolving management uncertainty

USGS Publications Warehouse

Maxwell, Sean L.; Rhodes, Jonathan R.; Runge, Michael C.; Possingham, Hugh P.; Ng, Chooi Fei; McDonald Madden, Eve

2015-01-01

Conservation decision-makers face a trade-off between spending limited funds on direct management action, or gaining new information in an attempt to improve management performance in the future. Value-of-information analysis can help to resolve this trade-off by evaluating how much management performance could improve if new information was gained. Value-of-information analysis has been used extensively in other disciplines, but there are only a few examples where it has informed conservation planning, none of which have used it to evaluate the financial value of gaining new information. We address this gap by applying value-of-information analysis to the management of a declining koala Phascolarctos cinereuspopulation. Decision-makers responsible for managing this population face uncertainty about survival and fecundity rates, and how habitat cover affects mortality threats. The value of gaining new information about these uncertainties was calculated using a deterministic matrix model of the koala population to find the expected population growth rate if koala mortality threats were optimally managed under alternative model hypotheses, which represented the uncertainties faced by koala managers. Gaining new information about survival and fecundity rates and the effect of habitat cover on mortality threats will do little to improve koala management. Across a range of management budgets, no more than 1·7% of the budget should be spent on resolving these uncertainties. The value of information was low because optimal management decisions were not sensitive to the uncertainties we considered. Decisions were instead driven by a substantial difference in the cost efficiency of management actions. The value of information was up to forty times higher when the cost efficiencies of different koala management actions were similar. Synthesis and applications. This study evaluates the ecological and financial benefits of gaining new information to inform a conservation problem. We also theoretically demonstrate that the value of reducing uncertainty is highest when it is not clear which management action is the most cost efficient. This study will help expand the use of value-of-information analyses in conservation by providing a cost efficiency metric by which to evaluate research or monitoring.

Session: Discussion of Research Needs

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

anon.

This final session at the Wind Energy and Birds/Bats workshop was lead by a facilitator who asked participants for their overall reaction to the research that had been presented during the workshop. Questions addressed by workshop participants included: how do you develop trust and confidence in the research, what are some of the specific gaps in our understanding of wind energy's impact on birds and bats; how do we prioritize and proceed with closing the data/research gaps; how do we connect the dots and bring various research and mapping efforts together; given gaps in the data, what are the criticalmore » questions we need to answer to make project decisions now; and, how do we track/influence the policies that will shape wind energy development. Conclusions reached regarding these questions are included in summary form.« less

[How much knowledge do health insurance companies need to make reimbursement decisions?].

PubMed

Pfeiffer, Doris

2009-01-01

Health insurance companies play a very significant role in the sociopolitical context. It is their responsibility to meet the demands of modern health services delivery, while at the same time limited financial resources need to be considered. Difficult decisions have to be made which must take into account the needs of the insured party as well as the healthcare situation and oncoming possibilities. Health insurance companies rely on secure knowledge with a high level of evidence to justify their decisions in a collectively funded healthcare system. Where the elimination of knowledge gaps is not related to the expectation of profit on the part of potential providers of medical services, procedures or products the funding of high-quality studies should be considered.

Is Financial Literacy a Determinant of Health?

PubMed

Meyer, Melanie

2017-08-01

Changes in economic conditions and healthcare delivery models have shifted more healthcare costs to patients, resulting in greater patient financial responsibilities. As a result, it is important to understand the potential impact of financial literacy on patients' healthcare behavior. With the focus on delivering better health outcomes at lower costs, factors that influence patient behavior are important considerations for healthcare providers. Although researchers have proposed a variety of conceptual models that identify influential factors, those models do not fully address financial literacy and its potential impact patients' healthcare decisions. This article examines existing models of patient healthcare decision-making and current research on factors affecting patient decision-making and behavior and then presents recommendations for closing the identified gap in our current knowledge.

Evaluating the quality and use of economic data in decisions about essential medicines.

PubMed

Moucheraud, Corrina; Wirtz, Veronika J; Reich, Michael R

2015-10-01

To evaluate the quality of economic data provided in applications to the World Health Organization (WHO) Model List of Essential Medicines and to evaluate the role of these data in decision-making by the expert committee that considers the applications. We analysed applications submitted to the WHO Expert Committee on the Selection and Use of Essential Medicines between 2002 and 2013. The completeness of data on the price and cost-effectiveness of medicines was extracted from application documents and coded using a four-point scale. We recorded whether or not the expert committee discussed economic information and the outcomes of each application. Associations between the completeness of economic data and application outcomes were assessed using χ 2 tests. The expert committee received 134 applications. Only eight applications (6%) included complete price data and economic evaluation data. Many applicants omitted or misinterpreted the economic evaluation section of the application form. Despite the lack of economic data, all applications were reviewed by the committee. There was no significant association between the completeness of economic information and application outcomes. The expert committee tried to address information gaps in applications by further review and analysis of data related to the application. The World Health Organization should revise the instructions to applicants on economic data requirements; develop new mechanisms to assist applicants in completing the application process; and define methods for the use of economic data in decision-making.

Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives.

PubMed

Silva, Diego S; Gibson, Jennifer L; Robertson, Ann; Bensimon, Cécile M; Sahni, Sachin; Maunula, Laena; Smith, Maxwell J

2012-03-26

Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.

Multicriteria Decision Framework for Cybersecurity Risk Assessment and Management.

PubMed

Ganin, Alexander A; Quach, Phuoc; Panwar, Mahesh; Collier, Zachary A; Keisler, Jeffrey M; Marchese, Dayton; Linkov, Igor

2017-09-05

Risk assessors and managers face many difficult challenges related to novel cyber systems. Among these challenges are the constantly changing nature of cyber systems caused by technical advances, their distribution across the physical, information, and sociocognitive domains, and the complex network structures often including thousands of nodes. Here, we review probabilistic and risk-based decision-making techniques applied to cyber systems and conclude that existing approaches typically do not address all components of the risk assessment triplet (threat, vulnerability, consequence) and lack the ability to integrate across multiple domains of cyber systems to provide guidance for enhancing cybersecurity. We present a decision-analysis-based approach that quantifies threat, vulnerability, and consequences through a set of criteria designed to assess the overall utility of cybersecurity management alternatives. The proposed framework bridges the gap between risk assessment and risk management, allowing an analyst to ensure a structured and transparent process of selecting risk management alternatives. The use of this technique is illustrated for a hypothetical, but realistic, case study exemplifying the process of evaluating and ranking five cybersecurity enhancement strategies. The approach presented does not necessarily eliminate biases and subjectivity necessary for selecting countermeasures, but provides justifiable methods for selecting risk management actions consistent with stakeholder and decisionmaker values and technical data. Published 2017. This article is a U.S. Government work and is in the public domain in the U.S.A.

Moving Forward after Sendai: How Countries Want to Use Science, Evidence and Technology for Disaster Risk Reduction.

PubMed

Calkins, Julie

2015-05-14

Following the 2004 Indian Ocean earthquake and tsunami event, the global community adopted the UN Hyogo Framework for Action (HFA) for Disaster Risk Reduction 2005-2015, which set out priorities to help countries achieve disaster resilience by encouraging the establishment of national platforms and strengthening disaster governance. In March 2015, UN member states adopted the successor to HFA, the Sendai Framework for Disaster Risk Reduction: 2015-2030 (SFDRR). The SFDRR recognises the cross-cutting nature of DRR policy and calls on stakeholders to help governments. Over the following months, the international science community as a stakeholder will contribute by outlining guidance, research opportunities and partnerships to help countries implement the new framework. To inform this process, this study examines government' and national scientists' perspectives about the needs to use science, evidence and technology to achieve disaster risk reduction (DRR) and put the words of the new framework into action. This study was conducted using qualitative content analysis and quantifiable survey results. Data was collected via extraction from published statements and online survey responses. For statement content analysis, search terms were determined iteratively in a sample of statements until no new terms emerged. Additionally, 167 national scientists were recruited to participate in the online survey with a response rate of 26.3% (44/167). Country priorities are clustered and clear, showing that there is a demand for greater science in DRR decision-making and solutions. The main themes highlighted by countries were promoting research and practitioner engagement; increase technology transfer mechanisms; open data; communication of usable evidence and user's needs; education and training; and lastly, international cooperation all contributing to national capacity building. As identified, the main difficulties with existing delivery are gaps in knowledge, lack of coordination and a gap in capacity to use scientific evidence for policy-making. Countries and organisations have identified a range of science and technology related needs, including through the preparatory and drafting process for the Sendai Framework for DRR. Across regions and development levels, countries are seeking to address the gaps they face in scientific capacities and information. It is hoped that understanding these priorities and challenges will help decision-makers and scientists in developing the implementation plan to consider how science, technology and innovation can be enabling factors for DRR. An implementation plan of action underpinned by scientific evidence has the potential to save lives, more accurately target investment, and contribute to greater resilience over the coming decades.

SACRIFICING THE ECOLOGICAL RESOLUTION OF VEGETATION MAPS AT THE ALTAR OF THEMATIC ACCURACY: ASSESSED MAP ACCURACIES FOR HIERARCHICAL VEGETATION CLASSIFICATIONS IN THE EASTERN GREAT BASIN OF THE SOUTHWEST REGIONAL GAP ANALYSIS PROJECT (SW REGAP)

EPA Science Inventory

The Southwest Regional Gap Analysis Project (SW ReGAP) improves upon previous GAP projects conducted in Arizona, Colorado, Nevada, New Mexico, and Utah to provide a
consistent, seamless vegetation map for this large and ecologically diverse geographic region. Nevada's compone...

