Exploring decision-making for environmental health services: perspectives from four cities.

PubMed

Hunt, C; Lewin, S

2000-01-01

Increasing resources are being allocated to environmental health monitoring, especially for developing methods and collecting data to construct environmental health indicators (EHIs). Yet, little research has focused on understanding how communities and service providers make decisions with regard to environmental health priorities and the role of indicators in this process. This paper presents insights regarding local decision-making that arose from a project to test the feasibility of using community-based EHIs to facilitate communication between the providers and the recipients of environmental services in four developing-country cities. The results of the study indicate that decision-making for environmental health services is complex and iterative rather than rational and linear. Contextual and process factors play an important role. These factors include the morale of service providers, the extent of collaboration between service agencies, the priorities of different community groups and relations between service providers and communities. Scientific information, in the form of EHIs, did not appear to be a key element of decision-making in the settings studied. As tools, EHIs are unlikely to become part of the decision-making process unless they are integrated with local agendas and backed by strong local representation.

Cable Television In Metro Denver. Background and Policy Issues For Local Decision-Making.

ERIC Educational Resources Information Center

Bortz, Paul I.; Gilmore, John S.

A general introduction to cable television (CATV) in the metropolitan Denver area, with a focus on policy issues for local decision-making, is provided. The overview is based upon a literature review, information presented at conferences, local surveys of CATV, interviews with people involved with CATV, and on-going research conducted by the…

Evidence-based medicine meets democracy: the role of evidence-based public health guidelines in local government.

PubMed

Kelly, M P; Atkins, L; Littleford, C; Leng, G; Michie, S

2017-12-01

In 2013, many public health functions transferred from the National Health Service to local government in England. From 2006 NICE had produced public health guidelines based on the principles of evidence-based medicine. This study explores how the guidelines were received in the new environment in local government and related issues raised relating to the use of evidence in local authoritites. In depth, interviews with 31 elected members and officers, including Directors of Public Health, from four very different local government organizations ('local authorities'). Participants reported that (i) there were tensions between evidence-based, and political decision-making; (ii) there were differences in views about what constituted 'good' evidence and (iii) that organizational life is an important mediator in the way evidence is used. Democratic political decision-making does not necessarily naturally align with decision-making based on evidence from the international scientific literature, and local knowledge and local evidence are very important in the ways that public health decisions are made. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health.

Decentralisation and health services delivery in Tanzania: Analysis of decision space in planning, allocation, and use of financial resources.

PubMed

Kigume, Ramadhani; Maluka, Stephen; Kamuzora, Peter

2018-04-01

While decentralisation of health systems has been on the policy agenda in low-income and middle-income countries since the 1970s, many studies have focused on understanding who has more decision-making powers but less attention is paid to understand what those powers encompass. Using the decision space approach, this study aimed to understand the amount of decision-making space transferred from the central government to institutions at the periphery in the decentralised health system in Tanzania. The findings of this study indicated that the decentralisation process in Tanzania has provided authorities with a range of decision-making space. In the areas of priority setting and planning, district health authorities had moderate decision space. However, in the financial resource allocation and expenditure of funds from the central government, the districts had narrow decision-making space. The districts, nevertheless, had wider decision-making space in mobilising and using locally generated financial resources. However, the ability of the districts to allocate and use locally generated resources was constrained by bureaucratic procedures of the central government. The study concludes that decentralisation by devolution which is being promoted in the policy documents in Tanzania is yet to be realised at the district and local levels. The study recommends that the central government should provide more space to the decentralised district health systems to incorporate locally defined priorities in the district health plans. Copyright © 2018 John Wiley & Sons, Ltd.

[Boundaries of the autonomy of local health administration: innovation, creativity and evidence-based decision-making].

PubMed

Silva, Silvio Fernandes da; Souza, Nathan Mendes; Barreto, Jorge Otávio Maia

2014-11-01

The scope of this article was to identify the boundaries of the autonomy of local administration in the context of the federal pact in the Brazilian Unified Health System and the importance and potential for promoting innovation, creativity and evidence-based decision-making by local governments. The methodology used was to ask questions that favored dialogue with the specific literature to identify the influence of centrally-formulated policies in spaces of local autonomy and then to identify strategies to foster innovation, creativity and the systematic use of evidence-based research in health policy implementation. A gradual reduction in municipal decision-making autonomy was detected due to increased financial commitment of the municipalities resulting from responsibilities assumed, albeit with the possibility of reverting this trend in the more recent context. Some determinants and challenges for the dissemination of innovative practices were analyzed and some relevant national and international experiences in this respect were presented. The conclusion drawn is that it is possible to make local decision-making more effective provided that initiatives are consolidated to promote this culture and the formulation and implementation of evidence-based health policies.

Community perspectives

NASA Technical Reports Server (NTRS)

1975-01-01

General aviation is considered from the perspective of the local community's decision-making process in determining its needs for access to general aviation services. The decision-making model, preliminary decision, community characteristics, and planning processes are discussed.

'It ain't what you do it's the way that you do it': lessons for health care from decommissioning of older people's services.

PubMed

Robinson, Suzanne; Glasby, Jon; Allen, Kerry

2013-11-01

Public sector organisations are facing one of the most difficult financial periods in history and local decision-makers are tasked with making tough rationing decisions. Withdrawing or limiting services is an emotive and complex task and something the National Health Service has always found difficult. Over time, local authorities have gained significant experience in the closure of care homes - an equally complex and controversial issue. Drawing on local knowledge and best practice examples, this article highlights lessons and themes identified by those decommissioning care home services. We believe that such lessons are relevant to those making disinvestment decisions across public sector services, including health-care. The study employed semi-structured interviews with 12 Directors of Adult Social Services who had been highlighted nationally as having extensive experience of home closures. Interviews were conducted over a 2-week period in March 2011. Results from the study found that having local policy guidance that is perceived as fair and reasonable was advocated by those involved in home closures. Many local policies had evolved over time and had often been developed following experiences of home closures (both good and bad). Decisions to close care home services require a combination of strong leadership, clear strategic goals, a fair decision-making process, strong evidence of the need for change and good communication, alongside wider stakeholder engagement and support. The current financial challenge means that public sector organisations need to make tough choices on investment and disinvestment decisions. Any such decisions need to be influenced by what we know constitutes best practice. Sharing lessons and experiences within and between sectors could well inform and develop decision-making practices. © 2013 John Wiley & Sons Ltd.

School and District Intervention: A Decision-Making Framework for Policymakers.

ERIC Educational Resources Information Center

Bowles, Susan A.; Churchill, Andrew M.; Effrat, Andrew; McDermott, Kathryn A.

This paper seeks to help state policymakers understand their relatively new role in improving the academic performance of local schools and districts. The first section, "Intervention Decision-Making Framework," focuses on the intervention decision making framework model, performance criteria, strategic criteria, diagnostic…

Local Management of Schools: Rationality and Decision-Making in the Employment of Teachers.

ERIC Educational Resources Information Center

Huckman, Lynda; Hill, Tim

1994-01-01

Examines the use of rational planning techniques in five English elementary schools. Discusses the decision-making processes used to determine the employment and remuneration of teachers. Finds that the decree of control over decision making was related closely to the extent to which decisions would contribute to solutions of other school…

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

Science.gov Websites

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

77 FR 40634 - Solicitation for a Cooperative Agreement: Pretrial Technical Assistance for Evidence-Based...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

...: Pretrial Technical Assistance for Evidence-Based Decision Making in Local Criminal Justice Systems AGENCY... NIC initiative, Evidence-Based Decision Making (EBDM) in Local Criminal Justice Systems. Work under... individual system planning activities. These change strategies are critical to meeting their system's harm...

The use of economic evaluations in NHS decision-making: a review and empirical investigation.

PubMed

Williams, I; McIver, S; Moore, D; Bryan, S

2008-04-01

To determine the extent to which health economic information is used in health policy decision-making in the UK, and to consider factors associated with the utilisation of such research findings. Major electronic databases were searched up to 2004. A systematic review of existing reviews on the use of economic evaluations in policy decision-making, of health and non-health literature on the use of economic analyses in policy making and of studies identifying actual or perceived barriers to the use of economic evaluations was undertaken. Five UK case studies of committees from four local and one national organisation [the Technology Appraisal Committee of the National Institute for Health and Clinical Excellence (NICE)] were conducted. Local case studies were augmented by documentary analysis of new technology request forms and by workshop discussions with members of local decision-making committees. The systematic review demonstrated few previous systematic reviews of evidence in the area. At the local level in the NHS, it was an exception for economic evaluation to inform technology coverage decisions. Local decision-making focused primarily on evidence of clinical benefit and cost implications. And whilst information on implementation was frequently requested, cost-effectiveness information was rarely accessed. A number of features of the decision-making environment appeared to militate against emphasis on cost-effectiveness analysis. Constraints on the capacity to generate, access and interpret information, led to a minor role for cost-effectiveness analysis in the local decision-making process. At the national policy level in the UK, economic analysis was found to be highly integrated into NICE's technology appraisal programme. Attitudes to economic evaluation varied between committee members with some significant disagreement and extraneous factors diluted the health economics analysis available to the committee. There was strong evidence of an ordinal approach to consideration of clinical effectiveness and cost-effectiveness information. Some interviewees considered the key role of a cost-effectiveness analysis to be the provision of a framework for decision-making. Interviewees indicated that NICE makes use of some form of cost-effectiveness threshold but expressed concern about its basis and its use in decision-making. Frustrations with the appraisal process were expressed in terms of the scope of the policy question being addressed. Committee members raised concerns about lack of understanding of the economic analysis but felt that a single measure of benefit, e.g. the quality-adjusted life-year, was useful in allowing comparison of disparate health interventions and in providing a benchmark for later decisions. The importance of ensuring that committee members understood the limitations of the analysis was highlighted for model-based analyses. This study suggests that research is needed into structures, processes and mechanisms by which technology coverage decisions can and should be made in healthcare. Further development of 'resource centres' may be useful to provide independent published analyses in order to support local decision-makers. Improved methods of economic analyses and of their presentation, which take account of the concerns of their users, are needed. Finally, the findings point to the need for further assessment of the feasibility and value of a formal process of clarification of the objectives that we seek from investments in healthcare.

Local dynamics in decision making: The evolution of preference within and across decisions

NASA Astrophysics Data System (ADS)

O'Hora, Denis; Dale, Rick; Piiroinen, Petri T.; Connolly, Fionnuala

2013-07-01

Within decisions, perceived alternatives compete until one is preferred. Across decisions, the playing field on which these alternatives compete evolves to favor certain alternatives. Mouse cursor trajectories provide rich continuous information related to such cognitive processes during decision making. In three experiments, participants learned to choose symbols to earn points in a discrimination learning paradigm and the cursor trajectories of their responses were recorded. Decisions between two choices that earned equally high-point rewards exhibited far less competition than decisions between choices that earned equally low-point rewards. Using positional coordinates in the trajectories, it was possible to infer a potential field in which the choice locations occupied areas of minimal potential. These decision spaces evolved through the experiments, as participants learned which options to choose. This visualisation approach provides a potential framework for the analysis of local dynamics in decision-making that could help mitigate both theoretical disputes and disparate empirical results.

Who wants to be involved in health care decisions? Comparing preferences for individual and collective involvement in England and Sweden.

PubMed

Fredriksson, Mio; Eriksson, Max; Tritter, Jonathan

2017-07-14

Patient and public involvement (PPI) is framed as positive for individuals, the health system, public health, as well as for communities and society as a whole. We investigated whether preferences for PPI differed between two countries with Beveridge type health systems-Sweden and England. We measured willingness to be involved in individual treatment decisions and in decisions about the organization and provision of local health and social care services. This was a comparative cross-sectional study of the general population's preferences. Together, the two samples included 3125 respondents; 1625 in England and 1500 in Sweden. Country differences were analysed in a multinomial regression model controlling for gender, age and educational attainment. Overall, 68% of respondents wanted a passive patient role and 44% wanted to be involved in local decisions about organization and provision of services. In comparison with in Sweden, they were in England less likely to want a health professional such as a GP or consultant to make decisions about their treatment and also more likely to want to make their own decisions. They were also less likely to want to be involved in local service development decisions. An increased likelihood of wanting to be involved in organizational decision-making was associated with individuals wanting to make their own treatment decisions. Women were less likely to want health professionals to make decisions and more likely to want to be involved in organizational decisions. An effective health system that ensures public health must integrate an effective approach to PPI both in individual treatment decisions and shaping local health and social care priorities. To be effective, involvement activities must take in to account the variation in the desire for involvement and the implications that this has for equity. More work is needed to understand the relationship between the desire to be involved and actually being involved, but both appear related to judgements of the impact of involvement on health care decisions.

The Legal Implications of Administrative Decision-Making.

ERIC Educational Resources Information Center

Bender, Louis W.

Administrative decision-making encompasses three levels on which increasing legal challenges and liability and their implications need to be considered. At the local level, this may involve violations of procedural due process. A second level concerns state laws and regulations. Line administrators, who frequently make decisions on programs,…

Examining Moral Reasoning and Ethical Decision Making among Mississippi's Community College Administrators

ERIC Educational Resources Information Center

Wilson, Vernesia Bracey

2010-01-01

As ethical dilemmas arise in community colleges, administrators make decisions that require sensitivity to the organizational, political, and environmental factors surrounding their particular institutional climates and locales. The moral reasoning and ethical decision-making of community college administrators were examined in this study. In…

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.

U.S. infrastructure : funding trends and opportunities to improve investment decisions

DOT National Transportation Integrated Search

2000-02-01

Given the profound economic and social importance of the public infrastructure, it is crucial that federal, state, and local governments make prudent decisions on how to invest limited available resources. In making these decisions, governments will ...

The Use of Information by Policymakers at the Local Community Level.

ERIC Educational Resources Information Center

Florio, Evelyn; DeMartini, Joseph R.

1993-01-01

Discussion of decision making focuses on a study that was conducted to examine how policymakers at the local community level use social science information in making decisions. The use of social science information and other information sources in two communities examining health care issues is described. (Contains 18 references.) (LRW)

Data Informed Decision Making--Perspectives of Oklahoma Superintendents

ERIC Educational Resources Information Center

Kettles, Thomas D.

2017-01-01

This descriptive, multiple case study was designed to convey a clear portrayal of the DIDM practice of six superintendents and to provide a description of what these superintendents employ during their decision making process. The ability of local education leaders to strategically influence the use of data for decision making has a large effect…

Conference on Public Policy and Education: The Making of Policy. Case Study: The Impact of Office of Civil Rights Rulings on Local Policy Making in Education. May 23, 1978. Proceedings.

ERIC Educational Resources Information Center

Lachman, Seymour P., Ed.

The conference was convened to provide a forum for educators, human rights representatives, and government officials to discuss decision-making processes of local education authorities. The focus of the conference was on the increasing influence on educational policy formation of federal and state court decisions, regulatory agencies, professional…

Tools to support evidence-informed public health decision making

PubMed Central

2014-01-01

Background Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. Methods As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Results Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the ‘actionable message(s)’ from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing and sustaining evidence-informed decision making. Conclusion Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools’ application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice. PMID:25034534

Tools to support evidence-informed public health decision making.

PubMed

Yost, Jennifer; Dobbins, Maureen; Traynor, Robyn; DeCorby, Kara; Workentine, Stephanie; Greco, Lori

2014-07-18

Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the 'actionable message(s)' from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing and sustaining evidence-informed decision making. Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools' application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice.

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.

Factors influencing the clinical decision-making of midwives: a qualitative study.

PubMed

Daemers, Darie O A; van Limbeek, Evelien B M; Wijnen, Hennie A A; Nieuwenhuijze, Marianne J; de Vries, Raymond G

2017-10-06

Although midwives make clinical decisions that have an impact on the health and well-being of mothers and babies, little is known about how they make those decisions. Wide variation in intrapartum decisions to refer women to obstetrician-led care suggests that midwives' decisions are based on more than the evidence based medicine (EBM) model - i.e. clinical evidence, midwife's expertise, and woman's values - alone. With this study we aimed to explore the factors that influence clinical decision-making of midwives who work independently. We used a qualitative approach, conducting in-depth interviews with a purposive sample of 11 Dutch primary care midwives. Data collection took place between May and September 2015. The interviews were semi-structured, using written vignettes to solicit midwives' clinical decision-making processes (Think Aloud method). We performed thematic analysis on the transcripts. We identified five themes that influenced clinical decision-making: the pregnant woman as a whole person, sources of knowledge, the midwife as a whole person, the collaboration between maternity care professionals, and the organisation of care. Regarding the midwife, her decisions were shaped not only by her experience, intuition, and personal circumstances, but also by her attitudes about physiology, woman-centredness, shared decision-making, and collaboration with other professionals. The nature of the local collaboration between maternity care professionals and locally-developed protocols dominated midwives' clinical decision-making. When midwives and obstetricians had different philosophies of care and different practice styles, their collaborative efforts were challenged. Midwives' clinical decision-making is a more varied and complex process than the EBM framework suggests. If midwives are to succeed in their role as promoters and protectors of physiological pregnancy and birth, they need to understand how clinical decisions in a multidisciplinary context are actually made.

Navigating the boundary of science for decision making at the state and local level

NASA Astrophysics Data System (ADS)

Gonzales, L. M.; Wood, C.; Boland, M. A.; Rose, C. A.

2015-12-01

Scientific information should play a vital role in many decision making processes, yet issues incorporating geoscience information often arise due to inherent differences between how scientists and decision makers operate. Decision makers and scientists have different priorities, produce work at different rates, and often lack an understanding of each others' institutional constraints. Boundary organizations, entities that facilitate collaboration and information flow across traditional boundaries such as that between scientists and decision makers, are in a unique position to improve the dialogue between disparate groups. The American Geosciences Institute (AGI), a nonprofit federation of 50 geoscience societies and organizations, is linking the geoscience and decision-making communities through its Critical Issues Program. AGI's Critical Issues program has first-hand experience in improving the transfer of information across the science-decision making boundary, particularly in areas pertaining to water resources and hazards. This presentation will focus on how, by collaborating with organizations representing the decision making and geoscience communities to inform our program development, we have created our three main content types - website, webinar series, and research database - to better meet the needs of the decision-making process. The program presents existing geoscience information in a way that makes the interconnected nature of geoscience topics more easily understood, encourages discussion between the scientific and decision-making communities, and has established a trusted source of impartial geoscience information. These efforts have focused on state and local decision makers—groups that increasingly influence climate and risk-related decisions, yet often lack the resources to access and understand geoscience information.

Shared Decision Making in Local School Planning: An Urban School System's Experience.

ERIC Educational Resources Information Center

Elenbogen, Janet C.; Hiestand, Nancy I.

The practices and perceptions of a shared planning team decision-making model and the effects on student achievement and attendance are examined in this study. Survey results, test scores, and background data on schools were utilized to analyze the relationships among the degree of shared decision-making and planning effectiveness ratings, student…

Health sector decentralization and local decision-making: Decision space, institutional capacities and accountability in Pakistan.

PubMed

Bossert, Thomas John; Mitchell, Andrew David

2011-01-01

Health sector decentralization has been widely adopted to improve delivery of health services. While many argue that institutional capacities and mechanisms of accountability required to transform decentralized decision-making into improvements in local health systems are lacking, few empirical studies exist which measure or relate together these concepts. Based on research instruments administered to a sample of 91 health sector decision-makers in 17 districts of Pakistan, this study analyzes relationships between three dimensions of decentralization: decentralized authority (referred to as "decision space"), institutional capacities, and accountability to local officials. Composite quantitative indicators of these three dimensions were constructed within four broad health functions (strategic and operational planning, budgeting, human resources management, and service organization/delivery) and on an overall/cross-function basis. Three main findings emerged. First, district-level respondents report varying degrees of each dimension despite being under a single decentralization regime and facing similar rules across provinces. Second, within dimensions of decentralization-particularly decision space and capacities-synergies exist between levels reported by respondents in one function and those reported in other functions (statistically significant coefficients of correlation ranging from ρ=0.22 to ρ=0.43). Third, synergies exist across dimensions of decentralization, particularly in terms of an overall indicator of institutional capacities (significantly correlated with both overall decision space (ρ=0.39) and accountability (ρ=0.23)). This study demonstrates that decentralization is a varied experience-with some district-level officials making greater use of decision space than others and that those who do so also tend to have more capacity to make decisions and are held more accountable to elected local officials for such choices. These findings suggest that Pakistan's decentralization policy should focus on synergies among dimensions of decentralization to encouraging more use of de jure decision space, work toward more uniform institutional capacity, and encourage greater accountability to local elected officials. Copyright © 2010 Elsevier Ltd. All rights reserved.

Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers' use of information in decision-making: experience from Cape Town, South Africa.

PubMed

Scott, Vera; Gilson, Lucy

2017-09-15

Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery. This paper, therefore, specifically examines experience from Cape Town, South Africa, asking the question: How is primary healthcare facility managers' use of information for decision-making influenced by governance across levels of the health system? The research is novel in that it both explores what information these facility managers actually use in decision-making, and considers how wider governance processes influence this information use. An academic researcher and four facility managers worked as co-researchers in a multi-case study in which three areas of management were served as the cases. There were iterative cycles of data collection and collaborative analysis with individual and peer reflective learning over a period of three years. Central governance shaped what information and knowledge was valued - and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based HIS which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential knowledge to make locally-appropriate and responsive decisions, and to perform the people management tasks required. Despite central level influences, modes of governance operating at the subdistrict level had influence over what information was valued, generated and used locally. Strengthening local level managers' ability to create enabling environments is an important leverage point in supporting informed local decision-making, and, in turn, translating national policies and priorities, including equity goals, into appropriate service delivery practices.

Tapping into community wisdom and integrating local knowledge into revitalization efforts

EPA Science Inventory

Local decision-making is sometimes considered a puzzle by research ecologists, resource managers, and policy researchers. The eternal hope is to find that model or concept that provides the “right” information to support local environmental decisions. Researchers have...

Adolescent and parental perceptions of medical decision-making in Hong Kong.

PubMed

Hui, Edwin

2011-11-01

To investigate whether Chinese adolescents in Hong Kong share similar perceptions with their Western counterparts regarding their capacity for autonomous decision-making, and secondarily whether Chinese parents underestimate their adolescent children's desire and capacity for autonomous decision-making. 'Healthy Adolescents' and their parents were recruited from four local secondary schools, and 'Sick Adolescents' and their parents from the pediatric wards and outpatient clinics. Their perceptions of adolescents' understanding of illnesses and treatments, maturity in judgment, risk-taking, openness to divergent opinions, pressure from parents and doctors, submission to parental authority and preference for autonomy in medical decision-making are surveyed by a 50-item questionnaire on a five-point Likert scale. Findings indicate that Chinese adolescents aged 14-16 perceive themselves to possess the necessary cognitive abilities and maturity in judgment to be autonomous decision-makers like their Western counterparts. Paradoxically, although they hesitate to assert their autonomy, they are also unwilling to surrender that autonomy to their parents even under coercion or intimidation. Parents tend to underestimate their adolescents' preferences for making autonomous decisions and overestimate the importance of parental authority in decision-making. '14-and-above' Chinese adolescents in Hong Kong perceive themselves as capable of autonomous decision-making in medically-related matters, but hesitate to assert their autonomy, probably because of the Confucian values of parental authority and filial piety that are deeply embedded in the local culture. © 2010 Blackwell Publishing Ltd.

Influence of Men's Personality and Social Support on Treatment Decision-Making for Localized Prostate Cancer.

PubMed

Reamer, Elyse; Yang, Felix; Holmes-Rovner, Margaret; Liu, Joe; Xu, Jinping

2017-01-01

Optimal treatment for localized prostate cancer (LPC) is controversial. We assessed the effects of personality, specialists seen, and involvement of spouse, family, or friends on treatment decision/decision-making qualities. We surveyed a population-based sample of men ≤ 75 years with newly diagnosed LPC about treatment choice, reasons for the choice, decision-making difficulty, satisfaction, and regret. Of 160 men (71 black, 89 white), with a mean age of 61 (±7.3) years, 59% chose surgery, 31% chose radiation, and 10% chose active surveillance (AS)/watchful waiting (WW). Adjusting for age, race, comorbidity, tumor risk level, and treatment status, men who consulted friends during decision-making were more likely to choose curative treatment (radiation or surgery) than WW/AS (OR = 11.1, p < 0.01; 8.7, p < 0.01). Men who saw a radiation oncologist in addition to a urologist were more likely to choose radiation than surgery (OR = 6.0, p = 0.04). Men who consulted family or friends (OR = 2.6, p < 0.01; 3.7, p < 0.01) experienced greater decision-making difficulty. No personality traits (pessimism, optimism, or faith) were associated with treatment choice/decision-making quality measures. In addition to specialist seen, consulting friends increased men's likelihood of choosing curative treatment. Consulting family or friends increased decision-making difficulty.

Exchanging environmental information and decision making: developing the local Pilot Environmental Virtual Observatory with stakeholder communities

NASA Astrophysics Data System (ADS)

Mackay, E.; Beven, K.; Brewer, P.; M, Haygarth, P.; Macklin, M.; Marshall, K.; Quinn, P.; Stutter, M.; Thomas, N.; Wilkinson, M.

2012-04-01

Public participation in the development of flood risk management and river basin management plans are explicit components of both the Water Framework and Floods Directives. At the local level, involving communities in land and water management has been found to (i) aid better environmental decision making, (ii) enhance social, economic and environmental benefits, and (iii) increase a sense of ownership. Facilitating the access and exchange of information on the local environment is an important part of this new approach to the land and water management process, which also includes local community stakeholders in decisions about the design and content of the information provided. As part of the Natural Environment Research Council's pilot Environment Virtual Observatory (EVO), the Local Level group are engaging with local community stakeholders in three different catchments in the UK (the rivers Eden, Tarland and Dyfi) to start the process of developing prototype visualisation tools to address the specific land and water management issues identified in each area. Through this local collaboration, we will provide novel visualisation tools through which to communicate complex catchment science outcomes and bring together different sources of environmental data in ways that better meet end-user needs as well as facilitate a far broader participatory approach in environmental decision making. The Local Landscape Visualisation Tools are being evolved iteratively during the project to reflect the needs, interests and capabilities of a wide range of stakeholders. The tools will use the latest concepts and technologies to communicate with and provide opportunities for the provision and exchange of information between the public, government agencies and scientists. This local toolkit will reside within a wider EVO platform that will include national datasets, models and state of the art cloud computer systems. As such, local stakeholder groups are assisting the EVO's development and participating in local decision making alongside policy makers, government agencies and scientists.

Virtual Beach: Decision Support Tools for Beach Pathogen Prediction

EPA Science Inventory

The Virtual Beach Managers Tool (VB) is decision-making software developed to help local beach managers make decisions as to when beaches should be closed due to predicted high levels of water borne pathogens. The tool is being developed under the umbrella of EPA's Advanced Monit...

Universal size effects for populations in group-outcome decision-making problems

NASA Astrophysics Data System (ADS)

Borghesi, Christian; Hernández, Laura; Louf, Rémi; Caparros, Fabrice

2013-12-01

Elections constitute a paradigm of decision-making problems that have puzzled experts of different disciplines for decades. We study two decision-making problems, where groups make decisions that impact only themselves as a group. In both studied cases, participation in local elections and the number of democratic representatives at different scales (from local to national), we observe a universal scaling with the constituency size. These results may be interpreted as constituencies having a hierarchical structure, where each group of N agents, at each level of the hierarchy, is divided in about Nδ subgroups with δ≈1/3. Following this interpretation, we propose a phenomenological model of vote participation where abstention is related to the perceived link of an agent to the rest of the constituency and which reproduces quantitatively the observed data.

Treatment decision-making strategies and influences in patients with localized prostate carcinoma.

PubMed

Gwede, Clement K; Pow-Sang, Julio; Seigne, John; Heysek, Randy; Helal, Mohamed; Shade, Kristin; Cantor, Alan; Jacobsen, Paul B

2005-10-01

Patients diagnosed with localized prostate carcinoma need to interpret complicated medical information to make an informed treatment selection from among treatments that have comparable efficacy but differing side effects. The authors reported initial results for treatment decision-making strategies among men receiving definitive treatment for localized prostate carcinoma. One hundred nineteen men treated with radical prostatectomy (44%) or brachytherapy (56%) consented to participate. Guided by a cognitive-affective theoretic framework, the authors assessed differences in decision-making strategies, and treatment and disease-relevant beliefs and affects, in addition to demographic and clinical variables. Approximately half of patients reported difficulty (49%) and distress (45%) while making treatment decisions, but no regrets (74%) regarding the treatment choice they made. Patients who underwent prostatectomy were younger, were more likely to be employed, had worse tumor grade, and had a shorter time since diagnosis (P < 0.01) compared with patients who did not undergo prostatectomy. In multivariate analyses, compared with patients who received radical prostatectomy, patients who received brachytherapy were more likely to say that they chose this treatment because it was "the least invasive" and they "wanted to avoid surgery" (P < 0.0001). In general, patients who received brachytherapy chose this treatment because of quality of life considerations, whereas "cure" and complete removal of the tumor were the main motivations for patients selecting radical prostatectomy. Long-term data are needed to evaluate distress and decisional regret as patients experience treatment-related chronic side effects and efficacy outcomes. Decision-making aids or other interventions to reduce decisional difficulty and emotional distress during decision making were indicated.

Goal-Directed Decision Making with Spiking Neurons.

