"Piensa" twice: on the foreign language effect in decision making.

PubMed

Costa, Albert; Foucart, Alice; Arnon, Inbal; Aparici, Melina; Apesteguia, Jose

2014-02-01

In this article, we assess to what extent decision making is affected by the language in which a given problem is presented (native vs. foreign). In particular, we aim to ask whether the impact of various heuristic biases in decision making is diminished when the problems are presented in a foreign language. To this end, we report four main studies in which more than 700 participants were tested on different types of individual decision making problems. In the first study, we replicated Keysar et al.'s (2012) recent observation regarding the foreign language effect on framing effects related to loss aversion. In the second section, we assessed whether the foreign language effect is present in other types of framing problems that involve psychological accounting biases rather than gain/loss dichotomies. In the third section, we studied the foreign language effect in several key aspects of the theory of decision making under risk and uncertainty. In the fourth study, we assessed the presence of a foreign language effect in the cognitive reflection test, a test that includes logical problems that do not carry emotional connotations. The absence of such an effect in this test suggests that foreign language leads to a reduction of heuristic biases in decision making across a range of decision making situations and provide also some evidence about the boundaries of the phenomenon. We explore several potential factors that may underlie the foreign language effect in decision making. Copyright © 2013 Elsevier B.V. All rights reserved.

A Guide to Trade-offs.

ERIC Educational Resources Information Center

Meszaros, Bonnie; Saunders, Phillip

The guide is designed to accompany fifteen 20-minute economic education film/television programs for ages nine to 13. The emphasis is on economic decision making and problem solving. A statement of key concepts, suggestions for introducing the program, a summary, questions to help students resolve the problem posed at the end of the program, and…

Socratic Problem-Solving in the Business World

ERIC Educational Resources Information Center

Peterson, Evan

2009-01-01

Accurate and effective decision-making is one of the most essential skills necessary for organizational success. The problem-solving process provides a systematic means of effectively recognizing, analyzing, and solving a dilemma. The key element in this process is critical analysis of the situation, which can be executed by a taking a Socratic…

Group assessment of key indicators of sustainable waste management in developing countries.

PubMed

Tot, Bojana; Vujić, Goran; Srđević, Zorica; Ubavin, Dejan; Russo, Mário Augusto Tavares

2017-09-01

Decision makers in developing countries are struggling to solve the present problems of solid waste management. Prioritisation and ranking of the most important indicators that influence the waste management system is very useful for any decision maker for the future planning and implementation of a sustainable waste management system. The aim of this study is to evaluate key indicators and their related sub-indicators in a group decision-making environment. In order to gain insight into the subject it was necessary to obtain the qualified opinions of decision makers from different countries who understand the situation in the sector of waste management in developing countries. An assessment is performed by 43 decision makers from both developed and developing countries, and the applied methodology is based on a combined use of the analytic hierarchy process, from the multi-criteria decision-making set of tools, and the preferential voting method known as Borda Count, which belongs to social choice theory. Pairwise comparison of indicators is performed with the analytic hierarchy process, and the ranking of indicators once obtained is assessed with Borda Count. Detailed analysis of the final results showed that the Institutional-Administrative indicator was the most important one, with the maximum weight as derived by both groups of decision makers. The results also showed that the combined use of the analytic hierarchy process and Borda Count contributes to the credibility and objectivity of the decision-making process, allowing its use in more complex waste management group decision-making problems to be recommended.

Constructing (un-)certainty: An exploration of journalistic decision-making in the reporting of neuroscience.

PubMed

Lehmkuhl, Markus; Peters, Hans Peter

2016-11-01

Based on 21 individual case studies, this article inventories the ways journalism deals with scientific uncertainty. The study identifies the decisions that impact a journalist's perception of a truth claim as unambiguous or ambiguous and the strategies to deal with uncertainty that arise from this perception. Key for understanding journalistic action is the outcome of three evaluations: What is the story about? How shall the story be told? What type of story is it? We reconstructed the strategies to overcome journalistic decision-making uncertainty in those cases in which they perceived scientific contingency as a problem. Journalism deals with uncertainty by way of omission, by contrasting the conflicting messages or by acknowledging the problem via the structure or language. One finding deserves particular mention: The lack of focus on scientific uncertainty is not only a problem of how journalists perceive and communicate but also a problem of how science communicates. © The Author(s) 2016.

A nonlinear bi-level programming approach for product portfolio management.

PubMed

Ma, Shuang

2016-01-01

Product portfolio management (PPM) is a critical decision-making for companies across various industries in today's competitive environment. Traditional studies on PPM problem have been motivated toward engineering feasibilities and marketing which relatively pay less attention to other competitors' actions and the competitive relations, especially in mathematical optimization domain. The key challenge lies in that how to construct a mathematical optimization model to describe this Stackelberg game-based leader-follower PPM problem and the competitive relations between them. The primary work of this paper is the representation of a decision framework and the optimization model to leverage the PPM problem of leader and follower. A nonlinear, integer bi-level programming model is developed based on the decision framework. Furthermore, a bi-level nested genetic algorithm is put forward to solve this nonlinear bi-level programming model for leader-follower PPM problem. A case study of notebook computer product portfolio optimization is reported. Results and analyses reveal that the leader-follower bi-level optimization model is robust and can empower product portfolio optimization.

Analysis of complex decisionmaking processes. [with application to jet engine development

NASA Technical Reports Server (NTRS)

Hill, J. D.; Ollila, R. G.

1978-01-01

The analysis of corporate decisionmaking processes related to major system developments is unusually difficult because of the number of decisionmakers involved in the process and the long development cycle. A method for analyzing such decision processes is developed and illustrated through its application to the analysis of the commercial jet engine development process. The method uses interaction matrices as the key tool for structuring the problem, recording data, and analyzing the data to establish the rank order of the major factors affecting development decisions. In the example, the use of interaction matrices permitted analysts to collect and analyze approximately 50 factors that influenced decisions during the four phases of the development cycle, and to determine the key influencers of decisions at each development phase. The results of this study indicate that the cost of new technology installed on an aircraft is the prime concern of the engine manufacturer.

Advanced decision aiding techniques applicable to space

NASA Technical Reports Server (NTRS)

Kruchten, Robert J.

1987-01-01

RADC has had an intensive program to show the feasibility of applying advanced technology to Air Force decision aiding situations. Some aspects of the program, such as Satellite Autonomy, are directly applicable to space systems. For example, RADC has shown the feasibility of decision aids that combine the advantages of laser disks and computer generated graphics; decision aids that interface object-oriented programs with expert systems; decision aids that solve path optimization problems; etc. Some of the key techniques that could be used in space applications are reviewed. Current applications are reviewed along with their advantages and disadvantages, and examples are given of possible space applications. The emphasis is to share RADC experience in decision aiding techniques.

Expectation Violation in Political Decision Making: A Psychological Case Study.

PubMed

Öllinger, Michael; Meissner, Karin; von Müller, Albrecht; Collado Seidel, Carlos

2017-01-01

Since the early Gestaltists there has been a strong interest in the question of how problem solvers get stuck in a mental impasse. A key idea is that the repeated activation of a successful strategy from the past results in a mental set ('Einstellung') which determines and constrains the option space to solve a problem. We propose that this phenomenon, which mostly was tested by fairly restricted experiments in the lab, could also be applied to more complex problem constellations and naturalistic decision making. We aim at scrutinizing and reconstructing how a mental set determines the misinterpretation of facts in the field of political decision making and leads in consequence to wrong expectations and an ill-defined problem representation. We will exemplify this psychological mechanism considering a historical example, namely the unexpected stabilization of the Franco regime at the end of World War II and its survival thereafter. A specific focus will be drawn to the significant observation that erroneous expectations were taken as the basis for decisions. This is congruent with the notion that in case of discrepancy between preconceived notions and new information, the former prevails over the new findings. Based on these findings, we suggest a theoretical model for expectation violation in political decision making and develop novel approaches for cognitive empirical research on the mechanisms of expectation violation and its maintenance in political decision making processes.

Expectation Violation in Political Decision Making: A Psychological Case Study

PubMed Central

Öllinger, Michael; Meissner, Karin; von Müller, Albrecht; Collado Seidel, Carlos

2017-01-01

Since the early Gestaltists there has been a strong interest in the question of how problem solvers get stuck in a mental impasse. A key idea is that the repeated activation of a successful strategy from the past results in a mental set (‘Einstellung’) which determines and constrains the option space to solve a problem. We propose that this phenomenon, which mostly was tested by fairly restricted experiments in the lab, could also be applied to more complex problem constellations and naturalistic decision making. We aim at scrutinizing and reconstructing how a mental set determines the misinterpretation of facts in the field of political decision making and leads in consequence to wrong expectations and an ill-defined problem representation. We will exemplify this psychological mechanism considering a historical example, namely the unexpected stabilization of the Franco regime at the end of World War II and its survival thereafter. A specific focus will be drawn to the significant observation that erroneous expectations were taken as the basis for decisions. This is congruent with the notion that in case of discrepancy between preconceived notions and new information, the former prevails over the new findings. Based on these findings, we suggest a theoretical model for expectation violation in political decision making and develop novel approaches for cognitive empirical research on the mechanisms of expectation violation and its maintenance in political decision making processes. PMID:29085316

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

NASA Technical Reports Server (NTRS)

Linden, Theodore A.

1993-01-01

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

Using Approximate Dynamic Programming to Solve the Military Inventory Routing Problem with Direct Delivery

DTIC Science & Technology

2015-03-26

benefit by no longer having to allocate resources to inventory management . When the inventory routing problem is solved , three key decisions are made at...industries rely on the transportation and manage – ment of goods. To aid in understanding the formulation and techniques for solving the military inventory...Using Approximate Dynamic Programming to Solve the Military Inventory Routing Problem with Direct Delivery THESIS MARCH 2015 Rebekah S. McKenna

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

Junior doctors' extended work hours and the effects on their performance: the Irish case.

PubMed

Flinn, Fiona; Armstrong, Claire

2011-04-01

To explore the relationship between junior doctors' long working hours and their performance in a variety of cognitive and clinical decision-making tests. Also, to consider the implications of performance decrements in such tests for healthcare quality. A within-subject design was used to eliminate variation related to individual differences. Each participant was tested twice, once post call and once rested. At each session, participants were tested on cognitive functioning and clinical decision-making. The study was based on six acute Irish hospitals during 2008. Thirty junior hospital doctors, ages ranged from 23 to 30 years; of them, 17 of the participants were female and 13 were male. Measures Cognitive functioning was measured by the MindStreams Global Assessment Battery (NeuroTrax Corp., NY, USA). This is a set of computerized tests, designed for use in medical settings, that assesses performance in memory, executive function, visual spatial perception, verbal function, attention, information processing speed and motor skills. Clinical decision-making was tested using Key Features Problems. Each Key Features Problem consists of a case scenario and then three to four questions about this scenario. In an effort to make it more realistic, the speed with which participants completed the three problems was also recorded. Participants' global cognitive scores, attention, information processing speed and motor skills were significantly worse post call than when rested. They also took longer to complete clinical decision-making questions in the post-call condition and obtained lower scores than when rested. There are significant negative changes in doctors' cognitive functioning and clinical decision-making performance that appear to be attributable to long working hours. This therefore raises the important question of whether working long hours decreases healthcare quality and compromises patient safety.

Approach of Decision Making Based on the Analytic Hierarchy Process for Urban Landscape Management

NASA Astrophysics Data System (ADS)

Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

2013-03-01

This paper proposes a two-stage group decision making approach to urban landscape management and planning supported by the analytic hierarchy process. The proposed approach combines an application of the consensus convergence model and the weighted geometric mean method. The application of the proposed approach is shown on a real urban landscape planning problem with a park-forest in Belgrade, Serbia. Decision makers were policy makers, i.e., representatives of several key national and municipal institutions, and experts coming from different scientific fields. As a result, the most suitable management plan from the set of plans is recognized. It includes both native vegetation renewal in degraded areas of park-forest and continued maintenance of its dominant tourism function. Decision makers included in this research consider the approach to be transparent and useful for addressing landscape management tasks. The central idea of this paper can be understood in a broader sense and easily applied to other decision making problems in various scientific fields.

Approach of decision making based on the analytic hierarchy process for urban landscape management.

PubMed

Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

2013-03-01

This paper proposes a two-stage group decision making approach to urban landscape management and planning supported by the analytic hierarchy process. The proposed approach combines an application of the consensus convergence model and the weighted geometric mean method. The application of the proposed approach is shown on a real urban landscape planning problem with a park-forest in Belgrade, Serbia. Decision makers were policy makers, i.e., representatives of several key national and municipal institutions, and experts coming from different scientific fields. As a result, the most suitable management plan from the set of plans is recognized. It includes both native vegetation renewal in degraded areas of park-forest and continued maintenance of its dominant tourism function. Decision makers included in this research consider the approach to be transparent and useful for addressing landscape management tasks. The central idea of this paper can be understood in a broader sense and easily applied to other decision making problems in various scientific fields.

The conception of the alternative and the decision to divorce.

PubMed

Kalb, M

1983-07-01

Despite soaring divorce rates and the effect of divorce on the individual, family, and society, professional scientific literature examining the factors governing the decision to divorce has been scant. The author suggests that the key variable affecting the decision to divorce can best be understood through an exploration of the individual's conception of the alternative. The factors that comprise the conception of the alternative are discussed and the problems inherent in its valid construction by the patient are examined. The therapeutic implementation of this conception is outlined.

State dependent optimization of measurement policy

NASA Astrophysics Data System (ADS)

Konkarikoski, K.

2010-07-01

Measurements are the key to rational decision making. Measurement information generates value, when it is applied in the decision making. An investment cost and maintenance costs are associated with each component of the measurement system. Clearly, there is - under a given set of scenarios - a measurement setup that is optimal in expected (discounted) utility. This paper deals how the measurement policy optimization is affected by different system states and how this problem can be tackled.

Regression-Based Approach For Feature Selection In Classification Issues. Application To Breast Cancer Detection And Recurrence

NASA Astrophysics Data System (ADS)

Belciug, Smaranda; Serbanescu, Mircea-Sebastian

2015-09-01

Feature selection is considered a key factor in classifications/decision problems. It is currently used in designing intelligent decision systems to choose the best features which allow the best performance. This paper proposes a regression-based approach to select the most important predictors to significantly increase the classification performance. Application to breast cancer detection and recurrence using publically available datasets proved the efficiency of this technique.

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.

Collaborative problem solving with a total quality model.

PubMed

Volden, C M; Monnig, R

1993-01-01

A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.

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.

Designing a systematic landscape monitoring approach for quantifying ecosystem services

EPA Science Inventory

A key problem encountered early on by governments striving to incorporate the ecosystem services concept into decision making is quantifying ecosystem services across large landscapes. Basically, they are faced with determining what to measure, how to measure it and how to aggre...

Assessing adaptation to the health risks of climate change: what guidance can existing frameworks provide?

PubMed

Füssel, Hans-Martin

2008-02-01

Climate change adaptation assessments aim at assisting policy-makers in reducing the health risks associated with climate change and variability. This paper identifies key characteristics of the climate-health relationship and of the adaptation decision problem that require consideration in climate change adaptation assessments. It then analyzes whether these characteristics are appropriately considered in existing guidelines for climate impact and adaptation assessment and in pertinent conceptual models from environmental epidemiology. The review finds three assessment guidelines based on a generalized risk management framework to be most useful for guiding adaptation assessments of human health. Since none of them adequately addresses all key challenges of the adaptation decision problem, actual adaptation assessments need to combine elements from different guidelines. Established conceptual models from environmental epidemiology are found to be of limited relevance for assessing and planning adaptation to climate change since the prevailing toxicological model of environmental health is not applicable to many climate-sensitive health risks.

Effects of additional team-based learning on students' clinical reasoning skills: a pilot study.

PubMed

Jost, Meike; Brüstle, Peter; Giesler, Marianne; Rijntjes, Michel; Brich, Jochen

2017-07-14

In the field of Neurology good clinical reasoning skills are essential for successful diagnosing and treatment. Team-based learning (TBL), an active learning and small group instructional strategy, is a promising method for fostering these skills. The aim of this pilot study was to examine the effects of a supplementary TBL-class on students' clinical decision-making skills. Fourth- and fifth-year medical students participated in this pilot study (static-group comparison design). The non-treatment group (n = 15) did not receive any additional training beyond regular teaching in the neurology course. The treatment group (n = 11) took part in a supplementary TBL-class optimized for teaching clinical reasoning in addition to the regular teaching in the neurology course. Clinical decision making skills were assessed using a key-feature problem examination. Factual and conceptual knowledge was assessed by a multiple-choice question examination. The TBL-group performed significantly better than the non-TBL-group (p = 0.026) in the key-feature problem examination. No significant differences between the results of the multiple-choice question examination of both groups were found. In this pilot study participants of a supplementary TBL-class significantly improved clinical decision-making skills, indicating that TBL may be an appropriate method for teaching clinical decision making in neurology. Further research is needed for replication in larger groups and other clinical fields.

A business man views commercial ventures in space.

NASA Technical Reports Server (NTRS)

Scarff, D. D.; Bloom, H. L.

1973-01-01

Paper reviews technical, resource planning and marketing steps an industrial organization must perform in arriving at a decision to undertake space development and production of commercial products or services for Users on the ground. Technical elements are supported by particular examples. Analysis of required resources emphasizes facility and financial inter-relationships between commercial organizations and NASA. Marketing planning covers elements of profitability. Paper addresses questions related to protection of corporate stockholders and public interest, investment decision timing, budget variations. Paper concludes with observations on timeliness of planning shuttle-based commercial ventures and on key industry/NASA problems and decisions.

Decisive Routing and Admission Control According to Quality of Service Constraints

DTIC Science & Technology

2009-03-01

Level &(Key Size) 1 1 RSA (1280); RSA (1536); Elg-E (1280) 1 2 Elg-E ( 768 ); Elg-E(1024); RSA (1024) 1 3 3DES, BlowFish, CAST5 2 1 Elg-E(1536); Elg-E(1792...upon the intractibility of the discrete logarithm problem [11] RSA A public key encryption scheme named after inventors R. Rivest, A. Shamir, and L...gpgTester would make system calls to the GNU Privacy Guard to choose from system and public key algorithms, ElGamal, RSA , AES, AES192, AES256, TwoFish

GAIA - A New Approach To Decision Making on Climate Disruption Issues

NASA Astrophysics Data System (ADS)

Paxton, L. J.; Weiss, M.; Schaefer, R. K.; Swartz, W. H.; Nix, M.; Strong, S. B.; Fountain, G. H.; Babin, S. M.; Pikas, C. K.; Parker, C. L.; Global Assimilation of InformationAction

2011-12-01

GAIA - the Global Assimilation of Information for Action program - provides a broadly extensible framework for enabling the development of a deeper understanding of the issues associated with climate disruption. The key notion of GAIA is that the global climate problem is so complex that a "system engineering" approach is needed in order to make it understandable. The key tenet of system engineering is to focus on requirements and to develop a cost-effective process for satisfying those requirements. To demonstrate this approach we focused first on the impact of climate disruption on public health. GAIA is described in some detail on our website (http://gaia.jhuapl.edu). Climate disruption is not just a scientific problem; one of the key issues that our community has is that of translating scientific results into knowledge that can be used to make informed decisions. In order to support decision makers we have to understand their issues and how to communicate with them. In this talk, we describe how we have built a community of interest that combines subject matter experts from diverse communities (public health, climate change, government, public policy, industry, etc) with policy makers and representatives from industry to develop, on a "level playing field", an understanding of each other's points of view and issues. The first application of this technology was the development of a workshop on Climate, Climate Change and Public Health held April 12-14, 2011. This paper describes our approach to going beyond the workshop environment to continue to engage the decision maker's community in a variety of ways that translate abstract scientific data into actionable information. Key ideas we will discuss include the development of social media, simulations of global/national/local environments affected by climate disruption, and visualizations of the monetary and health impacts of choosing not to address mitigation or adaptation to climate disruption.

Supplier Selection Using Weighted Utility Additive Method

NASA Astrophysics Data System (ADS)

Karande, Prasad; Chakraborty, Shankar

2015-10-01

Supplier selection is a multi-criteria decision-making (MCDM) problem which mainly involves evaluating a number of available suppliers according to a set of common criteria for choosing the best one to meet the organizational needs. For any manufacturing or service organization, selecting the right upstream suppliers is a key success factor that will significantly reduce purchasing cost, increase downstream customer satisfaction and improve competitive ability. The past researchers have attempted to solve the supplier selection problem employing different MCDM techniques which involve active participation of the decision makers in the decision-making process. This paper deals with the application of weighted utility additive (WUTA) method for solving supplier selection problems. The WUTA method, an extension of utility additive approach, is based on ordinal regression and consists of building a piece-wise linear additive decision model from a preference structure using linear programming (LP). It adopts preference disaggregation principle and addresses the decision-making activities through operational models which need implicit preferences in the form of a preorder of reference alternatives or a subset of these alternatives present in the process. The preferential preorder provided by the decision maker is used as a restriction of a LP problem, which has its own objective function, minimization of the sum of the errors associated with the ranking of each alternative. Based on a given reference ranking of alternatives, one or more additive utility functions are derived. Using these utility functions, the weighted utilities for individual criterion values are combined into an overall weighted utility for a given alternative. It is observed that WUTA method, having a sound mathematical background, can provide accurate ranking to the candidate suppliers and choose the best one to fulfill the organizational requirements. Two real time examples are illustrated to prove its applicability and appropriateness in solving supplier selection problems.

Optimizing Requirements Decisions with KEYS

NASA Technical Reports Server (NTRS)

Jalali, Omid; Menzies, Tim; Feather, Martin

2008-01-01

Recent work with NASA's Jet Propulsion Laboratory has allowed for external access to five of JPL's real-world requirements models, anonymized to conceal proprietary information, but retaining their computational nature. Experimentation with these models, reported herein, demonstrates a dramatic speedup in the computations performed on them. These models have a well defined goal: select mitigations that retire risks which, in turn, increases the number of attainable requirements. Such a non-linear optimization is a well-studied problem. However identification of not only (a) the optimal solution(s) but also (b) the key factors leading to them is less well studied. Our technique, called KEYS, shows a rapid way of simultaneously identifying the solutions and their key factors. KEYS improves on prior work by several orders of magnitude. Prior experiments with simulated annealing or treatment learning took tens of minutes to hours to terminate. KEYS runs much faster than that; e.g for one model, KEYS ran 13,000 times faster than treatment learning (40 minutes versus 0.18 seconds). Processing these JPL models is a non-linear optimization problem: the fewest mitigations must be selected while achieving the most requirements. Non-linear optimization is a well studied problem. With this paper, we challenge other members of the PROMISE community to improve on our results with other techniques.

The study of direct-to-consumer advertising for prescription drugs.

PubMed

Schommer, Jon C; Hansen, Richard A

2005-06-01

The objectives of this article are to (1) identify key methodological issues related to investigating the effects of direct-to-consumer advertising (DTCA) for prescription drugs, (2) highlight opportunities and challenges that these issues pose, and (3) provide suggestions to address these challenges and opportunities from a social and administrative pharmacy perspective. Through a review of existing literature and consultation with research colleagues, we identified 3 broad issues regarding the study of DTCA for prescription drugs: (1) the importance of problem formulation, (2) the role of health behavior and decision-making perspectives, and (3) data collection and data analysis challenges and opportunities. Based upon our findings, we developed recommendations for future research in this area. Clear problem formulation will be instructive for prioritizing research needs and for determining the role that health behavior and decision-making perspectives can serve in DTCA research. In addition, it appears that cluster bias, nonlinear relationships, mediating/moderating effects, time effects, acquiescent response, and case mix are particularly salient challenges for the DTCA research domain. We suggest that problem formulation, selection of sound theories upon which to base research, and data collection and data analysis challenges are key methodological issues related to investigating the effects of DTCA for prescription drugs.

Temperament Types of Social Studies Teachers.

ERIC Educational Resources Information Center

Dorow, Ernest B.

Temperament type is a key to understanding the classroom behavior of social studies teachers. Current criticisms of strategies employed, dependence on the textbook, fact oriented testing, and the dearth of problem solving in lesson planning are grounded in professional decisions based on temperament preferences. Employing four types of temperament…

The motivation, skills, and decision-making model of "drug abuse" prevention.

PubMed

Sussman, Steve; Earleywine, Mitchell; Wills, Thomas; Cody, Christine; Biglan, Tony; Dent, Clyde W; Newcomb, Michael D

2004-01-01

This article summarizes the theoretical basis for targeted prevention programs as they apply to different high-risk groups. We explain the advantages and disadvantages of different definitions of risk and discuss strategies for preventing drug use related problems in high-risk youth. Productive prevention programs for many at-risk groups share similar components, including those that address motivation, skills, and decision making. We present key aspects of these three components and link them to theories in clinical psychology, social psychology, sociology, and chemical dependence treatment. Among a total of 29 promising targeted prevention programs, we describe examples of empirically evaluated, intensive interventions that have made a positive impact on the attitudes and behavior of multiple problem youth. Incorporating the perspectives of multiple disciplines appears essential for progress in drug abuse and other problem behavior prevention.

A Decision Support System for Concrete Bridge Maintenance

NASA Astrophysics Data System (ADS)

Rashidi, Maria; Lemass, Brett; Gibson, Peter

2010-05-01

The maintenance of bridges as a key element in transportation infrastructure has become a major concern for asset managers and society due to increasing traffic volumes, deterioration of existing bridges and well-publicised bridge failures. A pivotal responsibility for asset managers in charge of bridge remediation is to identify the risks and assess the consequences of remediation programs to ensure that the decisions are transparent and lead to the lowest predicted losses in recognized constraint areas. The ranking of bridge remediation treatments can be quantitatively assessed using a weighted constraint approach to structure the otherwise ill-structured phases of problem definition, conceptualization and embodiment [1]. This Decision Support System helps asset managers in making the best decision with regards to financial limitations and other dominant constraints imposed upon the problem at hand. The risk management framework in this paper deals with the development of a quantitative intelligent decision support system for bridge maintenance which has the ability to provide a source for consistent decisions through selecting appropriate remediation treatments based upon cost, service life, product durability/sustainability, client preferences, legal and environmental constraints. Model verification and validation through industry case studies is ongoing.

Sensitivity-Informed De Novo Programming for Many-Objective Water Portfolio Planning Under Uncertainty

NASA Astrophysics Data System (ADS)

Kasprzyk, J. R.; Reed, P. M.; Kirsch, B. R.; Characklis, G. W.

2009-12-01

Risk-based water supply management presents severe cognitive, computational, and social challenges to planning in a changing world. Decision aiding frameworks must confront the cognitive biases implicit to risk, the severe uncertainties associated with long term planning horizons, and the consequent ambiguities that shape how we define and solve water resources planning and management problems. This paper proposes and demonstrates a new interactive framework for sensitivity informed de novo programming. The theoretical focus of our many-objective de novo programming is to promote learning and evolving problem formulations to enhance risk-based decision making. We have demonstrated our proposed de novo programming framework using a case study for a single city’s water supply in the Lower Rio Grande Valley (LRGV) in Texas. Key decisions in this case study include the purchase of permanent rights to reservoir inflows and anticipatory thresholds for acquiring transfers of water through optioning and spot leases. A 10-year Monte Carlo simulation driven by historical data is used to provide performance metrics for the supply portfolios. The three major components of our methodology include Sobol globoal sensitivity analysis, many-objective evolutionary optimization and interactive tradeoff visualization. The interplay between these components allows us to evaluate alternative design metrics, their decision variable controls and the consequent system vulnerabilities. Our LRGV case study measures water supply portfolios’ efficiency, reliability, and utilization of transfers in the water supply market. The sensitivity analysis is used interactively over interannual, annual, and monthly time scales to indicate how the problem controls change as a function of the timescale of interest. These results have been used then to improve our exploration and understanding of LRGV costs, vulnerabilities, and the water portfolios’ critical reliability constraints. These results demonstrate how we can adaptively improve the value and robustness of our problem formulations by evolving our definition of optimality to discover key tradeoffs.

Do Continuing Medical Education Articles Foster Shared Decision Making?

ERIC Educational Resources Information Center

Labrecque, Michel; Lafortune, Valerie; Lajeunesse, Judith; Lambert-Perrault, Anne-Marie; Manrique, Hermes; Blais, Johanne; Legare, France

2010-01-01

Introduction: Defined as reviews of clinical aspects of a specific health problem published in peer-reviewed and non-peer-reviewed medical journals, offered without charge, continuing medical education (CME) articles form a key strategy for translating knowledge into practice. This study assessed CME articles for mention of evidence-based…

Optimization and resilience in natural resources management

USGS Publications Warehouse

Williams, Byron K.; Johnson, Fred A.

2015-01-01

We consider the putative tradeoff between optimization and resilience in the management of natural resources, using a framework that incorporates different sources of uncertainty that are common in natural resources management. We address one-time decisions, and then expand the decision context to the more complex problem of iterative decision making. For both cases we focus on two key sources of uncertainty: partial observability of system state and uncertainty as to system dynamics. Optimal management strategies will vary considerably depending on the timeframe being considered and the amount and quality of information that is available to characterize system features and project the consequences of potential decisions. But in all cases an optimal decision making framework, if properly identified and focused, can be useful in recognizing sound decisions. We argue that under the conditions of deep uncertainty that characterize many resource systems, an optimal decision process that focuses on robustness does not automatically induce a loss of resilience.

Credit assignment in movement-dependent reinforcement learning

PubMed Central

Boggess, Matthew J.; Crossley, Matthew J.; Parvin, Darius; Ivry, Richard B.; Taylor, Jordan A.

2016-01-01

When a person fails to obtain an expected reward from an object in the environment, they face a credit assignment problem: Did the absence of reward reflect an extrinsic property of the environment or an intrinsic error in motor execution? To explore this problem, we modified a popular decision-making task used in studies of reinforcement learning, the two-armed bandit task. We compared a version in which choices were indicated by key presses, the standard response in such tasks, to a version in which the choices were indicated by reaching movements, which affords execution failures. In the key press condition, participants exhibited a strong risk aversion bias; strikingly, this bias reversed in the reaching condition. This result can be explained by a reinforcement model wherein movement errors influence decision-making, either by gating reward prediction errors or by modifying an implicit representation of motor competence. Two further experiments support the gating hypothesis. First, we used a condition in which we provided visual cues indicative of movement errors but informed the participants that trial outcomes were independent of their actual movements. The main result was replicated, indicating that the gating process is independent of participants’ explicit sense of control. Second, individuals with cerebellar degeneration failed to modulate their behavior between the key press and reach conditions, providing converging evidence of an implicit influence of movement error signals on reinforcement learning. These results provide a mechanistically tractable solution to the credit assignment problem. PMID:27247404

Credit assignment in movement-dependent reinforcement learning.

PubMed

McDougle, Samuel D; Boggess, Matthew J; Crossley, Matthew J; Parvin, Darius; Ivry, Richard B; Taylor, Jordan A

2016-06-14

When a person fails to obtain an expected reward from an object in the environment, they face a credit assignment problem: Did the absence of reward reflect an extrinsic property of the environment or an intrinsic error in motor execution? To explore this problem, we modified a popular decision-making task used in studies of reinforcement learning, the two-armed bandit task. We compared a version in which choices were indicated by key presses, the standard response in such tasks, to a version in which the choices were indicated by reaching movements, which affords execution failures. In the key press condition, participants exhibited a strong risk aversion bias; strikingly, this bias reversed in the reaching condition. This result can be explained by a reinforcement model wherein movement errors influence decision-making, either by gating reward prediction errors or by modifying an implicit representation of motor competence. Two further experiments support the gating hypothesis. First, we used a condition in which we provided visual cues indicative of movement errors but informed the participants that trial outcomes were independent of their actual movements. The main result was replicated, indicating that the gating process is independent of participants' explicit sense of control. Second, individuals with cerebellar degeneration failed to modulate their behavior between the key press and reach conditions, providing converging evidence of an implicit influence of movement error signals on reinforcement learning. These results provide a mechanistically tractable solution to the credit assignment problem.

Exposure levels for chemical threat compounds: information to facilitate chemical incident response.

PubMed

Hauschild, Veronique D; Watson, Annetta

2013-01-01

Although not widely known, a robust set of peer-reviewed public health and occupational exposure levels presently exist for key chemical warfare agents (CWAs) and certain acutely toxic industrial chemicals (TICs) identified as terrorist attack threats. Familiarity with these CWA and TIC exposure levels and their historic applications has facilitated emergency management decision-making by public and environmental health decision-makers. Specifically, multiple air, soil, and water exposure levels for CWAs and TICs summarized here have been extensively peer-reviewed and published; many have been recognized and are in use by federal and state health agencies as criteria for hazard zone prediction and assessment, occupational safety, and "how clean is clean enough" decisions. The key, however, is to know which criteria are most appropriate for specific decisions. While public safety is critical, high levels of concern often associated with perceived or actual proximity to extremely toxic chemical agents could result in overly cautious decisions that generate excessive delays, expenditure of scarce resources, and technological difficulties. Rapid selection of the most appropriate chemical exposure criteria is recommended to avoid such problems and expedite all phases of chemical incident response and recovery.

Using Concept Mapping to Define Problems and Identify Key Kernels during the Development of a Decision Support System

DTIC Science & Technology

1987-06-01

The problem chosen was an intriguing look at the question; ’When should a theater level commander request authorization for the use of tactical nuclear ...years experience in strategic nuclear missile systems, established ourselves as the best experts available. The literature search revealed the existence...CONTROL DSS Introduction This paper contains the storyboards of the DSS for the command and control of theater nuclear weapons. The storyboards are

Structuring decisions for managing threatened and endangered species in a changing climate.

PubMed

Gregory, Robin; Arvai, Joseph; Gerber, Leah R

2013-12-01

The management of endangered species under climate change is a challenging and often controversial task that incorporates input from a variety of different environmental, economic, social, and political interests. Yet many listing and recovery decisions for endangered species unfold on an ad hoc basis without reference to decision-aiding approaches that can improve the quality of management choices. Unlike many treatments of this issue, which consider endangered species management a science-based problem, we suggest that a clear decision-making process is equally necessary. In the face of new threats due to climate change, managers' choices about endangered species require closely linked analyses and deliberations that identify key objectives and develop measurable attributes, generate and compare management alternatives, estimate expected consequences and key sources of uncertainty, and clarify trade-offs across different dimensions of value. Several recent cases of endangered species conservation decisions illustrate our proposed decision-focused approach, including Gulf of Maine Atlantic salmon (Salmo salar) recovery framework development, Cultus Lake sockeye salmon (Oncorhynchus nerka) management, and Upper Columbia River white sturgeon (Acipenser transmontanus) recovery planning. Estructuración de Decisiones para Manejar Especies Amenazadas y en Peligro en un Clima Cambiante. © 2013 Society for Conservation Biology No claim to original US government works.

Independent assessment is key to financial well-being.

PubMed

Karling, J; Pyper, T

1999-02-01

Both traditional group practices and IPAs have felt the impact of changes brought about by managed care. Group practices need to ensure that their financial reporting and cost-accounting methods capture information that is key to decision making. An independent assessment of financial procedures helps identify any outstanding issues and maintain financial well-being. This assessment should be conducted at least quarterly so that potential problems can be resolved, income opportunities explored, and cost-saving measures adopted in a timely manner.

Deciding Where to Turn: A Qualitative Investigation of College Students' Helpseeking Decisions After Sexual Assault.

PubMed

DeLoveh, Heidi L M; Cattaneo, Lauren Bennett

2017-03-01

Sexual assault is a widespread problem on college campuses that has been the subject of substantial attention in recent years (Ali, 2011; Krebs, Lindquist, Berzofsky, Shook-Sa, & Peterson, 2016). Resources designed to address the problem exist, but there is evidence that they are underutilized by survivors (Campbell, 2008). The current study used grounded theory to explore how sexual assault survivors make decisions about helpseeking. In-depth interviews were conducted with 14 college sexual assault survivors to develop a theoretical model for their decision-making process. The resulting model, Deciding Where to Turn, suggests that survivors engage in three key decision points: determining if there is a problem related to the sexual assault (Do I Need Help), considering options (What Can I Do), and weighing the consequences of these options (What Will I Do). This process results in one of four behavioral choices: cope on one's own, seek support from friends/family, seek support from formal resources, or covert helpseeking, where needs are met without disclosure. Deciding Where to Turn contributes to the literature by providing a framework for understanding helpseeking decisions after sexual assault, highlighting the need to match reactions to survivor perceptions. The concept of covert helpseeking in particular adds to the way researchers and practitioners think about helpseeking. Research and practice implications are discussed. © Society for Community Research and Action 2017.

Campus and Community Coalitions in AOD Prevention. Prevention Updates

ERIC Educational Resources Information Center

Zimmerman, Robert

2004-01-01

Changing the environment that affects decisions about use of alcohol and other drugs has emerged as a key to reducing substance use problems among college and university students. The student environment, however, is not limited to the campus. Education, counseling, and campus-based prevention policies and activities cannot succeed if a campus is…

Boosting medical diagnostics by pooling independent judgments

PubMed Central

Kurvers, Ralf H. J. M.; Herzog, Stefan M.; Hertwig, Ralph; Krause, Jens; Carney, Patricia A.; Bogart, Andy; Argenziano, Giuseppe; Zalaudek, Iris; Wolf, Max

2016-01-01

Collective intelligence refers to the ability of groups to outperform individual decision makers when solving complex cognitive problems. Despite its potential to revolutionize decision making in a wide range of domains, including medical, economic, and political decision making, at present, little is known about the conditions underlying collective intelligence in real-world contexts. We here focus on two key areas of medical diagnostics, breast and skin cancer detection. Using a simulation study that draws on large real-world datasets, involving more than 140 doctors making more than 20,000 diagnoses, we investigate when combining the independent judgments of multiple doctors outperforms the best doctor in a group. We find that similarity in diagnostic accuracy is a key condition for collective intelligence: Aggregating the independent judgments of doctors outperforms the best doctor in a group whenever the diagnostic accuracy of doctors is relatively similar, but not when doctors’ diagnostic accuracy differs too much. This intriguingly simple result is highly robust and holds across different group sizes, performance levels of the best doctor, and collective intelligence rules. The enabling role of similarity, in turn, is explained by its systematic effects on the number of correct and incorrect decisions of the best doctor that are overruled by the collective. By identifying a key factor underlying collective intelligence in two important real-world contexts, our findings pave the way for innovative and more effective approaches to complex real-world decision making, and to the scientific analyses of those approaches. PMID:27432950

Decision PBL: A 4-year retrospective case study of the use of virtual patients in problem-based learning.

PubMed

Ellaway, Rachel H; Poulton, Terry; Jivram, Trupti

2015-01-01

In 2009, St George's University of London (SGUL) replaced their paper-based problem-based learning (PBL) cases with virtual patients for intermediate-level undergraduate students. This involved the development of Decision-Problem-Based Learning (D-PBL), a variation on progressive-release PBL that uses virtual patients instead of paper cases, and focuses on patient management decisions and their consequences. Using a case study method, this paper describes four years of developing and running D-PBL at SGUL from individual activities up to the ways in which D-PBL functioned as an educational system. A number of broad issues were identified: the importance of debates and decision-making in making D-PBL activities engaging and rewarding; the complexities of managing small group dynamics; the time taken to complete D-PBL activities; the changing role of the facilitator; and the erosion of the D-PBL process over time. A key point in understanding this work is the construction and execution of the D-PBL activity, as much of the value of this approach arises from the actions and interactions of students, their facilitators and the virtual patients rather than from the design of the virtual patients alone. At a systems level D-PBL needs to be periodically refreshed to retain its effectiveness.

NASA Risk-Informed Decision Making Handbook

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon; Stamatelatos, Michael; Maggio, Gaspare; Everett, Christopher; Youngblood, Robert; Rutledge, Peter; Benjamin, Allan; Williams, Rodney; Smith, Curtis; Guarro, Sergio

2010-01-01

This handbook provides guidance for conducting risk-informed decision making in the context of NASA risk management (RM), with a focus on the types of direction-setting key decisions that are characteristic of the NASA program and project life cycles, and which produce derived requirements in accordance with existing systems engineering practices that flow down through the NASA organizational hierarchy. The guidance in this handbook is not meant to be prescriptive. Instead, it is meant to be general enough, and contain a sufficient diversity of examples, to enable the reader to adapt the methods as needed to the particular decision problems that he or she faces. The handbook highlights major issues to consider when making decisions in the presence of potentially significant uncertainty, so that the user is better able to recognize and avoid pitfalls that might otherwise be experienced.

Concept mapping in a critical care orientation program: a pilot study to develop critical thinking and decision-making skills in novice nurses.

PubMed

Wahl, Stacy E; Thompson, Anita M

2013-10-01

Newly graduated registered nurses who were hired into a critical care intensive care unit showed a lack of critical thinking skills to inform their clinical decision-making abilities. This study evaluated the effectiveness of concept mapping as a teaching tool to improve critical thinking and clinical decision-making skills in novice nurses. A self-evaluation tool was administered before and after the learning intervention. The 25-item tool measured five key indicators of the development of critical thinking skills: problem recognition, clinical decision-making, prioritization, clinical implementation, and reflection. Statistically significant improvements were seen in 10 items encompassing all five indicators. Concept maps are an effective tool for educators to use in assisting novice nurses to develop their critical thinking and clinical decision-making skills. Copyright 2013, SLACK Incorporated.

Multiobjective optimization in a pseudometric objective space as applied to a general model of business activities

NASA Astrophysics Data System (ADS)

Khachaturov, R. V.

2016-09-01

It is shown that finding the equivalence set for solving multiobjective discrete optimization problems is advantageous over finding the set of Pareto optimal decisions. An example of a set of key parameters characterizing the economic efficiency of a commercial firm is proposed, and a mathematical model of its activities is constructed. In contrast to the classical problem of finding the maximum profit for any business, this study deals with a multiobjective optimization problem. A method for solving inverse multiobjective problems in a multidimensional pseudometric space is proposed for finding the best project of firm's activities. The solution of a particular problem of this type is presented.

Judicial and legislative viewpoints on physician misestimation of patient dysutilities: a problem for decision analysts.

PubMed

Mazur, D J

1990-01-01

Appellate courts, state legislatures, and ethicists have recently (post-1972) been interested-through the evolving court doctrine of informed consent-in patient-physician joint decision making. Yet these professional groups' approaches differ markedly from that of decision analysis, failing to include an explicit role for patients' rational processing of information in informed consent. In addition, these groups charge that decision analysts are misestimating patient dysutilities. This paper examines three issues: 1) in what sense(s), if any, is decision-analytic work in individualized medical decision making misestimating patient dysutilities, 2) if this misestimation is real, whether it is an example of the normative-descriptive tensions that exist in medical decision making, and 3) in what ways do the relationships between decision-analytic and judicial decision making change when informed consent is viewed in terms of contract law as opposed to tort law. This paper argues that a key link dividing these professional groups is the differing weights given to the "value of information" by decision-analytic vs. non-decision-analytic frameworks.

Healthcare provider attitudes towards the problem list in an electronic health record: a mixed-methods qualitative study

PubMed Central

2012-01-01

Background The problem list is a key part of the electronic health record (EHR) that allows practitioners to see a patient’s diagnoses and health issues. Yet, as the content of the problem list largely represents the subjective decisions of those who edit it, patients’ problem lists are often unreliable when shared across practitioners. The lack of standards for how the problem list is compiled in the EHR limits its effectiveness in improving patient care, particularly as a resource for clinical decision support and population management tools. The purpose of this study is to discover practitioner opinions towards the problem list and the logic behind their decisions during clinical situations. Materials and methods An observational cross-sectional study was conducted at two major Boston teaching hospitals. Practitioners’ opinions about the problem list were collected through both in-person interviews and an online questionnaire. Questions were framed using vignettes of clinical scenarios asking practitioners about their preferred actions towards the problem list. Results These data confirmed prior research that practitioners differ in their opinions over managing the problem list, but in most responses to a questionnaire, there was a common approach among the relative majority of respondents. Further, basic demographic characteristics of providers (age, medical experience, etc.) did not appear to strongly affect attitudes towards the problem list. Conclusion The results supported the premise that policies and EHR tools are needed to bring about a common approach. Further, the findings helped identify what issues might benefit the most from a defined policy and the level of restriction a problem list policy should place on the addition of different types of information. PMID:23140312

A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations.

PubMed

Dotson, G Scott; Hudson, Naomi L; Maier, Andrew

2015-01-01

Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management.

A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations

PubMed Central

Dotson, G. Scott; Hudson, Naomi L.; Maier, Andrew

2016-01-01

Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management. PMID:26312660

Value of DNA tests: a decision perspective.

PubMed

Taroni, Franco; Bozza, Silvia; Bernard, Magali; Champod, Christophe

2007-01-01

Before a Court of Law testifying in DNA-evidence cases, scientists are often challenged with the idea that the more markers (loci) the better, i.e., why does the scientist not use 16 or more markers? This paper introduces a new perspective, decision analysis, to deal with the problem of the number of markers to type in a criminal context. The decision-making process, which plays a key role in the routine work of a forensic scientist, consists of the rational choice, given personal objectives, between two or more possible outcomes when the consequences of the choice are uncertain. Simulated results support the hypothesis that analytical added value does not increase with the number of markers.

Editorial Commentary: Got Evidence? What We Really Need Is an Algorithm for Treating Symptomatic Bipartite Patella.

PubMed

Fithian, Donald C

2018-05-01

Bipartite patella is an uncommon but potentially troublesome problem for young athletes. Numerous uncontrolled retrospective studies have reported good results after various treatments. What is needed are studies that will guide workup and support treatment decisions based on the condition of the cartilage surfaces of the fragment, presence of pseudoarthrosis, and size and location of the fragment. To support decisions, we need prospective comparative studies, either randomized or, at least, prospective cohort studies that identify patients at the time of presentation, document key decision points, and follow patients to successful resolution of symptoms. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

Lazarova-Molnar, Sanja

2014-01-01

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

Direct migration motion estimation and mode decision to decoder for a low-complexity decoder Wyner-Ziv video coding

NASA Astrophysics Data System (ADS)

Lei, Ted Chih-Wei; Tseng, Fan-Shuo

2017-07-01

This paper addresses the problem of high-computational complexity decoding in traditional Wyner-Ziv video coding (WZVC). The key focus is the migration of two traditionally high-computationally complex encoder algorithms, namely motion estimation and mode decision. In order to reduce the computational burden in this process, the proposed architecture adopts the partial boundary matching algorithm and four flexible types of block mode decision at the decoder. This approach does away with the need for motion estimation and mode decision at the encoder. The experimental results show that the proposed padding block-based WZVC not only decreases decoder complexity to approximately one hundredth that of the state-of-the-art DISCOVER decoding but also outperforms DISCOVER codec by up to 3 to 4 dB.

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

NASA Astrophysics Data System (ADS)

Shimizu, Yoshiaki; Yamazaki, Yoshihiro; Wada, Takeshi

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

The Consultancy Protocol: Future School Leaders Engage in Collaborative Inquiry

ERIC Educational Resources Information Center

Kamler, Estelle

2016-01-01

Decision-making is key to being an effective administrator. The saying, "You are only as good as your last shot," sometimes applies to the way principals feel when a new plan that addresses a problem is met with opposition from disapproving faculty, staff, parents, or students. Experienced school principals learned early in their career…

MODELING MOLECULAR TARGETS FOR TOXICITY, A COMPUTATIONAL APPROACH TO UNDERSTANDING KEY STEPS IN THE MECHANISMS FOR TOXICITY AND A TOOL FOR PRIORITIZING BIOASSAY REQUIREMENTS

EPA Science Inventory

The Agency frequently encounters situations where it must make decisions about the potential health and environmental effects of chemicals when all of the relevant data is not available. One rational approach to this problem is to estimate the relevant missing information by ext...

Soup "du Jour" and so Much More: A Model for School Leader Preparation

ERIC Educational Resources Information Center

Sherman, Ross B.; Gill, Peggy B.; Sherman, Cynthia A.

2007-01-01

The future of educational leadership lies in the ability to teach the next generation of leaders how to use their conceptual and intellectual skills; in essence, how to think critically, solve problems appropriately, make decisions cogently and provide leadership to the enterprise. The key to preparing administrators is not "HOW" future leaders…

Predicting yields from Appalachian red oak logs and lumber

Treesearch

Daniel E. Dunmire

1971-01-01

One utilization problem is in pinpointing how to efficiently and effectively recover usable parts from logs, bolts, and lumber. Yields, which are output divided by input, provide a key to managers who make processing decisions. Research results are applied to indicate yields of graded lumber and dimension stock from graded Appalachian red oak (group) logs. How to...

[Impact of shared-decision making on patient satisfaction].

PubMed

Suh, Won S; Lee, Chae Kyung

2010-01-01

The purpose of this research is to analyze the impact of shared-decision making on patient satisfaction. The study is significant since it focuses on developing appropriate methodologies and analyzing data to identify patient preferences, with the goals of optimizing treatment selection, and substantiating the relationship between such preferences and their impact on outcomes. A thorough literature review that developed the framework illustrating key dimensions of shared decision making was followed by a quantitative assessment and regression analysis of patient-perceived satisfaction, and the degree of shared-decision making. A positive association was evident between shared-decision making and patient satisfaction. The impact of shared decision making on patient satisfaction was greater than other variable including gender, education, and number of visits. Patients who participate in care-related decisions and who are given an explanation of their health problems are more likely to be satisfied with their care. It would benefit health care organizations to train their medical professionals in this communication method, and to include it in their practice guidelines.

Producing More Actionable Science Isn't the Problem; It's Providing Decision-Makers with Access to Right Actionable Knowledge

NASA Astrophysics Data System (ADS)

Trexler, M.

2017-12-01

Policy-makers today have almost infinite climate-relevant scientific and other information available to them. The problem for climate change decision-making isn't missing science or inadequate knowledge of climate risks; the problem is that the "right" climate change actionable knowledge isn't getting to the right decision-maker, or is getting there too early or too late to effectively influence her decision-making. Actionable knowledge is not one-size-fit-all, and for a given decision-maker might involve scientific, economic, or risk-based information. Simply producing more and more information as we are today is not the solution, and actually makes it harder for individual decision-makers to access "their" actionable knowledge. The Climatographers began building the Climate Web five years ago to test the hypothesis that a knowledge management system could help navigate the gap between infinite information and individual actionable knowledge. Today the Climate Web's more than 1,500 index terms allow instant access to almost any climate change topic. It is a curated public-access knowledgebase of more than 1,000 books, 2,000 videos, 15,000 reports and articles, 25,000 news stories, and 3,000 websites. But it is also much more, linking together tens of thousands of individually extracted ideas and graphics, and providing Deep Dives into more than 100 key topics from changing probability distributions of extreme events to climate communications best practices to cognitive dissonance in climate change decision-making. The public-access Climate Web is uniquely able to support cross-silo learning, collaboration, and actionable knowledge dissemination. The presentation will use the Climate Web to demonstrate why knowledge management should be seen as a critical component of science and policy-making collaborations.

Use of Decision Models in the Development of Evidence-Based Clinical Preventive Services Recommendations: Methods of the U.S. Preventive Services Task Force.

PubMed

Owens, Douglas K; Whitlock, Evelyn P; Henderson, Jillian; Pignone, Michael P; Krist, Alex H; Bibbins-Domingo, Kirsten; Curry, Susan J; Davidson, Karina W; Ebell, Mark; Gillman, Matthew W; Grossman, David C; Kemper, Alex R; Kurth, Ann E; Maciosek, Michael; Siu, Albert L; LeFevre, Michael L

2016-10-04

The U.S. Preventive Services Task Force (USPSTF) develops evidence-based recommendations about preventive care based on comprehensive systematic reviews of the best available evidence. Decision models provide a complementary, quantitative approach to support the USPSTF as it deliberates about the evidence and develops recommendations for clinical and policy use. This article describes the rationale for using modeling, an approach to selecting topics for modeling, and how modeling may inform recommendations about clinical preventive services. Decision modeling is useful when clinical questions remain about how to target an empirically established clinical preventive service at the individual or program level or when complex determinations of magnitude of net benefit, overall or among important subpopulations, are required. Before deciding whether to use decision modeling, the USPSTF assesses whether the benefits and harms of the preventive service have been established empirically, assesses whether there are key issues about applicability or implementation that modeling could address, and then defines the decision problem and key questions to address through modeling. Decision analyses conducted for the USPSTF are expected to follow best practices for modeling. For chosen topics, the USPSTF assesses the strengths and limitations of the systematically reviewed evidence and the modeling analyses and integrates the results of each to make preventive service recommendations.

Identifying Key Features, Cutting Edge Cloud Resources, and Artificial Intelligence Tools to Achieve User-Friendly Water Science in the Cloud

NASA Astrophysics Data System (ADS)

Pierce, S. A.

2017-12-01

Decision making for groundwater systems is becoming increasingly important, as shifting water demands increasingly impact aquifers. As buffer systems, aquifers provide room for resilient responses and augment the actual timeframe for hydrological response. Yet the pace impacts, climate shifts, and degradation of water resources is accelerating. To meet these new drivers, groundwater science is transitioning toward the emerging field of Integrated Water Resources Management, or IWRM. IWRM incorporates a broad array of dimensions, methods, and tools to address problems that tend to be complex. Computational tools and accessible cyberinfrastructure (CI) are needed to cross the chasm between science and society. Fortunately cloud computing environments, such as the new Jetstream system, are evolving rapidly. While still targeting scientific user groups systems such as, Jetstream, offer configurable cyberinfrastructure to enable interactive computing and data analysis resources on demand. The web-based interfaces allow researchers to rapidly customize virtual machines, modify computing architecture and increase the usability and access for broader audiences to advanced compute environments. The result enables dexterous configurations and opening up opportunities for IWRM modelers to expand the reach of analyses, number of case studies, and quality of engagement with stakeholders and decision makers. The acute need to identify improved IWRM solutions paired with advanced computational resources refocuses the attention of IWRM researchers on applications, workflows, and intelligent systems that are capable of accelerating progress. IWRM must address key drivers of community concern, implement transdisciplinary methodologies, adapt and apply decision support tools in order to effectively support decisions about groundwater resource management. This presentation will provide an overview of advanced computing services in the cloud using integrated groundwater management case studies to highlight how Cloud CI streamlines the process for setting up an interactive decision support system. Moreover, advances in artificial intelligence offer new techniques for old problems from integrating data to adaptive sensing or from interactive dashboards to optimizing multi-attribute problems. The combination of scientific expertise, flexible cloud computing solutions, and intelligent systems opens new research horizons.

Theory of the decision/problem state

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

A theory of the decision-problem state was introduced and elaborated. Starting with the basic model of a decision-problem condition, an attempt was made to explain how a major decision-problem may consist of subsets of decision-problem conditions composing different condition sequences. In addition, the basic classical decision-tree model was modified to allow for the introduction of a series of characteristics that may be encountered in an analysis of a decision-problem state. The resulting hierarchical model reflects the unique attributes of the decision-problem state. The basic model of a decision-problem condition was used as a base to evolve a more complex model that is more representative of the decision-problem state and may be used to initiate research on decision-problem states.

A decision modeling for phasor measurement unit location selection in smart grid systems

NASA Astrophysics Data System (ADS)

Lee, Seung Yup

As a key technology for enhancing the smart grid system, Phasor Measurement Unit (PMU) provides synchronized phasor measurements of voltages and currents of wide-area electric power grid. With various benefits from its application, one of the critical issues in utilizing PMUs is the optimal site selection of units. The main aim of this research is to develop a decision support system, which can be used in resource allocation task for smart grid system analysis. As an effort to suggest a robust decision model and standardize the decision modeling process, a harmonized modeling framework, which considers operational circumstances of component, is proposed in connection with a deterministic approach utilizing integer programming. With the results obtained from the optimal PMU placement problem, the advantages and potential that the harmonized modeling process possesses are assessed and discussed.

Using Direct Observation to Assist in Eligibility Decisions and Intervention Planning: The Scales for Assessing Emotional Disturbance-2 Observation Form

ERIC Educational Resources Information Center

Nordness, Philip D.; Epstein, Michael H.; Cullinan, Douglas

2013-01-01

A key issue in using the federal definition of emotional disturbance (ED) is the challenge of measuring five characteristics of ED (Epstein, Nordness, Cullinan, & Hertzog, 2002). Stated briefly, these five characteristics include: (1) an inability to learn; (2) relationship problems; (3) inappropriate behavior; (4) unhappiness or depression;…

How to Suceed in Team Teaching--By Really Trying. Occasional Paper No. 13.

ERIC Educational Resources Information Center

Nolan, Robert R.; Roper, Susan Stavert

This paper provides guidelines in three areas for organizing and working in teaching teams: (1) getting started; (2) making the most of team meetings; and (3) minimizing team problems. Getting started requires a number of key decisions: (1) on what basis should team members be selected? (2) what should be the size of the team? (3) what areas…

Study on the key technology of grain logistics tracking system

NASA Astrophysics Data System (ADS)

Zhen, Tong; Ge, Hongyi; Jiang, Yuying; Che, Yi

2010-07-01

In recent year, with the rapid development of GIS technology, more and more programming problems depend on the GIS technology and professional model system. The solution of auxiliary programming problem by using GIS technology, which has become very popular. GIS is an important tool and technology, that captures, stores, analyzes, manages, and presents data that are linked to location. A grain logistics distribution system based on GIS is established, which provides a visualization scheme during the process of grain circulation and supports users making decision and analyzing for grain logistics enterprise.

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.

Participatory monitoring and evaluation approaches that influence decision-making: lessons from a maternal and newborn study in Eastern Uganda.

PubMed

Kananura, Rornald Muhumuza; Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Bumba, Ahmed; Mulekwa, Godfrey; Nakiganda-Busiku, Dinah; Oo, Htet Nay Lin; Kiwanuka, Suzanne Namusoke; George, Asha; Peters, David H

2017-12-28

The use of participatory monitoring and evaluation (M&E) approaches is important for guiding local decision-making, promoting the implementation of effective interventions and addressing emerging issues in the course of implementation. In this article, we explore how participatory M&E approaches helped to identify key design and implementation issues and how they influenced stakeholders' decision-making in eastern Uganda. The data for this paper is drawn from a retrospective reflection of various M&E approaches used in a maternal and newborn health project that was implemented in three districts in eastern Uganda. The methods included qualitative and quantitative M&E techniques such as  key informant interviews, formal surveys and supportive supervision, as well as participatory approaches, notably participatory impact pathway analysis. At the design stage, the M&E approaches were useful for identifying key local problems and feasible local solutions and informing the activities that were subsequently implemented. During the implementation phase, the M&E approaches provided evidence that informed decision-making and helped identify emerging issues, such as weak implementation by some village health teams, health facility constraints such as poor use of standard guidelines, lack of placenta disposal pits, inadequate fuel for the ambulance at some facilities, and poor care for low birth weight infants. Sharing this information with key stakeholders prompted them to take appropriate actions. For example, the sub-county leadership constructed placenta disposal pits, the district health officer provided fuel for ambulances, and health workers received refresher training and mentorship on how to care for newborns. Diverse sources of information and perspectives can help researchers and decision-makers understand and adapt evidence to contexts for more effective interventions. Supporting districts to have crosscutting, routine information generating and sharing platforms that bring together stakeholders from different sectors is therefore crucial for the successful implementation of complex development interventions.