Multi-criteria decision analysis as an innovative approach to managing zoonoses: results from a study on Lyme disease in Canada

PubMed Central

2013-01-01

Background Zoonoses are a growing international threat interacting at the human-animal-environment interface and call for transdisciplinary and multi-sectoral approaches in order to achieve effective disease management. The recent emergence of Lyme disease in Quebec, Canada is a good example of a complex health issue for which the public health sector must find protective interventions. Traditional preventive and control interventions can have important environmental, social and economic impacts and as a result, decision-making requires a systems approach capable of integrating these multiple aspects of interventions. This paper presents the results from a study of a multi-criteria decision analysis (MCDA) approach for the management of Lyme disease in Quebec, Canada. MCDA methods allow a comparison of interventions or alternatives based on multiple criteria. Methods MCDA models were developed to assess various prevention and control decision criteria pertinent to a comprehensive management of Lyme disease: a first model was developed for surveillance interventions and a second was developed for control interventions. Multi-criteria analyses were conducted under two epidemiological scenarios: a disease emergence scenario and an epidemic scenario. Results In general, we observed a good level of agreement between stakeholders. For the surveillance model, the three preferred interventions were: active surveillance of vectors by flagging or dragging, active surveillance of vectors by trapping of small rodents and passive surveillance of vectors of human origin. For the control interventions model, basic preventive communications, human vaccination and small scale landscaping were the three preferred interventions. Scenarios were found to only have a small effect on the group ranking of interventions in the control model. Conclusions MCDA was used to structure key decision criteria and capture the complexity of Lyme disease management. This facilitated the identification of gaps in the scientific literature and enabled a clear identification of complementary interventions that could be used to improve the relevance and acceptability of proposed prevention and control strategy. Overall, MCDA presents itself as an interesting systematic approach for public health planning and zoonoses management with a “One Health” perspective. PMID:24079303

Multi-criteria decision analysis as an innovative approach to managing zoonoses: results from a study on Lyme disease in Canada.

PubMed

Aenishaenslin, Cécile; Hongoh, Valérie; Cissé, Hassane Djibrilla; Hoen, Anne Gatewood; Samoura, Karim; Michel, Pascal; Waaub, Jean-Philippe; Bélanger, Denise

2013-09-30

Zoonoses are a growing international threat interacting at the human-animal-environment interface and call for transdisciplinary and multi-sectoral approaches in order to achieve effective disease management. The recent emergence of Lyme disease in Quebec, Canada is a good example of a complex health issue for which the public health sector must find protective interventions. Traditional preventive and control interventions can have important environmental, social and economic impacts and as a result, decision-making requires a systems approach capable of integrating these multiple aspects of interventions. This paper presents the results from a study of a multi-criteria decision analysis (MCDA) approach for the management of Lyme disease in Quebec, Canada. MCDA methods allow a comparison of interventions or alternatives based on multiple criteria. MCDA models were developed to assess various prevention and control decision criteria pertinent to a comprehensive management of Lyme disease: a first model was developed for surveillance interventions and a second was developed for control interventions. Multi-criteria analyses were conducted under two epidemiological scenarios: a disease emergence scenario and an epidemic scenario. In general, we observed a good level of agreement between stakeholders. For the surveillance model, the three preferred interventions were: active surveillance of vectors by flagging or dragging, active surveillance of vectors by trapping of small rodents and passive surveillance of vectors of human origin. For the control interventions model, basic preventive communications, human vaccination and small scale landscaping were the three preferred interventions. Scenarios were found to only have a small effect on the group ranking of interventions in the control model. MCDA was used to structure key decision criteria and capture the complexity of Lyme disease management. This facilitated the identification of gaps in the scientific literature and enabled a clear identification of complementary interventions that could be used to improve the relevance and acceptability of proposed prevention and control strategy. Overall, MCDA presents itself as an interesting systematic approach for public health planning and zoonoses management with a "One Health" perspective.

Does accountability for reasonableness work? A protocol for a mixed methods study using an audit tool to evaluate the decision-making of clinical commissioning groups in England.