PubMed

Friedrich, Johannes; Lengyel, Máté

2016-02-03

Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules such that its dynamics devise a near-optimal plan of action. By systematically comparing our model results to experimental data, we show that it reproduces behavioral decision times and choice probabilities as well as neural responses in a rich set of tasks. Our results thus offer the first biologically realistic account for complex goal-directed decision making at a computational, algorithmic, and implementational level. Copyright © 2016 the authors 0270-6474/16/361529-18$15.00/0.

Goal-Directed Decision Making with Spiking Neurons

PubMed Central

Lengyel, Máté

2016-01-01

Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. SIGNIFICANCE STATEMENT Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules such that its dynamics devise a near-optimal plan of action. By systematically comparing our model results to experimental data, we show that it reproduces behavioral decision times and choice probabilities as well as neural responses in a rich set of tasks. Our results thus offer the first biologically realistic account for complex goal-directed decision making at a computational, algorithmic, and implementational level. PMID:26843636

Career Decision Making and Its Evaluation.

ERIC Educational Resources Information Center

Miller-Tiedeman, Anna

1979-01-01

The author discusses a career decision-making program which she designed and implemented using a pyramidal model of exploration, crystallization, choice, and classification. Her article outlines the value of rigorous evaluation techniques applied by the local practitioner. (MF)

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

PubMed

Ruohonen, Toni; Ennejmy, Mohammed

2013-01-01

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

To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles.

PubMed

Lee, Yew Kong; Lee, Ping Yein; Cheong, Ai Theng; Ng, Chirk Jenn; Abdullah, Khatijah Lim; Ong, Teng Aik; Razack, Azad Hassan Abdul

2015-01-01

To explore the views of Malaysian healthcare professionals (HCPs) on stakeholders' decision making roles in localized prostate cancer (PCa) treatment. Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. The participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients' decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient's treatment due to Malaysia's close-knit family culture. A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.

To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles

PubMed Central

Lee, Yew Kong; Lee, Ping Yein; Cheong, Ai Theng; Ng, Chirk Jenn; Abdullah, Khatijah Lim; Ong, Teng Aik; Razack, Azad Hassan Abdul

2015-01-01

Aim To explore the views of Malaysian healthcare professionals (HCPs) on stakeholders’ decision making roles in localized prostate cancer (PCa) treatment. Methods Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Findings The participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients’ decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient’s treatment due to Malaysia’s close-knit family culture. Conclusions A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa. PMID:26559947

Treatment preferences and involvement in treatment decision making of patients with endometrial cancer and clinicians.

PubMed

Kunneman, M; Pieterse, A H; Stiggelbout, A M; Nout, R A; Kamps, M; Lutgens, L C H W; Paulissen, J; Mattheussens, O J A; Kruitwagen, R F P M; Creutzberg, C L

2014-08-12

Vaginal brachytherapy (VBT) in high-intermediate-risk endometrial cancer (EC) provides a significant reduction in the risk of local cancer recurrence, but without survival benefit and with increased mucosal atrophy. Five-year local control is estimated to be similar for VBT and a watchful waiting policy (WWP), in which patients receive VBT combined with external radiation in case of a recurrence. Our aim was to assess treatment preferences of EC patients and clinicians regarding VBT and WWP, and to evaluate their preferred and perceived involvement in treatment decision making. Interviews were held with 95 treated EC patients. The treatment trade-off method was used to assess the minimally desired benefit from VBT in local control. Patients' preferred and perceived involvement in decision making were assessed using a questionnaire. Seventy-seven clinicians completed a questionnaire assessing their minimally desired benefit and preferred involvement in decision making. Minimally desired benefit of VBT was significantly lower for patients than for clinicians (median=0 vs 8%, P<0.001), for irradiated than for non-irradiated patients (median=0 vs 6.5%, P<0.001), and for radiation oncologists than for gynaecologists (median=4 vs 13%, P<0.001). Substantial variation existed within the groups of patients and clinicians. Participants preferred the patient and clinician to share in the decision about VBT. However, irradiated patients indicated low perceived involvement in actual treatment decision making. We found variations between and within patients and clinicians in minimally desired benefit from VBT. However, the recurrence risk at which patients preferred VBT was low. Our results showed that patients consider active participation in decision making essential.

Treatment preferences and involvement in treatment decision making of patients with endometrial cancer and clinicians

PubMed Central

Kunneman, M; Pieterse, A H; Stiggelbout, A M; Nout, R A; Kamps, M; Lutgens, L C H W; Paulissen, J; Mattheussens, O J A; Kruitwagen, R F P M; Creutzberg, C L

2014-01-01

Background: Vaginal brachytherapy (VBT) in high–intermediate-risk endometrial cancer (EC) provides a significant reduction in the risk of local cancer recurrence, but without survival benefit and with increased mucosal atrophy. Five-year local control is estimated to be similar for VBT and a watchful waiting policy (WWP), in which patients receive VBT combined with external radiation in case of a recurrence. Our aim was to assess treatment preferences of EC patients and clinicians regarding VBT and WWP, and to evaluate their preferred and perceived involvement in treatment decision making. Methods: Interviews were held with 95 treated EC patients. The treatment trade-off method was used to assess the minimally desired benefit from VBT in local control. Patients' preferred and perceived involvement in decision making were assessed using a questionnaire. Seventy-seven clinicians completed a questionnaire assessing their minimally desired benefit and preferred involvement in decision making. Results: Minimally desired benefit of VBT was significantly lower for patients than for clinicians (median=0 vs 8%, P<0.001), for irradiated than for non-irradiated patients (median=0 vs 6.5%, P<0.001), and for radiation oncologists than for gynaecologists (median=4 vs 13%, P<0.001). Substantial variation existed within the groups of patients and clinicians. Participants preferred the patient and clinician to share in the decision about VBT. However, irradiated patients indicated low perceived involvement in actual treatment decision making. Conclusions: We found variations between and within patients and clinicians in minimally desired benefit from VBT. However, the recurrence risk at which patients preferred VBT was low. Our results showed that patients consider active participation in decision making essential. PMID:24921911

Health and wellbeing boards: public health decision making bodies or political pawns?

PubMed

Greaves, Z; McCafferty, S

2017-02-01

Health and Wellbeing boards in England are uniquely constituted; embedded in the local authorities with membership drawn from a range of stakeholders and partner organizations. This raises the question of how decision making functions of the boards reflects wider public health decision making, if criteria are applied to decision making, and what prioritization processes, if any, are used. Qualitative research methods were employed and five local boards were approached, interview dyads were conducted with the boards Chair and Director of Public Health across four of these (n = 4). Three questions were addressed: how are decisions made? What are the criteria applied to decision making? And how are criteria then prioritized? A thematic approach was used to analyse data identifying codes and extracting key themes. Equity, effectiveness and consistency with strategies of board and partners were most consistently identified by participants as criteria influencing decisions. Prioritization was described as an engaged and collaborative process, but criteria were not explicitly referenced in the decision making of the boards which instead made unstructured prioritization of population sub-groups or interventions agreed by consensus. Criteria identified are broadly consistent with those used in wider public health practice but additionally incorporated criteria which recognizes the political siting of the boards. The study explored the variety in different board's approaches to prioritization and identified a lack of clarity and rigour in the identification and use of criteria in prioritization processes. Decision making may benefit from the explicit inclusion of criteria in the prioritization process. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Activation of cannabinoid system in anterior cingulate cortex and orbitofrontal cortex modulates cost-benefit decision making.

PubMed

Khani, Abbas; Kermani, Mojtaba; Hesam, Soghra; Haghparast, Abbas; Argandoña, Enrike G; Rainer, Gregor

2015-06-01

Despite the evidence for altered decision making in cannabis abusers, the role of the cannabinoid system in decision-making circuits has not been studied. Here, we examined the effects of cannabinoid modulation during cost-benefit decision making in the anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC), key brain areas involved in decision making. We trained different groups of rats in a delay-based and an effort-based form of cost-benefit T-maze decision-making task. During test days, the rats received local injections of either vehicle or ACEA, a cannabinoid type-1 receptor (CB1R) agonist in the ACC or OFC. We measured spontaneous locomotor activity following the same treatments and characterized CB1Rs localization on different neuronal populations within these regions using immunohistochemistry. We showed that CB1R activation in the ACC impaired decision making such that rats were less willing to invest physical effort to gain high reward. Similarly, CB1R activation in the OFC induced impulsive pattern of choice such that rats preferred small immediate rewards to large delayed rewards. Control tasks ensured that the effects were specific for differential cost-benefit tasks. Furthermore, we characterized widespread colocalizations of CB1Rs on GABAergic axonal ends but few colocalizations on glutamatergic, dopaminergic, and serotonergic neuronal ends. These results provide first direct evidence that the cannabinoid system plays a critical role in regulating cost-benefit decision making in the ACC and OFC and implicate cannabinoid modulation of synaptic ends of predominantly interneurons and to a lesser degree other neuronal populations in these two frontal regions.

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

PubMed

Bedia, Manuel G; Di Paolo, Ezequiel

2012-01-01

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

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

PubMed Central

Bedia, Manuel G.; Di Paolo, Ezequiel

2012-01-01

Dual-process approaches of decision-making examine the interaction between affective/intuitive and deliberative processes underlying value judgment. From this perspective, decisions are supported by a combination of relatively explicit capabilities for abstract reasoning and relatively implicit evolved domain-general as well as learned domain-specific affective responses. One such approach, the somatic markers hypothesis (SMH), expresses these implicit processes as a system of evolved primary emotions supplemented by associations between affect and experience that accrue over lifetime, or somatic markers. In this view, somatic markers are useful only if their local capability to predict the value of an action is above a baseline equal to the predictive capability of the combined rational and primary emotional subsystems. We argue that decision-making has often been conceived of as a linear process: the effect of decision sequences is additive, local utility is cumulative, and there is no strong environmental feedback. This widespread assumption can have consequences for answering questions regarding the relative weight between the systems and their interaction within a cognitive architecture. We introduce a mathematical formalization of the SMH and study it in situations of dynamic, non-linear decision chains using a discrete-time stochastic model. We find, contrary to expectations, that decision-making events can interact non-additively with the environment in apparently paradoxical ways. We find that in non-lethal situations, primary emotions are represented globally over and above their local weight, showing a tendency for overcautiousness in situated decision chains. We also show that because they tend to counteract this trend, poorly attuned somatic markers that by themselves do not locally enhance decision-making, can still produce an overall positive effect. This result has developmental and evolutionary implications since, by promoting exploratory behavior, somatic markers would seem to be beneficial even at early stages when experiential attunement is poor. Although the model is formulated in terms of the SMH, the implications apply to dual systems theories in general since it makes minimal assumptions about the nature of the processes involved. PMID:23087655

Selecting Nonpharmaceutical Strategies to Minimize Influenza Spread: The 2009 Influenza A (H1N1) Pandemic and Beyond

PubMed Central

Koonin, Lisa M.; Kohl, Katrin S.; Cetron, Martin

2012-01-01

Shortly after the influenza A (H1N1) 2009 pandemic began, the U.S. government provided guidance to state and local authorities to assist decision-making for the use of nonpharmaceutical strategies to minimize influenza spread. This guidance included recommendations for flexible decision-making based on outbreak severity, and it allowed for uncertainty and course correction as the pandemic progressed. These recommendations build on a foundation of local, collaborative planning and posit a series of questions regarding epidemiology, the impact on the health-care system, and locally determined feasibility and acceptability of nonpharmaceutical strategies. This article describes -recommendations and key questions for decision makers. PMID:23115381

How Are California's Education Dollars Spent? EdFact.

ERIC Educational Resources Information Center

EdSource, Inc., Palo Alto, CA.

School spending decisions are made locally in California, mostly by the leaders in each school district. In making these decisions, local districts have to comply with the provisions of local collective bargaining contracts with employee unions and with state and federal regulations regarding how some money must be spent. An analysis of school…

A Hierarchical Analysis of Bridge Decision Makers ... The Role of New Technology Adoption in the Timber Bridge Market: Special Project

Treesearch

Robert L. Smith; Robert J. Bush; Daniel L. Schmoldt

1995-01-01

Bridge design engineers and local highway officials make bridge replacement decisions across the United States. The Analytical Hierarchy Process was used to characterize the bridge material selection decision of these individuals. State Department of Transportation engineers, private consulting engineers, and local highway officials were personally interviewed in...

Teacher and Lay Participation in Local Curriculum Change Considerations.

ERIC Educational Resources Information Center

Schaffarzick, Jon

This study examines the roles of teachers and citizens in decision-making related to curriculum planning and change. Interviews were conducted with persons involved in curriculum decision-making in 34 school districts in order to ascertain how they determined whether or not to make elementary-level curriculum changes. The rational and political…

Effective dialogue: Enhanced public engagement as a legitimising tool for municipal waste management decision-making

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

Garnett, Kenisha, E-mail: k.garnett@cranfield.ac.uk; Cooper, Tim, E-mail: t.h.cooper@ntu.ac.uk

2014-12-15

Highlights: • A review of public engagement in waste management decision-making is undertaken. • Enhanced public engagement is explored as a means to legitimise waste decisions. • Analytical–deliberative processes are explored as a tool for effective dialogue. • Considerations for integrating public values with technical analysis are outlined. • Insights into the design of appropriate public engagement processes are provided. - Abstract: The complexity of municipal waste management decision-making has increased in recent years, accompanied by growing scrutiny from stakeholders, including local communities. This complexity reflects a socio-technical framing of the risks and social impacts associated with selecting technologies andmore » sites for waste treatment and disposal facilities. Consequently there is growing pressure on local authorities for stakeholders (including communities) to be given an early opportunity to shape local waste policy in order to encourage swift planning, development and acceptance of the technologies needed to meet statutory targets to divert waste from landfill. This paper presents findings from a research project that explored the use of analytical–deliberative processes as a legitimising tool for waste management decision-making. Adopting a mixed methods approach, the study revealed that communicating the practical benefits of more inclusive forms of engagement is proving difficult even though planning and policy delays are hindering development and implementation of waste management infrastructure. Adopting analytical–deliberative processes at a more strategic level will require local authorities and practitioners to demonstrate how expert-citizen deliberations may foster progress in resolving controversial issues, through change in individuals, communities and institutions. The findings suggest that a significant shift in culture will be necessary for local authorities to realise the potential of more inclusive decision processes. This calls for political actors and civic society to collaborate in institutionalising public involvement in both strategic and local planning structures.« less

Teachers' Content Decisions: Potential for Conflict in Local Curriculum Development.

ERIC Educational Resources Information Center

Mason, Barbara L.

The purpose of the study was to identify external and internal influences that affected the decision making of four secondary teachers regarding the content of a family living course and to describe their decision-making strategies. Because the course had been shortened and a new textbook and new state guidelines had been received, the teachers…

Students' Reasoning Processes in Making Decisions about an Authentic, Local Socio-Scientific Issue: Bat Conservation

ERIC Educational Resources Information Center

Lee, Yeung Chung; Grace, Marcus

2010-01-01

Education for scientific literacy entails the development of scientific knowledge and the ability to apply this knowledge and value judgments to decisions about real-life issues. This paper reports an attempt to involve secondary level biology students in making decisions about an authentic socio-scientific issue--that of bat conservation--through…

Scan statistics with local vote for target detection in distributed system

NASA Astrophysics Data System (ADS)

Luo, Junhai; Wu, Qi

2017-12-01

Target detection has occupied a pivotal position in distributed system. Scan statistics, as one of the most efficient detection methods, has been applied to a variety of anomaly detection problems and significantly improves the probability of detection. However, scan statistics cannot achieve the expected performance when the noise intensity is strong, or the signal emitted by the target is weak. The local vote algorithm can also achieve higher target detection rate. After the local vote, the counting rule is always adopted for decision fusion. The counting rule does not use the information about the contiguity of sensors but takes all sensors' data into consideration, which makes the result undesirable. In this paper, we propose a scan statistics with local vote (SSLV) method. This method combines scan statistics with local vote decision. Before scan statistics, each sensor executes local vote decision according to the data of its neighbors and its own. By combining the advantages of both, our method can obtain higher detection rate in low signal-to-noise ratio environment than the scan statistics. After the local vote decision, the distribution of sensors which have detected the target becomes more intensive. To make full use of local vote decision, we introduce a variable-step-parameter for the SSLV. It significantly shortens the scan period especially when the target is absent. Analysis and simulations are presented to demonstrate the performance of our method.

Managing expectations from our land: 3 is the magic number.

NASA Astrophysics Data System (ADS)

Creamer, Rachel; Schulte, Rogier; O'Sullivan, Lilian; Staes, Jan; Vrebos, Dirk; Jones, Arwyn

2017-04-01

In recent years, sustainable food production has risen to the top of the EU policy agenda. Europe's land is now expected to provide multiple ecosystem services (soil functions) for society. These include: i) food production, ii) carbon storage, iii) the provision of clean water, iv) habitats for biodiversity and v) nutrient cycling. A tension exists between the demand for and supply of these soil functions on our land. We cannot expect all soil functions to be delivered simultaneously to optimal capacity, but with careful decision making we can optimise our soils to provide multiple functions. Our societal demands also vary in spatial extent, for example we may require nutrient cycling and food production to be focussed at local scale, but carbon sequestration may be a national target to reduce greenhouse gas emissions. Every day, farmers make decisions on how they manage their land and soil. At the same time, national and European policy makers make long-term decisions on how to manage their soil resources at larger scales. Therefore, the contemporary challenge for researchers and stakeholders is to link the decision making on land management across scales, so that the practicalities of how farmers make decisions is reflected in policy formation and that policies enable farmers to make decisions that meet EU policy objectives. LANDMARK (LAND Management: Assessment, Research, Knowledge base) is a Horizon 2020 consortium of 22 partner institutes from 14 EU countries plus Switzerland, China and Brazil. The primary objective of the LANDMARK project is to provide a policy framework for Functional Land Management at EU level. This implies the identification of policy instruments that could guide the management of soil functions at the appropriate scale. This presentation will provide an overview of the challenge faced across these scales, from local to European, it will demonstrate how local decision making must try and account for the delivery of at least three soil functions to contribute to sustainable soil management.

Informed Decision Making: Assessment of the Quality of Physician Communication about Prostate Cancer Diagnosis and Treatment.

PubMed

Holmes-Rovner, Margaret; Montgomery, Jeffrey S; Rovner, David R; Scherer, Laura D; Whitfield, Jesse; Kahn, Valerie C; Merkle, Edgar C; Ubel, Peter A; Fagerlin, Angela

2015-11-01

Little is known about how physicians present diagnosis and treatment planning in routine practice in preference-sensitive treatment decisions. We evaluated completeness and quality of informed decision making in localized prostate cancer post biopsy encounters. We analyzed audio-recorded office visits of 252 men with presumed localized prostate cancer (Gleason 6 and Gleason 7 scores) who were seeing 45 physicians at 4 Veterans Affairs Medical Centers. Data were collected between September 2008 and May 2012 in a trial of 2 decision aids (DAs). Braddock's previously validated Informed Decision Making (IDM) system was used to measure quality. Latent variable models for ordinal data examined the relationship of IDM score to treatment received. Mean IDM score showed modest quality (7.61±2.45 out of 18) and high variability. Treatment choice and risks and benefits were discussed in approximately 95% of encounters. However, in more than one-third of encounters, physicians provided a partial set of treatment options and omitted surveillance as a choice. Informing quality was greater in patients treated with surveillance (β = 1.1, p = .04). Gleason score (7 vs 6) and lower age were often cited as reasons to exclude surveillance. Patient preferences were elicited in the majority of cases, but not used to guide treatment planning. Encounter time was modestly correlated with IDM score (r = 0.237, p = .01). DA type was not associated with IDM score. Physicians informed patients of options and risks and benefits, but infrequently engaged patients in core shared decision-making processes. Despite patients having received DAs, physicians rarely provided an opportunity for preference-driven decision making. More attention to the underused patient decision-making and engagement elements could result in improved shared decision making. © The Author(s) 2015.

Integrating local, expert, and practical knowledge in community remediation and revitalization

EPA Science Inventory

Researchers and natural resource managers often develop tools and methods to facilitate the inclusion of science in local environmental decision-making. The eternal hope is to find that model or concept that provides the “right” information to support these decisions....

Improving the Slum Planning Through Geospatial Decision Support System

NASA Astrophysics Data System (ADS)

Shekhar, S.

2014-11-01

In India, a number of schemes and programmes have been launched from time to time in order to promote integrated city development and to enable the slum dwellers to gain access to the basic services. Despite the use of geospatial technologies in planning, the local, state and central governments have only been partially successful in dealing with these problems. The study on existing policies and programmes also proved that when the government is the sole provider or mediator, GIS can become a tool of coercion rather than participatory decision-making. It has also been observed that local level administrators who have adopted Geospatial technology for local planning continue to base decision-making on existing political processes. In this juncture, geospatial decision support system (GSDSS) can provide a framework for integrating database management systems with analytical models, graphical display, tabular reporting capabilities and the expert knowledge of decision makers. This assists decision-makers to generate and evaluate alternative solutions to spatial problems. During this process, decision-makers undertake a process of decision research - producing a large number of possible decision alternatives and provide opportunities to involve the community in decision making. The objective is to help decision makers and planners to find solutions through a quantitative spatial evaluation and verification process. The study investigates the options for slum development in a formal framework of RAY (Rajiv Awas Yojana), an ambitious program of Indian Government for slum development. The software modules for realizing the GSDSS were developed using the ArcGIS and Community -VIZ software for Gulbarga city.

Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments.

PubMed

Zwald, Marissa; Elliott, Lindsay; Brownson, Ross C; Skala, Mahree

2015-12-01

The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments, (2) assess feasibility of non-implemented diabetes prevention and control EBPPs, and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs. An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation. One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members, increased fruit and vegetable access in community settings, and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs. Local health departments are on the "front line" of public health, and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities. © 2015 The Author(s).

Evidence-based diabetes prevention and control programs and policies in local health departments

PubMed Central

Zwald, Marissa; Elliott, Lindsay; Brownson, Ross C.; Skala, Mahree

2016-01-01

Purpose The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments; (2) assess feasibility of non-implemented diabetes prevention and control EBPPs; and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs. Methods An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation. Results One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members; increased fruit and vegetable access in community settings; and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs. Conclusions Local health departments are the “front line” of public health and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities. PMID:26297714

Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan

PubMed Central

2013-01-01

Background Knowledge translation strategies are an approach to increase the use of evidence within policy and practice decision-making contexts. In clinical and health service contexts, knowledge translation strategies have focused on individual behavior change, however the multi-system context of public health requires a multi-level, multi-strategy approach. This paper describes the design of and implementation plan for a knowledge translation intervention for public health decision making in local government. Methods Four preliminary research studies contributed findings to the design of the intervention: a systematic review of knowledge translation intervention effectiveness research, a scoping study of knowledge translation perspectives and relevant theory literature, a survey of the local government public health workforce, and a study of the use of evidence-informed decision-making for public health in local government. A logic model was then developed to represent the putative pathways between intervention inputs, processes, and outcomes operating between individual-, organizational-, and system-level strategies. This formed the basis of the intervention plan. Results The systematic and scoping reviews identified that effective and promising strategies to increase access to research evidence require an integrated intervention of skill development, access to a knowledge broker, resources and tools for evidence-informed decision making, and networking for information sharing. Interviews and survey analysis suggested that the intervention needs to operate at individual and organizational levels, comprising workforce development, access to evidence, and regular contact with a knowledge broker to increase access to intervention evidence; develop skills in appraisal and integration of evidence; strengthen networks; and explore organizational factors to build organizational cultures receptive to embedding evidence in practice. The logic model incorporated these inputs and strategies with a set of outcomes to measure the intervention’s effectiveness based on the theoretical frameworks, evaluation studies, and decision-maker experiences. Conclusion Documenting the design of and implementation plan for this knowledge translation intervention provides a transparent, theoretical, and practical approach to a complex intervention. It provides significant insights into how practitioners might engage with evidence in public health decision making. While this intervention model was designed for the local government context, it is likely to be applicable and generalizable across sectors and settings. Trial registration Australia New Zealand Clinical Trials Register ACTRN12609000953235. PMID:24107358

Using structured decision making to manage disease risk for Montana wildlife

USGS Publications Warehouse

Mitchell, Michael S.; Gude, Justin A.; Anderson, Neil J.; Ramsey, Jennifer M.; Thompson, Michael J.; Sullivan, Mark G.; Edwards, Victoria L.; Gower, Claire N.; Cochrane, Jean Fitts; Irwin, Elise R.; Walshe, Terry

2013-01-01

We used structured decision-making to develop a 2-part framework to assist managers in the proactive management of disease outbreaks in Montana, USA. The first part of the framework is a model to estimate the probability of disease outbreak given field observations available to managers. The second part of the framework is decision analysis that evaluates likely outcomes of management alternatives based on the estimated probability of disease outbreak, and applies managers' values for different objectives to indicate a preferred management strategy. We used pneumonia in bighorn sheep (Ovis canadensis) as a case study for our approach, applying it to 2 populations in Montana that differed in their likelihood of a pneumonia outbreak. The framework provided credible predictions of both probability of disease outbreaks, as well as biological and monetary consequences of management actions. The structured decision-making approach to this problem was valuable for defining the challenges of disease management in a decentralized agency where decisions are generally made at the local level in cooperation with stakeholders. Our approach provides local managers with the ability to tailor management planning for disease outbreaks to local conditions. Further work is needed to refine our disease risk models and decision analysis, including robust prediction of disease outbreaks and improved assessment of management alternatives.

Situating School District Resource Decision Making in Policy Context

ERIC Educational Resources Information Center

Spain, Angeline K.

2016-01-01

Decentralization and deregulation policies assume that local educational leaders make better resource decisions than state policy makers do. Conceptual models drawn from organizational theory, however, offer competing predictions about how district central office administrators are likely to leverage their professional expertise in devolved…

Negotiating Northern Resource Development Frontiers: People, Energy, and Decision-Making in Yamal

NASA Astrophysics Data System (ADS)

Osipov, Igor A.

This dissertation examines contemporary models of co-existence and partnerships negotiated between local communities, government, and resource corporations in the Russian District of Purovsky (Arctic Yamal), with a particular focus on the relations of these partnerships to Russia's wider socio-cultural and political contexts and, more broadly, the circumpolar world. Yamal has Eurasia's richest oil and gas reserves, and is an important crossroads region where various geopolitical and financial interests intersect. With the opening up of new gas and oil fields, and construction of roads and pipelines, Yamal is experiencing rapid changes; and is being challenged to reshape its many 'frontiers' in which people, energy, and decisions are closely linked to one another. Since the late 1970s, resource development projects have had significant impacts on the lives of the local people in the Purovsky tundra. Along with experiencing negative consequences, such as water and soil contamination, impacts on land, wildlife, and local communities have also nurtured creative ways of adaptation, decision-making, and self-organization. Since 1998, a number of unique models of co-existence and participatory dialogue, involving public project reviews, and sound participation of local indigenous activist groups have been developed and implemented in Yamal. Furthermore, during the past decade the Purovsky District has served as a unique decision-making polygon for the Northeastern Urals. Several joint community-industry-government political and economic cooperation models have been tested and their elements have subsequently been implemented in other Arctic Russian localities. From 2006-2008 this project was focused on documenting these important developments by investigating and explicating the on-the-ground models of agreement-making in the context that these models have been developing since the 1970s. This project, as such, strives to benefit the areas of anthropology, political science, rural economy, as well as Northern studies in indigenous-state-industry relations spectrums. More specifically, this research contributes to a better understanding of the forms of public participation, negotiation, local activism; and their interconnections to the broader sociopolitical context, rural economic capacity building, power relations, and decision-making environments that local communities, governments, and corporations create effective co-existence/partnership models.

Decision Support | Solar Research | NREL

Science.gov Websites

informed solar decision making with credible, objective, accessible, and timely resources. Solar Energy Decision Support Decision Support NREL provides technical and analytical support to support provide unbiased information on solar policies and issues for state and local government decision makers

Localising and tailoring research evidence helps public health decision making.

PubMed

van der Graaf, Peter; Cheetham, Mandy; McCabe, Karen; Rushmer, Rosemary

2018-05-29

Published research evidence is typically not readily applicable to practice but needs to be actively mobilised. This paper explores the mechanisms used by information professionals with a specific knowledge mobilisation role to make evidence useful for local decision making and planning of public health interventions. Data are drawn from a NIHR project that studied how, when, where and by whom published research evidence is used in commissioning and planning across two sites (one in England and one in Scotland). Data included 11 in-depth interviews with information professionals, observations at meetings and documentary analysis. Published research evidence is made fit for local commissioning and planning purposes by information professionals through two mechanisms. They localise evidence (relate evidence to local context and needs) and tailor it (present actionable messages). Knowledge mobilisation roles of information professionals are not recognised and researched. Information professionals contribute to the 'inform' and 'relational' functions of knowledge mobilisation; however, they are less involved in improving the institutional environment for sustainable knowledge sharing. Information professionals are instrumental in shaping what evidence enters local decision making processes. Identifying and supporting knowledge mobilisation roles within health libraries should be the focus of future research and training. © 2018 Health Libraries Group.

Knowledge Co-production Strategies for Water Resources Modeling and Decision Making

NASA Astrophysics Data System (ADS)

Gober, P.