Nanotechnology on a dime: building affordable research facilities

NASA Astrophysics Data System (ADS)

DiBattista, Jeff; Clare, Donna; Lynch, David

2005-08-01

Designing buildings to house nanotechnology research presents a multitude of well-recognized challenges to architectural and engineering design teams, from environmental control to spatial arrangements to operational functionality. These technical challenges can be solved with relative ease on projects with large budgets: designers have the option of selecting leading-edge systems without undue regard for their expense. This is reflected in the construction cost of many nanotechnology research facilities that run well into the hundreds of millions of dollars. Smaller universities and other institutions need not be shut out of the nanotechnology research field simply because their construction budgets are tens of millions of dollars or less. The key to success for these less expensive projects lies with making good strategic decisions: identifying priorities for the facility in terms of what it will is--and will not--provide to the researchers. Making these strategic decisions puts bounds on the tactical, technical problems that the design team at large must address, allowing them to focus their efforts on the key areas for success. The process and challenges of this strategic decision-making process are examined, with emphasis placed on the types of decisions that must be made and the factors that must be considered when making them. Case study examples of projects undertaken at the University of Alberta are used to illustrate how strategic-level decision-making sets the stage for cutting-edge success on a modest budget.

Implementing interactive decision support: A case for combining cyberinfrastructure, data fusion, and social process to mobilize scientific knowledge in sustainability problems

NASA Astrophysics Data System (ADS)

Pierce, S. A.

2014-12-01

Geosciences are becoming increasingly data intensive, particularly in relation to sustainability problems, which are multi-dimensional, weakly structured and characterized by high levels of uncertainty. In the case of complex resource management problems, the challenge is to extract meaningful information from data and make sense of it. Simultaneously, scientific knowledge alone is insufficient to change practice. Creating tools, and group decision support processes for end users to interact with data are key challenges to transforming science-based information into actionable knowledge. The ENCOMPASS project began as a multi-year case study in the Atacama Desert of Chile to design and implement a knowledge transfer model for energy-water-mining conflicts in the region. ENCOMPASS combines the use of cyberinfrastructure (CI), automated data collection, interactive interfaces for dynamic decision support, and participatory modelling to support social learning. A pilot version of the ENCOMPASS CI uses open source systems and serves as a structure to integrate and store multiple forms of data and knowledge, such as DEM, meteorological, water quality, geomicrobiological, energy demand, and groundwater models. In the case study, informatics and data fusion needs related to scientific uncertainty around deep groundwater flowpaths and energy-water connections. Users may upload data from field sites with handheld devices or desktops. Once uploaded, data assets are accessible for a variety of uses. To address multi-attributed decision problems in the Atacama region a standalone application with touch-enabled interfaces was created to improve real-time interactions with datasets by groups. The tool was used to merge datasets from the ENCOMPASS CI to support exploration among alternatives and build shared understanding among stakeholders. To date, the project has increased technical capacity among stakeholders, resulted in the creation of both for-profit and non-profit entities, enabled cross-sector collaboration with mining-indigenous stakeholders, and produced an interactive application for group decision support. ENCOMPASS leverages advances in computational tools to deliver data and models for group decision support applied to sustainability science problems.

Key stakeholders' perceptions of the acceptability and usefulness of a tablet-based tool to improve communication and shared decision making in ICUs.

PubMed

Ernecoff, Natalie C; Witteman, Holly O; Chon, Kristen; Chen, Yanquan Iris; Buddadhumaruk, Praewpannarai; Chiarchiaro, Jared; Shotsberger, Kaitlin J; Shields, Anne-Marie; Myers, Brad A; Hough, Catherine L; Carson, Shannon S; Lo, Bernard; Matthay, Michael A; Anderson, Wendy G; Peterson, Michael W; Steingrub, Jay S; Arnold, Robert M; White, Douglas B

2016-06-01

Although barriers to shared decision making in intensive care units are well documented, there are currently no easily scaled interventions to overcome these problems. We sought to assess stakeholders' perceptions of the acceptability, usefulness, and design suggestions for a tablet-based tool to support communication and shared decision making in ICUs. We conducted in-depth semi-structured interviews with 58 key stakeholders (30 surrogates and 28 ICU care providers). Interviews explored stakeholders' perceptions about the acceptability of a tablet-based tool to support communication and shared decision making, including the usefulness of modules focused on orienting families to the ICU, educating them about the surrogate's role, completing a question prompt list, eliciting patient values, educating about treatment options, eliciting perceptions about prognosis, and providing psychosocial support resources. The interviewer also elicited stakeholders' design suggestions for such a tool. We used constant comparative methods to identify key themes that arose during the interviews. Overall, 95% (55/58) of participants perceived the proposed tool to be acceptable, with 98% (57/58) of interviewees finding six or more of the seven content domains acceptable. Stakeholders identified several potential benefits of the tool including that it would help families prepare for the surrogate role and for family meetings as well as give surrogates time and a framework to think about the patient's values and treatment options. Key design suggestions included: conceptualize the tool as a supplement to rather than a substitute for surrogate-clinician communication; make the tool flexible with respect to how, where, and when surrogates can access the tool; incorporate interactive exercises; use video and narration to minimize the cognitive load of the intervention; and build an extremely simple user interface to maximize usefulness for individuals with low computer literacy. There is broad support among stakeholders for the use of a tablet-based tool to improve communication and shared decision making in ICUs. Eliciting the perspectives of key stakeholders early in the design process yielded important insights to create a tool tailored to the needs of surrogates and care providers in ICUs. Copyright © 2016 Elsevier Inc. All rights reserved.

An Air Force Guide to the System Specification.

DTIC Science & Technology

1981-01-01

basis for sound management plans and decisions to initiate system full-scale development. Related topics include: current problems and questions...such current documents as AFR 800-2 and AFR 57-1. Key elements of coverage include the following: a. Levels of system engineering studies are...equipment and computer program elements of a system are acquired most directly acainst lower-level (configuration item) specifications. b. Current

Command Process Modeling & Risk Analysis

NASA Technical Reports Server (NTRS)

Meshkat, Leila

2011-01-01

Commanding Errors may be caused by a variety of root causes. It's important to understand the relative significance of each of these causes for making institutional investment decisions. One of these causes is the lack of standardized processes and procedures for command and control. We mitigate this problem by building periodic tables and models corresponding to key functions within it. These models include simulation analysis and probabilistic risk assessment models.

Intelligent data management for real-time spacecraft monitoring

NASA Technical Reports Server (NTRS)

Schwuttke, Ursula M.; Gasser, Les; Abramson, Bruce

1992-01-01

Real-time AI systems have begun to address the challenge of restructuring problem solving to meet real-time constraints by making key trade-offs that pursue less than optimal strategies with minimal impact on system goals. Several approaches for adapting to dynamic changes in system operating conditions are known. However, simultaneously adapting system decision criteria in a principled way has been difficult. Towards this end, a general technique for dynamically making such trade-offs using a combination of decision theory and domain knowledge has been developed. Multi-attribute utility theory (MAUT), a decision theoretic approach for making one-time decisions is discussed and dynamic trade-off evaluation is described as a knowledge-based extension of MAUT that is suitable for highly dynamic real-time environments, and provides an example of dynamic trade-off evaluation applied to a specific data management trade-off in a real-world spacecraft monitoring application.

Decision analysis with approximate probabilities

NASA Technical Reports Server (NTRS)

Whalen, Thomas

1992-01-01

This paper concerns decisions under uncertainty in which the probabilities of the states of nature are only approximately known. Decision problems involving three states of nature are studied. This is due to the fact that some key issues do not arise in two-state problems, while probability spaces with more than three states of nature are essentially impossible to graph. The primary focus is on two levels of probabilistic information. In one level, the three probabilities are separately rounded to the nearest tenth. This can lead to sets of rounded probabilities which add up to 0.9, 1.0, or 1.1. In the other level, probabilities are rounded to the nearest tenth in such a way that the rounded probabilities are forced to sum to 1.0. For comparison, six additional levels of probabilistic information, previously analyzed, were also included in the present analysis. A simulation experiment compared four criteria for decisionmaking using linearly constrained probabilities (Maximin, Midpoint, Standard Laplace, and Extended Laplace) under the eight different levels of information about probability. The Extended Laplace criterion, which uses a second order maximum entropy principle, performed best overall.

Decision support for patient care: implementing cybernetics.

PubMed

Ozbolt, Judy; Ozdas, Asli; Waitman, Lemuel R; Smith, Janis B; Brennan, Grace V; Miller, Randolph A

2004-01-01

The application of principles and methods of cybernetics permits clinicians and managers to use feedback about care effectiveness and resource expenditure to improve quality and to control costs. Keys to the process are the specification of therapeutic goals and the creation of an organizational culture that supports the use of feedback to improve care. Daily feedback on the achievement of each patient's therapeutic goals provides tactical decision support, enabling clinicians to adjust care as needed. Monthly or quarterly feedback on aggregated goal achievement for all patients on a clinical pathway provides strategic decision support, enabling clinicians and managers to identify problems with supposed "best practices" and to test hypotheses about solutions. Work is underway at Vanderbilt University Medical Center to implement feedback loops in care and management processes and to evaluate the effects.

Optimizing in a complex world: A statistician's role in decision making

DOE PAGES

Anderson-Cook, Christine M.

2016-08-09

As applied statisticians increasingly participate as active members of problem-solving and decision-making teams, our role continues to evolve. Historically, we may have been seen as those who can help with data collection strategies or answer a specific question from a set of data. Nowadays, we are or strive to be more deeply involved throughout the entire problem-solving process. An emerging role is to provide a set of leading choices from which subject matter experts and managers can choose to make informed decisions. A key to success is to provide vehicles for understanding the trade-offs between candidates and interpreting the meritsmore » of each choice in the context of the decision-makers priorities. To achieve this objective, it is helpful to be able (a) to help subject matter experts identify quantitative criteria that match their priorities, (b) eliminate non-competitive choices through the use of a Pareto front, and (c) provide summary tools from which the trade-offs between alternatives can be quantitatively evaluated and discussed. A structured but flexible process for contributing to team decisions is described for situations when all choices can easily be enumerated as well as when a search algorithm to explore a vast number of potential candidates is required. In conclusion, a collection of diverse examples ranging from model selection, through multiple response optimization, and designing an experiment illustrate the approach.« less

Optimizing in a complex world: A statistician's role in decision making

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

Anderson-Cook, Christine M.

As applied statisticians increasingly participate as active members of problem-solving and decision-making teams, our role continues to evolve. Historically, we may have been seen as those who can help with data collection strategies or answer a specific question from a set of data. Nowadays, we are or strive to be more deeply involved throughout the entire problem-solving process. An emerging role is to provide a set of leading choices from which subject matter experts and managers can choose to make informed decisions. A key to success is to provide vehicles for understanding the trade-offs between candidates and interpreting the meritsmore » of each choice in the context of the decision-makers priorities. To achieve this objective, it is helpful to be able (a) to help subject matter experts identify quantitative criteria that match their priorities, (b) eliminate non-competitive choices through the use of a Pareto front, and (c) provide summary tools from which the trade-offs between alternatives can be quantitatively evaluated and discussed. A structured but flexible process for contributing to team decisions is described for situations when all choices can easily be enumerated as well as when a search algorithm to explore a vast number of potential candidates is required. In conclusion, a collection of diverse examples ranging from model selection, through multiple response optimization, and designing an experiment illustrate the approach.« less

Secure Distributed Detection under Energy Constraint in IoT-Oriented Sensor Networks.

PubMed

Zhang, Guomei; Sun, Hao

2016-12-16

We study the secure distributed detection problems under energy constraint for IoT-oriented sensor networks. The conventional channel-aware encryption (CAE) is an efficient physical-layer secure distributed detection scheme in light of its energy efficiency, good scalability and robustness over diverse eavesdropping scenarios. However, in the CAE scheme, it remains an open problem of how to optimize the key thresholds for the estimated channel gain, which are used to determine the sensor's reporting action. Moreover, the CAE scheme does not jointly consider the accuracy of local detection results in determining whether to stay dormant for a sensor. To solve these problems, we first analyze the error probability and derive the optimal thresholds in the CAE scheme under a specified energy constraint. These results build a convenient mathematic framework for our further innovative design. Under this framework, we propose a hybrid secure distributed detection scheme. Our proposal can satisfy the energy constraint by keeping some sensors inactive according to the local detection confidence level, which is characterized by likelihood ratio. In the meanwhile, the security is guaranteed through randomly flipping the local decisions forwarded to the fusion center based on the channel amplitude. We further optimize the key parameters of our hybrid scheme, including two local decision thresholds and one channel comparison threshold. Performance evaluation results demonstrate that our hybrid scheme outperforms the CAE under stringent energy constraints, especially in the high signal-to-noise ratio scenario, while the security is still assured.

Secure Distributed Detection under Energy Constraint in IoT-Oriented Sensor Networks

PubMed Central

Zhang, Guomei; Sun, Hao

2016-01-01

We study the secure distributed detection problems under energy constraint for IoT-oriented sensor networks. The conventional channel-aware encryption (CAE) is an efficient physical-layer secure distributed detection scheme in light of its energy efficiency, good scalability and robustness over diverse eavesdropping scenarios. However, in the CAE scheme, it remains an open problem of how to optimize the key thresholds for the estimated channel gain, which are used to determine the sensor’s reporting action. Moreover, the CAE scheme does not jointly consider the accuracy of local detection results in determining whether to stay dormant for a sensor. To solve these problems, we first analyze the error probability and derive the optimal thresholds in the CAE scheme under a specified energy constraint. These results build a convenient mathematic framework for our further innovative design. Under this framework, we propose a hybrid secure distributed detection scheme. Our proposal can satisfy the energy constraint by keeping some sensors inactive according to the local detection confidence level, which is characterized by likelihood ratio. In the meanwhile, the security is guaranteed through randomly flipping the local decisions forwarded to the fusion center based on the channel amplitude. We further optimize the key parameters of our hybrid scheme, including two local decision thresholds and one channel comparison threshold. Performance evaluation results demonstrate that our hybrid scheme outperforms the CAE under stringent energy constraints, especially in the high signal-to-noise ratio scenario, while the security is still assured. PMID:27999282

Multicriteria analysis of ontologically represented information

NASA Astrophysics Data System (ADS)

Wasielewska, K.; Ganzha, M.; Paprzycki, M.; Bǎdicǎ, C.; Ivanovic, M.; Lirkov, I.

2014-11-01

Our current work concerns the development of a decision support system for the software selection problem. The main idea is to utilize expert knowledge to help the user in selecting the best software / method / computational resource to solve a computational problem. Obviously, this involves multicriterial decision making and the key open question is: which method to choose. The context of the work is provided by the Agents in Grid (AiG) project, where the software selection (and thus multicriterial analysis) is to be realized when all information concerning the problem, the hardware and the software is ontologically represented. Initially, we have considered the Analytical Hierarchy Process (AHP), which is well suited for the hierarchical data structures (e.g., such that have been formulated in terms of ontologies). However, due to its well-known shortcomings, we have decided to extend our search for the multicriterial analysis method best suited for the problem in question. In this paper we report results of our search, which involved: (i) TOPSIS (Technique for Order Preference by Similarity to Ideal Solution), (ii) PROMETHEE, and (iii) GRIP (Generalized Regression with Intensities of Preference). We also briefly argue why other methods have not been considered as valuable candidates.

Creative Activities for Teaching about the 1940's & 50's. Problem Solving and Critical Thinking Activities.

ERIC Educational Resources Information Center

Stevens, Lawrence

This unit focuses on the decades of the 1940s and 1950s by studying key events from the eras. Students analyze issues and think critically about decisions made during the time. Topics of the unit include: (1) "Japanese Relocation"; (2) "Rationing: Who Should Get What?"; (3) "War in the Pacific"; (4) "The Draft: Who Should Fight a War?"; (5)…

Decision Trajectories in Dementia Care Networks: Decisions and Related Key Events.

PubMed

Groen-van de Ven, Leontine; Smits, Carolien; Oldewarris, Karen; Span, Marijke; Jukema, Jan; Eefsting, Jan; Vernooij-Dassen, Myrra

2017-10-01

This prospective multiperspective study provides insight into the decision trajectories of people with dementia by studying the decisions made and related key events. This study includes three waves of interviews, conducted between July 2010 and July 2012, with 113 purposefully selected respondents (people with beginning to advanced stages of dementia and their informal and professional caregivers) completed in 12 months (285 interviews). Our multilayered qualitative analysis consists of content analysis, timeline methods, and constant comparison. Four decision themes emerged-managing daily life, arranging support, community living, and preparing for the future. Eight key events delineate the decision trajectories of people with dementia. Decisions and key events differ between people with dementia living alone and living with a caregiver. Our study clarifies that decisions relate not only to the disease but to living with the dementia. Individual differences in decision content and sequence may effect shared decision-making and advance care planning.

Medical education and cognitive continuum theory: an alternative perspective on medical problem solving and clinical reasoning.

PubMed

Custers, Eugène J F M

2013-08-01

Recently, human reasoning, problem solving, and decision making have been viewed as products of two separate systems: "System 1," the unconscious, intuitive, or nonanalytic system, and "System 2," the conscious, analytic, or reflective system. This view has penetrated the medical education literature, yet the idea of two independent dichotomous cognitive systems is not entirely without problems.This article outlines the difficulties of this "two-system view" and presents an alternative, developed by K.R. Hammond and colleagues, called cognitive continuum theory (CCT). CCT is featured by three key assumptions. First, human reasoning, problem solving, and decision making can be arranged on a cognitive continuum, with pure intuition at one end, pure analysis at the other, and a large middle ground called "quasirationality." Second, the nature and requirements of the cognitive task, as perceived by the person performing the task, determine to a large extent whether a task will be approached more intuitively or more analytically. Third, for optimal task performance, this approach needs to match the cognitive properties and requirements of the task. Finally, the author makes a case that CCT is better able than a two-system view to describe medical problem solving and clinical reasoning and that it provides clear clues for how to organize training in clinical reasoning.

Conceptual, Methodological, and Ethical Problems in Communicating Uncertainty in Clinical Evidence

PubMed Central

Han, Paul K. J.

2014-01-01

The communication of uncertainty in clinical evidence is an important endeavor that poses difficult conceptual, methodological, and ethical problems. Conceptual problems include logical paradoxes in the meaning of probability and “ambiguity”— second-order uncertainty arising from the lack of reliability, credibility, or adequacy of probability information. Methodological problems include questions about optimal methods for representing fundamental uncertainties and for communicating these uncertainties in clinical practice. Ethical problems include questions about whether communicating uncertainty enhances or diminishes patient autonomy and produces net benefits or harms. This article reviews the limited but growing literature on these problems and efforts to address them and identifies key areas of focus for future research. It is argued that the critical need moving forward is for greater conceptual clarity and consistent representational methods that make the meaning of various uncertainties understandable, and for clinical interventions to support patients in coping with uncertainty in decision making. PMID:23132891

Developing a rapid-response program for health system decision-makers in Canada: findings from an issue brief and stakeholder dialogue.

PubMed

Wilson, Michael G; Lavis, John N; Gauvin, Francois-Pierre

2015-03-11

There is currently no mechanism in place outside of government to provide rapid syntheses of the best available research evidence about problems, options and/or implementation considerations related to a specific health system challenge that Canadian health system decision-makers need to address in a timely manner. A 'rapid-response' program could address this gap by providing access to optimally packaged, relevant and high-quality research evidence over short periods of time (i.e. days or weeks). We prepared an issue brief that describes the best available research evidence related to the problem, three broad features of a program that addresses the problem and implementation considerations. We identified systematic reviews by searching for organization-targeted implementation strategies in Health Systems Evidence ( www.healthsystemsevidence.org ) and drew on an existing analytical framework for how knowledge-brokering organizations can organize themselves to operationalize the program features. The issue brief was then used to inform a half-day stakeholder dialogue about whether and how to develop a rapid-response program for health system decision-makers in Canada. We thematically synthesized the deliberations. We found very few relevant systematic reviews but used frameworks and examples from existing programs to 1) outline key considerations for organizing a rapid-response program,, 2) determine what can be done in timelines ranging from 3 to 10 and 30 business days, and 3) define success and measure it. The 11 dialogue participants from across Canada largely agreed with the content presented in the brief, but noted two key challenges to consider: securing stable, long-term funding and finding a way to effectively and equitably manage the expected demand. Recommendations and suggestions for next steps from dialogue participants included taking an 'organic' approach to developing a pan-Canadian network and including jurisdictional scans as a type of product to deliver through the program (rather than only syntheses of research evidence). Dialogue participants clearly signalled that there is an appetite for a rapid-response program for health system decision-makers in Canada. To 'organically' build such a program, we are currently engaging in efforts to build partnerships and secure funding to support the creation of a pan-Canadian network for conducting rapid syntheses for health system decision-makers in Canada.

Considering social and environmental concerns as reservoir operating objectives

NASA Astrophysics Data System (ADS)

Tilmant, A.; Georis, B.; Doulliez, P.

2003-04-01

Sustainability principles are now widely recognized as key criteria for water resource development schemes, such as hydroelectric and multipurpose reservoirs. Development decisions no longer rely solely on economic grounds, but also consider environmental and social concerns through the so-called environmental and social impact assessments. The objective of this paper is to show that environmental and social concerns can also be addressed in the management (operation) of existing or projected reservoir schemes. By either adequately exploiting the results of environmental and social impact assessments, or by carrying out survey of water users, experts and managers, efficient (Pareto optimal) reservoir operating rules can be derived using flexible mathematical programming techniques. By reformulating the problem as a multistage flexible constraint satisfaction problem, incommensurable and subjective operating objectives can contribute, along with classical economic objectives, to the determination of optimal release decisions. Employed in a simulation mode, the results can be used to assess the long-term impacts of various operating rules on the social well-being of affected populations as well as on the integrity of the environment. The methodology is illustrated with a reservoir reallocation problem in Chile.

Cost-effectiveness analysis and formulary decision making in England: findings from research.

PubMed

Williams, Iestyn P; Bryan, Stirling

2007-11-01

In a context of rapid technological advances in health care and increasing demand for expensive treatments, local formulary committees are key players in the management of scarce resources. However, little is known about the information and processes used when making decisions on the inclusion of new treatments. This paper reports research on the use of economic evaluations in technology coverage decisions in England, although the findings have a relevance to other health care systems with devolved responsibility for resource allocation. It reports a study of four local formulary committees in which both qualitative and quantitative data were collected. Our main research finding is that it is an exception for cost-effectiveness analysis to inform technology coverage decisions. Barriers to use include access and expertise levels, concerns relating to the independence of analyses and problems with implementation of study recommendations. Further barriers derive from the constraints on decision makers, a lack of clarity over functions and aims of local committees, and the challenge of disinvestment in medical technologies. The relative weakness of the research-practice dynamics in this context suggests the need for a rethinking of the role of both analysts and decision makers. Our research supports the view that in order to be useful, analysis needs to better reflect the constraints of the local decision-making environment. We also recommend that local decision-making committees and bodies in the National Health Service more clearly identify the 'problems' which they are charged with solving and how their outputs contribute to broader finance and commissioning functions. This would help to establish the ways in which the routine use of cost-effectiveness analysis might become a reality.

An integrated modeling approach to support management decisions of coupled groundwater-agricultural systems under multiple uncertainties

NASA Astrophysics Data System (ADS)

Hagos Subagadis, Yohannes; Schütze, Niels; Grundmann, Jens

2015-04-01

The planning and implementation of effective water resources management strategies need an assessment of multiple (physical, environmental, and socio-economic) issues, and often requires new research in which knowledge of diverse disciplines are combined in a unified methodological and operational frameworks. Such integrative research to link different knowledge domains faces several practical challenges. Such complexities are further compounded by multiple actors frequently with conflicting interests and multiple uncertainties about the consequences of potential management decisions. A fuzzy-stochastic multiple criteria decision analysis tool was developed in this study to systematically quantify both probabilistic and fuzzy uncertainties associated with complex hydrosystems management. It integrated physical process-based models, fuzzy logic, expert involvement and stochastic simulation within a general framework. Subsequently, the proposed new approach is applied to a water-scarce coastal arid region water management problem in northern Oman, where saltwater intrusion into a coastal aquifer due to excessive groundwater extraction for irrigated agriculture has affected the aquifer sustainability, endangering associated socio-economic conditions as well as traditional social structure. Results from the developed method have provided key decision alternatives which can serve as a platform for negotiation and further exploration. In addition, this approach has enabled to systematically quantify both probabilistic and fuzzy uncertainties associated with the decision problem. Sensitivity analysis applied within the developed tool has shown that the decision makers' risk aversion and risk taking attitude may yield in different ranking of decision alternatives. The developed approach can be applied to address the complexities and uncertainties inherent in water resources systems to support management decisions, while serving as a platform for stakeholder participation.

Reforming Management of Behavior Symptoms and Psychiatric Conditions in Long-Term Care Facilities: A Different Perspective.

PubMed

Levenson, Steven A; Desai, Abhilash K

2017-04-01

Despite much attention including national initiatives, concerns remain about the approaches to managing behavior symptoms and psychiatric conditions across all settings, including in long-term care settings such as nursing homes and assisted living facilities. One key reason why problems persist is because most efforts to "reform" and "correct" the situation have failed to explore or address root causes and instead have promoted inadequate piecemeal "solutions." Further improvement requires jumping off the bandwagon and rethinking the entire issue, including recognizing and applying key concepts of clinical reasoning and the care delivery process to every situation. The huge negative impact of cognitive biases and rote approaches on related clinical problem solving and decision making and patient outcomes also must be addressed. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Buried Versus Exposed Kirschner Wires Following Fixation of Hand Fractures: l Clinician and Patient Surveys.

PubMed

2018-04-01

Fractures of the metacarpals and phalanges are common. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). A recent systematic review found no evidence to support either approach. The aim of study was to investigate current clinical practice, understand the key factors influencing clinician decision-making, and explore patient preferences to inform the design of a randomized clinical trial. The steering group developed surveys for hand surgeons, hand therapists, and patients. Following piloting, they were distributed across the United Kingdom hand surgery units using the Reconstructive Surgery Trials Network. A total of 423 hand surgeons, 187 hand therapists, and 187 patients completed the surveys. Plastic surgeons and junior surgical trainees preferred to leave K-wires not buried. Ease of removal correlated with a decision to leave wires exposed, whereas perceived risk of infection correlated with burying wires. Cost did not affect the decision. Hand therapists were primarily concerned about infection and patient-related outcomes. Patients were most concerned about wire-related problems and pain. This national survey provides a new understanding of the use of K-wires to manage hand fractures in the United Kingdom. A number of nonevidence-based factors seem to influence the decision to bury or leave K-wires exposed. The choice has important clinical and health economic implications that justify a randomized controlled trial.

True Numerical Cognition in the Wild.

PubMed

Piantadosi, Steven T; Cantlon, Jessica F

2017-04-01

Cognitive and neural research over the past few decades has produced sophisticated models of the representations and algorithms underlying numerical reasoning in humans and other animals. These models make precise predictions for how humans and other animals should behave when faced with quantitative decisions, yet primarily have been tested only in laboratory tasks. We used data from wild baboons' troop movements recently reported by Strandburg-Peshkin, Farine, Couzin, and Crofoot (2015) to compare a variety of models of quantitative decision making. We found that the decisions made by these naturally behaving wild animals rely specifically on numerical representations that have key homologies with the psychophysics of human number representations. These findings provide important new data on the types of problems human numerical cognition was designed to solve and constitute the first robust evidence of true numerical reasoning in wild animals.

Model-based system-of-systems engineering for space-based command, control, communication, and information architecture design

NASA Astrophysics Data System (ADS)

Sindiy, Oleg V.

This dissertation presents a model-based system-of-systems engineering (SoSE) approach as a design philosophy for architecting in system-of-systems (SoS) problems. SoS refers to a special class of systems in which numerous systems with operational and managerial independence interact to generate new capabilities that satisfy societal needs. Design decisions are more complicated in a SoS setting. A revised Process Model for SoSE is presented to support three phases in SoS architecting: defining the scope of the design problem, abstracting key descriptors and their interrelations in a conceptual model, and implementing computer-based simulations for architectural analyses. The Process Model enables improved decision support considering multiple SoS features and develops computational models capable of highlighting configurations of organizational, policy, financial, operational, and/or technical features. Further, processes for verification and validation of SoS models and simulations are also important due to potential impact on critical decision-making and, thus, are addressed. Two research questions frame the research efforts described in this dissertation. The first concerns how the four key sources of SoS complexity---heterogeneity of systems, connectivity structure, multi-layer interactions, and the evolutionary nature---influence the formulation of SoS models and simulations, trade space, and solution performance and structure evaluation metrics. The second question pertains to the implementation of SoSE architecting processes to inform decision-making for a subset of SoS problems concerning the design of information exchange services in space-based operations domain. These questions motivate and guide the dissertation's contributions. A formal methodology for drawing relationships within a multi-dimensional trade space, forming simulation case studies from applications of candidate architecture solutions to a campaign of notional mission use cases, and executing multi-purpose analysis studies is presented. These efforts are coupled to the generation of aggregate and time-dependent solution performance metrics via the hierarchical decomposition of objectives and the analytical recomposition of multi-attribute qualitative program drivers from quantifiable measures. This methodology was also applied to generate problem-specific solution structure evaluation metrics that facilitate the comparison of alternate solutions at a high level of aggregation, at lower levels of abstraction, and to relate options for design variables with associated performance values. For proof-of-capability demonstration, the selected application problem concerns the design of command, control, communication, and information (C3I) architecture services for a notional campaign of crewed and robotic lunar surface missions. The impetus for the work was the demonstration of using model-based SoSE for design of sustainable interoperability capabilities between all data and communication assets in extended lunar campaigns. A comprehensive Lunar C3I simulation tool was developed by a team of researchers at Purdue University in support of NASA's Constellation Program; the author of this dissertation was a key contributor to the creation of this tool and made modifications and extensions to key components relevant to the methodological concepts presented in this dissertation. The dissertation concludes with a presentation of example results based on the interrogation of the constructed Lunar C3I computational model. The results are based on a family of studies, structured around a trade-tree of architecture options, which were conducted to test the hypothesis that the SoSE approach is efficacious in the information-exchange architecture design in space exploration domain. Included in the family of proof-of-capability studies is a simulation of the Apollo 17 mission, which allows not only for partial verification and validation of the model, but also provides insights for prioritizing future model design iterations to make it more realistic representation of the "real world." A caveat within the results presented is that they serve within the capacity of a proof-of-capability demonstration, and as such, they are a product of models and analyses that need further development before the tool's results can be employed for decision-making. Additional discussion is provided for how to further develop and validate the Lunar C3I tool and also to make it extensible to other SoS design problems of similar nature in space exploration and other problem application domains.

Evidence-informed decision making for nutrition: African experiences and way forward.

PubMed

Aryeetey, Richmond; Holdsworth, Michelle; Taljaard, Christine; Hounkpatin, Waliou Amoussa; Colecraft, Esi; Lachat, Carl; Nago, Eunice; Hailu, Tesfaye; Kolsteren, Patrick; Verstraeten, Roos

2017-11-01

Although substantial amount of nutrition research is conducted in Africa, the research agenda is mainly donor-driven. There is a clear need for a revised research agenda in Africa which is both driven by and responding to local priorities. The present paper summarises proceedings of a symposium on how evidence can guide decision makers towards context-appropriate priorities and decisions in nutrition. The paper focuses on lessons learnt from case studies by the Evidence Informed Decision Making in Nutrition and Health Network implemented between 2015 and 2016 in Benin, Ghana and South Africa. Activities within these countries were organised around problem-oriented evidence-informed decision-making (EIDM), capacity strengthening and leadership and horizontal collaboration. Using a combination of desk-reviews, stakeholder influence-mapping, semi-structured interviews and convening platforms, these country-level studies demonstrated strong interest for partnership between researchers and decision makers, and use of research evidence for prioritisation and decision making in nutrition. Identified capacity gaps were addressed through training workshops on EIDM, systematic reviews, cost-benefit evaluations and evidence contextualisation. Investing in knowledge partnerships and development of capacity and leadership are key to drive appropriate use of evidence in nutrition policy and programming in Africa.

An international comparison of legal frameworks for supported and substitute decision-making in mental health services.

PubMed

Davidson, Gavin; Brophy, Lisa; Campbell, Jim; Farrell, Susan J; Gooding, Piers; O'Brien, Ann-Marie

2016-01-01

There have been important recent developments in law, research, policy and practice relating to supporting people with decision-making impairments, in particular when a person's wishes and preferences are unclear or inaccessible. A driver in this respect is the United Nations Convention on the Rights of Persons with Disabilities (CRPD); the implications of the CRPD for policy and professional practices are currently debated. This article reviews and compares four legal frameworks for supported and substitute decision-making for people whose decision-making ability is impaired. In particular, it explores how these frameworks may apply to people with mental health problems. The four jurisdictions are: Ontario, Canada; Victoria, Australia; England and Wales, United Kingdom (UK); and Northern Ireland, UK. Comparisons and contrasts are made in the key areas of: the legal framework for supported and substitute decision-making; the criteria for intervention; the assessment process; the safeguards; and issues in practice. Thus Ontario has developed a relatively comprehensive, progressive and influential legal framework over the past 30 years but there remain concerns about the standardisation of decision-making ability assessments and how the laws work together. In Australia, the Victorian Law Reform Commission (2012) has recommended that the six different types of substitute decision-making under the three laws in that jurisdiction, need to be simplified, and integrated into a spectrum that includes supported decision-making. In England and Wales the Mental Capacity Act 2005 has a complex interface with mental health law. In Northern Ireland it is proposed to introduce a new Mental Capacity (Health, Welfare and Finance) Bill that will provide a unified structure for all substitute decision-making. The discussion will consider the key strengths and limitations of the approaches in each jurisdiction and identify possible ways that further progress can be made in law, policy and practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

Integrating public commentary and participation into environmental decision-making: The implications of Ontario`s Environmental Bill of Rights, 1993

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

McRobert, D.

1995-12-31

In February 1994, the Environmental Bill of Rights, 1993 (EBR) was proclaimed into law by the Ontario government. The EBR is intended to promote a new era in environmental decision-making one characterized by enhanced public participation, citizen empowerment and greater accountability of decision makers. A key challenge in the implementation of the EBR is the change it will force in government decision-making. Historically, Ontario environmental regulation focused on the development of appropriate pollution control instruments, techniques and standards to control harmful environmental activity. Often the knowledge of outsiders, (i.e. the public), was considered inadequate or irrelevant to the regulatory process.more » In contrast, the EBR recognizes the relevance and validity of public knowledge, and is intended to encourage decision-makers to mesh public and scientific knowledge through a new regulatory approval system based on notice of new developments, approvals and laws on a province-wide electronic bulletin board service. The positive potential of the EBR is in its ability to promote social understanding of the issues and risks in environmental management. The EBR mandates open dialogue and proactive interaction between government, industry, environmental groups, citizen groups, and employees to explore new mechanisms in environmental decision making. In addition, the EBR seeks to enlist the cooperation of all sectors of society in addressing the complex issues posed by the environment so that not only problem solving but problem identification and prevention activities are conducted in the context of greater shared responsibility and accountability.« less

Addressing overuse in emergency medicine: evidence of a role for greater patient engagement.

PubMed

Newton, Erika H

2017-12-01

Overuse of health care refers to tests, treatments, and even health care settings when used in circumstances where they are unlikely to help. Overuse is not only wasteful, it threatens patient safety by exposing patients to a greater chance of harm than benefit. It is a widespread problem and has proved resistant to change. Overuse of diagnostic testing is a particular problem in emergency medicine. Emergency physicians cite fear of missing a diagnosis, fear of law suits, and perceived patient expectations as key contributors. However, physicians' assumptions about what patients expect are often wrong, and overlook two of patients' most consistently voiced priorities: communication and empathy. Evidence indicates that patients who are more fully informed and engaged in their care often opt for less aggressive approaches. Shared decision making refers to (1) providing balanced information so that patients understand their options and the trade-offs involved, (2) encouraging them to voice their preferences and values, and (3) engaging them-to the extent appropriate or desired-in decision making. By adopting this approach to discretionary decision making, physicians are better positioned to address patients' concerns without the use of tests and treatments patients neither need nor value.

How to survive the medical misinformation mess.

PubMed

Ioannidis, John P A; Stuart, Michael E; Brownlee, Shannon; Strite, Sheri A

2017-11-01

Most physicians and other healthcare professionals are unaware of the pervasiveness of poor quality clinical evidence that contributes considerably to overuse, underuse, avoidable adverse events, missed opportunities for right care and wasted healthcare resources. The Medical Misinformation Mess comprises four key problems. First, much published medical research is not reliable or is of uncertain reliability, offers no benefit to patients, or is not useful to decision makers. Second, most healthcare professionals are not aware of this problem. Third, they also lack the skills necessary to evaluate the reliability and usefulness of medical evidence. Finally, patients and families frequently lack relevant, accurate medical evidence and skilled guidance at the time of medical decision-making. Increasing the reliability of available, published evidence may not be an imminently reachable goal. Therefore, efforts should focus on making healthcare professionals, more sensitive to the limitations of the evidence, training them to do critical appraisal, and enhancing their communication skills so that they can effectively summarize and discuss medical evidence with patients to improve decision-making. Similar efforts may need to target also patients, journalists, policy makers, the lay public and other healthcare stakeholders. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

Addressing overuse in emergency medicine: evidence of a role for greater patient engagement

PubMed Central

Newton, Erika H.

2017-01-01

Overuse of health care refers to tests, treatments, and even health care settings when used in circumstances where they are unlikely to help. Overuse is not only wasteful, it threatens patient safety by exposing patients to a greater chance of harm than benefit. It is a widespread problem and has proved resistant to change. Overuse of diagnostic testing is a particular problem in emergency medicine. Emergency physicians cite fear of missing a diagnosis, fear of law suits, and perceived patient expectations as key contributors. However, physicians’ assumptions about what patients expect are often wrong, and overlook two of patients’ most consistently voiced priorities: communication and empathy. Evidence indicates that patients who are more fully informed and engaged in their care often opt for less aggressive approaches. Shared decision making refers to (1) providing balanced information so that patients understand their options and the trade-offs involved, (2) encouraging them to voice their preferences and values, and (3) engaging them—to the extent appropriate or desired—in decision making. By adopting this approach to discretionary decision making, physicians are better positioned to address patients’ concerns without the use of tests and treatments patients neither need nor value. PMID:29306268

Assessing future scenarios for health care waste management using a multi-criteria decision analysis tool: A case study in the Turkish West Black Sea Region.

PubMed

Ciplak, Nesli

2015-08-01

The aim of this paper is to identify the best possible health care waste management option in the West Black Sea Region by taking into account economic, social, environmental, and technical aspects in the concept of multi-criteria decision analysis. In the scope of this research, three different health care waste management scenarios that consist of different technology alternatives were developed and compared using a decision-making computer software, called Right Choice, by identifying various criteria, measuring them, and ranking their relative importance from the point of key stakeholders. The results of the study show that the decentralized autoclave technology option coupled with the disposal through land-filling with energy recovery has potential to be an optimum option for health care waste management system, and an efficient health care waste segregation scheme should be given more attention by the authorities in the region. Furthermore, the discussion of the results points out multidisciplinary approach and the equilibrium between social, environmental, economic, and technical criteria. The methodology used in this research was developed in order to enable the decision makers to gain an increased perception of a decision problem. In general, the results and remarks of this study can be used as a basis of future planning and anticipation of needs for investment in the area of health care waste management in the region and also in developing countries that are dealing with the similar waste management problems.

A meta-analytic review of two modes of learning and the description-experience gap.

PubMed

Wulff, Dirk U; Mergenthaler-Canseco, Max; Hertwig, Ralph

2018-02-01

People can learn about the probabilistic consequences of their actions in two ways: One is by consulting descriptions of an action's consequences and probabilities (e.g., reading up on a medication's side effects). The other is by personally experiencing the probabilistic consequences of an action (e.g., beta testing software). In principle, people taking each route can reach analogous states of knowledge and consequently make analogous decisions. In the last dozen years, however, research has demonstrated systematic discrepancies between description- and experienced-based choices. This description-experience gap has been attributed to factors including reliance on a small set of experience, the impact of recency, and different weighting of probability information in the two decision types. In this meta-analysis focusing on studies using the sampling paradigm of decisions from experience, we evaluated these and other determinants of the decision-experience gap by reference to more than 70,000 choices made by more than 6,000 participants. We found, first, a robust description-experience gap but also a key moderator, namely, problem structure. Second, the largest determinant of the gap was reliance on small samples and the associated sampling error: free to terminate search, individuals explored too little to experience all possible outcomes. Third, the gap persisted when sampling error was basically eliminated, suggesting other determinants. Fourth, the occurrence of recency was contingent on decision makers' autonomy to terminate search, consistent with the notion of optional stopping. Finally, we found indications of different probability weighting in decisions from experience versus decisions from description when the problem structure involved a risky and a safe option. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Perceiving emotion: towards a realistic understanding of the task.

PubMed

Cowie, Roddy

2009-12-12

A decade ago, perceiving emotion was generally equated with taking a sample (a still photograph or a few seconds of speech) that unquestionably signified an archetypal emotional state, and attaching the appropriate label. Computational research has shifted that paradigm in multiple ways. Concern with realism is key. Emotion generally colours ongoing action and interaction: describing that colouring is a different problem from categorizing brief episodes of relatively pure emotion. Multiple challenges flow from that. Describing emotional colouring is a challenge in itself. One approach is to use everyday categories describing states that are partly emotional and partly cognitive. Another approach is to use dimensions. Both approaches need ways to deal with gradual changes over time and mixed emotions. Attaching target descriptions to a sample poses problems of both procedure and validation. Cues are likely to be distributed both in time and across modalities, and key decisions may depend heavily on context. The usefulness of acted data is limited because it tends not to reproduce these features. By engaging with these challenging issues, research is not only achieving impressive results, but also offering a much deeper understanding of the problem.

A shared computer-based problem-oriented patient record for the primary care team.

PubMed

Linnarsson, R; Nordgren, K

1995-01-01

1. INTRODUCTION. A computer-based patient record (CPR) system, Swedestar, has been developed for use in primary health care. The principal aim of the system is to support continuous quality improvement through improved information handling, improved decision-making, and improved procedures for quality assurance. The Swedestar system has evolved during a ten-year period beginning in 1984. 2. SYSTEM DESIGN. The design philosophy is based on the following key factors: a shared, problem-oriented patient record; structured data entry based on an extensive controlled vocabulary; advanced search and query functions, where the query language has the most important role; integrated decision support for drug prescribing and care protocols and guidelines; integrated procedures for quality assurance. 3. A SHARED PROBLEM-ORIENTED PATIENT RECORD. The core of the CPR system is the problem-oriented patient record. All problems of one patient, recorded by different members of the care team, are displayed on the problem list. Starting from this list, a problem follow-up can be made, one problem at a time or for several problems simultaneously. Thus, it is possible to get an integrated view, across provider categories, of those problems of one patient that belong together. This shared problem-oriented patient record provides an important basis for the primary care team work. 4. INTEGRATED DECISION SUPPORT. The decision support of the system includes a drug prescribing module and a care protocol module. The drug prescribing module is integrated with the patient records and includes an on-line check of the patient's medication list for potential interactions and data-driven reminders concerning major drug problems. Care protocols have been developed for the most common chronic diseases, such as asthma, diabetes, and hypertension. The patient records can be automatically checked according to the care protocols. 5. PRACTICAL EXPERIENCE. The Swedestar system has been implemented in a primary care area with 30,000 inhabitants. It is being used by all the primary care team members: 15 general practitioners, 25 district nurses, and 10 physiotherapists. Several years of practical experience of the CPR system shows that it has a positive impact on quality of care on four levels: 1) improved clinical follow-up of individual patients; 2) facilitated follow-up of aggregated data such as practice activity analysis, annual reports, and clinical indicators; 3) automated medical audit; and 4) concurrent audit. Within that primary care area, quality of care has improved substantially in several aspects due to the use of the CPR system [1].

Structured decision making as a framework for large-scale wildlife harvest management decisions

USGS Publications Warehouse

Robinson, Kelly F.; Fuller, Angela K.; Hurst, Jeremy E.; Swift, Bryan L.; Kirsch, Arthur; Farquhar, James F.; Decker, Daniel J.; Siemer, William F.

2016-01-01

Fish and wildlife harvest management at large spatial scales often involves making complex decisions with multiple objectives and difficult tradeoffs, population demographics that vary spatially, competing stakeholder values, and uncertainties that might affect management decisions. Structured decision making (SDM) provides a formal decision analytic framework for evaluating difficult decisions by breaking decisions into component parts and separating the values of stakeholders from the scientific evaluation of management actions and uncertainty. The result is a rigorous, transparent, and values-driven process. This decision-aiding process provides the decision maker with a more complete understanding of the problem and the effects of potential management actions on stakeholder values, as well as how key uncertainties can affect the decision. We use a case study to illustrate how SDM can be used as a decision-aiding tool for management decision making at large scales. We evaluated alternative white-tailed deer (Odocoileus virginianus) buck-harvest regulations in New York designed to reduce harvest of yearling bucks, taking into consideration the values of the state wildlife agency responsible for managing deer, as well as deer hunters. We incorporated tradeoffs about social, ecological, and economic management concerns throughout the state. Based on the outcomes of predictive models, expert elicitation, and hunter surveys, the SDM process identified management alternatives that optimized competing objectives. The SDM process provided biologists and managers insight about aspects of the buck-harvest decision that helped them adopt a management strategy most compatible with diverse hunter values and management concerns.

TIUPAM: A Framework for Trustworthiness-Centric Information Sharing

NASA Astrophysics Data System (ADS)

Xu, Shouhuai; Sandhu, Ravi; Bertino, Elisa

Information is essential to decision making. Nowadays, decision makers are often overwhelmed with large volumes of information, some of which may be inaccurate, incorrect, inappropriate, misleading, or maliciously introduced. With the advocated shift of information sharing paradigm from “need to know” to “need to share” this problem will be further compounded. This poses the challenge of achieving assured information sharing so that decision makers can always get and utilize the up-to-date information for making the right decisions, despite the existence of malicious attacks and without breaching privacy of honest participants. As a first step towards answering this challenge this paper proposes a systematic framework we call TIUPAM, which stands for “Trustworthiness-centric Identity, Usage, Provenance, and Attack Management.” The framework is centered at the need of trustworthiness and risk management for decision makers, and supported by four key components: identity management, usage management, provenance management and attack management. We explore the characterization of both the core functions and the supporting components in the TIUPAM framework, which may guide the design and realization of concrete schemes in the future.

A process for Decision-making after Pilot and feasibility Trials (ADePT): development following a feasibility study of a complex intervention for pelvic organ prolapse

PubMed Central

2013-01-01

Background Current Medical Research Council (MRC) guidance on complex interventions advocates pilot trials and feasibility studies as part of a phased approach to the development, testing, and evaluation of healthcare interventions. In this paper we discuss the results of a recent feasibility study and pilot trial for a randomized controlled trial (RCT) of pelvic floor muscle training for prolapse (ClinicalTrials.gov: NCT01136889). The ways in which researchers decide to respond to the results of feasibility work may have significant repercussions for both the nature and degree of tension between internal and external validity in a definitive trial. Methods We used methodological issues to classify and analyze the problems that arose in the feasibility study. Four centers participated with the aim of randomizing 50 women. Women were eligible if they had prolapse of any type, of stage I to IV, and had a pessary successfully fitted. Postal questionnaires were administered at baseline, 6 months, and 7 months post-randomization. After identifying problems arising within the pilot study we then sought to locate potential solutions that might minimize the trade-off between a subsequent explanatory versus pragmatic trial. Results The feasibility study pointed to significant potential problems in relation to participant recruitment, features of the intervention, acceptability of the intervention to participants, and outcome measurement. Finding minimal evidence to support our decision-making regarding the transition from feasibility work to a trial, we developed a systematic process (A process for Decision-making after Pilot and feasibility Trials (ADePT)) which we subsequently used as a guide. The process sought to: 1) encourage the systematic identification and appraisal of problems and potential solutions; 2) improve the transparency of decision-making processes; and 3) reveal the tensions that exist between pragmatic and explanatory choices. Conclusions We have developed a process that may aid researchers in their attempt to identify the most appropriate solutions to problems identified within future pilot and feasibility RCTs. The process includes three key steps: a decision about the type of problem, the identification of all solutions (whether addressed within the intervention, trial design or clinical context), and a systematic appraisal of these solutions. PMID:24160371

Cognitive reflection vs. calculation in decision making

PubMed Central

Sinayev, Aleksandr; Peters, Ellen

2015-01-01

Scores on the three-item Cognitive Reflection Test (CRT) have been linked with dual-system theory and normative decision making (Frederick, 2005). In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT's ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes); Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1) or calculated using proportions (Studies 1 and 2). These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead. PMID:25999877

Cognitive reflection vs. calculation in decision making.

PubMed

Sinayev, Aleksandr; Peters, Ellen

2015-01-01

Scores on the three-item Cognitive Reflection Test (CRT) have been linked with dual-system theory and normative decision making (Frederick, 2005). In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT's ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes); Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1) or calculated using proportions (Studies 1 and 2). These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead.

Examining sustainability in a hospital setting: case of smoking cessation.

PubMed

Campbell, Sharon; Pieters, Karen; Mullen, Kerri-Anne; Reece, Robin; Reid, Robert D

2011-09-14

The Ottawa Model of Smoking Cessation (OMSC) is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded. Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up) were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged. Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program. Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during implementation may provide insight into issues affecting program sustainability, and foster development of a sustainability plan. Based on this study, we suggest that sustainability plans should focus on enhancing interactions between the health problem, program features, and stakeholder influence.

Examining sustainability in a hospital setting: Case of smoking cessation

PubMed Central

2011-01-01

Background The Ottawa Model of Smoking Cessation (OMSC) is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded. Methods Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up) were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged. Results Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program. Conclusions Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during implementation may provide insight into issues affecting program sustainability, and foster development of a sustainability plan. Based on this study, we suggest that sustainability plans should focus on enhancing interactions between the health problem, program features, and stakeholder influence. PMID:21917156

Applications of decision analysis and related techniques to industrial engineering problems at KSC

NASA Technical Reports Server (NTRS)

Evans, Gerald W.

1995-01-01

This report provides: (1) a discussion of the origination of decision analysis problems (well-structured problems) from ill-structured problems; (2) a review of the various methodologies and software packages for decision analysis and related problem areas; (3) a discussion of how the characteristics of a decision analysis problem affect the choice of modeling methodologies, thus providing a guide as to when to choose a particular methodology; and (4) examples of applications of decision analysis to particular problems encountered by the IE Group at KSC. With respect to the specific applications at KSC, particular emphasis is placed on the use of the Demos software package (Lumina Decision Systems, 1993).

Drug policy, intravenous drug use, and heroin addiction in the UK.

PubMed

Geraghty, Jemell

In order to fully understand and appreciate today's drug problem in the UK, the foundations of drug legislation and the history of drug evolution require exploration. This paper critically examines the history of drug policy and the growth of heroin addiction from the perspective of a novice researcher who works closely with intravenous drug users in relation to leg ulceration and wound care in the acute setting. Today's drug policy has come a long way in understanding the problems of heroin addiction and establishing services to meet intravenous drug users' needs and the needs of society. This paper highlights the early warning signs of drug addiction and growth within the UK from an early stage with key areas such as who the early users were and how addiction grew so rapidly between 1920 and 1960. Current policy and decision makers as well as clinicians and researchers in this field must understand the impacts of past policy and embed it within their decisions surrounding drug policy today.

Robust parameter extraction for decision support using multimodal intensive care data

PubMed Central

Clifford, G.D.; Long, W.J.; Moody, G.B.; Szolovits, P.

2008-01-01

Digital information flow within the intensive care unit (ICU) continues to grow, with advances in technology and computational biology. Recent developments in the integration and archiving of these data have resulted in new opportunities for data analysis and clinical feedback. New problems associated with ICU databases have also arisen. ICU data are high-dimensional, often sparse, asynchronous and irregularly sampled, as well as being non-stationary, noisy and subject to frequent exogenous perturbations by clinical staff. Relationships between different physiological parameters are usually nonlinear (except within restricted ranges), and the equipment used to measure the observables is often inherently error-prone and biased. The prior probabilities associated with an individual's genetics, pre-existing conditions, lifestyle and ongoing medical treatment all affect prediction and classification accuracy. In this paper, we describe some of the key problems and associated methods that hold promise for robust parameter extraction and data fusion for use in clinical decision support in the ICU. PMID:18936019

Model-Based Anomaly Detection for a Transparent Optical Transmission System

NASA Astrophysics Data System (ADS)

Bengtsson, Thomas; Salamon, Todd; Ho, Tin Kam; White, Christopher A.

In this chapter, we present an approach for anomaly detection at the physical layer of networks where detailed knowledge about the devices and their operations is available. The approach combines physics-based process models with observational data models to characterize the uncertainties and derive the alarm decision rules. We formulate and apply three different methods based on this approach for a well-defined problem in optical network monitoring that features many typical challenges for this methodology. Specifically, we address the problem of monitoring optically transparent transmission systems that use dynamically controlled Raman amplification systems. We use models of amplifier physics together with statistical estimation to derive alarm decision rules and use these rules to automatically discriminate between measurement errors, anomalous losses, and pump failures. Our approach has led to an efficient tool for systematically detecting anomalies in the system behavior of a deployed network, where pro-active measures to address such anomalies are key to preventing unnecessary disturbances to the system's continuous operation.

Confronting Decision Cliffs: Diagnostic Assessment of Multi-Objective Evolutionary Algorithms' Performance for Addressing Uncertain Environmental Thresholds

NASA Astrophysics Data System (ADS)

Ward, V. L.; Singh, R.; Reed, P. M.; Keller, K.

2014-12-01

As water resources problems typically involve several stakeholders with conflicting objectives, multi-objective evolutionary algorithms (MOEAs) are now key tools for understanding management tradeoffs. Given the growing complexity of water planning problems, it is important to establish if an algorithm can consistently perform well on a given class of problems. This knowledge allows the decision analyst to focus on eliciting and evaluating appropriate problem formulations. This study proposes a multi-objective adaptation of the classic environmental economics "Lake Problem" as a computationally simple but mathematically challenging MOEA benchmarking problem. The lake problem abstracts a fictional town on a lake which hopes to maximize its economic benefit without degrading the lake's water quality to a eutrophic (polluted) state through excessive phosphorus loading. The problem poses the challenge of maintaining economic activity while confronting the uncertainty of potentially crossing a nonlinear and potentially irreversible pollution threshold beyond which the lake is eutrophic. Objectives for optimization are maximizing economic benefit from lake pollution, maximizing water quality, maximizing the reliability of remaining below the environmental threshold, and minimizing the probability that the town will have to drastically change pollution policies in any given year. The multi-objective formulation incorporates uncertainty with a stochastic phosphorus inflow abstracting non-point source pollution. We performed comprehensive diagnostics using 6 algorithms: Borg, MOEAD, eMOEA, eNSGAII, GDE3, and NSGAII to ascertain their controllability, reliability, efficiency, and effectiveness. The lake problem abstracts elements of many current water resources and climate related management applications where there is the potential for crossing irreversible, nonlinear thresholds. We show that many modern MOEAs can fail on this test problem, indicating its suitability as a useful and nontrivial benchmarking problem.

Voices of decision makers on evidence-based policy: A case of evolving TB/HIV co-infection policy in India.

PubMed

Reddy, K Srikanth; Sahay, Seema

2016-01-01

This study explores decision makers' perspectives on evidence-based policy (EBP) development using the case of TB/HIV co-infection in India. Twelve in-depth interviews were conducted with purposively selected key national and international policy decision makers in India. Verbatim transcripts were processed and analysed thematically using QSR (NUD*IST 6). The decision makers were unequivocal in recognizing the TB/HIV co-infection as an important public health issue in India and stated the problem to be different than Africa. The need of having a "third programme" for co-infection was not felt. According to them, the public health management of this co-infection must be within the realm of these two programmes. The study also emphasized on decision makers' perspectives on evidence and the process of utilization of evidence for decision-making for co-infection. Study findings showed global evidence was not always accepted by the decision makers and study shows several examples of decision makers demanding local evidence for policy decisions. Decision makers did make interim policies based on global evidence but most of the time their mandate was to get local evidence. Thus, operations research/implementation science especially multi-centric studies emerge as important strategy for EBP development. Researcher-policy maker interface was a gap where role of researcher as aggressive communicator of research findings was expected.

Optimal routing of hazardous substances in time-varying, stochastic transportation networks

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

Woods, A.L.; Miller-Hooks, E.; Mahmassani, H.S.

This report is concerned with the selection of routes in a network along which to transport hazardous substances, taking into consideration several key factors pertaining to the cost of transport and the risk of population exposure in the event of an accident. Furthermore, the fact that travel time and the risk measures are not constant over time is explicitly recognized in the routing decisions. Existing approaches typically assume static conditions, possibly resulting in inefficient route selection and unnecessary risk exposure. The report described the application of recent advances in network analysis methodologies to the problem of routing hazardous substances. Severalmore » specific problem formulations are presented, reflecting different degrees of risk aversion on the part of the decision-maker, as well as different possible operational scenarios. All procedures explicitly consider travel times and travel costs (including risk measures) to be stochastic time-varying quantities. The procedures include both exact algorithms, which may require extensive computational effort in some situations, as well as more efficient heuristics that may not guarantee a Pareto-optimal solution. All procedures are systematically illustrated for an example application using the Texas highway network, for both normal and incident condition scenarios. The application illustrates the trade-offs between the information obtained in the solution and computational efficiency, and highlights the benefits of incorporating these procedures in a decision-support system for hazardous substance shipment routing decisions.« less

Defender-Attacker Decision Tree Analysis to Combat Terrorism.

PubMed

Garcia, Ryan J B; von Winterfeldt, Detlof

2016-12-01

We propose a methodology, called defender-attacker decision tree analysis, to evaluate defensive actions against terrorist attacks in a dynamic and hostile environment. Like most game-theoretic formulations of this problem, we assume that the defenders act rationally by maximizing their expected utility or minimizing their expected costs. However, we do not assume that attackers maximize their expected utilities. Instead, we encode the defender's limited knowledge about the attacker's motivations and capabilities as a conditional probability distribution over the attacker's decisions. We apply this methodology to the problem of defending against possible terrorist attacks on commercial airplanes, using one of three weapons: infrared-guided MANPADS (man-portable air defense systems), laser-guided MANPADS, or visually targeted RPGs (rocket propelled grenades). We also evaluate three countermeasures against these weapons: DIRCMs (directional infrared countermeasures), perimeter control around the airport, and hardening airplanes. The model includes deterrence effects, the effectiveness of the countermeasures, and the substitution of weapons and targets once a specific countermeasure is selected. It also includes a second stage of defensive decisions after an attack occurs. Key findings are: (1) due to the high cost of the countermeasures, not implementing countermeasures is the preferred defensive alternative for a large range of parameters; (2) if the probability of an attack and the associated consequences are large, a combination of DIRCMs and ground perimeter control are preferred over any single countermeasure. © 2016 Society for Risk Analysis.

IT vendor selection model by using structural equation model & analytical hierarchy process

NASA Astrophysics Data System (ADS)

Maitra, Sarit; Dominic, P. D. D.