PubMed

Kieslich, Katharina; Littlejohns, Peter

2015-07-10

Clinical commissioning groups (CCGs) in England are tasked with making difficult decisions on which healthcare services to provide against the background of limited budgets. The question is how to ensure that these decisions are fair and legitimate. Accounts of what constitutes fair and legitimate priority setting in healthcare include Daniels' and Sabin's accountability for reasonableness (A4R) and Clark's and Weale's framework for the identification of social values. This study combines these accounts and asks whether the decisions of those CCGs that adhere to elements of such accounts are perceived as fairer and more legitimate by key stakeholders. The study addresses the empirical gap arising from a lack of research on whether frameworks such as A4R hold what they promise. It aims to understand the criteria that feature in CCG decision-making. Finally, it examines the usefulness of a decision-making audit tool (DMAT) in identifying the process and content criteria that CCGs apply when making decisions. The adherence of a sample of CCGs to criteria emerging from theories of fair priority setting will be examined using the DMAT developed by PL. The results will be triangulated with data from semistructured interviews with key stakeholders in the CCG sample to ascertain whether there is a correlation between those CCGs that performed well in the DMAT exercise and those whose decisions are perceived positively by interviewees. Descriptive statistical methods will be used to analyse the DMAT data. A combination of quantitative and qualitative content analysis methods will be used to analyse the interview transcripts. Full ethics approval was received by the King's College London Biomedical Sciences, Dentistry, Medicine and Natural and Mathematical Sciences Research Ethics Subcommittee. The results of the study will be disseminated through publications in peer review journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Woman's participation in the decision process of the pregnancy and puerperal cycle: nursing care integrative review].

PubMed

Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa; Lunardi, Valéria Lerch; dos Santos, Silvana Sidnei

2011-12-01

This is an integrative review that aims to identify the contribution of nursing care for woman's participation in the decision process of the pregnancy and puerperal cycle, as described in Brazilian scientific publications. The scientific productions were retrieved in May, 2010, from the Virtual Library of Health (Biblioteca Virtual em Saúde) database. From the eight articles reviewed, two themes stood out: Contributions of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle; and Limitations of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle. The following review supports the production of knowledge in nursing, by identifying a gap in what nurses know and do about this issue, as shown by the lack of nursing researches that concern, specifically, the participation of the woman in the decision process during the pregnancy and puerperal cycle and the possible contributions of nursing care to ensure women of this right.

The time course of saccadic decision making: dynamic field theory.

PubMed

Wilimzig, Claudia; Schneider, Stefan; Schöner, Gregor

2006-10-01

Making a saccadic eye movement involves two decisions, the decision to initiate the saccade and the selection of the visual target of the saccade. Here we provide a theoretical account for the time-courses of these two processes, whose instabilities are the basis of decision making. We show how the cross-over from spatial averaging for fast saccades to selection for slow saccades arises from the balance between excitatory and inhibitory processes. Initiating a saccade involves overcoming fixation, as can be observed in the countermanding paradigm, which we model accounting both for the temporal evolution of the suppression probability and its dependence on fixation activity. The interaction between the two forms of decision making is demonstrated by predicting how the cross-over from averaging to selection depends on the fixation stimulus in gap-step-overlap paradigms. We discuss how the activation dynamics of our model may be mapped onto neuronal structures including the motor map and the fixation cells in superior colliculus.

Development of a Spanish-Language Hospice Video.

PubMed

Chung, Kyusuk; Augustin, Frankline; Esparza, Salvador

2017-09-01

The nation faces a persistent issue of delayed access to hospice care. Even though hospice enrollment is considered to be one of the most difficult medical decisions, physician clinics and hospitals lack tools for helping patients/families faced with making decisions about enrollment. Health-care literature lacks discussion of development of decision-making aids in the context of hospice decisions for minority ethnic groups, even though those groups have decisional needs that may differ from those of non-Hispanic whites. To fill the gap, we developed a video of a Latino hospice patient with footages showing how the patient was being taken care of by her family with support from a hospice disciplinary team. A primary objective of this article is to describe how focus groups, existing decision aids, and individual interviews were used to develop and improve a Spanish-language hospice educational video targeting Latino subgroups with linguistic, cultural, and educational barriers. These steps may provide guidelines for developing and revising health-related videos targeting other minority ethnic groups.

An evaluation of health benefit modification in Taft-Hartley health and welfare funds: implications for encouraging tobacco-cessation coverage.

PubMed

Au-Yeung, Caroline M; Weisman, Susan R; Hennrikus, Deborah J; Forster, Jean L; Skoog, Rodney; Luneburg, Wade; Hesse, Bernie

2010-12-01

An estimated one fifth of all U.S. adult smokers receive health benefits through insurance plans administered by Taft-Hartley Health and Welfare Funds. Most funds do not offer comprehensive tobacco-cessation services to fund participants despite evidence that doing so would be cost effective and save lives. This paper examines the decision-making processes of Minnesota-based fund trustees and advisors to identify factors that influence decisions about modifications to benefits. Formative data about the process by which funds make health benefit modifications were collected in 2007-2008 from 25 in-depth key informant interviews with fund trustees and a cross-section of fund advisors, including administrators, attorneys, and healthcare business consultants. Analyses were performed using a general inductive approach to identify conceptual themes, employing qualitative data analysis software. The most commonly cited factors influencing trustees' decisions about health plan benefit modifications-including modifications regarding tobacco-cessation benefits-were benefit costs, participants' demand for services, and safeguarding participants' health. Barriers included information gaps, concerns about participants' response, and difficulty projecting benefit utilization and success. Advisors wielded considerable influence in decision-making processes. Trustees relied on a small pool of business, legal, and administrative advisors to provide guidance and recommendations about possible health plan benefit modifications. Providing advisors with evidence-based information and resources about benefit design, cost/return-on-investment (ROI), effectiveness, and promotion may be an effective means to influence funds to provide comprehensive tobacco-cessation benefits. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Towards the next generation of climate change assessment: learning from past experiences to inform a sustainable future

NASA Astrophysics Data System (ADS)

Mach, K. J.; Field, C. B.