2016-12-01

The limited impact of scientific information on policy making and climate adaptation in North America has raised awareness of the need for new modeling strategies and knowledge transfer processes. This paper outlines the rationale for a new paradigm in water resources modeling and management, using examples from the USA and Canada. Principles include anticipatory modeling, complex system dynamics, decision making under uncertainty, visualization, capacity to represent and manipulate critical trade-offs, stakeholder engagement, local knowledge, context-specific activities, social learning, vulnerability analysis, iterative and collaborative modeling, and the concept of a boundary organization. In this framework, scientists and stakeholders are partners in the production and dissemination of knowledge for decision making, and local knowledge is fused with scientific observation and methodology. Discussion draws from experience in building long-term collaborative boundary organizations in Phoenix, Arizona in the USA and the Saskatchewan River Basin (SRB) in Canada. Examples of boundary spanning activities include the use of visualization, the concept of a decision theater, infrastructure to support social learning, social networks, and reciprocity, simulation modeling to explore "what if" scenarios of the future, surveys to elicit how water problems are framed by scientists and stakeholders, and humanistic activities (theatrical performances, art exhibitions, etc.) to draw attention to local water issues. The social processes surrounding model development and dissemination are at least as important as modeling assumptions, procedures, and results in determining whether scientific knowledge will be used effectively for water resources decision making.

Cost-effectiveness on a local level: whether and when to adopt a new technology.

PubMed

Woertman, Willem H; Van De Wetering, Gijs; Adang, Eddy M M

2014-04-01

Cost-effectiveness analysis has become a widely accepted tool for decision making in health care. The standard textbook cost-effectiveness analysis focuses on whether to make the switch from an old or common practice technology to an innovative technology, and in doing so, it takes a global perspective. In this article, we are interested in a local perspective, and we look at the questions of whether and when the switch from old to new should be made. A new approach to cost-effectiveness from a local (e.g., a hospital) perspective, by means of a mathematical model for cost-effectiveness that explicitly incorporates time, is proposed. A decision rule is derived for establishing whether a new technology should be adopted, as well as a general rule for establishing when it pays to postpone adoption by 1 more period, and a set of decision rules that can be used to determine the optimal timing of adoption. Finally, a simple example is presented to illustrate our model and how it leads to optimal decision making in a number of cases.

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.

Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.

PubMed

Armstrong, Rebecca; Waters, Elizabeth; Moore, Laurence; Dobbins, Maureen; Pettman, Tahna; Burns, Cate; Swinburn, Boyd; Anderson, Laurie; Petticrew, Mark

2014-12-14

The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions. The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health. In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making. This study makes an important contribution to understanding how evidence is used within the public health LG context. ACTRN12609000953235.

District decision-making for health in low-income settings: a systematic literature review

PubMed Central

Avan, Bilal Iqbal

2016-01-01

Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages—identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely. PMID:27591202

Networking CD-ROMs: The Decision Maker's Guide to Local Area Network Solutions.

ERIC Educational Resources Information Center

Elshami, Ahmed M.

In an era when patrons want access to CD-ROM resources but few libraries can afford to buy multiple copies, CD-ROM local area networks (LANs) are emerging as a cost-effective way to provide shared access. To help librarians make informed decisions, this manual offers information on: (1) the basics of LANs, a "local area network primer";…

Cross-site comparison of land-use decision-making and its consequences across land systems with a generalized agent-based model.

PubMed

Magliocca, Nicholas R; Brown, Daniel G; Ellis, Erle C

2014-01-01

Local changes in land use result from the decisions and actions of land-users within land systems, which are structured by local and global environmental, economic, political, and cultural contexts. Such cross-scale causation presents a major challenge for developing a general understanding of how local decision-making shapes land-use changes at the global scale. This paper implements a generalized agent-based model (ABM) as a virtual laboratory to explore how global and local processes influence the land-use and livelihood decisions of local land-users, operationalized as settlement-level agents, across the landscapes of six real-world test sites. Test sites were chosen in USA, Laos, and China to capture globally-significant variation in population density, market influence, and environmental conditions, with land systems ranging from swidden to commercial agriculture. Publicly available global data were integrated into the ABM to model cross-scale effects of economic globalization on local land-use decisions. A suite of statistics was developed to assess the accuracy of model-predicted land-use outcomes relative to observed and random (i.e. null model) landscapes. At four of six sites, where environmental and demographic forces were important constraints on land-use choices, modeled land-use outcomes were more similar to those observed across sites than the null model. At the two sites in which market forces significantly influenced land-use and livelihood decisions, the model was a poorer predictor of land-use outcomes than the null model. Model successes and failures in simulating real-world land-use patterns enabled the testing of hypotheses on land-use decision-making and yielded insights on the importance of missing mechanisms. The virtual laboratory approach provides a practical framework for systematic improvement of both theory and predictive skill in land change science based on a continual process of experimentation and model enhancement.

Cross-Site Comparison of Land-Use Decision-Making and Its Consequences across Land Systems with a Generalized Agent-Based Model

PubMed Central

Magliocca, Nicholas R.; Brown, Daniel G.; Ellis, Erle C.

2014-01-01

Local changes in land use result from the decisions and actions of land-users within land systems, which are structured by local and global environmental, economic, political, and cultural contexts. Such cross-scale causation presents a major challenge for developing a general understanding of how local decision-making shapes land-use changes at the global scale. This paper implements a generalized agent-based model (ABM) as a virtual laboratory to explore how global and local processes influence the land-use and livelihood decisions of local land-users, operationalized as settlement-level agents, across the landscapes of six real-world test sites. Test sites were chosen in USA, Laos, and China to capture globally-significant variation in population density, market influence, and environmental conditions, with land systems ranging from swidden to commercial agriculture. Publicly available global data were integrated into the ABM to model cross-scale effects of economic globalization on local land-use decisions. A suite of statistics was developed to assess the accuracy of model-predicted land-use outcomes relative to observed and random (i.e. null model) landscapes. At four of six sites, where environmental and demographic forces were important constraints on land-use choices, modeled land-use outcomes were more similar to those observed across sites than the null model. At the two sites in which market forces significantly influenced land-use and livelihood decisions, the model was a poorer predictor of land-use outcomes than the null model. Model successes and failures in simulating real-world land-use patterns enabled the testing of hypotheses on land-use decision-making and yielded insights on the importance of missing mechanisms. The virtual laboratory approach provides a practical framework for systematic improvement of both theory and predictive skill in land change science based on a continual process of experimentation and model enhancement. PMID:24489696

Decision support for evidence-based integration of disease control: A proof of concept for malaria and schistosomiasis

PubMed Central

Graeden, Ellie; Kerr, Justin; Sorrell, Erin M.; Katz, Rebecca

2018-01-01

Managing infectious disease requires rapid and effective response to support decision making. The decisions are complex and require understanding of the diseases, disease intervention and control measures, and the disease-relevant characteristics of the local community. Though disease modeling frameworks have been developed to address these questions, the complexity of current models presents a significant barrier to community-level decision makers in using the outputs of the most scientifically robust methods to support pragmatic decisions about implementing a public health response effort, even for endemic diseases with which they are already familiar. Here, we describe the development of an application available on the internet, including from mobile devices, with a simple user interface, to support on-the-ground decision-making for integrating disease control programs, given local conditions and practical constraints. The model upon which the tool is built provides predictive analysis for the effectiveness of integration of schistosomiasis and malaria control, two diseases with extensive geographical and epidemiological overlap, and which result in significant morbidity and mortality in affected regions. Working with data from countries across sub-Saharan Africa and the Middle East, we present a proof-of-principle method and corresponding prototype tool to provide guidance on how to optimize integration of vertical disease control programs. This method and tool demonstrate significant progress in effectively translating the best available scientific models to support practical decision making on the ground with the potential to significantly increase the efficacy and cost-effectiveness of disease control. Author summary Designing and implementing effective programs for infectious disease control requires complex decision-making, informed by an understanding of the diseases, the types of disease interventions and control measures available, and the disease-relevant characteristics of the local community. Though disease modeling frameworks have been developed to address these questions and support decision-making, the complexity of current models presents a significant barrier to on-the-ground end users. The picture is further complicated when considering approaches for integration of different disease control programs, where co-infection dynamics, treatment interactions, and other variables must also be taken into account. Here, we describe the development of an application available on the internet with a simple user interface, to support on-the-ground decision-making for integrating disease control, given local conditions and practical constraints. The model upon which the tool is built provides predictive analysis for the effectiveness of integration of schistosomiasis and malaria control, two diseases with extensive geographical and epidemiological overlap. This proof-of-concept method and tool demonstrate significant progress in effectively translating the best available scientific models to support pragmatic decision-making on the ground, with the potential to significantly increase the impact and cost-effectiveness of disease control. PMID:29649260

Assessing the acceptability and usability of an interactive serious game in aiding treatment decisions for patients with localized prostate cancer.

PubMed

Reichlin, Lindsey; Mani, Nithya; McArthur, Kara; Harris, Amy M; Rajan, Nithin; Dacso, Clifford C

2011-01-12

Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men's awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers. This study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game. The study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey. A total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient's health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes. Serious games are a promising approach to health education and decision support for older men. Participants were receptive to the idea of a serious game as a decision aid in localized prostate cancer. However, usability issues are a major concern for this demographic, as is clarity and transparency of data sources.

Assessing the Acceptability and Usability of an Interactive Serious Game in Aiding Treatment Decisions for Patients with Localized Prostate Cancer

PubMed Central

2011-01-01

Background Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men’s awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers. Objective This study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game. Methods The study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey. Results A total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient’s health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes. Conclusions Serious games are a promising approach to health education and decision support for older men. Participants were receptive to the idea of a serious game as a decision aid in localized prostate cancer. However, usability issues are a major concern for this demographic, as is clarity and transparency of data sources. PMID:21239374

Sustainability in health care by allocating resources effectively (SHARE) 3: examining how resource allocation decisions are made, implemented and evaluated in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Brooke, Vanessa

2017-05-09

This is the third in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Leaders in a large Australian health service planned to establish an organisation-wide, systematic, integrated, evidence-based approach to disinvestment. In order to introduce new systems and processes for disinvestment into existing decision-making infrastructure, we aimed to understand where, how and by whom resource allocation decisions were made, implemented and evaluated. We also sought the knowledge and experience of staff regarding previous disinvestment activities. Structured interviews, workshops and document analysis were used to collect information from multiple sources in an environmental scan of decision-making systems and processes. Findings were synthesised using a theoretical framework. Sixty-eight respondents participated in interviews and workshops. Eight components in the process of resource allocation were identified: Governance, Administration, Stakeholder engagement, Resources, Decision-making, Implementation, Evaluation and, where appropriate, Reinvestment of savings. Elements of structure and practice for each component are described and a new framework was developed to capture the relationships between them. A range of decision-makers, decision-making settings, type and scope of decisions, criteria used, and strengths, weaknesses, barriers and enablers are outlined. The term 'disinvestment' was not used in health service decision-making. Previous projects that involved removal, reduction or restriction of current practices were driven by quality and safety issues, evidence-based practice or a need to find resource savings and not by initiatives where the primary aim was to disinvest. Measuring resource savings is difficult, in some situations impossible. Savings are often only theoretical as resources released may be utilised immediately by patients waiting for beds, clinic appointments or surgery. Decision-making systems and processes for resource allocation are more complex than assumed in previous studies. There is a wide range of decision-makers, settings, scope and type of decisions, and criteria used for allocating resources within a single institution. To our knowledge, this is the first paper to report this level of detail and to introduce eight components of the resource allocation process identified within a local health service.

Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study.

PubMed

Myers, Ronald E; Leader, Amy E; Censits, Jean Hoffman; Trabulsi, Edouard J; Keith, Scott W; Petrich, Anett M; Quinn, Anna M; Den, Robert B; Hurwitz, Mark D; Lallas, Costas D; Hegarty, Sarah E; Dicker, Adam P; Zeigler-Johnson, Charnita M; Giri, Veda N; Ayaz, Hasan; Gomella, Leonard G

2018-02-01

This study aimed to explore the effects of a decision support intervention (DSI) and shared decision making (SDM) on knowledge, perceptions about treatment, and treatment choice among men diagnosed with localized low-risk prostate cancer (PCa). At a multidisciplinary clinic visit, 30 consenting men with localized low-risk PCa completed a baseline survey, had a nurse-mediated online DS session to clarify preference for active surveillance (AS) or active treatment (AT), and met with clinicians for SDM. Participants also completed a follow-up survey at 30 days. We assessed change in treatment knowledge, decisional conflict, and perceptions and identified predictors of AS. At follow-up, participants exhibited increased knowledge (p < 0.001), decreased decisional conflict (p < 0.001), and more favorable perceptions of AS (p = 0.001). Furthermore, 25 of the 30 participants (83 %) initiated AS. Increased family and clinician support predicted this choice (p < 0.001). DSI/SDM prepared patients to make an informed decision. Perceived support of the decision facilitated patient choice of AS.

Long range healthcare capacity planning in the Netherlands. The case of radiotherapy.

PubMed

Postma, T J B M; Terpstra, S

2002-01-01

This contribution discusses centralization vs. decentralization in healthcare strategic decision making, focusing on long-range planning of facilities for radiotherapy. The radiotherapy case illustrates that more centralized, comprehensive, and systematic planning and strategic decisions making may be necessary to account for inputs of various parties and decision-making levels in this area. The expertise required cannot generally be found at a local or even regional level. It requires initiatives from coordinating healthcare institutions such as the Health Council and other professional organizations.

Superintendents and Principals Need Quality Public Information That Informs Decisions, Empowers Action. Don't Make Decisions in the Dark

ERIC Educational Resources Information Center

Data Quality Campaign, 2014

2014-01-01

District superintendents or school principals need to be able to access and use high-quality data to make good decisions. Often this data is collected and stored locally, but information that is publicly reported by the state can provide additional value. Although public reporting in a few states is designed to serve information needs, states'…

The Value of Participatory Decision-Making: A Collaborative Approach.

ERIC Educational Resources Information Center

Richardson, M. D.; And Others

This study investigated the practicality and feasibility of the public school administrator permitting those concerned, faculty, students, parents and interested citizens, to participate in the decision making process of the local school. An added purpose was to find applicable and effective ways the principal could support meaningful…

Engaging Pupils in Decision-Making about Biodiversity Conservation Issues

ERIC Educational Resources Information Center

Grace, Marcus; Byrne, Jenny

2010-01-01

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

Lessons learned in applying ecosystem goods and services to community decision making

EPA Science Inventory

This report is intended to describe lessons learned from the application of FEGS-based research in a series of PBS conducted by EPA’s Office of Research and Development (ORD) and make this information available and useful for planning future research into local decision sup...

REGIONAL VULNERABILITY ASSESSMENT (REVA) IMPROVING ENVIRONMENTAL DECISION MAKING THROUGH CLIENT PARTNERSHIPS

EPA Science Inventory

The Regional Vulnerability Assessment (ReV A) Program is an applied research program t,1at is focusing on using spatial information and model results to support environmental decision-making at regional- down to local-scales. Re VA has developed analysis and assessment methods to...

Joint federal research and development process to meet state and local needs. Part 1. Science and technology and political decision making

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

Wise, H F; Smith, L K; Einsweiler, R C

This part of the handbook addresses the basic how to do it - how states and local governments can identify complex and cross-cutting issues and develop and manage scientific and technical resources in seeking policy solutions to such issues. The following subjects are discussed: background statement of the issue; the research/decision-making process; defining problems and identifying research components; research and decision-making strategies; how to identify existing knowledge or ongoing research in the area of policy concern; and managing multi-disciplinary research. The fourteen agencies involved in this effort include: US Departments of Energy, Agriculture, Transportation, Housing and Urban Development, Environmental Protectionmore » Agency, and National Science Foundation. (PSB)« less

Effective dialogue: enhanced public engagement as a legitimising tool for municipal waste management decision-making.

PubMed

Garnett, Kenisha; Cooper, Tim

2014-12-01

The complexity of municipal waste management decision-making has increased in recent years, accompanied by growing scrutiny from stakeholders, including local communities. This complexity reflects a socio-technical framing of the risks and social impacts associated with selecting technologies and sites for waste treatment and disposal facilities. Consequently there is growing pressure on local authorities for stakeholders (including communities) to be given an early opportunity to shape local waste policy in order to encourage swift planning, development and acceptance of the technologies needed to meet statutory targets to divert waste from landfill. This paper presents findings from a research project that explored the use of analytical-deliberative processes as a legitimising tool for waste management decision-making. Adopting a mixed methods approach, the study revealed that communicating the practical benefits of more inclusive forms of engagement is proving difficult even though planning and policy delays are hindering development and implementation of waste management infrastructure. Adopting analytical-deliberative processes at a more strategic level will require local authorities and practitioners to demonstrate how expert-citizen deliberations may foster progress in resolving controversial issues, through change in individuals, communities and institutions. The findings suggest that a significant shift in culture will be necessary for local authorities to realise the potential of more inclusive decision processes. This calls for political actors and civic society to collaborate in institutionalising public involvement in both strategic and local planning structures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Introduction of new technologies and decision making processes: a framework to adapt a Local Health Technology Decision Support Program for other local settings.

PubMed

Poulin, Paule; Austen, Lea; Scott, Catherine M; Poulin, Michelle; Gall, Nadine; Seidel, Judy; Lafrenière, René

2013-01-01

Introducing new health technologies, including medical devices, into a local setting in a safe, effective, and transparent manner is a complex process, involving many disciplines and players within an organization. Decision making should be systematic, consistent, and transparent. It should involve translating and integrating scientific evidence, such as health technology assessment (HTA) reports, with context-sensitive evidence to develop recommendations on whether and under what conditions a new technology will be introduced. However, the development of a program to support such decision making can require considerable time and resources. An alternative is to adapt a preexisting program to the new setting. We describe a framework for adapting the Local HTA Decision Support Program, originally developed by the Department of Surgery and Surgical Services (Calgary, AB, Canada), for use by other departments. The framework consists of six steps: 1) development of a program review and adaptation manual, 2) education and readiness assessment of interested departments, 3) evaluation of the program by individual departments, 4) joint evaluation via retreats, 5) synthesis of feedback and program revision, and 6) evaluation of the adaptation process. Nine departments revised the Local HTA Decision Support Program and expressed strong satisfaction with the adaptation process. Key elements for success were identified. Adaptation of a preexisting program may reduce duplication of effort, save resources, raise the health care providers' awareness of HTA, and foster constructive stakeholder engagement, which enhances the legitimacy of evidence-informed recommendations for introducing new health technologies. We encourage others to use this framework for program adaptation and to report their experiences.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 7: supporting staff in evidence-based decision-making, implementation and evaluation in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Dyer, Tim; Brooke, Vanessa; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Gust, Anthony; Farjou, Dina

2017-06-21

This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects. From the literature and responses of local stakeholders it was clear that provision of expertise and education, training and support of health service staff would be required to achieve these aims. Four support services were proposed. This paper is a detailed case report of the development, implementation and evaluation of a Data Service, Capacity Building Service and Project Support Service. An Evidence Service is reported separately. Literature reviews, surveys, interviews, consultation and workshops were used to capture and process the relevant information. Existing theoretical frameworks were adapted for evaluation and explication of processes and outcomes. Surveys and interviews identified current practice in use of evidence in decision-making, implementation and evaluation; staff needs for evidence-based practice; nature, type and availability of local health service data; and preferred formats for education and training. The Capacity Building and Project Support Services were successful in achieving short term objectives; but long term outcomes were not evaluated due to reduced funding. The Data Service was not implemented at all. Factors influencing the processes and outcomes are discussed. Health service staff need access to education, training, expertise and support to enable evidence-based decision-making and to implement and evaluate the changes arising from those decisions. Three support services were proposed based on research evidence and local findings. Local factors, some unanticipated and some unavoidable, were the main barriers to successful implementation. All three proposed support services hold promise as facilitators of EBP in the local healthcare setting. The findings from this study will inform further exploration.

eHealth Literacy and Partner Involvement in Treatment Decision Making for Men With Newly Diagnosed Localized Prostate Cancer.

PubMed

Song, Lixin; Tatum, Kimberly; Greene, Giselle; Chen, Ronald C

2017-03-01

To examine how the eHealth literacy of partners of patients with newly diagnosed prostate cancer affects their involvement in decision making, and to identify the factors that influence their eHealth literacy.
. Cross-sectional exploratory study.
. North Carolina.
. 142 partners of men with newly diagnosed localized prostate cancer. 
. A telephone survey and descriptive and multiple linear regression analyses were used.
. The partners' eHealth literacy, involvement in treatment decision making, and demographics, and the health statuses of the patients and their partners. 
. Higher levels of eHealth literacy among partners were significantly associated with their involvement in getting a second opinion, their awareness of treatment options, and the size of the social network they relied on for additional information and support for treatment decision making for prostate cancer. The factor influencing eHealth literacy was the partners' access to the Internet for personal use, which explained some of the variance in eHealth literacy.
. This study described how partners' eHealth literacy influenced their involvement in treatment decision making for prostate cancer and highlighted the influencing factors (i.e., partners' access to the Internet for personal use).
. When helping men with prostate cancer and their partners with treatment decision making, nurses need to assess eHealth literacy levels to determine whether nonelectronically based education materials are needed and to provide clear instructions on how to use eHealth resources.

How normative interpretations of climate risk assessment affect local decision-making: an exploratory study at the city scale in Cork, Ireland.

PubMed

McDermott, T K J; Surminski, S

2018-06-13

Urban areas already suffer substantial losses in both economic and human terms from climate-related disasters. These losses are anticipated to grow substantially, in part as a result of the impacts of climate change. In this paper, we investigate the process of translating climate risk data into action for the city level. We apply a commonly used decision-framework as our backdrop and explore where in this process climate risk assessment and normative political judgements intersect. We use the case of flood risk management in Cork city in Ireland to investigate what is needed for translating risk assessment into action at the local city level. Evidence presented is based on focus group discussions at two stakeholder workshops, and a series of individual meetings and phone-discussions with stakeholders involved in local decision-making related to flood risk management and adaptation to climate change, in Ireland. Respondents were chosen on the basis of their expertise or involvement in the decision-making processes locally and nationally. Representatives of groups affected by flood risk and flood risk management and climate adaptation efforts were also included. The Cork example highlights that, despite ever more accurate data and an increasing range of theoretical approaches available to local decision-makers, it is the normative interpretation of this information that determines what action is taken. The use of risk assessments for decision-making is a process that requires normative decisions, such as setting 'acceptable risk levels' and identifying 'adequate' protection levels, which will not succeed without broader buy-in and stakeholder participation. Identifying and embracing those normative views up-front could strengthen the urban adaptation process-this may, in fact, turn out to be the biggest advantage of climate risk assessment: it offers an opportunity to create a shared understanding of the problem and enables an informed evaluation and discussion of remedial action.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Author(s).

How normative interpretations of climate risk assessment affect local decision-making: an exploratory study at the city scale in Cork, Ireland

NASA Astrophysics Data System (ADS)

McDermott, T. K. J.; Surminski, S.

2018-06-01

Urban areas already suffer substantial losses in both economic and human terms from climate-related disasters. These losses are anticipated to grow substantially, in part as a result of the impacts of climate change. In this paper, we investigate the process of translating climate risk data into action for the city level. We apply a commonly used decision-framework as our backdrop and explore where in this process climate risk assessment and normative political judgements intersect. We use the case of flood risk management in Cork city in Ireland to investigate what is needed for translating risk assessment into action at the local city level. Evidence presented is based on focus group discussions at two stakeholder workshops, and a series of individual meetings and phone-discussions with stakeholders involved in local decision-making related to flood risk management and adaptation to climate change, in Ireland. Respondents were chosen on the basis of their expertise or involvement in the decision-making processes locally and nationally. Representatives of groups affected by flood risk and flood risk management and climate adaptation efforts were also included. The Cork example highlights that, despite ever more accurate data and an increasing range of theoretical approaches available to local decision-makers, it is the normative interpretation of this information that determines what action is taken. The use of risk assessments for decision-making is a process that requires normative decisions, such as setting `acceptable risk levels' and identifying `adequate' protection levels, which will not succeed without broader buy-in and stakeholder participation. Identifying and embracing those normative views up-front could strengthen the urban adaptation process-this may, in fact, turn out to be the biggest advantage of climate risk assessment: it offers an opportunity to create a shared understanding of the problem and enables an informed evaluation and discussion of remedial action. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

Local Orientation and the Evolution of Foraging: Changes in Decision Making Can Eliminate Evolutionary Trade-offs

PubMed Central

van der Post, Daniel J.; Semmann, Dirk

2011-01-01

Information processing is a major aspect of the evolution of animal behavior. In foraging, responsiveness to local feeding opportunities can generate patterns of behavior which reflect or “recognize patterns” in the environment beyond the perception of individuals. Theory on the evolution of behavior generally neglects such opportunity-based adaptation. Using a spatial individual-based model we study the role of opportunity-based adaptation in the evolution of foraging, and how it depends on local decision making. We compare two model variants which differ in the individual decision making that can evolve (restricted and extended model), and study the evolution of simple foraging behavior in environments where food is distributed either uniformly or in patches. We find that opportunity-based adaptation and the pattern recognition it generates, plays an important role in foraging success, particularly in patchy environments where one of the main challenges is “staying in patches”. In the restricted model this is achieved by genetic adaptation of move and search behavior, in light of a trade-off on within- and between-patch behavior. In the extended model this trade-off does not arise because decision making capabilities allow for differentiated behavioral patterns. As a consequence, it becomes possible for properties of movement to be specialized for detection of patches with more food, a larger scale information processing not present in the restricted model. Our results show that changes in decision making abilities can alter what kinds of pattern recognition are possible, eliminate an evolutionary trade-off and change the adaptive landscape. PMID:21998571

Local orientation and the evolution of foraging: changes in decision making can eliminate evolutionary trade-offs.

PubMed

van der Post, Daniel J; Semmann, Dirk

2011-10-01

Information processing is a major aspect of the evolution of animal behavior. In foraging, responsiveness to local feeding opportunities can generate patterns of behavior which reflect or "recognize patterns" in the environment beyond the perception of individuals. Theory on the evolution of behavior generally neglects such opportunity-based adaptation. Using a spatial individual-based model we study the role of opportunity-based adaptation in the evolution of foraging, and how it depends on local decision making. We compare two model variants which differ in the individual decision making that can evolve (restricted and extended model), and study the evolution of simple foraging behavior in environments where food is distributed either uniformly or in patches. We find that opportunity-based adaptation and the pattern recognition it generates, plays an important role in foraging success, particularly in patchy environments where one of the main challenges is "staying in patches". In the restricted model this is achieved by genetic adaptation of move and search behavior, in light of a trade-off on within- and between-patch behavior. In the extended model this trade-off does not arise because decision making capabilities allow for differentiated behavioral patterns. As a consequence, it becomes possible for properties of movement to be specialized for detection of patches with more food, a larger scale information processing not present in the restricted model. Our results show that changes in decision making abilities can alter what kinds of pattern recognition are possible, eliminate an evolutionary trade-off and change the adaptive landscape.

Loosening the Reins: How Flexibility Policies Contribute to Student Achievement.

ERIC Educational Resources Information Center

Education Commission of the States, Denver, CO.

Many states give individual schools the authority to make decisions in response to local conditions while still meeting state and district goals. Providing flexibility to local decision-makers is also a potential means for improving student achievement. This report provides a snapshot of several states' recent experiences with flexibility and…

Multi-criteria development and incorporation into decision tools for health technology adoption.

PubMed

Poulin, Paule; Austen, Lea; Scott, Catherine M; Waddell, Cameron D; Dixon, Elijah; Poulin, Michelle; Lafrenière, René

2013-01-01

When introducing new health technologies, decision makers must integrate research evidence with local operational management information to guide decisions about whether and under what conditions the technology will be used. Multi-criteria decision analysis can support the adoption or prioritization of health interventions by using criteria to explicitly articulate the health organization's needs, limitations, and values in addition to evaluating evidence for safety and effectiveness. This paper seeks to describe the development of a framework to create agreed-upon criteria and decision tools to enhance a pre-existing local health technology assessment (HTA) decision support program. The authors compiled a list of published criteria from the literature, consulted with experts to refine the criteria list, and used a modified Delphi process with a group of key stakeholders to review, modify, and validate each criterion. In a workshop setting, the criteria were used to create decision tools. A set of user-validated criteria for new health technology evaluation and adoption was developed and integrated into the local HTA decision support program. Technology evaluation and decision guideline tools were created using these criteria to ensure that the decision process is systematic, consistent, and transparent. This framework can be used by others to develop decision-making criteria and tools to enhance similar technology adoption programs. The development of clear, user-validated criteria for evaluating new technologies adds a critical element to improve decision-making on technology adoption, and the decision tools ensure consistency, transparency, and real-world relevance.

Engaging Undergraduates in Soil Sustainability Decision-Making through an InTeGrate Module

ERIC Educational Resources Information Center

Fortner, Sarah K.; Scherer, Hannah H.; Murphy, Martha A.

2016-01-01

Continued agricultural productivity hinges on understanding how to manage soil resources. A 2-week undergraduate introductory-level module: "A Growing Concern: Sustaining Soil Resources Through Local Decision Making" was collaboratively developed through the InTeGrate Project. InTeGrate modules and courses engage students in grand…

Developing Effective Boards, Councils and Commissions. Revised.

ERIC Educational Resources Information Center

Dyer, Delwyn A.; Williams, Oscar M.