2012-11-01

Selecting and evaluating the right vendors is imperative for an organization's global marketplace competitiveness. Improper selection and evaluation of potential vendors can dwarf an organization's supply chain performance. Numerous studies have demonstrated that firms consider multiple criteria when selecting key vendors. This research intends to develop a new hybrid model for vendor selection process with better decision making. The new proposed model provides a suitable tool for assisting decision makers and managers to make the right decisions and select the most suitable vendor. This paper proposes a Hybrid model based on Structural Equation Model (SEM) and Analytical Hierarchy Process (AHP) for long-term strategic vendor selection problems. The five steps framework of the model has been designed after the thorough literature study. The proposed hybrid model will be applied using a real life case study to assess its effectiveness. In addition, What-if analysis technique will be used for model validation purpose.

Group decisions in humans and animals: a survey

PubMed Central

Conradt, Larissa; List, Christian

2008-01-01

Humans routinely make many decisions collectively, whether they choose a restaurant with friends, elect political leaders or decide actions to tackle international problems, such as climate change, that affect the future of the whole planet. We might be less aware of it, but group decisions are just as important to social animals as they are for us. Animal groups have to collectively decide about communal movements, activities, nesting sites and enterprises, such as cooperative breeding or hunting, that crucially affect their survival and reproduction. While human group decisions have been studied for millennia, the study of animal group decisions is relatively young, but is now expanding rapidly. It emerges that group decisions in animals pose many similar questions to those in humans. The purpose of the present issue is to integrate and combine approaches in the social and natural sciences in an area in which theoretical challenges and research questions are often similar, and to introduce each discipline to the other's key ideas, findings and successful methods. In order to make such an introduction as effective as possible, here, we briefly review conceptual similarities and differences between the sciences, and provide a guide to the present issue. PMID:19073475

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

Steed, Chad A

Interactive data visualization leverages human visual perception and cognition to improve the accuracy and effectiveness of data analysis. When combined with automated data analytics, data visualization systems orchestrate the strengths of humans with the computational power of machines to solve problems neither approach can manage in isolation. In the intelligent transportation system domain, such systems are necessary to support decision making in large and complex data streams. In this chapter, we provide an introduction to several key topics related to the design of data visualization systems. In addition to an overview of key techniques and strategies, we will describe practicalmore » design principles. The chapter is concluded with a detailed case study involving the design of a multivariate visualization tool.« less

Setting objectives for managing Key deer

USGS Publications Warehouse

Diefenbach, Duane R.; Wagner, Tyler; Stauffer, Glenn E.

2014-01-01

The U.S. Fish and Wildlife Service (FWS) is responsible for the protection and management of Key deer (Odocoileus virginianus clavium) because the species is listed as Endangered under the Endangered Species Act (ESA). The purpose of the ESA is to protect and recover imperiled species and the ecosystems upon which they depend. There are a host of actions that could possibly be undertaken to recover the Key deer population, but without a clearly defined problem and stated objectives it can be difficult to compare and evaluate alternative actions. In addition, management goals and the acceptability of alternative management actions are inherently linked to stakeholders, who should be engaged throughout the process of developing a decision framework. The purpose of this project was to engage a representative group of stakeholders to develop a problem statement that captured the management problem the FWS must address with Key deer and identify objectives that, if met, would help solve the problem. In addition, the objectives were organized in a hierarchical manner (i.e., an objectives network) to show how they are linked, and measurable attributes were identified for each objective. We organized a group of people who represented stakeholders interested in and potentially affected by the management of Key deer. These stakeholders included individuals who represented local, state, and federal governments, non-governmental organizations, the general public, and local businesses. This stakeholder group met five full days over the course of an eight-week period to identify objectives that would address the following problem:“As recovery and removal from the Endangered Species list is the purpose of the Endangered Species Act, the U.S. Fish and Wildlife Service needs a management approach that will ensure a sustainable, viable, and healthy Key deer population. Urbanization has affected the behavior and population dynamics of the Key deer and the amount and characteristics of available habitat. The identified management approach must balance relevant social and economic concerns, Federal (e.g., Endangered Species Act, Wilderness Act, Refuge Act) and state regulations, and the conservation of biodiversity (e.g., Endangered/Threatened species, native habitat) in the Lower Keys.”The stakeholder group identified four fundamental objectives that are essential to addressing the problem: 1) Maximize a sustainable, viable, and healthy Key deer population, 2) Maximize value of Key deer to the People, 3) Minimize deer-related negative impacts to biodiversity, and 4) Minimize costs. In addition, the group identified 25 additional objectives that, if met, would help meet the fundamental objectives. The objectives network and measurable attributes identified by the stakeholder group can be used in the future to develop and evaluate potential management alternatives.

A fuzzy multi-objective model for capacity allocation and pricing policy of provider in data communication service with different QoS levels

NASA Astrophysics Data System (ADS)

Pan, Wei; Wang, Xianjia; Zhong, Yong-guang; Yu, Lean; Jie, Cao; Ran, Lun; Qiao, Han; Wang, Shouyang; Xu, Xianhao

2012-06-01

Data communication service has an important influence on e-commerce. The key challenge for the users is, ultimately, to select a suitable provider. However, in this article, we do not focus on this aspect but the viewpoint and decision-making of providers for order allocation and pricing policy when orders exceed service capacity. It is a multiple criteria decision-making problem such as profit and cancellation ratio. Meanwhile, we know realistic situations in which much of the input information is uncertain. Thus, it becomes very complex in a real-life environment. In this situation, fuzzy sets theory is the best tool for solving this problem. Our fuzzy model is formulated in such a way as to simultaneously consider the imprecision of information, price sensitive demand, stochastic variables, cancellation fee and the general membership function. For solving the problem, a new fuzzy programming is developed. Finally, a numerical example is presented to illustrate the proposed method. The results show that it is effective for determining the suitable order set and pricing policy of provider in data communication service with different quality of service (QoS) levels.

Key concepts relevant to quality of complex and shared decision-making in health care: a literature review.

PubMed

Dy, Sydney M; Purnell, Tanjala S

2012-02-01

High-quality provider-patient decision-making is key to quality care for complex conditions. We performed an analysis of key elements relevant to quality and complex, shared medical decision-making. Based on a search of electronic databases, including Medline and the Cochrane Library, as well as relevant articles' reference lists, reviews of tools, and annotated bibliographies, we developed a list of key concepts and applied them to a decision-making example. Key concepts identified included provider competence, trustworthiness, and cultural competence; communication with patients and families; information quality; patient/surrogate competence; and roles and involvement. We applied this concept list to a case example, shared decision-making for live donor kidney transplantation, and identified the likely most important concepts as provider and cultural competence, information quality, and communication with patients and families. This concept list may be useful for conceptualizing the quality of complex shared decision-making and in guiding research in this area. Copyright © 2011 Elsevier Ltd. All rights reserved.

Using social network analysis to evaluate health-related adaptation decision-making in Cambodia.

PubMed

Bowen, Kathryn J; Alexander, Damon; Miller, Fiona; Dany, Va

2014-01-30

Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or 'shadow networks') in the context of climate change adaptation policy and activities. The health governance 'map' in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes.

Using Social Network Analysis to Evaluate Health-Related Adaptation Decision-Making in Cambodia

PubMed Central

Bowen, Kathryn J.; Alexander, Damon; Miller, Fiona; Dany, Va

2014-01-01

Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or ‘shadow networks’) in the context of climate change adaptation policy and activities. The health governance ‘map’ in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes. PMID:24487452

Decision-Making, Cognitive Distortions and Alcohol Use in Adolescent Problem and Non-problem Gamblers: An Experimental Study.

PubMed

Ciccarelli, Maria; Griffiths, Mark D; Nigro, Giovanna; Cosenza, Marina

2016-12-01

In the psychological literature, many studies have investigated the neuropsychological and behavioral changes that occur developmentally during adolescence. These studies have consistently observed a deficit in the decision-making ability of children and adolescents. This deficit has been ascribed to incomplete brain development. The same deficit has also been observed in adult problem and pathological gamblers. However, to date, no study has examined decision-making in adolescents with and without gambling problems. Furthermore, no study has ever examined associations between problem gambling, decision-making, cognitive distortions and alcohol use in youth. To address these issues, 104 male adolescents participated in this study. They were equally divided in two groups, problem gamblers and non-problem gamblers, based on South Oaks Gambling Screen Revised for Adolescents scores. All participants performed the Iowa gambling task and completed the Gambling Related Cognitions Scale and the alcohol use disorders identification test. Adolescent problem gamblers displayed impaired decision-making, reported high cognitive distortions, and had more problematic alcohol use compared to non-problem gamblers. Strong correlations between problem gambling, alcohol use, and cognitive distortions were observed. Decision-making correlated with interpretative bias. This study demonstrated that adolescent problem gamblers appear to have the same psychological profile as adult problem gamblers and that gambling involvement can negatively impact on decision-making ability that, in adolescence, is still developing. The correlations between interpretative bias and decision-making suggested that the beliefs in the ability to influence gambling outcomes may facilitate decision-making impairment.

An Internationally Consented Standard for Nursing Process-Clinical Decision Support Systems in Electronic Health Records.

PubMed

Müller-Staub, Maria; de Graaf-Waar, Helen; Paans, Wolter

2016-11-01

Nurses are accountable to apply the nursing process, which is key for patient care: It is a problem-solving process providing the structure for care plans and documentation. The state-of-the art nursing process is based on classifications that contain standardized concepts, and therefore, it is named Advanced Nursing Process. It contains valid assessments, nursing diagnoses, interventions, and nursing-sensitive patient outcomes. Electronic decision support systems can assist nurses to apply the Advanced Nursing Process. However, nursing decision support systems are missing, and no "gold standard" is available. The study aim is to develop a valid Nursing Process-Clinical Decision Support System Standard to guide future developments of clinical decision support systems. In a multistep approach, a Nursing Process-Clinical Decision Support System Standard with 28 criteria was developed. After pilot testing (N = 29 nurses), the criteria were reduced to 25. The Nursing Process-Clinical Decision Support System Standard was then presented to eight internationally known experts, who performed qualitative interviews according to Mayring. Fourteen categories demonstrate expert consensus on the Nursing Process-Clinical Decision Support System Standard and its content validity. All experts agreed the Advanced Nursing Process should be the centerpiece for the Nursing Process-Clinical Decision Support System and should suggest research-based, predefined nursing diagnoses and correct linkages between diagnoses, evidence-based interventions, and patient outcomes.

An investigation of aviator problem-solving skills as they relate to amount of total flight time

NASA Astrophysics Data System (ADS)

Guilkey, James Elwood, Jr.

As aircraft become increasingly more reliable, safety issues have shifted towards the human component of flight, the pilot. Jensen (1995) indicated that 80% of all General Aviation (GA) accidents are the result, at least in part, of errors committed by the aviator. One major focus of current research involves aviator decision making (ADM). ADM combines a broad range of psychological factors including personality, attitude, and motivation. This approach fails to isolate certain key components such as aviator problem-solving (APS) which are paramount to safe operations. It should be noted that there is a clear delineation between problem-solving and decision making and not assume that they are homogenous. For years, researchers, industry, and the Federal Aviation Administration (FAA) have depended on total flight hours as the standard by which to judge aviator expertise. A pilot with less than a prescribed number of hours is considered a novice while those above that mark are considered experts. The reliance on time as a predictor of performance may be accurate when considering skills which are required on every flight (i.e., takeoff and landing) but we can't assume that this holds true for all aspects of aviator expertise. Complex problem-solving for example, is something that is rarely faced during the normal course of flying. In fact, there are a myriad of procedures and FAA mandated regulations designed to assist pilots in avoiding problems. Thus, one should not assume that aviator problem-solving skills will increase over time. This study investigated the relationship between problem-solving skills of general aviation pilots and total number of flight hours. It was discovered that flight time is not a good predictor of problem-solving performance. There were two distinct strategies that were identified in the study. The first, progressive problem solving (PPS) was characterized by a stepwise method in which pilots gathered information, formulated hypotheses, and evaluated outcomes. Both high time as well as low time pilots demonstrated this approach. The second method, termed knee-jerk decision making was distinguished by a lack of problem-solving abilities and involved an almost immediate decision with little if any supporting information. Again both high and low time pilots performed in this manner. The result of these findings is a recommendation that the FAA adopt new training methods which will allow pilots to develop the skills required to handle critical inflight situations.

Factors influencing nurses' judgements about self-neglect cases.

PubMed

Lauder, W; Ludwick, R; Zeller, R; Winchell, J

2006-06-01

From the perspective of the practising nurse self-neglect may best be understood in terms of a set of complex and often poorly defined clinical problems in which two key clinical issues are "how do I judge whether this person has the capacity to make decisions about their lifestyle?" and "do we need to treat this person using mental health legislation?" These are taxing questions as judging if a patient has the capacity to make decisions about their lifestyle choices is difficult for even the most experienced clinicians. Such determinations require nurses to form a judgement as to mental capacity of the patient. We do not know what patient characteristics and in what combination nurses use these when making these judgements. This factorial survey aimed to identify which patient characteristics influenced Registered Nurses' judgements on decision-making capacity and decisions on the use of interventions which require statutory interventions in cases of self-neglect. Judgements on decision-making capacity were overwhelmingly predicted by information of the patients' mental health status. Nurses place patients in one of three broad categories of no mental illness, minor mental illness and severe mental illness. This categorization appears to operate as a fast and frugal heuristic indicating that nurses may use mental status as a cognitive screen to work from in judging self-neglect. Although there is a correlation between the severity of mental illness and the capacity for making decisions they are not the same. This study shows the continued work that needs done in educating nurses not only about self-neglect but also about the role a patient's mental status may have in assessment of problems.

Primary Care Provider Views About Usefulness and Dissemination of a Web-Based Depression Treatment Information Decision Aid.

PubMed

Beaulac, Julie; Westmacott, Robin; Walker, John R; Vardanyan, Gohar

2016-06-08

Decisions related to mental health are often complex, problems often remain undetected and untreated, information unavailable or not used, and treatment decisions frequently not informed by best practice or patient preferences. The objective of this paper was to obtain the opinions of health professionals working in primary health care settings about a Web-based information decision aid (IDA) for patients concerning treatment options for depression and the dissemination of the resources in primary care settings. Participants were recruited from primary care clinics in Winnipeg and Ottawa, Canada, and included 48 family physicians, nurses, and primary care staff. The study design was a qualitative framework analytic approach of 5 focus groups. Focus groups were conducted during regular staff meetings, were digitally recorded, and transcripts created. Analysis involved a content and theme analysis. Seven key themes emerged including the key role of the primary care provider, common questions about treatments, treatment barriers, sources of patient information, concern about quality and quantity of available information, positive opinions about the IDA, and disseminating the IDA. The most common questions mentioned were about medication and side effects and alternatives to medication. Patients have limited access to alternative treatment options owing to cost and availability. Practitioners evaluated the IDA positively. The resources were described as useful, supportive of providers' messages, and accessible for patients. There was unanimous consensus that information needs to be available electronically through the Internet.

Sell in May and Go Away? Learning and Risk Taking in Nonmonotonic Decision Problems

ERIC Educational Resources Information Center

Frey, Renato; Rieskamp, Jörg; Hertwig, Ralph

2015-01-01

In nonmonotonic decision problems, the magnitude of outcomes can both increase and decrease over time depending on the state of the decision problem. These increases and decreases may occur repeatedly and result in a variety of possible outcome distributions. In many previously investigated sequential decision problems, in contrast, outcomes (or…

A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States.

PubMed

Zullig, Leah L; Granger, Bradi B; Bosworth, Hayden B

2016-01-01

Nonadherence to prescription medications is a common and costly problem with multiple contributing factors, spanning the dimensions of individual behavior change, psychology, medicine, and health policy, among others. Addressing the problem of medication nonadherence requires strategic input from key experts in a number of fields. The Medication Adherence Alliance is a group of key experts, predominately from the US, in the field of medication nonadherence. Members include representatives from consumer advocacy groups, community health providers, nonprofit groups, the academic community, decision-making government officials, and industry. In 2015, the Medication Adherence Alliance convened to review the current landscape of medication adherence. The group then established three working groups that will develop recommendations for shifting toward solutions-oriented science. From the perspective of the Medication Adherence Alliance, the objective of this commentary is to describe changes in the US landscape of medication adherence, framing the evolving field in the context of a recent think tank meeting of experts in the field of medication adherence.

Pediatric provider processes for behavioral health screening, decision making, and referral in sites with colocated mental health services.

PubMed

Hacker, Karen; Goldstein, Joel; Link, David; Sengupta, Nandini; Bowers, Rachael; Tendulkar, Shalini; Wissow, Larry

2013-01-01

Validated behavioral health (BH) screens are recommended for use at well-child visits. This study aimed to explore how pediatricians experience and use these screens for subsequent care decisions in primary care. The study took place at 4 safety net health centers. Fourteen interviews were conducted with pediatricians who were mandated to use validated BH screens at well-child visits. Interview questions focused on key domains, including clinic BH context, screening processes, assessment of screening scores, and decision making about referral to mental health services. Qualitative analysis used the Framework Approach. A variety of themes emerged: BH screens were well accepted and valued for the way they facilitated discussion of mental health issues. However, screening results were not always used in the way that instrument designers intended. Providers' beliefs about the face validity of the instruments, and their observations about performance of instruments, led to discounting scored results. As a result, clinical decisions were made based on a variety of evidence, including individual item responses, parent or patient concerns, and perceived readiness for treatment. Additionally, providers, although interested in expanding their mental health discussions, perceived a lack of time and of their own skills to be major obstacles in this pursuit. Screens act as important prompts to stimulate discussion of BH problems, but their actual scored results play a variable role in problem identification and treatment decisions. Modifications to scheduling policies, additional provider training, and enhanced collaboration with mental health professionals could support better BH integration in pediatric primary care.

SUPPORT Tools for evidence-informed health Policymaking (STP) 7: Finding systematic reviews

PubMed Central

2009-01-01

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Systematic reviews are increasingly seen as a key source of information in policymaking, particularly in terms of assisting with descriptions of the impacts of options. Relative to single studies they offer a number of advantages related to understanding impacts and are also seen as a key source of information for clarifying problems and providing complementary perspectives on options. Systematic reviews can be undertaken to place problems in comparative perspective and to describe the likely harms of an option. They also assist with understanding the meanings that individuals or groups attach to a problem, how and why options work, and stakeholder views and experiences related to particular options. A number of constraints have hindered the wider use of systematic reviews in policymaking. These include a lack of awareness of their value and a mismatch between the terms employed by policymakers, when attempting to retrieve systematic reviews, and the terms used by the original authors of those reviews. Mismatches between the types of information that policymakers are seeking, and the way in which authors fail to highlight (or make obvious) such information within systematic reviews have also proved problematic. In this article, we suggest three questions that can be used to guide those searching for systematic reviews, particularly reviews about the impacts of options being considered. These are: 1. Is a systematic review really what is needed? 2. What databases and search strategies can be used to find relevant systematic reviews? 3. What alternatives are available when no relevant review can be found? PMID:20018114

Participatory Systems Modeling to Explore Sustainable ...

EPA Pesticide Factsheets

Decision makers often need assistance in understanding dynamic interactions and linkages among economic, environmental and social systems in coastal watersheds. They also need scientific input to better evaluate potential costs and benefits of alternative policy interventions. The US EPA is applying sustainability science to address these needs. Triple Value (3V) Scoping and Modeling projects bring a systems approach to understand complex environmental problems, incorporate local knowledge, and allow decision-makers to explore policy scenarios. This leads to better understanding of feedbacks and outcomes to both human and environmental systems. The Suffolk County, NY (eastern Long Island) 3V Case uses SES interconnections to explore possible policy options and scenarios for intervention to mitigate the effects of excess nitrogen (N) loading to ground, surface, and estuarine waters. Many of the environmental impacts of N pollution negatively affect social and economic well-being and productivity. Key are loss of enjoyment and recreational use of local beach environments and loss of income and revenues from tourism and local fisheries. Stakeholders generated this Problem Statement: Suffolk County is experiencing widespread degradation to groundwater and the coastal marine environment caused by excess nitrogen. How can local stakeholders and decision makers in Suffolk County arrest and reverse this degradation, restore conditions to support a healthy thriving ecos

Feasibility of neuro-morphic computing to emulate error-conflict based decision making.

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

Branch, Darren W.

2009-09-01

A key aspect of decision making is determining when errors or conflicts exist in information and knowing whether to continue or terminate an action. Understanding the error-conflict processing is crucial in order to emulate higher brain functions in hardware and software systems. Specific brain regions, most notably the anterior cingulate cortex (ACC) are known to respond to the presence of conflicts in information by assigning a value to an action. Essentially, this conflict signal triggers strategic adjustments in cognitive control, which serve to prevent further conflict. The most probable mechanism is the ACC reports and discriminates different types of feedback,more » both positive and negative, that relate to different adaptations. Unique cells called spindle neurons that are primarily found in the ACC (layer Vb) are known to be responsible for cognitive dissonance (disambiguation between alternatives). Thus, the ACC through a specific set of cells likely plays a central role in the ability of humans to make difficult decisions and solve challenging problems in the midst of conflicting information. In addition to dealing with cognitive dissonance, decision making in high consequence scenarios also relies on the integration of multiple sets of information (sensory, reward, emotion, etc.). Thus, a second area of interest for this proposal lies in the corticostriatal networks that serve as an integration region for multiple cognitive inputs. In order to engineer neurological decision making processes in silicon devices, we will determine the key cells, inputs, and outputs of conflict/error detection in the ACC region. The second goal is understand in vitro models of corticostriatal networks and the impact of physical deficits on decision making, specifically in stressful scenarios with conflicting streams of data from multiple inputs. We will elucidate the mechanisms of cognitive data integration in order to implement a future corticostriatal-like network in silicon devices for improved decision processing.« less

An Analysis of the Associations among Cognitive Impulsiveness, Reasoning Process, and Rational Decision Making

PubMed Central

Jelihovschi, Ana P. G.; Cardoso, Ricardo L.; Linhares, Alexandre

2018-01-01

Impulsivity may lead to several unfortunate consequences and maladaptive behaviors for both clinical and nonclinical people. It has a key role in many forms of psychopathology. Although literature has discussed the negative impact of impulsivity, few have emphasized the relationship between cognitive impulsiveness and decision making. The aim of this study is to investigate the effects of cognitive impulsiveness on decision making and explore the strategies used by participants to solve problems. For this purpose, we apply two measures of impulsivity: the self-report Barratt Impulsiveness Scale (BIS-11) and the performance based Cognitive Reflection Test (CRT). Moreover, we evaluate participants' reasoning processes employed to answer CRT questions based on the calculation expressions, data organization, and erasures they made while answering the CRT (note that we utilized the instruments using pen and paper). These reasoning processes are related to the role of executive functions in decision making, and its relationship with impulsiveness. The sample consists of 191 adults, who were either professionals or undergraduate students from the fields of business, management, or accounting. The results show that cognitive impulsiveness may negatively affect decision making, and that those who presented the calculation to answer the CRT questions made better decisions. Moreover, there was no difference in the strategies used by impulsive vs. nonimpulsive participants during decision making. Finally, people who inhibited their immediate answers to CRT questions performed better during decision making. PMID:29375440

An Analysis of the Associations among Cognitive Impulsiveness, Reasoning Process, and Rational Decision Making.

PubMed

Jelihovschi, Ana P G; Cardoso, Ricardo L; Linhares, Alexandre

2017-01-01

Impulsivity may lead to several unfortunate consequences and maladaptive behaviors for both clinical and nonclinical people. It has a key role in many forms of psychopathology. Although literature has discussed the negative impact of impulsivity, few have emphasized the relationship between cognitive impulsiveness and decision making. The aim of this study is to investigate the effects of cognitive impulsiveness on decision making and explore the strategies used by participants to solve problems. For this purpose, we apply two measures of impulsivity: the self-report Barratt Impulsiveness Scale (BIS-11) and the performance based Cognitive Reflection Test (CRT). Moreover, we evaluate participants' reasoning processes employed to answer CRT questions based on the calculation expressions, data organization, and erasures they made while answering the CRT (note that we utilized the instruments using pen and paper). These reasoning processes are related to the role of executive functions in decision making, and its relationship with impulsiveness. The sample consists of 191 adults, who were either professionals or undergraduate students from the fields of business, management, or accounting. The results show that cognitive impulsiveness may negatively affect decision making, and that those who presented the calculation to answer the CRT questions made better decisions. Moreover, there was no difference in the strategies used by impulsive vs. nonimpulsive participants during decision making. Finally, people who inhibited their immediate answers to CRT questions performed better during decision making.

Key Decision Record Creation and Approval Module

NASA Technical Reports Server (NTRS)

Hebert, Barrt; Messer, Elizabeth A.; Albasini, Colby; Le, Thang; ORourke, William, Sr.; Stiglets, Tim; Strain, Ted

2012-01-01

Retaining good key decision records is critical to ensuring the success of a project or operation. Having adequately documented decisions with supporting documents and rationale can greatly reduce the amount of rework or reinvention over a project's, vehicle's, or facility's lifecycle. Stennis Space Center developed and uses a software tool that automates the Key Decision Record (KDR) process for its engineering and test projects. It provides the ability for a user to log key decisions that are made during the course of a project. By customizing Parametric Technology Corporation's (PTC) Windchill product, the team was able to log all information about a decision, and electronically route that information for approval. Customizing the Windchill product allowed the team to directly connect these decisions to the engineering data that it might affect and notify data owners of the decision. The user interface was created in JSP and Javascript, within the OOTB (Out of the Box) Windchill product, allowing users to create KDRs. Not only does this interface allow users to create and track KDRs, but it also plugs directly into the OOTB ability to associate these decision records with other relevant engineering data such as drawings, designs, models, requirements, or specifications

Robust Decision Making: The Cognitive and Computational Modeling of Team Problem Solving for Decision Making under Complex and Dynamic Conditions

DTIC Science & Technology

2015-07-14

AFRL-OSR-VA-TR-2015-0202 Robust Decision Making: The Cognitive and Computational Modeling of Team Problem Solving for Decision Making under Complex...Computational Modeling of Team Problem Solving for Decision Making Under Complex and Dynamic Conditions 5a. CONTRACT NUMBER 5b. GRANT NUMBER FA9550-12-1...functioning as they solve complex problems, and propose the means to improve the performance of teams, under changing or adversarial conditions. By

Implementing shared decision making in routine mental health care

PubMed Central

Slade, Mike

2017-01-01

Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non‐maleficence. It is argued that SDM is “polyvalent”, a sociological concept which describes an idea commanding superficial but not deep agreement between disparate stakeholders. Implementing SDM in routine mental health services is as much a cultural as a technical problem. Three challenges are identified: creating widespread access to high‐quality decision support tools; integrating SDM with other recovery‐supporting interventions; and responding to cultural changes as patients develop the normal expectations of citizenship. Two approaches which may inform responses in the mental health system to these cultural changes – social marketing and the hospitality industry – are identified. PMID:28498575

Making Debris Avoidance Decisions for ESMO's EOS Mission Set

NASA Technical Reports Server (NTRS)

Mantziaras, Dimitrios

2016-01-01

The presentation will cover the aspects of making debris risk decisions from the NASA Mission Director's perspective, specifically for NASA Earth Science Mission Operations (ESMO) Earth Observing System (EOS) mission set. ESMO has been involved in analyzing potential debris risk conjunctions with secondary objects since the inception of this discipline. Through the cumulated years of experience and continued exposure to various debris scenarios, ESMO's understanding of the problem and process to deal with this issue has evolved. The presentation will describe the evolution of the ESMO process, specifically as it relates to the maneuver execution and spacecraft risk management decision process. It will briefly cover the original Drag Make-Up Maneuver, several day, methodical manually intensive, ramp up waive off approach, to the present day more automated, pre-canned onboard command, tools based approach. The presentation will also cover the key information needed to make debris decisions and challenges in doing so while still trying to meet science goals, constellation constraints and manage resources. A slide or two at the end of the presentation, will be devoted to discussing what further improvements could be helpful to improve decision making and future process improvement plans challenges.

Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'.

PubMed

Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F

2012-03-14

A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

Understanding and applying principles of social cognition and decision making in adaptive environmental governance.

PubMed

DeCaro, Daniel A; Arnol, Craig Anthony Tony; Boama, Emmanuel Frimpong; Garmestani, Ahjond S

2017-03-01

Environmental governance systems are under greater pressure to adapt and to cope with increased social and ecological uncertainty from stressors like climate change. We review principles of social cognition and decision making that shape and constrain how environmental governance systems adapt. We focus primarily on the interplay between key decision makers in society and legal systems. We argue that adaptive governance must overcome three cooperative dilemmas to facilitate adaptation: (1) encouraging collaborative problem solving, (2) garnering social acceptance and commitment, and (3) cultivating a culture of trust and tolerance for change and uncertainty. However, to do so governance systems must cope with biases in people's decision making that cloud their judgment and create conflict. These systems must also satisfy people's fundamental needs for self-determination, fairness, and security, ensuring that changes to environmental governance are perceived as legitimate, trustworthy, and acceptable. We discuss the implications of these principles for common governance solutions (e.g., public participation, enforcement) and conclude with methodological recommendations. We outline how scholars can investigate the social cognitive principles involved in cases of adaptive governance.

Optimal two-stage dynamic treatment regimes from a classification perspective with censored survival data.

PubMed

Hager, Rebecca; Tsiatis, Anastasios A; Davidian, Marie

2018-05-18

Clinicians often make multiple treatment decisions at key points over the course of a patient's disease. A dynamic treatment regime is a sequence of decision rules, each mapping a patient's observed history to the set of available, feasible treatment options at each decision point, and thus formalizes this process. An optimal regime is one leading to the most beneficial outcome on average if used to select treatment for the patient population. We propose a method for estimation of an optimal regime involving two decision points when the outcome of interest is a censored survival time, which is based on maximizing a locally efficient, doubly robust, augmented inverse probability weighted estimator for average outcome over a class of regimes. By casting this optimization as a classification problem, we exploit well-studied classification techniques such as support vector machines to characterize the class of regimes and facilitate implementation via a backward iterative algorithm. Simulation studies of performance and application of the method to data from a sequential, multiple assignment randomized clinical trial in acute leukemia are presented. © 2018, The International Biometric Society.

Supply chain network design problem for a new market opportunity in an agile manufacturing system

NASA Astrophysics Data System (ADS)

Babazadeh, Reza; Razmi, Jafar; Ghodsi, Reza

2012-08-01

The characteristics of today's competitive environment, such as the speed with which products are designed, manufactured, and distributed, and the need for higher responsiveness and lower operational cost, are forcing companies to search for innovative ways to do business. The concept of agile manufacturing has been proposed in response to these challenges for companies. This paper copes with the strategic and tactical level decisions in agile supply chain network design. An efficient mixed-integer linear programming model that is able to consider the key characteristics of agile supply chain such as direct shipments, outsourcing, different transportation modes, discount, alliance (process and information integration) between opened facilities, and maximum waiting time of customers for deliveries is developed. In addition, in the proposed model, the capacity of facilities is determined as decision variables, which are often assumed to be fixed. Computational results illustrate that the proposed model can be applied as a power tool in agile supply chain network design as well as in the integration of strategic decisions with tactical decisions.

Understanding and applying principles of social cognition and decision making in adaptive environmental governance

PubMed Central

DeCaro, Daniel A.; Arnol, Craig Anthony (Tony); Boama, Emmanuel Frimpong; Garmestani, Ahjond S.

2018-01-01

Environmental governance systems are under greater pressure to adapt and to cope with increased social and ecological uncertainty from stressors like climate change. We review principles of social cognition and decision making that shape and constrain how environmental governance systems adapt. We focus primarily on the interplay between key decision makers in society and legal systems. We argue that adaptive governance must overcome three cooperative dilemmas to facilitate adaptation: (1) encouraging collaborative problem solving, (2) garnering social acceptance and commitment, and (3) cultivating a culture of trust and tolerance for change and uncertainty. However, to do so governance systems must cope with biases in people’s decision making that cloud their judgment and create conflict. These systems must also satisfy people’s fundamental needs for self-determination, fairness, and security, ensuring that changes to environmental governance are perceived as legitimate, trustworthy, and acceptable. We discuss the implications of these principles for common governance solutions (e.g., public participation, enforcement) and conclude with methodological recommendations. We outline how scholars can investigate the social cognitive principles involved in cases of adaptive governance. PMID:29780425

Efforts to improve patient safety in large, capitated medical groups: description and conceptual model.

PubMed

Miller, Robert H; Bovbjerg, Randall R

2002-06-01

Medical care should be safer. Inpatient problems and solutions have received the most attention; this outpatient qualitative case study addresses a gap in knowledge. We describe safety improvements among large physician groups, model the key influences on their behavior, and identify beneficial public and private policies. All groups were trying to reduce medical injury, which was part of the sample design. The most commonly targeted problems are those that are similar across groups: shortcomings in diagnosis, abnormal tests follow-up, scope of practice and referral patterns, and continuity of care. Medical group innovators vary greatly, however, in implementation of improvements, that is, in the extent to which they implement process changes that identify events/problems, analyze and track incidents, decide how to change clinical and administrative practices, and monitor impacts of the changes. Our conceptual model identifies key determinants: (1) demand for safety comes from external factors: legal, market, and professional; (2) organizational responses depend on internal factors: group size, scope, and integration; leadership and governance; professional culture; information-system assets; and financial and intellectual capital. Further, safety is an aspect of quality (the same tools, decision making, interventions, and monitoring apply), and safety management benefits from prior efficiency management (similar skills and culture of innovation). Observed variation in even simple safeguards shows that existing safety incentives are too weak. Our model suggests that the biggest improvement would come from boosting the demand for quality and safety from both private and public larger group purchasers. Current policy relies too much on litigation and discipline, which have sometimes helped, but not solved, problems because they are inefficient, tend to drive needed information underground, and complicate needed cultural change. Patients' safety demand is also weak for want of information and market power. Big purchasers' demands, however, quickly influence the internal environment of medical groups, helping managers advance quality safety toward the top of groups' congested decision-making "queues."

The application of system dynamics modelling to environmental health decision-making and policy - a scoping review.

PubMed

Currie, Danielle J; Smith, Carl; Jagals, Paul

2018-03-27

Policy and decision-making processes are routinely challenged by the complex and dynamic nature of environmental health problems. System dynamics modelling has demonstrated considerable value across a number of different fields to help decision-makers understand and predict the dynamic behaviour of complex systems in support the development of effective policy actions. In this scoping review we investigate if, and in what contexts, system dynamics modelling is being used to inform policy or decision-making processes related to environmental health. Four electronic databases and the grey literature were systematically searched to identify studies that intersect the areas environmental health, system dynamics modelling, and decision-making. Studies identified in the initial screening were further screened for their contextual, methodological and application-related relevancy. Studies deemed 'relevant' or 'highly relevant' according to all three criteria were included in this review. Key themes related to the rationale, impact and limitation of using system dynamics in the context of environmental health decision-making and policy were analysed. We identified a limited number of relevant studies (n = 15), two-thirds of which were conducted between 2011 and 2016. The majority of applications occurred in non-health related sectors (n = 9) including transportation, public utilities, water, housing, food, agriculture, and urban and regional planning. Applications were primarily targeted at micro-level (local, community or grassroots) decision-making processes (n = 9), with macro-level (national or international) decision-making to a lesser degree. There was significant heterogeneity in the stated rationales for using system dynamics and the intended impact of the system dynamics model on decision-making processes. A series of user-related, technical and application-related limitations and challenges were identified. None of the reported limitations or challenges appeared unique to the application of system dynamics within the context of environmental health problems, but rather to the use of system dynamics in general. This review reveals that while system dynamics modelling is increasingly being used to inform decision-making related to environmental health, applications are currently limited. Greater application of system dynamics within this context is needed before its benefits and limitations can be fully understood.

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

USGS Publications Warehouse

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

2013-01-01

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

Accuracy and reliability of forensic latent fingerprint decisions

PubMed Central

Ulery, Bradford T.; Hicklin, R. Austin; Buscaglia, JoAnn; Roberts, Maria Antonia

2011-01-01

The interpretation of forensic fingerprint evidence relies on the expertise of latent print examiners. The National Research Council of the National Academies and the legal and forensic sciences communities have called for research to measure the accuracy and reliability of latent print examiners’ decisions, a challenging and complex problem in need of systematic analysis. Our research is focused on the development of empirical approaches to studying this problem. Here, we report on the first large-scale study of the accuracy and reliability of latent print examiners’ decisions, in which 169 latent print examiners each compared approximately 100 pairs of latent and exemplar fingerprints from a pool of 744 pairs. The fingerprints were selected to include a range of attributes and quality encountered in forensic casework, and to be comparable to searches of an automated fingerprint identification system containing more than 58 million subjects. This study evaluated examiners on key decision points in the fingerprint examination process; procedures used operationally include additional safeguards designed to minimize errors. Five examiners made false positive errors for an overall false positive rate of 0.1%. Eighty-five percent of examiners made at least one false negative error for an overall false negative rate of 7.5%. Independent examination of the same comparisons by different participants (analogous to blind verification) was found to detect all false positive errors and the majority of false negative errors in this study. Examiners frequently differed on whether fingerprints were suitable for reaching a conclusion. PMID:21518906

Accuracy and reliability of forensic latent fingerprint decisions.

PubMed

Ulery, Bradford T; Hicklin, R Austin; Buscaglia, Joann; Roberts, Maria Antonia

2011-05-10

The interpretation of forensic fingerprint evidence relies on the expertise of latent print examiners. The National Research Council of the National Academies and the legal and forensic sciences communities have called for research to measure the accuracy and reliability of latent print examiners' decisions, a challenging and complex problem in need of systematic analysis. Our research is focused on the development of empirical approaches to studying this problem. Here, we report on the first large-scale study of the accuracy and reliability of latent print examiners' decisions, in which 169 latent print examiners each compared approximately 100 pairs of latent and exemplar fingerprints from a pool of 744 pairs. The fingerprints were selected to include a range of attributes and quality encountered in forensic casework, and to be comparable to searches of an automated fingerprint identification system containing more than 58 million subjects. This study evaluated examiners on key decision points in the fingerprint examination process; procedures used operationally include additional safeguards designed to minimize errors. Five examiners made false positive errors for an overall false positive rate of 0.1%. Eighty-five percent of examiners made at least one false negative error for an overall false negative rate of 7.5%. Independent examination of the same comparisons by different participants (analogous to blind verification) was found to detect all false positive errors and the majority of false negative errors in this study. Examiners frequently differed on whether fingerprints were suitable for reaching a conclusion.

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

PubMed

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

2014-07-01

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

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

PubMed Central

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

2014-01-01

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

A unified framework for addiction: Vulnerabilities in the decision process

PubMed Central

Redish, A. David; Jensen, Steve; Johnson, Adam

2013-01-01

The understanding of decision-making systems has come together in recent years to form a unified theory of decision-making in the mammalian brain as arising from multiple, interacting systems (a planning system, a habit system, and a situation-recognition system). This unified decision-making system has multiple potential access points through which it can be driven to make maladaptive choices, particularly choices that entail seeking of certain drugs or behaviors. We identify 10 key vulnerabilities in the system: (1) moving away from homeostasis, (2) changing allostatic set points, (3) euphorigenic “reward-like” signals, (4) overvaluation in the planning system, (5) incorrect search of situation-action-outcome relationships, (6) misclassification of situations, (7) overvaluation in the habit system, (8) a mismatch in the balance of the two decision systems, (9) over-fast discounting processes, and (10) changed learning rates. These vulnerabilities provide a taxonomy of potential problems with decision-making systems. Although each vulnerability can drive an agent to return to the addictive choice, each vulnerability also implies a characteristic symptomology. Different drugs, different behaviors, and different individuals are likely to access different vulnerabilities. This has implications for an individual’s susceptibility to addiction and the transition to addiction, for the potential for relapse, and for the potential for treatment. PMID:18662461

Using cognitive task analysis to identify critical decisions in the laparoscopic environment.

PubMed

Craig, Curtis; Klein, Martina I; Griswold, John; Gaitonde, Krishnanath; McGill, Thomas; Halldorsson, Ari

2012-12-01

The aim of this study was to identify the critical decisions surgeons need to make regarding laparoscopic surgery, the information these decisions are based on, the strategies employed by surgeons to reach their objectives, and the difficulties experienced by novices. Laparoscopic training focuses on the development of technical skills. However, successful surgical outcomes are also dependent on appropriate decisions made during surgery, which are influenced by critical cues and the use of appropriate strategies. Novices might not be as adept at cue detection and strategy use. Participants were eight attending surgeons. The authors employed task-analytic techniques to identify critical decisions inherent in laparoscopy and the cues, strategies, and novice traps associated with these decisions. The authors used decision requirements tables to organize the data into the key decisions made during the preoperative, operative, and postoperative phases as well as the cues, strategies, and novice traps associated with these decisions. Key decisions identified for the preoperative phase included but were not limited to the decision of performing a laparoscopic versus open surgery, necessity to review the literature, practicing the procedure, and trocar placement. Some key decisions identified for the operative phase included converting to open surgery, performing angiograms, cutting tissue or organs, and reevaluation of the approach. Only one key decision was identified for the postoperative phrase: whether the surgeon's technique needs to be evaluated and revised. The laparoscopic environment requires complex decision making, and novices are prone to errors in their decisions. The information elicited in this study is applicable to laparoscopic training.

Simulation reduction using the Taguchi method

NASA Technical Reports Server (NTRS)

Mistree, Farrokh; Lautenschlager, Ume; Erikstad, Stein Owe; Allen, Janet K.

1993-01-01

A large amount of engineering effort is consumed in conducting experiments to obtain information needed for making design decisions. Efficiency in generating such information is the key to meeting market windows, keeping development and manufacturing costs low, and having high-quality products. The principal focus of this project is to develop and implement applications of Taguchi's quality engineering techniques. In particular, we show how these techniques are applied to reduce the number of experiments for trajectory simulation of the LifeSat space vehicle. Orthogonal arrays are used to study many parameters simultaneously with a minimum of time and resources. Taguchi's signal to noise ratio is being employed to measure quality. A compromise Decision Support Problem and Robust Design are applied to demonstrate how quality is designed into a product in the early stages of designing.

Impacts of Lateral Boundary Conditions on US Ozone ...

EPA Pesticide Factsheets

Chemical boundary conditions are a key input to regional-scale photochemical models. In this study, we perform annual simulations over North America with chemical boundary conditions prepared from two global models (GEOS-CHEM and Hemispheric CMAQ). Results indicate that the impacts of different boundary conditions on ozone can be significant throughout the year. The National Exposure Research Laboratory (NERL) Computational Exposure Division (CED) develops and evaluates data, decision-support tools, and models to be applied to media-specific or receptor-specific problem areas. CED uses modeling-based approaches to characterize exposures, evaluate fate and transport, and support environmental diagnostics/forensics with input from multiple data sources. It also develops media- and receptor-specific models, process models, and decision support tools for use both within and outside of EPA.

Strategic and non-strategic problem gamblers differ on decision-making under risk and ambiguity.

PubMed

Lorains, Felicity K; Dowling, Nicki A; Enticott, Peter G; Bradshaw, John L; Trueblood, Jennifer S; Stout, Julie C

2014-07-01

To analyse problem gamblers' decision-making under conditions of risk and ambiguity, investigate underlying psychological factors associated with their choice behaviour and examine whether decision-making differed in strategic (e.g., sports betting) and non-strategic (e.g., electronic gaming machine) problem gamblers. Cross-sectional study. Out-patient treatment centres and university testing facilities in Victoria, Australia. Thirty-nine problem gamblers and 41 age, gender and estimated IQ-matched controls. Decision-making tasks included the Iowa Gambling Task (IGT) and a loss aversion task. The Prospect Valence Learning (PVL) model was used to provide an explanation of cognitive, motivational and response style factors involved in IGT performance. Overall, problem gamblers performed more poorly than controls on both the IGT (P = 0.04) and the loss aversion task (P = 0.01), and their IGT decisions were associated with heightened attention to gains (P = 0.003) and less consistency (P = 0.002). Strategic problem gamblers did not differ from matched controls on either decision-making task, but non-strategic problem gamblers performed worse on both the IGT (P = 0.006) and the loss aversion task (P = 0.02). Furthermore, we found differences in the PVL model parameters underlying strategic and non-strategic problem gamblers' choices on the IGT. Problem gamblers demonstrated poor decision-making under conditions of risk and ambiguity. Strategic (e.g. sports betting, poker) and non-strategic (e.g. electronic gaming machines) problem gamblers differed in decision-making and the underlying psychological processes associated with their decisions. © 2014 Society for the Study of Addiction.

Designing for Decision Making

ERIC Educational Resources Information Center

Jonassen, David H.

2012-01-01

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

A Monte-Carlo game theoretic approach for Multi-Criteria Decision Making under uncertainty

NASA Astrophysics Data System (ADS)

Madani, Kaveh; Lund, Jay R.

2011-05-01

Game theory provides a useful framework for studying Multi-Criteria Decision Making problems. This paper suggests modeling Multi-Criteria Decision Making problems as strategic games and solving them using non-cooperative game theory concepts. The suggested method can be used to prescribe non-dominated solutions and also can be used as a method to predict the outcome of a decision making problem. Non-cooperative stability definitions for solving the games allow consideration of non-cooperative behaviors, often neglected by other methods which assume perfect cooperation among decision makers. To deal with the uncertainty in input variables a Monte-Carlo Game Theory (MCGT) approach is suggested which maps the stochastic problem into many deterministic strategic games. The games are solved using non-cooperative stability definitions and the results include possible effects of uncertainty in input variables on outcomes. The method can handle multi-criteria multi-decision-maker problems with uncertainty. The suggested method does not require criteria weighting, developing a compound decision objective, and accurate quantitative (cardinal) information as it simplifies the decision analysis by solving problems based on qualitative (ordinal) information, reducing the computational burden substantially. The MCGT method is applied to analyze California's Sacramento-San Joaquin Delta problem. The suggested method provides insights, identifies non-dominated alternatives, and predicts likely decision outcomes.

Application of household production theory to selected natural-resource problems in less-developed countries

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

Mercer, D.E.

The objectives are threefold: (1) to perform an analytical survey of household production theory as it relates to natural-resource problems in less-developed countries, (2) to develop a household production model of fuelwood decision making, (3) to derive a theoretical framework for travel-cost demand studies of international nature tourism. The model of household fuelwood decision making provides a rich array of implications and predictions for empirical analysis. For example, it is shown that fuelwood and modern fuels may be either substitutes or complements depending on the interaction of the gross-substitution and income-expansion effects. Therefore, empirical analysis should precede adoption of anymore » inter-fuel substitution policies such as subsidizing kerosene. The fuelwood model also provides a framework for analyzing the conditions and factors determining entry and exit by households into the wood-burning subpopulation, a key for designing optimal household energy policies in the Third World. The international nature tourism travel cost model predicts that the demand for nature tourism is an aggregate of the demand for the individual activities undertaken during the trip.« less

Efficient Workflows for Curation of Heterogeneous Data Supporting Modeling of U-Nb Alloy Aging

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

Ward, Logan Timothy; Hackenberg, Robert Errol

These are slides from a presentation summarizing a graduate research associate's summer project. The following topics are covered in these slides: data challenges in materials, aging in U-Nb Alloys, Building an Aging Model, Different Phase Trans. in U-Nb, the Challenge, Storing Materials Data, Example Data Source, Organizing Data: What is a Schema?, What does a "XML Schema" look like?, Our Data Schema: Nice and Simple, Storing Data: Materials Data Curation System (MDCS), Problem with MDCS: Slow Data Entry, Getting Literature into MDCS, Staging Data in Excel Document, Final Result: MDCS Records, Analyzing Image Data, Process for Making TTT Diagram, Bottleneckmore » Number 1: Image Analysis, Fitting a TTP Boundary, Fitting a TTP Curve: Comparable Results, How Does it Compare to Our Data?, Image Analysis Workflow, Curating Hardness Records, Hardness Data: Two Key Decisions, Before Peak Age? - Automation, Interactive Viz, Which Transformation?, Microstructure-Informed Model, Tracking the Entire Process, General Problem with Property Models, Pinyon: Toolkit for Managing Model Creation, Tracking Individual Decisions, Jupyter: Docs and Code in One File, Hardness Analysis Workflow, Workflow for Aging Models, and conclusions.« less

Budget- and Priority-Setting Criteria at State Health Agencies in Times of Austerity: A Mixed-Methods Study

PubMed Central

Resnick, Beth; Kass, Nancy; Sellers, Katie; Young, Jessica; Bernet, Patrick; Jarris, Paul

2014-01-01

Objectives. We examined critical budget and priority criteria for state health agencies to identify likely decision-making factors, pressures, and opportunities in times of austerity. Methods. We have presented findings from a 2-stage, mixed-methods study with state public health leaders regarding public health budget- and priority-setting processes. In stage 1, we conducted hour-long interviews in 2011 with 45 health agency executive and division or bureau leaders from 6 states. Stage 2 was an online survey of 207 executive and division or bureau leaders from all state health agencies (66% response rate). Results. Respondents identified 5 key criteria: whether a program was viewed as “mission critical,” the seriousness of the consequences of not funding the program, financing considerations, external directives and mandates, and the magnitude of the problem the program addressed. Conclusions. We have presented empirical findings on criteria used in state health agency budgetary decision-making. These criteria suggested a focus and interest on core public health and the largest public health problems with the most serious ramifications. PMID:24825212

Budget- and priority-setting criteria at state health agencies in times of austerity: a mixed-methods study.

PubMed

Leider, Jonathon P; Resnick, Beth; Kass, Nancy; Sellers, Katie; Young, Jessica; Bernet, Patrick; Jarris, Paul

2014-06-01

We examined critical budget and priority criteria for state health agencies to identify likely decision-making factors, pressures, and opportunities in times of austerity. We have presented findings from a 2-stage, mixed-methods study with state public health leaders regarding public health budget- and priority-setting processes. In stage 1, we conducted hour-long interviews in 2011 with 45 health agency executive and division or bureau leaders from 6 states. Stage 2 was an online survey of 207 executive and division or bureau leaders from all state health agencies (66% response rate). Respondents identified 5 key criteria: whether a program was viewed as "mission critical," the seriousness of the consequences of not funding the program, financing considerations, external directives and mandates, and the magnitude of the problem the program addressed. We have presented empirical findings on criteria used in state health agency budgetary decision-making. These criteria suggested a focus and interest on core public health and the largest public health problems with the most serious ramifications.

A Tentative Organizational Schema for Decision-Making Problems.

ERIC Educational Resources Information Center

Osborn, William C.; Goodman, Barbara Ettinger

This report presents the results of research that examined widely diverse decision problems and attempted to specify their common behavior elements. To take into account the psychological complexity of most real-life decision problems, and to develop a tentative organization of decision behavior that will embrace the many, highly diverse types of…

Training conservation practitioners to be better decision makers

USGS Publications Warehouse

Johnson, Fred A.; Eaton, Mitchell J.; Williams, James H.; Jensen, Gitte H.; Madsen, Jesper

2015-01-01

Traditional conservation curricula and training typically emphasizes only one part of systematic decision making (i.e., the science), at the expense of preparing conservation practitioners with critical skills in values-setting, working with decision makers and stakeholders, and effective problem framing. In this article we describe how the application of decision science is relevant to conservation problems and suggest how current and future conservation practitioners can be trained to be better decision makers. Though decision-analytic approaches vary considerably, they all involve: (1) properly formulating the decision problem; (2) specifying feasible alternative actions; and (3) selecting criteria for evaluating potential outcomes. Two approaches are available for providing training in decision science, with each serving different needs. Formal education is useful for providing simple, well-defined problems that allow demonstrations of the structure, axioms and general characteristics of a decision-analytic approach. In contrast, practical training can offer complex, realistic decision problems requiring more careful structuring and analysis than those used for formal training purposes. Ultimately, the kinds and degree of training necessary depend on the role conservation practitioners play in a decision-making process. Those attempting to facilitate decision-making processes will need advanced training in both technical aspects of decision science and in facilitation techniques, as well as opportunities to apprentice under decision analysts/consultants. Our primary goal should be an attempt to ingrain a discipline for applying clarity of thought to all decisions.

Transforming Social Regularities in a Multicomponent Community-Based Intervention: A Case Study of Professionals' Adaptability to Better Support Parents to Meet Their Children's Needs.

PubMed

Quiroz Saavedra, Rodrigo; Brunson, Liesette; Bigras, Nathalie

2017-06-01

This paper presents an in-depth case study of the dynamic processes of mutual adjustment that occurred between two professional teams participating in a multicomponent community-based intervention (CBI). Drawing on the concept of social regularities, we focus on patterns of social interaction within and across the two microsystems involved in delivering the intervention. Two research strategies, narrative analysis and structural network analysis, were used to reveal the social regularities linking the two microsystems. Results document strategies and actions undertaken by the professionals responsible for the intervention to modify intersetting social regularities to deal with a problem situation that arose during the course of one intervention cycle. The results illustrate how key social regularities were modified in order to resolve the problem situation and allow the intervention to continue to function smoothly. We propose that these changes represent a transition to a new state of the ecological intervention system. This transformation appeared to be the result of certain key intervening mechanisms: changing key role relationships, boundary spanning, and synergy. The transformation also appeared to be linked to positive setting-level and individual-level outcomes: confidence of key team members, joint planning, decision-making and intervention activities, and the achievement of desired intervention objectives. © Society for Community Research and Action 2017.

Health-care process improvement decisions: a systems perspective.

PubMed

Walley, Paul; Silvester, Kate; Mountford, Shaun

2006-01-01

The paper seeks to investigate decision-making processes within hospital improvement activity, to understand how performance measurement systems influence decisions and potentially lead to unsuccessful or unsustainable process changes. A longitudinal study over a 33-month period investigates key events, decisions and outcomes at one medium-sized hospital in the UK. Process improvement events are monitored using process control methods and by direct observation. The authors took a systems perspective of the health-care processes, ensuring that the impacts of decisions across the health-care supply chain were appropriately interpreted. The research uncovers the ways in which measurement systems disguise failed decisions and encourage managers to take a low-risk approach of "symptomatic relief" when trying to improve performance metrics. This prevents many managers from trying higher risk, sustainable process improvement changes. The behaviour of the health-care system is not understood by many managers and this leads to poor analysis of problem situations. Measurement using time-series methodologies, such as statistical process control are vital for a better understanding of the systems impact of changes. Senior managers must also be aware of the behavioural influence of similar performance measurement systems that discourage sustainable improvement. There is a risk that such experiences will tarnish the reputation of performance management as a discipline. Recommends process control measures as a way of creating an organization memory of how decisions affect performance--something that is currently lacking.

Merging spatially variant physical process models under an optimized systems dynamics framework.

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

Cain, William O.; Lowry, Thomas Stephen; Pierce, Suzanne A.

The complexity of water resource issues, its interconnectedness to other systems, and the involvement of competing stakeholders often overwhelm decision-makers and inhibit the creation of clear management strategies. While a range of modeling tools and procedures exist to address these problems, they tend to be case specific and generally emphasize either a quantitative and overly analytic approach or present a qualitative dialogue-based approach lacking the ability to fully explore consequences of different policy decisions. The integration of these two approaches is needed to drive toward final decisions and engender effective outcomes. Given these limitations, the Computer Assisted Dispute Resolution systemmore » (CADRe) was developed to aid in stakeholder inclusive resource planning. This modeling and negotiation system uniquely addresses resource concerns by developing a spatially varying system dynamics model as well as innovative global optimization search techniques to maximize outcomes from participatory dialogues. Ultimately, the core system architecture of CADRe also serves as the cornerstone upon which key scientific innovation and challenges can be addressed.« less

[Women's health in violent situations: municipal administrative roles and decision-making in the Brazilian public health system].

PubMed

Porto, Madge; McCallum, Cecilia; Scott, Russell Parry; de Morais, Heloísa M Mendonça

2003-01-01

The aim of this study was to investigate the role of health management staff concerning the health of women facing violent situations and the impact these roles have on decisions concerning health measures targeting these women. The study employed a qualitative, descriptive methodology including 18 health management staff members from three municipalities classified as having fully autonomous municipal management systems under the Unified National Health System (SUS) in Greater Metropolitan Recife, Pernambuco State, Brazil. Staff members were divided into three distinct groups according to their opinions on women in violent situations and women's health interventions. However, the three groups were convergent with respect to their roles in determining decisions on health actions for these women. The health management staff's commitment to the feminist movement proved to be the most relevant factor. Common issues among staff members, such as the problem of public health and quality of living, or more technically, the cost-benefit issue, did appear as key arguments.

Adaptive Management: From More Talk to Real Action

NASA Astrophysics Data System (ADS)

Williams, Byron K.; Brown, Eleanor D.

2014-02-01

The challenges currently facing resource managers are large-scale and complex, and demand new approaches to balance development and conservation goals. One approach that shows considerable promise for addressing these challenges is adaptive management, which by now is broadly seen as a natural, intuitive, and potentially effective way to address decision-making in the face of uncertainties. Yet the concept of adaptive management continues to evolve, and its record of success remains limited. In this article, we present an operational framework for adaptive decision-making, and describe the challenges and opportunities in applying it to real-world problems. We discuss the key elements required for adaptive decision-making, and their integration into an iterative process that highlights and distinguishes technical and social learning. We illustrate the elements and processes of the framework with some successful on-the-ground examples of natural resource management. Finally, we address some of the difficulties in applying learning-based management, and finish with a discussion of future directions and strategic challenges.

Clarification process: Resolution of decision-problem conditions

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

A model of a general process which occurs in both decisionmaking and problem-solving tasks is presented. It is called the clarification model and is highly dependent on information flow. The model addresses the possible constraints of individual indifferences and experience in achieving success in resolving decision-problem conditions. As indicated, the application of the clarification process model is only necessary for certain classes of the basic decision-problem condition. With less complex decision problem conditions, certain phases of the model may be omitted. The model may be applied across a wide range of decision problem conditions. The model consists of two major components: (1) the five-phase prescriptive sequence (based on previous approaches to both concepts) and (2) the information manipulation function (which draws upon current ideas in the areas of information processing, computer programming, memory, and thinking). The two components are linked together to provide a structure that assists in understanding the process of resolving problems and making decisions.

Decisions to Attend and Drink at Party Events: The Effects of Incentives and Disincentives and Lifetime Alcohol and Antisocial Problems.

PubMed

Finn, Peter R; Gerst, Kyle; Lake, Allison; Bogg, Tim

2017-09-01

Alcohol use disorders are associated with patterns of impulsive/risky decision making on behavioral economic decision tasks, but little is known about the factors affecting drinking-related decisions. The effects of incentives and disincentives to attend and drink at hypothetical alcohol-related party events as a function of lifetime (LT) alcohol and antisocial problems were examined in a sample of 434 young adults who varied widely in LT alcohol and antisocial problems. Moderate and high disincentives substantially discouraged decisions to attend the party events and were associated with decisions to drink less at the party events. High versus low party incentives were associated with more attendance decisions. LT antisocial problems were associated with being less deterred from attending by moderate and high disincentives. LT alcohol problems were associated with greater attendance at high party incentive contexts. LT alcohol problems were associated with drinking more at the majority of events; however, the results indicate that young adults with high levels of alcohol problems moderate their drinking in response to moderate and high disincentives. Finally, attendance and drinking decisions on this hypothetical task were significantly related to actual drinking practices. The results suggest that antisocial symptoms are associated with a reduced sensitivity to the potential negative consequences of drinking, while alcohol problems are associated with a greater sensitivity to the rewarding aspects of partying. The results also underline the value of directly assessing drinking-related decisions in different hypothetical contexts as well as assessing decisions about attendance at risky drinking events in addition to drinking amount decisions. Copyright © 2017 by the Research Society on Alcoholism.