2017-12-01

Over decades, assessment by the Intergovernmental Panel on Climate Change and many others has bolstered understanding of the climate problem: unequivocal warming, pervasive impacts, and serious risks from continued high emissions of heat-trapping gases. Societies are increasingly responding with early actions to decarbonize energy systems and prepare for impacts. This emerging era of climate solutions creates a need for new approaches to assessment that emphasize learning from ongoing real-world experiences and that help close the gap between aspirations and the pace of progress. Against this backdrop, the presentation will take stock of recent advances and challenges in assessment, especially drawing from analysis of climate change assessment. Four assessment priorities will be considered: (1) integrating diverse evidence including quantitative and qualitative results, (2) applying rigorous expert judgment in evaluating knowledge and uncertainties, (3) exploring widely ranging futures and their connections to ongoing choices and actions, and (4) incorporating interactions among experts and decision-makers in assessment processes. Across these assessment priorities, the presentation will critique both opportunities and pitfalls, outlining possibilities for future experimentation, innovation, and learning. It will evaluate, in particular, lessons from risk-based approaches; strategies for transparently acknowledging persistent uncertainties and contested priorities; ways to minimize biases and foster creativity in expert judgments; scenario-based assessment of surprises, deep uncertainties, and decision-making implications; and opportunities for broadening the conception of expertise and engaging different decision-makers and stakeholders. Overall, these approaches can advance assessment products and processes as a basis for sustained dialogue supporting decision-making.

Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda

PubMed Central

Nabyonga-Orem, Juliet; Mijumbi, Rhona

2015-01-01

Background: Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods: Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results: Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion: What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. PMID:25905479

Who opts for self-employment after retirement? A longitudinal study in the Netherlands.

PubMed

van Solinge, Hanna

2014-09-01

Self-employment among older age groups is rising. A better understanding of the role of self-employment in extending the working lives of individuals is, therefore, relevant from a policy perspective. By bridging the gap in the literature on work/retirement decision-making and entrepreneurship, the present study examines the factors associated with entry into self-employment post-retirement, after a worker has left a regular salaried position. This decision is modelled as a choice between full retirement and prolonged labour force participation, in the form of either a typical wage-providing job or self-employment. Data were derived from the Netherlands Interdisciplinary Demographic Institute Work and Retirement Panel, an ongoing longitudinal survey of older workers (50 years and over) employed by three private sector organisations and employed as civil servants in the Netherlands. These data were then analysed using multinomial logistic regression analysis. The results of this study show that the decision to pursue self-employment is primarily taken by retirees with relatively high levels of financial and human capital (wealth and educational attainment), those possessing entrepreneurial attitudes (high self-efficacy scores) and those who perceive their retirements to be completely involuntary. The results lend support to self-employment being selected as a postretirement path through opportunity rather than out of necessity. The fact that the retirements of the studied population were generally quite early, while not considered involuntary also suggests that the timing of the decision to retire may be driven by the emergence of new (business) opportunities.

Assessing Patient Organization Participation in Health Policy: A Comparative Study in France and Italy

PubMed Central

Souliotis, Kyriakos; Agapidaki, Eirini; Evangelia Peppou, Lily; Tzavara, Chara; Varvaras, Dimitrios; Buonomo, Oreste Claudio; Debiais, Dominique; Hasurdjiev, Stanimir; Sarkozy, Francois

2018-01-01

Background: Even though there are many patient organizations across Europe, their role in impacting health policy decisions and reforms has not been well documented. In line with this, the present study endeavours to fill this gap in the international literature. To this end, it aims to validate further a previously developed instrument (the Health Democracy Index - HDI) measuring patient organization participation in health policy decision-making. In addition, by utilizing this tool, it aims to provide a snapshot of the degree and impact of cancer patient organization (CPO) participation in Italy and France. Methods: A convenient sample of 188 members of CPOs participated in the study (95 respondents from 10 CPOs in Italy and 93 from 12 CPOs in France). Participants completed online a self-reported questionnaire, encompassing the 9-item index and questions enquiring about the type and impact of participation in various facets of health policy decisionmaking. The psychometric properties of the scale were explored by performing factor analysis (construct validity) and by computing Cronbach α (internal consistency). Results: Findings indicate that the index has good internal consistency and the construct it taps is unidimensional. The degree and impact of CPO participation in health policy decision-making were found to be low in both countries; however in Italy they were comparatively lower than in France. Conclusion: In conclusion, the HDI can be effectively used in international policy and research contexts. CPOs participation is low in Italy and France and concerted efforts should be made on upgrading their role in health policy decision-making. PMID:29325402