Effective board operations are an art as well as a science. Local advisory boards or governing boards/councils refer to active, duly organized, and representative bodies that hold regular meetings and make decisions on behalf of the membership, and whose members serve without pay. Advisory boards assist those who make organizational decisions but…

Responding to the Gulf War: A Case Study of Instructional Decision Making.

ERIC Educational Resources Information Center

Merryfield, Merry M.

1993-01-01

Reports on study of teacher decision making regarding instruction about Gulf War. Finds teachers were influenced by student grade level, number of students in class from another culture, and their own knowledge of Middle Eastern history and geography. Concludes that local and state curriculum officials should provide more flexibility so teachers…

Student's Local Top-Up Higher Education Choices

ERIC Educational Resources Information Center

Agbola, Frank W.; Cheng, Calvin

2017-01-01

Making decisions about education choices is challenging and difficult for students. Utilising the theory of reasoned action, we specify and estimate a conceptual framework that captures the cognitive process of decision making of students in choosing top-up higher degrees in Hong Kong. Top-up higher or bachelor's degrees are top-up undergraduate…

Anthropology, knowledge-flows and global health.

PubMed

Feierman, S; Kleinman, A; Stewart, K; Farmer, D; Das, V

2010-01-01

Global health programmes are damaged by blockages in the upward flow of information from localities and regional centres about realities of professional practice and about patients' lives and conditions of treatment. Power differentials between local actors and national or international decision-makers present further obstacles to effective action. Anthropological research and action, in its most effective current forms, make important contributions to these issues. This research often continues over the long term, intensively. It can be multi-sited, studying actors at local, national and international levels simultaneously. It studies the relative knowledge and power of impoverished patients and global decision-makers, all within a single frame. By doing so, anthropological research is capable of providing new and important insights on the diverse meanings of patient decision-making, informed consent, non-compliance, public health reporting, the building of political coalitions for health and many other issues.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-05

This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally. This paper outlines the investigation of potential settings and methods for decision-making about disinvestment in the context of an Australian health service. Methods include a literature review on the concepts and terminology relating to disinvestment, a survey of national and international researchers, and interviews and workshops with local informants. A conceptual framework was drafted and refined with stakeholder feedback. There is a lack of common terminology regarding definitions and concepts related to disinvestment and no guidance for an organisation-wide systematic approach to disinvestment in a local healthcare service. A summary of issues from the literature and respondents highlight the lack of theoretical knowledge and practical experience and provide a guide to the information required to develop future models or methods for disinvestment in the local context. A conceptual framework was developed. Three mechanisms that provide opportunities to introduce disinvestment decisions into health service systems and processes were identified. Presented in order of complexity, time to achieve outcomes and resources required they include 1) Explicit consideration of potential disinvestment in routine decision-making, 2) Proactive decision-making about disinvestment driven by available evidence from published research and local data, and 3) Specific exercises in priority setting and system redesign. This framework identifies potential opportunities to initiate disinvestment activities in a systematic integrated approach that can be applied across a whole organisation using transparent, evidence-based methods. Incorporating considerations for disinvestment into existing decision-making systems and processes might be achieved quickly with minimal cost; however establishment of new systems requires research into appropriate methods and provision of appropriate skills and resources to deliver them.

The precuneus may encode irrationality in human gambling.

PubMed

Sacre, P; Kerr, M S D; Subramanian, S; Kahn, K; Gonzalez-Martinez, J; Johnson, M A; Sarma, S V; Gale, J T

2016-08-01

Humans often make irrational decisions, especially psychiatric patients who have dysfunctional cognitive and emotional circuitry. Understanding the neural basis of decision-making is therefore essential towards patient management, yet current studies suffer from several limitations. Functional magnetic resonance imaging (fMRI) studies in humans have dominated decision-making neuroscience, but have poor temporal resolution and the blood oxygenation level-dependent signal is only a proxy for neural activity. On the other hand, lesion studies in humans used to infer functionality in decision-making lack characterization of neural activity altogether. Using a combination of local field potential recordings in human subjects performing a financial decision-making task, spectral analyses, and non-parametric cluster statistics, we analyzed the activity in the precuneus. In nine subjects, the neural activity modulated significantly between rational and irrational trials in the precuneus (p <; 0.001). In particular, high-frequency activity (70-100 Hz) increased when irrational decisions were made. Although preliminary, these results suggest suppression of gamma rhythms via electrical stimulation in the precuneus as a therapeutic intervention for pathological decision-making.

[Decision-making process and health management councils: theoretical approaches].

PubMed

Wendhausen, Agueda; Cardoso, Sandra de Mello

2007-01-01

With the institutionalization of participation in health, through conferences and management councils at national, state, municipal and local levels, a process of democratization is initiated in the health area. However, in relation to the health councils in particular, there is still much to be done, including improving the quality of the decision-making process. This work aims to place the decision-making process in its theoretical context in terms of participatory democracy, elements which make up, factors which influence its development, and finally, to explore some possibilities of this theoretical basis to analyze the practices of the health councils in the area of health. It is hoped that it will make a theoretical contribution to the analyses carried out in this area, in order to provide a decision-making process that is more inclusive in terms of participation.

Complexity reduction of rate-equations models for two-choice decision-making.

PubMed

Carrillo, José Antonio; Cordier, Stéphane; Deco, Gustavo; Mancini, Simona

2013-01-01

We are concerned with the complexity reduction of a stochastic system of differential equations governing the dynamics of a neuronal circuit describing a decision-making task. This reduction is based on the slow-fast behavior of the problem and holds on the whole phase space and not only locally around the spontaneous state. Macroscopic quantities, such as performance and reaction times, computed applying this reduction are in agreement with previous works in which the complexity reduction is locally performed at the spontaneous point by means of a Taylor expansion.

Skill Transfer and Virtual Training for IND Response Decision-Making: Analysis of Decision-Making Skills for Large Scale Incidents

DTIC Science & Technology

2016-01-01

issues comes from the Fukushima Daiichi nuclear disaster (2011). The local medical health professional on staff at the U.S. embassy in Tokyo was not...distribution unlimited. This page intentionally left blank. iii EXECUTIVE SUMMARY An improvised nuclear device (IND...from the phase one analysis are as follows : • There is strong consistency in both the key decisions and underlying skills emphasized by emergency

The politics of local hospital reform: a case study of hospital reorganization following the 2002 Norwegian hospital reform.

PubMed

Tjerbo, Trond

2009-11-20

The Norwegian hospital reform of 2002 was an attempt to make restructuring of hospitals easier by removing politicians from the decision-making processes. To facilitate changes seen as necessary but politically difficult, the central state took over ownership of the hospitals and stripped the county politicians of what had been their main responsibility for decades. This meant that decisions regarding hospital structure and organization were now being taken by professional administrators and not by politically elected representatives. The question raised here is whether this has had any effect on the speed of restructuring of the hospital sector. The empirical part is a case study of the restructuring process in Innlandet Hospital Trust (IHT), which was one of the largest enterprise established after the hospital reform and where the vision for restructuring was clearly set. Different sources of qualitative data are used in the analysis. These include interviews with key actors, observational data and document studies. The analysis demonstrates how the new professional leaders at first acted in accordance with the intentions of the hospital reform, but soon chose to avoid the more ambitious plans for restructuring the hospital structure and in fact reintroduced local politics into the decision-making process. The analysis further illustrates how local networks and engagement of political representatives from all levels of government complicated the decision-making process surrounding local structural reforms. Local political representatives teamed up with other actors and created powerful networks. At the same time, national politicians had incentives to involve themselves in the processes as supporters of the status quo. Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did not necessarily facilitate reforms in the hospital structure. Keeping politics at an arm's length may simply be unrealistic and further complicate the politics of local hospital reforms.

The politics of local hospital reform: a case study of hospital reorganization following the 2002 Norwegian hospital reform

PubMed Central

2009-01-01

Background The Norwegian hospital reform of 2002 was an attempt to make restructuring of hospitals easier by removing politicians from the decision-making processes. To facilitate changes seen as necessary but politically difficult, the central state took over ownership of the hospitals and stripped the county politicians of what had been their main responsibility for decades. This meant that decisions regarding hospital structure and organization were now being taken by professional administrators and not by politically elected representatives. The question raised here is whether this has had any effect on the speed of restructuring of the hospital sector. Method The empirical part is a case study of the restructuring process in Innlandet Hospital Trust (IHT), which was one of the largest enterprise established after the hospital reform and where the vision for restructuring was clearly set. Different sources of qualitative data are used in the analysis. These include interviews with key actors, observational data and document studies. Results The analysis demonstrates how the new professional leaders at first acted in accordance with the intentions of the hospital reform, but soon chose to avoid the more ambitious plans for restructuring the hospital structure and in fact reintroduced local politics into the decision-making process. The analysis further illustrates how local networks and engagement of political representatives from all levels of government complicated the decision-making process surrounding local structural reforms. Local political representatives teamed up with other actors and created powerful networks. At the same time, national politicians had incentives to involve themselves in the processes as supporters of the status quo. Conclusion Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did not necessarily facilitate reforms in the hospital structure. Keeping politics at an arm's length may simply be unrealistic and further complicate the politics of local hospital reforms. PMID:19930553

District decision-making for health in low-income settings: a systematic literature review.

PubMed

Wickremasinghe, Deepthi; Hashmi, Iram Ejaz; Schellenberg, Joanna; Avan, Bilal Iqbal

2016-09-01

Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages-identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The Effects of Safety Information on Aeronautical Decision Making

NASA Technical Reports Server (NTRS)

Lee, Jang R.; Fanjoy, Richard O.; Dillman, Brian G.

2005-01-01

The importance of aeronautical decision making (ADM) has been considered one of the most critical issues of flight education for future professional pilots. Researchers have suggested that a safety information system based on information from incidents and near misses is an important tool to improve the intelligence and readiness of pilots. This paper describes a study that examines the effect of safety information on aeronautical decision making for students in a collegiate flight program. Data was collected from study participants who were exposed to periodic information about local aircraft malfunctions. Participants were then evaluated using a flight simulator profile and a pen and pencil test of situational judgment. Findings suggest that regular access to the described safety information program significantly improves decision making of student pilots.

Rural and remote young people's health career decision making within a health workforce development program: a qualitative exploration.

PubMed

Kumar, Koshila; Jones, Debra; Naden, Kathryn; Roberts, Chris

2015-01-01

One strategy aimed at resolving ongoing health workforce shortages in rural and remote settings has been to implement workforce development initiatives involving the early activation and development of health career aspirations and intentions among young people in these settings. This strategy aligns with the considerable evidence showing that rural background is a strong predictor of rural practice intentions and preferences. The Broken Hill Regional Health Career Academy Program (BHRHCAP) is an initiative aimed at addressing local health workforce challenges by helping young people in the region develop and further their health career aspirations and goals. This article reports the factors impacting on rural and remote youths' health career decision-making within the context of a health workforce development program. Data were collected using interviews and focus groups with a range of stakeholders involved in the BHRHCAP including local secondary school students, secondary school teachers, career advisors, school principals, parents, and pre-graduate health students undertaking a clinical placement in Broken Hill, and local clinicians. Data interpretation was informed by the theoretical constructs articulated within socio cognitive career theory. Young people's career decision-making in the context of a local health workforce development program was influenced by a range of personal, contextual and experiential factors. These included personal factors related to young people's career goals and motivations and their confidence to engage in career decision-making, contextual factors related to BHRHCAP program design and structure as well as the visibility and accessibility of health career pathways in a rural setting, and experiential factors related to the interaction and engagement between young people and role models or influential others in the health and education sectors. This study provided theoretical insight into the broader range of interrelating and complex personal, contextual and experiential factors impacting on rural and remote youths' career decision-making within a health workforce development initiative.

The Political Effects of Site-Based Decision Making on Local School Governance in the State of Texas.

ERIC Educational Resources Information Center

Lutz, Frank W.; Iden, Robert M.

As Texas public schools undertake their third year of implementing site-based decision making (SBDM), it becomes increasingly important to examine the extent to which SBDM has achieved its purported goals. This paper examined how Texas public school districts might effect mandated governance changes through the political phenomenon known as…

Parent Decision-Making When Selecting Schools: The Case of Nepal

ERIC Educational Resources Information Center

Joshi, Priyadarshani

2014-01-01

This paper analyzes the parent decision-making processes underlying school selection in Nepal. The analysis is based on primary survey and focus group data collected from parent meetings in diverse local education markets in two districts of Nepal in 2011. It highlights three main arguments that are less frequently discussed in the context of…

Attitudes and Factors that Influence Decision-Making in Adoption from Care in Northern Ireland

ERIC Educational Resources Information Center

Barr, Lily

2004-01-01

This is a small-scale local study aimed at exploring the thinking and attitudes that inform or influence decision-making around proceeding to adoption. It also sought to explore or establish practitioners' views of potential tensions in this area and potential supports. It included open questions, attitudinal questions and required respondents to…

Collective decision-making in microbes

PubMed Central

Ross-Gillespie, Adin; Kümmerli, Rolf

2014-01-01

Microbes are intensely social organisms that routinely cooperate and coordinate their activities to express elaborate population level phenotypes. Such coordination requires a process of collective decision-making, in which individuals detect and collate information not only from their physical environment, but also from their social environment, in order to arrive at an appropriately calibrated response. Here, we present a conceptual overview of collective decision-making as it applies to all group-living organisms; we introduce key concepts and principles developed in the context of animal and human group decisions; and we discuss, with appropriate examples, the applicability of each of these concepts in microbial contexts. In particular, we discuss the roles of information pooling, control skew, speed vs. accuracy trade-offs, local feedbacks, quorum thresholds, conflicts of interest, and the reliability of social information. We conclude that collective decision-making in microbes shares many features with collective decision-making in higher taxa, and we call for greater integration between this fledgling field and other allied areas of research, including in the humanities and the physical sciences. PMID:24624121

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

PubMed

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

2010-01-01

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

Modelling emergency decisions: recognition-primed decision making. The literature in relation to an ophthalmic critical incident.

PubMed

Bond, Susan; Cooper, Simon

2006-08-01

To review and reflect on the literature on recognition-primed decision (RPD) making and influences on emergency decisions with particular reference to an ophthalmic critical incident involving the sub-arachnoid spread of local anaesthesia following the peribulbar injection. This paper critics the literature on recognition-primed decision making, with particular reference to emergency situations. It illustrates the findings by focussing on an ophthalmic critical incident. Systematic literature review with critical incident reflection. Medline, CINAHL and PsychINFO databases were searched for papers on recognition-primed decision making (1996-2004) followed by the 'snowball method'. Studies were selected in accordance with preset criteria. A total of 12 papers were included identifying the recognition-primed decision making as a good theoretical description of acute emergency decisions. In addition, cognitive resources, situational awareness, stress, team support and task complexity were identified as influences on the decision process. Recognition-primed decision-making theory describes the decision processes of experts in time-bound emergency situations and is the foundation for a model of emergency decision making (Fig. 2). Decision theory and models, in this case related to emergency situations, inform practice and enhance clinical effectiveness. The critical incident described highlights the need for nurses to have a comprehensive and in-depth understanding of anaesthetic techniques as well as an ability to manage and resuscitate patients autonomously. In addition, it illustrates how the critical incidents should influence the audit cycle with improvements in patient safety.

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

NASA Astrophysics Data System (ADS)

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

2014-05-01

Natural hazard risk management requires decision making in several stages. Decision making on alternatives for risk reduction planning starts with an intelligence phase for recognition of the decision problems and identifying the objectives. Development of the alternatives and assigning the variable by decision makers to each alternative are employed to the design phase. Final phase evaluates the optimal choice by comparing the alternatives, defining indicators, assigning a weight to each and ranking them. This process is referred to as Multi-Criteria Decision Making analysis (MCDM), Multi-Criteria Evaluation (MCE) or Multi-Criteria Analysis (MCA). In the framework of the ongoing 7th Framework Program "CHANGES" (2011-2014, Grant Agreement No. 263953) of the European Commission, a Spatial Decision Support System is under development, that has the aim to analyse changes in hydro-meteorological risk and provide support to selecting the best risk reduction alternative. This paper describes the module for Multi-Criteria Decision Making analysis (MCDM) that incorporates monetary and non-monetary criteria in the analysis of the optimal alternative. The MCDM module consists of several components. The first step is to define criteria (or Indicators) which are subdivided into disadvantages (criteria that indicate the difficulty for implementing the risk reduction strategy, also referred to as Costs) and advantages (criteria that indicate the favorability, also referred to as benefits). In the next step the stakeholders can use the developed web-based tool for prioritizing criteria and decision matrix. Public participation plays a role in decision making and this is also planned through the use of a mobile web-version where the general local public can indicate their agreement on the proposed alternatives. The application is being tested through a case study related to risk reduction of a mountainous valley in the Alps affected by flooding. Four alternatives are evaluated in this case study namely: construction of defense structures, relocation, implementation of an early warning system and spatial planning regulations. Some of the criteria are determined partly in other modules of the CHANGES SDSS, such as the costs for implementation, the risk reduction in monetary values, and societal risk. Other criteria, which could be environmental, economic, cultural, perception in nature, are defined by different stakeholders such as local authorities, expert organizations, private sector, and local public. In the next step, the stakeholders weight the importance of the criteria by pairwise comparison and visualize the decision matrix, which is a matrix based on criteria versus alternatives values. Finally alternatives are ranked by Analytic Hierarchy Process (AHP) method. We expect that this approach will help the decision makers to ease their works and reduce their costs, because the process is more transparent, more accurate and involves a group decision. In that way there will be more confidence in the overall decision making process. Keywords: MCDM, Analytic Hierarchy Process (AHP), SDSS, Natural Hazard Risk Management

24 CFR 55.20 - Decision making process.

Code of Federal Regulations, 2012 CFR

2012-04-01

... appropriate local printed news medium, and must be sent to federal, state, and local public agencies... technological alternatives, hazard reduction methods and related mitigation costs, and environmental impacts. (d...

24 CFR 55.20 - Decision making process.

Code of Federal Regulations, 2013 CFR

2013-04-01

... appropriate local printed news medium, and must be sent to federal, state, and local public agencies... technological alternatives, hazard reduction methods and related mitigation costs, and environmental impacts. (d...

Hierarchical analysis of bridge decision makers : the role of new technology adoption in the timber bridge market : special project fiscal year 1992

DOT National Transportation Integrated Search

1995-08-01

Bridge design engineers and local highway officials make bridge replacement decisions across the : United States. The Analytical Hierarchy Process was used to characterize the bridge material selection : decision of these individuals. State Departmen...

Strategic planning decision making using fuzzy SWOT-TOPSIS with reliability factor

NASA Astrophysics Data System (ADS)

Mohamad, Daud; Afandi, Nur Syamimi; Kamis, Nor Hanimah

2015-10-01

Strategic planning is a process of decision making and action for long-term activities in an organization. The Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis has been commonly used to help organizations in strategizing their future direction by analyzing internal and external environment. However, SWOT analysis has some limitations as it is unable to prioritize appropriately the multiple alternative strategic decisions. Some efforts have been made to solve this problem by incorporating Multi Criteria Decision Making (MCDM) methods. Nevertheless, another important aspect has raised concerns on obtaining the decision that is the reliability of the information. Decision makers evaluate differently depending on their level of confidence or sureness in the evaluation. This study proposes a decision making procedure for strategic planning using SWOT-TOPSIS method by incorporating the reliability factor of the evaluation based on Z-number. An example using a local authority in the east coast of Malaysia is illustrated to determine the strategic options ranking and to prioritize factors in each SWOT category.

Stakeholder Attitudes, Knowledge and Engagement in Local Road Systems Planning and Decision Making

DOT National Transportation Integrated Search

2017-10-01

Political and policy dynamics associated with local road systems planning, management, and financing merit special attention. This study: 1) analyzes stakeholder attitudes, knowledge, and engagement about financing for local road system management, t...

Staggering successes amid controversy in California water management

NASA Astrophysics Data System (ADS)

Lund, J. R.

2012-12-01

Water in California has always been important and controversial, and it probably always will be. California has a large, growing economy and population in a semi-arid climate. But California's aridity, hydrologic variability, and water controversies have not precluded considerable economic successes. The successes of California's water system have stemmed from the decentralization of water management with historically punctuated periods of more centralized strategic decision-making. Decentralized management has allowed California's water users to efficiently explore incremental solutions to water problems, ranging from early local development of water systems (such as Hetch Hetchy, Owens Valley, and numerous local irrigation projects) to more contemporary efforts at water conservation, water markets, wastewater reuse, and conjunctive use of surface and groundwater. In the cacophony of local and stakeholder interests, strategic decisions have been more difficult, and consequently occur less frequently. California state water projects and Sacramento Valley flood control are examples where decades of effort, crises, floods and droughts were needed to mobilize local interests to agree to major strategic decisions. Currently, the state is faced with making strategic environmental and water management decisions regarding its deteriorating Sacramento-San Joaquin Delta. Not surprisingly, human uncertainties and physical and fiscal non-stationarities dominate this process.

Planning for outdoor play: Government and family decision-making.

PubMed

Sterman, Julia J; Naughton, Geraldine A; Bundy, Anita C; Froude, Elspeth; Villeneuve, Michelle A

2018-03-08

Despite indisputable developmental benefits of outdoor play, children with disabilities can experience play inequity. Play decisions are multifactorial; influenced by children's skills and their familial and community environments. Government agencies have responsibilities for equity and inclusion of people with disabilities; including in play. This multiple-perspective case study aimed to understand outdoor play decision-making for children with disabilities from the perspectives and interactions of: local government and families of primary school-aged children with disabilities. Five mothers, four local government employees, and two not-for-profit organization representatives participated in semi-structured interviews. Inductive and iterative analyzes involved first understanding perspectives of individuals, then stakeholders (local government and families), and finally similarities and differences through cross-case analysis. Local government focused more on physical access, than social inclusion. Local government met only minimal requirements and had little engagement with families. This resulted in poor understanding and action around family needs and preferences when designing public outdoor play spaces. To increase meaningful choice and participation in outdoor play, government understanding of family values and agency around engagement with local government needs to improve. Supporting familial collective capabilities requires understanding interactions between individuals, play, disability, and outdoor play environments.

Teacher Roles in the Process of Critical Thinking/Decision Making Skills Development among Elementary/Secondary Students in the Social Studies Curriculum.

ERIC Educational Resources Information Center

Peters, Richard

Today's students must be aware of local, regional, national, and international issues, problems, situations, and cultural diversities. This paper presents curriculum ideas for involving elementary and secondary students in classroom inquiry processes and in field-based settings in order to teach them to think critically, make decisions, act, and…

Decision-Making and Residence on Tagtabon Island. Working Paper of the Language Behavior Research Laboratory, No. 17.

ERIC Educational Resources Information Center

Geoghegan, William H.

This paper demonstrates, with reference to the Samal of Tagtabon Island, how the structure of local domestic groups and the statistical distribution of residence types can be derived from a detailed description of the decision rules used by Samal native actors themselves in making, evaluating and predicting residence choices. Considering the…

Financial Management and Control for Decision Making in Urban Local Bodies in India Using Statistical Techniques

NASA Astrophysics Data System (ADS)

Bhattacharyya, Sidhakam; Bandyopadhyay, Gautam

2010-10-01

The council of most of the Urban Local Bodies (ULBs) has a limited scope for decision making in the absence of appropriate financial control mechanism. The information about expected amount of own fund during a particular period is of great importance for decision making. Therefore, in this paper, efforts are being made to present set of findings and to establish a model of estimating receipts of own sources and payments thereof using multiple regression analysis. Data for sixty months from a reputed ULB in West Bengal have been considered for ascertaining the regression models. This can be used as a part of financial management and control procedure by the council to estimate the effect on own fund. In our study we have considered two models using multiple regression analysis. "Model I" comprises of total adjusted receipt as the dependent variable and selected individual receipts as the independent variables. Similarly "Model II" consists of total adjusted payments as the dependent variable and selected individual payments as independent variables. The resultant of Model I and Model II is the surplus or deficit effecting own fund. This may be applied for decision making purpose by the council.

Models, Measurements, and Local Decisions: Assessing and Addressing Impacts from Port Expansion and Traffic Activity

EPA Science Inventory

This presentation includes a combination of modeling and measurement results to characterize near-source air quality in Newark, New Jersey with consideration of how this information could be used to inform decision making to reduce risk of health impacts. Decisions could include ...

School Boards as Policy-Makers.

ERIC Educational Resources Information Center

Coleman, Peter

Decision-making in general and policy decisions in particular are the prime responsibility of school boards because policies are control mechanisms by which trustees assert local control. Policy decisions differ from others in their concern with values and purposes and the legitimization of the organization to society at large. Additionally, they…

Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice.

PubMed

Hajjaj, F M; Salek, M S; Basra, M K A; Finlay, A Y

2010-05-01

This article reviews an aspect of daily clinical practice which is of critical importance in virtually every clinical consultation, but which is seldom formally considered. Non-clinical influences on clinical decision-making profoundly affect medical decisions. These influences include patient-related factors such as socioeconomic status, quality of life and patient's expectations and wishes, physician-related factors such as personal characteristics and interaction with their professional community, and features of clinical practice such as private versus public practice as well as local management policies. This review brings together the different strands of knowledge concerning non-clinical influences on clinical decision-making. This aspect of decision-making may be the biggest obstacle to the reality of practising evidence-based medicine. It needs to be understood in order to develop clinical strategies that will facilitate the practice of evidence-based medicine.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 11: reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Ramsey, Wayne; King, Richard; Green, Sally

2018-05-30

This is the final paper in a thematic series reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was established to explore a systematic, integrated, evidence-based organisation-wide approach to disinvestment in a large Australian health service network. This paper summarises the findings, discusses the contribution of the SHARE Program to the body of knowledge and understanding of disinvestment in the local healthcare setting, and considers implications for policy, practice and research. The SHARE program was conducted in three phases. Phase One was undertaken to understand concepts and practices related to disinvestment and the implications for a local health service and, based on this information, to identify potential settings and methods for decision-making about disinvestment. The aim of Phase Two was to implement and evaluate the proposed methods to determine which were sustainable, effective and appropriate in a local health service. A review of the current literature incorporating the SHARE findings was conducted in Phase Three to contribute to the understanding of systematic approaches to disinvestment in the local healthcare context. SHARE differed from many other published examples of disinvestment in several ways: by seeking to identify and implement disinvestment opportunities within organisational infrastructure rather than as standalone projects; considering disinvestment in the context of all resource allocation decisions rather than in isolation; including allocation of non-monetary resources as well as financial decisions; and focusing on effective use of limited resources to optimise healthcare outcomes. The SHARE findings provide a rich source of new information about local health service decision-making, in a level of detail not previously reported, to inform others in similar situations. Multiple innovations related to disinvestment were found to be acceptable and feasible in the local setting. Factors influencing decision-making, implementation processes and final outcomes were identified; and methods for further exploration, or avoidance, in attempting disinvestment in this context are proposed based on these findings. The settings, frameworks, models, methods and tools arising from the SHARE findings have potential to enhance health care and patient outcomes.

Factors affecting evidence-based decision making in local health departments.

PubMed

Sosnowy, Collette D; Weiss, Linda J; Maylahn, Christopher M; Pirani, Sylvia J; Katagiri, Nancy J

2013-12-01

Data indicating the extent to which evidence-based decision making (EBDM) is used in local health departments (LHDs) are limited. This study aims to determine use of decision-making processes by New York State LHD leaders and upper-level staff and identify facilitators and barriers to the use of EBDM in LHDs. The New York Public Health Practice-Based Research Network implemented a mixed-methods study in 31 LHDs. There were 20 individual interviews; five small-group interviews (two or three participants each); and two focus groups (eight participants each) conducted with people who had decision-making authority. Information was obtained about each person's background and position, decision-making responsibilities, how decisions are made within their LHD, knowledge and experience with EBDM, use of each step of the EBDM process, and barriers and facilitators to EBDM implementation. Data were collected from June to November 2010 and analyzed in 2011. Overall, participants supported EBDM and expressed a desire to increase their department's use of it. Although most people understood the concept, a relatively small number had substantial expertise and experience with its practice. Many indicated that they applied EBDM unevenly. Factors associated with use of EBDM included strong leadership; workforce capacity (number and skills); resources; funding and program mandates; political support; and access to data and program models suitable to community conditions. EBDM is used inconsistently in LHDs in New York. Despite knowledge and interest among LHD leadership, the LHD capacity, resources, appropriate programming, and other issues serve as impediments to EBDM and optimal implementation of evidence-based strategies. Published by Elsevier Inc.

Decision Processes and Determinants of Hospital Evacuation and Shelter-in-Place During Hurricane Sandy.