Channelling information flows from observation to decision; or how to increase certainty

NASA Astrophysics Data System (ADS)

Weijs, S. V.

2015-12-01

To make adequate decisions in an uncertain world, information needs to reach the decision problem, to enable overseeing the full consequences of each possible decision.On its way from the physical world to a decision problem, information is transferred through the physical processes that influence the sensor, then through processes that happen in the sensor, through wires or electromagnetic waves. For the last decade, most information becomes digitized at some point. From moment of digitization, information can in principle be transferred losslessly. Information about the physical world is often also stored, sometimes in compressed form, such as physical laws, concepts, or models of specific hydrological systems. It is important to note, however, that all information about a physical system eventually has to originate from observation (although inevitably coloured by some prior assumptions). This colouring makes the compression lossy, but is effectively the only way to make use of similarities in time and space that enable predictions while measuring only a a few macro-states of a complex hydrological system.Adding physical process knowledge to a hydrological model can thus be seen as a convenient way to transfer information from observations from a different time or place, to make predictions about another situation, assuming the same dynamics are at work.The key challenge to achieve more certainty in hydrological prediction can therefore be formulated as a challenge to tap and channel information flows from the environment. For tapping more information flows, new measurement techniques, large scale campaigns, historical data sets, and large sample hydrology and regionalization efforts can bring progress. For channelling the information flows with minimum loss, model calibration, and model formulation techniques should be critically investigated. Some experience from research in a Swiss high alpine catchment are used as an illustration.

Deciding on Science: An Analysis of Higher Education Science Student Major Choice Criteria

NASA Astrophysics Data System (ADS)

White, Stephen Wilson

The number of college students choosing to major in science, technology, engineering, and math (STEM) in the United States affects the size and quality of the American workforce (Winters, 2009). The number of graduates in these academic fields has been on the decline in the United States since the 1960s, which, according to Lips and McNeil (2009), has resulted in a diminished ability of the United States to compete in science and engineering on the world stage. The purpose of this research was to learn why students chose a STEM major and determine what decision criteria influenced this decision. According to Ajzen's (1991) theory of planned behavior (TPB), the key components of decision-making can be quantified and used as predictors of behavior. In this study the STEM majors' decision criteria were compared between different institution types (two-year, public four-year, and private four-year), and between demographic groups (age and sex). Career, grade, intrinsic, self-efficacy, and self-determination were reported as motivational factors by a majority of science majors participating in this study. Few students reported being influenced by friends and family when deciding to major in science. Science students overwhelmingly attributed the desire to solve meaningful problems as central to their decision to major in science. A majority of students surveyed credited a teacher for influencing their desire to pursue science as a college major. This new information about the motivational construct of the studied group of science majors can be applied to the previously stated problem of not enough STEM majors in the American higher education system to provide workers required to fill the demand of a globally STEM-competitive United States (National Academy of Sciences, National Academy of Engineering, & Institute of Medicine, 2010).

Establishing the effectiveness of patient decision aids: key constructs and measurement instruments

PubMed Central

2013-01-01

Background Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. Methods This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration’s review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. Results The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study reported on all key decision-making process and decision quality constructs. Conclusions Evidence of PtDA effectiveness in improving the quality of the decision-making process and decision quality is strong and growing. There is not, however, consensus or standardization of measurement for either the decision-making process or decision quality. Additional work is needed to develop and evaluate measurement instruments and further explore theoretical issues to advance future research on PtDA effectiveness. PMID:24625035

Establishing the effectiveness of patient decision aids: key constructs and measurement instruments.

PubMed

Sepucha, Karen R; Borkhoff, Cornelia M; Lally, Joanne; Levin, Carrie A; Matlock, Daniel D; Ng, Chirk Jenn; Ropka, Mary E; Stacey, Dawn; Joseph-Williams, Natalie; Wills, Celia E; Thomson, Richard

2013-01-01

Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration's review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study reported on all key decision-making process and decision quality constructs. Evidence of PtDA effectiveness in improving the quality of the decision-making process and decision quality is strong and growing. There is not, however, consensus or standardization of measurement for either the decision-making process or decision quality. Additional work is needed to develop and evaluate measurement instruments and further explore theoretical issues to advance future research on PtDA effectiveness.

Decision-Making Styles and Problem-Solving Appraisal.

ERIC Educational Resources Information Center

Phillips, Susan D.; And Others

1984-01-01

Compared decision-making style and problem-solving appraisal in 243 undergraduates. Results suggested that individuals who employ rational decision-making strategies approach problematic situations, while individuals who endorse dependent decisional strategies approach problematic situations without confidence in their problem-solving abilities.…

Robust optimization modelling with applications to industry and environmental problems

NASA Astrophysics Data System (ADS)

Chaerani, Diah; Dewanto, Stanley P.; Lesmana, Eman

2017-10-01

Robust Optimization (RO) modeling is one of the existing methodology for handling data uncertainty in optimization problem. The main challenge in this RO methodology is how and when we can reformulate the robust counterpart of uncertain problems as a computationally tractable optimization problem or at least approximate the robust counterpart by a tractable problem. Due to its definition the robust counterpart highly depends on how we choose the uncertainty set. As a consequence we can meet this challenge only if this set is chosen in a suitable way. The development on RO grows fast, since 2004, a new approach of RO called Adjustable Robust Optimization (ARO) is introduced to handle uncertain problems when the decision variables must be decided as a ”wait and see” decision variables. Different than the classic Robust Optimization (RO) that models decision variables as ”here and now”. In ARO, the uncertain problems can be considered as a multistage decision problem, thus decision variables involved are now become the wait and see decision variables. In this paper we present the applications of both RO and ARO. We present briefly all results to strengthen the importance of RO and ARO in many real life problems.

Study on Amortization Time and Rationality in Real Estate Investment

NASA Astrophysics Data System (ADS)

Li, Yancang; Zhou, Shujing; Suo, Juanjuan

Amortization time and rationality has been discussed a lot in real estate investment research. As the price of real estate is driven by Geometric Brown Motion (GBM), whether the mortgagors should amortize in advance has become a key issue in amortization time research. This paper presents a new method to solve the problem by using the optimal stopping time theory and option pricing theory models. We discuss the option value in amortizing decision based on this model. A simulation method is used to test this method.

[Connections between sleep and Alzheimer's disease : Insomnia, amnesia and amyloid].

PubMed

Busche, M A; Kekuš, M; Förstl, H

2017-03-01

Sleep plays an essential role in memory consolidation. Although sleep problems are common in Alzheimer's disease, they are not usually thought to be key features of the disease; however, new experimental research has shown that sleep disturbances not only occur before the onset of typical cognitive deficits but are also associated with the pathogenesis of Alzheimer's disease and may have a decisive influence on the symptoms and course. Thus, sleep disturbances may be potentially modifiable risk factors for Alzheimer's disease that deserve more attention in research, diagnostics and treatment.

Children as agents of change in combatting antibiotic resistance.

PubMed

Molnar, Andreea

2017-01-01

Antibiotic resistance is a worldwide problem and changes are needed in the way antibiotics are used. The value of engaging children as key contributors in health care campaigns to increase the appropriate use of antibiotics has not been fully recognized. Little is known about how to design educational materials for children in order to enable them to be agents of change in their communities. Science education needs to improve the way it engages children so as to give them the tools needed to make responsible decisions on antibiotic use.

Decision-problem state analysis methodology

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

A methodology for analyzing a decision-problem state is presented. The methodology is based on the analysis of an incident in terms of the set of decision-problem conditions encountered. By decomposing the events that preceded an unwanted outcome, such as an accident, into the set of decision-problem conditions that were resolved, a more comprehensive understanding is possible. All human-error accidents are not caused by faulty decision-problem resolutions, but it appears to be one of the major areas of accidents cited in the literature. A three-phase methodology is presented which accommodates a wide spectrum of events. It allows for a systems content analysis of the available data to establish: (1) the resolutions made, (2) alternatives not considered, (3) resolutions missed, and (4) possible conditions not considered. The product is a map of the decision-problem conditions that were encountered as well as a projected, assumed set of conditions that should have been considered. The application of this methodology introduces a systematic approach to decomposing the events that transpired prior to the accident. The initial emphasis is on decision and problem resolution. The technique allows for a standardized method of accident into a scenario which may used for review or the development of a training simulation.

Exploring the future with anticipatory networks

NASA Astrophysics Data System (ADS)

Skulimowski, A. M. J.

2013-01-01

This paper presents a theory of anticipatory networks that originates from anticipatory models of consequences in multicriteria decision problems. When making a decision, the decision maker takes into account the anticipated outcomes of each future decision problem linked by the causal relations with the present one. In a network of linked decision problems, the causal relations are defined between time-ordered nodes. The scenarios of future consequences of each decision are modeled by multiple vertices starting from an appropriate node. The network is supplemented by one or more relations of anticipation, or future feedback, which describe a situation where decision makers take into account the anticipated results of some future optimization problems while making their choice. So arises a multigraph of decision problems linked causally and by one or more anticipation relation, termed here the anticipatory network. We will present the properties of anticipatory networks and propose a method of reducing, transforming and using them to solve current decision problems. Furthermore, it will be shown that most anticipatory networks can be regarded as superanticipatory systems, i.e. systems that are anticipatory in the Rosen sense and contain a future model of at least one other anticipatory system. The anticipatory networks can also be applied to filter the set of future scenarios in a foresight exercise.

Decision rules for allocation of finances to health systems strengthening

PubMed Central

Morton, Alec; Thomas, Ranjeeta; Smith, Peter C.

2017-01-01

A key dilemma in global health is how to allocate funds between disease-specific “vertical projects” on the one hand and “horizontal programmes” which aim to strengthen the entire health system on the other. While economic evaluation provides a way of approaching the prioritisation of vertical projects, it provides less guidance on how to prioritise between horizontal and vertical spending. We approach this problem by formulating a mathematical program which captures the complementary benefits of funding both vertical projects and horizontal programmes. We show that our solution to this math program has an appealing intuitive structure. We illustrate our model by computationally solving two specialised versions of this problem, with illustrations based on the problem of allocating funding for infectious diseases in sub-Saharan Africa. We conclude by reflecting on how such a model may be developed in the future and used to guide empirical data collection and theory development. PMID:27394006

Strengths and weaknesses of Problem Based Learning from the professional perspective of registered nurses.

PubMed

Cónsul-Giribet, María; Medina-Moya, José Luis

2014-10-01

To identify competency strengths and weaknesses as perceived by nursing professionals who graduated with a integrated curriculum and competency-based through Problem Based Learning in small groups. An intrinsic case study method was used, which analyzes this innovation through former students (from the first class) with three years of professional experience. The data were collected through a questionnaire and discussion groups. The results show that their competency level is valued in a very satisfactory manner. This level paradoxically contrasts with the lack of theoretical knowledge they perceived at the end of their education, when they started working in clinical practice. The teaching strategy was key to motivate an in-depth study and arouse the desire to know. In addition, Problem Based Learning favors and reinforces the decision to learn, which is that necessary in the course of professional life.

Strengths and weaknesses of Problem Based Learning from the professional perspective of registered nurses 1

PubMed Central

Cónsul-Giribet, María; Medina-Moya, José Luis

2014-01-01

OBJECTIVE: to identify competency strengths and weaknesses as perceived by nursing professionals who graduated with a integrated curriculum and competency-based through Problem Based Learning in small groups. METHOD: an intrinsic case study method was used, which analyzes this innovation through former students (from the first class) with three years of professional experience. The data were collected through a questionnaire and discussion groups. RESULTS: the results show that their competency level is valued in a very satisfactory manner. This level paradoxically contrasts with the lack of theoretical knowledge they perceived at the end of their education, when they started working in clinical practice. CONCLUSIONS: the teaching strategy was key to motivate an in-depth study and arouse the desire to know. In addition, Problem Based Learning favors and reinforces the decision to learn, which is that necessary in the course of professional life. PMID:25493666

The Students Decision Making in Solving Discount Problem

ERIC Educational Resources Information Center

Abdillah; Nusantara, Toto; Subanji; Susanto, Hery; Abadyo

2016-01-01

This research is reviewing students' process of decision making intuitively, analytically, and interactively. The research done by using discount problem which specially created to explore student's intuition, analytically, and interactively. In solving discount problems, researcher exploring student's decision in determining their attitude which…

From micronutrient recommendations to policy: consumer and stakeholder involvement.

PubMed

Timotijevic, L; Raats, M M; Barnett, J; Brown, K; Shepherd, R; Fernandez, L; Dömölki, L; Ruprich, J; Sonne, A-M; Hermoso, M; Koletzko, B; Frost-Andersen, L; Timmer, A

2010-06-01

To achieve the nutritional goals stipulated by micronutrient recommendations, greater attention must be paid to the behavioural routes to such nutritional outcomes. Coopting stakeholders and consumers into decisions regarding micronutrient recommendations is an important step towards achieving a greater link between micronutrient recommendations and behaviour. This study aims to examine the rationale and processes associated with consumer and stakeholder involvement in setting micronutrient recommendations across Europe. Using the contacts established through the Eurreca network of excellence (commissioned by the European Commission), the research involved in-depth desk research of key documents and communication channels linked to the process of setting micronutrient recommendations across seven countries: the United Kingdom, Norway, Denmark, Germany, Spain, the Czech Republic and Hungary. Stakeholder engagement is recognized by most countries as an important aspect of the process of setting micronutrient recommendations and their translation into policy, although there is notable variation in the extent to which this has been achieved across the seven countries and its effect on final decisions. Stakeholders were not involved at the outset of the process ('framing' of the problem) in any of the countries, and there was no evidence of consumer involvement and open public fora. Some of the key explanatory factors for diversity in the degree of involvement include historical sociopolitical context; the extent to which food and nutrition are key policy agenda; and the relative power of stakeholders in influencing food and nutrition policy.

Evaluation of a primary school drug drama project: methodological issues and key findings.

PubMed

Starkey, F; Orme, J

2001-10-01

This paper describes the impact evaluation of a primary school drug drama project developed by a health promotion service and a theatre's education department in England. The project targeted 10-11 year olds in 41 schools with an interactive drama production and workshop day on attitudes, choices, decisions and risks of alcohol, tobacco and illegal drug use. Parents were also involved in parents' evenings and watching children's performances. The research consisted of both process evaluation, consultation with pupils, teachers, parents, actors and health promotion staff on the project itself, and impact evaluation which looked at potential changes in children's knowledge, attitudes and decision-making skills. This paper reports findings of the impact evaluation, from six of the schools participating in the project. The impact evaluation consisted of pre- and post-project testing using a 'draw and write' and a problem-solving exercise. These findings suggest that the project had a significant impact on the children's knowledge of names of specific illegal drugs, and on their awareness that alcohol and cigarettes were also drugs, and secondly encouraged the children to think in less stereotypical terms about drugs and drug users. The problem-solving exercise, involving decision-making scenarios, showed small but positive trends between pre- and post-project solutions in more than half of the response categories. Methodological difficulties relating to evaluating such a project are discussed.

Cooperation, psychological game theory, and limitations of rationality in social interaction.

PubMed

Colman, Andrew M

2003-04-01

Rational choice theory enjoys unprecedented popularity and influence in the behavioral and social sciences, but it generates intractable problems when applied to socially interactive decisions. In individual decisions, instrumental rationality is defined in terms of expected utility maximization. This becomes problematic in interactive decisions, when individuals have only partial control over the outcomes, because expected utility maximization is undefined in the absence of assumptions about how the other participants will behave. Game theory therefore incorporates not only rationality but also common knowledge assumptions, enabling players to anticipate their co-players' strategies. Under these assumptions, disparate anomalies emerge. Instrumental rationality, conventionally interpreted, fails to explain intuitively obvious features of human interaction, yields predictions starkly at variance with experimental findings, and breaks down completely in certain cases. In particular, focal point selection in pure coordination games is inexplicable, though it is easily achieved in practice; the intuitively compelling payoff-dominance principle lacks rational justification; rationality in social dilemmas is self-defeating; a key solution concept for cooperative coalition games is frequently inapplicable; and rational choice in certain sequential games generates contradictions. In experiments, human players behave more cooperatively and receive higher payoffs than strict rationality would permit. Orthodox conceptions of rationality are evidently internally deficient and inadequate for explaining human interaction. Psychological game theory, based on nonstandard assumptions, is required to solve these problems, and some suggestions along these lines have already been put forward.

Health policy in a new key: setting democratic priorities.

PubMed

Jennings, B

1993-01-01

Health policy in the United States is entering an era in which explicitly value-based allocation decisions require direct attention. Policies concerning access to care, financing, and utilization management will necessarily have redistributive effects. For these policies to command social legitimacy and political support, some consensus will have to emerge around the values and ideals justifying these policies. This article addresses the problems of conceptual clarification and democratic process raised by the prospect of an explicitly value-based allocation policy. It offers a conceptual matrix distinguishing the scope of the issue of allocation in health care. Drawing on the activities of community health decisions projects in several states, it also offers suggestions about building a participatory and educational process at the grassroots level that might lead to a democratic consensus suitable for guiding policy choice.

Finding the numerical compensation in multiple criteria decision-making problems under fuzzy environment

NASA Astrophysics Data System (ADS)

Gupta, Mahima; Mohanty, B. K.

2017-04-01

In this paper, we have developed a methodology to derive the level of compensation numerically in multiple criteria decision-making (MCDM) problems under fuzzy environment. The degree of compensation is dependent on the tranquility and anxiety level experienced by the decision-maker while taking the decision. Higher tranquility leads to the higher realisation of the compensation whereas the increased level of anxiety reduces the amount of compensation in the decision process. This work determines the level of tranquility (or anxiety) using the concept of fuzzy sets and its various level sets. The concepts of indexing of fuzzy numbers, the risk barriers and the tranquility level of the decision-maker are used to derive his/her risk prone or risk averse attitude of decision-maker in each criterion. The aggregation of the risk levels in each criterion gives us the amount of compensation in the entire MCDM problem. Inclusion of the compensation leads us to model the MCDM problem as binary integer programming problem (BIP). The solution to BIP gives us the compensatory decision to MCDM. The proposed methodology is illustrated through a numerical example.

Patients' ratings of genetic conditions validate a taxonomy to simplify decisions about preconception carrier screening via genome sequencing.

PubMed

Leo, Michael C; McMullen, Carmit; Wilfond, Benjamin S; Lynch, Frances L; Reiss, Jacob A; Gilmore, Marian J; Himes, Patricia; Kauffman, Tia L; Davis, James V; Jarvik, Gail P; Berg, Jonathan S; Harding, Cary; Kennedy, Kathleen A; Simpson, Dana Kostiner; Quigley, Denise I; Richards, C Sue; Rope, Alan F; Goddard, Katrina A B

2016-03-01

Advances in genome sequencing and gene discovery have created opportunities to efficiently assess more genetic conditions than ever before. Given the large number of conditions that can be screened, the implementation of expanded carrier screening using genome sequencing will require practical methods of simplifying decisions about the conditions for which patients want to be screened. One method to simplify decision making is to generate a taxonomy based on expert judgment. However, expert perceptions of condition attributes used to classify these conditions may differ from those used by patients. To understand whether expert and patient perceptions differ, we asked women who had received preconception genetic carrier screening in the last 3 years to fill out a survey to rate the attributes (predictability, controllability, visibility, and severity) of several autosomal recessive or X-linked genetic conditions. These conditions were classified into one of five taxonomy categories developed by subject experts (significantly shortened lifespan, serious medical problems, mild medical problems, unpredictable medical outcomes, and adult-onset conditions). A total of 193 women provided 739 usable ratings across 20 conditions. The mean ratings and correlations demonstrated that participants made distinctions across both attributes and categories. Aggregated mean attribute ratings across categories demonstrated logical consistency between the key features of each attribute and category, although participants perceived little difference between the mild and serious categories. This study provides empirical evidence for the validity of our proposed taxonomy, which will simplify patient decisions for results they would like to receive from preconception carrier screening via genome sequencing. © 2016 Wiley Periodicals, Inc.

What is the Nondominated Formulation? A Demonstration of de Novo Water Supply Portfolio Planning Under Deep Uncertainty

NASA Astrophysics Data System (ADS)

Kasprzyk, J. R.; Reed, P. M.; Characklis, G. W.; Kirsch, B. R.

2010-12-01

This paper proposes and demonstrates a new interactive framework for sensitivity-informed de Novo programming, in which a learning approach to formulating decision problems can confront the deep uncertainty within water management problems. The framework couples global sensitivity analysis using Sobol’ variance decomposition with multiobjective evolutionary algorithms (MOEAs) to generate planning alternatives and test their robustness to new modeling assumptions and scenarios. We explore these issues within the context of a risk-based water supply management problem, where a city seeks the most efficient use of a water market. The case study examines a single city’s water supply in the Lower Rio Grande Valley (LRGV) in Texas, using both a 10-year planning horizon and an extreme single-year drought scenario. The city’s water supply portfolio comprises a volume of permanent rights to reservoir inflows and use of a water market through anticipatory thresholds for acquiring transfers of water through optioning and spot leases. Diagnostic information from the Sobol’ variance decomposition is used to create a sensitivity-informed problem formulation testing different decision variable configurations, with tradeoffs for the formulation solved using a MOEA. Subsequent analysis uses the drought scenario to expose tradeoffs between long-term and short-term planning and illustrate the impact of deeply uncertain assumptions on water availability in droughts. The results demonstrate water supply portfolios’ efficiency, reliability, and utilization of transfers in the water supply market and show how to adaptively improve the value and robustness of our problem formulations by evolving our definition of optimality to discover key tradeoffs.

The "Spirit of New Orleans": translating a model of intervention with maltreated children and their families for the Glasgow context.

PubMed

Minnis, Helen; Bryce, Graham; Phin, Louise; Wilson, Phil

2010-10-01

Children in care have higher rates of mental health problems than the general population and placement instability contributes to this. Children are both most vulnerable to the effects of poor quality care and most responsive to treatment in the early weeks and months of life yet, in the UK, permanency decisions are generally not in place until around the age of four. We aimed to understand the components of an innovative system for assessing and intervening with maltreated children and their families developed in New Orleans and to consider how it might be implemented in Glasgow, UK. During and after a visit to New Orleans by a team of Glasgow practitioners, eight key interviews and meetings with New Orleans and Glasgow staff were audio-recorded. Qualitative analysis of verbatim transcripts identified key themes. Themes highlighted shared aspects of the context and attitudes of the two teams, identified gaps in the Glasgow service and steps that would be needed to implement a version of the New Orleans model in Glasgow. Our discussions with the New Orleans team have highlighted concrete steps we can take, in Glasgow, to make better decision-making for vulnerable children a reality.

Stop making plans; start making decisions.

PubMed

Mankins, Michael C; Steele, Richard

2006-01-01

Many executives have grown skeptical of strategic planning. Is it any wonder? Despite all the time and energy that go into it, strategic planning most often acts as a barrier to good decision making and does little to influence strategy. Strategic planning fails because of two factors: It typically occurs annually, and it focuses on individual business units. As such, the process is completely at odds with the way executives actually make important strategy decisions, which are neither constrained by the calendar nor defined by unit boundaries. Thus, according to a survey of 156 large companies, senior executives often make strategic decisions outside the planning process, in an ad hoc fashion and without rigorous analysis or productive debate. But companies can fix the process if they attack its root problems. A few forward-looking firms have thrown out their calendar-driven, business-unit-focused planning procedures and replaced them with continuous, issues-focused decision making. In doing so, they rely on several basic principles: They separate, but integrate, decision making and plan making. They focus on a few key themes. And they structure strategy reviews to produce real decisions. When companies change the timing and focus of strategic planning, they also change the nature of senior management's discussions about strategy--from "review and approve" to "debate and decide," in which top executives actively think through every major decision and its implications for the company's performance and value. The authors have found that these companies make more than twice as many important strategic decisions per year as companies that follow the traditional planning model.

[Physician's anxiety and physician's elegance. Problems in dealing with cost reduction, education of general practitioners and optimal size of practice networks in a cross-national comparison].

PubMed

Behrens, J

2000-03-01

The key reason for physicians networking in managed care is to get a better coping with uncertainty on action (treatment) decisions. The second reason for networking in managed care are financial benefits grounds. But this reason is very ambivalent. Three different action problems (role conflicts) in managed care network are to solved, which was also in single practices. In the lecture the decision strategies and decision resources has been compared. Observations are done using expert interviews, patient interviews and analysis of documents in USA, Germany and Switzerland. The first problem is the choosing of a cost reduction strategy which is not reducing the effectiveness. Such "ugly" solution strategies like exclusion of "expensive" patients and a rationing of necessary medical services in a kind of McDonalds network of physicians will fail the target. The optimost way is a saving of all unnecessary medical even injourious performances. The chosen cost reduction strategy is not real visible from outside but in fact limited cognizable and controllable. Evidence based health care can be a resource of treatment decisions and could train such decisions but it will not substitute these decisions. The second problem is the making of real family practitioners as gatekeepers. Knowledge about the care system is still not making a real family practitioner, even if this is the minimum condition of their work. Also contractual relationships between insurance and doctor as a gatekeeper or financial incentives for patients are still making not a real family practitioner as a gatekpeeper. Only throughout the trust of patients supported by second opinions is making the real family practitioner as a gatekeeper. "Doctor hopping" could be the reaction by scarcity of trustworthy family practitioners as gatekeepers. The third problem is the choosing of the optimal scale of a network due to the very different optimal size of networks regarding the requirement of risk spreeds, of the motivated engagement, of competition, incentives of inclusion of insurantes, they always need other net sizes. But it is possible, for each requirement there could function different networks. A practice (doctor's office) can be a member in different networks in several levels. The social transition from a small office to a network of offices is in all business lines a cultural shock involving not only benefits also psychical and social distress. In this there is no difference between health or agriculture or each other business of trade and industry. The destiny of the joint doctor's offices in Germany suggest due to a very serious power to scatter this networks. The comparative analysis of conflicts, strains, resources and strategies of associations and networks could yield from a developed methodical repository in sociology and social psychology what exists since 40 years (see also Meyer--in this journal). But therefore must be included also the action problems, which are only mentioned in passing of the according profession horizon.

Will the Conscious-Subconscious Pacing Quagmire Help Elucidate the Mechanisms of Self-Paced Exercise? New Opportunities in Dual Process Theory and Process Tracing Methods.

PubMed

Micklewright, Dominic; Kegerreis, Sue; Raglin, John; Hettinga, Florentina

2017-07-01

The extent to which athletic pacing decisions are made consciously or subconsciously is a prevailing issue. In this article we discuss why the one-dimensional conscious-subconscious debate that has reigned in the pacing literature has suppressed our understanding of the multidimensional processes that occur in pacing decisions. How do we make our decisions in real-life competitive situations? What information do we use and how do we respond to opponents? These are questions that need to be explored and better understood, using smartly designed experiments. The paper provides clarity about key conscious, preconscious, subconscious and unconscious concepts, terms that have previously been used in conflicting and confusing ways. The potential of dual process theory in articulating multidimensional aspects of intuitive and deliberative decision-making processes is discussed in the context of athletic pacing along with associated process-tracing research methods. In attempting to refine pacing models and improve training strategies and psychological skills for athletes, the dual-process framework could be used to gain a clearer understanding of (1) the situational conditions for which either intuitive or deliberative decisions are optimal; (2) how intuitive and deliberative decisions are biased by things such as perception, emotion and experience; and (3) the underlying cognitive mechanisms such as memory, attention allocation, problem solving and hypothetical thought.

Cognitive issues in autonomous spacecraft-control operations: An investigation of software-mediated decision making in a scaled environment

NASA Astrophysics Data System (ADS)

Murphy, Elizabeth Drummond

As advances in technology are applied in complex, semi-automated domains, human controllers are distanced from the controlled process. This physical and psychological distance may both facilitate and degrade human performance. To investigate cognitive issues in spacecraft ground-control operations, the present experimental research was undertaken. The primary issue concerned the ability of operations analysts who do not monitor operations to make timely, accurate decisions when autonomous software calls for human help. Another key issue involved the potential effects of spatial-visualization ability (SVA) in environments that present data in graphical formats. Hypotheses were derived largely from previous findings and predictions in the literature. Undergraduate psychology students were assigned at random to a monitoring condition or an on-call condition in a scaled environment. The experimental task required subjects to decide on the veracity of a problem diagnosis delivered by a software process on-board a simulated spacecraft. To support decision-making, tabular and graphical data displays presented information on system status. A level of software confidence in the problem diagnosis was displayed, and subjects reported their own level of confidence in their decisions. Contrary to expectations, the performance of on-call subjects did not differ significantly from that of continuous monitors. Analysis yielded a significant interaction of sex and condition: Females in the on-call condition had the lowest mean accuracy. Results included a preference for bar charts over line graphs and faster performance with tables than with line graphs. A significant correlation was found between subjective confidence and decision accuracy. SVA was found to be predictive of accuracy but not speed; and SVA was found to be a stronger predictor of performance for males than for females. Low-SVA subjects reported that they relied more on software confidence than did medium- or high-SVA subjects. These and other findings have implications for the design of user interfaces to support human decision-making in on-call situations and to accommodate low-SVA users.

Multidimensional model to assess the readiness of Saudi Arabia to implement evidence based child maltreatment prevention programs at a large scale.

PubMed

Almuneef, Maha A; Qayad, Mohamed; Noor, Ismail K; Al-Eissa, Majid A; Albuhairan, Fadia S; Inam, Sarah; Mikton, Christopher

2014-03-01

There has been increased awareness of child maltreatment in Saudi Arabia recently. This study assessed the readiness for implementing large-scale evidence-based child maltreatment prevention programs in Saudi Arabia. Key informants, who were key decision makers and senior managers in the field of child maltreatment, were invited to participate in the study. A multidimensional tool, developed by WHO and collaborators from several middle and low income countries, was used to assess 10 dimensions of readiness. A group of experts also gave an objective assessment of the 10 dimensions and key informants' and experts' scores were compared. On a scale of 100, the key informants gave a readiness score of 43% for Saudi Arabia to implement large-scale, evidence-based CM prevention programs, and experts gave an overall readiness score of 40%. Both the key informants and experts agreed that 4 of the dimensions (attitudes toward child maltreatment prevention, institutional links and resources, material resources, and human and technical resources) had low readiness scores (<5) each and three dimensions (knowledge of child maltreatment prevention, scientific data on child maltreatment prevention, and will to address child maltreatment problem) had high readiness scores (≥5) each. There was significant disagreement between key informants and experts on the remaining 3 dimensions. Overall, Saudi Arabia has a moderate/fair readiness to implement large-scale child maltreatment prevention programs. Capacity building; strengthening of material resources; and improving institutional links, collaborations, and attitudes toward the child maltreatment problem are required to improve the country's readiness to implement such programs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Influencing health policy through public deliberation: Lessons learned from two decades of Citizens'/community juries.

PubMed

Degeling, Chris; Rychetnik, Lucie; Street, Jackie; Thomas, Rae; Carter, Stacy M

2017-04-01

Citizens'/community juries [CJs] engage members of the public in policy decision-making processes. CJs can be employed to develop policy responses to health problems that require the consideration of both community values and scientific evidence. Based on the principles of deliberative democracy, recent reviews indicate that findings from CJs have successfully been used to influence health policy decision-making. Despite this evidence of success, there appears to be a gap between the goals of health researchers who organize CJs and the needs of policy actors and decision makers. Drawing on our experiences working with CJs and recent research on CJ methods, we describe a synopsis of the current state of the art organized around four key questions, and informed by insights from deliberative theory and critical policy studies. Our intention is to stimulate further discussion as to the types of health policy questions that can be usefully addressed through public deliberation, and provide guidance on the methodological and political dimensions that need to be considered in deciding whether a CJ is an appropriate approach for informing a policy decision-making process. Copyright © 2017 Elsevier Ltd. All rights reserved.

Team Leadership and Cancer End-of-Life Decision Making.

PubMed

Waldfogel, Julie M; Battle, Dena J; Rosen, Michael; Knight, Louise; Saiki, Catherine B; Nesbit, Suzanne A; Cooper, Rhonda S; Browner, Ilene S; Hoofring, Laura H; Billing, Lynn S; Dy, Sydney M

2016-11-01

End-of-life decision making in cancer can be a complicated process. Patients and families encounter multiple providers throughout their cancer care. When the efforts of these providers are not well coordinated in teams, opportunities for high-quality, longitudinal goals of care discussions can be missed. This article reviews the case of a 55-year-old man with lung cancer, illustrating the barriers and missed opportunities for end-of-life decision making in his care through the lens of team leadership, a key principle in the science of teams. The challenges demonstrated in this case reflect the importance of the four functions of team leadership: information search and structuring, information use in problem solving, managing personnel resources, and managing material resources. Engaging in shared leadership of these four functions can help care providers improve their interactions with patients and families concerning end-of-life care decision making. This shared leadership can also produce a cohesive care plan that benefits from the expertise of the range of available providers while reflecting patient needs and preferences. Clinicians and researchers should consider the roles of team leadership functions and shared leadership in improving patient care when developing and studying models of cancer care delivery.

Conscious thought beats deliberation without attention in diagnostic decision-making: at least when you are an expert

PubMed Central

Schmidt, Henk G.; Rikers, Remy M. J. P.; Custers, Eugene J. F. M.; Splinter, Ted A. W.; van Saase, Jan L. C. M.

2010-01-01

Contrary to what common sense makes us believe, deliberation without attention has recently been suggested to produce better decisions in complex situations than deliberation with attention. Based on differences between cognitive processes of experts and novices, we hypothesized that experts make in fact better decisions after consciously thinking about complex problems whereas novices may benefit from deliberation-without-attention. These hypotheses were confirmed in a study among doctors and medical students. They diagnosed complex and routine problems under three conditions, an immediate-decision condition and two delayed conditions: conscious thought and deliberation-without-attention. Doctors did better with conscious deliberation when problems were complex, whereas reasoning mode did not matter in simple problems. In contrast, deliberation-without-attention improved novices’ decisions, but only in simple problems. Experts benefit from consciously thinking about complex problems; for novices thinking does not help in those cases. PMID:20354726

Conscious thought beats deliberation without attention in diagnostic decision-making: at least when you are an expert.

PubMed

Mamede, Sílvia; Schmidt, Henk G; Rikers, Remy M J P; Custers, Eugene J F M; Splinter, Ted A W; van Saase, Jan L C M

2010-11-01

Contrary to what common sense makes us believe, deliberation without attention has recently been suggested to produce better decisions in complex situations than deliberation with attention. Based on differences between cognitive processes of experts and novices, we hypothesized that experts make in fact better decisions after consciously thinking about complex problems whereas novices may benefit from deliberation-without-attention. These hypotheses were confirmed in a study among doctors and medical students. They diagnosed complex and routine problems under three conditions, an immediate-decision condition and two delayed conditions: conscious thought and deliberation-without-attention. Doctors did better with conscious deliberation when problems were complex, whereas reasoning mode did not matter in simple problems. In contrast, deliberation-without-attention improved novices' decisions, but only in simple problems. Experts benefit from consciously thinking about complex problems; for novices thinking does not help in those cases.

Social decision making mediates the association between anger and externalising problems in Chinese adolescents.

PubMed

Li, Nan; Hein, Sascha; Ye, Lin; Liu, Yangyang

2018-04-06

The goal of this study was to test the mediating effect of social decision making in the relations of anger and anger control to externalising and internalising problems. A sample of 174 Chinese adolescents (mean age = 15.36 years) completed self-reports of trait anger, anger control, externalising problems, internalising problems and social decision making, which was operationalized as situational judgement reflecting an individual's ability to interact effectively with parents, teachers and peers. Findings indicated that adolescents' trait anger and anger control were positively related to both externalising and internalising problems. In addition, path analysis revealed that social decision making mediated the relationship between trait anger, anger control and externalising problems. Findings on the mediating effect will be discussed by referencing appraisal tendency theory and response evaluation and decision. © 2018 International Union of Psychological Science.

Problem formulation and option assessment (PFOA) linking governance and environmental risk assessment for technologies: a methodology for problem analysis of nanotechnologies and genetically engineered organisms.

PubMed

Nelson, Kristen C; Andow, David A; Banker, Michael J

2009-01-01

Societal evaluation of new technologies, specifically nanotechnology and genetically engineered organisms (GEOs), challenges current practices of governance and science. Employing environmental risk assessment (ERA) for governance and oversight assumes we have a reasonable ability to understand consequences and predict adverse effects. However, traditional ERA has come under considerable criticism for its many shortcomings and current governance institutions have demonstrated limitations in transparency, public input, and capacity. Problem Formulation and Options Assessment (PFOA) is a methodology founded on three key concepts in risk assessment (science-based consideration, deliberation, and multi-criteria analysis) and three in governance (participation, transparency, and accountability). Developed through a series of international workshops, the PFOA process emphasizes engagement with stakeholders in iterative stages, from identification of the problem(s) through comparison of multiple technology solutions that could be used in the future with their relative benefits, harms, and risk. It provides "upstream public engagement" in a deliberation informed by science that identifies values for improved decision making.

Decision e Informacion en Solucion de Problemas. Publicacion No. 77 (Information and Decision Making in Problem Solving. Publication No. 77).

ERIC Educational Resources Information Center

Rimoldi, Horacio J. A.; And Others

A technique using information and decision-making theories to evaluate problem solving tactics is presented. In problem solving, the process of solution is evaluated by investigating the questions that the subject doing the problem solving asks. The sequence of questions asked is called a tactic. It is assumed that: (1) tactics are the observable…

A comparison of representations for discrete multi-criteria decision problems☆

PubMed Central

Gettinger, Johannes; Kiesling, Elmar; Stummer, Christian; Vetschera, Rudolf

2013-01-01

Discrete multi-criteria decision problems with numerous Pareto-efficient solution candidates place a significant cognitive burden on the decision maker. An interactive, aspiration-based search process that iteratively progresses toward the most preferred solution can alleviate this task. In this paper, we study three ways of representing such problems in a DSS, and compare them in a laboratory experiment using subjective and objective measures of the decision process as well as solution quality and problem understanding. In addition to an immediate user evaluation, we performed a re-evaluation several weeks later. Furthermore, we consider several levels of problem complexity and user characteristics. Results indicate that different problem representations have a considerable influence on search behavior, although long-term consistency appears to remain unaffected. We also found interesting discrepancies between subjective evaluations and objective measures. Conclusions from our experiments can help designers of DSS for large multi-criteria decision problems to fit problem representations to the goals of their system and the specific task at hand. PMID:24882912

Solving multi-objective optimization problems in conservation with the reference point method

PubMed Central

Dujardin, Yann; Chadès, Iadine

2018-01-01

Managing the biodiversity extinction crisis requires wise decision-making processes able to account for the limited resources available. In most decision problems in conservation biology, several conflicting objectives have to be taken into account. Most methods used in conservation either provide suboptimal solutions or use strong assumptions about the decision-maker’s preferences. Our paper reviews some of the existing approaches to solve multi-objective decision problems and presents new multi-objective linear programming formulations of two multi-objective optimization problems in conservation, allowing the use of a reference point approach. Reference point approaches solve multi-objective optimization problems by interactively representing the preferences of the decision-maker with a point in the criteria (objectives) space, called the reference point. We modelled and solved the following two problems in conservation: a dynamic multi-species management problem under uncertainty and a spatial allocation resource management problem. Results show that the reference point method outperforms classic methods while illustrating the use of an interactive methodology for solving combinatorial problems with multiple objectives. The method is general and can be adapted to a wide range of ecological combinatorial problems. PMID:29293650

Analysing causal structures with entropy

PubMed Central

Weilenmann, Mirjam

2017-01-01

A central question for causal inference is to decide whether a set of correlations fits a given causal structure. In general, this decision problem is computationally infeasible and hence several approaches have emerged that look for certificates of compatibility. Here, we review several such approaches based on entropy. We bring together the key aspects of these entropic techniques with unified terminology, filling several gaps and establishing new connections, all illustrated with examples. We consider cases where unobserved causes are classical, quantum and post-quantum, and discuss what entropic analyses tell us about the difference. This difference has applications to quantum cryptography, where it can be crucial to eliminate the possibility of classical causes. We discuss the achievements and limitations of the entropic approach in comparison to other techniques and point out the main open problems. PMID:29225499

Analysing causal structures with entropy

NASA Astrophysics Data System (ADS)

Weilenmann, Mirjam; Colbeck, Roger

2017-11-01

A central question for causal inference is to decide whether a set of correlations fits a given causal structure. In general, this decision problem is computationally infeasible and hence several approaches have emerged that look for certificates of compatibility. Here, we review several such approaches based on entropy. We bring together the key aspects of these entropic techniques with unified terminology, filling several gaps and establishing new connections, all illustrated with examples. We consider cases where unobserved causes are classical, quantum and post-quantum, and discuss what entropic analyses tell us about the difference. This difference has applications to quantum cryptography, where it can be crucial to eliminate the possibility of classical causes. We discuss the achievements and limitations of the entropic approach in comparison to other techniques and point out the main open problems.

Applications of Decision Theory to Test-Based Decision Making. Project Psychometric Aspects of Item Banking No. 23. Research Report 87-9.

ERIC Educational Resources Information Center

van der Linden, Wim J.

The use of Bayesian decision theory to solve problems in test-based decision making is discussed. Four basic decision problems are distinguished: (1) selection; (2) mastery; (3) placement; and (4) classification, the situation where each treatment has its own criterion. Each type of decision can be identified as a specific configuration of one or…

Some Problems in Educational Administration

ERIC Educational Resources Information Center

Lyons, Raymond F.

1977-01-01

Educational administration problems in developing countries are discussed. Possible solutions to problems of decision-making, decision implementation, communications, task definition, and financial control are suggested. (Author/DB)

The standard of care and conflicts at the end of life in critical care: lessons from medical-legal crossroads and the role of a quasi-judicial tribunal in decision-making.

PubMed

Hawryluck, Laura; Sibbald, Robert; Chidwick, Paula

2013-12-01

The goals of this qualitative study were to review the last 7 years of end of life legal decisions within the critical care field to explore how medical benefit is defined and by whom and the role of the standard of care (SoC) in conflict resolution. A public online, non-profit database of the Federation of Law Societies of Canada was searched for relevant Consent and Capacity Board decisions from 2003 to 2012. In total, 1486 cases were collected, and purposive sampling identified a total of 29 decisions regarding use of life-sustaining treatments at end of life. Using modified grounded theory, decisions were read and analyzed from a central SoC concept to understand definitions of benefit, rationales for case adjudication, and repercussions of legal recourse in conflict resolution. Medical benefit was clearly defined, and its role in determining SoC, transparent. Perceptions of variability in SoC were enhanced by physicians in intractable conflicts seeking legal validation by framing SoC issues as "best interest" determinations. The results reveal some key problems in recourse to the Consent and Capacity Board for clinicians, patients and substitute decision makers in such conflict situations. This study can help improve decision-making by debunking myth of variability in determinations of medical benefit and the standards of care at end of life and reveal the pitfalls of legal recourse in resolving intractable conflicts. © 2013.

The role of decision-making in cannabis-related problems among young adults

PubMed Central

Gonzalez, Raul; Schuster, Randi M.; Mermelstein, Robin M.; Diviak, Kathleen R.

2015-01-01

Background Deficits in decision-making and episodic memory are often reported among heavy cannabis users, yet little is known on how they influence negative consequences from cannabis use. Individual differences in decision-making may explain, in part, why some individuals experience significant problems from their cannabis use whereas others do not. We hypothesized that poor decision-making would moderate relationships between amount of cannabis use and problems from cannabis use whereas episodic memory performance would not. Method Young adult cannabis users (n = 52) with cannabis as their drug of choice and with minimal comorbidities completed semi-structured interviews, self-report questionnaires, and measures of neurocognitive functioning, with decision-making accessed via the Iowa Gambling Task (IGT), episodic memory via the Hopkins Verbal Learning Test – Revised (HVLT) and problems from cannabis use with the Marijuana Problems Scale. Results Strong relationships were observed between amount of cannabis use (lifetime, 12-month, and 30-day) and problems reported from use, but only among participants with Low (impaired) decision-making (R2 = .39 to .51; p < .01). No significant relationships were observed among those with better (low average to high average) decision-making performance (p > .05). In contrast, episodic memory performance was not a significant moderator of the relationship between amount of cannabis use and cannabis problems (p > .05). Conclusions Cannabis users with poor decision-making may be at greater risk for experiencing significant negative consequences from their cannabis use. Our results lend further support to emerging evidence of decision-making as a risk factor for addiction and extend these findings to cannabis users. PMID:26199058

The balancing act: key issues in the lives of women general practitioners in Australia.

PubMed

Kilmartin, Margaret R; Newell, Christopher J; Line, Martin A

2002-07-15

To identify key issues affecting women general practitioners in their professional and non-professional lives. A qualitative study using the Delphi technique, with three rounds of data provision circulated to each participant. Coding was used to ensure anonymity. The participants were a purposive sample of 40 women GPs drawn from all Australian States and Territories. The study was conducted between October 1996 and January 1997. Key issues affecting the professional and non-professional lives of women GPs. Some of the key professional issues for women GPs were job satisfaction, balancing work and personal life, autonomy, availability of flexible and part-time work and training, affordability of professional expenses, fair remuneration, and having a voice in decision-making. Key non-professional issues included self-care; time for relationships with a partner, children, family and friends; and time management to allow pursuit of non-medical interests. The conflicting demands made on women GPs diminish their job satisfaction and lead to stress and imbalance in their lives. Recommendations to ameliorate the problems for women GPs include appropriate training, policy formation, financial and other support, and a change in cultural expectations of women GPs by the community, the profession and governments.

Recent advances in applying decision science to managing national forests

Treesearch

Bruce G. Marcot; Matthew P. Thompson; Michael C. Runge; Frank R. Thompson; Steven McNulty; David Cleaves; Monica Tomosy; Larry A. Fisher; Andrew Bliss

2012-01-01

Management of federal public forests to meet sustainability goals and multiple use regulations is an immense challenge. To succeed, we suggest use of formal decision science procedures and tools in the context of structured decision making (SDM). SDM entails four stages: problem structuring (framing the problem and defining objectives and evaluation criteria), problem...

The Effects of Gender on Career Decision Problems in Young Adults.

ERIC Educational Resources Information Center

Larson, Jeffry H.; And Others

1994-01-01

Investigated gender differences in psychological problems--decision anxiety, life-goal awareness, and others--in the career decision-making process (CDM) of 1,006 college students. Results indicated no gender differences in global levels of problems in CDM. Some specific difficulties, such as life-goal awareness and authority orientation, were…

Funding Decisions for Newborn Screening: A Comparative Review of 22 Decision Processes in Europe

PubMed Central

Fischer, Katharina Elisabeth; Rogowski, Wolf Henning

2014-01-01

Decision-makers need to make choices to improve public health. Population-based newborn screening (NBS) is considered as one strategy to prevent adverse health outcomes and address rare disease patients’ needs. The aim of this study was to describe key characteristics of decisions for funding new NBS programmes in Europe. We analysed past decisions using a conceptual framework. It incorporates indicators that capture the steps of decision processes by health care payers. Based on an internet survey, we compared 22 decisions for which answers among two respondents were validated for each observation. The frequencies of indicators were calculated to elicit key characteristics. All decisions resulted in positive, mostly unrestricted funding. Stakeholder participation was diverse focusing on information provision or voting. Often, decisions were not fully transparent. Assessment of NBS technologies concentrated on expert opinion, literature review and rough cost estimates. Most important appraisal criteria were effectiveness (i.e., health gain from testing for the children being screened), disease severity and availability of treatments. Some common and diverging key characteristics were identified. Although no evidence of explicit healthcare rationing was found, processes may be improved in respect of transparency and scientific rigour of assessment. PMID:24852389

Synergistic Information Processing Encrypts Strategic Reasoning in Poker.

PubMed

Frey, Seth; Albino, Dominic K; Williams, Paul L

2018-06-14

There is a tendency in decision-making research to treat uncertainty only as a problem to be overcome. But it is also a feature that can be leveraged, particularly in social interaction. Comparing the behavior of profitable and unprofitable poker players, we reveal a strategic use of information processing that keeps decision makers unpredictable. To win at poker, a player must exploit public signals from others. But using public inputs makes it easier for an observer to reconstruct that player's strategy and predict his or her behavior. How should players trade off between exploiting profitable opportunities and remaining unexploitable themselves? Using a recent multivariate approach to information theoretic data analysis and 1.75 million hands of online two-player No-Limit Texas Hold'em, we find that the important difference between winning and losing players is not in the amount of information they process, but how they process it. In particular, winning players are better at integrative information processing-creating new information from the interaction between their cards and their opponents' signals. We argue that integrative information processing does not just produce better decisions, it makes decision-making harder for others to reverse engineer, as an expert poker player's cards act like the private key in public-key cryptography. Poker players encrypt their reasoning with the way they process information. The encryption function of integrative information processing makes it possible for players to exploit others while remaining unexploitable. By recognizing the act of information processing as a strategic behavior in its own right, we offer a detailed account of how experts use endemic uncertainty to conceal their intentions in high-stakes competitive environments, and we highlight new opportunities between cognitive science, information theory, and game theory. Copyright © 2018 Cognitive Science Society, Inc.

How Qualitative Methods Can be Used to Inform Model Development.

PubMed

Husbands, Samantha; Jowett, Susan; Barton, Pelham; Coast, Joanna

2017-06-01

Decision-analytic models play a key role in informing healthcare resource allocation decisions. However, there are ongoing concerns with the credibility of models. Modelling methods guidance can encourage good practice within model development, but its value is dependent on its ability to address the areas that modellers find most challenging. Further, it is important that modelling methods and related guidance are continually updated in light of any new approaches that could potentially enhance model credibility. The objective of this article was to highlight the ways in which qualitative methods have been used and recommended to inform decision-analytic model development and enhance modelling practices. With reference to the literature, the article discusses two key ways in which qualitative methods can be, and have been, applied. The first approach involves using qualitative methods to understand and inform general and future processes of model development, and the second, using qualitative techniques to directly inform the development of individual models. The literature suggests that qualitative methods can improve the validity and credibility of modelling processes by providing a means to understand existing modelling approaches that identifies where problems are occurring and further guidance is needed. It can also be applied within model development to facilitate the input of experts to structural development. We recommend that current and future model development would benefit from the greater integration of qualitative methods, specifically by studying 'real' modelling processes, and by developing recommendations around how qualitative methods can be adopted within everyday modelling practice.

Trait urgency and gambling problems in young people by age: the mediating role of decision-making processes.

PubMed

Canale, Natale; Vieno, Alessio; Griffiths, Mark D; Rubaltelli, Enrico; Santinello, Massimo

2015-07-01

Although the personality trait of urgency has been linked to problem gambling, less is known about psychological mechanisms that mediate the relationship between urgency and problem gambling. One individual variable of potential relevance to impulsivity and addictive disorders is age. The aims of this study were to examine: (i) a theoretical model associating urgency and gambling problems, (ii) the mediating effects of decision-making processes (operationalized as preference for small/immediate rewards and lower levels of deliberative decision-making); and (iii) age differences in these relationships. Participants comprised 986 students (64% male; mean age=19.51 years; SD=2.30) divided into three groups: 16-17 years, 18-21 years, and 22-25 years. All participants completed measures of urgency, problem gambling, and a delay-discounting questionnaire involving choices between a smaller amount of money received immediately and a larger amount of money received later. Participants were also asked to reflect on their decision-making process. Compared to those aged 16-17 years and 22-25 years, participants aged 18-21 years had a higher level of gambling problems and decreased scores on lower levels of deliberative decision-making. Higher levels of urgency were associated with higher levels of gambling problems. The association was mediated by a lower level of deliberative decision-making and preference for an immediate/small reward. A distinct pathway was observed for lower levels of deliberative decision-making. Young people who tend to act rashly in response to extreme moods, had lower levels of deliberative decision-making, that in turn were positively related to gambling problems. This study highlights unique decision-making pathways through which urgency trait may operate, suggesting that those developing prevention and/or treatment strategies may want to consider the model's variables, including urgency, delay discounting, and deliberative decision-making. Copyright © 2015 Elsevier Ltd. All rights reserved.

A problem solving and decision making toolbox for approaching clinical problems and decisions.

PubMed

Margolis, C; Jotkowitz, A; Sitter, H

2004-08-01

In this paper, we begin by presenting three real patients and then review all the practical conceptual tools that have been suggested for systematically analyzing clinical problems. Each of these conceptual tools (e.g. Evidence-Based Medicine, Clinical Practice Guidelines, Decision Analysis) deals mainly with a different type or aspect of clinical problems. We suggest that all of these conceptual tools can be thought of as belonging in the clinician's toolbox for solving clinical problems and making clinical decisions. A heuristic for guiding the clinician in using the tools is proposed. The heuristic is then used to analyze management of the three patients presented at the outset. Copyright 2004 Birkhäuser Verlag, Basel

Recovery approach to the care of people with dementia: decision making and 'best interests' concerns.

PubMed

Martin, G

2009-09-01

The concept of 'recovery' has been central to the discussion of the care of people with mental health problems in recent years, in this paper these ideas will be applied to the care of people with dementia in an attempt to focus nursing practice on the notion that it is possible to involve this group of patients in their own decision-making processes. It is acknowledged that this is not always possible without support and advocacy by nurses and other carers who must take on board the need to arrive at solutions to problems or change that are in the person's best interests. The provisions of the Mental Capacity Act in 2005 are key to this discussion, and ways forward are recommended, which include a nursing model for change, in an effort to bring together the concepts addressed in this paper. The conclusion reached is that the recovery approach has some difficulties when applied to people with dementia but it remains an essential aspect of the care process which, together with the provisions of the Mental Capacity Act, could bring about radical improvements to the lives of this group of vulnerable people.

Smartphone users: Understanding how security mechanisms are perceived and new persuasive methods

PubMed Central

Alsaleh, Mansour; Alomar, Noura; Alarifi, Abdulrahman

2017-01-01

Protecting smartphones against security threats is a multidimensional problem involving human and technological factors. This study investigates how smartphone users’ security- and privacy-related decisions are influenced by their attitudes, perceptions, and understanding of various security threats. In this work, we seek to provide quantified insights into smartphone users’ behavior toward multiple key security features including locking mechanisms, application repositories, mobile instant messaging, and smartphone location services. To the best of our knowledge, this is the first study that reveals often unforeseen correlations and dependencies between various privacy- and security-related behaviors. Our work also provides evidence that making correct security decisions might not necessarily correlate with individuals’ awareness of the consequences of security threats. By comparing participants’ behavior and their motives for adopting or ignoring certain security practices, we suggest implementing additional persuasive approaches that focus on addressing social and technological aspects of the problem. On the basis of our findings and the results presented in the literature, we identify the factors that might influence smartphone users’ security behaviors. We then use our understanding of what might drive and influence significant behavioral changes to propose several platform design modifications that we believe could improve the security levels of smartphones. PMID:28297719

Smartphone users: Understanding how security mechanisms are perceived and new persuasive methods.

PubMed

Alsaleh, Mansour; Alomar, Noura; Alarifi, Abdulrahman

2017-01-01

Protecting smartphones against security threats is a multidimensional problem involving human and technological factors. This study investigates how smartphone users' security- and privacy-related decisions are influenced by their attitudes, perceptions, and understanding of various security threats. In this work, we seek to provide quantified insights into smartphone users' behavior toward multiple key security features including locking mechanisms, application repositories, mobile instant messaging, and smartphone location services. To the best of our knowledge, this is the first study that reveals often unforeseen correlations and dependencies between various privacy- and security-related behaviors. Our work also provides evidence that making correct security decisions might not necessarily correlate with individuals' awareness of the consequences of security threats. By comparing participants' behavior and their motives for adopting or ignoring certain security practices, we suggest implementing additional persuasive approaches that focus on addressing social and technological aspects of the problem. On the basis of our findings and the results presented in the literature, we identify the factors that might influence smartphone users' security behaviors. We then use our understanding of what might drive and influence significant behavioral changes to propose several platform design modifications that we believe could improve the security levels of smartphones.

Decentralized Hypothesis Testing in Energy Harvesting Wireless Sensor Networks

NASA Astrophysics Data System (ADS)

Tarighati, Alla; Gross, James; Jalden, Joakim

2017-09-01

We consider the problem of decentralized hypothesis testing in a network of energy harvesting sensors, where sensors make noisy observations of a phenomenon and send quantized information about the phenomenon towards a fusion center. The fusion center makes a decision about the present hypothesis using the aggregate received data during a time interval. We explicitly consider a scenario under which the messages are sent through parallel access channels towards the fusion center. To avoid limited lifetime issues, we assume each sensor is capable of harvesting all the energy it needs for the communication from the environment. Each sensor has an energy buffer (battery) to save its harvested energy for use in other time intervals. Our key contribution is to formulate the problem of decentralized detection in a sensor network with energy harvesting devices. Our analysis is based on a queuing-theoretic model for the battery and we propose a sensor decision design method by considering long term energy management at the sensors. We show how the performance of the system changes for different battery capacities. We then numerically show how our findings can be used in the design of sensor networks with energy harvesting sensors.

Neuroethology of Decision-making

PubMed Central

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

2012-01-01

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

[Clinical reasoning in nursing, concept analysis].

PubMed

Côté, Sarah; St-Cyr Tribble, Denise

2012-12-01

Nurses work in situations of complex care requiring great clinical reasoning abilities. In literature, clinical reasoning is often confused with other concepts and it has no consensual definition. To conduct a concept analysis of a nurse's clinical reasoning in order to clarify, define and distinguish it from the other concepts as well as to better understand clinical reasoning. Rodgers's method of concept analysis was used, after literature was retrieved with the use of clinical reasoning, concept analysis, nurse, intensive care and decision making as key-words. The use of cognition, cognitive strategies, a systematic approach of analysis and data interpretation, generating hypothesis and alternatives are attributes of clinical reasoning. The antecedents are experience, knowledge, memory, cues, intuition and data collection. The consequences are decision making, action, clues and problem resolution. This concept analysis helped to define clinical reasoning, to distinguish it from other concepts used synonymously and to guide future research.

Identifying Opportunities for Decision Support Systems in Support of Regional Resource Use Planning: An Approach Through Soft Systems Methodology.

PubMed

Zhu; Dale

2000-10-01

/ Regional resource use planning relies on key regional stakeholder groups using and having equitable access to appropriate social, economic, and environmental information and assessment tools. Decision support systems (DSS) can improve stakeholder access to such information and analysis tools. Regional resource use planning, however, is a complex process involving multiple issues, multiple assessment criteria, multiple stakeholders, and multiple values. There is a need for an approach to DSS development that can assist in understanding and modeling complex problem situations in regional resource use so that areas where DSSs could provide effective support can be identified, and the user requirements can be well established. This paper presents an approach based on the soft systems methodology for identifying DSS opportunities for regional resource use planning, taking the Central Highlands Region of Queensland, Australia, as a case study.

Alterations in choice behavior by manipulations of world model.

PubMed

Green, C S; Benson, C; Kersten, D; Schrater, P

2010-09-14

How to compute initially unknown reward values makes up one of the key problems in reinforcement learning theory, with two basic approaches being used. Model-free algorithms rely on the accumulation of substantial amounts of experience to compute the value of actions, whereas in model-based learning, the agent seeks to learn the generative process for outcomes from which the value of actions can be predicted. Here we show that (i) "probability matching"-a consistent example of suboptimal choice behavior seen in humans-occurs in an optimal Bayesian model-based learner using a max decision rule that is initialized with ecologically plausible, but incorrect beliefs about the generative process for outcomes and (ii) human behavior can be strongly and predictably altered by the presence of cues suggestive of various generative processes, despite statistically identical outcome generation. These results suggest human decision making is rational and model based and not consistent with model-free learning.