`G.A.T.E': Gap analysis for TTX evaluation

NASA Astrophysics Data System (ADS)

Cacciotti, Ilaria; Di Giovanni, Daniele; Pergolini, Alessandro; Malizia, Andrea; Carestia, Mariachiara; Palombi, Leonardo; Bellecci, Carlo; Gaudio, Pasquale

2016-06-01

A Table Top Exercise (TTX) gap analysis tool was developed with the aim to provide a complete, systematic and objective evaluation of TTXs organized in safety and security fields. A TTX consists in a discussion-based emergency management exercise, organized in a simulated emergency scenario, involving groups of players who are subjected to a set of solicitations (`injects'), in order to evaluate their emergency response abilities. This kind of exercise is devoted to identify strengths and shortfalls and to propose potential and promising changes in the approach to a particular situation. In order to manage the TTX derived data collection and analysis, a gap analysis tool would be very useful and functional at identifying the 'gap' between them and specific areas and actions for improvement, consisting the gap analysis in a comparison between actual performances and optimal/expected ones. In this context, a TTX gap analysis tool was designed, with the objective to provide an evaluation of Team players' competences and performances and TTX organization and structure. The influence of both the players' expertise and the reaction time (difference between expected time and time necessary to actually complete the injects) on the final evaluation of the inject responses was also taken into account.

Management of the Israeli National Water System under Uncertainty

NASA Astrophysics Data System (ADS)

Shamir, U.; Housh, M.; Ostfeld, A.; Zaide, M.

2009-12-01

Uncertainty in our region is due to the natural variability of hydrological patterns, with recurring extended droughts, reduced average and broadening variability of recharge that seem to indicate the effect of climate change, as well as to deterioration of water quality in the natural sources, to population growth and distribution, to shifting demand patterns among consumer sectors, and to expected future regional water agreements. These factors combine to create a challenging environment in which highly stressed water resources and water systems have to be developed, operated and managed. The natural sources have been used to their sustainable capacity and often beyond. The main policy responses are a shift of fresh water from agriculture to the cities, replacing it with treated wastewater for irrigation, and a major program for construction of sea-water desalination plants and the associated infrastructure needed for its integration into the supply systems. Organizational reforms, regulation, and demand management options are also being developed, including full-cost pricing. Management of the water resources and systems under these conditions requires a long-term perspective. The methodologies for supporting management decisions that have been used to date by the Israeli Water Authority include evaluation by scenarios, simulation, and optimization with sensitivity analysis. We review existing approaches and models for management of the Israeli water system (Zaide 2006) and then present some new methodologies for addressing operational decisions under hydrological uncertainty, which include generation of tradeoffs between the expected value and variability of the outcomes, and an Info-Gap (Ben-Haim 2006) based approach. These methodologies are demonstrated on examples that emulate portions of a regional water system and are then applied to the Israeli National Water System. Ben-Haim, Y. (2006) Info-Gap Theory: Decisions under Severe Uncertainty, 2nd Ed., Academic Press, London. Zaide, M. (2006) A Model for Management of Water Quantity and Quality in the Israeli National System", MSc Thesis, Faculty of Civil Engineering, Technion. http://urishamir.wri.technion.ac.il/files/documents/Miki%20Zaide%20-%20Thesis%20Final%2015.03.06.pdf

Therapeutic Decisions in Atrial Fibrillation for Stroke Prevention: The Role of Aversion to Ambiguity and Physicians' Risk Preferences.

PubMed

Sposato, Luciano A; Stirling, Devin; Saposnik, Gustavo

2018-04-09

Knowledge-to-action gaps influence therapeutic decisions in atrial fibrillation (AF). Physician-related factors are common, but the least studied. We evaluated the prevalence and determinants of physician-related factors and knowledge-to-action gaps among physicians involved in the management of AF patients. In this cross-sectional study, participants from 6 South American countries recruited during an educational program answered questions regarding 16 case scenarios of patients with AF and completed experiments assessing 3 outcome measures: therapeutic inertia, herding, and errors in risk stratification knowledge translated into action (ERSKTA) based on commonly used stratification tools (Congestive heart failure, Hypertension, Age ≥75 years (double), Diabetes mellitus, previous Stroke/transient ischemic attack/thromboembolism (double), Vascular disease, Age 65-74 years, and female gender (score of 0 for males and 1 for female) (CHA 2 DS 2 -VASc) and Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, and previous Stroke/transient ischemic attack (double) (CHADS 2 )). Logistic regression analysis was conducted to determine factors associated with the outcomes. Overall, 149 physicians were invited to participate, of which 88 (59.1%) completed the online assessment tool. Cardiology was the most frequent specialty (69.3%). Therapeutic inertia was present in 53 participants (60.2%), herding in 66 (75.0%), and ERSKTA in 46 (52.3%). Therapeutic inertia was inversely associated with willingness to take financial risks (odds ratio [OR] .72, 95% confidence interval [CI] .59-.89 per point in the financial risk propensity score), herding was associated with aversion to ambiguity in the medical domain (OR 5.35, 95% CI 1.40-20.46), and ERSKTA was associated with the willingness to take risks (OR 1.70, 95% CI 1.15-2.50, per point in score). Among physicians involved in stroke prevention in AF, individual risk preferences and aversion to ambiguity lead to therapeutic inertia, herding, and errors in risk stratification and subsequent use of oral anticoagulants. Educational interventions, including formal training in risk management and decision-making are needed. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Medical Decision-Making for Adults Who Lack Decision-Making Capacity and a Surrogate: State of the Science.