PubMed

McGinty, Meghan D; Burke, Thomas A; Resnick, Beth; Barnett, Daniel J; Smith, Katherine C; Rutkow, Lainie

Evacuation and shelter-in-place decision making for hospitals is complex, and existing literature contains little information about how these decisions are made in practice. To describe decision-making processes and identify determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. Semistructured interviews were conducted from March 2014 to February 2015 with key informants who had authority and responsibility for evacuation and shelter-in-place decisions for hospitals during Hurricane Sandy in 2012. Interviews were recorded, transcribed, and thematically analyzed. Interviewees included hospital executives and state and local public health, emergency management, and emergency medical service officials from Delaware, Maryland, New Jersey, and New York. Interviewees identified decision processes and determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. We interviewed 42 individuals from 32 organizations. Decisions makers reported relying on their instincts rather than employing guides or tools to make evacuation and shelter-in-place decisions during Hurricane Sandy. Risk to patient health from evacuation, prior experience, cost, and ability to maintain continuity of operations were the most influential factors in decision making. Flooding and utility outages, which were predicted to or actually impacted continuity of operations, were the primary determinants of evacuation. Evacuation and shelter-in-place decision making for hospitals can be improved by ensuring hospital emergency plans address flooding and include explicit thresholds that, if exceeded, would trigger evacuation. Comparative risk assessments that inform decision making would be enhanced by improved collection, analysis, and communication of data on morbidity and mortality associated with evacuation versus sheltering-in-place of hospitals. In addition, administrators and public officials can improve their preparedness to make evacuation and shelter-in-place decisions by practicing the use of decision-making tools during training and exercises.

Determinants of "Community Participation": The Tradition of Local Initiatives and the Institutionalisation of School Management Committees in Oromia Region, Ethiopia

ERIC Educational Resources Information Center

Yamada, Shoko

2014-01-01

A School Management Committee (SMC) is an administrative tool adopted in many developing countries to decentralise administrative and financial responsibilities at school level, while involving local people in decision-making and making education more responsive to demands. I question the assumption linking administrative decentralisation and…

Innovative Environmental Protection Tools

EPA Pesticide Factsheets

Local decision makers and citizens can make use of EPA tools for interacting with and learning about their local environments with tools that include green apps, My Environment, the National Stormwater Calculator, EPEAT, and EnvirFacts.

Brazilian LTER: ecosystem and biodiversity information in support of decision-making.

PubMed

Barbosa, F A R; Scarano, F R; Sabará, M G; Esteves, F A

2004-01-01

Brazil officially joined the International Long Term Ecological Research (ILTER) network in January 2000, when nine research sites were created and funded by the Brazilian Council for Science and Technology (CNPq). Two-years later some positive signs already emerge of the scientific, social and political achievements of the Brazilian LTER program. We discuss examples of how ecosystem and biodiversity information gathered within a long-term research approach are currently subsidizing decision-making as regards biodiversity conservation and watershed management at local and regional scales. Success in this respect has often been related to satisfactory communication between scientists, private companies, government and local citizens. Environmental education programs in the LTER sites are playing an important role in social and political integration. Most examples of integration of ecological research to decision-making in Brazil derive from case studies at local or regional scale. Despite the predominance of a bottom-up integrative pathway (from case studies to models; from local to national scale), some top-down initiatives are also in order, such as the construction of a model to estimate the inpact of different macroeconomic policies and growth trajectories on land use. We believe science and society in Brazil will benefit of the coexistence of bottom-up and top-down integrative approaches.

Afghanistan: Politics, Elections, and Government Performance

DTIC Science & Technology

2009-11-02

local notables, are key mechanisms for making authoritative local decisions or dispensing justice. Afghans turn often to these local mechanisms to...support of Afghan women, including women’s empowerment, maternal and child health and nutrition, funding the Ministry of Women’s Affairs, and micro

Cost-benefit decision circuitry: proposed modulatory role for acetylcholine.

PubMed

Fobbs, Wambura C; Mizumori, Sheri J Y

2014-01-01

In order to select which action should be taken, an animal must weigh the costs and benefits of possible outcomes associate with each action. Such decisions, called cost-benefit decisions, likely involve several cognitive processes (including memory) and a vast neural circuitry. Rodent models have allowed research to begin to probe the neural basis of three forms of cost-benefit decision making: effort-, delay-, and risk-based decision making. In this review, we detail the current understanding of the functional circuits that subserve each form of decision making. We highlight the extensive literature by detailing the ability of dopamine to influence decisions by modulating structures within these circuits. Since acetylcholine projects to all of the same important structures, we propose several ways in which the cholinergic system may play a local modulatory role that will allow it to shape these behaviors. A greater understanding of the contribution of the cholinergic system to cost-benefit decisions will permit us to better link the decision and memory processes, and this will help us to better understand and/or treat individuals with deficits in a number of higher cognitive functions including decision making, learning, memory, and language. © 2014 Elsevier Inc. All rights reserved.

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.

Studying the Study Section: How Group Decision Making in Person and via Videoconferencing Affects the Grant Peer Review Process. WCER Working Paper No. 2015-6

ERIC Educational Resources Information Center

Pier, Elizabeth L.; Raclaw, Joshua; Nathan, Mitchell J.; Kaatz, Anna; Carnes, Molly; Ford, Cecilia E.

2015-01-01

Grant peer review is a foundational component of scientific research. In the context of grant review meetings, the review process is a collaborative, socially mediated, locally constructed decision-making task. The current study examines how collaborative discussion affects reviewers' scores of grant proposals, how different review panels score…

The Role of Evidence-Based Research in the Decision-Making Process as Perceived by Local Board of Education Policymakers in West Virginia

ERIC Educational Resources Information Center

Hoylman, Elizabeth Anne

2017-01-01

This non-experimental, descriptive study explored the perceptions of PK-12 policymakers in West Virginia regarding the sources of information they use in the decision-making process; whether and how evidence-based research is relied upon; whether evidence-based research is considered credible and usable; and what barriers, facilitators, and…

Temporal coding of reward-guided choice in the posterior parietal cortex

PubMed Central

Hawellek, David J.; Wong, Yan T.; Pesaran, Bijan

2016-01-01

Making a decision involves computations across distributed cortical and subcortical networks. How such distributed processing is performed remains unclear. We test how the encoding of choice in a key decision-making node, the posterior parietal cortex (PPC), depends on the temporal structure of the surrounding population activity. We recorded spiking and local field potential (LFP) activity in the PPC while two rhesus macaques performed a decision-making task. We quantified the mutual information that neurons carried about an upcoming choice and its dependence on LFP activity. The spiking of PPC neurons was correlated with LFP phases at three distinct time scales in the theta, beta, and gamma frequency bands. Importantly, activity at these time scales encoded upcoming decisions differently. Choice information contained in neural firing varied with the phase of beta and gamma activity. For gamma activity, maximum choice information occurred at the same phase as the maximum spike count. However, for beta activity, choice information and spike count were greatest at different phases. In contrast, theta activity did not modulate the encoding properties of PPC units directly but was correlated with beta and gamma activity through cross-frequency coupling. We propose that the relative timing of local spiking and choice information reveals temporal reference frames for computations in either local or large-scale decision networks. Differences between the timing of task information and activity patterns may be a general signature of distributed processing across large-scale networks. PMID:27821752

(De)centralization of social support in six Western European countries.

PubMed

Kroneman, Madelon; Cardol, Mieke; Friele, Roland

2012-06-01

Participation of disabled or chronically ill persons into the society may require support in the sense of human or technical aid. In this study we look into the decision making power of governments and the way citizens are involved in these processes. Decision making power can be political, financial and administrative and may be organized at national, regional or local level. This is a cross-sectional descriptive study of the decision making power in Belgium, France, Germany, the Netherlands, Sweden and the United Kingdom in 2010. We focused on acts and regulations for human and technical aids and for making the environment accessible. Several acts and regulations were identified in relation to social support. In the Netherlands and Sweden social support was mainly organized in one act, whereas in the other countries social support was part of several acts or regulations. Citizen's voice appeared to be represented in boards or advisory committees. Descriptions of entitlements varied from explicitly formulated to globally described. The level of decision making power varies between the countries en between the types of decision making power. Citizens' participation is mainly represented through patient associations. Countries with strongly decentralized decision making make use of framework legislation at national level to set general targets or aims. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Incentives for Optimal Multi-level Allocation of HIV Prevention Resources

PubMed Central

Malvankar, Monali M.; Zaric, Gregory S.

2013-01-01

HIV/AIDS prevention funds are often allocated at multiple levels of decision-making. Optimal allocation of HIV prevention funds maximizes the number of HIV infections averted. However, decision makers often allocate using simple heuristics such as proportional allocation. We evaluate the impact of using incentives to encourage optimal allocation in a two-level decision-making process. We model an incentive based decision-making process consisting of an upper-level decision maker allocating funds to a single lower-level decision maker who then distributes funds to local programs. We assume that the lower-level utility function is linear in the amount of the budget received from the upper-level, the fraction of funds reserved for proportional allocation, and the number of infections averted. We assume that the upper level objective is to maximize the number of infections averted. We illustrate with an example using data from California, U.S. PMID:23766551

Shared decision making and use of decision AIDS for localized prostate cancer : perceptions from radiation oncologists and urologists.

PubMed

Wang, Elyn H; Gross, Cary P; Tilburt, Jon C; Yu, James B; Nguyen, Paul L; Smaldone, Marc C; Shah, Nilay D; Abouassally, Robert; Sun, Maxine; Kim, Simon P

2015-05-01

The current attitudes of prostate cancer specialists toward decision aids and their use in clinical practice to facilitate shared decision making are poorly understood. To assess attitudes toward decision aids and their dissemination in clinical practice. A survey was mailed to a national random sample of 1422 specialists (711 radiation oncologists and 711 urologists) in the United States from November 1, 2011, through April 30, 2012. Respondents were asked about familiarity, perceptions, and use of decision aids for clinically localized prostate cancer and trust in various professional societies in developing decision aids. The Pearson χ2 test was used to test for bivariate associations between physician characteristics and outcomes. Similar response rates were observed for radiation oncologists and urologists (44.0% vs 46.1%; P=.46). Although most respondents had some familiarity with decision aids, only 35.5% currently use a decision aid in clinic practice. The most commonly cited barriers to decision aid use included the perception that their ability to estimate the risk of recurrence was superior to that of decision aids (7.7% in those not using decision aids and 26.2% in those using decision aids; P<.001) and the concern that patients could not process information from a decision aid (7.6% in those not using decision aids and 23.7% in those using decision aids; P<.001). In assessing trust in decision aids established by various professional medical societies, specialists consistently reported trust in favor of their respective organizations, with 9.2% being very confident and 59.2% being moderately confident (P=.01). Use of decision aids among specialists treating patients with prostate cancer is relatively low. Efforts to address barriers to clinical implementation of decision aids may facilitate greater shared decision making for patients diagnosed as having prostate cancer.

Locus of decision making in multinational corporations and its relationship to subsidiary performance

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

Goehle, D.G.

1978-01-01

A conceptual model was developed which drew from the existing research in organization theory, comparative management, and international business which assisted in the delineation of the relevant variables and suggested the nature of their relationship to the locus of decision making. The conceptual model incorporated certain corporate and subsidiary factors considered an influence on the determination of the locus of decision making. Corporate factors included product line or industry, size and complexity of international operations, organization structure, availability of managerial talent, and corporate philosophy. Subsidiary characteristics included subsidiary age and size, availability of local managerial talent, geographic distance from headquartersmore » and other affiliated units, and subsidiary environmental characteristics. The locus of desicion making was measured by the level of participation the headquarters and subsidiary management had in decision making for twenty-nine decisions, representing six functional areas. Levels of participation for headquarters and subsidiary managers were measured for each decision based on responses to a five-point scale of decision process categories which indicated varying levels of headquarters and subsidiary participation. The sample included ten US multinational corporations representing five industries: pharmaceuticals, tire and rubber, automobiles, capital equipment, and food processing.« less

Relating Local to Global Spatial Knowledge: Heuristic Influence of Local Features on Direction Estimates

ERIC Educational Resources Information Center

Phillips, Daniel W.; Montello, Daniel R.

2015-01-01

Previous research has examined heuristics--simplified decision-making rules-of-thumb--for geospatial reasoning. This study examined at two locations the influence of beliefs about local coastline orientation on estimated directions to local and distant places; estimates were made immediately or after fifteen seconds. This study goes beyond…

The application of the heuristic-systematic processing model to treatment decision making about prostate cancer.

PubMed

Steginga, Suzanne K; Occhipinti, Stefano

2004-01-01

The study investigated the utility of the Heuristic-Systematic Processing Model as a framework for the investigation of patient decision making. A total of 111 men recently diagnosed with localized prostate cancer were assessed using Verbal Protocol Analysis and self-report measures. Study variables included men's use of nonsystematic and systematic information processing, desire for involvement in decision making, and the individual differences of health locus of control, tolerance of ambiguity, and decision-related uncertainty. Most men (68%) preferred that decision making be shared equally between them and their doctor. Men's use of the expert opinion heuristic was related to men's verbal reports of decisional uncertainty and having a positive orientation to their doctor and medical care; a desire for greater involvement in decision making was predicted by a high internal locus of health control. Trends were observed for systematic information processing to increase when the heuristic strategy used was negatively affect laden and when men were uncertain about the probabilities for cure and side effects. There was a trend for decreased systematic processing when the expert opinion heuristic was used. Findings were consistent with the Heuristic-Systematic Processing Model and suggest that this model has utility for future research in applied decision making about health.

Introduction of New Vaccines: Decision-making Process in Bangladesh

PubMed Central

Sarma, Haribondhu; Bari, Tajul I.; Koehlmoos, Tracey P.

2013-01-01

The understanding of the decision-making process in the introduction of new vaccines helps establish why vaccines are adopted or not. It also contributes to building a sustainable demand for vaccines in a country. The purpose of the study was to map and analyze the formal decision-making process in relation to the introduction of new vaccines within the context of health policy and health systems and identify the ways of making decisions to introduce new vaccines in Bangladesh. During February-April 2011, a qualitative assessment was made at the national level to evaluate the decision-making process around the adoption of new vaccines in Bangladesh. The study population included: policy-level people, programme heads or associates, and key decision-makers of the Government, private sector, non-governmental organizations, and international agencies at the national level. In total, 13 key informants were purposively selected. Data were collected by interviewing key informants and reviewing documents. Data were analyzed thematically. The findings revealed that the actors from different sectors at the policy level were involved in the decision-making process in the introduction of new vaccines. They included policy-makers from the ministries of health and family welfare, finance, and local government and rural development; academicians; researchers; representatives from professional associations; development partners; and members of different committees on EPI. They contributed to the introduction of new vaccines in their own capacity. The burden of disease, research findings on vaccine-preventable diseases, political issues relating to outbreaks of certain diseases, initiatives of international and local stakeholders, pressure of development partners, the Global Alliance for Vaccines and Immunization (GAVI) support, and financial matters were the key factors in the introduction of new vaccines in Bangladesh. The slow introduction and uptake of new vaccines is a concern in the country. Rapid action on the application of GAVI support and less time taken by the Government in processing the implementation and administrative work may expedite the introduction of new vaccines in future in this country. PMID:23930339

Introduction of new vaccines: decision-making process in Bangladesh.

PubMed

Uddin, Jasim; Sarma, Haribondhu; Bari, Tajul I; Koehlmoos, Tracey P

2013-06-01

The understanding of the decision-making process in the introduction of new vaccines helps establish why vaccines are adopted or not. It also contributes to building a sustainable demand for vaccines in a country. The purpose of the study was to map and analyze the formal decision-making process in relation to the introduction of new vaccines within the context of health policy and health systems and identify the ways of making decisions to introduce new vaccines in Bangladesh. During February-April 2011, a qualitative assessment was made at the national level to evaluate the decision-making process around the adoption of new vaccines in Bangladesh. The study population included: policy-level people, programme heads or associates, and key decision-makers of the Government, private sector, non-governmental organizations, and international agencies at the national level. In total, 13 key informants were purposively selected. Data were collected by interviewing key informants and reviewing documents. Data were analyzed thematically. The findings revealed that the actors from different sectors at the policy level were involved in the decision-making process in the introduction of new vaccines. They included policy-makers from the ministries of health and family welfare, finance, and local government and rural development; academicians; researchers; representatives from professional associations; development partners; and members of different committees on EPI. They contributed to the introduction of new vaccines in their own capacity. The burden of disease, research findings on vaccine-preventable diseases, political issues relating to outbreaks of certain diseases, initiatives of international and local stakeholders, pressure of development partners, the Global Alliance for Vaccines and Immunization (GAVI) support, and financial matters were the key factors in the introduction of new vaccines in Bangladesh. The slow introduction and uptake of new vaccines is a concern in the country. Rapid action on the application of GAVI support and less time taken by the Government in processing the implementation and administrative work may expedite the introduction of new vaccines in future in this country.

Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making.

PubMed

Jensen, Jan L; Travers, Andrew H

2017-05-01

Nationally, emphasis on the importance of evidence-based practice (EBP) in emergency medicine and emergency medical services (EMS) has continuously increased. However, meaningful incorporation of effective and sustainable EBP into clinical and administrative decision-making remains a challenge. We propose a vision for EBP in EMS: Canadian EMS clinicians and leaders will understand and use the best available evidence for clinical and administrative decision-making, to improve patient health outcomes, the capability and quality of EMS systems of care, and safety of patients and EMS professionals. This vision can be implemented with the use of a structure, process, system, and outcome taxonomy to identify current barriers to true EBP, to recognize the opportunities that exist, and propose corresponding recommended strategies for local EMS agencies and at the national level. Framing local and national discussions with this approach will be useful for developing a cohesive and collaborative Canadian EBP strategy.

Models of governance in multihospital systems. Implications for hospital and system-level decision-making.

PubMed

Morlock, L L; Alexander, J A

1986-12-01

This study utilizes data from a national survey of 159 multihospital systems in order to describe the types of governance structures currently being utilized, and to compare the policy making process for various types of decisions in systems with different approaches to governance. Survey results indicate that multihospital systems most often use one of three governance models. Forty-one percent of the systems (including 33% of system hospitals) use a parent holding company model in which there is a system-wide corporate governing board and separate governing boards for each member hospital. Twenty-two percent of systems in the sample (but 47% of all system hospitals) utilize what we have termed a modified parent holding company model in which there is one system-wide governing board, but advisory boards are substituted for governing boards at the local hospital level. Twenty-three percent of the sampled systems (including 11% of system hospitals) use a corporate model in which there is one system-wide governing board but no other governing or advisory boards at either the divisional, regional or local hospital levels. A comparison of systems using these three governance approaches found significant variation in terms of system size, ownership and the geographic proximity of member hospitals. In order to examine the relationship between alternative approaches to governance and patterns of decision-making, the three model types were compared with respect to the percentages of systems reporting that local boards, corporate management and/or system-wide corporate boards have responsibility for decision-making in a number of specific issue areas. Study results indicate that, regardless of model type, corporate boards are most likely to have responsibility for decisions regarding the transfer, pledging and sale of assets; the formation of new companies; purchase of assets greater than $100,000; changes in hospital bylaws; and the appointment of local board members. In contrast corporate management is relatively uninvolved in these issues, again regardless of governance model type. There is substantial variation in the locus of decision-making responsibility by governance model type for a variety of other issues, however, including: hospital-level service additions and deletions; operating and capital budgets; medical staff privileges, hospital-level long-range planning; hospital CEO performance evaluation and the appointment of hospital CEOs.(ABSTRACT TRUNCATED AT 400 WORDS)

Can SIA empower communities

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

Gagnon, C.; Hirsch, P.; Howitt, R.

1993-07-01

Public participation in social impact assessment (SIA) has been identified as a source of improved decision-making about resource development in several countries, with an implicit assumption that this sort of participation provides an avenue for empowerment of affected communities in these decision-making processes. This paper provides a critical discussion of the effectiveness of SIA as a means of local empowerment through case studies of resource projects in Australia, Canada, and Southeast Asia.

Comparing a generic and individualized information decision support intervention for men newly diagnosed with localized prostate cancer.

PubMed

Davison, B Joyce; Goldenberg, S Larry; Wiens, Kristin P; Gleave, Martin E

2007-01-01

A randomized study was conducted to compare a generic and individualized approach to providing decisional support to men newly diagnosed with localized prostate cancer. Patients (N = 324) were referred by community urologists to a patient education center where they were randomly assigned to receive either an individualized or generic information intervention. Men assigned to the generic group viewed a video on the various treatments available for localized prostate cancer. Men in the individualized information group used a computer program to identify their information preferences. Computer printouts on top information preferences were individualized according to patient's specific disease characteristics, followed by a discussion of the pros and cons of each recommended treatment option. Both groups received a standardized package of written information. Men completed measures of decision control, satisfaction, and decision conflict at baseline and after a definitive treatment decision was made. Results demonstrated that overall both groups reported increased levels of decision control and lower levels of decision conflict after their treatment decision. All men reported being satisfied with their preparation to make a treatment decision. Compared to the generic information group, men who received the individualized information were more satisfied with the type, amount and method of providing information, and role played in treatment decision making with their physician (P < .002). Both information interventions seem to be similar in providing decisional support to this group of men at the time of diagnosis. Further research is required to determine how to identify men who may benefit from a more individualized approach.

The Cool Hand Luke Effect: Failure to Communicate Effectively (Invited)

NASA Astrophysics Data System (ADS)

Davidson, M. A.

2010-12-01

There is a growing concern with the accelerating rate of local sea level change and its implications for local and regional planning and development. While there are a growing number of local governments that are beginning to seriously consider their adaptation options, the vast majority of local leaders have not yet developed confidence in the various scenarios that are currently available. To adequately address the range of possible impacts and options for addressing local sea level change, one must have more than high resolution data, model output and decision support tools. We need to have a better understandin of the range of likely impacts upon and the value of local ecosystem services as well as as understanding of the foundations of the local economies. A sound scientific foundation must exist to support 'decision making under uncertainty' but we also need to understand the very local specific cultural frameworks within which decision makers must work. This is why working with local civic organizations, NGOs and other boundary organizations is increasingly important.

The Role of Science in Advising the Decision Making Process: A Pathway for Building Effective Climate Change Mitigation Policies in Mexico at the Local Level.

PubMed

Barraza, Roberto; Velazquez-Angulo, Gilberto; Flores-Tavizón, Edith; Romero-González, Jaime; Huertas-Cardozo, José Ignacio

2016-04-27

This study examines a pathway for building urban climate change mitigation policies by presenting a multi-dimensional and transdisciplinary approach in which technical, economic, environmental, social, and political dimensions interact. Now, more than ever, the gap between science and policymaking needs to be bridged; this will enable judicious choices to be made in regarding energy and climate change mitigation strategies, leading to positive social impacts, in particular for the populations at-risk at the local level. Through a case study in Juarez, Chihuahua, Mexico, we propose a multidimensional and transdisciplinary approach with the role of scientist as policy advisers to improve the role of science in decision-making on mitigation policies at the local level in Mexico.

2010 Comprehensive Economic Development Strategy "Vision Hampton Roads"

DOT National Transportation Integrated Search

2010-02-19

The strategy is an economic development planning tool intended to aid : local governments in decision-making. The document provides an analysis : of regional and local economic conditions within the Hampton Roads : region, defined as including the te...

Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study

PubMed Central

Schön, Ulla-Karin; Grim, Katarina; Wallin, Lars; Rosenberg, David; Svedberg, Petra

2018-01-01

ABSTRACT Purpose: Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. Method: The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. Results: The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. Conclusion: The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures. PMID:29405889

Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study.

PubMed

Schön, Ulla-Karin; Grim, Katarina; Wallin, Lars; Rosenberg, David; Svedberg, Petra

2018-12-01

Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

Three education modules using EnviroAtlas - Greenway Case Study Puts Students in the Decision-Making Role: Using Technology and Maps to Informs Development Decisions

EPA Science Inventory

Session #1: Exploration and Discovery through Maps: Teaching Science with Technology (elementary school) - EnviroAtlas is a tool developed by the U.S. Environmental Protection Agency and its partners that empowers anyone with the internet to be a highly informed local decision-ma...

Identifying and assessing the application of ecosystem services approaches in environmental policies and decision making.

PubMed

Van Wensem, Joke; Calow, Peter; Dollacker, Annik; Maltby, Lorraine; Olander, Lydia; Tuvendal, Magnus; Van Houtven, George

2017-01-01

The presumption is that ecosystem services (ES) approaches provide a better basis for environmental decision making than do other approaches because they make explicit the connection between human well-being and ecosystem structures and processes. However, the existing literature does not provide a precise description of ES approaches for environmental policy and decision making, nor does it assess whether these applications will make a difference in terms of changing decisions and improving outcomes. We describe 3 criteria that can be used to identify whether and to what extent ES approaches are being applied: 1) connect impacts all the way from ecosystem changes to human well-being, 2) consider all relevant ES affected by the decision, and 3) consider and compare the changes in well-being of different stakeholders. As a demonstration, we then analyze retrospectively whether and how the criteria were met in different decision-making contexts. For this assessment, we have developed an analysis format that describes the type of policy, the relevant scales, the decisions or questions, the decision maker, and the underlying documents. This format includes a general judgment of how far the 3 ES criteria have been applied. It shows that the criteria can be applied to many different decision-making processes, ranging from the supranational to the local scale and to different parts of decision-making processes. In conclusion we suggest these criteria could be used for assessments of the extent to which ES approaches have been and should be applied, what benefits and challenges arise, and whether using ES approaches made a difference in the decision-making process, decisions made, or outcomes of those decisions. Results from such studies could inform future use and development of ES approaches, draw attention to where the greatest benefits and challenges are, and help to target integration of ES approaches into policies, where they can be most effective. Integr Environ Assess Manag 2017;13:41-51. © 2016 SETAC. © 2016 SETAC.

A Decision Support Tool for Sustainable Land Use, Transportation, Buildings/Infrastructure, and Materials Management

EPA Science Inventory

One issue for community groups, local and regional planners, and politicians, is that they require relevant information to develop programs and initiatives for incorporating sustainability principles into their physical infrastructure, operations, and decision-making processes. T...

Virtual Beach Manager Toolset

EPA Science Inventory

The Virtual Beach Manager Toolset (VB) is a set of decision support software tools developed to help local beach managers make decisions as to when beaches should be closed due to predicted high levels of water borne pathogens. The tools are being developed under the umbrella of...

Performance Standards

ERIC Educational Resources Information Center

Burton, Nancy W.

2011-01-01

The educational technologies of the past quarter century--from teaching machines to minimal competency testing--all share the general purpose of helping educators make better, or more uniform, decisions. The currently favored technique for shaping local decisions is criterion-referenced testing. Some criterion-referenced testers first find out how…

Models, Measurements, and Local Decisions: Assessing and ...

EPA Pesticide Factsheets

This presentation includes a combination of modeling and measurement results to characterize near-source air quality in Newark, New Jersey with consideration of how this information could be used to inform decision making to reduce risk of health impacts. Decisions could include either exposure or emissions reduction, and a host of stakeholders, including residents, academics, NGOs, local and federal agencies. This presentation includes results from the C-PORT modeling system, and from a citizen science project from the local area. 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.

Integrated modelling of stormwater treatment systems uptake.

PubMed

Castonguay, A C; Iftekhar, M S; Urich, C; Bach, P M; Deletic, A

2018-05-24

Nature-based solutions provide a variety of benefits in growing cities, ranging from stormwater treatment to amenity provision such as aesthetics. However, the decision-making process involved in the installation of such green infrastructure is not straightforward, as much uncertainty around the location, size, costs and benefits impedes systematic decision-making. We developed a model to simulate decision rules used by local municipalities to install nature-based stormwater treatment systems, namely constructed wetlands, ponds/basins and raingardens. The model was used to test twenty-four scenarios of policy-making, by combining four asset selection, two location selection and three budget constraint decision rules. Based on the case study of a local municipality in Metropolitan Melbourne, Australia, the modelled uptake of stormwater treatment systems was compared with attributes of real-world systems for the simulation period. Results show that the actual budgeted funding is not reliable to predict systems' uptake and that policy-makers are more likely to plan expenditures based on installation costs. The model was able to replicate the cumulative treatment capacity and the location of systems. As such, it offers a novel approach to investigate the impact of using different decision rules to provide environmental services considering biophysical and economic factors. Copyright © 2018 Elsevier Ltd. All rights reserved.

Globally optimal trial design for local decision making.

PubMed

Eckermann, Simon; Willan, Andrew R

2009-02-01

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

Cortical topography of intracortical inhibition influences the speed of decision making.

PubMed

Wilimzig, Claudia; Ragert, Patrick; Dinse, Hubert R

2012-02-21

The neocortex contains orderly topographic maps; however, their functional role remains controversial. Theoretical studies have suggested a role in minimizing computational costs, whereas empirical studies have focused on spatial localization. Using a tactile multiple-choice reaction time (RT) task before and after the induction of perceptual learning through repetitive sensory stimulation, we extend the framework of cortical topographies by demonstrating that the topographic arrangement of intracortical inhibition contributes to the speed of human perceptual decision-making processes. RTs differ among fingers, displaying an inverted U-shaped function. Simulations using neural fields show the inverted U-shaped RT distribution as an emergent consequence of lateral inhibition. Weakening inhibition through learning shortens RTs, which is modeled through topographically reorganized inhibition. Whereas changes in decision making are often regarded as an outcome of higher cortical areas, our data show that the spatial layout of interaction processes within representational maps contributes to selection and decision-making processes.

Cortical topography of intracortical inhibition influences the speed of decision making

PubMed Central

Wilimzig, Claudia; Ragert, Patrick; Dinse, Hubert R.