Alterations in choice behavior by manipulations of world model

PubMed Central

Green, C. S.; Benson, C.; Kersten, D.; Schrater, P.

2010-01-01

How to compute initially unknown reward values makes up one of the key problems in reinforcement learning theory, with two basic approaches being used. Model-free algorithms rely on the accumulation of substantial amounts of experience to compute the value of actions, whereas in model-based learning, the agent seeks to learn the generative process for outcomes from which the value of actions can be predicted. Here we show that (i) “probability matching”—a consistent example of suboptimal choice behavior seen in humans—occurs in an optimal Bayesian model-based learner using a max decision rule that is initialized with ecologically plausible, but incorrect beliefs about the generative process for outcomes and (ii) human behavior can be strongly and predictably altered by the presence of cues suggestive of various generative processes, despite statistically identical outcome generation. These results suggest human decision making is rational and model based and not consistent with model-free learning. PMID:20805507

A call to insect scientists: Challenges and opportunities of managing insect communities under climate change

USGS Publications Warehouse

Hellmann, Jessica J.; Grundel, Ralph; Hoving, Chris; Schuurman, Gregor W.

2016-01-01

As climate change moves insect systems into uncharted territory, more knowledge about insect dynamics and the factors that drive them could enable us to better manage and conserve insect communities. Climate change may also require us revisit insect management goals and strategies and lead to a new kind of scientific engagement in management decision-making. Here we make five key points about the role of insect science in aiding and crafting management decisions, and we illustrate those points with the monarch butterfly and the Karner blue butterfly, two species undergoing considerable change and facing new management dilemmas. Insect biology has a strong history of engagement in applied problems, and as the impacts of climate change increase, a reimagined ethic of entomology in service of broader society may emerge. We hope to motivate insect biologists to contribute time and effort toward solving the challenges of climate change.

WRF/CMAQ AQMEII3 Simulations of US Regional-Scale ...

EPA Pesticide Factsheets

Chemical boundary conditions are a key input to regional-scale photochemical models. In this study, performed during the third phase of the Air Quality Model Evaluation International Initiative (AQMEII3), we perform annual simulations over North America with chemical boundary conditions prepared from four different global models. Results indicate that the impacts of different boundary conditions are significant for ozone throughout the year and most pronounced outside the summer season. The National Exposure Research Laboratory (NERL) Computational Exposure Division (CED) develops and evaluates data, decision-support tools, and models to be applied to media-specific or receptor-specific problem areas. CED uses modeling-based approaches to characterize exposures, evaluate fate and transport, and support environmental diagnostics/forensics with input from multiple data sources. It also develops media- and receptor-specific models, process models, and decision support tools for use both within and outside of EPA.

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

Mundaca, Luis; Neij, Lena; Worrell, Ernst

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

Recommendation System for Adaptive Learning.

PubMed

Chen, Yunxiao; Li, Xiaoou; Liu, Jingchen; Ying, Zhiliang

2018-01-01

An adaptive learning system aims at providing instruction tailored to the current status of a learner, differing from the traditional classroom experience. The latest advances in technology make adaptive learning possible, which has the potential to provide students with high-quality learning benefit at a low cost. A key component of an adaptive learning system is a recommendation system, which recommends the next material (video lectures, practices, and so on, on different skills) to the learner, based on the psychometric assessment results and possibly other individual characteristics. An important question then follows: How should recommendations be made? To answer this question, a mathematical framework is proposed that characterizes the recommendation process as a Markov decision problem, for which decisions are made based on the current knowledge of the learner and that of the learning materials. In particular, two plain vanilla systems are introduced, for which the optimal recommendation at each stage can be obtained analytically.

Reducing work related psychological ill health and sickness absence: a systematic literature review

PubMed Central

Michie, S; Williams, S

2003-01-01

A literature review revealed the following: key work factors associated with psychological ill health and sickness absence in staff were long hours worked, work overload and pressure, and the effects of these on personal lives; lack of control over work; lack of participation in decision making; poor social support; and unclear management and work role. There was some evidence that sickness absence was associated with poor management style. Successful interventions that improved psychological health and levels of sickness absence used training and organisational approaches to increase participation in decision making and problem solving, increase support and feedback, and improve communication. It is concluded that many of the work related variables associated with high levels of psychological ill health are potentially amenable to change. This is shown in intervention studies that have successfully improved psychological health and reduced sickness absence. PMID:12499449

Multi-criteria GIS-based siting of transfer station for municipal solid waste: The case of Kumasi Metropolitan Area, Ghana.

PubMed

Bosompem, Christian; Stemn, Eric; Fei-Baffoe, Bernard

2016-10-01

The increase in the quantity of municipal solid waste generated as a result of population growth in most urban areas has resulted in the difficulty of locating suitable land areas to be used as landfills. To curb this, waste transfer stations are used. The Kumasi Metropolitan Area, even though it has an engineered landfill, is faced with the problem of waste collection from the generation centres to the final disposal site. Thus in this study, multi-criteria decision analysis incorporated into a geographic information system was used to determine potential waste transfer station sites. The key result established 11 sites located within six different sub-metros. This result can be used by decision makers for site selection of the waste transfer stations after taking into account other relevant ecological and economic factors. © The Author(s) 2016.

Economic analyses to support decisions about HPV vaccination in low- and middle-income countries: a consensus report and guide for analysts.

PubMed

Jit, Mark; Levin, Carol; Brisson, Marc; Levin, Ann; Resch, Stephen; Berkhof, Johannes; Kim, Jane; Hutubessy, Raymond

2013-01-30

Low- and middle-income countries need to consider economic issues such as cost-effectiveness, affordability and sustainability before introducing a program for human papillomavirus (HPV) vaccination. However, many such countries lack the technical capacity and data to conduct their own analyses. Analysts informing policy decisions should address the following questions: 1) Is an economic analysis needed? 2) Should analyses address costs, epidemiological outcomes, or both? 3) If costs are considered, what sort of analysis is needed? 4) If outcomes are considered, what sort of model should be used? 5) How complex should the analysis be? 6) How should uncertainty be captured? 7) How should model results be communicated? Selecting the appropriate analysis is essential to ensure that all the important features of the decision problem are correctly represented, but that the analyses are not more complex than necessary. This report describes the consensus of an expert group convened by the World Health Organization, prioritizing key issues to be addressed when considering economic analyses to support HPV vaccine introduction in these countries.

Conservation in the face of climate change: The roles of alternative models, monitoring, and adaptation in confronting and reducing uncertainty

USGS Publications Warehouse

Conroy, M.J.; Runge, M.C.; Nichols, J.D.; Stodola, K.W.; Cooper, R.J.

2011-01-01

The broad physical and biological principles behind climate change and its potential large scale ecological impacts on biota are fairly well understood, although likely responses of biotic communities at fine spatio-temporal scales are not, limiting the ability of conservation programs to respond effectively to climate change outside the range of human experience. Much of the climate debate has focused on attempts to resolve key uncertainties in a hypothesis-testing framework. However, conservation decisions cannot await resolution of these scientific issues and instead must proceed in the face of uncertainty. We suggest that conservation should precede in an adaptive management framework, in which decisions are guided by predictions under multiple, plausible hypotheses about climate impacts. Under this plan, monitoring is used to evaluate the response of the system to climate drivers, and management actions (perhaps experimental) are used to confront testable predictions with data, in turn providing feedback for future decision making. We illustrate these principles with the problem of mitigating the effects of climate change on terrestrial bird communities in the southern Appalachian Mountains, USA. ?? 2010 Elsevier Ltd.

Intersubjective decision-making for computer-aided forging technology design

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Equipment Selection by using Fuzzy TOPSIS Method

NASA Astrophysics Data System (ADS)

Yavuz, Mahmut

2016-10-01

In this study, Fuzzy TOPSIS method was performed for the selection of open pit truck and the optimal solution of the problem was investigated. Data from Turkish Coal Enterprises was used in the application of the method. This paper explains the Fuzzy TOPSIS approaches with group decision-making application in an open pit coal mine in Turkey. An algorithm of the multi-person multi-criteria decision making with fuzzy set approach was applied an equipment selection problem. It was found that Fuzzy TOPSIS with a group decision making is a method that may help decision-makers in solving different decision-making problems in mining.

Problems of quality and equity in pain management: exploring the role of biomedical culture.

PubMed

Crowley-Matoka, Megan; Saha, Somnath; Dobscha, Steven K; Burgess, Diana J

2009-10-01

To explore how social scientific analyses of the culture of biomedicine may contribute to advancing our understanding of ongoing issues of quality and equity in pain management. Drawing upon the rich body of social scientific literature on the culture of biomedicine, we identify key features of biomedical culture with particular salience for pain management. We then examine how these cultural features of biomedicine may shape key phases of the pain management process in ways that have implications not just for quality, but for equity in pain management as well. We bring together a range of literatures in developing our analysis, including literatures on the culture of biomedicine, pain management and health care disparities. We surveyed the relevant literatures to identify and inter-relate key features of biomedical culture, key phases of the pain management process, and key dimensions of identified problems with suboptimal and inequitable treatment of pain. We identified three key features of biomedical culture with critical implications for pain management: 1) mind-body dualism; 2) a focus on disease vs illness; and 3) a bias toward cure vs care. Each of these cultural features play a role in the key phases of pain management, specifically pain-related communication, assessment and treatment decision-making, in ways that may hinder successful treatment of pain in general -- and of pain patients from disadvantaged groups in particular. Deepening our understanding of the role of biomedical culture in pain management has implications for education, policy and research as part of ongoing efforts to ameliorate problems in both quality and equity in managing pain. In particular, we suggest that building upon the existing the cultural competence movement in medicine to include fostering a deeper understanding of biomedical culture and its impact on physicians may be useful. From a policy perspective, we identify pain management as an area where the need for a shift to a more biopsychosocial model of health care is particularly pressing, and suggest prioritization of inter-disciplinary, multimodal approaches to pain as one key strategy in realizing this shift. Finally, in terms of research, we identify the need for empirical research to assess aspects of biomedical culture that may influence physician's attitudes and behaviors related to pain management, as well as to explore how these cultural values and their effects may vary across different settings within the practice of medicine.

Economic evaluation of health promotion for older people-methodological problems and challenges.

PubMed

Huter, Kai; Kocot, Ewa; Kissimova-Skarbek, Katarzyna; Dubas-Jakóbczyk, Katarzyna; Rothgang, Heinz

2016-09-05

The support of health promotion activities for older people gains societal relevance in terms of enhancing the health and well-being of older people with a view to the efficient use of financial resources in the healthcare sector. Health economic evaluations have become an important instrument to support decision-making processes in many countries. Sound evidence on the cost-effectiveness of health promotion activities would encourage support for the implementation of health promotion activities for older people. This debate article discusses to what extent economic evaluation techniques are appropriate to support decision makers in the allocation of resources regarding health promotion activities for older people. We address the problem that the economic evaluation of these interventions is hampered by methodological obstacles that limit comparability, e.g. with economic evaluations of curative measures. Our central objective is to describe and discuss the specific problems and challenges entailed in the economic evaluation of health promotion activities especially for older people with regard to their usefulness for informing decision making processes. Beyond general problems concerning the economic evaluation of health promotion, our discussion focusses on problems that pertain to the analysis of cost and outcomes of health promotion interventions for older people. With regard to costs these are general problems of economic evaluations, namely the actual implementation of a societal perspective, the appropriate measurement and valuation of informal caregiver time, the measurement and valuation of productivity costs and costs incurred in added years of life. The main problems concerning the identification and measurement of outcomes are related to the identification of outcome parameters that, firstly, adequately reflect the broad effects of health promotion interventions, especially social benefits that gain importance for older people, and secondly, ensure a comparability of effects across different age groups. In particular, the limitations of the widely used QALY for older people are discussed and recently developed alternatives are presented. The key conclusion of the article is that a comparison of the effects of different health promotion initiatives between different age groups by means of economic evaluation is not recommendable. Taking into account the complex outcomes of health promotion interventions it has to be accepted that the outcomes of these interventions will often not be comparable with clinical interventions and have to be assessed differently.

The Decision Support Matrix (DSM) Approach to Reducing Risk of Flooding and Water Pollution in Farmed Landscapes

NASA Astrophysics Data System (ADS)

Hewett, Caspar J. M.; Quinn, Paul; Wilkinson, Mark

2014-05-01

Intense farming plays a key role in contributing to problems such as increased flood risk, soil erosion and poor water quality. This means that there is great potential for agricultural practitioners to play a major part in reducing multiple risks through better land-use management. Greater understanding by farmers, land managers, practitioners and policy-makers of the ways in which farmed landscapes contribute to risks and the ways in which those risks might be mitigated can be an essential component in improving practice. The Decision Support Matrix (DSM) approach involves the development of a range of visualization and communication tools to help compare the risks associated with different farming practices and explore options to manage runoff. DSMs are simple decision support systems intended for use by the non-expert which combine expert hydrological evidence with local knowledge of runoff patterns. They are developed through direct engagement with stakeholders, ensuring that the examples and language used makes sense to end-users. A key element of the tools is that they show the current conditions of the land and describe extremes of land-use management within a hydrological and agricultural land-management context. The tools include conceptual models of a series of pre-determined runoff scenarios, providing the end-user with a variety of potential land management practices and runoff management options. Visual examples of different farming practices are used to illustrate the impact of good and bad practice on specific problems such as nutrient export or risk of flooding. These show both how current conditions cause problems downstream and how systems are vulnerable to changes in climate and land-use intensification. The level of risk associated with a particular land management option is represented by a mapping on a two- or three-dimensional matrix. Interactive spreadsheet-based tools are developed in which multiple questions allow the user to explore different management options and see the impact of decisions plotted as a risk level on the DSM. They employ a ranking methodology combined with a simple mapping of information onto a visual matrix. A nominal scoring system is used to rank higher or lower runoff risk. The end-user can then assess numerous land use and runoff management options to lower risk. The objective is to encourage policy makers, catchment managers and farmers to produce resilient local landscapes at minimal cost. A number of DSMs have been developed successfully over a number of years working with a variety of stakeholders in the UK, including the Phosphorus Export Risk Matrix (PERM), The Nitrate Export Risk Matrix (NO3RM) and arable and livestock versions of the Floods and Agriculture Risk Matrix (FARM) (available from http://research.ncl.ac.uk/thefarm). Despite uncertainty, the tools do contribute to stakeholders having greater confidence in making decisions to make landscapes more resilient. DSMs have been taken up widely in the UK by bodies such as the Environment Agency and Defra, and have been successfully employed within wider decision support frameworks alongside modelling at multiple scales. Such tools could be used in similar farmed landscapes internationally.

Human-computer interface for the study of information fusion concepts in situation analysis and command decision support systems

NASA Astrophysics Data System (ADS)

Roy, Jean; Breton, Richard; Paradis, Stephane

2001-08-01

Situation Awareness (SAW) is essential for commanders to conduct decision-making (DM) activities. Situation Analysis (SA) is defined as a process, the examination of a situation, its elements, and their relations, to provide and maintain a product, i.e., a state of SAW for the decision maker. Operational trends in warfare put the situation analysis process under pressure. This emphasizes the need for a real-time computer-based Situation analysis Support System (SASS) to aid commanders in achieving the appropriate situation awareness, thereby supporting their response to actual or anticipated threats. Data fusion is clearly a key enabler for SA and a SASS. Since data fusion is used for SA in support of dynamic human decision-making, the exploration of the SA concepts and the design of data fusion techniques must take into account human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight integration of the human element with the SA technology is essential. Regarding these issues, this paper provides a description of CODSI (Command Decision Support Interface), and operational- like human machine interface prototype for investigations in computer-based SA and command decision support. With CODSI, one objective was to apply recent developments in SA theory and information display technology to the problem of enhancing SAW quality. It thus provides a capability to adequately convey tactical information to command decision makers. It also supports the study of human-computer interactions for SA, and methodologies for SAW measurement.

Problems for judgment and decision making.

PubMed

Hastie, R

2001-01-01

This review examines recent developments during the past 5 years in the field of judgment and decision making, written in the form of a list of 16 research problems. Many of the problems involve natural extensions of traditional, originally rational, theories of decision making. Others are derived from descriptive algebraic modeling approaches or from recent developments in cognitive psychology and cognitive neuroscience.

Minimizing risks from spilled oil to ecosystem services using influence diagrams: the Deepwater Horizon spill response.

PubMed

Carriger, John F; Barron, Mace G

2011-09-15

Decision science tools can be used in evaluating response options and making inferences on risks to ecosystem services (ES) from ecological disasters. Influence diagrams (IDs) are probabilistic networks that explicitly represent the decisions related to a problem and their influence on desired or undesired outcomes. To examine how IDs might be useful in probabilistic risk management for spill response efforts, an ID was constructed to display the potential interactions between exposure events and the trade-offs between costs and ES impacts from spilled oil and response decisions in the DWH spill event. Quantitative knowledge was not formally incorporated but an ID platform for doing this was examined. Probabilities were assigned for conditional relationships in the ID and scenarios examining the impact of different response actions on components of spilled oil were investigated in hypothetical scenarios. Given the structure of the ID, potential knowledge gaps included understanding of the movement of oil, the ecological risk of different spill-related stressors to key receptors (e.g., endangered species, fisheries), and the need for stakeholder valuation of the ES benefits that could be impacted by a spill. Framing the Deepwater Horizon problem domain in an ID conceptualized important variables and relationships that could be optimally accounted for in preparing and managing responses in future spills. These features of the developed IDs may assist in better investigating the uncertainty, costs, and the trade-offs if large-scale, deep ocean spills were to occur again.

The relationship between child- and parent-reported shared decision making and child-, parent-, and clinician-reported treatment outcome in routinely collected child mental health services data.

PubMed

Edbrooke-Childs, Julian; Jacob, Jenna; Argent, Rachel; Patalay, Praveetha; Deighton, Jessica; Wolpert, Miranda

2016-04-01

Shared decision making (SDM) between service users and providers is increasingly being suggested as a key component of good healthcare. The aim of this research was to explore whether child- and parent-reported experience of SDM was associated with child- and parent-reported improvement in psychosocial difficulties and clinician-reported functioning at the end of treatment in child and adolescent mental health services (CAMHS). The sample comprised N = 177 children (62% female; 31% aged 6-12 and 69% aged 13-18) with a variety of mental health problems from 17 services where routinely collected data consisted of presenting problems at outset, child- and parent-reported change in symptoms between Time 1 and Time 2 (Strengths and Difficulties Questionnaire; SDQ), clinician-reported change in functioning between Time 1 and Time 2 (Children's Global Assessment Scale; CGAS), and experience of SDM at Time 2 (as measured by responses to the Experience of Service Questionnaire; ESQ). Analysis revealed that both child- and parent-reported experience of SDM were associated with higher levels of child- and parent-reported improvement in psychosocial difficulties. However, child-reported experience of SDM was only associated with higher levels of child-reported improvement when their parents also reported higher levels of SDM. In CAMHS, involving both children and parents in decision making may contribute to enhanced treatment outcomes. © The Author(s) 2015.

Discrete Event Simulation for Decision Modeling in Health Care: Lessons from Abdominal Aortic Aneurysm Screening

PubMed Central

Jones, Edmund; Masconi, Katya L.; Sweeting, Michael J.; Thompson, Simon G.; Powell, Janet T.

2018-01-01

Markov models are often used to evaluate the cost-effectiveness of new healthcare interventions but they are sometimes not flexible enough to allow accurate modeling or investigation of alternative scenarios and policies. A Markov model previously demonstrated that a one-off invitation to screening for abdominal aortic aneurysm (AAA) for men aged 65 y in the UK and subsequent follow-up of identified AAAs was likely to be highly cost-effective at thresholds commonly adopted in the UK (£20,000 to £30,000 per quality adjusted life-year). However, new evidence has emerged and the decision problem has evolved to include exploration of the circumstances under which AAA screening may be cost-effective, which the Markov model is not easily able to address. A new model to handle this more complex decision problem was needed, and the case of AAA screening thus provides an illustration of the relative merits of Markov models and discrete event simulation (DES) models. An individual-level DES model was built using the R programming language to reflect possible events and pathways of individuals invited to screening v. those not invited. The model was validated against key events and cost-effectiveness, as observed in a large, randomized trial. Different screening protocol scenarios were investigated to demonstrate the flexibility of the DES. The case of AAA screening highlights the benefits of DES, particularly in the context of screening studies.

Making objective decisions in mechanical engineering problems

NASA Astrophysics Data System (ADS)

Raicu, A.; Oanta, E.; Sabau, A.

2017-08-01

Decision making process has a great influence in the development of a given project, the goal being to select an optimal choice in a given context. Because of its great importance, the decision making was studied using various science methods, finally being conceived the game theory that is considered the background for the science of logical decision making in various fields. The paper presents some basic ideas regarding the game theory in order to offer the necessary information to understand the multiple-criteria decision making (MCDM) problems in engineering. The solution is to transform the multiple-criteria problem in a one-criterion decision problem, using the notion of utility, together with the weighting sum model or the weighting product model. The weighted importance of the criteria is computed using the so-called Step method applied to a relation of preferences between the criteria. Two relevant examples from engineering are also presented. The future directions of research consist of the use of other types of criteria, the development of computer based instruments for decision making general problems and to conceive a software module based on expert system principles to be included in the Wiki software applications for polymeric materials that are already operational.

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

NASA Astrophysics Data System (ADS)

Li, Yongchang

In systems engineering, design and operation of systems are two main problems which always attract researcher's attentions. The accomplishment of activities in these problems often requires proper decisions to be made so that the desired goal can be achieved, thus, decision making needs to be carefully fulfilled in the design and operation of systems. Design is a decision making process which permeates through out the design process, and is at the core of all design activities. In modern aircraft design, more and more attention is paid to the conceptual and preliminary design phases so as to increase the odds of choosing a design that will ultimately be successful at the completion of the design process, therefore, decisions made during these early design stages play a critical role in determining the success of a design. Since aerospace systems are complex systems with interacting disciplines and technologies, the Decision Makers (DMs) dealing with such design problems are involved in balancing the multiple, potentially conflicting attributes/criteria, transforming a large amount of customer supplied guidelines into a solidly defined set of requirement definitions. Thus, one could state with confidence that modern aerospace system design is a Multiple Criteria Decision Making (MCDM) process. A variety of existing decision making methods are available to deal with this type of decision problems. The selection of the most appropriate decision making method is of particular importance since inappropriate decision methods are likely causes of misleading engineering design decisions. With no sufficient knowledge about each of the methods, it is usually difficult for the DMs to find an appropriate analytical model capable of solving their problems. In addition, with the complexity of the decision problem and the demand for more capable methods increasing, new decision making methods are emerging with time. These various methods exacerbate the difficulty of the selection of an appropriate decision making method. Furthermore, some DMs may be exclusively using one or two specific methods which they are familiar with or trust and not realizing that they may be inappropriate to handle certain classes of the problems, thus yielding erroneous results. These issues reveal that in order to ensure a good decision a suitable decision method should be chosen before the decision making process proceeds. The first part of this dissertation proposes an MCDM process supported by an intelligent, knowledge-based advisor system referred to as Multi-Criteria Interactive Decision-Making Advisor and Synthesis process (MIDAS), which is able to facilitate the selection of the most appropriate decision making method and which provides insight to the user for fulfilling different preferences. The second part of this dissertation presents an autonomous decision making advisor which is capable of dealing with ever-evolving real time information and making autonomous decisions under uncertain conditions. The advisor encompasses a Markov Decision Process (MDP) formulation which takes uncertainty into account when determines the best action for each system state. (Abstract shortened by UMI.)

Maternal depression and trajectories of child internalizing and externalizing problems: the roles of child decision making and working memory.

PubMed

Flouri, E; Ruddy, A; Midouhas, E

2017-04-01

Maternal depression may affect the emotional/behavioural outcomes of children with normal neurocognitive functioning less severely than it does those without. To guide prevention and intervention efforts, research must specify which aspects of a child's cognitive functioning both moderate the effect of maternal depression and are amenable to change. Working memory and decision making may be amenable to change and are so far unexplored as moderators of this effect. Our sample was 17 160 Millennium Cohort Study children. We analysed trajectories of externalizing (conduct and hyperactivity) and internalizing (emotional and peer) problems, measured with the Strengths and Difficulties Questionnaire at the ages 3, 5, 7 and 11 years, using growth curve models. We characterized maternal depression, also time-varying at these ages, by a high score on the K6. Working memory was measured with the Cambridge Neuropsychological Test Automated Battery Spatial Working Memory Task, and decision making (risk taking and quality of decision making) with the Cambridge Gambling Task, both at age 11 years. Maternal depression predicted both the level and the growth of problems. Risk taking and poor-quality decision making were related positively to externalizing and non-significantly to internalizing problems. Poor working memory was related to both problem types. Neither decision making nor working memory explained the effect of maternal depression on child internalizing/externalizing problems. Importantly, risk taking amplified the effect of maternal depression on internalizing problems, and poor working memory that on internalizing and conduct problems. Impaired decision making and working memory in children amplify the adverse effect of maternal depression on, particularly, internalizing problems.

Training innovations in gastroenterology and educational resources: a new vision of gastrointestinal education across Europe.

PubMed

Berberat, Pascal O; de Wit, Niek J; Bockhorn, Maximilian; Lundell, Lars; Drenth, Joost P H

2010-12-01

To define a new educational strategy for the United European Gastroenterology Federation (UEGF) to be followed and implemented in the near future. UEGF organized a consensus-based strategy meeting with stakeholders and key decision makers in European Gastroenterology on Training Innovations in Gastroenterology and Educational Resources. In May 2010, in an 'open-face conference' at Starnberg, Germany, 59 specialists in gastroenterology, hepatology, and related fields from 15 countries and 16 societies participated. Breakout sessions identified the key problem areas, possible solutions, and formulated statements subsequently voted upon in plenum. A majority of the formulated statements (59%) reached a strong agreement. Topics in which UEGF should focus are the future educational activities that include developing ways to advocate multidisciplinarity and integration between levels of care and specialties, ways to improve quality of care, and the development of training tools. The successful outcome of the Training Innovations in Gastroenterology and Educational Resources conference was achieved with the production of a strategy layout for new UEGF educational activities. There was an agreement that improvement in topics related to multidisciplinarity and professionalism, which is crucial for further development. An open-face conference, such as that embodied by the Training Innovations in Gastroenterology and Educational Resources meeting, was shown to be an effective tool in identifying the key problem areas in education and in formulating new strategies.

DOD Financial Management: Effect of Continuing Weaknesses on Management and Operations and Status of Key Challenges

DTIC Science & Technology

2014-05-13

the information needed to effectively (1) manage its assets, (2) assess program performance and make budget decisions , (3) make cost- effective ... decision making, including the information needed to effectively (1) manage its assets, (2) assess program performance and make budget decisions , (3...incorporating key elements of a comprehensive management approach , such as a complete analysis of the return on investment, quantitatively -defined goals

A Framework for Developing the Structure of Public Health Economic Models.

PubMed

Squires, Hazel; Chilcott, James; Akehurst, Ronald; Burr, Jennifer; Kelly, Michael P

2016-01-01

A conceptual modeling framework is a methodology that assists modelers through the process of developing a model structure. Public health interventions tend to operate in dynamically complex systems. Modeling public health interventions requires broader considerations than clinical ones. Inappropriately simple models may lead to poor validity and credibility, resulting in suboptimal allocation of resources. This article presents the first conceptual modeling framework for public health economic evaluation. The framework presented here was informed by literature reviews of the key challenges in public health economic modeling and existing conceptual modeling frameworks; qualitative research to understand the experiences of modelers when developing public health economic models; and piloting a draft version of the framework. The conceptual modeling framework comprises four key principles of good practice and a proposed methodology. The key principles are that 1) a systems approach to modeling should be taken; 2) a documented understanding of the problem is imperative before and alongside developing and justifying the model structure; 3) strong communication with stakeholders and members of the team throughout model development is essential; and 4) a systematic consideration of the determinants of health is central to identifying the key impacts of public health interventions. The methodology consists of four phases: phase A, aligning the framework with the decision-making process; phase B, identifying relevant stakeholders; phase C, understanding the problem; and phase D, developing and justifying the model structure. Key areas for further research involve evaluation of the framework in diverse case studies and the development of methods for modeling individual and social behavior. This approach could improve the quality of Public Health economic models, supporting efficient allocation of scarce resources. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Probabilistic Risk Assessment for Decision Making During Spacecraft Operations

NASA Technical Reports Server (NTRS)

Meshkat, Leila

2009-01-01

Decisions made during the operational phase of a space mission often have significant and immediate consequences. Without the explicit consideration of the risks involved and their representation in a solid model, it is very likely that these risks are not considered systematically in trade studies. Wrong decisions during the operational phase of a space mission can lead to immediate system failure whereas correct decisions can help recover the system even from faulty conditions. A problem of special interest is the determination of the system fault protection strategies upon the occurrence of faults within the system. Decisions regarding the fault protection strategy also heavily rely on a correct understanding of the state of the system and an integrated risk model that represents the various possible scenarios and their respective likelihoods. Probabilistic Risk Assessment (PRA) modeling is applicable to the full lifecycle of a space mission project, from concept development to preliminary design, detailed design, development and operations. The benefits and utilities of the model, however, depend on the phase of the mission for which it is used. This is because of the difference in the key strategic decisions that support each mission phase. The focus of this paper is on describing the particular methods used for PRA modeling during the operational phase of a spacecraft by gleaning insight from recently conducted case studies on two operational Mars orbiters. During operations, the key decisions relate to the commands sent to the spacecraft for any kind of diagnostics, anomaly resolution, trajectory changes, or planning. Often, faults and failures occur in the parts of the spacecraft but are contained or mitigated before they can cause serious damage. The failure behavior of the system during operations provides valuable data for updating and adjusting the related PRA models that are built primarily based on historical failure data. The PRA models, in turn, provide insight into the effect of various faults or failures on the risk and failure drivers of the system and the likelihood of possible end case scenarios, thereby facilitating the decision making process during operations. This paper describes the process of adjusting PRA models based on observed spacecraft data, on one hand, and utilizing the models for insight into the future system behavior on the other hand. While PRA models are typically used as a decision aid during the design phase of a space mission, we advocate adjusting them based on the observed behavior of the spacecraft and utilizing them for decision support during the operations phase.

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

PubMed

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

2016-01-01

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

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

Warner, R.E.

This paper seeks to provoke the thought of whether the battle manager of the future will be a human or a computer and where he/it will be located. The sensors, weapons, and problems with the missile-attack warning systems threat need to be understood before decisions can be made about the future. The author talks about technology driving the decisions and the time to make the decisions being key factors in space-battle management. He looks at when and how to kill a missile launched either from Soviet soil or space and the myriad of things that must happen before the battlemore » manager can make a decision: (1) the missile(s) must be detected; (2) then all the information about the missile(s) needs to be passed to the battle manager and all the decision makers in the chain of command, including the National Command Authority. It is emphasize the communication process must be fast and not affected by either jamming or nuclear bursts, and it also must be designed so that if a part is destroyed the system is still responsive to the battle manager. Questions such as should only the United States be protected by this system or should it include our allies; and then who are they and should an international body control the system are asked. The author finally concludes that the battle manager of the future will be located in space.« less

The challenges of strategic purchasing of healthcare services in Iran Health Insurance Organization: a qualitative study.

PubMed

Gorji, Hasan Abolghasem; Mousavi, Sayyed Masoud Shajari Pour; Shojaei, Ali; Keshavarzi, Anahita; Zare, Hossein

2018-02-01

Strategic purchasing in healthcare services is a key component in improving health system performance, and it has been one of the most important issues in health system reform around the world, especially Europe in the last decade. Iran health system and insurance, although sometimes considered the issue of strategic purchasing goals, has not been made possible to achieve or even to implement, due to the associated problems. To determine the associated problems of strategic purchasing in the Iran Health Insurance Organization (IHIO). This study is a qualitative study, and framework analysis which was conducted in Iran in 2014-15. The participants in this study were 34 individuals from decision-makers and executives in the IHIO purchasing process, and university experts who have been chosen purposefully. This study conducted frame analysis, by using MAXQDA 10. The findings included associated problems of IHIO strategic purchasing in 12 themes and 65 subthemes. The themes included: Laws and regulations for purchasing, Organization of purchasing, Qualified and authorized providers, Right type of services, Right type of contracts, Target groups for purchasing, Resources allocation, financing and pricing system, Purchasing as improving performance and quality, Purchasing as shaping the market and competition, Purchasing as health progress state of people and society, Guided purchasing and stewardship of government, Structure of decision-making process in the health and welfare ministries. The findings of this study showed associated problems in IHIO strategic purchasing. To achieve strategic purchasing goals in Iran, identification of all issues and factors of the total insurers and health system sets which affect strategic purchasing is essential.

The thinking doctor: clinical decision making in contemporary medicine.

PubMed

Trimble, Michael; Hamilton, Paul

2016-08-01

Diagnostic errors are responsible for a significant number of adverse events. Logical reasoning and good decision-making skills are key factors in reducing such errors, but little emphasis has traditionally been placed on how these thought processes occur, and how errors could be minimised. In this article, we explore key cognitive ideas that underpin clinical decision making and suggest that by employing some simple strategies, physicians might be better able to understand how they make decisions and how the process might be optimised. © 2016 Royal College of Physicians.

A new patent-based approach for technology mapping in the pharmaceutical domain.

PubMed

Russo, Davide; Montecchi, Tiziano; Carrara, Paolo

2013-09-01

The key factor in decision-making is the quality of information collected and processed in the problem analysis. In most cases, patents represent a very important source of information. The main problem is how to extract such information from the huge corpus of documents with a high recall and precision, and in a short time. This article demonstrates a patent search and classification method, called Knowledge Organizing Module, which consists of creating, almost automatically, a pool of patents based on polysemy expansion and homonymy disambiguation. Since the pool is done, an automatic patent technology landscaping is provided for fixing the state of the art of our product, and exploring competing alternative treatments and/or possible technological opportunities. An exemplary case study is provided, it deals with a patent analysis in the field of verruca treatments.

The policies of organ transplantation in Europe: issues and problems.

PubMed

Defever, M

1990-11-01

Transplantation has evolved from an experiment to a routinely performed procedure for a widening range of organs. Transplantation in Europe is dominated by the scarcity of organs from deceased donors leading to problems of selection criteria for recipients, of legal protection for donors and of the empowerment of agencies for allocative decisions. Although public involvement is very emotional, there has been a benign neglect in several European countries by policy makers, accepting implicitly organ transplantation leading to a variety of programs for diffusion, organization, and financing of transplantation. Non-transplanting hospitals play a key role in organ procurement and transplant centers are increasingly subject to quality assessment, whereby the issue of the relation between improved outcome at higher volumes comes to the forefront. International cooperation is critical for the development of effective transplant programs in Europe.

Combining statistical inference and decisions in ecology

USGS Publications Warehouse

Williams, Perry J.; Hooten, Mevin B.

2016-01-01

Statistical decision theory (SDT) is a sub-field of decision theory that formally incorporates statistical investigation into a decision-theoretic framework to account for uncertainties in a decision problem. SDT provides a unifying analysis of three types of information: statistical results from a data set, knowledge of the consequences of potential choices (i.e., loss), and prior beliefs about a system. SDT links the theoretical development of a large body of statistical methods including point estimation, hypothesis testing, and confidence interval estimation. The theory and application of SDT have mainly been developed and published in the fields of mathematics, statistics, operations research, and other decision sciences, but have had limited exposure in ecology. Thus, we provide an introduction to SDT for ecologists and describe its utility for linking the conventionally separate tasks of statistical investigation and decision making in a single framework. We describe the basic framework of both Bayesian and frequentist SDT, its traditional use in statistics, and discuss its application to decision problems that occur in ecology. We demonstrate SDT with two types of decisions: Bayesian point estimation, and an applied management problem of selecting a prescribed fire rotation for managing a grassland bird species. Central to SDT, and decision theory in general, are loss functions. Thus, we also provide basic guidance and references for constructing loss functions for an SDT problem.

Criteria for assessing problem solving and decision making in complex environments

NASA Technical Reports Server (NTRS)

Orasanu, Judith

1993-01-01

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

Dynamic Decision Making under Uncertainty and Partial Information

DTIC Science & Technology

2017-01-30

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

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard.

PubMed

Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

2015-08-01

management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process.

[Health advocacy in violence against women: an experience].

PubMed

Vives-Cases, Carmen; Alvarez-Dardet, Carlos; Colomer, Concha; Bertomeu, Angustias

2005-01-01

The development of political responses to a problem needs for its construction as a social problem of a continuous epidemiological surveillance system available for the affected public and key decision makers. A women's health advocacy net based initiative was launched in November 2003. Every month the epidemic index of deaths (ratio of deaths in that month and median of deaths occurring the previous 5 years) due to Intimate Partner Violence (IPV) is published in a section called "Violence Alert" of e-leusis.net a women's web page. The objective was giving visibility to information contributing to shape the problem. from a population perspective. The initiative was introduced at the beginning to journalists and every month a press release with the index results and a comment on it is circulated. More than half of the months studied (January 2003-December 2004) were epidemic (epidemic indexb > or = 1.25). "Violence alert" has received 2330 visits since then, an average of 65 visits per week. The page attracted media coverage from radio, TV and newspapers.

Decisional needs assessment of patients with complex care needs in primary care: a participatory systematic mixed studies review protocol

PubMed Central

Pluye, Pierre; Légaré, France; Haggerty, Jeannie; Gore, Genevieve C; Sherif, Reem El; Poitras, Marie-Ève; Beaulieu, Marie-Claude; Beaulieu, Marie-Dominique; Bush, Paula L; Couturier, Yves; Débarges, Béatrice; Gagnon, Justin; Giguère, Anik; Grad, Roland; Granikov, Vera; Goulet, Serge; Hudon, Catherine; Kremer, Bernardo; Kröger, Edeltraut; Kudrina, Irina; Lebouché, Bertrand; Loignon, Christine; Lussier, Marie-Thérèse; Martello, Cristiano; Nguyen, Quynh; Pratt, Rebekah; Rihoux, Benoit; Rosenberg, Ellen; Samson, Isabelle; Senn, Nicolas; Li Tang, David; Tsujimoto, Masashi; Vedel, Isabelle; Ventelou, Bruno; Wensing, Michel; Bigras, Magali

2017-01-01

Introduction Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers). Methods and analysis This review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs’ qualitative decisional need assessment (semistructured interviews and focus group with stakeholders). Ethics and dissemination This systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs’ decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network. PROSPERO registration number CRD42015020558. PMID:29133314

Decisional needs assessment of patients with complex care needs in primary care: a participatory systematic mixed studies review protocol.

PubMed

Bujold, Mathieu; Pluye, Pierre; Légaré, France; Haggerty, Jeannie; Gore, Genevieve C; Sherif, Reem El; Poitras, Marie-Eve; Beaulieu, Marie-Claude; Beaulieu, Marie-Dominique; Bush, Paula L; Couturier, Yves; Débarges, Beatrice; Gagnon, Justin; Giguère, Anik; Grad, Roland; Granikov, Vera; Goulet, Serge; Hudon, Catherine; Kremer, Bernardo; Kröger, Edeltraut; Kudrina, Irina; Lebouché, Bertrand; Loignon, Christine; Lussier, Marie-Therese; Martello, Cristiano; Nguyen, Quynh; Pratt, Rebekah; Rihoux, Benoit; Rosenberg, Ellen; Samson, Isabelle; Senn, Nicolas; Li Tang, David; Tsujimoto, Masashi; Vedel, Isabelle; Ventelou, Bruno; Wensing, Michel

2017-11-12

Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers). This review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs' qualitative decisional need assessment (semistructured interviews and focus group with stakeholders). This systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs' decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network. CRD42015020558. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Operator models for delivering municipal solid waste management services in developing countries: Part B: Decision support.

PubMed

Soós, Reka; Whiteman, Andrew D; Wilson, David C; Briciu, Cosmin; Nürnberger, Sofia; Oelz, Barbara; Gunsilius, Ellen; Schwehn, Ekkehard

2017-08-01

This is the second of two papers reporting the results of a major study considering 'operator models' for municipal solid waste management (MSWM) in emerging and developing countries. Part A documents the evidence base, while Part B presents a four-step decision support system for selecting an appropriate operator model in a particular local situation. Step 1 focuses on understanding local problems and framework conditions; Step 2 on formulating and prioritising local objectives; and Step 3 on assessing capacities and conditions, and thus identifying strengths and weaknesses, which underpin selection of the operator model. Step 4A addresses three generic questions, including public versus private operation, inter-municipal co-operation and integration of services. For steps 1-4A, checklists have been developed as decision support tools. Step 4B helps choose locally appropriate models from an evidence-based set of 42 common operator models ( coms); decision support tools here are a detailed catalogue of the coms, setting out advantages and disadvantages of each, and a decision-making flowchart. The decision-making process is iterative, repeating steps 2-4 as required. The advantages of a more formal process include avoiding pre-selection of a particular com known to and favoured by one decision maker, and also its assistance in identifying the possible weaknesses and aspects to consider in the selection and design of operator models. To make the best of whichever operator models are selected, key issues which need to be addressed include the capacity of the public authority as 'client', management in general and financial management in particular.

Research of Simple Multi-Attribute Rating Technique for Decision Support

NASA Astrophysics Data System (ADS)

Siregar, Dodi; Arisandi, Diki; Usman, Ari; Irwan, Dedy; Rahim, Robbi

2017-12-01

One of the roles of decision support system is that it can assist the decision maker in obtaining the appropriate alternative with the desired criteria, one of the methods that could apply for the decision maker is SMART method with multicriteria decision making. This multi-criteria decision-making theory has meaning where every alternative has criteria and has value and weight, and the author uses this approach to facilitate decision making with a compelling case. The problems discussed in this paper are classified into problems of a variety Multiobjective (multiple goals to be accomplished) and multicriteria (many of the decisive criteria in reaching such decisions).

Get People Talking: Sharing Tsunami Science Beyond the Web

NASA Astrophysics Data System (ADS)

Ross, S.; Jones, L.; Miller, K.; Wilson, R. I.; Bahng, B.; Borrero, J. C.; Brosnan, D. M.; Burkett, E. R.; Bwarie, J.; Campbell, N. M.; Geist, E. L.; Johnson, L.; Kirby, S. H.; Knight, W. R.; Long, K.; Lynett, P. J.; Nicolsky, D.; Oglesby, D. D.; Barberopoulou, A.; Perry, S. C.; Plumlee, G. S.; Porter, K.; Real, C. R.; Ritchie, L.; Ryan, K. J.; Suleimani, E.; Thio, H. K.; Titov, V. V.; Wein, A. M.; Whitmore, P.; Wood, N. J.

2016-12-01

The SAFRR Tsunami Scenario, a collaborative product between the USGS, NOAA, the California Geological Survey, Cal OES and other agencies and institutions, modeled the potential implications of a plausible tsunami caused by a hypothetical magnitude 9.1 earthquake off the Alaskan Peninsula. A multi-disciplinary team of researchers and practitioners looked at what such an event could mean to the coastal residents, visitors, infrastructure, economy, and environment in California. The intended users were those responsible for making mitigation decisions before and those who need to make rapid decisions during future tsunamis. The Tsunami Scenario process was evaluated by the University of Colorado's Natural Hazards Center; it was the first time that a USGS scenario of that scale was formally and systematically evaluated by an external party. The scenario was published as a USGS Open-File Report (http://pubs.usgs.gov/of/2013/1170/) and as a fact sheet. The report's website received over 1 million hits in the first year, demonstrating that the project received a great deal of attention. To make sure the information was accessible to the key users, we also held a series of regional workshops. These workshops brought together project scientists with emergency managers, maritime authorities, first responders, elected officials and staffers, the business sector, state agencies, local media, scientific partners, and special districts such as utilities. Each workshop had about 10 SAFRR project participants and an audience of about 40-100 potential users. The half-day workshops began with presentations on the scenario results and also included significant time for facilitated discussions to identify practical problems and propose solutions to mitigate the hazards. Two of the key lessons learned included: a) recognizing the value of having scenario developers personally present the scenario to user groups and b) stimulating dialogue among the practitioners to solve problems.

Engineering the System and Technical Integration

NASA Technical Reports Server (NTRS)

Blair, J. C.; Ryan, R. S.; Schutzenhofer, L. A.

2011-01-01

Approximately 80% of the problems encountered in aerospace systems have been due to a breakdown in technical integration and/or systems engineering. One of the major challenges we face in designing, building, and operating space systems is: how is adequate integration achieved for the systems various functions, parts, and infrastructure? This Contractor Report (CR) deals with part of the problem of how we engineer the total system in order to achieve the best balanced design. We will discuss a key aspect of this question - the principle of Technical Integration and its components, along with management and decision making. The CR will first provide an introduction with a discussion of the Challenges in Space System Design and meeting the challenges. Next is an overview of Engineering the System including Technical Integration. Engineering the System is expanded to include key aspects of the Design Process, Lifecycle Considerations, etc. The basic information and figures used in this CR were presented in a NASA training program for Program and Project Managers Development (PPMD) in classes at Georgia Tech and at Marshall Space Flight Center (MSFC). Many of the principles and illustrations are extracted from the courses we teach for MSFC.

Applying Cases to Solve Ethical Problems: The Significance of Positive and Process-Oriented Reflection

PubMed Central

Antes, Alison L.; Thiel, Chase E.; Martin, Laura E.; Stenmark, Cheryl K.; Connelly, Shane; Devenport, Lynn D.; Mumford, Michael D.

2015-01-01

This study examined the role of reflection on personal cases for making ethical decisions with regard to new ethical problems. Participants assumed the position of a business manager in a hypothetical organization and solved ethical problems that might be encountered. Prior to making a decision for the business problems, participants reflected on a relevant ethical experience. The findings revealed that application of material garnered from reflection on a personal experience was associated with decisions of higher ethicality. However, whether the case was viewed as positive or negative, and whether the outcomes, process, or outcomes and processes embedded in the experience were examined, influenced the application of case material to the new problem. As expected, examining positive experiences and the processes involved in those positive experiences resulted in greater application of case material to new problems. Future directions and implications for understanding ethical decision-making are discussed. PMID:26257506

The use of multi-criteria decision analysis to tackle waste management problems: a literature review.

PubMed

Achillas, Charisios; Moussiopoulos, Nicolas; Karagiannidis, Avraam; Banias, Georgias; Perkoulidis, George

2013-02-01

Problems in waste management have become more and more complex during recent decades. The increasing volumes of waste produced and social environmental consciousness present prominent drivers for environmental managers towards the achievement of a sustainable waste management scheme. However, in practice, there are many factors and influences - often mutually conflicting - criteria for finding solutions in real-life applications. This paper presents a review of the literature on multi-criteria decision aiding in waste management problems for all reported waste streams. Despite limitations, which are clearly stated, most of the work published in this field is reviewed. The present review aims to provide environmental managers and decision-makers with a thorough list of practical applications of the multi-criteria decision analysis techniques that are used to solve real-life waste management problems, as well as the criteria that are mostly employed in such applications according to the nature of the problem under study. Moreover, the paper explores the advantages and disadvantages of using multi-criteria decision analysis techniques in waste management problems in comparison to other available alternatives.

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.

Exploration-Related Research on the International Space Station: Connecting Science Results to the Design of Future Missions

NASA Technical Reports Server (NTRS)

Rhatigan, Jennifer L.; Robinson, Julie A.; Sawin, Charles F.; Ahlf, Peter R.

2005-01-01

In January, 2004, the US President announced a vision for space exploration, and charged NASA with utilizing the International Space Station (ISS) for research and technology targeted at supporting the US space exploration goals. This paper describes: 1) what we have learned from the first four years of research on ISS relative to the exploration mission, 2) the on-going research being conducted in this regard, 3) our current understanding of the major exploration mission risks that the ISS can be used to address, and 4) current progress in realigning NASA s research portfolio for ISS to support exploration missions. Specifically, we discuss the focus of research on solving the perplexing problems of maintaining human health on long-duration missions, and the development of countermeasures to protect humans from the space environment, enabling long duration exploration missions. The interchange between mission design and research needs is dynamic, where design decisions influence the type of research needed, and results of research influence design decisions. The fundamental challenge to science on ISS is completing experiments that answer key questions in time to shape design decisions for future exploration. In this context, exploration-relevant research must do more than be conceptually connected to design decisions-it must become a part of the mission design process.

Fuzzy approaches to supplier selection problem

NASA Astrophysics Data System (ADS)

Ozkok, Beyza Ahlatcioglu; Kocken, Hale Gonce

2013-09-01

Supplier selection problem is a multi-criteria decision making problem which includes both qualitative and quantitative factors. In the selection process many criteria may conflict with each other, therefore decision-making process becomes complicated. In this study, we handled the supplier selection problem under uncertainty. In this context; we used minimum criterion, arithmetic mean criterion, regret criterion, optimistic criterion, geometric mean and harmonic mean. The membership functions created with the help of the characteristics of used criteria, and we tried to provide consistent supplier selection decisions by using these memberships for evaluating alternative suppliers. During the analysis, no need to use expert opinion is a strong aspect of the methodology used in the decision-making.

Fuzzy bilevel programming with multiple non-cooperative followers: model, algorithm and application

NASA Astrophysics Data System (ADS)

Ke, Hua; Huang, Hu; Ralescu, Dan A.; Wang, Lei

2016-04-01

In centralized decision problems, it is not complicated for decision-makers to make modelling technique selections under uncertainty. When a decentralized decision problem is considered, however, choosing appropriate models is no longer easy due to the difficulty in estimating the other decision-makers' inconclusive decision criteria. These decision criteria may vary with different decision-makers because of their special risk tolerances and management requirements. Considering the general differences among the decision-makers in decentralized systems, we propose a general framework of fuzzy bilevel programming including hybrid models (integrated with different modelling methods in different levels). Specially, we discuss two of these models which may have wide applications in many fields. Furthermore, we apply the proposed two models to formulate a pricing decision problem in a decentralized supply chain with fuzzy coefficients. In order to solve these models, a hybrid intelligent algorithm integrating fuzzy simulation, neural network and particle swarm optimization based on penalty function approach is designed. Some suggestions on the applications of these models are also presented.

Integrating conflict analysis and consensus reaching in a decision support system for water resource management.

PubMed

Giordano, R; Passarella, G; Uricchio, V F; Vurro, M

2007-07-01

The importance of shared decision processes in water management derives from the awareness of the inadequacy of traditional--i.e. engineering--approaches in dealing with complex and ill-structured problems. It is becoming increasingly obvious that traditional problem solving and decision support techniques, based on optimisation and factual knowledge, have to be combined with stakeholder based policy design and implementation. The aim of our research is the definition of an integrated decision support system for consensus achievement (IDSS-C) able to support a participative decision-making process in all its phases: problem definition and structuring, identification of the possible alternatives, formulation of participants' judgments, and consensus achievement. Furthermore, the IDSS-C aims at structuring, i.e. systematising the knowledge which has emerged during the participative process in order to make it comprehensible for the decision-makers and functional for the decision process. Problem structuring methods (PSM) and multi-group evaluation methods (MEM) have been integrated in the IDSS-C. PSM are used to support the stakeholders in providing their perspective of the problem and to elicit their interests and preferences, while MEM are used to define not only the degree of consensus for each alternative, highlighting those where the agreement is high, but also the consensus label for each alternative and the behaviour of individuals during the participative decision-making. The IDSS-C is applied experimentally to a decision process regarding the use of treated wastewater for agricultural irrigation in the Apulia Region (southern Italy).

Foster care assessment: A study of the placement decision process in Flanders.

PubMed

Vanderfaeillie, Johan; Pijnenburg, Huub; Damen, Harm; Van Holen, Frank

2015-11-01

Family foster care placement decision-making has a weak scientific underpinning. Mostly a 'variable-oriented approach' is taken, which requires a lot of information that is not always available. The identification of clusters of foster children with similar characteristics may be a more viable decision strategy. In this study we investigated if foster children could indeed be clustered, which problems were identified at the time of placement, and the influence of placement history. It proved possible to group foster children into two clusters: (1) young children with familial problems and few behavioral problems, and (2) older children with prominent child problems and behavioral problems. For foster children with and without placement history, problems associated with placement proved identical. Considering that a foster care placement did not result in fundamental change in the problems present at time of placement, the importance is stressed of approaching foster care assessment as part of a decision making process which looks back as well as forward. Placement decisions should be based on an appraisal of the appropriateness of foster placement as a solution for the child. In conjunction with this appraisal a decision is required on how parents can be supported toward reunification. Or--if this is not an option--whether long term foster care is the best option for the child and if so, what conditions need to be met. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reproductive autonomy, the non-identity problem, and the non-person problem.

PubMed

DiSilvestro, Russell

2009-01-01

The Non-Identity Problem is the problem of explaining the apparent wrongness of a decision that does not harm people, especially since some of the people affected by the decision would not exist at all were it not for the decision. One approach to this problem, in the context of reproductive decisions, is to focus on wronging, rather than harming, one's offspring. But a Non-Person Problem emerges for any view that claims (1) that only persons can be wronged and (2) that the person-making properties allow for there to be human non-persons. Consider an individual human organism that is prevented from ever possessing the person-making properties. On person-only accounts of the victims of wronging, this organism cannot be wronged by anyone. Hence even individuals whose decisions prevent it from ever possessing the person-making properties cannot wrong it. But this is counter-intuitive. We can think of examples where a human organism is wronged by precisely those decisions that prevent it from possessing the person-making properties. The best solution to this problem, in the case where the person-making property is rational self-governance in pursuit of a meaningful life, is to adjust the concept of a person so that it refers, not merely to those with the immediate capacity for rational self-governance in pursuit of a meaningful life, but also to those with a higher-order capacity for such self-governance. Any solution to the Non-Identity Problem that focuses on wronging rather than harming should incorporate this sort of solution to the Non-Person Problem.

Effect of training problem-solving skill on decision-making and critical thinking of personnel at medical emergencies

PubMed Central

Heidari, Mohammad; Shahbazi, Sara

2016-01-01

Background: The aim of this study was to determine the effect of problem-solving training on decision-making skill and critical thinking in emergency medical personnel. Materials and Methods: This study is an experimental study that performed in 95 emergency medical personnel in two groups of control (48) and experimental (47). Then, a short problem-solving course based on 8 sessions of 2 h during the term, was performed for the experimental group. Of data gathering was used demographic and researcher made decision-making and California critical thinking skills questionnaires. Data were analyzed using SPSS software. Results: The finding revealed that decision-making and critical thinking score in emergency medical personnel are low and problem-solving course, positively affected the personnel’ decision-making skill and critical thinking after the educational program (P < 0.05). Conclusions: Therefore, this kind of education on problem-solving in various emergency medicine domains such as education, research, and management, is recommended. PMID:28149823

The Concept of Strategic Decisionmaking.

ERIC Educational Resources Information Center

Collier, Douglas J.

Strategic decision-making literature is reviewed, and applications to colleges and universities are made. The key requirement for strategic decision-making is that decisions affect the entire organization. While strategic decision-making can occur at different levels within the organization, the specific strategic decisions available to the…

23 CFR 450.210 - Interested parties, public involvement, and consultation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... opportunities for public review and comment at key decision points. (1) The State's public involvement process... agencies, representatives of public transportation employees, freight shippers, private providers of... comment at key decision points, including but not limited to a reasonable opportunity to comment on the...

23 CFR 450.210 - Interested parties, public involvement, and consultation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... opportunities for public review and comment at key decision points. (1) The State's public involvement process... agencies, representatives of public transportation employees, freight shippers, private providers of... comment at key decision points, including but not limited to a reasonable opportunity to comment on the...

23 CFR 450.210 - Interested parties, public involvement, and consultation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... opportunities for public review and comment at key decision points. (1) The State's public involvement process... agencies, representatives of public transportation employees, freight shippers, private providers of... comment at key decision points, including but not limited to a reasonable opportunity to comment on the...

Negative mood induction normalizes decision making in male cocaine dependent individuals.

PubMed

Fernández-Serrano, María José; Moreno-López, Laura; Pérez-García, Miguel; Viedma-Del Jesús, María I; Sánchez-Barrera, María B; Verdejo-García, Antonio

2011-10-01

Decision making is thought to play a key role in psychostimulant relapse, but very few studies have addressed the issue of how to counteract decision-making deficits in addicted individuals. According to the somatic marker framework, pervasive decision-making problems in addicted individuals may relate to abnormalities in the processing of emotional signals that work to anticipate the prospective outcomes of potential decisions. The present study was conducted to test whether the induction of different emotional states (positive, negative, or drug-related) could either normalize or further impair decision-making performance in male cocaine polysubstance-using individuals (CPSI), as indexed by the Iowa gambling task (IGT). Forty-two CPSI and 65 healthy control individuals (all males) were randomly allocated in four affective conditions using a parallel-group design. Participants in the different conditions performed the IGT during exposure to neutral, positive, negative, or drug-related sets of affective images. The results showed that the CPSI exposed to the negative affective context showed a preference for the risk-averse safe choices of the IGT and had a net performance indistinguishable from that of controls. On the other hand, CPSI exposed to positive, drug-related, and neutral contexts showed the typical pattern of disadvantageous performance in the IGT and performed significantly poorer than controls. The impact of the negative mood induction could not be explained in terms of baseline differences in decision-making skills, personality traits related to sensitivity to reward/punishment, or trait positive/negative affect. We conclude that negative mood induction can normalize decision-making performance in male CPSI, which may have important implications for the treatment of cocaine use-related disorders.

Development of S-ARIMA Model for Forecasting Demand in a Beverage Supply Chain

NASA Astrophysics Data System (ADS)

Mircetic, Dejan; Nikolicic, Svetlana; Maslaric, Marinko; Ralevic, Nebojsa; Debelic, Borna

2016-11-01

Demand forecasting is one of the key activities in planning the freight flows in supply chains, and accordingly it is essential for planning and scheduling of logistic activities within observed supply chain. Accurate demand forecasting models directly influence the decrease of logistics costs, since they provide an assessment of customer demand. Customer demand is a key component for planning all logistic processes in supply chain, and therefore determining levels of customer demand is of great interest for supply chain managers. In this paper we deal with exactly this kind of problem, and we develop the seasonal Autoregressive IntegratedMoving Average (SARIMA) model for forecasting demand patterns of a major product of an observed beverage company. The model is easy to understand, flexible to use and appropriate for assisting the expert in decision making process about consumer demand in particular periods.

Demodulation Algorithms for the Ofdm Signals in the Time- and Frequency-Scattering Channels

NASA Astrophysics Data System (ADS)

Bochkov, G. N.; Gorokhov, K. V.; Kolobkov, A. V.

2016-06-01

We consider a method based on the generalized maximum-likelihood rule for solving the problem of reception of the signals with orthogonal frequency division multiplexing of their harmonic components (OFDM signals) in the time- and frequency-scattering channels. The coherent and incoherent demodulators effectively using the time scattering due to the fast fading of the signal are developed. Using computer simulation, we performed comparative analysis of the proposed algorithms and well-known signal-reception algorithms with equalizers. The proposed symbolby-symbol detector with decision feedback and restriction of the number of searched variants is shown to have the best bit-error-rate performance. It is shown that under conditions of the limited accuracy of estimating the communication-channel parameters, the incoherent OFDMsignal detectors with differential phase-shift keying can ensure a better bit-error-rate performance compared with the coherent OFDM-signal detectors with absolute phase-shift keying.