PubMed

Kim, Hyejin; Song, Mi-Kyung

2018-01-01

Adults who lack decision-making capacity and a surrogate ("unbefriended" adults) are a vulnerable, voiceless population in health care. But little is known about this population, including how medical decisions are made for these individuals. This integrative review was to examine what is known about unbefriended adults and identify gaps in the literature. Six electronic databases were searched using 4 keywords: "unbefriended," "unrepresented patients," "adult orphans," and "incapacitated patients without surrogates." After screening, the final sample included 10 data-based articles for synthesis. Main findings include the following: (1) various terms were used to refer to adults who lack decision-making capacity and a surrogate; (2) the number of unbefriended adults was sizable and likely to grow; (3) approaches to medical decision-making for this population in health-care settings varied; and (4) professional guidelines and laws to address the issues related to this population were inconsistent. There have been no studies regarding the quality of medical decision-making and its outcomes for this population or societal impact. Extremely limited empirical data exist on unbefriended adults to develop strategies to improve how medical decisions are made for this population. There is an urgent need for research to examine the quality of medical decision-making and its outcomes for this vulnerable population.

Processing of social and monetary rewards in the human striatum.

PubMed

Izuma, Keise; Saito, Daisuke N; Sadato, Norihiro

2008-04-24

Despite an increasing focus on the neural basis of human decision making in neuroscience, relatively little attention has been paid to decision making in social settings. Moreover, although human social decision making has been explored in a social psychology context, few neural explanations for the observed findings have been considered. To bridge this gap and improve models of human social decision making, we investigated whether acquiring a good reputation, which is an important incentive in human social behaviors, activates the same reward circuitry as monetary rewards. In total, 19 subjects participated in functional magnetic resonance imaging (fMRI) experiments involving monetary and social rewards. The acquisition of one's good reputation robustly activated reward-related brain areas, notably the striatum, and these overlapped with the areas activated by monetary rewards. Our findings support the idea of a "common neural currency" for rewards and represent an important first step toward a neural explanation for complex human social behaviors.

Health services research: building capacity to meet the needs of the health care system

PubMed Central

Barratt, Helen; Shaw, Jay; Simpson, Lisa; Bhatia, Sacha; Fulop, Naomi

2017-01-01

Health services researchers have an important role to play in helping health care systems around the world provide high quality, affordable services. However, gaps between the best evidence and current practice suggest that researchers need to work in new ways. The production of research that meets the needs and priorities of the health system requires researchers to work in partnership with decision-makers to conduct research and then mobilize the findings. To do this effectively, researchers require a new set of skills that are not conventionally taught as part of doctoral research programmes. In addition to wider contextual changes, researchers need to understand better the needs of decision-makers, for example through short placements in health system decision-making settings. Second, researchers need to learn to accommodate those needs throughout the research process, including identifying research needs; conducting research collaboratively with decision-makers and producing effective research products. PMID:28786700

[Which research is needed to support clinical decision-making on integrative medicine? Can comparative effectiveness research close the gap?].

PubMed

Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Berman, Brian M

2013-08-01

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of best care options. This evidence, more generalizable than evidence generated by traditional randomized clinical trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on CER is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

Which research is needed to support clinical decision-making on integrative medicine?- Can comparative effectiveness research close the gap?

PubMed

Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Bm, Berman

2012-10-01

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

More than just the mean: moving to a dynamic view of performance-based compensation.

PubMed

Barnes, Christopher M; Reb, Jochen; Ang, Dionysius

2012-05-01

Compensation decisions have important consequences for employees and organizations and affect factors such as retention, motivation, and recruitment. Past research has primarily focused on mean performance as a predictor of compensation, promoting the implicit assumption that alternative aspects of dynamic performance are not relevant. To address this gap in the literature, we examined the influence of dynamic performance characteristics on compensation decisions in the National Basketball Association (NBA). We predicted that, in addition to performance mean, performance trend and variability would also affect compensation decisions. Results revealed that performance mean and trend, but not variability, were significantly and positively related to changes in compensation levels of NBA players. Moreover, trend (but not mean or variability) predicted compensation when controlling for future performance, suggesting that organizations overweighted trend in their compensation decisions. Theoretical and practical implications are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Evaluation of the National Gap Analysis Program (GAP): survey of users of GAP data: report to respondents

USGS Publications Warehouse

Ratz, Joan M.