2012-01-01

The neocortex contains orderly topographic maps; however, their functional role remains controversial. Theoretical studies have suggested a role in minimizing computational costs, whereas empirical studies have focused on spatial localization. Using a tactile multiple-choice reaction time (RT) task before and after the induction of perceptual learning through repetitive sensory stimulation, we extend the framework of cortical topographies by demonstrating that the topographic arrangement of intracortical inhibition contributes to the speed of human perceptual decision-making processes. RTs differ among fingers, displaying an inverted U-shaped function. Simulations using neural fields show the inverted U-shaped RT distribution as an emergent consequence of lateral inhibition. Weakening inhibition through learning shortens RTs, which is modeled through topographically reorganized inhibition. Whereas changes in decision making are often regarded as an outcome of higher cortical areas, our data show that the spatial layout of interaction processes within representational maps contributes to selection and decision-making processes. PMID:22315409

Building Capacity to Use Earth Observations in Decision Making: A Case Study of NASA's DEVELOP National Program Methods and Best Practices

NASA Astrophysics Data System (ADS)

Childs-Gleason, L. M.; Ross, K. W.; Crepps, G.; Miller, T. N.; Favors, J. E.; Rogers, L.; Allsbrook, K. N.; Bender, M. R.; Ruiz, M. L.

2015-12-01

NASA's DEVELOP National Program fosters an immersive research environment for dual capacity building. Through rapid feasibility Earth science projects, the future workforce and current decision makers are engaged in research projects to build skills and capabilities to use Earth observation in environmental management and policy making. DEVELOP conducts over 80 projects annually, successfully building skills through partnerships with over 150 organizations and providing over 350 opportunities for project participants each year. Filling a void between short-term training courses and long-term research projects, the DEVELOP model has been successful in supporting state, local, federal and international government organizations to adopt methodologies and enhance decision making processes. This presentation will highlight programmatic best practices, feedback from participants and partner organizations, and three sample case studies of successful adoption of methods in the decision making process.

An Integrated Framework to Analyze Local Decision Making and Adaptation to Sea-Level Rise in Coastal Regions in Santos-Brazil, Broward County-USA and Selsey-UK

NASA Astrophysics Data System (ADS)

Marengo, J. A.; Muller-Karger, F. E.; Pelling, M.; Reynolds, C. J.; Merril, S. B.; Nunes, L. H.; Paterson, S.; Gray, A.; Lockman, J. T.; Kartez, J.; Moreira, F.; Greco, R.; Harari, J.; Souza, C. G.; Alves, L. M.; Hosokawa, E.; Tabuchi, E.

2016-12-01

One of the clear signals of present climate change is sea level rise (SLR). There is mounting evidence of other changes, including warmer temperatures in many localities, and changes in the intensity and frequency of extreme meteorological events, including wind, rain, and waves. A rising sea level combined with these factors and tides is expected to affect coastal communities through a number of processes, including increased risk of flooding and contamination of water sources. An international collaboration between Brazil, the United Kingdom, and the United States was designed to evaluate local decision making processes and to open convening space for local urban managers to reflect on possible actions toward adaption to SLR and the constraints imposed by framing administrative and institutional structures. The overall goal of the project is to help coastal communities better understand factors that facilitate or hinder their intrinsic, local decision-making processes related to planning for adaptation to risk. The project carried out these tests in 2014 and 2015 in one coastal city in each partnering nation. The framework was designed by an interdisciplinary team that incorporated social and natural scientists from these three nations, and which included local government officials. To support the overall goal, this paper 1) discusses some aspects of adaptive capacity and participant survey research conducted through the project, 2) presents technical modelling results for adaptation options that may reduce the potential damages of SLR and storm surge in each location, and 3) identifies project design considerations for similar transnational adaptation projects.

Dilemmas Presented by State Agency Takeovers of Local School Districts.

ERIC Educational Resources Information Center

Steffy, Betty E.

During the 1988-89 school year, two local school districts were placed into "Phase III" of the Kentucky Educational Improvement Act (1978), a category of state receivership in which much local decision-making power was transferred to Kentucky Department of Education officials. When state education department intervention occurs, major…

Incorporation of a health economic modelling tool into public health commissioning: Evidence use in a politicised context.

PubMed

Sanders, Tom; Grove, Amy; Salway, Sarah; Hampshaw, Susan; Goyder, Elizabeth

2017-08-01

This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency. The former highlighted the diverse evidence cultures present in the LA with politicians influenced by the 'soft' social care agendas affecting their local population and treating local opinion as evidence, whilst public health managers prioritised the scientific view of evidence informed by research. System interdependency further complicated the decision making process by recognizing interlinking with departments and other disease groups. To achieve legitimacy within the commissioning arena health economic modelling needs to function effectively in a highly politicised environment where decisions are made not only on the basis of research evidence, but on grounds of 'soft' data, personal opinion and intelligence. In this context decisions become politicised, with multiple opinions seeking a voice. The way that such decisions are negotiated and which ones establish authority is of importance. We analyse the data using Larson's (1990) discursive field concept to show how the tool becomes an object of research push and pull likely to be used instrumentally by stakeholders to advance specific agendas, not a means of informing complex decisions. In conclusion, LA decision making is underpinned by a transactional business ethic which is a further potential 'pull' mechanism for the incorporation of health economic modelling in local commissioning. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Planning Protective Action Decision-Making: Evacuate or Shelter-in-Place

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

Sorensen, J.H.

Appropriate protective action recommendations or decisions (PARs/PADs) are needed to achieve maximum protection of a population at risk. The factors that affect protective action decisions are complex but fairly well documented. Protective action decisions take into account population distributions, projected or actual exposure to a chemical substance, availability of adequate shelters, evacuation time estimates, and other relevant factors. To choose in-place sheltering, there should be a reasonable assurance that the movement of people beyond their residence, workplace, or school will endanger the health and safety of the public more so than allowing them to remain in place. The decision tomore » evacuate the public should be based on the reasonable assurance that the movement of people to an area outside of an affected area is in the best interest of their health and safety, and is of minimal risk to them. In reality, an evacuation decision is also a resource-dependent decision. The availability of transportation and other resources, including shelters, may factor heavily in the protective action decision-making process. All strategies to protect the health and safety of the public from a release of hazardous chemicals are explicitly considered during emergency decision making. Each institutional facility (such as hospitals, schools, day care centers, correctional facilities, assisted living facilities or nursing homes) in the community should be considered separately to determine what special protective actions may be necessary. Deciding whether to evacuate or to shelter-in-place is one of the most important questions facing local emergency planners responding to a toxic chemical release. That such a complex decision with such important potential consequences must be made with such urgency places tremendous responsibility on the planners and officials involved. Researchers have devoted considerable attention to the evacuation/shelter-in-place protection decision. While several decision aids have been developed, no single approach has achieved widespread acceptance based on validity, utility, and effectiveness (Ujihara 1989, Mannan and Kilpatrick 2000). In the absence of an agreed-upon methodology for making this decision, the best strategy for local emergency planners and officials is a thorough understanding of all the components affecting the decision. This paper summarizes what is currently known about the evacuation/shelter-in-place protection decision and points to available literature that more thoroughly explores the individual components of the decision. The next section summarizes the major issues in protective action decision process. This is followed by a discussion of all the factors that may bear on the protective action decision process. The final section address how to make a protective action decision.« less

Precipitation Variability and Projection Uncertainties in Climate Change Adaptation: Go Local!

EPA Science Inventory

Presentations agenda includes: Regional and local climate change effects: The relevance; Variability and uncertainty in decision- making and adaptation approaches; Adaptation attributes for the U.S. Southwest: Water availability, storage capacity, and related; EPA research...

Creating partnerships with local communities to manage and preserve corridors : technical report.

DOT National Transportation Integrated Search

2008-07-01

There is a serious need in Texas for better integration of land use and transportation planning, and better : coordination of land use and transportation decision making. Coordinated local-state partnerships in corridor : management and preservation ...

An Investigation Into the Navy Public Works Centers Specific Work Service Processing Problems.

DTIC Science & Technology

1980-12-01

demonstrated. These computations are from Navy Area Audit Service reports or PWC and NAVFACENGCOM reports. Number One-time Annual Personnel 3,553...study, all of the endorsements, and a Navy Audit Service audit of the cost analysis, the CNO makes the final consolidation decision. With a decision to...organizations to which local activities turn for environmental issue assistance such as noise, water and air polution , airfield encroachment, local

Migrant decision-making in a frontier landscape

NASA Astrophysics Data System (ADS)

Salerno, Jonathan

2016-04-01

Across the tropics, rural farmers and livestock keepers use mobility as an adaptive livelihood strategy. Continued migration to and within frontier areas is widely viewed as a driver of environmental decline and biodiversity loss. Recent scholarship advances our understanding of migration decision-making in the context of changing climate and environments, and in doing so it highlights the variation in migration responses to primarily economic and environmental factors. Building on these insights, this letter investigates past and future migration decisions in a frontier landscape of Tanzania, East Africa. Combining field observations and household data within a multilevel modeling framework, the letter analyzes the explicit importance of social factors relative to economic and environmental factors in driving decisions to migrate or remain. Results indeed suggest that local community ties and non-local social networks drive both immobility and anticipated migration, respectively. In addition, positive interactions with local protected natural resource areas promote longer-term residence. Findings shed new light on how frontier areas transition to human dominated landscapes. This highlights critical links between migration behavior and the conservation of biodiversity and management of natural resources, as well as how migrants evolve to become integrated into communities.

How Connecticut health directors deal with public health budget cuts at the local level.

PubMed

Prust, Margaret L; Clark, Kathleen; Davis, Brigette; Pallas, Sarah W; Kertanis, Jennifer; O'Keefe, Elaine; Araas, Michael; Iyer, Neel S; Dandorf, Stewart; Platis, Stephanie; Humphries, Debbie

2015-04-01

We investigated the perspectives of local health jurisdiction (LHJ) directors on coping mechanisms used to respond to budget reductions and constraints on their decision-making. We conducted in-depth interviews with 17 LHJ directors. Interviews were audio recorded, transcribed, and analyzed using the constant comparative method. LHJ directors use a range of coping mechanisms, including identifying alternative revenue sources, adjusting services, amending staffing arrangements, appealing to local political leaders, and forming strategic partnerships. LHJs also face constraints on their decision-making because of state and local statutory requirements, political priorities, pressures from other LHJs, and LHJ structure. LHJs respond creatively to budget cuts to maintain important public health services. Some LHJ adjustments to administrative resources may obscure the long-term costs of public health budget cuts in such areas as staff morale and turnover. Not all coping strategies are available to each LHJ because of the contextual constraints of its locality, pointing to important policy questions on identifying optimum jurisdiction size and improving efficiency.

[Adoption of new technologies by health services: the challenge of analyzing relevant factors].

PubMed

Trindade, Evelinda

2008-05-01

The exponential increase in the incorporation of health technologies has been considered a key factor in increased expenditures by the health sector. Such decisions involve multiple levels and stakeholders. Decentralization has multiplied the decision-making levels, with numerous difficult choices and limited resources. The interrelationship between stakeholders is complex, in creative systems with multiple determinants and confounders. The current review discusses the interaction between the factors influencing the decisions to incorporate technologies by health services, and proposes a structure for their analysis. The application and intensity of these factors in decision-making and the incorporation of products and programs by health services shapes the installed capacity of local and regional networks and modifies the health system. Empirical observation of decision-making and technology incorporation in Brazilian health services poses an important challenge. The structured recognition and measurement of these variables can assist proactive planning of health services.

The state of shared decision making in Malaysia.

PubMed

Lee, Yew Kong; Ng, Chirk Jenn

2017-06-01

Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships. Current research on SDM comprises baseline surveys of decisional role preferences, development and implementation of locally developed patient decision aids, and conducting of SDM training workshops. Most of this research is carried out by public research universities. In summary, the current state of SDM in Malaysia is still at its infancy. However, there are increasing recognition and efforts from the academic institutions and Ministry of Health to conduct research in SDM, develop patient decision support tools and initiate national discussion on patient involvement in decision making. Copyright © 2017. Published by Elsevier GmbH.

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.

Shared decision making in preventive care in Switzerland: From theory to action.

PubMed

Selby, Kevin; Auer, Reto; Cornuz, Jacques

2017-06-01

Switzerland with its decentralized, liberal health system and its tradition of direct democracy may be an ideal place for shared decision making (SDM) to take root organically, rather than using top-down regulations seen in other countries. There are now multiple directives and programmes in place to encourage SDM, with the creation of several decision aids and specific training programs in the five Swiss medical schools. There has been an emphasis on preventive care, with the integration of patient preference into an organized colorectal cancer screening program, clear recommendations for prostate cancer screening, and inroads into the primary prevention of cardiovascular disease. Focusing on the experience of the University of Lausanne, we describe multiple approaches being taken to teaching SDM and the local development of decision aids, drawing on international experience but tailored to local needs. Efforts are being made to further involve patients in not only SDM, but also associated research and quality improvement projects. Copyright © 2017. Published by Elsevier GmbH.

How decision reversibility affects motivation.

PubMed

Bullens, Lottie; van Harreveld, Frenk; Förster, Jens; Higgins, Tory E

2014-04-01

The present research examined how decision reversibility can affect motivation. On the basis of extant findings, it was suggested that 1 way it could affect motivation would be to strengthen different regulatory foci, with reversible decision making, compared to irreversible decision making, strengthening prevention-related motivation relatively more than promotion-related motivation. If so, then decision reversibility should have effects associated with the relative differences between prevention and promotion motivation. In 5 studies, we manipulated the reversibility of a decision and used different indicators of regulatory focus motivation to test these predictions. Specifically, Study 1 tested for differences in participants' preference for approach versus avoidance strategies toward a desired end state. In Study 2, we used speed and accuracy performance as indicators of participants' regulatory motivation, and in Study 3, we measured global versus local reaction time performance. In Study 4, we approached the research question in a different way, making use of the value-from-fit hypothesis (Higgins, 2000, 2002). We tested whether a fit between chronic regulatory focus and focus induced by the reversibility of the decision increased participants' subjective positive feelings about the decision outcome. Finally, in Study 5, we tested whether regulatory motivation, induced by decision reversibility, also influenced participants' preference in specific product features. The results generally support our hypothesis showing that, compared to irreversible decisions, reversible decisions strengthen a prevention focus more than a promotion focus. Implications for research on decision making are discussed.

The capacity of people with a 'mental disability' to make a health care decision.

PubMed

Wong, J G; Clare, C H; Holland, A J; Watson, P C; Gunn, M

2000-03-01

Based on the developing clinical and legal literature, and using the framework adopted in draft legislation, capacity to make a valid decision about a clinically required blood test was investigated in three groups of people with a 'mental disability' (i.e. mental illness (chronic schizophrenia), 'learning disability' ('mental retardation', or intellectual or developmental disability), or, dementia) and a fourth, comparison group. The three 'mental disability' groups (N = 20 in the 'learning disability' group, N = 21 in each of the other two groups) were recruited through the relevant local clinical services; and through a phlebotomy clinic for the 'general population' comparison group (N = 20). The decision-making task was progressively simplified by presenting the relevant information as separate elements and modifying the assessment of capacity so that responding became gradually less dependent on expressive verbal ability. Compared with the 'general population' group, capacity to make the particular decision was significantly more impaired in the 'learning disability' and 'dementia' groups. Importantly, however, it was not more impaired among the 'mental illness' group. All the groups benefited as the decision-making task was simplified, but at different stages. In each of the 'mental disability' groups, one participant benefited only when responding did not require any expensive verbal ability. Consistent with current views, capacity reflected an interaction between the decision-maker and the demands of the decision-making task. The findings have implications for the way in which decisions about health care interventions are sought from people with a 'mental disability'. The methodology may be extended to assess capacity to make other legally-significant decisions.

Development of a support tool for complex decision-making in the provision of rural maternity care.

PubMed

Hearns, Glen; Klein, Michael C; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

2010-02-01

Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the manual was specifically intended to deal with rural maternity issues, the NH decision-makers feel the method can be easily adapted to assist decision-making in other contexts in medicine where there are conflicting objectives, values and opinions. Decisions on the location of new facilities or infrastructure, or enhancing or altering services such as surgical or palliative care, would be examples of complex decisions that might benefit from this methodology.

Development of a Support Tool for Complex Decision-Making in the Provision of Rural Maternity Care

PubMed Central

Hearns, Glen; Klein, Michael C.; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

2010-01-01

Context: Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. Objective: To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Design: Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Setting: Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Participants: Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). Results: We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Conclusions: Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the manual was specifically intended to deal with rural maternity issues, the NH decision-makers feel the method can be easily adapted to assist decision-making in other contexts in medicine where there are conflicting objectives, values and opinions. Decisions on the location of new facilities or infrastructure, or enhancing or altering services such as surgical or palliative care, would be examples of complex decisions that might benefit from this methodology. PMID:21286270

The influences and neural correlates of past and present during gambling in humans.

PubMed

Sacré, Pierre; Subramanian, Sandya; Kerr, Matthew S D; Kahn, Kevin; Johnson, Matthew A; Bulacio, Juan; González-Martínez, Jorge A; Sarma, Sridevi V; Gale, John T

2017-12-07

During financial decision-making tasks, humans often make "rational" decisions, where they maximize expected reward. However, this rationality may compete with a bias that reflects past outcomes. That is, if one just lost money or won money, this may impact future decisions. It is unclear how past outcomes influence future decisions in humans, and how neural circuits encode present and past information. In this study, six human subjects performed a financial decision-making task while we recorded local field potentials from multiple brain structures. We constructed a model for each subject characterizing bets on each trial as a function of present and past information. The models suggest that some patients are more influenced by previous trial outcomes (i.e., previous return and risk) than others who stick to more fixed decision strategies. In addition, past return and present risk modulated with the activity in the cuneus; while present return and past risk modulated with the activity in the superior temporal gyrus and the angular gyrus, respectively. Our findings suggest that these structures play a role in decision-making beyond their classical functions by incorporating predictions and risks in humans' decision strategy, and provide new insight into how humans link their internal biases to decisions.

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

DOT National Transportation Integrated Search

1997-03-01

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

2010 Comprehensive Economic Development Strategy "Vision Hampton Roads" : Executive Summary

DOT National Transportation Integrated Search

2010-02-19

The strategy is an economic development planning tool intended to aid local governments in decision-making. The document provides an analysis of regional and local economic conditions within the Hampton Roads region, defined as including the ten (10)...

Afghanistan: Politics, Elections, and Government Performance

DTIC Science & Technology

2009-10-23

making authoritative local decisions or dispensing justice. Afghans turn often to these local mechanisms to adjudicate disputes rather than use the...women, including women’s empowerment, maternal and child health and nutrition, funding the Ministry of Women’s Affairs, and micro-finance projects

Afghanistan: Politics, Elections, and Government Performance

DTIC Science & Technology

2010-01-11

shuras, or jirgas (consultative councils)2 composed of local notables, are key mechanisms for making authoritative local decisions or dispensing justice...Department, the United States has implemented several hundred projects directly in support of Afghan women, including women’s empowerment, maternal and

Afghanistan: Politics, Elections, and Government Performance

DTIC Science & Technology

2009-12-22

notables, are key mechanisms for making authoritative local decisions or dispensing justice. Afghans turn often to these local mechanisms to...implemented several hundred projects directly in support of Afghan women, including women’s empowerment, maternal and child health and nutrition, funding the

The Role of Science in Advising the Decision Making Process: A Pathway for Building Effective Climate Change Mitigation Policies in Mexico at the Local Level

PubMed Central

Barraza, Roberto; Velazquez-Angulo, Gilberto; Flores-Tavizón, Edith; Romero-González, Jaime; Huertas-Cardozo, José Ignacio

2016-01-01

This study examines a pathway for building urban climate change mitigation policies by presenting a multi-dimensional and transdisciplinary approach in which technical, economic, environmental, social, and political dimensions interact. Now, more than ever, the gap between science and policymaking needs to be bridged; this will enable judicious choices to be made in regarding energy and climate change mitigation strategies, leading to positive social impacts, in particular for the populations at-risk at the local level. Through a case study in Juarez, Chihuahua, Mexico, we propose a multidimensional and transdisciplinary approach with the role of scientist as policy advisers to improve the role of science in decision-making on mitigation policies at the local level in Mexico. PMID:27128933

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.

How do we trust strangers? The neural correlates of decision making and outcome evaluation of generalized trust

PubMed Central

Wang, Yiwen; Zhang, Zhen; Jing, Yiming; Valadez, Emilio A.

2016-01-01

This study investigates the brain correlates of decision making and outcome evaluation of generalized trust (i.e. trust in unfamiliar social agents)—a core component of social capital which facilitates civic cooperation and economic exchange. We measured 18 (9 male) Chinese participants’ event-related potentials while they played the role of the trustor in a one-shot trust game with unspecified social agents (trustees) allegedly selected from a large representative sample. At the decision-making phase, greater N2 amplitudes were found for trustors’ distrusting decisions compared to trusting decisions, which may reflect greater cognitive control exerted to distrust. Source localization identified the precentral gyrus as one possible neuronal generator of this N2 component. At the outcome evaluation phase, principal components analysis revealed that the so called feedback-related negativity was in fact driven by a reward positivity, which was greater in response to gain feedback compared to loss feedback. This reduced reward positivity following loss feedback may indicate that the absence of reward for trusting decisions was unexpected by the trustor. In addition, we found preliminary evidence suggesting that the decision-making processes may differ between high trustors and low trustors. PMID:27317927

Risk assessment and decision making about in-labour transfer from rural maternity care: a social judgment and signal detection analysis

PubMed Central

2012-01-01

Background The importance of respecting women’s wishes to give birth close to their local community is supported by policy in many developed countries. However, persistent concerns about the quality and safety of maternity care in rural communities have been expressed. Safe childbirth in rural communities depends on good risk assessment and decision making as to whether and when the transfer of a woman in labour to an obstetric led unit is required. This is a difficult decision. Wide variation in transfer rates between rural maternity units have been reported suggesting different decision making criteria may be involved; furthermore, rural midwives and family doctors report feeling isolated in making these decisions and that staff in urban centres do not understand the difficulties they face. In order to develop more evidence based decision making strategies greater understanding of the way in which maternity care providers currently make decisions is required. This study aimed to examine how midwives working in urban and rural settings and obstetricians make intrapartum transfer decisions, and describe sources of variation in decision making. Methods The study was conducted in three stages. 1. 20 midwives and four obstetricians described factors influencing transfer decisions. 2. Vignettes depicting an intrapartum scenario were developed based on stage one data. 3. Vignettes were presented to 122 midwives and 12 obstetricians who were asked to assess the level of risk in each case and decide whether to transfer or not. Social judgment analysis was used to identify the factors and factor weights used in assessment. Signal detection analysis was used to identify participants’ ability to distinguish high and low risk cases and personal decision thresholds. Results When reviewing the same case information in vignettes midwives in different settings and obstetricians made very similar risk assessments. Despite this, a wide range of transfer decisions were still made, suggesting that the main source of variation in decision making and transfer rates is not in the assessment but the personal decision thresholds of clinicians. Conclusions Currently health care practice focuses on supporting or improving decision making through skills training and clinical guidelines. However, these methods alone are unlikely to be effective in improving consistency of decision making. PMID:23114289

Local Implementation and Land Use Decision Making.

ERIC Educational Resources Information Center

Garlasco, Chris; And Others

This material includes student guide sheets, reference material, and tape script for the audio-tutorial unit on Local Implementation. An audio tape is used with the materials. The material is designed for use with Connecticut schools, but can be adapted to other localities. The material in this unit emphasizes the role of planning and zoning in…

The Wired City; A Handbook on Cable Television for Local Officials.

ERIC Educational Resources Information Center

Ledbetter, Theodore, Jr.; Mendelson, Gilbert

Viewing cable television systems as a new communications system rather than just another business, this handbook provides a variety of information designed for local officials who must make knowledgeable public interest decisions. After a critical history of franchising procedures and a discussion of the naivete of local governments, the specific…

A Case Study of School District Consolidation

ERIC Educational Resources Information Center

Cronin, Joseph M.

2010-01-01

Several New England states have been rethinking the system whereby small towns make the key decisions about school budgets and staffing under the banner of local control. Maine already has mandated a reduction in the number of local school districts from 290 to 80, allowing localities to vote on the larger districts. This consolidation, unpopular…

Dissociating sensory from decision processes in human perceptual decision making.

PubMed

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

2015-12-15

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

Dissociating sensory from decision processes in human perceptual decision making

PubMed Central

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

2015-01-01

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

Translation and cross-cultural adaptation of a family booklet on comfort care in dementia: sensitive topics revised before implementation.

PubMed

van der Steen, Jenny T; Hertogh, Cees M P M; de Graas, Tjomme; Nakanishi, Miharu; Toscani, Franco; Arcand, Marcel

2013-02-01

Families of patients with dementia may need support in difficult end-of-life decision making. Such guidance may be culturally sensitive. To support families in Canada, a booklet was developed to aid decision making on palliative care issues. For reasons of cost effectiveness and promising effects, we prepared for its implementation in Italy, the Netherlands and Japan. Local teams translated and adapted the booklet to local ethical, legal and medical standards where needed, retaining guidance on palliative care. Using qualitative content analyses, we grouped and compared adaptations to understand culturally sensitive aspects. Three themes emerged: (1) relationships among patient, physician and other professionals-the authority of the physician was more explicit in adapted versions; (2) patient rights and family position-adding detail about local regulations; and (3) typology of treatments and decisions. Considerations underlying palliative care decisions were detailed (Dutch and Italian versions), and the Japanese version frequently referred to professional and legal standards, and life-prolongation was a competing goal. Text on artificial feeding or fluids and euthanasia was revised extensively. Providing artificial feeding and fluids and discussing euthanasia may be particularly sensitive topics, and guidance on these subjects needs careful consideration of ethical aspects and possible adaptations to local standards and practice. The findings may promote cross-national debate on sensitive, core issues regarding end-of-life care in dementia.

Fostering Innovation: How User-Centered Design Can Help Us Get the Local Control Funding Formula Right. Policy and Practice Brief

ERIC Educational Resources Information Center

Knudson, Joel; Ramanathan, Arun; Carter, Allison; O'Day, Jennifer

2017-01-01

The Local Control Funding Formula (LCFF) has introduced positive and much-needed change to California's approach to K-12 education funding by allocating resources according to student need and freeing districts to make decisions that address local priorities. For all of LCFF's advantages, however, the Local Control Accountability Plans (LCAPs) in…

Skill Transfer and Virtual Training for IND Response Decision-Making: Analysis of Decision-Making Skills for Large-Scale Incidents

DTIC Science & Technology

2016-04-12

One example of communication issues comes from the Fukushima Daiichi nuclear disaster (2011). The local medical health professional on staff at the...field of radiological and nuclear disaster management to help disaster management professionals develop and demonstrate relevant expertise [3]. The next...improvised nuclear device (IND) detonation in an urban area would be one of the most catastrophic incidents that could occur in the United States, resulting

Scenarios in Social-Ecological Systems: Co-Producing Futures in Arctic Alaska

NASA Astrophysics Data System (ADS)

Lovecraft, A. L.; Eicken, H.

2016-12-01

Companies use scenarios to gain the capacity to think ahead in rapidly changing complex competitive environments and make crucial decisions in absence of complete information about the future. Currently, at many regional scales of governance there is a growing need for tools that enable the actors at local-scales to address pressing concerns in the midst of uncertainty. This is particularly true of areas experiencing rapidly changing environments (e.g., drought, floods, diminishing sea ice, erosion) and complex social problems (e.g., remote communities, resource extraction, threatened cultures). Resilience theory and deliberative democracy both promote governance by informed actors in an effort to produce decisions that avoid social-environmental collapse. The former focusing on resilient ecosystems, the latter on informed social choices. Scenario exercises produce neither forecasts of what is to come nor are they visions of what participants would like to happen. Rather, they produce pertinent and accurate information related to questions of "what would happen if…" and thus provide the possibility of strategic decision-making to reduce risk and promote community resilience. Scenarios can be forms of social learning and among local-scale experts they create a deliberative process to make decisions about proactive adaptation. This talk represents the results from two projects from Alaska's Arctic Slope region. Resident expert participants from the Northwest Arctic and North Slope Boroughs addressed the focal question "What is needed for healthy sustainable communities by 2040?" Our findings reinforce the growing evidence from studies related to Arctic community sustainability and human development that indicate tight connections between fate-control, health, and environmental change. Our work differs, however, in using a future studies approach. The participants are addressing social-ecological resilience from a proactive standpoint thinking long-term about local and regional scale concerns rather than examining global-scale forecasts for near-term decision-making. The results contribute to a multi-disciplinary cross-cultural discussion of the importance of innovative thinking at the local scale and future directions for geophysical researchers in a rapidly changing Arctic.

Reduction in Force: A Legal Update.

ERIC Educational Resources Information Center

Beckham, Joseph C.

Courts have been reluctant to interfere with the decision-making authority of local school boards. However, a reduction-in-force (RIF) decision can be legally challenged by a discharged employee with evidence that the school board has either: (1) acted arbitrarily or capriciously, (2) failed to comply with procedural mandates, or (3) utilized…

Timber salvage economics

Treesearch

Jeffrey P. Prestemon; Thomas P. Holmes

2008-01-01

Timber salvage is commonly done following natural disturbances, to recover some value from damaged forests. Decision making about salvage, however, is affected by ownership objectives, the nature of the damage agent, site factors, and the strength of the local timber market. For profit-maximizing landowners, salvage decisions must balance the cost of harvesting...

MULTI-SCALED VULNERABILITY ANALYSES: IMPROVING DECISION-MAKING AT REGIONAL TO LOCAL LEVELS THROUGH PARTNERSHIP

EPA Science Inventory

Decision-makers at all scales are faced with setting priorities for both use of limited resources and for risk management. While there are all kinds of monitoring data and models to project conditions at different spatial and temporal scales, synthesized information to establish ...