Medical Problem-Solving: A Critique of the Literature.

ERIC Educational Resources Information Center

McGuire, Christine H.

1985-01-01

Prescriptive, decision-analysis of medical problem-solving has been based on decision theory that involves calculation and manipulation of complex probability and utility values to arrive at optimal decisions that will maximize patient benefits. The studies offer a methodology for improving clinical judgment. (Author/MLW)

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

THE RELATIONSHIP BETWEEN MEASURES OF IMPULSIVITY AND ALCOHOL MISUSE: AN INTEGRATIVE STRUCTURAL EQUATION MODELING APPROACH

PubMed Central

Courtney, Kelly E.; Arellano, Ryan; Barkley-Levenson, Emily; Gálvan, Adriana; Poldrack, Russell A.; MacKillop, James; Jentsch, J. David; Ray, Lara A.

2011-01-01

Background Higher levels of impulsivity have been implicated in the development of alcohol use disorders. Recent findings suggest that impulsivity is not a unitary construct, highlighted by the diverse ways in which the various measures of impulsivity relate to alcohol use outcomes. This study simultaneously tested the following dimensions of impulsivity as determinants of alcohol use and alcohol problems: risky decision-making, self-reported risk attitudes, response inhibition, and impulsive decision-making. Method Participants were a community sample of non-treatment seeking problem drinkers (N = 158). Structural Equation Modeling (SEM) analyses employed behavioral measures of impulsive decision-making (Delay Discounting Task, DDT), response inhibition (Stop Signal Task, SST), and risky decision-making (Balloon Analogue Risk Task, BART), and a self-report measure of risk attitudes (Domain-specific Risk-attitude Scale, DOSPERT), as predictors of alcohol use and of alcohol-related problems in this sample. Results The model fit well, accounting for 38% of the variance in alcohol problems, and identified two impulsivity dimensions that significantly loaded onto alcohol outcomes: (1) impulsive decision-making, indexed by the DDT; and (2) risky decision-making, measured by the BART. Conclusions The impulsive decision-making dimension of impulsivity, indexed by the DDT, was the strongest predictor of alcohol use and alcohol pathology in this sample of problem drinkers. Unexpectedly, a negative relationship was found between risky decision-making and alcohol problems. The results highlight the importance of considering the distinct facets of impulsivity in order to elucidate their individual and combined effects on alcohol use initiation, escalation, and dependence. PMID:22091877

Can Classification Tree Analyses Help Improve Decision Making About Treatments for Depression and Anxiety Disorders? A Preliminary Investigation

PubMed Central

Rhodes, Louisa; Naumann, Ulrike M.

2011-01-01

Objective: To identify how decisions about treatment are being made in secondary services for anxiety disorders and depression and, specifically, whether it was possible to predict the decisions to refer for evidence-based treatments. Method: Post hoc classification tree analysis was performed using a sample from an audit on implementation of the National Institute for Health and Clinical Excellence Guidelines for Depression and Anxiety Disorders. The audit was of 5 teams offering secondary care services; they included psychiatrists, psychologists, community psychiatric nurses, social workers, dual-diagnosis workers, and vocational workers. The patient sample included all of those with a primary problem of depression (n = 56) or an anxiety disorder (n = 16) who were offered treatment from February 16 to April 3, 2009. The outcome variable was whether or not evidence-based treatments were offered, and the predictor variables were presenting problem, risk, comorbid problem, social problems, and previous psychiatric history. Results: Treatment decisions could be more accurately predicted for anxiety disorders (93% correct) than for depression (55%). For anxiety disorders, the presence or absence of social problems was a good predictor for whether evidence-based or non–evidence-based treatments were offered; 44% (4/9) of those with social problems vs 100% (6/6) of those without social problems were offered evidence-based treatments. For depression, patients’ risk rating had the largest impact on treatment decisions, although no one variable could be identified as individually predictive of all treatment decisions. Conclusions: Treatment decisions were generally consistent for anxiety disorders but more idiosyncratic for depression, making the development of a decision-making model very difficult for depression. The lack of clarity of some terms in the clinical guidelines and the more complex nature of depression could be factors contributing to this difficulty. Further research is needed to understand the complex nature of decision making with depressed patients. PMID:22295255

Human Cognitive Limitations. Broad, Consistent, Clinical Application of Physiological Principles Will Require Decision Support.

PubMed

Morris, Alan H

2018-02-01

Our education system seems to fail to enable clinicians to broadly understand core physiological principles. The emphasis on reductionist science, including "omics" branches of research, has likely contributed to this decrease in understanding. Consequently, clinicians cannot be expected to consistently make clinical decisions linked to best physiological evidence. This is a large-scale problem with multiple determinants, within an even larger clinical decision problem: the failure of clinicians to consistently link their decisions to best evidence. Clinicians, like all human decision-makers, suffer from significant cognitive limitations. Detailed context-sensitive computer protocols can generate personalized medicine instructions that are well matched to individual patient needs over time and can partially resolve this problem.

A Decision Support Framework for Science-Based, Multi-Stakeholder Deliberation: A Coral Reef Example

NASA Astrophysics Data System (ADS)

Rehr, Amanda P.; Small, Mitchell J.; Bradley, Patricia; Fisher, William S.; Vega, Ann; Black, Kelly; Stockton, Tom

2012-12-01

We present a decision support framework for science-based assessment and multi-stakeholder deliberation. The framework consists of two parts: a DPSIR (Drivers-Pressures-States-Impacts-Responses) analysis to identify the important causal relationships among anthropogenic environmental stressors, processes, and outcomes; and a Decision Landscape analysis to depict the legal, social, and institutional dimensions of environmental decisions. The Decision Landscape incorporates interactions among government agencies, regulated businesses, non-government organizations, and other stakeholders. It also identifies where scientific information regarding environmental processes is collected and transmitted to improve knowledge about elements of the DPSIR and to improve the scientific basis for decisions. Our application of the decision support framework to coral reef protection and restoration in the Florida Keys focusing on anthropogenic stressors, such as wastewater, proved to be successful and offered several insights. Using information from a management plan, it was possible to capture the current state of the science with a DPSIR analysis as well as important decision options, decision makers and applicable laws with a the Decision Landscape analysis. A structured elicitation of values and beliefs conducted at a coral reef management workshop held in Key West, Florida provided a diversity of opinion and also indicated a prioritization of several environmental stressors affecting coral reef health. The integrated DPSIR/Decision landscape framework for the Florida Keys developed based on the elicited opinion and the DPSIR analysis can be used to inform management decisions, to reveal the role that further scientific information and research might play to populate the framework, and to facilitate better-informed agreement among participants.

Two Quantum Protocols for Oblivious Set-member Decision Problem

NASA Astrophysics Data System (ADS)

Shi, Run-Hua; Mu, Yi; Zhong, Hong; Cui, Jie; Zhang, Shun

2015-10-01

In this paper, we defined a new secure multi-party computation problem, called Oblivious Set-member Decision problem, which allows one party to decide whether a secret of another party belongs to his private set in an oblivious manner. There are lots of important applications of Oblivious Set-member Decision problem in fields of the multi-party collaborative computation of protecting the privacy of the users, such as private set intersection and union, anonymous authentication, electronic voting and electronic auction. Furthermore, we presented two quantum protocols to solve the Oblivious Set-member Decision problem. Protocol I takes advantage of powerful quantum oracle operations so that it needs lower costs in both communication and computation complexity; while Protocol II takes photons as quantum resources and only performs simple single-particle projective measurements, thus it is more feasible with the present technology.

Two Quantum Protocols for Oblivious Set-member Decision Problem

PubMed Central

Shi, Run-hua; Mu, Yi; Zhong, Hong; Cui, Jie; Zhang, Shun

2015-01-01

In this paper, we defined a new secure multi-party computation problem, called Oblivious Set-member Decision problem, which allows one party to decide whether a secret of another party belongs to his private set in an oblivious manner. There are lots of important applications of Oblivious Set-member Decision problem in fields of the multi-party collaborative computation of protecting the privacy of the users, such as private set intersection and union, anonymous authentication, electronic voting and electronic auction. Furthermore, we presented two quantum protocols to solve the Oblivious Set-member Decision problem. Protocol I takes advantage of powerful quantum oracle operations so that it needs lower costs in both communication and computation complexity; while Protocol II takes photons as quantum resources and only performs simple single-particle projective measurements, thus it is more feasible with the present technology. PMID:26514668

Two Quantum Protocols for Oblivious Set-member Decision Problem.

PubMed

Shi, Run-Hua; Mu, Yi; Zhong, Hong; Cui, Jie; Zhang, Shun

2015-10-30

In this paper, we defined a new secure multi-party computation problem, called Oblivious Set-member Decision problem, which allows one party to decide whether a secret of another party belongs to his private set in an oblivious manner. There are lots of important applications of Oblivious Set-member Decision problem in fields of the multi-party collaborative computation of protecting the privacy of the users, such as private set intersection and union, anonymous authentication, electronic voting and electronic auction. Furthermore, we presented two quantum protocols to solve the Oblivious Set-member Decision problem. Protocol I takes advantage of powerful quantum oracle operations so that it needs lower costs in both communication and computation complexity; while Protocol II takes photons as quantum resources and only performs simple single-particle projective measurements, thus it is more feasible with the present technology.

Combining statistical inference and decisions in ecology.

PubMed

Williams, Perry J; Hooten, Mevin B

2016-09-01

Statistical decision theory (SDT) is a sub-field of decision theory that formally incorporates statistical investigation into a decision-theoretic framework to account for uncertainties in a decision problem. SDT provides a unifying analysis of three types of information: statistical results from a data set, knowledge of the consequences of potential choices (i.e., loss), and prior beliefs about a system. SDT links the theoretical development of a large body of statistical methods, including point estimation, hypothesis testing, and confidence interval estimation. The theory and application of SDT have mainly been developed and published in the fields of mathematics, statistics, operations research, and other decision sciences, but have had limited exposure in ecology. Thus, we provide an introduction to SDT for ecologists and describe its utility for linking the conventionally separate tasks of statistical investigation and decision making in a single framework. We describe the basic framework of both Bayesian and frequentist SDT, its traditional use in statistics, and discuss its application to decision problems that occur in ecology. We demonstrate SDT with two types of decisions: Bayesian point estimation and an applied management problem of selecting a prescribed fire rotation for managing a grassland bird species. Central to SDT, and decision theory in general, are loss functions. Thus, we also provide basic guidance and references for constructing loss functions for an SDT problem. © 2016 by the Ecological Society of America.

Using wind plant data to increase reliability.

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

Peters, Valerie A.; Ogilvie, Alistair B.; McKenney, Bridget L.

2011-01-01

Operators interested in improving reliability should begin with a focus on the performance of the wind plant as a whole. To then understand the factors which drive individual turbine performance, which together comprise the plant performance, it is necessary to track a number of key indicators. Analysis of these key indicators can reveal the type, frequency, and cause of failures and will also identify their contributions to overall plant performance. The ideal approach to using data to drive good decisions includes first determining which critical decisions can be based on data. When those required decisions are understood, then the analysismore » required to inform those decisions can be identified, and finally the data to be collected in support of those analyses can be determined. Once equipped with high-quality data and analysis capabilities, the key steps to data-based decision making for reliability improvements are to isolate possible improvements, select the improvements with largest return on investment (ROI), implement the selected improvements, and finally to track their impact.« less

An Iterative Information-Reduced Quadriphase-Shift-Keyed Carrier Synchronization Scheme Using Decision Feedback for Low Signal-to-Noise Ratio Applications

NASA Technical Reports Server (NTRS)

Simon, M.; Tkacenko, A.

2006-01-01

In a previous publication [1], an iterative closed-loop carrier synchronization scheme for binary phase-shift keyed (BPSK) modulation was proposed that was based on feeding back data decisions to the input of the loop, the purpose being to remove the modulation prior to carrier synchronization as opposed to the more conventional decision-feedback schemes that incorporate such feedback inside the loop. The idea there was that, with sufficient independence between the received data and the decisions on it that are fed back (as would occur in an error-correction coding environment with sufficient decoding delay), a pure tone in the presence of noise would ultimately be produced (after sufficient iteration and low enough error probability) and thus could be tracked without any squaring loss. This article demonstrates that, with some modification, the same idea of iterative information reduction through decision feedback can be applied to quadrature phase-shift keyed (QPSK) modulation, something that was mentioned in the previous publication but never pursued.

The Key Decision Log: Facilitating high reliability and organizational learning

Treesearch

Anne E. Black

2009-01-01

If you were involved in the 2008 fire season in the West, you may have heard the term "Key Decision Log" or "KDL." This article describes the KDL concept, it's intent (past and present), how it was applied in 2008, and where the practice is heading.

Legal Briefing: Medicare Coverage of Advance Care Planning.

PubMed

Pope, Thaddeus Mason

2015-01-01

This issue's "Legal Briefing" column covers the recent decision by the Centers for Medicare and Medicaid Services (CMS) to expand Medicare coverage of advance care planning, beginning 1 January 2016. Since 2009, most "Legal Briefings" in this journal have covered a wide gamut of judicial, legislative, and regulatory developments concerning a particular topic in clinical ethics. In contrast, this "Legal Briefing" is more narrowly focused on one single legal development. This concentration on Medicare coverage of advance care planning seems warranted. Advance care planning is a frequent subject of articles in JCE. After all, it has long been seen as an important, albeit only partial, solution to a significant range of big problems in clinical ethics. These problems range from medical futility disputes to decision making for incapacitated patients who have no available legally authorized surrogate. Consequently, expanded Medicare coverage of advance care planning is a potentially seismic development. It may materially reduce both the frequency and severity of key problems in clinical ethics. Since the sociological, medical, and ethical literature on advance care planning is voluminous, I will not even summarize it here. Instead, I focus on Medicare coverage. I proceed, chronologically, in six stages: 1. Prior Medicare Coverage of Advance Care Planning 2. Proposed Expanded Medicare Coverage in 2015 3. Proposed Expanded Medicare Coverage in 2016 4. The Final Rule Expanding Medicare Coverage in 2016 5. Remaining Issues for CMS to Address in 2017 6. Pending Federal Legislation. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

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

ERIC Educational Resources Information Center

Pashiardis, Petros

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

Recovery and Resilience After a Nuclear Power Plant Disaster: A Medical Decision model for Managing an Effective, Timely, and Balanced Response

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

Coleman, C. Norman; Blumenthal, Daniel J.

2013-05-01

Based on experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, a real-time, medical decision model is presented by which to make key health-related decisions given the central role of health and medical issues in such disasters. Focus is on response and recovery activities that are safe, timely, effective, and well-organized. This approach empowers on-site decision makers to make interim decisions without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Key features of this approach include ongoing assessment, consultation, information, and adaption to the changing conditions. This medical decision model presented ismore » compatible with the existing US National Response Framework structure.« less

The design of aircraft using the decision support problem technique

NASA Technical Reports Server (NTRS)

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

1988-01-01

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

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.

Assessing the Value of Frost Forecasts to Orchardists: A Dynamic Decision-Making Approach.

NASA Astrophysics Data System (ADS)

Katz, Richard W.; Murphy, Allan H.; Winkler, Robert L.

1982-04-01

The methodology of decision analysis is used to investigate the economic value of frost (i.e., minimum temperature) forecasts to orchardists. First, the fruit-frost situation and previous studies of the value of minimum temperature forecasts in this context are described. Then, after a brief overview of decision analysis, a decision-making model for the fruit-frost problem is presented. The model involves identifying the relevant actions and events (or outcomes), specifying the effect of taking protective action, and describing the relationships among temperature, bud loss, and yield loss. A bivariate normal distribution is used to model the relationship between forecast and observed temperatures, thereby characterizing the quality of different types of information. Since the orchardist wants to minimize expenses (or maximize payoffs) over the entire frost-protection season and since current actions and outcomes at any point in the season are related to both previous and future actions and outcomes, the decision-making problem is inherently dynamic in nature. As a result, a class of dynamic models known as Markov decision processes is considered. A computational technique called dynamic programming is used in conjunction with these models to determine the optimal actions and to estimate the value of meteorological information.Some results concerning the value of frost forecasts to orchardists in the Yakima Valley of central Washington are presented for the cases of red delicious apples, bartlett pears, and elberta peaches. Estimates of the parameter values in the Markov decision process are obtained from relevant physical and economic data. Twenty years of National Weather Service forecast and observed temperatures for the Yakima key station are used to estimate the quality of different types of information, including perfect forecasts, current forecasts, and climatological information. The orchardist's optimal actions over the frost-protection season and the expected expenses associated with the use of such information are determined using a dynamic programming algorithm. The value of meteorological information is defined as the difference between the expected expense for the information of interest and the expected expense for climatological information. Over the entire frost-protection season, the value estimates (in 1977 dollars) for current forecasts were $808 per acre for red delicious apples, $492 per acre for bartlett pears, and $270 per acre for elberta peaches. These amounts account for 66, 63, and 47%, respectively, of the economic value associated with decisions based on perfect forecasts. Varying the quality of the minimum temperature forecasts reveals that the relationship between the accuracy and value of such forecasts is nonlinear and that improvements in current forecasts would not be as significant in terms of economic value as were comparable improvements in the past.Several possible extensions of this study of the value of frost forecasts to orchardists are briefly described. Finally, the application of the dynamic model formulated in this paper to other decision-making problems involving the use of meteorological information is mentioned.

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

ERIC Educational Resources Information Center

Allanson, Susie

2007-01-01

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

[Patient expectations about decision-making for various health problems].

PubMed

Delgado, Ana; López-Fernández, Luis Andrés; de Dios Luna, Juan; Saletti Cuesta, Lorena; Gil Garrido, Natalia; Puga González, Almudena

2010-01-01

To identify patient expectations of clinical decision-making at consultations with their general practitioners for distinct health problems and to determine the patient and general practitioner characteristics related to these expectations, with special focus on gender. We performed a multicenter cross-sectional study in 360 patients who were interviewed at home. Data on patients' sociodemographic, clinical characteristics and satisfaction were gathered. General practitioners supplied information on their gender and postgraduate training in family medicine. A questionnaire was used to collect data on patients' expectations that their general practitioner at consultations with their general practitioner for five problems or hypothetical clinical scenarios (strong chest pain/cold with fever/abnormal discharge/depression or sadness/severe family problem). Patients were asked to indicate their preference that decisions on diagnosis and treatment be taken by: a) the general practitioner alone; b) the general practitioner, taking account of the patient's opinion; c) the patient, taking account of the general practitioner's opinion and d) the patient alone. A logistic regression was performed for clinical decision-making. The response rate was 90%. The mean age was 47.3 + or - 16.5 years and 51% were female. Patients' expectations that their general practitioner listen, explain and take account of their opinions were higher than their expectations of participating in decision-making, depending on the problem in question: 32% wished to participate in chest pain and 49% in family problems. Women had lower expectations of participating in depression and family problems. Patients with female general practitioners had higher expectations of participating in family problems and colds. Most patients wished to be listened to, informed and taken into account by their general practitioners and, to a lesser extent, wished to take decisions autonomously, especially for biomedical problems. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

Cloud-based mobility management in heterogeneous wireless networks

NASA Astrophysics Data System (ADS)

Kravchuk, Serhii; Minochkin, Dmytro; Omiotek, Zbigniew; Bainazarov, Ulan; Weryńska-Bieniasz, RóŻa; Iskakova, Aigul

2017-08-01

Mobility management is the key feature that supports the roaming of users between different systems. Handover is the essential aspect in the development of solutions supporting mobility scenarios. The handover process becomes more complex in a heterogeneous environment compared to the homogeneous one. Seamlessness and reduction of delay in servicing the handover calls, which can reduce the handover dropping probability, also require complex algorithms to provide a desired QoS for mobile users. A challenging problem to increase the scalability and availability of handover decision mechanisms is discussed. The aim of the paper is to propose cloud based handover as a service concept to cope with the challenges that arise.

Reasoning methods in medical consultation systems: artificial intelligence approaches.

PubMed

Shortliffe, E H

1984-01-01

It has been argued that the problem of medical diagnosis is fundamentally ill-structured, particularly during the early stages when the number of possible explanations for presenting complaints can be immense. This paper discusses the process of clinical hypothesis evocation, contrasts it with the structured decision making approaches used in traditional computer-based diagnostic systems, and briefly surveys the more open-ended reasoning methods that have been used in medical artificial intelligence (AI) programs. The additional complexity introduced when an advice system is designed to suggest management instead of (or in addition to) diagnosis is also emphasized. Example systems are discussed to illustrate the key concepts.

Controlling corrosion in drinking water distribution systems: a grand challenge for the 21st century.

PubMed

Edwards, M

2004-01-01

It is argued that the water distribution system will be a key public health battlefield of the 21st century. Corrosion in private plumbing is deserving of special attention, since the health and economic impacts are probably of equal or greater magnitude compared to public systems, and there has not been an advocate working on behalf of the consumer to solve these problems. To better serve society in this endeavour we will need educational programs, aggressive research to minimize the unsustainable costs of corrosion, and to consider our legacy to future generations when making decisions on materials use.

Medication Adherence: A Call for Action

PubMed Central

Bosworth, Hayden B.; Granger, Bradi B.; Mendys, Phil; Brindis, Ralph; Burkholder, Rebecca; Czajkowski, Susan M.; Daniel, Jodi G.; Ekman, Inger; Ho, Michael; Johnson, Mimi; Kimmel, Stephen E.; Liu, Larry Z; Musaus, John; Shrank, William H.; Buono, Elizabeth Whalley; Weiss, Karen; Granger, Christopher B.

2013-01-01

Poor adherence to efficacious cardiovascular related medications has led to considerable morbidity, mortality, and avoidable health care costs. This paper provides results of a recent think tank meeting in which various stakeholder groups representing key experts from consumers, community health providers, the academic community, decision-making government officials (FDA, NIH, etc), and industry scientists met to evaluate the current status of medication adherence and provide recommendations for improving outcomes. Below, we review the magnitude of the problem of medication adherence, prevalence, impact, and cost. We then summarize proven effective approaches and conclude with a discussion of recommendations to address this growing and significant public health issue of medication non adherence. PMID:21884856

Plan execution monitoring with distributed intelligent agents for battle command

NASA Astrophysics Data System (ADS)

Allen, James P.; Barry, Kevin P.; McCormick, John M.; Paul, Ross A.

2004-07-01

As military tactics evolve toward execution centric operations the ability to analyze vast amounts of mission relevant data is essential to command and control decision making. To maintain operational tempo and achieve information superiority we have developed Vigilant Advisor, a mobile agent-based distributed Plan Execution Monitoring system. It provides military commanders with continuous contingency monitoring tailored to their preferences while overcoming the network bandwidth problem often associated with traditional remote data querying. This paper presents an overview of Plan Execution Monitoring as well as a detailed view of the Vigilant Advisor system including key features and statistical analysis of resource savings provided by its mobile agent-based approach.

Implications of Contingency Planning Support for Weather and Icing Information

NASA Technical Reports Server (NTRS)

Vigeant-Langlois, Laurence; Hansman, R. John, Jr.

2003-01-01

A human-centered systems analysis was applied to the adverse aircraft weather encounter problem in order to identify desirable functions of weather and icing information. The importance of contingency planning was identified as emerging from a system safety design methodology as well as from results of other aviation decision-making studies. The relationship between contingency planning support and information on regions clear of adverse weather was investigated in a scenario- based analysis. A rapid prototype example of the key elements in the depiction of icing conditions was developed in a case study, and the implications for the components of the icing information system were articulated.

Do endothelial cells dream of eclectic shape?

PubMed

Bentley, Katie; Philippides, Andrew; Ravasz Regan, Erzsébet

2014-04-28

Endothelial cells (ECs) exhibit dramatic plasticity of form at the single- and collective-cell level during new vessel growth, adult vascular homeostasis, and pathology. Understanding how, when, and why individual ECs coordinate decisions to change shape, in relation to the myriad of dynamic environmental signals, is key to understanding normal and pathological blood vessel behavior. However, this is a complex spatial and temporal problem. In this review we show that the multidisciplinary field of Adaptive Systems offers a refreshing perspective, common biological language, and straightforward toolkit that cell biologists can use to untangle the complexity of dynamic, morphogenetic systems. Copyright © 2014 Elsevier Inc. All rights reserved.

Decision Support Framework Implementation Of The Web-Based Environmental Decision Analysis DASEES: Decision Analysis For A Sustainable Environment, Economy, And Society

EPA Science Inventory

Solutions to pervasive environmental problems often are not amenable to a straightforward application of science-based actions. These problems encompass large-scale environmental policy questions where environmental concerns, economic constraints, and societal values conflict ca...

Utility of flood warning systems for emergency management

NASA Astrophysics Data System (ADS)

Molinari, Daniela; Ballio, Francesco; Menoni, Scira

2010-05-01

The presentation is focused on a simple and crucial question for warning systems: are flood and hydrological modelling and forecasting helpful to manage flood events? Indeed, it is well known that a warning process can be invalidated by inadequate forecasts so that the accuracy and robustness of the previsional model is a key issue for any flood warning procedure. However, one problem still arises at this perspective: when forecasts can be considered to be adequate? According to Murphy (1993, Wea. Forecasting 8, 281-293), forecasts hold no intrinsic value but they acquire it through their ability to influence the decisions made by their users. Moreover, we can add that forecasts value depends on the particular problem at stake showing, this way, a multifaceted nature. As a result, forecasts verification should not be seen as a universal process, instead it should be tailored to the particular context in which forecasts are implemented. This presentation focuses on warning problems in mountain regions, whereas the short time which is distinctive of flood events makes the provision of adequate forecasts particularly significant. In this context, the quality of a forecast is linked to its capability to reduce the impact of a flood by improving the correctness of the decision about issuing (or not) a warning as well as of the implementation of a proper set of actions aimed at lowering potential flood damages. The present study evaluates the performance of a real flood forecasting system from this perspective. In detail, a back analysis of past flood events and available verification tools have been implemented. The final objective was to evaluate the system ability to support appropriate decisions with respect not only to the flood characteristics but also to the peculiarities of the area at risk as well as to the uncertainty of forecasts. This meant to consider also flood damages and forecasting uncertainty among the decision variables. Last but not least, the presentation explains how the procedure implemented in the case study could support the definition of a proper warning rule.

Interventionist and participatory approaches to flood risk mitigation decisions: two case studies in the Italian Alps

NASA Astrophysics Data System (ADS)

Bianchizza, C.; Del Bianco, D.; Pellizzoni, L.; Scolobig, A.

2012-04-01

Flood risk mitigation decisions pose key challenges not only from a technical but also from a social, economic and political viewpoint. There is an increasing demand for improving the quality of these processes by including different stakeholders - and especially by involving the local residents in the decision making process - and by guaranteeing the actual improvement of local social capacities during and after the decision making. In this paper we analyse two case studies of flood risk mitigation decisions, Malborghetto-Valbruna and Vipiteno-Sterzing, in the Italian Alps. In both of them, mitigation works have been completed or planned, yet following completely different approaches especially in terms of responses of residents and involvement of local authorities. In Malborghetto-Valbruna an 'interventionist' approach (i.e. leaning towards a top down/technocratic decision process) was used to make decisions after the flood event that affected the municipality in the year 2003. In Vipiteno-Sterzing, a 'participatory' approach (i.e. leaning towards a bottom-up/inclusive decision process) was applied: decisions about risk mitigation measures were made by submitting different projects to the local citizens and by involving them in the decision making process. The analysis of the two case studies presented in the paper is grounded on the results of two research projects. Structured and in-depth interviews, as well as questionnaire surveys were used to explore residents' and local authorities' orientations toward flood risk mitigation. Also a SWOT analysis (Strengths, Weaknesses, Opportunities and Threats) involving key stakeholders was used to better understand the characteristics of the communities and their perception of flood risk mitigation issues. The results highlight some key differences between interventionist and participatory approaches, together with some implications of their adoption in the local context. Strengths and weaknesses of the two approaches, as well as key challenges for the future are also discussed.

The value of forecasting key-decision variables for rain-fed farming

NASA Astrophysics Data System (ADS)

Winsemius, Hessel; Werner, Micha

2013-04-01

Rain-fed farmers are highly vulnerable to variability in rainfall. Timely knowledge of the onset of the rainy season, the expected amount of rainfall and the occurrence of dry spells can help rain-fed farmers to plan the cropping season. Seasonal probabilistic weather forecasts may provide such information to farmers, but need to provide reliable forecasts of key variables with which farmers can make decisions. In this contribution, we present a new method to evaluate the value of meteorological forecasts in predicting these key variables. The proposed method measures skill by assessing whether a forecast was useful to this decision. This is done by taking into account the required accuracy of timing of the event to make the decision useful. The method progresses the estimate of forecast skill to forecast value by taking into account the required accuracy that is needed to make the decision valuable, based on the cost/loss ratio of possible decisions. The method is applied over the Limpopo region in Southern Africa. We demonstrate the method using the example of temporary water harvesting techniques. Such techniques require time to construct and must be ready long enough before the occurrence of a dry spell to be effective. The value of the forecasts to the decision used as an example is shown to be highly sensitive to the accuracy in the timing of forecasted dry spells, and the tolerance in the decision to timing error. The skill with which dry spells can be predicted is shown to be higher in some parts of the basin, indicating that these forecasts have higher value for the decision in those parts than in others. Through assessing the skill of forecasting key decision variables to the farmers we show that it is easier to understand if the forecasts have value in reducing risk, or if other adaptation strategies should be implemented.

Collaborative Communication in Pediatric Palliative Care: A Foundation for Problem-Solving and Decision-Making

PubMed Central

Feudtner, Chris

2007-01-01

Summary In an ideal world, all of us – patients, parents, family members, nurses, physicians, social workers, therapists, pastoral care workers, and others – would always work together in a collaborative manner to provide the best care possible to the patient: this article is committed to this ideal. The chapter will base the frameworks and suggestions in part upon studies of communication between patients, families, and clinicians, as well as more general works on communication, collaboration, decision-making, mediation, and ethics. This article unfolds in four parts. In Part I, we will explore what we mean by collaborative communication. In Part II, we will examine key concepts that influence how we frame the situations that children with life-threatening conditions confront and how these frameworks shape the care we provide. In Part III, we will consider a few general topics that are quite important to the task of collaborative communication, specifically how we use little “habits of thought”– called heuristics – when we set about to solve complicated problems; how emotion affects the exchange of information between people; and how we can avoid certain pitfalls when engaging in difficult conversations. In Part IV, we will proceed through three common tasks of collaborative communication offering practical advice for patient care. PMID:17933613

Resolving structural uncertainty in natural resources management using POMDP approaches

USGS Publications Warehouse

Williams, B.K.

2011-01-01

In recent years there has been a growing focus on the uncertainties of natural resources management, and the importance of accounting for uncertainty in assessing management effectiveness. This paper focuses on uncertainty in resource management in terms of discrete-state Markov decision processes (MDP) under structural uncertainty and partial observability. It describes the treatment of structural uncertainty with approaches developed for partially observable resource systems. In particular, I show how value iteration for partially observable MDPs (POMDP) can be extended to structurally uncertain MDPs. A key difference between these process classes is that structurally uncertain MDPs require the tracking of system state as well as a probability structure for the structure uncertainty, whereas with POMDPs require only a probability structure for the observation uncertainty. The added complexity of the optimization problem under structural uncertainty is compensated by reduced dimensionality in the search for optimal strategy. A solution algorithm for structurally uncertain processes is outlined for a simple example in conservation biology. By building on the conceptual framework developed for POMDPs, natural resource analysts and decision makers who confront structural uncertainties in natural resources can take advantage of the rapid growth in POMDP methods and approaches, and thereby produce better conservation strategies over a larger class of resource problems. ?? 2011.

A Method of Detections' Fusion for GNSS Anti-Spoofing.

PubMed

Tao, Huiqi; Li, Hong; Lu, Mingquan

2016-12-19

The spoofing attack is one of the security threats of systems depending on the Global Navigation Satellite System (GNSS). There have been many GNSS spoofing detection methods, and each of them focuses on a characteristic of the GNSS signal or a measurement that the receiver has obtained. The method based on a single detector is insufficient against spoofing attacks in some scenarios. How to fuse multiple detections together is a problem that concerns the performance of GNSS anti-spoofing. Scholars have put forward a model to fuse different detection results based on the Dempster-Shafer theory (DST) of evidence combination. However, there are some problems in the application. The main challenge is the valuation of the belief function, which is a key issue in DST. This paper proposes a practical method of detections' fusion based on an approach to assign the belief function for spoofing detections. The frame of discernment is simplified, and the hard decision of hypothesis testing is replaced by the soft decision; then, the belief functions for some detections can be evaluated. The method is discussed in detail, and a performance evaluation is provided, as well. Detections' fusion reduces false alarms of detection and makes the result more reliable. Experimental results based on public test datasets demonstrate the performance of the proposed method.

Consequences Identification in Forecasting and Ethical Decision-making

PubMed Central

Stenmark, Cheryl K.; Antes, Alison L.; Thiel, Chase E.; Caughron, Jared J.; Wang, Xiaoqian; Mumford, Michael D.

2015-01-01

Forecasting involves predicting outcomes based on observations of the situation at hand. We examined the impact of the number and types of consequences considered on the quality of ethical decision-making. Undergraduates role-played several ethical problems in which they forecast potential outcomes and made decisions. Performance pressure (difficult demands placed on the situation) and interpersonal conflict (clashes among people in the problem situation) were manipulated within each problem scenario. The results indicated that the identification of potential consequences was positively associated with both higher quality forecasts and more ethical decisions. Neither performance pressure nor interpersonal conflict affected the quality of forecasts or decisions. Theoretical and practical implications of these findings and the use of this research approach are discussed. PMID:21460584

Intelligent system for pilot and astronaut Psychophysiological status monitoring and recuperating.

NASA Astrophysics Data System (ADS)

Janicki, Andrzej; -Bogumila Pecyna, S. Maria

The proposal for development of synthetic indicators of the individuals psychophysiological status as well as measurements methodology which are responsible for decision making process, is discussed. The interdisciplinary of principles methods and tools (instruments) which was created out of a specific inter-section of multiply domains of science and technology belonging to the common domain of scientific information systems with specific utility objectives and measures of quality assessment of solutions is presented. As it is well-known, the development directions of the space technology in contemporary terms are increasingly associated with the system approach to solving the problems that are defined in a holistic way, with the emphasis on the aspects to their usefulness. This results in the necessity to create solutions, which are in fact decisions of a negotiating nature, taken in the systems of incomplete information with blurs as well as social and psychological contexts on the grounds of the importance of the human factor (human-centric approach). For the sake of one thing - explicitness in operating with contents, we find support in ontology, and the human factor in the system complexes is treated by us in accordance with the principles of the “human being ecology”. Hence, a key role is played here by so-called “three-factor utility function” proposed by the author [Janicki, 1991], both as an objective function and as a measure of the quality assessment of solutions, where the first factor is interpreted as the will of striving for the objective, the second one - as the fear of the consequences, and the third one - as the internal consistency of the decision-maker (intelligent agent coherence). It reflects in fact a trans-disciplinary union of the problem-solving approaches proposed earlier [Minsky, Antonovsky and Kulikowski, 1987-1993]. The solutions to these problems themselves come down to the calculations of a heuristic nature, which are often called intelligent computations, and their methodology is called “computational intelligence”. The absence of gravity which causes significant physiological stress with broad biomedical changes generated key problems for researchers and practitioners of aviations and space flight. Following previous experiences we had on the matter, some current results achieved on the bases of FlexComp Infinity/Biograph Infiniti, V6.1™ of Thought Technology ltd. [Janicki, Pecyna, 2014] are underlined. A particular emphasis has been placed on the ability of the distributed parallel computations connected with the sophisticated application of the NASA Autogenic Feedback Training AFTE [PS Cowings, 2011] method combined biofeedback and Autogenic Therapy exercises [WIML-NASA, 2011]. The present paper reports on the results of a serious preliminary experiments addressed especially to space disorientation and/or awareness of reality problem. Keywords: pilot’s decision making process; intelligent a agent; coherency; psychophysiological pilot status; remote monitoring; remote training; synthetic indicators; scientific information system; three-factor utility function; space disorientation;Near-Infrared Hemoencephalography; References: A.Janicki “three-factor utility function” in LabTSI™ Modeling and Simulation Platform, KUL Univ. publication 2011 - in polish, page 95-103 M.B. Pecyna and M. Pokorski "Near-Infrared Hemoencephalography for Monitoring Blood Oxygenation in Prefrontal Cortical Areas in diagnosis and Therapy of Developmental Dyslexia" in "Neurobiology of Respiration" Springer Science+Business Media Dordrecht 2013 page 175 - 180. NASA-WIML Workshop on 2011, Psychophysiological Aspects of Flight Safety In Aerospace Operations, WIML 2011

Multi-objective optimisation and decision-making of space station logistics strategies

NASA Astrophysics Data System (ADS)

Zhu, Yue-he; Luo, Ya-zhong

2016-10-01

Space station logistics strategy optimisation is a complex engineering problem with multiple objectives. Finding a decision-maker-preferred compromise solution becomes more significant when solving such a problem. However, the designer-preferred solution is not easy to determine using the traditional method. Thus, a hybrid approach that combines the multi-objective evolutionary algorithm, physical programming, and differential evolution (DE) algorithm is proposed to deal with the optimisation and decision-making of space station logistics strategies. A multi-objective evolutionary algorithm is used to acquire a Pareto frontier and help determine the range parameters of the physical programming. Physical programming is employed to convert the four-objective problem into a single-objective problem, and a DE algorithm is applied to solve the resulting physical programming-based optimisation problem. Five kinds of objective preference are simulated and compared. The simulation results indicate that the proposed approach can produce good compromise solutions corresponding to different decision-makers' preferences.

A Decision Support System for Evaluating and Selecting Information Systems Projects

NASA Astrophysics Data System (ADS)

Deng, Hepu; Wibowo, Santoso

2009-01-01

This chapter presents a decision support system (DSS) for effectively solving the information systems (IS) project selection problem. The proposed DSS recognizes the multidimensional nature of the IS project selection problem, the availability of multicriteria analysis (MA) methods, and the preferences of the decision-maker (DM) on the use of specific MA methods in a given situation. A knowledge base consisting of IF-THEN production rules is developed for assisting the DM with a systematic adoption of the most appropriate method with the efficient use of the powerful reasoning and explanation capabilities of intelligent DSS. The idea of letting the problem to be solved determines the method to be used is incorporated into the proposed DSS. As a result, effective decisions can be made for solving the IS project selection problem. An example is presented to demonstrate the applicability of the proposed DSS for solving the problem of selecting IS projects in real world situations.

Towards a Collaborative Filtering Approach to Medication Reconciliation

PubMed Central

Hasan, Sharique; Duncan, George T.; Neill, Daniel B.; Padman, Rema

2008-01-01

A physician’s prescribing decisions depend on knowledge of the patient’s medication list. This knowledge is often incomplete, and errors or omissions could result in adverse outcomes. To address this problem, the Joint Commission recommends medication reconciliation for creating a more accurate list of a patient’s medications. In this paper, we develop techniques for automatic detection of omissions in medication lists, identifying drugs that the patient may be taking but are not on the patient’s medication list. Our key insight is that this problem is analogous to the collaborative filtering framework increasingly used by online retailers to recommend relevant products to customers. The collaborative filtering approach enables a variety of solution techniques, including nearest neighbor and co-occurrence approaches. We evaluate the effectiveness of these approaches using medication data from a long-term care center in the Eastern US. Preliminary results suggest that this framework may become a valuable tool for medication reconciliation. PMID:18998834

Towards a collaborative filtering approach to medication reconciliation.

PubMed

Hasan, Sharique; Duncan, George T; Neill, Daniel B; Padman, Rema

2008-11-06

A physicians prescribing decisions depend on knowledge of the patients medication list. This knowledge is often incomplete, and errors or omissions could result in adverse outcomes. To address this problem, the Joint Commission recommends medication reconciliation for creating a more accurate list of a patients medications. In this paper, we develop techniques for automatic detection of omissions in medication lists, identifying drugs that the patient may be taking but are not on the patients medication list. Our key insight is that this problem is analogous to the collaborative filtering framework increasingly used by online retailers to recommend relevant products to customers. The collaborative filtering approach enables a variety of solution techniques, including nearest neighbor and co-occurrence approaches. We evaluate the effectiveness of these approaches using medication data from a long-term care center in the Eastern US. Preliminary results suggest that this framework may become a valuable tool for medication reconciliation.

An intelligent case-adjustment algorithm for the automated design of population-based quality auditing protocols.

PubMed

Advani, Aneel; Jones, Neil; Shahar, Yuval; Goldstein, Mary K; Musen, Mark A

2004-01-01

We develop a method and algorithm for deciding the optimal approach to creating quality-auditing protocols for guideline-based clinical performance measures. An important element of the audit protocol design problem is deciding which guide-line elements to audit. Specifically, the problem is how and when to aggregate individual patient case-specific guideline elements into population-based quality measures. The key statistical issue involved is the trade-off between increased reliability with more general population-based quality measures versus increased validity from individually case-adjusted but more restricted measures done at a greater audit cost. Our intelligent algorithm for auditing protocol design is based on hierarchically modeling incrementally case-adjusted quality constraints. We select quality constraints to measure using an optimization criterion based on statistical generalizability coefficients. We present results of the approach from a deployed decision support system for a hypertension guideline.

Decision-Making under Criteria Uncertainty

NASA Astrophysics Data System (ADS)

Kureychik, V. M.; Safronenkova, I. B.

2018-05-01

Uncertainty is an essential part of a decision-making procedure. The paper deals with the problem of decision-making under criteria uncertainty. In this context, decision-making under uncertainty, types and conditions of uncertainty were examined. The decision-making problem under uncertainty was formalized. A modification of the mathematical decision support method under uncertainty via ontologies was proposed. A critical distinction of the developed method is ontology usage as its base elements. The goal of this work is a development of a decision-making method under criteria uncertainty with the use of ontologies in the area of multilayer board designing. This method is oriented to improvement of technical-economic values of the examined domain.

Constructing a Graphic Organizer in the Classroom: Introductory Students' Perception of Achievement Using a Decision Map to Solve Aqueous Acid-Base Equilibria Problems

ERIC Educational Resources Information Center

DeMeo, Stephen

2007-01-01

Common examples of graphic organizers include flow diagrams, concept maps, and decision trees. The author has created a novel type of graphic organizer called a decision map. A decision map is a directional heuristic that helps learners solve problems within a generic framework. It incorporates questions that the user must answer and contains…

Electricity system expansion studies to consider uncertainties and interactions in restructured markets

NASA Astrophysics Data System (ADS)

Jin, Shan

This dissertation concerns power system expansion planning under different market mechanisms. The thesis follows a three paper format, in which each paper emphasizes a different perspective. The first paper investigates the impact of market uncertainties on a long term centralized generation expansion planning problem. The problem is modeled as a two-stage stochastic program with uncertain fuel prices and demands, which are represented as probabilistic scenario paths in a multi-period tree. Two measurements, expected cost (EC) and Conditional Value-at-Risk (CVaR), are used to minimize, respectively, the total expected cost among scenarios and the risk of incurring high costs in unfavorable scenarios. We sample paths from the scenario tree to reduce the problem scale and determine the sufficient number of scenarios by computing confidence intervals on the objective values. The second paper studies an integrated electricity supply system including generation, transmission and fuel transportation with a restructured wholesale electricity market. This integrated system expansion problem is modeled as a bi-level program in which a centralized system expansion decision is made in the upper level and the operational decisions of multiple market participants are made in the lower level. The difficulty of solving a bi-level programming problem to global optimality is discussed and three problem relaxations obtained by reformulation are explored. The third paper solves a more realistic market-based generation and transmission expansion problem. It focuses on interactions among a centralized transmission expansion decision and decentralized generation expansion decisions. It allows each generator to make its own strategic investment and operational decisions both in response to a transmission expansion decision and in anticipation of a market price settled by an Independent System Operator (ISO) market clearing problem. The model poses a complicated tri-level structure including an equilibrium problem with equilibrium constraints (EPEC) sub-problem. A hybrid iterative algorithm is proposed to solve the problem efficiently and reliably.

Evaluating Multisystemic Efforts to Impact Disproportionality through Key Decision Points

ERIC Educational Resources Information Center

Derezotes, Dennette; Richardson, Brad; King, Connie Bear; Kleinschmit-Rembert, Julia; Pratt, Betty

2008-01-01

Working in four communities, Casey Foundation/Center for the Study of Social Policy (CSSP) Alliance on Racial Equity (the Alliance) have developed a Racial Equity Scorecard for measuring disproportionality at key decision points for use in impacting disproportionality in the child welfare system. The four communities include King County,…

The doctor-patient relationship as a toolkit for uncertain clinical decisions.

PubMed

Diamond-Brown, Lauren

2016-06-01

Medical uncertainty is a well-recognized problem in healthcare, yet how doctors make decisions in the face of uncertainty remains to be understood. This article draws on interdisciplinary literature on uncertainty and physician decision-making to examine a specific physician response to uncertainty: using the doctor-patient relationship as a toolkit. Additionally, I ask what happens to this process when the doctor-patient relationship becomes fragmented. I answer these questions by examining obstetrician-gynecologists' narratives regarding how they make decisions when faced with uncertainty in childbirth. Between 2013 and 2014, I performed 21 semi-structured interviews with obstetricians in the United States. Obstetricians were selected to maximize variation in relevant physician, hospital, and practice characteristics. I began with grounded theory and moved to analytical coding of themes in relation to relevant literature. My analysis renders it evident that some physicians use the doctor-patient relationship as a toolkit for dealing with uncertainty. I analyze how this process varies for physicians in different models of care by comparing doctors' experiences in models with continuous versus fragmented doctor-patient relationships. My key findings are that obstetricians in both models appealed to the ideal of patient-centered decision-making to cope with uncertain decisions, but in practice physicians in fragmented care faced a number of challenges to using the doctor-patient relationship as a toolkit for decision-making. These challenges led to additional uncertainties and in some cases to poor outcomes for doctors and/or patients; they also raised concerns about the reproduction of inequality. Thus organization of care delivery mitigates the efficacy of doctors' use of the doctor-patient relationship toolkit for uncertain decisions. These findings have implications for theorizing about decision-making under conditions of medical uncertainty, for understanding how the doctor-patient relationship and model of care affect physician decision-making, and for forming policy on the optimal structure of medical work. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

Are patient decision aids the best way to improve clinical decision making? Report of the IPDAS Symposium.

PubMed

Holmes-Rovner, Margaret; Nelson, Wendy L; Pignone, Michael; Elwyn, Glyn; Rovner, David R; O'Connor, Annette M; Coulter, Angela; Correa-de-Araujo, Rosaly

2007-01-01

This article reports on the International Patient Decision Aid Standards Symposium held in 2006 at the annual meeting of the Society for Medical Decision Making in Cambridge, Massachusetts. The symposium featured a debate regarding the proposition that "decision aids are the best way to improve clinical decision making.'' The formal debate addressed the theoretical problem of the appropriate gold standard for an improved decision, efficacy of decision aids, and prospects for implementation. Audience comments and questions focused on both theory and practice: the often unacknowledged roots of decision aids in expected utility theory and the practical problems of limited patient decision aid implementation in health care. The participants' vote on the proposition was approximately half for and half against.

Making Good Decisions in Healthcare with Multi-Criteria Decision Analysis: The Use, Current Research and Future Development of MCDA.

PubMed

Mühlbacher, Axel C; Kaczynski, Anika

2016-02-01

Healthcare decision making is usually characterized by a low degree of transparency. The demand for transparent decision processes can be fulfilled only when assessment, appraisal and decisions about health technologies are performed under a systematic construct of benefit assessment. The benefit of an intervention is often multidimensional and, thus, must be represented by several decision criteria. Complex decision problems require an assessment and appraisal of various criteria; therefore, a decision process that systematically identifies the best available alternative and enables an optimal and transparent decision is needed. For that reason, decision criteria must be weighted and goal achievement must be scored for all alternatives. Methods of multi-criteria decision analysis (MCDA) are available to analyse and appraise multiple clinical endpoints and structure complex decision problems in healthcare decision making. By means of MCDA, value judgments, priorities and preferences of patients, insurees and experts can be integrated systematically and transparently into the decision-making process. This article describes the MCDA framework and identifies potential areas where MCDA can be of use (e.g. approval, guidelines and reimbursement/pricing of health technologies). A literature search was performed to identify current research in healthcare. The results showed that healthcare decision making is addressing the problem of multiple decision criteria and is focusing on the future development and use of techniques to weight and score different decision criteria. This article emphasizes the use and future benefit of MCDA.

An optimal repartitioning decision policy

NASA Technical Reports Server (NTRS)

Nicol, D. M.; Reynolds, P. F., Jr.

1986-01-01

A central problem to parallel processing is the determination of an effective partitioning of workload to processors. The effectiveness of any given partition is dependent on the stochastic nature of the workload. The problem of determining when and if the stochastic behavior of the workload has changed enough to warrant the calculation of a new partition is treated. The problem is modeled as a Markov decision process, and an optimal decision policy is derived. Quantification of this policy is usually intractable. A heuristic policy which performs nearly optimally is investigated empirically. The results suggest that the detection of change is the predominant issue in this problem.

Reunifying abused or neglected children: Decision-making and outcomes.

PubMed

Biehal, Nina; Sinclair, Ian; Wade, Jim

2015-11-01

Little is known about decision-making regarding the reunification of children in care, or about the consequences of these decisions for the children concerned. This study compared decision-making and outcomes for 149 maltreated children in seven English authorities (68 reunified, 81 who remained in care). Children were followed up six months after their return home or, for those who were not reunified, six months after the 'effective decision' that they should remain in care. They were followed up again four years (on average) after the return or effective decision. Data were extracted from case files at baseline and six month follow-up and were gathered from surveys of social workers and teachers at final follow-up. The two key predictors of reunification were assessments that parental problems had improved and that risks to the child were not unacceptably high. Two-thirds returned to improved family circumstances, sometimes due to a change in the household they returned to, but others were reunified despite persisting concerns. However 35% re-entered care within six months and 63% re-entered at some point during the four-year follow-up period, often due to recurring abuse or neglect. At final follow-up remaining in care was the strongest predictor of positive outcomes on a range of dimensions, even once children's characteristics and histories were taken into account. Outcomes were especially poor for neglected children who were reunified, irrespective of whether reunification was stable or unstable. Results show the potential of the care system to produce positive outcomes for maltreated children. Copyright © 2015 Elsevier Ltd. All rights reserved.

Common decisions made and actions taken during small-animal consultations at eight first-opinion practices in the United Kingdom.

PubMed

Robinson, N J; Brennan, M L; Cobb, M; Dean, R S

2017-04-01

In order for veterinary surgeons to undertake an evidence-based approach to making decisions about their patients, it is important that new evidence is generated to support the clinical decision-making process. Many of the decisions are likely to be around the actions taken to treat or manage health problems discussed during the consultation, and little is currently known about the factors which affect the type of action taken. The aim of this study was to determine the decisions made and actions taken for health problems discussed during first-opinion small-animal consultations, as well as identifying factors which may affect the decision-making process. Data were gathered during direct observation of small-animal consultations conducted by 62 veterinary surgeons in eight first-opinion practices in the United Kingdom. For each patient presented, data were gathered on all health problems discussed during the consultation. The decision made (whether an action was taken or not) and the action taken where applicable (e.g. therapeutic treatment with antibiotics) was also recorded. A three-level multivariable logistic-regression model was developed, with problem (Level 1) nested within patient (Level 2) nested within consulting veterinary surgeon (Level 3), and a binary outcome variable of action versus no action. At least one action was taken for 69% (n=2203/3192) of all problems discussed. Therapeutic treatment was the most common action taken (n=1286/3192 problems; 40.3%), followed by management advice (n=1040/3192; 32.6%) and diagnostic work-up (n=323/3192; 10.1%). The most common therapeutic treatment was antibiotics (n=386/1286; 30%), while the most common management advice given was dietary advice (n=509/1040; 48.9%). The three explanatory variables remaining in the final model were whether the problem was a presenting or non-presenting problem, the type of diagnosis made, and the body system affected. Explanatory variables which did not remain in the final model were patient signalment, problem history, consultation type, clinical examination type, and who raised the problem (veterinary surgeon or owner). For over two-thirds of problems discussed, an action was taken which suggests these problems may be seen as important by the veterinary surgeon and/or pet owner. No action was taken for almost a third of cases which could represent 'watchful waiting', which has been highlighted as important in human healthcare. Future research should focus on the common actions taken, further exploring the complex decision-making process, and examining the effect of the decisions made on long-term patient outcomes. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Validation in the Absence of Observed Events

DOE PAGES

Lathrop, John; Ezell, Barry

2015-07-22

Here our paper addresses the problem of validating models in the absence of observed events, in the area of Weapons of Mass Destruction terrorism risk assessment. We address that problem with a broadened definition of “Validation,” based on “backing up” to the reason why modelers and decision makers seek validation, and from that basis re-define validation as testing how well the model can advise decision makers in terrorism risk management decisions. We develop that into two conditions: Validation must be based on cues available in the observable world; and it must focus on what can be done to affect thatmore » observable world, i.e. risk management. That in turn leads to two foci: 1.) the risk generating process, 2.) best use of available data. Based on our experience with nine WMD terrorism risk assessment models, we then describe three best use of available data pitfalls: SME confidence bias, lack of SME cross-referencing, and problematic initiation rates. Those two foci and three pitfalls provide a basis from which we define validation in this context in terms of four tests -- Does the model: … capture initiation? … capture the sequence of events by which attack scenarios unfold? … consider unanticipated scenarios? … consider alternative causal chains? Finally, we corroborate our approach against three key validation tests from the DOD literature: Is the model a correct representation of the simuland? To what degree are the model results comparable to the real world? Over what range of inputs are the model results useful?« less

Using serious gaming to transfer knowledge and develop soft skills in postgraduate education

NASA Astrophysics Data System (ADS)

Craven, Joanne; Corzo Perez, Gerald Augusto; Karimi, Poolad; Dastgheib, Ali

2017-04-01

"Serious gaming" is gaming designed for a purpose other than entertainment and involves using board games, computer games and role-plays or a combination of all, for serious purposes, such as education, outreach, training, or decision support. It is argued that this approach provides a safe environment which facilitates group learning, allows for "learning by experience" in fields where long timescales or high risks make real experience impossible, motivates learners and stimulates players from different disciplines to share knowledge with each other. UNESCO-IHE offers education to water sector professionals from around the globe. All the courses at UNESCO-IHE involve serious games in one way or another. A varied range of games is developed and/or used: the group sizes for the games range from 5 students to over 100. Sometimes they are used as simulations to illustrate feedbacks, tradeoffs, variability, uncertainty and other phenomena, create an awareness of multidimensional water related issues, and sometimes they are used to train and develop soft skills, such as interdisciplinary collaboration, creative problem identification and problem solving, teamwork and robust decision-making under uncertainty. Often, they are able to do both, which is a key strength of serious games as an education tool. These games are also been used in research and advisory projects as well to communicate research outputs to stakeholders and the public and together with them reach an optimum technical decision which is socially viable. This session will discuss the experience with these games and what lessons can be learned for the future.

Stakeholders Participation In The European Water Framework Directive

NASA Astrophysics Data System (ADS)

van Ast, J. A.; Boot, S. P.

In the new framework directive, public information and consultation are main ele- ments in the procedure towards River Basin Management Plans. In general decision making in integrated water management should not be limited to the application of models and desk study. All important decisions need interaction with societal actors. These stakeholders have visions, ideas, patterns of behaviour and solutions for per- ceived problems. For example, farmer organisations, environmental groups and house- owners associations all have different ideas about measures that change the physical, chemical or biological characteristics of a river basin. Well- organised interaction has two main advantages: 1. The quality of the decision will be higher because specific knowledge of involved people and their different views are being taken into consider- ation. 2. The interaction enables exchange of information which can lead to a better understanding of the ins and outs of the specific situation and in this way contribute to public support. There are different ways for operationalisation of public informa- tion and consultation, like interactive workshops, internet assessment and interview rounds with key players. In this paper some of the different methods of interaction with stakeholders are elaborated. The aim is to improve the quality of integrated water management in river basins.

Understanding and applying principles of social cognition and ...

EPA Pesticide Factsheets

Environmental governance systems are under greater pressure to adapt and to cope with increased social and ecological uncertainty from stressors like climate change. We review principles of social cognition and decision making that shape and constrain how environmental governance systems adapt. We focus primarily on the interplay between key decision makers in society and legal systems. We argue that adaptive governance must overcome three cooperative dilemmas to facilitate adaptation: (1) encouraging collaborative problem solving, (2) garnering social acceptance and commitment, and (3) cultivating a culture of trust and tolerance for change and uncertainty. However, to do so governance systems must cope with biases in people’s decision making that cloud their judgment and create conflict. These systems must also satisfy people’s fundamental needs for self-determination, fairness, and security, ensuring that changes to environmental governance are perceived as legitimate, trustworthy, and acceptable. We discuss the implications of these principles for common governance solutions (e.g., public participation, enforcement) and conclude with methodological recommendations. We outline how scholars can investigate the social cognitive principles involved in cases of adaptive governance. Social-ecological stressors place significant pressure on major societal systems, triggering adaptive reforms in human governance and environmental law. Though potentially benefici

System design and improvement of an emergency department using Simulation-Based Multi-Objective Optimization

NASA Astrophysics Data System (ADS)

Goienetxea Uriarte, A.; Ruiz Zúñiga, E.; Urenda Moris, M.; Ng, A. H. C.

2015-05-01

Discrete Event Simulation (DES) is nowadays widely used to support decision makers in system analysis and improvement. However, the use of simulation for improving stochastic logistic processes is not common among healthcare providers. The process of improving healthcare systems involves the necessity to deal with trade-off optimal solutions that take into consideration a multiple number of variables and objectives. Complementing DES with Multi-Objective Optimization (SMO) creates a superior base for finding these solutions and in consequence, facilitates the decision-making process. This paper presents how SMO has been applied for system improvement analysis in a Swedish Emergency Department (ED). A significant number of input variables, constraints and objectives were considered when defining the optimization problem. As a result of the project, the decision makers were provided with a range of optimal solutions which reduces considerably the length of stay and waiting times for the ED patients. SMO has proved to be an appropriate technique to support healthcare system design and improvement processes. A key factor for the success of this project has been the involvement and engagement of the stakeholders during the whole process.

Coping strategies and immune neglect in affective forecasting: Direct evidence and key moderators

PubMed Central

Hoerger, Michael

2012-01-01

Affective forecasting skills have important implications for decision making. However, recent research suggests that immune neglect – the tendency to overlook coping strategies that reduce future distress – may lead to affective forecasting problems. Prior evidence for immune neglect has been indirect. More direct evidence and a deeper understanding of immune neglect are vital to informing the design of future decision-support interventions. In the current study, young adults (N = 325) supplied predicted, actual, and recollected reactions to an emotionally-evocative interpersonal event, Valentine’s Day. Based on participants’ qualitative descriptions of the holiday, a team of raters reliably coded the effectiveness of their coping strategies. Supporting the immune neglect hypothesis, participants overlooked the powerful role of coping strategies when predicting their emotional reactions. Immune neglect was present not only for those experiencing the holiday negatively (non-daters) but also for those experiencing it positively (daters), suggesting that the bias may be more robust than originally theorized. Immune neglect was greater for immediate emotional reactions than more enduring reactions. Further, immune neglect was conspicuously absent from recollected emotional reactions. Implications for decision-support interventions are discussed. PMID:22375161

Report of the Presidential Commission on the Space Shuttle Challenger Accident, Volume 1

NASA Technical Reports Server (NTRS)

Rogers, W. P.; Armstrong, N. A.; Acheson, D. C.; Covert, E. E.; Feynman, R. P.; Hotz, R. B.; Kutyna, D. J.; Ride, S. K.; Rummel, R. W.; Sutter, J. F.