2014-01-01

This report provides a summary of responses to the questions included in a survey of individuals who use or have used data created and provided by the U.S. Geological Survey National Gap Analysis Program (GAP). The survey was commissioned by the GAP main office and was conducted by U.S. Geological Survey personnel in the Policy Analysis and Science Assistance branch. The data collection process started on September 18, 2012, and ended on November 9, 2012. The dataset includes the responses from 359 individuals. The adjusted response rate for the survey was 35 percent. This report provides a summary of results for the survey questions in the order in which the questions were asked. The text of comments provided by respondents to open-ended questions is provided.

Better Building Alliance, Plug and Process Loads in Commercial Buildings: Capacity and Power Requirement Analysis (Brochure)

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

Not Available

2014-09-01

This brochure addresses gaps in actionable knowledge that can help reduce the plug load capacities designed into buildings. Prospective building occupants and real estate brokers lack accurate references for plug and process load (PPL) capacity requirements, so they often request 5-10 W/ft2 in their lease agreements. This brochure should be used to make these decisions so systems can operate more energy efficiently; upfront capital costs will also decrease. This information can also be used to drive changes in negotiations about PPL energy demands. It should enable brokers and tenants to agree about lower PPL capacities. Owner-occupied buildings will also benefit.more » Overestimating PPL capacity leads designers to oversize electrical infrastructure and cooling systems.« less

CEOS SEO and GISS Meeting

NASA Technical Reports Server (NTRS)

Killough, Brian; Stover, Shelley

2008-01-01

The Committee on Earth Observation Satellites (CEOS) provides a brief to the Goddard Institute for Space Studies (GISS) regarding the CEOS Systems Engineering Office (SEO) and current work on climate requirements and analysis. A "system framework" is provided for the Global Earth Observation System of Systems (GEOSS). SEO climate-related tasks are outlined including the assessment of essential climate variable (ECV) parameters, use of the "systems framework" to determine relevant informational products and science models and the performance of assessments and gap analyses of measurements and missions for each ECV. Climate requirements, including instruments and missions, measurements, knowledge and models, and decision makers, are also outlined. These requirements would establish traceability from instruments to products and services allowing for benefit evaluation of instruments and measurements. Additionally, traceable climate requirements would provide a better understanding of global climate models.

Effects of Information Visualization on Older Adults' Decision-Making Performance in a Medicare Plan Selection Task: A Comparative Usability Study.

PubMed

Price, Margaux M; Crumley-Branyon, Jessica J; Leidheiser, William R; Pak, Richard

2016-06-01

Technology gains have improved tools for evaluating complex tasks by providing environmental supports (ES) that increase ease of use and improve performance outcomes through the use of information visualizations (info-vis). Complex info-vis emphasize the need to understand individual differences in abilities of target users, the key cognitive abilities needed to execute a decision task, and the graphical elements that can serve as the most effective ES. Older adults may be one such target user group that would benefit from increased ES to mitigate specific declines in cognitive abilities. For example, choosing a prescription drug plan is a necessary and complex task that can impact quality of life if the wrong choice is made. The decision to enroll in one plan over another can involve comparing over 15 plans across many categories. Within this context, the large amount of complex information and reduced working memory capacity puts older adults' decision making at a disadvantage. An intentionally designed ES, such as an info-vis that reduces working memory demand, may assist older adults in making the most effective decision among many options. The objective of this study is to examine whether the use of an info-vis can lower working memory demands and positively affect complex decision-making performance of older adults in the context of choosing a Medicare prescription drug plan. Participants performed a computerized decision-making task in the context of finding the best health care plan. Data included quantitative decision-making performance indicators and surveys examining previous history with purchasing insurance. Participants used a colored info-vis ES or a table (no ES) to perform the decision task. Task difficulty was manipulated by increasing the number of selection criteria used to make an accurate decision. A repeated measures analysis was performed to examine differences between the two table designs. Twenty-three older adults between the ages of 66 and 80 completed the study. There was a main effect for accuracy such that older adults made more accurate decisions in the color info-vis condition than the table condition. In the low difficulty condition, participants were more successful at choosing the correct answer when the question was about the gap coverage attribute in the info-vis condition. Participants also made significantly faster decisions in the info-vis condition than in the table condition. Reducing the working memory demand of the task through the use of an ES can improve decision accuracy, especially when selection criteria is only focused on a single attribute of the insurance plan.