A Hierarchical Analysis of Bridge Decision Makers; the Role of New Technology Adoption in the Timber Bridge Market: Special Project Fiscal Year 1992

DOT National Transportation Integrated Search

1995-08-01

Bridge design engineers and local highway officials make bridge replacement decsions across the U.S. The Analytical Hierarchical Process was used to characterize the bridge material selection decisions of these individuals. State Departments of Trans...

A user-friendly mathematical modelling web interface to assist local decision making in the fight against drug-resistant tuberculosis.

PubMed

Ragonnet, Romain; Trauer, James M; Denholm, Justin T; Marais, Ben J; McBryde, Emma S

2017-05-30

Multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) represent an important challenge for global tuberculosis (TB) control. The high rates of MDR/RR-TB observed among re-treatment cases can arise from diverse pathways: de novo amplification during initial treatment, inappropriate treatment of undiagnosed MDR/RR-TB, relapse despite appropriate treatment, or reinfection with MDR/RR-TB. Mathematical modelling allows quantification of the contribution made by these pathways in different settings. This information provides valuable insights for TB policy-makers, allowing better contextualised solutions. However, mathematical modelling outputs need to consider local data and be easily accessible to decision makers in order to improve their usefulness. We present a user-friendly web-based modelling interface, which can be used by people without technical knowledge. Users can input their own parameter values and produce estimates for their specific setting. This innovative tool provides easy access to mathematical modelling outputs that are highly relevant to national TB control programs. In future, the same approach could be applied to a variety of modelling applications, enhancing local decision making.

Social capacity building towards flood risk resilience in England: The impact of shifts in risk governance

NASA Astrophysics Data System (ADS)

Begg, C.; Walker, G.

2012-04-01

CapHaz-Net - capacity building for natural hazards in Europe: towards more resilient societies - sees efforts to reduce vulnerability to natural hazards as a social endeavor. One of the findings from this project is the importance of as well as the advantages and pitfalls of participation within the natural hazard management process. Although participation is seen to be important it is still only a small part of the overall management process. However, as European societies see shifts in risk governance from the state to the local level, how are these participation processes likely to change? This paper takes these findings and looks at England as a case study. This case study focuses on the Big Society which promises to be the change that will remedy what Prime Minister David Cameron sees as a broken society. The idea has been put into practice through the Localism Act. The Act seeks not to totally repeal state control but to make decision-making processes more democratic. This includes less bureaucracy for local government to deal with and more space for innovation when dealing with local issues and support for volunteers, mutuals, co-ops, charities and social enterprises to get involved in decision-making and provision of services. But how is this shift going to be everything that it promises to be? And, what does this shift mean for flood risk management? Moreover, how are local people engaged to become involved in shaping the decisions that affect them? By conducting interviews with key stakeholders, this research aims at gaining an understanding of forms of participation that exist in the British context and the public reaction to such opportunities. In turn, this research aims to understand the boundaries of localism in regards to the delivery of flood risk management.

Strengthening Community Capacity to Participate in Making Decisions to Reduce Disproportionate Environmental Exposures

PubMed Central

Pastor, Manuel; Israel, Barbara

2011-01-01

Environmental exposures impose a disproportionate health burden on low-income populations and communities of color. One contributing factor may be the obstacles such communities face to full participation in making policy decisions about environmental health. This study described and analyzed the characteristics that contributed to communities' capacity to participate in making environmental decisions and suggested steps public agencies could take to achieve more meaningful participation. By strengthening community capacity, advancing authentic participation, and building democratic power, it might be possible to alter current patterns of health inequities. Strengthening participation by working with communities to develop the capacities needed to be effective in such processes is a key role for local, state, and national environmental agencies. PMID:22021323

A Systems Thinking Framework for Assessing and Addressing Malaria Locally: An Alternative to the Globalization of Anti-Malaria Policies

ERIC Educational Resources Information Center

Willis, Derek W.

2010-01-01

This dissertation analyzes a decision system that was used in the early 1900s in the Federated Malay States (FMS) by Malcolm Watson in order to make anti-malaria program recommendations to decision makers in a wide range of ecological settings. Watson's recommendations to decision makers throughout the FMS led to a dramatic suppression of malaria…

Local Choices: Rationality and the Contextuality of Decision-Making

PubMed Central

Vlaev, Ivo

2018-01-01

Rational explanation is ubiquitous in psychology and social sciences, ranging from rational analysis, expectancy-value theories, ideal observer models, mental logic to probabilistic frameworks, rational choice theory, and informal “folk psychological” explanation. However, rational explanation appears to be challenged by apparently systematic irrationality observed in psychological experiments, especially in the field of judgement and decision-making (JDM). Here, it is proposed that the experimental results require not that rational explanation should be rejected, but that rational explanation is local, i.e., within a context. Thus, rational models need to be supplemented with a theory of contextual shifts. We review evidence in JDM that patterns of choices are often consistent within contexts, but unstable between contexts. We also demonstrate that for a limited, though reasonably broad, class of decision-making domains, recent theoretical models can be viewed as providing theories of contextual shifts. It is argued that one particular significant source of global inconsistency arises from a cognitive inability to represent absolute magnitudes, whether for perceptual variables, utilities, payoffs, or probabilities. This overall argument provides a fresh perspective on the scope and limits of human rationality. PMID:29301289

Importance of scientific resources among local public health practitioners.

PubMed

Fields, Robert P; Stamatakis, Katherine A; Duggan, Kathleen; Brownson, Ross C

2015-04-01

We examined the perceived importance of scientific resources for decision-making among local health department (LHD) practitioners in the United States. We used data from LHD practitioners (n = 849). Respondents ranked important decision-making resources, methods for learning about public health research, and academic journal use. We calculated descriptive statistics and used logistic regression to measure associations of individual and LHD characteristics with importance of scientific resources. Systematic reviews of scientific literature (24.7%) were most frequently ranked as important among scientific resources, followed by scientific reports (15.9%), general literature review articles (6.5%), and 1 or a few scientific studies (4.8%). Graduate-level education (adjusted odds ratios [AORs] = 1.7-3.5), larger LHD size (AORs = 2.0-3.5), and leadership support (AOR = 1.6; 95% confidence interval = 1.1, 2.3) were associated with a higher ranking of importance of scientific resources. Graduate training, larger LHD size, and leadership that supports a culture of evidence-based decision-making may increase the likelihood of practitioners viewing scientific resources as important. Targeting communication channels that practitioners view as important can also guide research dissemination strategies.

Local Choices: Rationality and the Contextuality of Decision-Making.

PubMed

Vlaev, Ivo

2018-01-02

Rational explanation is ubiquitous in psychology and social sciences, ranging from rational analysis, expectancy-value theories, ideal observer models, mental logic to probabilistic frameworks, rational choice theory, and informal "folk psychological" explanation. However, rational explanation appears to be challenged by apparently systematic irrationality observed in psychological experiments, especially in the field of judgement and decision-making (JDM). Here, it is proposed that the experimental results require not that rational explanation should be rejected, but that rational explanation is local , i.e., within a context. Thus, rational models need to be supplemented with a theory of contextual shifts. We review evidence in JDM that patterns of choices are often consistent within contexts, but unstable between contexts. We also demonstrate that for a limited, though reasonably broad, class of decision-making domains, recent theoretical models can be viewed as providing theories of contextual shifts. It is argued that one particular significant source of global inconsistency arises from a cognitive inability to represent absolute magnitudes, whether for perceptual variables, utilities, payoffs, or probabilities. This overall argument provides a fresh perspective on the scope and limits of human rationality.

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

PubMed

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

2016-10-31

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

Impact of a web-based prostate cancer treatment decision aid on patient-reported decision process parameters: results from the Prostate Cancer Patient Centered Care trial.

PubMed

Cuypers, Maarten; Lamers, Romy E D; Kil, Paul J M; van de Poll-Franse, Lonneke V; de Vries, Marieke

2018-05-12

To compare patients' evaluation of the treatment decision-making process in localized prostate cancer between counseling that included an online decision aid (DA) and standard counseling. Eighteen Dutch hospitals were randomized to DA counseling (n = 235) or the control group with standard counseling (n = 101) in a pragmatic, cluster randomized controlled trial. The DA was provided to patients at, or soon after diagnosis. Decisional conflict, involvement, knowledge, and satisfaction with information were assessed with a questionnaire after treatment decision-making. Anxiety and depression served as covariates. The levels of decision involvement and conflict were comparable between patients in both groups. Patients with a DA felt more knowledgeable but scored equally well on a knowledge test as patients without a DA. Small significant negative effects were found on satisfaction with information and preparation for decision-making. A preference for print over online and depression and anxiety symptoms was negatively associated with satisfaction and conflict scores in the DA group. The DA aimed to support shared decision-making, while outcomes for a majority of DA users were comparable to patients who received standard counseling. Patients, who are less comfortable with the online DA format or experience anxiety or depression symptoms, could require more guidance toward shared decision-making. To evaluate long-term DA effects, follow-up evaluation on treatment satisfaction and decisional regret will be done.

Characterizing uncertain sea-level rise projections to support investment decisions.

PubMed

Sriver, Ryan L; Lempert, Robert J; Wikman-Svahn, Per; Keller, Klaus

2018-01-01

Many institutions worldwide are considering how to include uncertainty about future changes in sea-levels and storm surges into their investment decisions regarding large capital infrastructures. Here we examine how to characterize deeply uncertain climate change projections to support such decisions using Robust Decision Making analysis. We address questions regarding how to confront the potential for future changes in low probability but large impact flooding events due to changes in sea-levels and storm surges. Such extreme events can affect investments in infrastructure but have proved difficult to consider in such decisions because of the deep uncertainty surrounding them. This study utilizes Robust Decision Making methods to address two questions applied to investment decisions at the Port of Los Angeles: (1) Under what future conditions would a Port of Los Angeles decision to harden its facilities against extreme flood scenarios at the next upgrade pass a cost-benefit test, and (2) Do sea-level rise projections and other information suggest such conditions are sufficiently likely to justify such an investment? We also compare and contrast the Robust Decision Making methods with a full probabilistic analysis. These two analysis frameworks result in similar investment recommendations for different idealized future sea-level projections, but provide different information to decision makers and envision different types of engagement with stakeholders. In particular, the full probabilistic analysis begins by aggregating the best scientific information into a single set of joint probability distributions, while the Robust Decision Making analysis identifies scenarios where a decision to invest in near-term response to extreme sea-level rise passes a cost-benefit test, and then assembles scientific information of differing levels of confidence to help decision makers judge whether or not these scenarios are sufficiently likely to justify making such investments. Results highlight the highly-localized and context dependent nature of applying Robust Decision Making methods to inform investment decisions.

Characterizing uncertain sea-level rise projections to support investment decisions

PubMed Central

Lempert, Robert J.; Wikman-Svahn, Per; Keller, Klaus

2018-01-01

Many institutions worldwide are considering how to include uncertainty about future changes in sea-levels and storm surges into their investment decisions regarding large capital infrastructures. Here we examine how to characterize deeply uncertain climate change projections to support such decisions using Robust Decision Making analysis. We address questions regarding how to confront the potential for future changes in low probability but large impact flooding events due to changes in sea-levels and storm surges. Such extreme events can affect investments in infrastructure but have proved difficult to consider in such decisions because of the deep uncertainty surrounding them. This study utilizes Robust Decision Making methods to address two questions applied to investment decisions at the Port of Los Angeles: (1) Under what future conditions would a Port of Los Angeles decision to harden its facilities against extreme flood scenarios at the next upgrade pass a cost-benefit test, and (2) Do sea-level rise projections and other information suggest such conditions are sufficiently likely to justify such an investment? We also compare and contrast the Robust Decision Making methods with a full probabilistic analysis. These two analysis frameworks result in similar investment recommendations for different idealized future sea-level projections, but provide different information to decision makers and envision different types of engagement with stakeholders. In particular, the full probabilistic analysis begins by aggregating the best scientific information into a single set of joint probability distributions, while the Robust Decision Making analysis identifies scenarios where a decision to invest in near-term response to extreme sea-level rise passes a cost-benefit test, and then assembles scientific information of differing levels of confidence to help decision makers judge whether or not these scenarios are sufficiently likely to justify making such investments. Results highlight the highly-localized and context dependent nature of applying Robust Decision Making methods to inform investment decisions. PMID:29414978

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.

Analysis of the decision-making process leading to appendectomy: a grounded theory study.

PubMed

Larsson, Gerry; Weibull, Henrik; Larsson, Bodil Wilde

2004-11-01

The aim was to develop a theoretical understanding of the decision-making process leading to appendectomy. A qualitative interview study was performed in the grounded theory tradition using the constant comparative method to analyze data. The study setting was one county hospital and two local hospitals in Sweden, where 11 surgeons and 15 surgical nurses were interviewed. A model was developed which suggests that surgeons' decision making regarding appendectomy is formed by the interplay between their medical assessment of the patient's condition and a set of contextual characteristics. The latter consist of three interacting factors: (1) organizational conditions, (2) the professional actors' individual characteristics and interaction, and (3) the personal characteristics of the patient and his or her family or relatives. In case the outcome of medical assessment is ambiguous, the risk evaluation and final decision will be influenced by an interaction of the contextual characteristics. It was concluded that, compared to existing, rational models of decision making, the model presented identified potentially important contextual characteristics and an outline on when they come into play.

24 CFR 55.27 - Documentation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FLOODPLAIN MANAGEMENT Procedures for Making Determinations on Floodplain Management § 55.27 Documentation. (a... outside the floodplain, but within the local housing market area, the local public utility service area..., documentation of compliance with this part must be included as a part of the record of decision (or...

Effect of Wind Farm Noise on Local Residents' Decision to Adopt Mitigation Measures.

PubMed

Botelho, Anabela; Arezes, Pedro; Bernardo, Carlos; Dias, Hernâni; Pinto, Lígia M Costa

2017-07-11

Wind turbines' noise is frequently pointed out as the reason for local communities' objection to the installation of wind farms. The literature suggests that local residents feel annoyed by such noise and that, in many instances, this is significant enough to make them adopt noise-abatement interventions on their homes. Aiming at characterizing the relationship between wind turbine noise, annoyance, and mitigating actions, we propose a novel conceptual framework. The proposed framework posits that actual sound pressure levels of wind turbines determine individual homes' noise-abatement decisions; in addition, the framework analyzes the role that self-reported annoyance, and perception of noise levels, plays on the relationship between actual noise pressure levels and those decisions. The application of this framework to a particular case study shows that noise perception and annoyance constitutes a link between the two. Importantly, however, noise also directly affects people's decision to adopt mitigating measures, independently of the reported annoyance.

Making Health System Performance Measurement Useful to Policy Makers: Aligning Strategies, Measurement and Local Health System Accountability in Ontario

PubMed Central

Veillard, Jeremy; Huynh, Tai; Ardal, Sten; Kadandale, Sowmya; Klazinga, Niek S.; Brown, Adalsteinn D.

2010-01-01

This study examined the experience of the Ontario Ministry of Health and Long-Term Care in enhancing its stewardship and performance management role by developing a health system strategy map and a strategy-based scorecard through a process of policy reviews and expert consultations, and linking them to accountability agreements. An evaluation of the implementation and of the effects of the policy intervention has been carried out through direct policy observation over three years, document analysis, interviews with decision-makers and systematic discussion of findings with other authors and external reviewers. Cascading strategies at health and local health system levels were identified, and a core set of health system and local health system performance indicators was selected and incorporated into accountability agreements with the Local Health Integration Networks. despite the persistence of such challenges as measurement limitations and lack of systematic linkage to decision-making processes, these activities helped to strengthen substantially the ministry's performance management function. PMID:21286268

Integrating Indigenous Traditional, Local and Scientific Knowledge for Improved Management, Policy and Decision-Making in Reindeer Husbandry in the Russian Arctic

NASA Technical Reports Server (NTRS)

Maynard, Nancy G.; Yurchak, Boris; Turi, Johan Mathis; Mathiesen, Svein D.; Aissi-Wespi, Rita L.

2004-01-01

As scientists and policy-makers from both indigenous and non-indigenous communities begin to build closer partnerships to address common sustainability issues such as the health impacts of climate change and anthropogenic activities, it becomes increasingly important to create shared information management systems which integrate all relevant factors for optimal information sharing and decision-making. This paper describes a new GIs-based system being designed to bring local and indigenous traditional knowledge together with scientific data and information, remote sensing, and information technologies to address health-related environment, weather, climate, pollution and land use change issues for improved decision/policy-making for reindeer husbandry. The system is building an easily-accessible archive of relevant current and historical, traditional, local and remotely-sensed and other data and observations for shared analysis, measuring, and monitoring parameters of interest. Protection of indigenous culturally sensitive information will be respected through appropriate data protocols. A mechanism which enables easy information sharing among all participants, which is real time and geo-referenced and which allows interconnectivity with remote sites is also being designed into the system for maximum communication among partners. A preliminary version of our system will be described for a Russian reindeer test site, which will include a combination of indigenous knowledge about local conditions and issues, remote sensing and ground-based data on such parameters as the vegetation state and distribution, snow cover, temperature, ice condition, and infrastructure.

Chronic Motivational State Interacts with Task Reward Structure in Dynamic Decision-Making

PubMed Central

Cooper, Jessica A.; Worthy, Darrell A.; Maddox, W. Todd

2015-01-01

Research distinguishes between a habitual, model-free system motivated toward immediately rewarding actions, and a goal-directed, model-based system motivated toward actions that improve future state. We examined the balance of processing in these two systems during state-based decision-making. We tested a regulatory fit hypothesis (Maddox & Markman, 2010) that predicts that global trait motivation affects the balance of habitual- vs. goal-directed processing but only through its interaction with the task framing as gain-maximization or loss-minimization. We found support for the hypothesis that a match between an individual’s chronic motivational state and the task framing enhances goal-directed processing, and thus state-based decision-making. Specifically, chronic promotion-focused individuals under gain-maximization and chronic prevention-focused individuals under loss-minimization both showed enhanced state-based decision-making. Computational modeling indicates that individuals in a match between global chronic motivational state and local task reward structure engaged more goal-directed processing, whereas those in a mismatch engaged more habitual processing. PMID:26520256

Gender, households, and decision-making for wildfire safety.

PubMed

Tyler, Meagan; Fairbrother, Peter

2018-03-13

This paper considers the impact of gendered norms on decision-making for wildfire preparation and response at the household level. Focusing on Australia, it provides a theoretical thematic analysis of data acquired in 107 interviews with residents of nine different localities. It builds on existing research on gender and disaster, as well as on decision-making and wildfires, and analyses the narratives that centre on 'split' households plans (where a male partner plans to stay and a female partner plans to evacuate) and disagreements within heterosexual couples as to an appropriate wildfire safety plan. The study finds that gender inequality and differences in gendered expectations are likely to create difficult conditions for negotiation between members of a heterosexual couple when there is disagreement over a plan and that this may contribute to risky decision-making practices and outcomes. The paper reiterates, therefore, the importance of taking into account the social construction of gender in wildfire research and policy. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

The neural circuit and synaptic dynamics underlying perceptual decision-making

NASA Astrophysics Data System (ADS)

Liu, Feng

2015-03-01

Decision-making with several choice options is central to cognition. To elucidate the neural mechanisms of multiple-choice motion discrimination, we built a continuous recurrent network model to represent a local circuit in the lateral intraparietal area (LIP). The network is composed of pyramidal cells and interneurons, which are directionally tuned. All neurons are reciprocally connected, and the synaptic connectivity strength is heterogeneous. Specifically, we assume two types of inhibitory connectivity to pyramidal cells: opposite-feature and similar-feature inhibition. The model accounted for both physiological and behavioral data from monkey experiments. The network is endowed with slow excitatory reverberation, which subserves the buildup and maintenance of persistent neural activity, and predominant feedback inhibition, which underlies the winner-take-all competition and attractor dynamics. The opposite-feature and opposite-feature inhibition have different effects on decision-making, and only their combination allows for a categorical choice among 12 alternatives. Together, our work highlights the importance of structured synaptic inhibition in multiple-choice decision-making processes.

The Role of Local Action Teams in School Improvement. Linking R&D with Schools.

ERIC Educational Resources Information Center

Kell, Diane; Louis, Karen Seashore

Intended as a guide for educators in shared decision-making, this report summarizes the structures, procedures, and activities of local action teams in 49 schools involved in the National Institute of Education's Research and Development Utilization (RDU) program. Local action teams in the RDU program consisted of formal groups of teachers and…

Financing State and Local Governments. Third Edition. Studies of Government Finance Series.

ERIC Educational Resources Information Center

Maxwell, James A.; Aronson, J. Richard

This book provides a nontechnical analysis of state and local finances that is intended to provide educators, lawmakers, students, and voters with the background necessary to form intelligent opinions and make effective decisions. The authors summarize current theories of the incidence of the major state and local taxes, assess the capacity of…

The Local Food Grower's Behavior during Planning, Growing, Harvesting, and Selling

ERIC Educational Resources Information Center

Gumirakiza, J. Dominique

2016-01-01

This article presents a perspective on the behavior of the local food grower during the market-related decision-making process. The relevant behavior is manifested during the planning, growing, and harvesting and selling phases of the agricultural business cycle. The local food grower faces a set of market alternatives from which, if applying a…

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

PubMed

Jbilou, Jalila; Amara, Nabil; Landry, Réjean

2007-06-01

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

Managing resources in NHS dentistry: the views of decision-makers in primary care organisations.

PubMed

Holmes, R D; Donaldson, C; Exley, C; Steele, J G

2008-09-27

To investigate priority setting and decision-making in primary care organisations and to determine how resources are managed in order to meet the oral health needs of local populations. This is a qualitative study. The purposive sample comprised twelve dental public health consultants and six senior finance representatives from contrasting care systems across the United Kingdom. Participants completed a written information sheet followed by a recorded semi-structured telephone interview. Conversations were professionally transcribed verbatim and analysed independently by two investigators using the constant comparative method. The emergent themes focused upon: the role of participants in decision-making; professional relationships; managing change; information needs; and identifying and managing priorities. There was wide interpretation with respect to participants' roles and perceived information needs for decision-making and commissioning. A unifying factor was the importance placed by participants upon trust and the influence of individuals on the success of relationships forged between primary care organisations and general dental practitioners. To facilitate decision-making in primary care organisations, commissioners and managers could engage further with practitioners and incorporate them into commissioning and resource allocation processes. Greater clarity is required regarding the role of dental public health consultants within primary care organisations and commissioning decisions.

Is it Worth the Effort? Novel Insights into Obesity-Associated Alterations in Cost-Benefit Decision-Making

PubMed Central

Mathar, David; Horstmann, Annette; Pleger, Burkhard; Villringer, Arno; Neumann, Jane

2016-01-01

Cost-benefit decision-making entails the process of evaluating potential actions according to the trade-off between the expected reward (benefit) and the anticipated effort (costs). Recent research revealed that dopaminergic transmission within the fronto-striatal circuitry strongly modulates cost-benefit decision-making. Alterations within the dopaminergic fronto-striatal system have been associated with obesity, but little is known about cost-benefit decision-making differences in obese compared with lean individuals. With a newly developed experimental task we investigate obesity-associated alterations in cost-benefit decision-making, utilizing physical effort by handgrip-force exertion and both food and non-food rewards. We relate our behavioral findings to alterations in local gray matter volume assessed by structural MRI. Obese compared with lean subjects were less willing to engage in physical effort in particular for high-caloric sweet snack food. Further, self-reported body dissatisfaction negatively correlated with the willingness to invest effort for sweet snacks in obese men. On a structural level, obesity was associated with reductions in gray matter volume in bilateral prefrontal cortex. Nucleus accumbens volume positively correlated with task induced implicit food craving. Our results challenge the common notion that obese individuals are willing to work harder to obtain high-caloric food and emphasize the need for further exploration of the underlying neural mechanisms regarding cost-benefit decision-making differences in obesity. PMID:26793079

Decision-making performance in Parkinson's disease correlates with lateral orbitofrontal volume.

PubMed

Kobayakawa, Mutsutaka; Tsuruya, Natsuko; Kawamura, Mitsuru

2017-01-15

Patients with Parkinson's disease (PD) exhibit poor decision-making, and the underlying neural correlates are unclear. We used voxel-based morphometry with Diffeomorphic Anatomical Registration through Exponentiated Lie algebra to examine this issue. The decision-making abilities of 20 patients with PD and 37 healthy controls (HCs) were measured with a computerized Iowa Gambling Task (IGT). We assessed the local gray matter volumes of the patients and HCs and their correlations with decision-making performance, disease duration, disease severity, and anti-Parkinsonism medication dose. Compared with the HCs, the patients with PD exhibited poor IGT performances. The gray matter volumes in the medial orbitofrontal cortex, left inferior temporal cortex, and right middle frontal gyrus were decreased in the patients. Results in the regression analysis showed that lateral orbitofrontal volume correlated with performance in the IGT in PD. Regions that correlated with disease duration, severity, and medication dose did not overlap with orbitofrontal regions. Our results indicate that the lateral and medial orbitofrontal cortex are related to decision-making in PD patients. Since the medial orbitofrontal cortex is shown to be involved in monitoring reward, reward monitoring seems to be impaired as a whole in PD patients. Meanwhile, the lateral region is related to evaluation of punishment, which is considered to have an influence on individual differences in decision-making performance in PD patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Is it Worth the Effort? Novel Insights into Obesity-Associated Alterations in Cost-Benefit Decision-Making.

PubMed

Mathar, David; Horstmann, Annette; Pleger, Burkhard; Villringer, Arno; Neumann, Jane

2015-01-01

Cost-benefit decision-making entails the process of evaluating potential actions according to the trade-off between the expected reward (benefit) and the anticipated effort (costs). Recent research revealed that dopaminergic transmission within the fronto-striatal circuitry strongly modulates cost-benefit decision-making. Alterations within the dopaminergic fronto-striatal system have been associated with obesity, but little is known about cost-benefit decision-making differences in obese compared with lean individuals. With a newly developed experimental task we investigate obesity-associated alterations in cost-benefit decision-making, utilizing physical effort by handgrip-force exertion and both food and non-food rewards. We relate our behavioral findings to alterations in local gray matter volume assessed by structural MRI. Obese compared with lean subjects were less willing to engage in physical effort in particular for high-caloric sweet snack food. Further, self-reported body dissatisfaction negatively correlated with the willingness to invest effort for sweet snacks in obese men. On a structural level, obesity was associated with reductions in gray matter volume in bilateral prefrontal cortex. Nucleus accumbens volume positively correlated with task induced implicit food craving. Our results challenge the common notion that obese individuals are willing to work harder to obtain high-caloric food and emphasize the need for further exploration of the underlying neural mechanisms regarding cost-benefit decision-making differences in obesity.

New Zealand's new alcohol laws: protocol for a mixed-methods evaluation.

PubMed

Maclennan, Brett; Kypri, Kypros; Connor, Jennie; Potiki, Tuari; Room, Robin

2016-01-13

Alcohol consumption is a major cause of mortality and morbidity globally. In response to strong calls from the public for alcohol law reform, the New Zealand Government recently reduced the blood alcohol limit for driving and introduced the Sale and Supply of Alcohol Act which aim to (1) improve community input into local decision-making on alcohol; (2) reduce the availability of alcohol; and (3) reduce hazardous drinking and alcohol-related harm. In this project we seek to evaluate the new laws in terms of these objectives. A policy evaluation framework is proposed to investigate the implementation and outcomes of the reforms. We will use quantitative and qualitative methods, employing a pre-post design. Participants include members of the public, local government staff, iwi (Māori tribal groups that function collectively to support their members) and community group representatives. Data will be collected via postal surveys, interviews and analysis of local government documents. Liquor licensing, police and hospital injury data will also be used. Community input into local government decision-making will be operationalised as: the number of objections per license application and the number of local governments adopting a local alcohol policy (LAP). Outcome measures will be the 'restrictiveness' of LAPs compared to previous policies, the number (per 1000 residents) and density (per square kilometre) of alcohol outlets throughout NZ, and the number of weekend late-night (i.e., post 10 pm) trading hours. For consumption and harm, outcomes will be the prevalence of hazardous drinking, harm from own and others' drinking, community amenity effects, rates of assault, and rates of alcohol-involved traffic crashes. Multiple regression will be used to model how the outcomes vary by local government area from before to after the law changes take effect. These measures will be complemented by qualitative analysis of LAP development and public participation in local decision-making on alcohol. The project will evaluate how well the reforms meet their explicit public health objectives.

Information Foraging Across the Life Span: Search and Switch in Unknown Patches.

PubMed

Chin, Jessie; Payne, Brennan R; Fu, Wai-Tat; Morrow, Daniel G; Stine-Morrow, Elizabeth A L

2015-07-01

In this study, we used a word search puzzle paradigm to investigate age differences in the rate of information gain (RG; i.e., word gain as a function of time) and the cues used to make patch-departure decisions in information foraging. The likelihood of patch departure increased as the profitability of the patch decreased generally. Both younger and older adults persisted past the point of optimality as defined by the marginal value theorem (Charnov, 1976), which assumes perfect knowledge of the foraging ecology. Nevertheless, there was evidence that adults were rational in terms of being sensitive to the change in RG for making the patch-departure decisions. However, given the limitations in cognitive resources and knowledge about the ecology, the estimation of RG may not be accurate. Younger adults were more likely to leave the puzzle as the long-term RG incrementally decreased, whereas older adults were more likely to leave the puzzle as the local RG decreased. However, older adults with better executive control were more likely to adjust their likelihood of patch-departure decisions to the long-term change in RG. Thus, age-dependent reliance on the long-term or local change in RG to make patch-departure decisions might be due to individual differences in executive control. Copyright © 2015 Cognitive Science Society, Inc.