1986-01-01

The findings of the Commission regarding the circumstances surrounding the Challenger accident are reported and recommendations for corrective action are outlined. All available mission data, subsequent tests, and wreckage analyses were reviewed and specific failure scenarios were developed. The Commission concluded that the cause of the Mission 51-L accident was the failure of the pressure seal in the aft field joint of the right solid rocket motor. The failure was due to a faulty design unacceptably sensitive to a number of factors. These factors were the effects of temperature, physical dimensions, the character of materials, the effects of reuse, processing, and the reaction of the joint to dynamic loading. In addition to analyzing the material causes of the accident, the Commission examined the chain of decisions that culminated in approval of the launch. It concluded that the decision making process was flawed in several ways including (1) failure in communication resulting in a launch decision based on incomplete and misleading information, (2) a conflict between engineering data and management judgements, and (3) a NASA management structure that permitted flight safety problems to bypass key Shuttle managers.

Key elements of optimal treatment decision-making for surgeons and older patients with colorectal or pancreatic cancer: A qualitative study.

PubMed

Geessink, Noralie H; Schoon, Yvonne; van Herk, Hanneke C P; van Goor, Harry; Olde Rikkert, Marcel G M

2017-03-01

To identify key elements of optimal treatment decision-making for surgeons and older patients with colorectal (CRC) or pancreatic cancer (PC). Six focus groups with different participants were performed: three with older CRC/PC patients and relatives, and three with physicians. Supplementary in-depth interviews were conducted in another seven patients. Framework analysis was used to identify key elements in decision-making. 23 physicians, 22 patients and 14 relatives participated. Three interacting components were revealed: preconditions, content and facilitators of decision-making. To provide optimal information about treatments' impact on an older patient's daily life, physicians should obtain an overall picture and take into account patients' frailty. Depending on patients' preferences and capacities, dividing decision-making into more sessions will be helpful and simultaneously emphasize patients' own responsibility. GPs may have a valuable contribution because of their background knowledge and supportive role. Stakeholders identified several crucial elements in the complex surgical decision-making of older CRC/PC patients. Structured qualitative research may also be of great help in optimizing other treatment directed decision-making processes. Surgeons should be trained in examining preconditions and useful facilitators in decision-making in older CRC/PC patients to optimize its content and to improve the quality of shared care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Changing Times, Complex Decisions: Presidential Values and Decision Making

ERIC Educational Resources Information Center

Hornak, Anne M.; Garza Mitchell, Regina L.

2016-01-01

Objective: The objective of this article is to delve more deeply into the thought processes of the key decision makers at community colleges and understand how they make decisions. Specifically, this article focuses on the role of the community college president's personal values in decision making. Method: We conducted interviews with 13…

The challenges of strategic purchasing of healthcare services in Iran Health Insurance Organization: a qualitative study

PubMed Central

Gorji, Hasan Abolghasem; Shojaei, Ali; Keshavarzi, Anahita; Zare, Hossein

2018-01-01

Background Strategic purchasing in healthcare services is a key component in improving health system performance, and it has been one of the most important issues in health system reform around the world, especially Europe in the last decade. Iran health system and insurance, although sometimes considered the issue of strategic purchasing goals, has not been made possible to achieve or even to implement, due to the associated problems. Objective To determine the associated problems of strategic purchasing in the Iran Health Insurance Organization (IHIO). Methods This study is a qualitative study, and framework analysis which was conducted in Iran in 2014–15. The participants in this study were 34 individuals from decision-makers and executives in the IHIO purchasing process, and university experts who have been chosen purposefully. This study conducted frame analysis, by using MAXQDA 10. Results The findings included associated problems of IHIO strategic purchasing in 12 themes and 65 subthemes. The themes included: Laws and regulations for purchasing, Organization of purchasing, Qualified and authorized providers, Right type of services, Right type of contracts, Target groups for purchasing, Resources allocation, financing and pricing system, Purchasing as improving performance and quality, Purchasing as shaping the market and competition, Purchasing as health progress state of people and society, Guided purchasing and stewardship of government, Structure of decision-making process in the health and welfare ministries. Conclusion The findings of this study showed associated problems in IHIO strategic purchasing. To achieve strategic purchasing goals in Iran, identification of all issues and factors of the total insurers and health system sets which affect strategic purchasing is essential. PMID:29629051

Factors influencing the patient with rheumatoid arthritis in their decision to seek podiatry.

PubMed

Blake, A; Mandy, P J; Stew, G

2013-12-01

Despite the level of foot involvement in rheumatoid arthritis (RA), and the literature to support early assessment of foot care needs, local referral of patients to podiatry has been occurring too late to instigate certain preventative interventions. Preliminary fieldwork has highlighted that the primary responsibility for the instigation of this lies with the patient. The present study describes the factors that influence the patient with RA in their decision to self-report foot problems. A case study research strategy was employed. Nine patients attending the outpatient rheumatology department participated in the study and data were gathered through semi-structured interviews. This information was analysed using a framework approach. The key themes derived from the data suggested that there are a variety of factors influencing the patient's decision to self-report foot concerns. Some will act to encourage the action and others will act to oppose it. Other factors can influence the decision either way, depending on the individual patient (psychological state, previous experience, body image changes). In addition, age, gender, and cultural and social aspects are also significant. Due to the multitude of factors influencing the individual's decision to seek help, the patient cannot be given sole responsibility for their foot health if we wish to achieve timely and appropriate podiatry, as recommended in the literature. Responsibility should be three-way; the patient, the members of the rheumatology team and, once in the podiatry service, the podiatrist should maintain this. Copyright © 2013 John Wiley & Sons, Ltd.

Facilitating participatory multilevel decision-making by using interactive mental maps.

PubMed

Pfeiffer, Constanze; Glaser, Stephanie; Vencatesan, Jayshree; Schliermann-Kraus, Elke; Drescher, Axel; Glaser, Rüdiger

2008-11-01

Participation of citizens in political, economic or social decisions is increasingly recognized as a precondition to foster sustainable development processes. Since spatial information is often important during planning and decision making, participatory mapping gains in popularity. However, little attention has been paid to the fact that information must be presented in a useful way to reach city planners and policy makers. Above all, the importance of visualisation tools to support collaboration, analytical reasoning, problem solving and decision-making in analysing and planning processes has been underestimated. In this paper, we describe how an interactive mental map tool has been developed in a highly interdisciplinary disaster management project in Chennai, India. We moved from a hand drawn mental maps approach to an interactive mental map tool. This was achieved by merging socio-economic and geospatial data on infrastructure, local perceptions, coping and adaptation strategies with remote sensing data and modern technology of map making. This newly developed interactive mapping tool allowed for insights into different locally-constructed realities and facilitated the communication of results to the wider public and respective policy makers. It proved to be useful in visualising information and promoting participatory decision-making processes. We argue that the tool bears potential also for health research projects. The interactive mental map can be used to spatially and temporally assess key health themes such as availability of, and accessibility to, existing health care services, breeding sites of disease vectors, collection and storage of water, waste disposal, location of public toilets or defecation sites.

Validation workflow for a clinical Bayesian network model in multidisciplinary decision making in head and neck oncology treatment.

PubMed

Cypko, Mario A; Stoehr, Matthaeus; Kozniewski, Marcin; Druzdzel, Marek J; Dietz, Andreas; Berliner, Leonard; Lemke, Heinz U

2017-11-01

Oncological treatment is being increasingly complex, and therefore, decision making in multidisciplinary teams is becoming the key activity in the clinical pathways. The increased complexity is related to the number and variability of possible treatment decisions that may be relevant to a patient. In this paper, we describe validation of a multidisciplinary cancer treatment decision in the clinical domain of head and neck oncology. Probabilistic graphical models and corresponding inference algorithms, in the form of Bayesian networks, can support complex decision-making processes by providing a mathematically reproducible and transparent advice. The quality of BN-based advice depends on the quality of the model. Therefore, it is vital to validate the model before it is applied in practice. For an example BN subnetwork of laryngeal cancer with 303 variables, we evaluated 66 patient records. To validate the model on this dataset, a validation workflow was applied in combination with quantitative and qualitative analyses. In the subsequent analyses, we observed four sources of imprecise predictions: incorrect data, incomplete patient data, outvoting relevant observations, and incorrect model. Finally, the four problems were solved by modifying the data and the model. The presented validation effort is related to the model complexity. For simpler models, the validation workflow is the same, although it may require fewer validation methods. The validation success is related to the model's well-founded knowledge base. The remaining laryngeal cancer model may disclose additional sources of imprecise predictions.

Multi-objective, multiple participant decision support for water management in the Andarax catchment, Almeria

NASA Astrophysics Data System (ADS)

van Cauwenbergh, N.; Pinte, D.; Tilmant, A.; Frances, I.; Pulido-Bosch, A.; Vanclooster, M.

2008-04-01

Water management in the Andarax river basin (Almeria, Spain) is a multi-objective, multi-participant, long-term decision-making problem that faces several challenges. Adequate water allocation needs informed decisions to meet increasing socio-economic demands while respecting the environmental integrity of this basin. Key players in the Andarax water sector include the municipality of Almeria, the irrigators involved in the intensive greenhouse agricultural sector, and booming second residences. A decision support system (DSS) is developed to rank different sustainable planning and management alternatives according to their socio-economic and environmental performance. The DSS is intimately linked to sustainability indicators and is designed through a public participation process. Indicators are linked to criteria reflecting stakeholders concerns in the 2005 field survey, such as fulfilling water demand, water price, technical and economical efficiency, social and environmental impacts. Indicators can be partly quantified after simulating the operation of the groundwater reservoir over a 20-year planning period and partly through a parallel expert evaluation process. To predict the impact of future water demand in the catchment, several development scenarios are designed to be evaluated in the DSS. The successive multi-criteria analysis of the performance indicators permits the ranking of the different management alternatives according to the multiple objectives formulated by the different sectors/participants. This allows more informed and transparent decision-making processes for the Andarax river basin, recognizing both the socio-economic and environmental dimensions of water resources management.

Creating an advance-care-planning decision aid for high-risk surgery: a qualitative study

PubMed Central

2014-01-01

Background High-risk surgery patients may lose decision-making capacity as a result of surgical complications. Advance care planning prior to surgery may be beneficial, but remains controversial and is hindered by a lack of appropriate decision aids. This study sought to examine stakeholders’ views on the appropriateness of using decision aids, in general, to support advance care planning among high-risk surgery populations and the design of such a decision aid. Methods Key informants were recruited through purposive and snowball sampling. Semi-structured interviews were conducted by phone until data collected reached theoretical saturation. Key informants were asked to discuss their thoughts about advance care planning and interventions to support advance care planning, particularly for this population. Researchers took de-identified notes that were analyzed for emerging concordant, discordant, and recurrent themes using interpretative phenomenological analysis. Results Key informants described the importance of initiating advance care planning preoperatively, despite potential challenges present in surgical settings. In general, decision aids were viewed as an appropriate approach to support advance care planning for this population. A recipe emerged from the data that outlines tools, ingredients, and tips for success that are needed to design an advance care planning decision aid for high-risk surgical settings. Conclusions Stakeholders supported incorporating advance care planning in high-risk surgical settings and endorsed the appropriateness of using decision aids to do so. Findings will inform the next stages of developing the first advance care planning decision aid for high-risk surgery patients. PMID:25067908

Creating an advance-care-planning decision aid for high-risk surgery: a qualitative study.

PubMed

Schuster, Anne Lr; Aslakson, Rebecca A; Bridges, John Fp

2014-01-01

High-risk surgery patients may lose decision-making capacity as a result of surgical complications. Advance care planning prior to surgery may be beneficial, but remains controversial and is hindered by a lack of appropriate decision aids. This study sought to examine stakeholders' views on the appropriateness of using decision aids, in general, to support advance care planning among high-risk surgery populations and the design of such a decision aid. Key informants were recruited through purposive and snowball sampling. Semi-structured interviews were conducted by phone until data collected reached theoretical saturation. Key informants were asked to discuss their thoughts about advance care planning and interventions to support advance care planning, particularly for this population. Researchers took de-identified notes that were analyzed for emerging concordant, discordant, and recurrent themes using interpretative phenomenological analysis. Key informants described the importance of initiating advance care planning preoperatively, despite potential challenges present in surgical settings. In general, decision aids were viewed as an appropriate approach to support advance care planning for this population. A recipe emerged from the data that outlines tools, ingredients, and tips for success that are needed to design an advance care planning decision aid for high-risk surgical settings. Stakeholders supported incorporating advance care planning in high-risk surgical settings and endorsed the appropriateness of using decision aids to do so. Findings will inform the next stages of developing the first advance care planning decision aid for high-risk surgery patients.

Advance decision.

PubMed

Samuels, Alec; Barrister, J P

2007-10-01

In the UK, patients have a statutory right to refuse treatment. Parliament has authorised 'advance decision' whereby a person can specify his or her wishes regarding further medical treatment. Although the advance decision may give a person peace of mind, it could create real problems for doctors and other healthcare professionals. This article will examine the conditions and procedures surrounding the drawing up of an advance decision as well as some of the problems that could arise such as layman's language.

The marketing activities of hospitals: environmental, organizational, and managerial influences.

PubMed

Myrtle, R C; Martinez, C F

1991-03-01

This article reports the results of a study designed to examine the relationship of environmental, organizational and structural factors, perceptions of key decision makers about competitive conditions, and changes in operational performance with the level of the marketing activities engaged in by 145 California hospitals. Measures assessing the impact of environmental conditions and the perception of the key decision makers were found to be related to the marketing activities of the organization. However, the relationship between measures which examined the structural and performance impacts on the marketing activities did not demonstrate the same predictive ability. The results suggest that marketing activities were affected by the key decision maker's assessment of the competitive nature of the environment, influence of key stakeholders, and tangible changes in the organization's task environment. Performance and other measures were not found to be as influential in determining these activities.

Perspectives of self-direction: a systematic review of key areas contributing to service users' engagement and choice-making in self-directed disability services and supports.

PubMed

Lakhani, Ali; McDonald, Donna; Zeeman, Heidi

2018-05-01

Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research must continue to investigate the perspectives of service users pertaining to their engagement, as their participation is central to the effectiveness of the approach. © 2016 John Wiley & Sons Ltd.

Boundary work for implementing adaptive management: A water sector application.

PubMed

Adem Esmail, Blal; Geneletti, Davide; Albert, Christian

2017-09-01

Boundary work, defined as effort to mediate between knowledge and action, is a promising approach for facilitating knowledge co-production for sustainable development. Here, we investigate a case study of knowledge co-production, to assess the applicability of boundary work as a conceptual framework to support implementing adaptive management in the water sector. We refer to a boundary work classification recently proposed by Clark et al., (2016), based on three types of knowledge uses, i.e. enlightenment, decision-, and negotiation-support, and three types of sources, i.e. personal expertise, single, and multiple communities of expertise. Our empirical results confirm boundary work has been crucial for the three types of knowledge use. For enlightenment and decision-support, effective interaction among knowledge producers and users was achieved through diverse boundary work practices, including joint agenda setting, and sharing of data and expertise. This initial boundary work eased subsequent knowledge co-production for decision-support and negotiations, in combination with stepping up of cooperation between relevant actors, suitable legislation and pressure for problem solving. Our analysis highlighted the temporal dimension matters - building trust around enlightenment first, and then using this as a basis for managing knowledge co-production for decision-, and negotiation support. We reconfirmed that boundary work is not a single time achievement, rather is a dynamic process, and we emphasized the importance of key actors driving the process, such as water utilities. Our results provide a rich case study of how strategic boundary work can facilitate knowledge co-production for adaptive management in the water sector. The boundary work practices employed here could also be transferred to other cases. Water utilities, as intermediaries between providers and beneficiaries of the important water-related ecosystem service of clean water provision, can indeed serve as key actors for initiating such boundary work practices. Copyright © 2017 Elsevier B.V. All rights reserved.

A Data Analysis Expert System For Large Established Distributed Databases

NASA Astrophysics Data System (ADS)

Gnacek, Anne-Marie; An, Y. Kim; Ryan, J. Patrick

1987-05-01

The purpose of this work is to analyze the applicability of artificial intelligence techniques for developing a user-friendly, parallel interface to large isolated, incompatible NASA databases for the purpose of assisting the management decision process. To carry out this work, a survey was conducted to establish the data access requirements of several key NASA user groups. In addition, current NASA database access methods were evaluated. The results of this work are presented in the form of a design for a natural language database interface system, called the Deductively Augmented NASA Management Decision Support System (DANMDS). This design is feasible principally because of recently announced commercial hardware and software product developments which allow cross-vendor compatibility. The goal of the DANMDS system is commensurate with the central dilemma confronting most large companies and institutions in America, the retrieval of information from large, established, incompatible database systems. The DANMDS system implementation would represent a significant first step toward this problem's resolution.

Attention control learning in the decision space using state estimation

NASA Astrophysics Data System (ADS)

Gharaee, Zahra; Fatehi, Alireza; Mirian, Maryam S.; Nili Ahmadabadi, Majid

2016-05-01

The main goal of this paper is modelling attention while using it in efficient path planning of mobile robots. The key challenge in concurrently aiming these two goals is how to make an optimal, or near-optimal, decision in spite of time and processing power limitations, which inherently exist in a typical multi-sensor real-world robotic application. To efficiently recognise the environment under these two limitations, attention of an intelligent agent is controlled by employing the reinforcement learning framework. We propose an estimation method using estimated mixture-of-experts task and attention learning in perceptual space. An agent learns how to employ its sensory resources, and when to stop observing, by estimating its perceptual space. In this paper, static estimation of the state space in a learning task problem, which is examined in the WebotsTM simulator, is performed. Simulation results show that a robot learns how to achieve an optimal policy with a controlled cost by estimating the state space instead of continually updating sensory information.

DeMAID/GA USER'S GUIDE Design Manager's Aid for Intelligent Decomposition with a Genetic Algorithm

NASA Technical Reports Server (NTRS)

Rogers, James L.

1996-01-01

Many companies are looking for new tools and techniques to aid a design manager in making decisions that can reduce the time and cost of a design cycle. One tool that is available to aid in this decision making process is the Design Manager's Aid for Intelligent Decomposition (DeMAID). Since the initial release of DEMAID in 1989, numerous enhancements have been added to aid the design manager in saving both cost and time in a design cycle. The key enhancement is a genetic algorithm (GA) and the enhanced version is called DeMAID/GA. The GA orders the sequence of design processes to minimize the cost and time to converge to a solution. These enhancements as well as the existing features of the original version of DEMAID are described. Two sample problems are used to show how these enhancements can be applied to improve the design cycle. This report serves as a user's guide for DeMAID/GA.

Evidence-informed recommendations to reduce dissemination bias in clinical research: conclusions from the OPEN (Overcome failure to Publish nEgative fiNdings) project based on an international consensus meeting

PubMed Central

Meerpohl, Joerg J; Schell, Lisa K; Bassler, Dirk; Gallus, Silvano; Kleijnen, Jos; Kulig, Michael; La Vecchia, Carlo; Marušić, Ana; Ravaud, Philippe; Reis, Andreas; Schmucker, Christine; Strech, Daniel; Urrútia, Gerard; Antes, Gerd

2015-01-01

Background Dissemination bias in clinical research severely impedes informed decision-making not only for healthcare professionals and patients, but also for funders, research ethics committees, regulatory bodies and other stakeholder groups that make health-related decisions. Decisions based on incomplete and biased evidence cannot only harm people, but may also have huge financial implications by wasting resources on ineffective or harmful diagnostic and therapeutic measures, and unnecessary research. Owing to involvement of multiple stakeholders, it remains easy for any single group to assign responsibility for resolving the problem to others. Objective To develop evidence-informed general and targeted recommendations addressing the various stakeholders involved in knowledge generation and dissemination to help overcome the problem of dissemination bias on the basis of previously collated evidence. Methods Based on findings from systematic reviews, document analyses and surveys, we developed general and targeted draft recommendations. During a 2-day workshop in summer 2013, these draft recommendations were discussed with external experts and key stakeholders, and refined following a rigorous and transparent methodological approach. Results Four general, overarching recommendations applicable to all or most stakeholder groups were formulated, addressing (1) awareness raising, (2) implementation of targeted recommendations, (3) trial registration and results posting, and (4) systematic approaches to evidence synthesis. These general recommendations are complemented and specified by 47 targeted recommendations tailored towards funding agencies, pharmaceutical and device companies, research institutions, researchers (systematic reviewers and trialists), research ethics committees, trial registries, journal editors and publishers, regulatory agencies, benefit (health technology) assessment institutions and legislators. Conclusions Despite various recent examples of dissemination bias and several initiatives to reduce it, the problem of dissemination bias has not been resolved. Tailored recommendations based on a comprehensive approach will hopefully help increase transparency in biomedical research by overcoming the failure to disseminate negative findings. PMID:25943371

Reconciliation of Decision-Making Heuristics Based on Decision Trees Topologies and Incomplete Fuzzy Probabilities Sets

PubMed Central

Doubravsky, Karel; Dohnal, Mirko

2015-01-01

Complex decision making tasks of different natures, e.g. economics, safety engineering, ecology and biology, are based on vague, sparse, partially inconsistent and subjective knowledge. Moreover, decision making economists / engineers are usually not willing to invest too much time into study of complex formal theories. They require such decisions which can be (re)checked by human like common sense reasoning. One important problem related to realistic decision making tasks are incomplete data sets required by the chosen decision making algorithm. This paper presents a relatively simple algorithm how some missing III (input information items) can be generated using mainly decision tree topologies and integrated into incomplete data sets. The algorithm is based on an easy to understand heuristics, e.g. a longer decision tree sub-path is less probable. This heuristic can solve decision problems under total ignorance, i.e. the decision tree topology is the only information available. But in a practice, isolated information items e.g. some vaguely known probabilities (e.g. fuzzy probabilities) are usually available. It means that a realistic problem is analysed under partial ignorance. The proposed algorithm reconciles topology related heuristics and additional fuzzy sets using fuzzy linear programming. The case study, represented by a tree with six lotteries and one fuzzy probability, is presented in details. PMID:26158662

Reconciliation of Decision-Making Heuristics Based on Decision Trees Topologies and Incomplete Fuzzy Probabilities Sets.

PubMed

Doubravsky, Karel; Dohnal, Mirko

2015-01-01

Complex decision making tasks of different natures, e.g. economics, safety engineering, ecology and biology, are based on vague, sparse, partially inconsistent and subjective knowledge. Moreover, decision making economists / engineers are usually not willing to invest too much time into study of complex formal theories. They require such decisions which can be (re)checked by human like common sense reasoning. One important problem related to realistic decision making tasks are incomplete data sets required by the chosen decision making algorithm. This paper presents a relatively simple algorithm how some missing III (input information items) can be generated using mainly decision tree topologies and integrated into incomplete data sets. The algorithm is based on an easy to understand heuristics, e.g. a longer decision tree sub-path is less probable. This heuristic can solve decision problems under total ignorance, i.e. the decision tree topology is the only information available. But in a practice, isolated information items e.g. some vaguely known probabilities (e.g. fuzzy probabilities) are usually available. It means that a realistic problem is analysed under partial ignorance. The proposed algorithm reconciles topology related heuristics and additional fuzzy sets using fuzzy linear programming. The case study, represented by a tree with six lotteries and one fuzzy probability, is presented in details.

Teaching Behavioral Ethics: Overcoming the Key Impediments to Ethical Behavior

ERIC Educational Resources Information Center

Schwartz, Mark S.

2017-01-01

To better understand the ethical decision-making process and why individuals fail to act ethically, the aim of this article is to explore what are seen as the key impediments to ethical behavior and their pedagogical implications. Using the ethical decision-making process proposed by Rest as an overarching framework, the article examines the…

Improving the quality of mass produced maps

USGS Publications Warehouse

Simley, J.

2001-01-01

Quality is critical in cartography because key decisions are often made based on the information the map communicates. The mass production of digital cartographic information to support geographic information science has now added a new dimension to the problem of cartographic quality, as problems once limited to small volumes can now proliferate in mass production programs. These problems can also affect the economics of map production by diverting a sizeable portion of production cost to pay for rework on maps with poor quality. Such problems are common to general industry-in response, the quality engineering profession has developed a number of successful methods to overcome these problems. Two important methods are the reduction of error through statistical analysis and addressing the quality environment in which people work. Once initial and obvious quality problems have been solved, outside influences periodically appear that cause adverse variations in quality and consequently increase production costs. Such errors can be difficult to detect before the customer is affected. However, a number of statistical techniques can be employed to detect variation so that the problem is eliminated before significant damage is caused. Additionally, the environment in which the workforce operates must be conductive to quality. Managers have a powerful responsibility to create this environment. Two sets of guidelines, known as Deming's Fourteen Points and ISO-9000, provide models for this environment.

[The framing effect: medical implications].

PubMed

Mazzocco, Ketti; Cherubini, Paolo; Rumiati, Rino

2005-01-01

Over the last 20 years, many studies explored how the way information is presented modifies choices. This sort of effect, referred to as "framing effects", typically consists of the inversion of choices when presenting structurally identical decision problems in different ways. It is a common assumption that physicians are unaffected (or less affected) by the surface description of a decision problem, because they are formally trained in medical decision making. However, several studies showed that framing effects occur even in the medical field. The complexity and variability of these effects are remarkable, making it necessary to distinguish among different framing effects, depending on whether the effect is obtained by modifying adjectives (attribute framing), goals of a behavior (goal framing), or the probability of an outcome (risky choice framing). A further reason for the high variability of the framing effects seems to be the domain of the decision problem, with different effects occurring in prevention decisions, disease-detection decisions, and treatment decisions. The present work reviews the studies on framing effects, in order to summarize them and clarify their possible role in medical decision making.

Should I stay or should I go? A systematic review of factors that influence healthcare students' decisions around study abroad programmes.

PubMed

Brown, Mary; Boateng, Edward Appiah; Evans, Catrin

2016-04-01

Study abroad programmes have been shown to have significant benefits for participating healthcare students such as promoting cultural awareness and understanding of different healthcare settings, policies and practices. Healthcare students are encouraged to undertake elective or Erasmus placements overseas to enhance personal and professional development and to broaden horizons through lived cultural experience. However, there is a relatively low uptake of such opportunities amongst this student group. This systematic review aimed to explore factors that influence healthcare students' decision making around study abroad opportunities within undergraduate training programmes. A systematic review was undertaken utilising a narrative synthesis approach. A comprehensive literature search was conducted on MEDLINE, CINAHL, EMBASE, PsycINFO, ASSIA, and ERIC databases. Key institutions were contacted for grey literature. Studies that reported on factors that influence healthcare students' decisions regarding study abroad programmes were included in the review. Ten studies were identified for inclusion (5 qualitative studies, 5 surveys), indicating a paucity of research in this area. Data synthesis indicates that factors that influence healthcare students' decisions to participate in study abroad programmes are similar across different geographic locations and different professional groups. Factors that support decisions to study overseas include having sufficient information about study abroad programmes, especially early in an academic programme, having an interest in other cultures/countries and having academic staff and family as positive role models who motivate them to study abroad. Key barriers are cost and language issues. Language remains a significant barrier even when generous bursaries are available, as with the Erasmus scheme, when students are not proficient with the language spoken in host countries. Students tend to prefer destinations where language is not a problem or where countries have cultural or historical connections, such as being part of the Commonwealth countries. Promotion of study abroad opportunities needs to start early in an academic programme. It should include detailed information and provision of language support. Faculty have an important part to play as enthusiastic role models. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Children's Use of Meta-Cognition in Solving Everyday Problems: Children's Monetary Decision-Making

ERIC Educational Resources Information Center

Lee, Chwee Beng; Koh, Noi Keng; Cai, Xin Le; Quek, Choon Lang

2012-01-01

The purpose of this study was to understand how children use meta-cognition in their everyday problem-solving, particularly making monetary decisions. A particular focus was to identify components of meta-cognition, such as regulation of cognition and knowledge of cognition observed in children's monetary decision-making process, the roles of…

Leadership Style, Decision Context, and the Poliheuristic Theory of Decision Making: An Experimental Analysis

ERIC Educational Resources Information Center

Keller, Jonathan W.; Yang, Yi Edward

2008-01-01

The poliheuristic (PH) theory of decision making has made important contributions to our understanding of political decision making but remains silent about certain key aspects of the decision process. Specifically, PH theory contends that leaders screen out politically unacceptable options, but it provides no guidance on (1) the crucial threshold…

Roles, processes, and outcomes of interprofessional shared decision-making in a neonatal intensive care unit: A qualitative study.

PubMed

Dunn, Sandra I; Cragg, Betty; Graham, Ian D; Medves, Jennifer; Gaboury, Isabelle

2018-05-01

Shared decision-making provides an opportunity for the knowledge and skills of care providers to synergistically influence patient care. Little is known about interprofessional shared decision-making processes in critical care settings. The aim of this study was to explore interprofessional team members' perspectives about the nature of interprofessional shared decision-making in a neonatal intensive care unit (NICU) and to determine if there are any differences in perspectives across professional groups. An exploratory qualitative approach was used consisting of semi-structured interviews with 22 members of an interprofessional team working in a tertiary care NICU in Canada. Participants identified four key roles involved in interprofessional shared decision-making: leader, clinical experts, parents, and synthesizer. Participants perceived that interprofessional shared decision-making happens through collaboration, sharing, and weighing the options, the evidence and the credibility of opinions put forward. The process of interprofessional shared decision-making leads to a well-informed decision and participants feeling valued. Findings from this study identified key concepts of interprofessional shared decision-making, increased awareness of differing professional perspectives about this process of shared decision-making, and clarified understanding of the different roles involved in the decision-making process in an NICU.

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention

PubMed Central

Fisher, Brian; Smith, Jennifer; Pike, Ian

2017-01-01

Background: Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods: Inspired by the Delphi method, we introduced a novel methodology—group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders’ observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results: The GA methodology triggered the emergence of ‘common ground’ among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders’ verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusions: Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ‘common ground’ among diverse stakeholders about health data and their implications. PMID:28895928

The environmental management problem of Pohorje, Slovenia: A new group approach within ANP - SWOT framework.

PubMed

Grošelj, Petra; Zadnik Stirn, Lidija

2015-09-15

Environmental management problems can be dealt with by combining participatory methods, which make it possible to include various stakeholders in a decision-making process, and multi-criteria methods, which offer a formal model for structuring and solving a problem. This paper proposes a three-phase decision making approach based on the analytic network process and SWOT (strengths, weaknesses, opportunities and threats) analysis. The approach enables inclusion of various stakeholders or groups of stakeholders in particular stages of decision making. The structure of the proposed approach is composed of a network consisting of an objective cluster, a cluster of strategic goals, a cluster of SWOT factors and a cluster of alternatives. The application of the suggested approach is applied to a management problem of Pohorje, a mountainous area in Slovenia. Stakeholders from sectors that are important for Pohorje (forestry, agriculture, tourism and nature protection agencies) who can offer a wide range of expert knowledge were included in the decision-making process. The results identify the alternative of "sustainable development" as the most appropriate for development of Pohorje. The application in the paper offers an example of employing the new approach to an environmental management problem. This can also be applied to decision-making problems in various other fields. Copyright © 2015 Elsevier Ltd. All rights reserved.

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention.

PubMed

Al-Hajj, Samar; Fisher, Brian; Smith, Jennifer; Pike, Ian

2017-09-12

Background : Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods : Inspired by the Delphi method, we introduced a novel methodology-group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders' observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results : The GA methodology triggered the emergence of ' common g round ' among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders' verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusion s : Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ' common ground' among diverse stakeholders about health data and their implications.

Motor activity as a way of preventing musculoskeletal problems in string musicians.

PubMed

Wilke, Christiane; Priebus, Julian; Biallas, Bianca; Froböse, Ingo

2011-03-01

The health status of performing artists, especially musicians, was not an issue for medical research until the 1980s. Musicians tend to suffer from health-related problems, as playing an instrument demands long and intensive practice. This paper provides a literature review of health problems of string players in particular. It analyzes whether their problems are playing-related or if various parameters potentially influence their health state, and it subsequently presents a concept of efficient training. Health disorders and diseases are individual. In order to ensure efficient prevention, a profile of qualification, including physical and psychological aspects as well as key skills, allows developing an individual training schedule and thus should be included in the process of prevention. Physical performance plays a decisive role and is more important than commonly thought. Strength, endurance, and flexibility in particular have an immense influence on the musician's performance. Playing an instrument requires both physical and mental skills, and all too often this leads to excessive demands. It is necessary to highlight the possible causes and provide the musician with a therapeutic intervention and educational work. As the demand for preventative work in this field grows steadily, this paper draws a detailed concept of a therapeutic intervention.

Deformed Palmprint Matching Based on Stable Regions.

PubMed

Wu, Xiangqian; Zhao, Qiushi

2015-12-01

Palmprint recognition (PR) is an effective technology for personal recognition. A main problem, which deteriorates the performance of PR, is the deformations of palmprint images. This problem becomes more severe on contactless occasions, in which images are acquired without any guiding mechanisms, and hence critically limits the applications of PR. To solve the deformation problems, in this paper, a model for non-linearly deformed palmprint matching is derived by approximating non-linear deformed palmprint images with piecewise-linear deformed stable regions. Based on this model, a novel approach for deformed palmprint matching, named key point-based block growing (KPBG), is proposed. In KPBG, an iterative M-estimator sample consensus algorithm based on scale invariant feature transform features is devised to compute piecewise-linear transformations to approximate the non-linear deformations of palmprints, and then, the stable regions complying with the linear transformations are decided using a block growing algorithm. Palmprint feature extraction and matching are performed over these stable regions to compute matching scores for decision. Experiments on several public palmprint databases show that the proposed models and the KPBG approach can effectively solve the deformation problem in palmprint verification and outperform the state-of-the-art methods.

Active inference, evidence accumulation and the urn task

PubMed Central

FitzGerald, Thomas HB; Schwartenbeck, Philipp; Moutoussis, Michael; Dolan, Raymond J; Friston, Karl

2015-01-01

Deciding how much evidence to accumulate before making a decision is a problem we and other animals often face, but one which is not completely understood. This issue is particularly important because a tendency to sample less information (often known as reflection impulsivity) is a feature in several psychopathologies, such as psychosis. A formal understanding information sampling may therefore clarify the computational anatomy of psychopathology. In this theoretical paper, we consider evidence accumulation in terms of active (Bayesian) inference using a generic model of Markov decision processes. Here, agents are equipped with beliefs about their own behaviour – in this case, that they will make informed decisions. Normative decision-making is then modelled using variational Bayes to minimise surprise about choice outcomes. Under this scheme, different facets of belief updating map naturally onto the functional anatomy of the brain (at least at a heuristic level). Of particular interest is the key role played by the expected precision of beliefs about control, which we have previously suggested may be encoded by dopaminergic neurons in the midbrain. We show that manipulating expected precision strongly affects how much information an agent characteristically samples, and thus provides a possible link between impulsivity and dopaminergic dysfunction. Our study therefore represents a step towards understanding evidence accumulation in terms of neurobiologically plausible Bayesian inference, and may cast light on why this process is disordered in psychopathology. PMID:25514108

[Why controlled studies may lead to misleading and unconfirmed therapeutic concepts--a critical view of evidence-based medicine].

PubMed

Flachskampf, F A

2002-03-01

The concept of evidence-based medicine has gathered widespread support during recent years. While this concept has clear merits in compiling and qualifying up-to-date information for clinical decisions, it should be viewed with caution as the sole valid knowledge source for clinical decision-making. The limitations of such an approach are particularly striking when reviewing two key developments in modern cardiology, fibrinolysis and acute percutaneous intervention in acute myocardial infarction. In both cases, early studies and meta-analyses showed no benefit for these therapeutic interventions over earlier treatment. Only after further refinement (mainly in dosage, time window, concomitant heparin therapy for fibrinolysis, and the introduction of stents and IIb/IIIa inhibitors for acute intervention) did these therapies become universally acknowledged. It is therefore crucial to understand that especially for physicians actively participating in the development of a clinical field clinical decisions cannot be exclusively based on published evidence. Another important problem to consider is the time gap between the emergence of new therapies and the publication and reception by the medical audience, in particular in rapidly evolving fields as cardiology. While it is clear that clinical decision-making must be backed by solid knowledge of the published evidence, in particular the specialist involved in-depth in the field may use not yet proven therapeutic concepts and measures to the patient's advantage.

Comparison of fuzzy AHP and fuzzy TODIM methods for landfill location selection.

PubMed

Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

2016-01-01

Landfill location selection is a multi-criteria decision problem and has a strategic importance for many regions. The conventional methods for landfill location selection are insufficient in dealing with the vague or imprecise nature of linguistic assessment. To resolve this problem, fuzzy multi-criteria decision-making methods are proposed. The aim of this paper is to use fuzzy TODIM (the acronym for Interactive and Multi-criteria Decision Making in Portuguese) and the fuzzy analytic hierarchy process (AHP) methods for the selection of landfill location. The proposed methods have been applied to a landfill location selection problem in the region of Casablanca, Morocco. After determining the criteria affecting the landfill location decisions, fuzzy TODIM and fuzzy AHP methods are applied to the problem and results are presented. The comparisons of these two methods are also discussed.

Decision-making Strategies and Performance among Seniors1

PubMed Central

Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael

2011-01-01

Using paper and pencil experiments administered in senior centers, we examine decision-making performance in multi-attribute decision problems. We differentiate the effects of declining cognitive performance and changing cognitive process on decision-making performance of seniors as they age. We find a significant decline in performance with age due to reduced reliance on common heuristics and increased decision-making randomness among our oldest subjects. However, we find that increasing the number of options in a decision problem increases the number of heuristics brought to the task. This challenges the choice overload view that people give up when confronted with too much choice. PMID:22408282

Linguistic Multi-Attribute Group Decision Making with Risk Preferences and Its Use in Low-Carbon Tourism Destination Selection.

PubMed

Lin, Hui; Wang, Zhou-Jing

2017-09-17

Low-carbon tourism plays an important role in carbon emission reduction and environmental protection. Low-carbon tourism destination selection often involves multiple conflicting and incommensurate attributes or criteria and can be modelled as a multi-attribute decision-making problem. This paper develops a framework to solve multi-attribute group decision-making problems, where attribute evaluation values are provided as linguistic terms and the attribute weight information is incomplete. In order to obtain a group risk preference captured by a linguistic term set with triangular fuzzy semantic information, a nonlinear programming model is established on the basis of individual risk preferences. We first convert individual linguistic-term-based decision matrices to their respective triangular fuzzy decision matrices, which are then aggregated into a group triangular fuzzy decision matrix. Based on this group decision matrix and the incomplete attribute weight information, a linear program is developed to find an optimal attribute weight vector. A detailed procedure is devised for tackling linguistic multi-attribute group decision making problems. A low-carbon tourism destination selection case study is offered to illustrate how to use the developed group decision-making model in practice.

Linguistic Multi-Attribute Group Decision Making with Risk Preferences and Its Use in Low-Carbon Tourism Destination Selection

PubMed Central

Lin, Hui; Wang, Zhou-Jing

2017-01-01

Low-carbon tourism plays an important role in carbon emission reduction and environmental protection. Low-carbon tourism destination selection often involves multiple conflicting and incommensurate attributes or criteria and can be modelled as a multi-attribute decision-making problem. This paper develops a framework to solve multi-attribute group decision-making problems, where attribute evaluation values are provided as linguistic terms and the attribute weight information is incomplete. In order to obtain a group risk preference captured by a linguistic term set with triangular fuzzy semantic information, a nonlinear programming model is established on the basis of individual risk preferences. We first convert individual linguistic-term-based decision matrices to their respective triangular fuzzy decision matrices, which are then aggregated into a group triangular fuzzy decision matrix. Based on this group decision matrix and the incomplete attribute weight information, a linear program is developed to find an optimal attribute weight vector. A detailed procedure is devised for tackling linguistic multi-attribute group decision making problems. A low-carbon tourism destination selection case study is offered to illustrate how to use the developed group decision-making model in practice. PMID:28926985

Association Between Anticipatory Grief and Problem Solving Among Family Caregivers of Persons with Cognitive Impairment

PubMed Central

Fowler, Nicole R.; Hansen, Alexandra S.; Barnato, Amber E.; Garand, Linda

2013-01-01

Objective Measure perceived involvement in medical decision making and determine if anticipatory grief is associated with problem solving among family caregivers of older adults with cognitive impairment. Method Retrospective analysis of baseline data from a caregiver intervention (n=73). Multivariable regression models testing the association between caregivers’ anticipatory grief, measured by the Anticipatory Grief Scale (AGS), with problem solving abilities, measured by the Social Problem Solving Inventory – Revised: Short Form (SPSI-R: S). Results 47/73 (64%) of caregivers reported involvement in medical decision making. Mean AGS was 70.1 (± 14.8) and mean SPSI-R:S was 107.2 (± 11.6). Higher AGS scores were associated with lower positive problem orientation (P=0.041) and higher negative problem orientation scores (P=0.001) but not other components of problem solving- rational problem solving, avoidance style, and impulsivity/carelessness style. Discussion Higher anticipatory grief among family caregivers impaired problem solving, which could have negative consequences for their medical decision making responsibilities. PMID:23428394

Understanding The Decision Context: DPSIR, Decision Landscape, And Social Network Analysis

EPA Science Inventory

Establishing the decision context for a management problem is the critical first step for effective decision analysis. Understanding the decision context allow stakeholders and decision-makers to integrate the societal, environmental, and economic considerations that must be con...

Consensus Building: A Key to School Transformation

ERIC Educational Resources Information Center

Baron, Daniel

2008-01-01

Consensus-based decision making can turn faculty meetings into meaningful and productive work sessions in which faculty members know that their input is respected and valued and important decisions are made. Reaching consensus has different meanings in different contexts. Decisions are made "by consensus" when the decision affects the entire…

Keys to success for data-driven decision making: Lessons from participatory monitoring and collaborative adaptive management

USDA-ARS?s Scientific Manuscript database

Recent years have witnessed a call for evidence-based decisions in conservation and natural resource management, including data-driven decision-making. Adaptive management (AM) is one prevalent model for integrating scientific data into decision-making, yet AM has faced numerous challenges and limit...

What Learning Environments Help Improve Decision-Making?

ERIC Educational Resources Information Center

O'Connor, Donna; Larkin, Paul; Williams, A. Mark

2017-01-01

Background: Decision-making is a key component of performance in sport. However, there has been minimal investigation of how coaches may adapt practice sessions to specifically develop decision-making. Purpose: The aim in this exploratory study was to investigate the pedagogical approaches coaches use to develop decision-making in soccer. Method:…

Offset quadrature communications with decision-feedback carrier synchronization

NASA Technical Reports Server (NTRS)

Simon, M. K.; Smith, J. G.

1974-01-01

In order to accommodate a quadrature amplitude-shift-keyed (QASK) signal, Simon and Smith (1974) have modified the decision-feedback loop which tracks a quadrature phase-shift-keyed (QPSK). In the investigation reported approaches are considered to modify the loops in such a way that offset QASK signals can be tracked, giving attention to the special case of an offset QPSK. The development of the stochastic integro-differential equation of operation for a decision-feedback offset QASK loop is discussed along with the probability density function of the phase error process.

Linked Sensitivity Analysis, Calibration, and Uncertainty Analysis Using a System Dynamics Model for Stroke Comparative Effectiveness Research.

PubMed

Tian, Yuan; Hassmiller Lich, Kristen; Osgood, Nathaniel D; Eom, Kirsten; Matchar, David B

2016-11-01

As health services researchers and decision makers tackle more difficult problems using simulation models, the number of parameters and the corresponding degree of uncertainty have increased. This often results in reduced confidence in such complex models to guide decision making. To demonstrate a systematic approach of linked sensitivity analysis, calibration, and uncertainty analysis to improve confidence in complex models. Four techniques were integrated and applied to a System Dynamics stroke model of US veterans, which was developed to inform systemwide intervention and research planning: Morris method (sensitivity analysis), multistart Powell hill-climbing algorithm and generalized likelihood uncertainty estimation (calibration), and Monte Carlo simulation (uncertainty analysis). Of 60 uncertain parameters, sensitivity analysis identified 29 needing calibration, 7 that did not need calibration but significantly influenced key stroke outcomes, and 24 not influential to calibration or stroke outcomes that were fixed at their best guess values. One thousand alternative well-calibrated baselines were obtained to reflect calibration uncertainty and brought into uncertainty analysis. The initial stroke incidence rate among veterans was identified as the most influential uncertain parameter, for which further data should be collected. That said, accounting for current uncertainty, the analysis of 15 distinct prevention and treatment interventions provided a robust conclusion that hypertension control for all veterans would yield the largest gain in quality-adjusted life years. For complex health care models, a mixed approach was applied to examine the uncertainty surrounding key stroke outcomes and the robustness of conclusions. We demonstrate that this rigorous approach can be practical and advocate for such analysis to promote understanding of the limits of certainty in applying models to current decisions and to guide future data collection. © The Author(s) 2016.

A Cognitive Information Processing Approach to Employment Problem Solving and Decision Making.

ERIC Educational Resources Information Center

Sampson, James P., Jr.; Lenz, Janet G.; Reardon, Robert C.; Peterson, Gary W.

1999-01-01

Applies a cognitive information processing approach to the specific process of employment problem solving and decision making. Definitions and accompanying employment examples are followed by an exploration of the nature of employment problems. Examples of positive and negative cognitions that have an impact on the effectiveness of employment…

Topics in inference and decision-making with partial knowledge

NASA Technical Reports Server (NTRS)

Safavian, S. Rasoul; Landgrebe, David

1990-01-01

Two essential elements needed in the process of inference and decision-making are prior probabilities and likelihood functions. When both of these components are known accurately and precisely, the Bayesian approach provides a consistent and coherent solution to the problems of inference and decision-making. In many situations, however, either one or both of the above components may not be known, or at least may not be known precisely. This problem of partial knowledge about prior probabilities and likelihood functions is addressed. There are at least two ways to cope with this lack of precise knowledge: robust methods, and interval-valued methods. First, ways of modeling imprecision and indeterminacies in prior probabilities and likelihood functions are examined; then how imprecision in the above components carries over to the posterior probabilities is examined. Finally, the problem of decision making with imprecise posterior probabilities and the consequences of such actions are addressed. Application areas where the above problems may occur are in statistical pattern recognition problems, for example, the problem of classification of high-dimensional multispectral remote sensing image data.

Innovative environmental education contributes to improved management practices in the Mid-Atlantic region of the United States.

PubMed

Bradley, M Patricia; Hanson, Royce; Walbeck, Eric S

2004-06-01

The Mid-Atlantic Integrated Assessment (MAIA) and its partner, University of Maryland, Baltimore County (UMBC) have developed a graduate-level course focused on successful application of science by decision-makers to address a particular problem. Students conduct a literature review, interview the decision-makers and scientists, and synthesize and document the management problem, the science that was applied to that problem, and other issues that might constrain or drive the solution (e.g., legalities, social pressures, expense, politics, personalities, etc.). Students also quantify the results, evaluate who the intended audience is and how they most appropriately target them, and determine if there are other management problems that could be addressed with the science. The final products are short publications geared towards other decision-makers who might have a similar problem and might be seeking successful innovative solutions. MAIA is distributing these short publications to decision-makers throughout the Mid-Atlantic Region. The publications have been very positively received by state and local governments and watershed groups.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard

PubMed Central

Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

2015-01-01

Introduction: management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. Methods: the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. Results: the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. Conclusion: the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process. PMID:26483593

ζ Oph and the weak-wind problem

NASA Astrophysics Data System (ADS)

Gvaramadze, V. V.; Langer, N.; Mackey, J.

2012-11-01

Mass-loss rate, ?, is one of the key parameters affecting evolution and observational manifestations of massive stars and their impact on the ambient medium. Despite its importance, there is a factor of ˜100 discrepancy between empirical and theoretical ? of late-type O dwarfs, the so-called weak-wind problem. In this Letter, we propose a simple novel method to constrain ? of runaway massive stars through observation of their bow shocks and Strömgren spheres, which might be of decisive importance for resolving the weak-wind problem. Using this method, we found that ? of the well-known runaway O9.5 V star ζ Oph is more than an order of magnitude higher than that derived from ultraviolet (UV) line fitting and is by a factor of 6-7 lower than those based on the theoretical recipe by Vink et al. and the Hα line. The discrepancy between ? derived by our method and that based on UV lines would be even more severe if the stellar wind is clumpy. At the same time, our estimate of ? agrees with that predicted by the moving reversing layer theory by Lucy.

Effective monitoring of agriculture: a response.

PubMed

Sachs, Jeffrey D; Remans, Roseline; Smukler, Sean M; Winowiecki, Leigh; Andelman, Sandy J; Cassman, Kenneth G; Castle, David; DeFries, Ruth; Denning, Glenn; Fanzo, Jessica; Jackson, Louise E; Leemans, Rik; Lehmann, Johannes; Milder, Jeffrey C; Naeem, Shahid; Nziguheba, Generose; Palm, Cheryl A; Pingali, Prabhu L; Reganold, John P; Richter, Daniel D; Scherr, Sara J; Sircely, Jason; Sullivan, Clare; Tomich, Thomas P; Sanchez, Pedro A

2012-03-01

The development of effective agricultural monitoring networks is essential to track, anticipate and manage changes in the social, economic and environmental aspects of agriculture. We welcome the perspective of Lindenmayer and Likens (J. Environ. Monit., 2011, 13, 1559) as published in the Journal of Environmental Monitoring on our earlier paper, "Monitoring the World's Agriculture" (Sachs et al., Nature, 2010, 466, 558-560). In this response, we address their three main critiques labeled as 'the passive approach', 'the problem with uniform metrics' and 'the problem with composite metrics'. We expand on specific research questions at the core of the network design, on the distinction between key universal and site-specific metrics to detect change over time and across scales, and on the need for composite metrics in decision-making. We believe that simultaneously measuring indicators of the three pillars of sustainability (environmentally sound, social responsible and economically viable) in an effectively integrated monitoring system will ultimately allow scientists and land managers alike to find solutions to the most pressing problems facing global food security. This journal is © The Royal Society of Chemistry 2012

Decision-making without a brain: how an amoeboid organism solves the two-armed bandit.

PubMed

Reid, Chris R; MacDonald, Hannelore; Mann, Richard P; Marshall, James A R; Latty, Tanya; Garnier, Simon

2016-06-01

Several recent studies hint at shared patterns in decision-making between taxonomically distant organisms, yet few studies demonstrate and dissect mechanisms of decision-making in simpler organisms. We examine decision-making in the unicellular slime mould Physarum polycephalum using a classical decision problem adapted from human and animal decision-making studies: the two-armed bandit problem. This problem has previously only been used to study organisms with brains, yet here we demonstrate that a brainless unicellular organism compares the relative qualities of multiple options, integrates over repeated samplings to perform well in random environments, and combines information on reward frequency and magnitude in order to make correct and adaptive decisions. We extend our inquiry by using Bayesian model selection to determine the most likely algorithm used by the cell when making decisions. We deduce that this algorithm centres around a tendency to exploit environments in proportion to their reward experienced through past sampling. The algorithm is intermediate in computational complexity between simple, reactionary heuristics and calculation-intensive optimal performance algorithms, yet it has very good relative performance. Our study provides insight into ancestral mechanisms of decision-making and suggests that fundamental principles of decision-making, information processing and even cognition are shared among diverse biological systems. © 2016 The Authors.

The Use of Research Evidence in Public Health Decision Making Processes: Systematic Review

PubMed Central

Orton, Lois; Lloyd-Williams, Ffion; Taylor-Robinson, David; O'Flaherty, Martin; Capewell, Simon

2011-01-01

Background The use of research evidence to underpin public health policy is strongly promoted. However, its implementation has not been straightforward. The objectives of this systematic review were to synthesise empirical evidence on the use of research evidence by public health decision makers in settings with universal health care systems. Methods To locate eligible studies, 13 bibliographic databases were screened, organisational websites were scanned, key informants were contacted and bibliographies of included studies were scrutinised. Two reviewers independently assessed studies for inclusion, extracted data and assessed methodological quality. Data were synthesised as a narrative review. Findings 18 studies were included: 15 qualitative studies, and three surveys. Their methodological quality was mixed. They were set in a range of country and decision making settings. Study participants included 1063 public health decision makers, 72 researchers, and 174 with overlapping roles. Decision making processes varied widely between settings, and were viewed differently by key players. A range of research evidence was accessed. However, there was no reliable evidence on the extent of its use. Its impact was often indirect, competing with other influences. Barriers to the use of research evidence included: decision makers' perceptions of research evidence; the gulf between researchers and decision makers; the culture of decision making; competing influences on decision making; and practical constraints. Suggested (but largely untested) ways of overcoming these barriers included: research targeted at the needs of decision makers; research clearly highlighting key messages; and capacity building. There was little evidence on the role of research evidence in decision making to reduce inequalities. Conclusions To more effectively implement research informed public health policy, action is required by decision makers and researchers to address the barriers identified in this systematic review. There is an urgent need for evidence to support the use of research evidence to inform public health decision making to reduce inequalities. PMID:21818262

Collaborating with Youth to Inform and Develop Tools for Psychotropic Decision Making

PubMed Central

Murphy, Andrea; Gardner, David; Kutcher, Stan; Davidson, Simon; Manion, Ian

2010-01-01

Introduction: Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. Methods: A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. Results: Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. Conclusion: An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders. PMID:21037916

An Analysis of Categorical and Quantitative Methods for Planning Under Uncertainty

PubMed Central

Langlotz, Curtis P.; Shortliffe, Edward H.

1988-01-01

Decision theory and logical reasoning are both methods for representing and solving medical decision problems. We analyze the usefulness of these two approaches to medical therapy planning by establishing a simple correspondence between decision theory and non-monotonic logic, a formalization of categorical logical reasoning. The analysis indicates that categorical approaches to planning can be viewed as comprising two decision-theoretic concepts: probabilities (degrees of belief in planning hypotheses) and utilities (degrees of desirability of planning outcomes). We present and discuss examples of the following lessons from this decision-theoretic view of categorical (nonmonotonic) reasoning: (1) Decision theory and artificial intelligence techniques are intended to solve different components of the planning problem. (2) When considered in the context of planning under uncertainty, nonmonotonic logics do not retain the domain-independent characteristics of classical logical reasoning for planning under certainty. (3) Because certain nonmonotonic programming paradigms (e.g., frame-based inheritance, rule-based planning, protocol-based reminders) are inherently problem-specific, they may be inappropriate to employ in the solution of certain types of planning problems. We discuss how these conclusions affect several current medical informatics research issues, including the construction of “very large” medical knowledge bases.

Flexible Demand Management under Time-Varying Prices

NASA Astrophysics Data System (ADS)

Liang, Yong

In this dissertation, the problem of flexible demand management under time-varying prices is studied. This generic problem has many applications, which usually have multiple periods in which decisions on satisfying demand need to be made, and prices in these periods are time-varying. Examples of such applications include multi-period procurement problem, operating room scheduling, and user-end demand scheduling in the Smart Grid, where the last application is used as the main motivating story throughout the dissertation. The current grid is experiencing an upgrade with lots of new designs. What is of particular interest is the idea of passing time-varying prices that reflect electricity market conditions to end users as incentives for load shifting. One key component, consequently, is the demand management system at the user-end. The objective of the system is to find the optimal trade-off between cost saving and discomfort increment resulted from load shifting. In this dissertation, we approach this problem from the following aspects: (1) construct a generic model, solve for Pareto optimal solutions, and analyze the robust solution that optimizes the worst-case payoffs, (2) extend to a distribution-free model for multiple types of demand (appliances), for which an approximate dynamic programming (ADP) approach is developed, and (3) design other efficient algorithms for practical purposes of the flexible demand management system. We first construct a novel multi-objective flexible demand management model, in which there are a finite number of periods with time-varying prices, and demand arrives in each period. In each period, the decision maker chooses to either satisfy or defer outstanding demand to minimize costs and discomfort over a certain number of periods. We consider both the deterministic model, models with stochastic demand or prices, and when only partial information about the stochastic demand or prices is known. We first analyze the stochastic optimization problem when the objective is to minimize the expected total cost and discomfort, then since the decision maker is likely to be risk-averse, and she wants to protect herself from price spikes, we study the robust optimization problem to address the risk-aversion of the decision maker. We conduct numerical studies to evaluate the price of robustness. Next, we present a detailed model that manages multiple types of flexible demand in the absence of knowledge regarding the distributions of related stochastic processes. Specifically, we consider the case in which time-varying prices with general structures are offered to users, and an energy management system for each household makes optimal energy usage, storage, and trading decisions according to the preferences of users. Because of the uncertainties associated with electricity prices, local generation, and the arrival processes of demand, we formulate a stochastic dynamic programming model, and outline a novel and tractable ADP approach to overcome the curses of dimensionality. Then, we perform numerical studies, whose results demonstrate the effectiveness of the ADP approach. At last, we propose another approximation approach based on Q-learning. In addition, we also develop another decentralization-based heuristic. Both the Q-learning approach and the heuristic make necessary assumptions on the knowledge of information, and each of them has unique advantages. We conduct numerical studies on a testing problem. The simulation results show that both the Q-learning and the decentralization based heuristic approaches work well. Lastly, we conclude the paper with some discussions on future extension directions.

The framing of decisions and the psychology of choice.

PubMed

Tversky, A; Kahneman, D

1981-01-30

The psychological principles that govern the perception of decision problems and the evaluation of probabilities and outcomes produce predictable shifts of preference when the same problem is framed in different ways. Reversals of preference are demonstrated in choices regarding monetary outcomes, both hypothetical and real, and in questions pertaining to the loss of human lives. The effects of frames on preferences are compared to the effects of perspectives on perceptual appearance. The dependence of preferences on the formulation of decision problems is a significant concern for the theory of rational choice.

Caregiving and, Decision-Making For Seniors: How You Can Help

MedlinePlus

... Issue Past Issues Feature: Senior Living Caregiving and Decision-Making For Seniors: How You Can Help Past Issues / ... key resources and suggestions for effective care and decision-making for seniors. —The Editors To Find Out More ...

Mediation: a response to aid-in-dying and the Supreme Court decision.

PubMed

Saulo, M; Wagener, R J; Rothschild, I S

1998-01-01

The recent U.S. Supreme Court decision concerning aid-in-dying has drawn attention to the complexity of end-of-life care. The authors summarize the recent Supreme Court's decision and the problems surrounding this complex issue. A case study is provided to demonstrate how mediation facilitates collaborative problem solving. Finally, the authors demonstrate how nurse leaders can apply this three-stage process and its attendant principles to facilitate ethical decision making in end-of-life care.

Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK)

PubMed Central

2012-01-01

Background School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evidence of school-based interventions tend to be highly problem- or intervention- specific, thereby missing potential generic insights into implementation and effectiveness of such programmes across problems. Methods/design A realist systematic review will be undertaken to explain how, why and in what circumstances schools can provide feasible settings for effective health promotion programmes in the United Kingdom (UK). The review will be conducted in two phases. Phase 1 will identify programme theories about implementation (ideas about what enables or inhibits effective health promotion to be delivered in a school setting). Phase 2 will test the programme theories so that they can be challenged, endorsed and/or refined. A Review Advisory Group of education and health professionals will be convened to help identify and choose potential programme theories, provide a ‘reality check’ on the clarity and explanatory strength of the mechanisms to be tested, and help shape the presentation of findings to be usable by practitioners and decision-makers. Review findings will be disseminated through liaison with decision-makers, and voluntary and professional groups in the fields of education and health. PMID:23083508

Exploring the role of practical nursing wisdom in the care of patients with urinary problems at the end of life: a qualitative interview study.

PubMed

Farrington, Naomi; Fader, Mandy; Richardson, Alison; Sartain, Samantha

2015-10-01

This study examined how nurses understand urinary problems at the end of life, and identified sources of evidence upon which they base their practice through semi-structured qualitative interviews. The aim was to decide whether research or interventions (such as formulation of best practice guidelines) could improve continence care at the end of life. There is little evidence in nursing literature to indicate how nurses should manage urinary problems at the end of life. Evidence is particularly lacking regarding the insertion of indwelling urinary catheters. This was an applied qualitative interview study which used the 'guided interview' approach. Twelve participants who worked in two hospital wards and one hospice were interviewed about management of patients with urinary problems approaching the end of life. The transcribed interviews were organised using the qualitative analysis software qsr NVivo version 10 (QSR International, Melbourne, Australia). Constant comparison was used to analyse the interviews. The patient and their family were a key concern of all interviewees. Participants focused on processes including: giving care, making decisions, managing uncertainty and assimilating knowledge. These processes are mediated by 'phronesis' or practical wisdom. Within each of the processes (giving care, making decisions, managing uncertainty and assimilating knowledge), participants approached each patient as an individual, using experience, patient wishes, available resources, clinical knowledge and advice from colleagues to provide care. A generalised set of guidelines on managing urinary problems at the end of life would probably not be useful. There is uncertainty about what constitutes best practice in specific areas of continence care at the end of life such as indwelling urinary catheter insertion. A careful approach is needed to ensure that the intellectual and moral knowledge that constitutes practical wisdom is shared and developed throughout teams. © 2015 John Wiley & Sons Ltd.

Cost-effectiveness of alternative strategies for the initial medical management of non-ST elevation acute coronary syndrome: systematic review and decision-analytical modelling.

PubMed

Robinson, M; Palmer, S; Sculpher, M; Philips, Z; Ginnelly, L; Bowens, A; Golder, S; Alfakih, K; Bakhai, A; Packham, C; Cooper, N; Abrams, K; Eastwood, A; Pearman, A; Flather, M; Gray, D; Hall, A

2005-07-01

To identify and prioritise key areas of clinical uncertainty regarding the medical management of non-ST elevation acute coronary syndrome (ACS) in current UK practice. Electronic databases. Consultations with clinical advisors. Postal survey of cardiologists. Potential areas of important uncertainty were identified and 'decision problems' prioritised. A systematic literature review was carried out using standard methods. The constructed decision model consisted of a short-term phase that applied the results of the systematic review and a long-term phase that included relevant information from a UK observational study to extrapolate estimated costs and effects. Sensitivity analyses were undertaken to examine the dependence of the results on baseline parameters, using alternative data sources. Expected value of information analysis was undertaken to estimate the expected value of perfect information associated with the decision problem. This provided an upper bound on the monetary value associated with additional research in the area. Seven current areas of clinical uncertainty (decision problems) in the drug treatment of unstable angina patients were identified. The agents concerned were clopidogrel, low molecular weight heparin, hirudin and intravenous glycoprotein antagonists (GPAs). Twelve published clinical guidelines for unstable angina or non-ST elevation ACS were identified, but few contained recommendations about the specified decision problems. The postal survey of clinicians showed that the greatest disagreement existed for the use of small molecule GPAs, and the greatest uncertainty existed for decisions relating to the use of abciximab (a large molecule GPA). Overall, decision problems concerning the GPA class of drugs were considered to be the highest priority for further study. Selected papers describing the clinical efficacy of treatment were divided into three groups, each representing an alternative strategy. The strategy involving the use of GPAs as part of the initial medical management of all non-ST elevation ACS was the optimal choice, with an incremental cost-effectiveness ratio (ICER) of 5738 pounds per quality-adjusted life-year (QALY) compared with no use of GPAs. Stochastic analysis showed that if the health service is willing to pay 10,000 pounds per additional QALY, the probability of this strategy being cost-effective was around 82%, increasing to 95% at a threshold of 50,000 pounds per QALY. A sensitivity analysis including an additional strategy of using GPAs as part of initial medical management only in patients at particular high risk (as defined by age, ST depression or diabetes) showed that this additional strategy was yet more cost-effective, with an ICER of 3996 pounds per QALY compared with no treatment with GPA. Value of information analysis suggested that there was considerable merit in additional research to reduce the level of uncertainty in the optimal decision. At a threshold of 10,000 pounds per QALY, the maximum potential value of such research in the base case was calculated as 12.7 million pounds per annum for the UK as a whole. Taking account of the greater uncertainty in the sensitivity analyses including clopidogrel, this figure was increased to approximately 50 million pounds. This study suggests the use of GPAs in all non-ST elevation ACS patients as part of their initial medical management. Sensitivity analysis showed that virtually all of the benefit could be realised by treating only high-risk patients. Further clarification of the optimum role of GPAs in the UK NHS depends on the availability of further high-quality observational and trial data. Value of information analysis derived from the model suggests that a relatively large investment in such research may be worthwhile. Further research should focus on the identification of the characteristics of patients who benefit most from GPAs as part of medical management, the comparison of GPAs with clopidogrel as an adjunct to standard care, follow-up cohort studies of the costs and outcomes of high-risk non-ST elevation ACS over several years, and exploring how clinicians' decisions combine a normative evidence-based decision model with their own personal behavioural perspective.

Deepening the quality of clinical reasoning and decision-making in rural hospital nursing practice.

PubMed

Sedgwick, M G; Grigg, L; Dersch, S

2014-01-01

Rural acute care nursing requires an extensive breadth and depth of knowledge as well as the ability to quickly reason through problems in order to make sound clinical decisions. This reasoning often occurs within an environment that has minimal medical or ancillary support. Registered nurses (RN) new to rural nursing, and employers, have raised concerns about patient safety while new nurses make the transition into rural practice. In addition, feeling unprepared for the rigors of rural hospital nursing practice is a central issue influencing RN recruitment and retention. Understanding how rural RNs reason is a key element for identifying professional development needs and may support recruitment and retention of skilled rural nurses. The purpose of this study was to explore how rural RNs reason through clinical problems as well as to assess the quality of such reasoning. This study used a non-traditional approach for data collection. Fifteen rural acute care nurses with varying years of experience working in southern Alberta, Canada, were observed while they provided care to patients of varying acuity within a simulated rural setting. Following the simulation, semi-structured interviews were conducted using a substantive approach to critical thinking. Findings revealed that the ability to engage in deep clinical reasoning varied considerably among participants despite being given the same information under the same circumstances. Furthermore, the number of years of experience did not seem to be directly linked to the ability to engage in sound clinical reasoning. Novice nurses, however, did rely heavily on others in their decision making in order to ensure they were making the right decision. Hence, their relationships with other staff members influenced their ability to engage in clinical reasoning and decision making. In situations where the patient's condition was deteriorating quickly, regardless of years of experience, all of the participants depended on their colleagues when making decisions and reasoning throughout the simulation. Deep clinical reasoning and decision making is a function of reflection and self-correction that requires a critical self-awareness and is more about how nurses think than what they think. The degree of sophistication in reasoning of experts and novices is at times equivalent in that the reasoning of experts and novices can be somewhat limited and focused primarily on human physicality and less on conceptual knowledge. To become proficient in clinical reasoning, practice is necessary. The study supports the accumulating evidence that using clinical simulation and reflective interviewing that emphasize how clinical decisions are made enhances reasoning skills and confidence.

Insight and analysis problem solving in microbes to machines.

PubMed

Clark, Kevin B

2015-11-01

A key feature for obtaining solutions to difficult problems, insight is oftentimes vaguely regarded as a special discontinuous intellectual process and/or a cognitive restructuring of problem representation or goal approach. However, this nearly century-old state of art devised by the Gestalt tradition to explain the non-analytical or non-trial-and-error, goal-seeking aptitude of primate mentality tends to neglect problem-solving capabilities of lower animal phyla, Kingdoms other than Animalia, and advancing smart computational technologies built from biological, artificial, and composite media. Attempting to provide an inclusive, precise definition of insight, two major criteria of insight, discontinuous processing and problem restructuring, are here reframed using terminology and statistical mechanical properties of computational complexity classes. Discontinuous processing becomes abrupt state transitions in algorithmic/heuristic outcomes or in types of algorithms/heuristics executed by agents using classical and/or quantum computational models. And problem restructuring becomes combinatorial reorganization of resources, problem-type substitution, and/or exchange of computational models. With insight bounded by computational complexity, humans, ciliated protozoa, and complex technological networks, for example, show insight when restructuring time requirements, combinatorial complexity, and problem type to solve polynomial and nondeterministic polynomial decision problems. Similar effects are expected from other problem types, supporting the idea that insight might be an epiphenomenon of analytical problem solving and consequently a larger information processing framework. Thus, this computational complexity definition of insight improves the power, external and internal validity, and reliability of operational parameters with which to classify, investigate, and produce the phenomenon for computational agents ranging from microbes to man-made devices. Copyright © 2015 Elsevier Ltd. All rights reserved.

A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.

PubMed

Ferrie, Suzie

2006-04-01

Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems.

Data Transmission Signal Design and Analysis

NASA Technical Reports Server (NTRS)

Moore, J. D.

1972-01-01

The error performances of several digital signaling methods are determined as a function of a specified signal-to-noise ratio. Results are obtained for Gaussian noise and impulse noise. Performance of a receiver for differentially encoded biphase signaling is obtained by extending the results of differential phase shift keying. The analysis presented obtains a closed-form answer through the use of some simplifying assumptions. The results give an insight into the analysis problem, however, the actual error performance may show a degradation because of the assumptions made in the analysis. Bipolar signaling decision-threshold selection is investigated. The optimum threshold depends on the signal-to-noise ratio and requires the use of an adaptive receiver.

Moral Hypocrisy on the Basis of Construal Level: To Be a Utilitarian Personal Decision Maker or to Be a Moral Advisor?

PubMed Central

Xiao, Wei; Wu, Qing; Yang, Qun; Zhou, Liang; Jiang, Yuan; Zhang, Jiaxi; Miao, Danmin; Peng, Jiaxi

2015-01-01

Background People encounter various moral issues that involve making decisions for others by giving advice. Objective This study investigated the characteristics of providing suggestions for oneself versus providing suggestions for others in ethical decision-making and the differences between them based on Construal Level Theory (CLT). Methods A total of 768 undergraduate students from three universities in China were randomly assigned to eight groups on the basis of a grid of two Construal Levels (self or others) by two different numbers of people saved (5 people or 15 people) by two problem situations (trolley problem vs. footbridge problem). The investigation examined participants’ decisions to opt to take action or refrain from action that would have the consequence of saving more people. Results The main effects of Construal Level (F1, 752 = 6.46, p = .011), saving number (F1, 752 = 35.81, p < .001), and problem situation type (F1, 752 = 330.55, p < .001) were all significant. The interaction of the problem situation and saving number (F1, 752 = 1.01, p = .31), and social distance and saving number (F1, 752 = 0.85, p = .36), and interaction of the three independent factors (F1, 752 = 0.47, p = .49) were not significant. However, the interaction of social distance and problem situation (F1, 752 = 9.46, p = .002) was significant. Results indicated the participants utilized a component of utilitarian reasoning in the decision-making, and their behaviors appeared more utilitarian at low Construal Levels (CLs) compared to high. Conclusion CLs, saving numbers, and problem situation significantly affected moral decision-making and exhibited significant interaction. Making decisions for oneself (low-construal) rather than giving advice to others (high-construal) was one important factor that determined whether the people were utilitarian or not. Utilitarian considerations are more relevant in impersonal dilemmas. PMID:25689521

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

PubMed

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

2017-11-01

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

Evaluating the Effects that Existing Instruction on Responsible Conduct of Research Has on Ethical Decision Making

PubMed Central

Antes, Alison L.; Wang, Xiaoqian; Mumford, Michael D.; Brown, Ryan P.; Connelly, Shane; Devenport, Lynn D.

2015-01-01

Purpose To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social–behavioral responses). Method In 2005–2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. Results A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others’ perspectives. Participants also increased in their endorsement of detrimental social–behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. Conclusions These findings indicated that RCR instruction may not be as effective as intended, and in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction. PMID:20182131

Evaluating the effects that existing instruction on responsible conduct of research has on ethical decision making.

PubMed

Antes, Alison L; Wang, Xiaoqian; Mumford, Michael D; Brown, Ryan P; Connelly, Shane; Devenport, Lynn D

2010-03-01

To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social-behavioral responses). In 2005-2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others' perspectives. Participants also increased their endorsement of detrimental social-behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. These findings indicated that RCR instruction may not be as effective as intended and, in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction.

Use of modified Delphi to plan knowledge translation for decision makers: an application in the field of advanced practice nursing.

PubMed

Carter, Nancy; Lavis, John N; MacDonald-Rencz, Sandra

2014-01-01

Disseminating research to decision makers is difficult. Interaction between researchers and decision makers can identify key messages and processes for dissemination. To gain agreement on the key findings from a synthesis on the integration of advanced practice nurses, we used a modified Delphi process. Nursing decision makers contributed ideas via e-mail, discussed and clarified ideas face to face, and then prioritized statements. Sixteen (89%) participated and 14 (77%) completed the final phase. Priority key messages were around access to care and outcomes. The majority identified "NPs increase access to care" and "NPs and CNSs improve patient and system outcomes" as priority messaging statements. Participants agreed policy makers and the public were target audiences for messages. Consulting with policy makers provided the necessary context to develop tailored policy messages and is a helpful approach for research dissemination. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Obtaining Reimbursement in France and Italy for New Diabetes Products

PubMed Central

Schaefer, Elmar; Sonsalla, Jessica

2015-01-01

Manufacturers launching next-generation or innovative medical devices in Europe face a very heterogeneous reimbursement landscape, with each country having its own pathways, timing, requirements and success factors. We selected 2 markets for a deeper look into the reimbursement landscape: France, representing a country with central decision making with defined processes, and Italy, which delegates reimbursement decisions to the regional level, resulting in a less transparent approach to reimbursement. Based on our experience in working on various new product launches and analyzing recent reimbursement decisions, we found that payers in both countries do not reward improved next-generation products with incremental reimbursement. Looking at innovations, we observe that manufacturers face a challenging and lengthy process to obtain reimbursement. In addition, requirements and key success factors differ by country: In France, comparative clinical evidence and budget impact very much drive reimbursement decisions in terms of pricing and restrictions, whereas in Italy, regional key opinion leader (KOL) support and additional local observational data are key. PMID:25550411

Obtaining reimbursement in France and Italy for new diabetes products.

PubMed

Schaefer, Elmar; Schnell, Gerald; Sonsalla, Jessica

2015-01-01

Manufacturers launching next-generation or innovative medical devices in Europe face a very heterogeneous reimbursement landscape, with each country having its own pathways, timing, requirements and success factors. We selected 2 markets for a deeper look into the reimbursement landscape: France, representing a country with central decision making with defined processes, and Italy, which delegates reimbursement decisions to the regional level, resulting in a less transparent approach to reimbursement. Based on our experience in working on various new product launches and analyzing recent reimbursement decisions, we found that payers in both countries do not reward improved next-generation products with incremental reimbursement. Looking at innovations, we observe that manufacturers face a challenging and lengthy process to obtain reimbursement. In addition, requirements and key success factors differ by country: In France, comparative clinical evidence and budget impact very much drive reimbursement decisions in terms of pricing and restrictions, whereas in Italy, regional key opinion leader (KOL) support and additional local observational data are key. © 2015 Diabetes Technology Society.

The Framing of Decisions and the Psychology of Choice.

ERIC Educational Resources Information Center

Tversky, Amos; Kahneman, Daniel

1981-01-01

Presents evidence that the psychological principles that govern the perception of decision problems and evaluation of probabilities and outcomes produce predictable shifts of preference when the same problem is framed in different ways. (Author/SK)

Making better decisions in groups

PubMed Central

Frith, Chris D.

2017-01-01

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

Disciplinary and Academic Decisions Pertaining to Students: A Review of the 1997 Judicial Decisions.

ERIC Educational Resources Information Center

Stoner, Edward N.; Schupansky, Susan P.

1998-01-01

Reviews key cases concerning disciplinary and academic decisions in higher education handed down by courts in 1997. Cases touched on procedural due process (for medical residents, academic versus disciplinary decisions, other notable issues), double jeopardy, breach of contract, student discipline records under the Family Education Rights and…

The Elementary School Principal's Influence on Teachers' Curricular and Instructional Decisions.

ERIC Educational Resources Information Center

Larsen, Marci L.; Malen, Betty

Within the research on teacher planning and decision making the principal is seldom mentioned as a key shaper of teachers' curricular and instructional decision making. This paper presents findings of a case study of two elementary school principals. The study examined the congruence between principals' aims and teachers' decisions; the statements…

Supporting Valid Decision Making: Uses and Misuses of Assessment Data within the Context of RtI

ERIC Educational Resources Information Center

Ball, Carrie R.; Christ, Theodore J.

2012-01-01

Within an RtI problem-solving context, assessment and decision making generally center around the tasks of problem identification, problem analysis, progress monitoring, and program evaluation. We use this framework to discuss the current state of the literature regarding curriculum based measurement, its technical properties, and its utility for…

Honor Code/Code of Conduct in International Institutions of Higher Education

ERIC Educational Resources Information Center

Alahmad, Ala'

2013-01-01

In today's society, students are faced with many ethical decisions about which they are uncertain. Unfortunately, many of these problems are rooted not only in their academic lives, but also in the workplace. These problems stem from a lack of knowledge concerning decision-making. This problem presents an actual global dilemma. Codifying ethics in…

Strategy Keys as Tools for Problem Solving

ERIC Educational Resources Information Center

Herold-Blasius, Raja

2017-01-01

Problem solving is one of the main competences we seek to teach students at school for use in their future lives. However, when dealing with mathematical problems, teachers encounter a wide variety of difficulties. To foster students' problem-solving skills, the authors developed "strategy keys." Strategy keys can serve as material to…

48 CFR 34.003 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... shall identify the key decision points of each major system acquisition and the agency official(s) for making those decisions. (c) Systems acquisitions normally designated as major are those programs that, as... management attention, including specific agency-head decisions. The agency procedures may establish...

Quantifying the Value of Downscaled Climate Model Information for Adaptation Decisions: When is Downscaling a Smart Decision?

NASA Astrophysics Data System (ADS)

Terando, A. J.; Wootten, A.; Eaton, M. J.; Runge, M. C.; Littell, J. S.; Bryan, A. M.; Carter, S. L.

2015-12-01

Two types of decisions face society with respect to anthropogenic climate change: (1) whether to enact a global greenhouse gas abatement policy, and (2) how to adapt to the local consequences of current and future climatic changes. The practice of downscaling global climate models (GCMs) is often used to address (2) because GCMs do not resolve key features that will mediate global climate change at the local scale. In response, the development of downscaling techniques and models has accelerated to aid decision makers seeking adaptation guidance. However, quantifiable estimates of the value of information are difficult to obtain, particularly in decision contexts characterized by deep uncertainty and low system-controllability. Here we demonstrate a method to quantify the additional value that decision makers could expect if research investments are directed towards developing new downscaled climate projections. As a proof of concept we focus on a real-world management problem: whether to undertake assisted migration for an endangered tropical avian species. We also take advantage of recently published multivariate methods that account for three vexing issues in climate impacts modeling: maximizing climate model quality information, accounting for model dependence in ensembles of opportunity, and deriving probabilistic projections. We expand on these global methods by including regional (Caribbean Basin) and local (Puerto Rico) domains. In the local domain, we test whether a high resolution (2km) dynamically downscaled GCM reduces the multivariate error estimate compared to the original coarse-scale GCM. Initial tests show little difference between the downscaled and original GCM multivariate error. When propagated through to a species population model, the Value of Information analysis indicates that the expected utility that would accrue to the manager (and species) if this downscaling were completed may not justify the cost compared to alternative actions.

The International Decision Support Initiative Reference Case for Economic Evaluation: An Aid to Thought.

PubMed

Wilkinson, Thomas; Sculpher, Mark J; Claxton, Karl; Revill, Paul; Briggs, Andrew; Cairns, John A; Teerawattananon, Yot; Asfaw, Elias; Lopert, Ruth; Culyer, Anthony J; Walker, Damian G

2016-12-01

Policymakers in high-, low-, and middle-income countries alike face challenging choices about resource allocation in health. Economic evaluation can be useful in providing decision makers with the best evidence of the anticipated benefits of new investments, as well as their expected opportunity costs-the benefits forgone of the options not chosen. To guide the decisions of health systems effectively, it is important that the methods of economic evaluation are founded on clear principles, are applied systematically, and are appropriate to the decision problems they seek to inform. The Bill and Melinda Gates Foundation, a major funder of economic evaluations of health technologies in low- and middle-income countries (LMICs), commissioned a "reference case" through the International Decision Support Initiative (iDSI) to guide future evaluations, and improve both the consistency and usefulness to decision makers. The iDSI Reference Case draws on previous insights from the World Health Organization, the US Panel on Cost-Effectiveness in Health Care, and the UK National Institute for Health and Care Excellence. Comprising 11 key principles, each accompanied by methodological specifications and reporting standards, the iDSI Reference Case also serves as a means of identifying priorities for methods research, and can be used as a framework for capacity building and technical assistance in LMICs. The iDSI Reference Case is an aid to thought, not a substitute for it, and should not be followed slavishly without regard to context, culture, or history. This article presents the iDSI Reference Case and discusses the rationale, approach, components, and application in LMICs. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Artificial immune algorithm for multi-depot vehicle scheduling problems

NASA Astrophysics Data System (ADS)

Wu, Zhongyi; Wang, Donggen; Xia, Linyuan; Chen, Xiaoling

2008-10-01

In the fast-developing logistics and supply chain management fields, one of the key problems in the decision support system is that how to arrange, for a lot of customers and suppliers, the supplier-to-customer assignment and produce a detailed supply schedule under a set of constraints. Solutions to the multi-depot vehicle scheduling problems (MDVRP) help in solving this problem in case of transportation applications. The objective of the MDVSP is to minimize the total distance covered by all vehicles, which can be considered as delivery costs or time consumption. The MDVSP is one of nondeterministic polynomial-time hard (NP-hard) problem which cannot be solved to optimality within polynomial bounded computational time. Many different approaches have been developed to tackle MDVSP, such as exact algorithm (EA), one-stage approach (OSA), two-phase heuristic method (TPHM), tabu search algorithm (TSA), genetic algorithm (GA) and hierarchical multiplex structure (HIMS). Most of the methods mentioned above are time consuming and have high risk to result in local optimum. In this paper, a new search algorithm is proposed to solve MDVSP based on Artificial Immune Systems (AIS), which are inspirited by vertebrate immune systems. The proposed AIS algorithm is tested with 30 customers and 6 vehicles located in 3 depots. Experimental results show that the artificial immune system algorithm is an effective and efficient method for solving MDVSP problems.

The Case for Absolute Ligand Discrimination: Modeling Information Processing and Decision by Immune T Cells

NASA Astrophysics Data System (ADS)

François, Paul; Altan-Bonnet, Grégoire

2016-03-01

Some cells have to take decision based on the quality of surroundings ligands, almost irrespective of their quantity, a problem we name "absolute discrimination". An example of absolute discrimination is recognition of not-self by immune T Cells. We show how the problem of absolute discrimination can be solved by a process called "adaptive sorting". We review several implementations of adaptive sorting, as well as its generic properties such as antagonism. We show how kinetic proofreading with negative feedback implement an approximate version of adaptive sorting in the immune context. Finally, we revisit the decision problem at the cell population level, showing how phenotypic variability and feedbacks between population and single cells are crucial for proper decision.

Evaluating the Quality of Patient Decision-Making Regarding Post-Acute Care.

PubMed

Burke, Robert E; Jones, Jacqueline; Lawrence, Emily; Ladebue, Amy; Ayele, Roman; Leonard, Chelsea; Lippmann, Brandi; Matlock, Daniel D; Allyn, Rebecca; Cumbler, Ethan

2018-05-01

Despite a national focus on post-acute care brought about by recent payment reforms, relatively little is known about how hospitalized older adults and their caregivers decide whether to go to a skilled nursing facility (SNF) after hospitalization. We sought to understand to what extent hospitalized older adults and their caregivers are empowered to make a high-quality decision about utilizing an SNF for post-acute care and what contextual or process elements led to satisfaction with the outcome of their decision once in SNF. Qualitative inquiry using the Ottawa Decision Support Framework (ODSF), a conceptual framework that describes key components of high-quality decision-making. Thirty-two previously community-dwelling older adults (≥ 65 years old) and 22 caregivers interviewed at three different hospitals and three skilled nursing facilities. We used key components of the ODSF to identify elements of context and process that affected decision-making and to what extent the outcome was characteristic of a high-quality decision: informed, values based, and not associated with regret or blame. The most important contextual themes were the presence of active medical conditions in the hospital that made decision-making difficult, prior experiences with hospital readmission or SNF, relative level of caregiver support, and pressure to make a decision quickly for which participants felt unprepared. Patients described playing a passive role in the decision-making process and largely relying on recommendations from the medical team. Patients commonly expressed resignation and a perceived lack of choice or autonomy, leading to dissatisfaction with the outcome. Understanding and intervening to improve the quality of decision-making regarding post-acute care supports is essential for improving outcomes of hospitalized older adults. Our results suggest that simply providing information is not sufficient; rather, incorporating key contextual factors and improving the decision-making process for both patients and clinicians are also essential.

Technologic Distractions (Part 1): Summary of Approaches to Manage Alert Quantity With Intent to Reduce Alert Fatigue and Suggestions for Alert Fatigue Metrics.

PubMed

Kane-Gill, Sandra L; O'Connor, Michael F; Rothschild, Jeffrey M; Selby, Nicholas M; McLean, Barbara; Bonafide, Christopher P; Cvach, Maria M; Hu, Xiao; Konkani, Avinash; Pelter, Michele M; Winters, Bradford D

2017-09-01

To provide ICU clinicians with evidence-based guidance on tested interventions that reduce or prevent alert fatigue within clinical decision support systems. Systematic review of PubMed, Embase, SCOPUS, and CINAHL for relevant literature from 1966 to February 2017. Focus on critically ill patients and included evaluations in other patient care settings, as well. Identified interventions designed to reduce or prevent alert fatigue within clinical decision support systems. Study selection was based on one primary key question to identify effective interventions that attempted to reduce alert fatigue and three secondary key questions that covered the negative effects of alert fatigue, potential unintended consequences of efforts to reduce alert fatigue, and ideal alert quantity. Data were abstracted by two reviewers independently using a standardized abstraction tool. Surveys, meeting abstracts, "gray" literature, studies not available in English, and studies with non-original data were excluded. For the primary key question, articles were excluded if they did not provide a comparator as key question 1 was designed as a problem, intervention, comparison, and outcome question. We anticipated that reduction in alert fatigue, including the concept of desensitization may not be directly measured and thus considered interventions that reduced alert quantity as a surrogate marker for alert fatigue. Twenty-six articles met the inclusion criteria. Approaches for managing alert fatigue in the ICU are provided as a result of reviewing tested interventions that reduced alert quantity with the anticipated effect of reducing fatigue. Suggested alert management strategies include prioritizing alerts, developing sophisticated alerts, customizing commercially available alerts, and including end user opinion in alert selection. Alert fatigue itself is studied less frequently, as an outcome, and there is a need for more precise evaluation. Standardized metrics for alert fatigue is needed to advance the field. Suggestions for standardized metrics are provided in this document.

Incentive Control Strategies for Decision Problems with Parametric Uncertainties

NASA Astrophysics Data System (ADS)

Cansever, Derya H.

The central theme of this thesis is the design of incentive control policies in large scale systems with hierarchical decision structures, under the stipulation that the objective functionals of the agents at the lower level of the hierarchy are uncertain to the top-level controller (the leader). These uncertainties are modeled as a finite -dimensional parameter vector whose exact value constitutes private information to the relevant agent at the lower level. The approach we have adopted is to design incentive policies for the leader such that the dependence of the decision of the agents on the uncertain parameter is minimized. We have identified several classes of problems for which this approach is feasible. In particular, we have constructed policies whose performance is arbitrarily close to the solution of a version of the same problem that does not involve uncertainties. We have also shown that for a certain class of problem wherein the leader observes a linear combination of the agents' decisions, the leader can achieve the performance he would obtain if he had observed each decision separately.

Cooperative Solutions in Multi-Person Quadratic Decision Problems: Finite-Horizon and State-Feedback Cost-Cumulant Control Paradigm

DTIC Science & Technology

2007-01-01

CONTRACT NUMBER Problems: Finite -Horizon and State-Feedback Cost-Cumulant Control Paradigm (PREPRINT) 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER...cooperative cost-cumulant control regime for the class of multi-person single-objective decision problems characterized by quadratic random costs and... finite -horizon integral quadratic cost associated with a linear stochastic system . Since this problem formation is parameterized by the number of cost

Predicting problem behaviors with multiple expectancies: expanding expectancy-value theory.

PubMed

Borders, Ashley; Earleywine, Mitchell; Huey, Stanley J

2004-01-01

Expectancy-value theory emphasizes the importance of outcome expectancies for behavioral decisions, but most tests of the theory focus on a single behavior and a single expectancy. However, the matching law suggests that individuals consider expected outcomes for both the target behavior and alternative behaviors when making decisions. In this study, we expanded expectancy-value theory to evaluate the contributions of two competing expectancies to adolescent behavior problems. One hundred twenty-one high school students completed measures of behavior problems, expectancies for both acting out and academic effort, and perceived academic competence. Students' self-reported behavior problems covaried mostly with perceived competence and academic expectancies and only nominally with problem behavior expectancies. We suggest that behavior problems may result from students perceiving a lack of valued or feasible alternative behaviors, such as studying. We discuss implications for interventions and suggest that future research continue to investigate the contribution of alternative expectancies to behavioral decisions.

Community Work and Local Authority Decision Making: Potential and Problems

ERIC Educational Resources Information Center

Corina, Lewis

1976-01-01

British local authority and decision making procedures are described for community developers. Included are potential ways of influencing the authority system, and problems and areas of weakness that may be encountered in dealing with the system. (ABM)

Ares-I-X Stability and Control Flight Test: Analysis and Plans

NASA Technical Reports Server (NTRS)

Brandon, Jay M.; Derry, Stephen D.; Heim, Eugene H.; Hueschen, Richard M.; Bacon, Barton J.

2008-01-01

The flight test of the Ares I-X vehicle provides a unique opportunity to reduce risk of the design of the Ares I vehicle and test out design, math modeling, and analysis methods. One of the key features of the Ares I design is the significant static aerodynamic instability coupled with the relatively flexible vehicle - potentially resulting in a challenging controls problem to provide adequate flight path performance while also providing adequate structural mode damping and preventing adverse control coupling to the flexible structural modes. Another challenge is to obtain enough data from the single flight to be able to conduct analysis showing the effectiveness of the controls solutions and have data to inform design decisions for Ares I. This paper will outline the modeling approaches and control system design to conduct this flight test, and also the system identification techniques developed to extract key information such as control system performance (gain/phase margins, for example), structural dynamics responses, and aerodynamic model estimations.

Key opinion leaders and the corruption of medical knowledge: what the Sunshine Act will and won't cast light on.

PubMed

Sismondo, Sergio

2013-01-01

The pharmaceutical industry, in its marketing efforts, often turns to "key opinion leaders" or "KOLs" to disseminate scientific information. Drawing on the author's fieldwork, this article documents and examines the use of KOLs in pharmaceutical companies' marketing efforts. Partly due to the use of KOLs, a small number of companies with well-defined and narrow interests have inordinate influence over how medical knowledge is produced, circulated, and consumed. The issue here, as in many other cases of institutional corruption, is that a few actors have accumulated the power to shape the information on which many others base their decisions. Efforts to address this corruption should focus on correcting large imbalances in the current political economy of medical knowledge. A sequestration of pharmaceutical research and development on one hand from pharmaceutical marketing on the other, though difficult to achieve, would address this and many other problems. © 2013 American Society of Law, Medicine & Ethics, Inc.

InformedTogether: Usability Evaluation of a Web-Based Decision Aid to Facilitate Shared Advance Care Planning for Severe Chronic Obstructive Pulmonary Disease

PubMed Central

Uhler, Lauren M; Pérez Figueroa, Rafael E; Dickson, Mark; McCullagh, Lauren; Kushniruk, Andre; Monkman, Helen; Witteman, Holly O

2015-01-01

Background Advance care planning may help patients receive treatments that better align with their goals for care. We developed a Web-based decision aid called InformedTogether to facilitate shared advance care planning between chronic obstructive pulmonary disease (COPD) patients and their doctors. Objective Our objective was to assess the usability of the InformedTogether decision aid, including whether users could interact with the decision aid to engage in tasks required for shared decision making, whether users found the decision aid acceptable, and implications for redesign. Methods We conducted an observational study with 15 patients and 8 doctors at two ethnically and socioeconomically diverse outpatient clinics. Data included quantitative and qualitative observations of patients and doctors using the decision aid on tablet or laptop computers and data from semistructured interviews. Patients were shown the decision aid by a researcher acting as the doctor. Pulmonary doctors were observed using the decision aid independently and asked to think aloud (ie, verbalize their thoughts). A thematic analysis was implemented to explore key issues related to decision aid usability. Results Although patients and doctors found InformedTogether acceptable and would recommend that doctors use the decision aid with COPD patients, many patients had difficulty understanding the icon arrays that were used to communicate estimated prognoses and could not articulate the definitions of the two treatment choices—Full Code and Do Not Resuscitate (DNR). Minor usability problems regarding content, links, layout, and consistency were also identified and corresponding recommendations were outlined. In particular, participants suggested including more information about potential changes in quality of life resulting from the alternative advance directives. Some doctor participants thought the decision aid was too long and some thought it may cause nervousness among patients due to the topic area. Conclusions A decision aid for shared advance care planning for severe COPD was found acceptable to most COPD patients and their doctors. However, many patient participants did not demonstrate understanding of the treatment options or prognostic estimates. Many participants endorsed the use of the decision aid between doctors and their patients with COPD, although they desired more information about quality of life. The design must optimize comprehensibility, including revising the presentation of statistical information in the icon array, and feasibility of integration into clinical workflow, including shortening the decision aid. PMID:27025896

Shared Problem Models and Crew Decision Making

NASA Technical Reports Server (NTRS)

Orasanu, Judith; Statler, Irving C. (Technical Monitor)

1994-01-01

The importance of crew decision making to aviation safety has been well established through NTSB accident analyses: Crew judgment and decision making have been cited as causes or contributing factors in over half of all accidents in commercial air transport, general aviation, and military aviation. Yet the bulk of research on decision making has not proven helpful in improving the quality of decisions in the cockpit. One reason is that traditional analytic decision models are inappropriate to the dynamic complex nature of cockpit decision making and do not accurately describe what expert human decision makers do when they make decisions. A new model of dynamic naturalistic decision making is offered that may prove more useful for training or aiding cockpit decision making. Based on analyses of crew performance in full-mission simulation and National Transportation Safety Board accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation and reflect the crew's metacognitive skill. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking in response to a problem. This presentation will examine the relation between communication that serves to build performance. Implications of these findings for crew training will be discussed.

Fair Resource Allocation to Health Research: Priority Topics for Bioethics Scholarship.

PubMed

Pratt, Bridget; Hyder, Adnan A

2017-07-01

This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics - namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders' decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. © 2017 John Wiley & Sons Ltd.

Community ambulation: influences on therapists and clients reasoning and decision making.

PubMed

Corrigan, Rosemary; McBurney, Helen

2008-01-01

Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community after stroke remain unclear.

Acceptability and Perceived Benefits and Risks of Public and Patient Involvement in Health Care Policy: A Delphi Survey in Belgian Stakeholders.

PubMed

Cleemput, Irina; Christiaens, Wendy; Kohn, Laurence; Léonard, Christian; Daue, François; Denis, Alain

2015-06-01

In systems with public health insurance, coverage decisions should reflect social values. Deliberation among stakeholders could achieve this goal, but rarely involves patients and citizens directly. This study aimed at evaluating the acceptability, and the perceived benefits and risks, of public and patient involvement (PPI) in coverage decision making to Belgian stakeholders. A two-round Delphi survey was conducted among all stakeholder groups. The survey was constructed on the basis of interviews with 10 key stakeholders and a review of the literature on participation models. Consensus was defined as 65% or more of the respondents agreeing with a statement and less than 15% disagreeing. Eighty stakeholders participated in both rounds. They were defined as the Delphi panel. Belgian stakeholders are open toward PPI in coverage decision processes. Benefits are expected to exceed risks. The preferred model for involvement is to consult citizens or patients, within the existing decision-making structures and at specific milestones in the process. Consulting citizens and patients is a higher level of involvement than merely informing them and a lower level than letting them participate actively. Consultation involves asking nonbinding advice on (parts of) the decision problem. According to the Delphi panel, the benefits of PPI could be increasing awareness among members of the general public and patients about the challenges and costs of health care, and enriched decision processes with expertise by experience from patients. Potential risks include subjectivity, insufficient resources to participate and weigh on the process, difficulties in finding effective ways to express a collective opinion, the risk of manipulation, and lobbying or power games of other stakeholders. PPI in coverage decision-making processes is acceptable to Belgian stakeholders, be it in different ways for different types of decisions. Benefits are expected to outweigh risks. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Toward actionable science: Empowering ecologists to engage in the process of translation through decision-maker and stakeholder partnerships

NASA Astrophysics Data System (ADS)

Enquist, C.; Jackson, S. T.; Garfin, G. M.

2017-12-01

Translational ecology is an approach by which ecologists, stakeholders, and decision-makers work collaboratively to develop and deliver ecological research that, ideally, results in actionable science that leads to improved environmental decision-making. We analyzed a diverse array of real-world case studies and distilled six principles that characterize the practice of translational ecology: communication, commitment, collaboration, engagement, process, and decision-framing. In this talk, we highlight a subset of the case studies that illustrate these principles. Notably, we found that translational ecology is distinct from both basic and applied ecological research. As a practice, the approach deliberately extends research beyond theory or opportunistic applications, motivated by a search for outcomes that directly serve the needs of natural resource managers and decision-makers. Translational ecology is also distinct from knowledge co-production in that it does not require deep engagement between collaborators, although incorporating differing modes of co-production relative to the decision context, associated time frame, and available financial resources can greatly enhance the translational approach. Although there is a need for incentives to pursue in this type of work, we found that the creativity and context-specific knowledge of resource managers, practitioners, and decision-makers informs and enriches the scientific process, helping shape actionable science. Moreover, the process of addressing research questions arising from on-the-ground management issues, rather than from the top-down or expert-oriented perspectives of traditional science, can foster the long-term trust and commitment that is critical for long-term, sustained engagement between partners. Now, perhaps more than ever, the climate and environmental issues facing society are complex, often politicized, and value-laden. We argue that ecological science should play a key role in informing these problems and ecologists can engage as important partners committed to finding solutions. More broadly, scientists that embrace translational approaches are poised to make science-informed decision-making a reality in the face of a rapidly changing global environment.

Mental model mapping as a new tool to analyse the use of information in decision-making in integrated water management

NASA Astrophysics Data System (ADS)

Kolkman, M. J.; Kok, M.; van der Veen, A.

The solution of complex, unstructured problems is faced with policy controversy and dispute, unused and misused knowledge, project delay and failure, and decline of public trust in governmental decisions. Mental model mapping (also called concept mapping) is a technique to analyse these difficulties on a fundamental cognitive level, which can reveal experiences, perceptions, assumptions, knowledge and subjective beliefs of stakeholders, experts and other actors, and can stimulate communication and learning. This article presents the theoretical framework from which the use of mental model mapping techniques to analyse this type of problems emerges as a promising technique. The framework consists of the problem solving or policy design cycle, the knowledge production or modelling cycle, and the (computer) model as interface between the cycles. Literature attributes difficulties in the decision-making process to communication gaps between decision makers, stakeholders and scientists, and to the construction of knowledge within different paradigm groups that leads to different interpretation of the problem situation. Analysis of the decision-making process literature indicates that choices, which are made in all steps of the problem solving cycle, are based on an individual decision maker’s frame of perception. This frame, in turn, depends on the mental model residing in the mind of the individual. Thus we identify three levels of awareness on which the decision process can be analysed. This research focuses on the third level. Mental models can be elicited using mapping techniques. In this way, analysing an individual’s mental model can shed light on decision-making problems. The steps of the knowledge production cycle are, in the same manner, ultimately driven by the mental models of the scientist in a specific discipline. Remnants of this mental model can be found in the resulting computer model. The characteristics of unstructured problems (complexity, uncertainty and disagreement) can be positioned in the framework, as can the communities of knowledge construction and valuation involved in the solution of these problems (core science, applied science, and professional consultancy, and “post-normal” science). Mental model maps, this research hypothesises, are suitable to analyse the above aspects of the problem. This hypothesis is tested for the case of the Zwolle storm surch barrier. Analysis can aid integration between disciplines, participation of public stakeholders, and can stimulate learning processes. Mental model mapping is recommended to visualise the use of knowledge, to analyse difficulties in problem solving process, and to aid information transfer and communication. Mental model mapping help scientists to shape their new, post-normal responsibilities in a manner that complies with integrity when dealing with unstructured problems in complex, multifunctional systems.

Review of various approaches for assessing public health risks in regulatory decision making: choosing the right approach for the problem.

PubMed

Dearfield, Kerry L; Hoelzer, Karin; Kause, Janell R

2014-08-01

Stakeholders in the public health risk analysis community can possess differing opinions about what is meant by "conduct a risk assessment." In reality, there is no one-size-fits-all risk assessment that can address all public health issues, problems, and regulatory needs. Although several international and national organizations (e.g., Codex Alimentarius Commission, Office International des Epizooties, Food and Agricultural Organization, World Health Organization, National Research Council, and European Food Safety Authority) have addressed this issue, confusion remains. The type and complexity of a risk assessment must reflect the risk management needs to appropriately inform a regulatory or nonregulatory decision, i.e., a risk assessment is ideally "fit for purpose" and directly applicable to risk management issues of concern. Frequently however, there is a lack of understanding by those not completely familiar with risk assessment regarding the specific utility of different approaches for assessing public health risks. This unfamiliarity can unduly hamper the acceptance of risk assessment results by risk managers and may reduce the usefulness of such results for guiding public health policies, practices, and operations. Differences in interpretation of risk assessment terminology further complicate effective communication among risk assessors, risk managers, and stakeholders. This article provides an overview of the types of risk assessments commonly conducted, with examples primarily from the food and agricultural sectors, and a discussion of the utility and limitations of these specific approaches for assessing public health risks. Clarification of the risk management issues and corresponding risk assessment design needs during the formative stages of the risk analysis process is a key step for ensuring that the most appropriate assessment of risk is developed and used to guide risk management decisions.

Decision-making styles of business and industry: Five insights to improving your sales success

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

Bramson, R.M.

1996-04-01

Corporations, like people, have styles-even personalities-that in varied but vital ways affect every decision made at every level in the organization. This report describes five key organizational styles, methods for assessing which style a utility sales representative might encounter, and practical strategies that increase the odds of proposal acceptance. Each style is defined by its (1) goals and priorities, (2) administrative/communicative network, (3) key players, (4) events or circumstances prompting decisions, and (5) typical decision barriers, biases, and selling points. Written in highly readable style, this report provides tools that will help utility representatives proactively overcome organizational sales barriers, shortenmore » selling cycles, reduce sales expense, increase revenue and enhance customer loyalty.« less

Participatory Decision Making.

ERIC Educational Resources Information Center

King, M. Bruce; And Others

Shifting from traditional, hierarchical bureaucracies to participatory governance and decision making is a major theme in school restructuring. This paper focuses on the involvement of teachers in key aspects of school decision making. Specifically, the paper describes how changes in power relations supported teachers' focus on improving the…

Noise, cost and speed-accuracy trade-offs: decision-making in a decentralized system

PubMed Central

Marshall, James A.R.; Dornhaus, Anna; Franks, Nigel R.; Kovacs, Tim

2005-01-01

Many natural and artificial decision-making systems face decision problems where there is an inherent compromise between two or more objectives. One such common compromise is between the speed and accuracy of a decision. The ability to exploit the characteristics of a decision problem in order to vary between the extremes of making maximally rapid, or maximally accurate decisions, is a useful property of such systems. Colonies of the ant Temnothorax albipennis (formerly Leptothorax albipennis) are a paradigmatic decentralized decision-making system, and have been shown flexibly to compromise accuracy for speed when making decisions during house-hunting. During emigration, a colony must typically evaluate and choose between several possible alternative new nest sites of differing quality. In this paper, we examine this speed-accuracy trade-off through modelling, and conclude that noise and time-cost of assessing alternative choices are likely to be significant for T. albipennis. Noise and cost of such assessments are likely to mean that T. albipennis' decision-making mechanism is Pareto-optimal in one crucial regard; increasing the willingness of individuals to change their decisions cannot improve collective accuracy overall without impairing speed. We propose that a decentralized control algorithm based on this emigration behaviour may be derived for applications in engineering domains and specify the characteristics of the problems to which it should be suited, based on our new results. PMID:16849234

GIS, modeling, and politics: on the tensions of collaborative decision support.

PubMed

Ramsey, Kevin

2009-05-01

A tension exists at the heart of efforts to support collaboration with GIS. Many scholars and practitioners seek to support two separate objectives: (1) problem solving and (2) the exploration of diverse problem understandings. GIS applications designed for problem solving often pre-define the problem space by structuring the kind of information that can be considered or the way in which the problem is conceptualized. In doing so, they necessarily privilege particular perspectives and understandings of the problem while marginalizing others. As a result, these initiatives undermine their second objective. This is problematic in the context of contentious environmental decisions which have broad-reaching impacts on people with diverse perspectives and interests. In such contexts, I argue that equitable collaboration is impossible without first emphasizing the exploration of diverse problem understandings. I support this argument theoretically by turning to the literatures on collaborative planning and spatial decision support, and empirically in my analysis of a case study of an effort to construct a GIS for supporting collaborative water resource management in rural Idaho. Reflecting upon the case, I provide a set of recommendations to those seeking to better negotiate the tensions of supporting collaboration with GIS in the context of contentious environmental and natural resource decisions.

Vulnerability assessment of urban ecosystems driven by water resources, human health and atmospheric environment

NASA Astrophysics Data System (ADS)

Shen, Jing; Lu, Hongwei; Zhang, Yang; Song, Xinshuang; He, Li

2016-05-01

As ecosystem management is a hotspot and urgent topic with increasing population growth and resource depletion. This paper develops an urban ecosystem vulnerability assessment method representing a new vulnerability paradigm for decision makers and environmental managers, as it's an early warning system to identify and prioritize the undesirable environmental changes in terms of natural, human, economic and social elements. The whole idea is to decompose a complex problem into sub-problem, and analyze each sub-problem, and then aggregate all sub-problems to solve this problem. This method integrates spatial context of Geographic Information System (GIS) tool, multi-criteria decision analysis (MCDA) method, ordered weighted averaging (OWA) operators, and socio-economic elements. Decision makers can find out relevant urban ecosystem vulnerability assessment results with different vulnerable attitude. To test the potential of the vulnerability methodology, it has been applied to a case study area in Beijing, China, where it proved to be reliable and consistent with the Beijing City Master Plan. The results of urban ecosystem vulnerability assessment can support decision makers in evaluating the necessary of taking specific measures to preserve the quality of human health and environmental stressors for a city or multiple cities, with identifying the implications and consequences of their decisions.

A new simultaneous compression and encryption method for images suitable to recognize form by optical correlation

NASA Astrophysics Data System (ADS)

Alfalou, Ayman; Elbouz, Marwa; Jridi, Maher; Loussert, Alain

2009-09-01

In some recognition form applications (which require multiple images: facial identification or sign-language), many images should be transmitted or stored. This requires the use of communication systems with a good security level (encryption) and an acceptable transmission rate (compression rate). In the literature, several encryption and compression techniques can be found. In order to use optical correlation, encryption and compression techniques cannot be deployed independently and in a cascade manner. Otherwise, our system will suffer from two major problems. In fact, we cannot simply use these techniques in a cascade manner without considering the impact of one technique over another. Secondly, a standard compression can affect the correlation decision, because the correlation is sensitive to the loss of information. To solve both problems, we developed a new technique to simultaneously compress & encrypt multiple images using a BPOF optimized filter. The main idea of our approach consists in multiplexing the spectrums of different transformed images by a Discrete Cosine Transform (DCT). To this end, the spectral plane should be divided into several areas and each of them corresponds to the spectrum of one image. On the other hand, Encryption is achieved using the multiplexing, a specific rotation functions, biometric encryption keys and random phase keys. A random phase key is widely used in optical encryption approaches. Finally, many simulations have been conducted. Obtained results corroborate the good performance of our approach. We should also mention that the recording of the multiplexed and encrypted spectra is optimized using an adapted quantification technique to improve the overall compression rate.

Decision Support Framework (DSF) For Evaluating Planned Land And Resource Use Decisions: Hypothetical Application Of The DSF To Address Nutrient Loads In The Florida Keys

EPA Science Inventory

The mission of ORD's Ecosystme Services Research Program (ESRP) is to provide the information and methods needed by decision-makers to assess the benefits of ecosystem goods and services to human well-being for inclusion in management alternatives. The Decision Support Framework...

A study exploring factors which influence the decision to commence nurse-led weaning.

PubMed

Gelsthorpe, Tony; Crocker, Cheryl

2004-01-01

Nurse-led weaning can improve patient outcome. Exploration of the factors that influence the commencement of weaning. Themes of decision-making, pathophysiological and multidisciplinary team factors emerged. Experience was a key factor in the decision to wean. The use of protocol-led weaning may not be useful in the decision to wean.

How Decision Support Systems Can Benefit from a Theory of Change Approach.

PubMed

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

How Decision Support Systems Can Benefit from a Theory of Change Approach

NASA Astrophysics Data System (ADS)

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

Bayesian design of decision rules for failure detection

NASA Technical Reports Server (NTRS)

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

1984-01-01

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

Chinese immigrant parents' vaccination decision making for children: a qualitative analysis.

PubMed

Wang, Linda D L; Lam, Wendy W T; Wu, Joseph T; Liao, Qiuyan; Fielding, Richard

2014-02-07

While immunization coverage rates for childhood routine vaccines in Hong Kong are almost 100%, the uptake rates of optional vaccines remain suboptimal. Understanding parental decision-making for children's vaccination is important, particularly among minority groups who are most vulnerable and underserved. This study explored how a subsample of new immigrant mothers from mainland China, a rapidly-growing subpopulation in Hong Kong, made decisions on various childhood and adolescent vaccines for their offspring, and identified key influences affecting their decision making. Semi-structured in-depth interviews were conducted with 23 Chinese new immigrant mothers recruited by purposive sampling. All interviews were audio-taped, transcribed and analyzed using a Grounded Theory approach. Participants' conversation revealed five underlying themes which influenced parents' vaccination decision-making: (1) Institutional factors, (2) Insufficient vaccination knowledge and advice, (3) Affective impacts on motivation, (4) Vaccination barriers, and (5) Social influences. The role of social norms appeared overwhelmingly salient influencing parents' vaccination decision making. Institutional factors shaped parent's perceptions of vaccination necessity. Fear of vaccine-targeted diseases was a key motivating factor for parents adopting vaccination. Insufficient knowledge about vaccines and targeted diseases, lack of advice from health professionals and, if provided, suspicions regarding the motivations for such advice were common issues. Vaccination cost was a major barrier for many new immigrant parents. Social norms play a key role influencing parental vaccination decision-making. Insight gained from this study will help inform healthcare providers in vaccination communication and policymakers in future vaccination programme.

Research on investment decisions model of trans-regional transmission network based on the theory of NPV

NASA Astrophysics Data System (ADS)

Zai, Wenjiao; Wang, Bo; Liu, Jichun; Shi, Haobo; Zeng, Pingliang

2018-02-01

The investment decision model of trans-regional transmission network in the context of Global Energy Internet was studied in this paper. The key factors affecting the trans-regional transmission network investment income: the income tax rate, the loan interest rate, the expected return on investment of the investment subject, the per capita GDP and so on were considered in the transmission network investment income model. First, according to the principle of system dynamics, the causality diagram of key factors was constructed. Then, the dynamic model of transmission investment decision was established. A case study of the power transmission network between China and Mongolia, through the simulation of the system dynamic model, the influence of the above key factors on the investment returns was analyzed, and the feasibility and effectiveness of the model was proved.

An interactive approach based on a discrete differential evolution algorithm for a class of integer bilevel programming problems

NASA Astrophysics Data System (ADS)

Li, Hong; Zhang, Li; Jiao, Yong-Chang

2016-07-01

This paper presents an interactive approach based on a discrete differential evolution algorithm to solve a class of integer bilevel programming problems, in which integer decision variables are controlled by an upper-level decision maker and real-value or continuous decision variables are controlled by a lower-level decision maker. Using the Karush--Kuhn-Tucker optimality conditions in the lower-level programming, the original discrete bilevel formulation can be converted into a discrete single-level nonlinear programming problem with the complementarity constraints, and then the smoothing technique is applied to deal with the complementarity constraints. Finally, a discrete single-level nonlinear programming problem is obtained, and solved by an interactive approach. In each iteration, for each given upper-level discrete variable, a system of nonlinear equations including the lower-level variables and Lagrange multipliers is solved first, and then a discrete nonlinear programming problem only with inequality constraints is handled by using a discrete differential evolution algorithm. Simulation results show the effectiveness of the proposed approach.

Health concerns associated with unconventional gas mining in rural Australia.

PubMed

Haswell, Melissa R; Bethmont, Anna

2016-01-01

Many governments globally are investigating the benefits and risks associated with unconventional gas mining for shale, tight and coal seam gas (coalbed methane) to determine whether the industry should proceed in their jurisdiction. Most locations likely to be developed are in rural areas, with potential impact on farmers and small communities. Despite significant health concerns, public health knowledge and growing evidence are often overlooked in decision-making. It is difficult to gain a broad but accurate understanding of the health concerns for rural communities because the evidence has grown very recently and rapidly, is complex and largely based in the USA, where the industry is advanced. In 2016, a concerned South Australian beef and lamb farmer in an area targeted for potential unconventional gas development organised visits to homes in developed unconventional gas areas of Pennsylvania and forums with leading researchers and lawyers in Pennsylvania and New York. Guided by priorities identified during this trip, this communication concisely distils the research evidence on these key concerns, highlighting the Australian situation where evidence exists. It summarises key information of particular concern to rural regions, using Australia as an example, to assist rural health professionals to be better prepared to engage in decision-making and address the challenges associated with this new industry. Discussions with communities and experts, supported by the expanding research from the USA and Australia, revealed increasing health concerns in six key areas. These are absence of a safe solution to the toxic wastewater management problems, air pollution, land and water competition, mental health and psychosocial wellbeing risks, fugitive methane emissions and lack of proven regulatory regimes. Emerging epidemiological studies suggesting interference with foetal development and birth outcomes, and exacerbation of asthma conditions, are particularly concerning to rural families and livestock. Rural residents in potentially affected areas should be supported to access and interpret the best current evidence regarding the multiple health concerns associated with unconventional gas mining. This knowledge should be part of wider discourse and decision-making processes driving local economic development and national and global energy choices.

Field trials of medical decision-aids: potential problems and solutions.

PubMed Central

Wyatt, J.; Spiegelhalter, D.

1991-01-01

Only clinical trials can assess the impact of prototype medical decision-aids, but they are seldom performed before dissemination. Many problems are encountered when designing such studies, including ensuring generality, deciding what to measure, feasible study designs, correcting for biases caused by the trial itself and by the decision-aid, resolving the "Evaluation Paradox", and potential legal and ethical doubts. These are discussed in this paper. PMID:1807610

Knowledge Requirements and Management in Expert Decision Support Systems for (Military) Situation Assessment

DTIC Science & Technology

1983-08-01

constitutes a fundamental problem in many decision making processes. In business management we face this problem when determining the status of an...Tehiical Report 576 ( 1 ) 4 KNOWLEDGE REQUIREMENTS AND MANAGEMENT IN EXPERT DECISION SUPPORT SYSTEMS FOR (MILITARY) SITUATION ASSESSMENT MOOM sen...accomplished under contract for the Department of the Army The Israel Institute of Business Research Technical review by Robert H. Sasmor Joseph M

A commentary on decision-making and organisational legitimacy in the Risk Society.

PubMed

Benn, Suzanne; Brown, Paul; North-Samardzic, Andrea

2009-04-01

Key concepts of Risk Society as elaborated by Ulrich Beck and others (Beck, U., 1992 (trans. Mark Ritter). The Risk Society. Sage Publications, London. Beck, U., 1995, Ecological Politics in the Age of Risk. Polity Press, Cambridge. Beck, U., 1999, World Risk Society. Polity Press, Cambridge. Giddens, A., 1994, Beyond Left and Right. Polity Press, Oxford. Beck, U., Giddens, A. and Lash, S., 1994, Reflexive Modernisation: Politics, Tradition and Aesthetics in the Modern Social Order. Stanford University Press, Stanford. Beck, U., Bonss, W. and Lau, C., 2003, Theory, Culture & Society 2003, Sage, London, 20(2), pp. 1-33.) are illuminated though a case study of managed environmental risk, namely the hexachlorobenzene (HCB) controversy at Botany, a southeast suburb of Sydney. We observe the way multiple stakeholder decision-making plays out a number of Risk Society themes, including the emergence of 'unbounded risk' and of highly 'individualised' and 'reflexive' risk communities. Across several decades, the events of the HCB story support Risk Society predictions of legitimacy problems faced by corporations as they harness technoscientific support for innovation in their products and industrial processes without due recognition of social and environmental risk. Tensions involving identity, trust and access to expert knowledge advance our understanding of democratic 'sub-political' decision-making and ways of distributing environmental risk.

Evidence-based clinical practice, [corrected] evidence-based medicine and the Cochrane collaboration.

PubMed

Gambrill, E

1999-03-01

Encouraging professionals in training and later to consider practice-related research findings when making important clinical decisions is an on-going concern. Evidenced-Based Medicine (EBM) and the Cochrane Collaboration (CC) provide a source of tools and ideas for doing so, as well as a roster of colleagues who share this interest. Evidenced-based medicine involves integrating clinical expertise with the best available external evidence from systematic research as well as considering the values and expectations of patients/clients. Advantage can be taken of educational formats developed in EBM, such as problem-based learning and critical-appraisal workshops in which participants learn how to ask key answerable questions related to important clinical practice questions (e.g., regarding effectiveness, accuracy of assessment measures, prediction, prevention, and quality of clinical practice guidelines) and to access and critically appraise related research. The Cochrane Collaboration is a world-wide network of centers that prepare, maintain, and disseminate high-quality systematic reviews on the efficacy of healthcare. These databases allow access to evidence related to clinical practice decisions. Forging reciprocal working relationships with those involved in EBM reciprocal and the CC should contribute to the pursuit of shared goals such as basing clinical decisions on the best-available evidence and involving clients as informed consumers.