Health technology assessment in Saudi Arabia.

PubMed

Al-Aqeel, Sinaa

2018-05-16

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

Constructing a clinical decision-making framework for image-guided radiotherapy using a Bayesian Network

NASA Astrophysics Data System (ADS)

Hargrave, C.; Moores, M.; Deegan, T.; Gibbs, A.; Poulsen, M.; Harden, F.; Mengersen, K.

2014-03-01

A decision-making framework for image-guided radiotherapy (IGRT) is being developed using a Bayesian Network (BN) to graphically describe, and probabilistically quantify, the many interacting factors that are involved in this complex clinical process. Outputs of the BN will provide decision-support for radiation therapists to assist them to make correct inferences relating to the likelihood of treatment delivery accuracy for a given image-guided set-up correction. The framework is being developed as a dynamic object-oriented BN, allowing for complex modelling with specific subregions, as well as representation of the sequential decision-making and belief updating associated with IGRT. A prototype graphic structure for the BN was developed by analysing IGRT practices at a local radiotherapy department and incorporating results obtained from a literature review. Clinical stakeholders reviewed the BN to validate its structure. The BN consists of a sub-network for evaluating the accuracy of IGRT practices and technology. The directed acyclic graph (DAG) contains nodes and directional arcs representing the causal relationship between the many interacting factors such as tumour site and its associated critical organs, technology and technique, and inter-user variability. The BN was extended to support on-line and off-line decision-making with respect to treatment plan compliance. Following conceptualisation of the framework, the BN will be quantified. It is anticipated that the finalised decision-making framework will provide a foundation to develop better decision-support strategies and automated correction algorithms for IGRT.

How Connecticut Health Directors Deal With Public Health Budget Cuts at the Local Level

PubMed Central

Prust, Margaret L.; Clark, Kathleen; Davis, Brigette; Pallas, Sarah W.; Kertanis, Jennifer; O’Keefe, Elaine; Araas, Michael; Iyer, Neel S.; Dandorf, Stewart; Platis, Stephanie

2015-01-01

Objectives. We investigated the perspectives of local health jurisdiction (LHJ) directors on coping mechanisms used to respond to budget reductions and constraints on their decision-making. Methods. We conducted in-depth interviews with 17 LHJ directors. Interviews were audio recorded, transcribed, and analyzed using the constant comparative method. Results. LHJ directors use a range of coping mechanisms, including identifying alternative revenue sources, adjusting services, amending staffing arrangements, appealing to local political leaders, and forming strategic partnerships. LHJs also face constraints on their decision-making because of state and local statutory requirements, political priorities, pressures from other LHJs, and LHJ structure. Conclusions. LHJs respond creatively to budget cuts to maintain important public health services. Some LHJ adjustments to administrative resources may obscure the long-term costs of public health budget cuts in such areas as staff morale and turnover. Not all coping strategies are available to each LHJ because of the contextual constraints of its locality, pointing to important policy questions on identifying optimum jurisdiction size and improving efficiency. PMID:25689206

Evacuate or Shelter-in-place? The Role of Corporate Memory and Political Environment in Hospital-evacuation Decision Making.

PubMed

Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Kranke, Derrick; Dobalian, Aram

2015-06-01

Hospital-evacuation decisions are rarely straightforward in protracted advance-warning events. Previous work provides little insight into the decision-making process around evacuation. This study was conducted to identify factors that most heavily influenced the decisions to evacuate the US Department of Veterans Affairs (VA) New York Harbor Healthcare System's (NYHHS; New York USA) Manhattan Campus before Hurricane Irene in 2011 and before Superstorm Sandy in 2012. Semi-structured interviews with 11 senior leaders were conducted on the processes and factors that influenced the evacuation decisions prior to each event. The most influential factor in the decision to evacuate the Manhattan Campus before Hurricane Irene was New York City's (NYC's) hospital-evacuation mandate. As a federal facility, the Manhattan VA medical center (VAMC) was exempt from the city's order, but decision makers felt compelled to comply. In the case of Superstorm Sandy, corporate memory of a similar 1992 storm that crippled the Manhattan facility drove the decision to evacuate before the storm hit. Results suggest that hospital-evacuation decisions are confounded by political considerations and are influenced by past disaster experience. Greater shared situational awareness among at-risk hospitals, along with a more coordinated approach to evacuation decision making, could reduce pressure on hospitals to make these high-stakes decisions. Systematic mechanisms for collecting, documenting, and sharing lessons learned from past disasters are sorely needed at the institutional, local, and national levels.

Making the right decisions about new technologies: a perspective on criteria and preferences in hospitals.

PubMed

Gurtner, Sebastian

2014-01-01

Decision makers in hospitals are regularly faced with choices about the adoption of new technologies. Wrong decisions lead to a waste of resources and can have serious effects on the patients' and hospital's well-being. The goal of this research was to contribute to the understanding of decision making in hospitals. This study produced insights regarding relevant decision criteria and explored their specific relevance. An initial empirical survey was used to collect the relevant criteria for technological decision making in hospitals. In total, 220 experts in the field of health technology assessment from 34 countries participated in the survey. As a second step, the abovementioned criteria were used to form the basis of an analytic hierarchy process model. A group of 115 physicians, medical technical assistants, and other staff, all of whom worked in the field of radiooncology, prioritized the criteria. An analysis of variance was performed to explore differences among groups in terms of institutional and personal categorization variables. The first part of the research revealed seven key criteria for technological decision making in hospitals. The analytic hierarchy process model revealed that organizational impact was the most important criterion, followed by budget impact. The analysis of variance indicated that there were differences in the perceptions of the importance of the identified criteria. This exploration of the criteria for technological decision making in hospitals will help decision makers consider all of the relevant aspects, leading to more structured and rational decisions. For the optimal resource allocation, all of the relevant stakeholder perspectives and local issues must be considered appropriately.

Working Memory and Decision-Making in a Frontoparietal Circuit Model

PubMed Central

2017-01-01

Working memory (WM) and decision-making (DM) are fundamental cognitive functions involving a distributed interacting network of brain areas, with the posterior parietal cortex (PPC) and prefrontal cortex (PFC) at the core. However, the shared and distinct roles of these areas and the nature of their coordination in cognitive function remain poorly understood. Biophysically based computational models of cortical circuits have provided insights into the mechanisms supporting these functions, yet they have primarily focused on the local microcircuit level, raising questions about the principles for distributed cognitive computation in multiregional networks. To examine these issues, we developed a distributed circuit model of two reciprocally interacting modules representing PPC and PFC circuits. The circuit architecture includes hierarchical differences in local recurrent structure and implements reciprocal long-range projections. This parsimonious model captures a range of behavioral and neuronal features of frontoparietal circuits across multiple WM and DM paradigms. In the context of WM, both areas exhibit persistent activity, but, in response to intervening distractors, PPC transiently encodes distractors while PFC filters distractors and supports WM robustness. With regard to DM, the PPC module generates graded representations of accumulated evidence supporting target selection, while the PFC module generates more categorical responses related to action or choice. These findings suggest computational principles for distributed, hierarchical processing in cortex during cognitive function and provide a framework for extension to multiregional models. SIGNIFICANCE STATEMENT Working memory and decision-making are fundamental “building blocks” of cognition, and deficits in these functions are associated with neuropsychiatric disorders such as schizophrenia. These cognitive functions engage distributed networks with prefrontal cortex (PFC) and posterior parietal cortex (PPC) at the core. It is not clear, however, what the contributions of PPC and PFC are in light of the computations that subserve working memory and decision-making. We constructed a biophysical model of a reciprocally connected frontoparietal circuit that revealed shared and distinct functions for the PFC and PPC across working memory and decision-making tasks. Our parsimonious model connects circuit-level properties to cognitive functions and suggests novel design principles beyond those of local circuits for cognitive processing in multiregional brain networks. PMID:29114071

Working Memory and Decision-Making in a Frontoparietal Circuit Model.

PubMed

Murray, John D; Jaramillo, Jorge; Wang, Xiao-Jing

2017-12-13

Working memory (WM) and decision-making (DM) are fundamental cognitive functions involving a distributed interacting network of brain areas, with the posterior parietal cortex (PPC) and prefrontal cortex (PFC) at the core. However, the shared and distinct roles of these areas and the nature of their coordination in cognitive function remain poorly understood. Biophysically based computational models of cortical circuits have provided insights into the mechanisms supporting these functions, yet they have primarily focused on the local microcircuit level, raising questions about the principles for distributed cognitive computation in multiregional networks. To examine these issues, we developed a distributed circuit model of two reciprocally interacting modules representing PPC and PFC circuits. The circuit architecture includes hierarchical differences in local recurrent structure and implements reciprocal long-range projections. This parsimonious model captures a range of behavioral and neuronal features of frontoparietal circuits across multiple WM and DM paradigms. In the context of WM, both areas exhibit persistent activity, but, in response to intervening distractors, PPC transiently encodes distractors while PFC filters distractors and supports WM robustness. With regard to DM, the PPC module generates graded representations of accumulated evidence supporting target selection, while the PFC module generates more categorical responses related to action or choice. These findings suggest computational principles for distributed, hierarchical processing in cortex during cognitive function and provide a framework for extension to multiregional models. SIGNIFICANCE STATEMENT Working memory and decision-making are fundamental "building blocks" of cognition, and deficits in these functions are associated with neuropsychiatric disorders such as schizophrenia. These cognitive functions engage distributed networks with prefrontal cortex (PFC) and posterior parietal cortex (PPC) at the core. It is not clear, however, what the contributions of PPC and PFC are in light of the computations that subserve working memory and decision-making. We constructed a biophysical model of a reciprocally connected frontoparietal circuit that revealed shared and distinct functions for the PFC and PPC across working memory and decision-making tasks. Our parsimonious model connects circuit-level properties to cognitive functions and suggests novel design principles beyond those of local circuits for cognitive processing in multiregional brain networks. Copyright © 2017 the authors 0270-6474/17/3712167-20$15.00/0.

Lucky Rhythms in Orbitofrontal Cortex Bias Gambling Decisions in Humans

PubMed Central

Sacré, Pierre; Kerr, Matthew S. D.; Kahn, Kevin; Gonzalez-Martinez, Jorge; Bulacio, Juan; Park, Hyun-Joo; Johnson, Matthew A.; Thompson, Susan; Jones, Jaes; Chib, Vikram S.; Gale, John T.; Sarma, Sridevi V.

2016-01-01

It is well established that emotions influence our decisions, yet the neural basis of this biasing effect is not well understood. Here we directly recorded local field potentials from the OrbitoFrontal Cortex (OFC) in five human subjects performing a financial decision-making task. We observed a striking increase in gamma-band (36–50 Hz) oscillatory activity that reflected subjects’ decisions to make riskier choices. Additionally, these gamma rhythms were linked back to mismatched expectations or “luck” occurring in past trials. Specifically, when a subject expected to win but lost, the trial was defined as “unlucky” and when the subject expected to lose but won, the trial was defined as “lucky”. Finally, a fading memory model of luck correlated to an objective measure of emotion, heart rate variability. Our findings suggest OFC may play a pivotal role in processing a subject’s internal (emotional) state during financial decision-making, a particularly interesting result in light of the more recent “cognitive map” theory of OFC function. PMID:27830753

Menopause and the virtuous woman: the importance of the moral order in accounting for medical decision making.

PubMed

Stephens, Christine; Breheny, Mary

2008-01-01

Whether or not to use hormone replacement therapy (HRT) around the time of menopause is seen as an important decision for many mid-aged women. Recent studies of information provided to women to assist them in making a medical decision about the use of HRT have highlighted the importance of understanding the broader social context of the decision. In this article we examine one important aspect of western mid-aged women's social world: the moral order and the imperative of virtue. Qualitative data from a survey, focus group discussions, and interviews with mid-aged women about HRT use are used to provide examples of the importance of the local moral order in women's talk about menopause and HRT use. The implications of these data will be discussed in terms of the different narrative resources available to construct menopause and HRT, the role of morality, and the demonstration of virtue in daily social life, including medical decision making.

Employee Participation Programs: Considerations for the School Site. Studies in Collective Bargaining.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Research Div.

Site-based decisionmaking programs offer important opportunities for school systems; however, the risks involved are significant and the decision to embrace the concept at the local level is a highly complex one. With site-based decisionmaking programs, teachers are directly involved in making decisions that affect the whole school, not merely…

Performance-Based Compensation: Focus on Special Education Teachers. inForum

ERIC Educational Resources Information Center

Burdette, Paula

2011-01-01

The purpose of this document is to describe states' work in the area of performance-based compensation with a focus on special educators, including how teacher evaluation informs compensation decisions, support given to local education agencies (LEAs), variables used to make compensation decisions and how performance-based compensation is funded.…

Policy Analysis | Energy Analysis | NREL

Science.gov Websites

policymakers and inform decision making. Featured Analysis 2016: Measuring the Impacts of Federal Tax Credit state policy on decision makers. Learn more about clean energy policy on the NREL State and Local Portfolio Standards also shows national water withdrawals and water consumption by fossil-fuel plants were

Enhanced Decision-Making: The Use of a Videotape Decision-Aid for Patients with Prostate Cancer.

ERIC Educational Resources Information Center

Schapira, Marilyn M.; Meade, Cathy; Nattinger, Ann B.

1997-01-01

The development of a videotape for patients considering treatment options for clinically localized prostate cancer is described. The effectiveness of videotape in improving short-term recall of treatment options and outcomes was assessed quantitatively; qualitative analysis was used to assess the likelihood of patient's active participation in the…

PLUS: 'Planning Land Use with Students' is a Local Land Use Policy That Showcase the Geosciences

NASA Astrophysics Data System (ADS)

Turrin, M.

2014-12-01

Land Use decisions in the local community are well represented in geoscience topics and issues, and provide an excellent opportunity to showcase a wide range of geoscience careers to high school students. In PLUS (Planning Land Use with Students) we work with youth corps, volunteer agencies and the County Departments of Planning, Transportation, Public Health, Water Resources to run a program for high school seniors to engage the students in the complex layers of decision making connected with land use as we showcase geoscience careers (http://www.ldeo.columbia.edu/edu/plus/index.html). How development occurs, what resources are in use and who makes these decisions is both interesting and relevant for students. We develop case studies around current, active, local land use issues large enough in scale to have a formal environmental review at the County and/or the State level. Sections of each case study are dedicated to addressing the range of environmental issues that are central to each land use decision. Water, its availability, planned use and treatment on the site, brings in both a review of local hydrology and a discussion of storm water management. Air quality and the impact of the proposed project's density, transportation plans, and commercial and industrial uses brings in air quality issues like air quality ratings, existing pollution, and local air monitoring. A review of the site plans brings in grading plans for the project area, which highlights issues of drainage, soil stability, and exposure to toxins or pollutants depending on the historic use of the site. Brownfield redevelopments are especially challenging with various monitoring, clean up and usage restrictions that are extremely interesting to the students. Students' work with mentors from the community who represent various roles in the planning process including a range of geosciences, community business members and other players in the planning process. This interplay of individuals provides a realistic look at the forces that move land use decision-making in a community. Discussion of impacts and mitigations highlight the intersection of policy and science. Debate arises on how much science should guide policy and how much land use policy decisions require science monitoring, pushing new scientific developments.

Participatory health impact assessment used to support decision-making in waste management planning: A replicable experience from Italy.

PubMed

Linzalone, Nunzia; Coi, Alessio; Lauriola, Paolo; Luise, Daniela; Pedone, Alessandra; Romizi, Roberto; Sallese, Domenico; Bianchi, Fabrizio

2017-01-01

The lack of participatory tools in Health Impact Assessment (HIA) to support decision-makers is a critical factor that negatively affects the impacts of waste policies. This study describes the participatory HIA used in deciding on the possible doubling of the municipal solid waste incinerating plant located near the city of Arezzo, Italy. Within the framework of the new waste management plan, a methodology for the democratic participation of stakeholders was designed adopting the Local Agenda 21 methodology. Communication and participation events with the stakeholders were set up from the plan's development to its implementation. Eleven different categories of stakeholders including individual citizens were involved in 21 local events, reaching over 500 participants in three years. Actions were performed to build the commitment and ownership of the local administrators. Then, together with the environment and health agencies and a representative from the local committees, the local administrators collaborated with scientists and technicians in the knowledge-building and scoping stages. Focus groups of voluntary citizens worked together with the researchers to provide qualitative and quantitative evidence in the assessment stage. Periodic public forums were held to discuss processes, methods and findings. The local government authority considered the HIA results in the final decision and a new waste strategy was adopted both in the short term (increased curbside collection, waste sustainability program) and in the long term (limited repowering of the incinerator, new targets for separate collection). In conclusion, an effective participatory HIA was carried out at the municipal level to support decision makers in the waste management plan. The HIA21 study contributed to evidence-based decisions and to make a broadly participatory experience. The authors are confident that these achievements may improve the governance of the waste cycle and the trust in the public administration. Copyright © 2016 Elsevier Ltd. All rights reserved.

How do patients between the age of 65 and 75 use a web-based decision aid for treatment choice in localized prostate cancer?

PubMed

Schrijvers, Jessie; Vanderhaegen, Joke; Van Poppel, Hendrik; Haustermans, Karin; Van Audenhove, Chantal

2013-08-01

This study was designed to evaluate the use of a web-based decision aid by a 65plus patient group in their decision-making process for treatment of localized prostate cancer. Of particular interest was the use of technology features such as patients' statements, comparative tables, and a values clarification tool. One hundred men from the University Hospital of Leuven campus, Gasthuisberg, were invited to use the web-based decision aid in their decision-making process. Twenty-six men were excluded based on non- or limited use of the decision aid. Of the remaining 74 men, user specifications, decision aid surfing characteristics by means of web-log data, and especially the use of technology features were analyzed. Men spent on average 30 minutes on the web-based decision aid. Most time was spent on the pages with information on treatment options. These pages were also most frequently accessed. The use of the feature 'comparative tables' was the highest, followed by the 'values clarification tool'. According to age (<70 or >70 years) differences were observed for the time spent on the decision aid, the pages accessed, and the use of the technology features. Despite concerns about the usability of a web-based decision aid for elderly patients, these results indicated that the majority of 65plus persons with good internet skills use a web-based decision aid as well as its incorporated technology features. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study.

PubMed

Hoffman, Richard M; Lo, Mary; Clark, Jack A; Albertsen, Peter C; Barry, Michael J; Goodman, Michael; Penson, David F; Stanford, Janet L; Stroup, Antoinette M; Hamilton, Ann S

2017-07-10

Purpose To determine the demographic, clinical, decision-making, and quality-of-life factors that are associated with treatment decision regret among long-term survivors of localized prostate cancer. Patients and Methods We evaluated men who were age ≤ 75 years when diagnosed with localized prostate cancer between October 1994 and October 1995 in one of six SEER tumor registries and who completed a 15-year follow-up survey. The survey obtained demographic, socioeconomic, and clinical data and measured treatment decision regret, informed decision making, general- and disease-specific quality of life, health worry, prostate-specific antigen (PSA) concern, and outlook on life. We used multivariable logistic regression analyses to identify factors associated with regret. Results We surveyed 934 participants, 69.3% of known survivors. Among the cohort, 59.1% had low-risk tumor characteristics (PSA < 10 ng/mL and Gleason score < 7), and 89.2% underwent active treatment. Overall, 14.6% expressed treatment decision regret: 8.2% of those whose disease was managed conservatively, 15.0% of those who received surgery, and 16.6% of those who underwent radiotherapy. Factors associated with regret on multivariable analysis included reporting moderate or big sexual function bother (reported by 39.0%; OR, 2.77; 95% CI, 1.51 to 5.0), moderate or big bowel function bother (reported by 7.7%; OR, 2.32; 95% CI, 1.04 to 5.15), and PSA concern (mean score 52.8; OR, 1.01 per point change; 95% CI, 1.00 to 1.02). Increasing age at diagnosis and report of having made an informed treatment decision were inversely associated with regret. Conclusion Regret was a relatively infrequently reported outcome among long-term survivors of localized prostate cancer; however, our results suggest that better informing men about treatment options, in particular, conservative treatment, might help mitigate long-term regret. These findings are timely for men with low-risk cancers who are being encouraged to consider active surveillance.

Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda

PubMed Central

Nabyonga-Orem, Juliet; Mijumbi, Rhona

2015-01-01

Background: Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods: Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results: Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion: What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. PMID:25905479

Promoting the rights and responsibilities of children: a South Australian example.

PubMed

George, Emma; Schmidt, Casey; Vella, Grace; McDonagh, Imelda

2017-03-01

In 2014, the Parafield Gardens Children's Centre for Early Childhood Development and Parenting was recognised as a Global Peace School - Early Years (GPSEY). During the recognition process, a project promoting the rights and responsibilities of children and families was facilitated. Partnering with children and families in decision making was a project priority. Young children had an active role in decision making. Through age-appropriate activities and discussions, children and families developed deeper understanding of child rights, peace building, global awareness and social inclusion. Educational staff were supported to enhance this child rights focus. A GPSEY recognition celebration acknowledged child rights and the community's cultural diversity. The outcome of GPSEY recognition is significant but the process that fostered community ownership, participation and social inclusion is worth noting. Involving children in decision making and development promotes their rights and responsibilities; this can make a positive difference for children locally, and globally.

Physician-Researchers' Experiences of the Consent Process in the Sociocultural Context of a Developing Country

PubMed Central

Malik, Aisha Y.

2011-01-01

Background: International guidelines for medical research involving human subjects maintain the primacy of informed consent while recognizing cultural diversity. Methods: This article draws on empirical data obtained from interviews with physician-researchers in teaching hospitals of Lahore, Pakistan, to identify social and cultural factors that affect the consent process for participants in research. Results: This article presents variable findings with regards to communication, comprehension, and decision making. While some physicians consider that social factors such as lack of education, a patriarchal family system, and skepticism about research can make patients dependent on either the physician-researcher or the family, others believe that patients do make independent decisions. Conclusions: In light of the findings, the article ends with a recommendation for communication and decision making that is sensitive to the local sociocultural environment while at the same time meeting the ethical imperative of respect for persons. PMID:22816063

Physician-Researchers' Experiences of the Consent Process in the Sociocultural Context of a Developing Country.

PubMed

Malik, Aisha Y

2011-07-01

Background: International guidelines for medical research involving human subjects maintain the primacy of informed consent while recognizing cultural diversity. Methods: This article draws on empirical data obtained from interviews with physician-researchers in teaching hospitals of Lahore, Pakistan, to identify social and cultural factors that affect the consent process for participants in research. Results: This article presents variable findings with regards to communication, comprehension, and decision making. While some physicians consider that social factors such as lack of education, a patriarchal family system, and skepticism about research can make patients dependent on either the physician-researcher or the family, others believe that patients do make independent decisions. Conclusions: In light of the findings, the article ends with a recommendation for communication and decision making that is sensitive to the local sociocultural environment while at the same time meeting the ethical imperative of respect for persons.

Effects and repercussions of local/hospital-based health technology assessment (HTA): a systematic review.

PubMed

Gagnon, Marie-Pierre; Desmartis, Marie; Poder, Thomas; Witteman, William

2014-10-28

Health technology assessment (HTA) is increasingly performed at the local or hospital level where the costs, impacts, and benefits of health technologies can be directly assessed. Although local/hospital-based HTA has been implemented for more than two decades in some jurisdictions, little is known about its effects and impact on hospital budget, clinical practices, and patient outcomes. We conducted a mixed-methods systematic review that aimed to synthesize current evidence regarding the effects and impact of local/hospital-based HTA. We identified articles through PubMed and Embase and by citation tracking of included studies. We selected qualitative, quantitative, or mixed-methods studies with empirical data about the effects or impact of local/hospital-based HTA on decision-making, budget, or perceptions of stakeholders. We extracted the following information from included studies: country, methodological approach, and use of conceptual framework; local/hospital HTA approach and activities described; reported effects and impacts of local/hospital-based HTA; factors facilitating/hampering the use of hospital-based HTA recommendations; and perceptions of stakeholders concerning local/hospital HTA. Due to the great heterogeneity among studies, we conducted a narrative synthesis of their results. A total of 18 studies met the inclusion criteria. We reported the results according to the four approaches for performing HTA proposed by the Hospital Based HTA Interest Sub-Group: ambassador model, mini-HTA, internal committee, and HTA unit. Results showed that each of these approaches for performing HTA corresponds to specific needs and structures and has its strengths and limitations. Overall, studies showed positive impacts related to local/hospital-based HTA on hospital decisions and budgets, as well as positive perceptions from managers and clinicians. Local/hospital-based HTA could influence decision-making on several aspects. It is difficult to evaluate the real impacts of local HTA at the different levels of health care given the relatively small number of evaluations with quantitative data and the lack of clear comparators. Further research is necessary to explore the conditions under which local/hospital-based HTA results and recommendations can impact hospital policies, clinical decisions, and quality of care and optimize the use of scarce resources.

Effects and repercussions of local/hospital-based health technology assessment (HTA): a systematic review

PubMed Central

2014-01-01

Background Health technology assessment (HTA) is increasingly performed at the local or hospital level where the costs, impacts, and benefits of health technologies can be directly assessed. Although local/hospital-based HTA has been implemented for more than two decades in some jurisdictions, little is known about its effects and impact on hospital budget, clinical practices, and patient outcomes. We conducted a mixed-methods systematic review that aimed to synthesize current evidence regarding the effects and impact of local/hospital-based HTA. Methods We identified articles through PubMed and Embase and by citation tracking of included studies. We selected qualitative, quantitative, or mixed-methods studies with empirical data about the effects or impact of local/hospital-based HTA on decision-making, budget, or perceptions of stakeholders. We extracted the following information from included studies: country, methodological approach, and use of conceptual framework; local/hospital HTA approach and activities described; reported effects and impacts of local/hospital-based HTA; factors facilitating/hampering the use of hospital-based HTA recommendations; and perceptions of stakeholders concerning local/hospital HTA. Due to the great heterogeneity among studies, we conducted a narrative synthesis of their results. Results A total of 18 studies met the inclusion criteria. We reported the results according to the four approaches for performing HTA proposed by the Hospital Based HTA Interest Sub-Group: ambassador model, mini-HTA, internal committee, and HTA unit. Results showed that each of these approaches for performing HTA corresponds to specific needs and structures and has its strengths and limitations. Overall, studies showed positive impacts related to local/hospital-based HTA on hospital decisions and budgets, as well as positive perceptions from managers and clinicians. Conclusions Local/hospital-based HTA could influence decision-making on several aspects. It is difficult to evaluate the real impacts of local HTA at the different levels of health care given the relatively small number of evaluations with quantitative data and the lack of clear comparators. Further research is necessary to explore the conditions under which local/hospital-based HTA results and recommendations can impact hospital policies, clinical decisions, and quality of care and optimize the use of scarce resources. PMID:25352182

State vs. Local Control: Reality or Myth over Concern for Local Autonomy.

ERIC Educational Resources Information Center

Mundt, John C.

1978-01-01

As examples of the trend towards decision-making processes resting on the interaction of various legitimate public sector interests, the author considers outside forces producing operational strictures within the system, including executive orders, lapsing and allotment procedures, accounting requirements, information demands, legal opinions,…

School-Based Management and Arts Education: Lessons from Chicago

ERIC Educational Resources Information Center

Fitzpatrick, Kate R.

2012-01-01

School-based management, or local school control, is an organizational school reform effort aimed at decentralizing school decision-making that has become prevalent in districts throughout the United States. Using the groundbreaking Chicago system of local school control as an exemplar, this article outlines the implications of such reform efforts…

Analysis And Assistant Planning System Ofregional Agricultural Economic Inform

NASA Astrophysics Data System (ADS)

Han, Jie; Zhang, Junfeng

For the common problems existed in regional development and planning, we try to design a decision support system for assisting regional agricultural development and alignment as a decision-making tool for local government and decision maker. The analysis methods of forecast, comparative advantage, liner programming and statistical analysis are adopted. According to comparative advantage theory, the regional advantage can be determined by calculating and comparing yield advantage index (YAI), Scale advantage index (SAI), Complicated advantage index (CAI). Combining with GIS, agricultural data are presented as a form of graph such as area, bar and pie to uncover the principle and trend for decision-making which can't be found in data table. This system provides assistant decisions for agricultural structure adjustment, agro-forestry development and planning, and can be integrated to information technologies such as RS, AI and so on.

Basic Information About the School Siting Guidelines

EPA Pesticide Factsheets

EPA's voluntary school siting guidelines provide recommendations for local school districts and community members on how to evaluate environmental factors to make the best possible school siting decisions.

The Complex Decision-Making Processes of Rural Emerging Adults: Counseling beyond Dualism

ERIC Educational Resources Information Center

San Antonio, Donna M.

2016-01-01

Rural adolescents approach the transition out of high school with individual concerns about making an emotionally or financially expensive "mistake," family concerns about young people leaving home, and national and local concerns about declining rural economies and out-migration. The literature concerning this topic considers factors…

Farmer responses to multiple stresses in the face of global change: Assessing five case studies to enhance adaptation

NASA Astrophysics Data System (ADS)

Nicholas, K. A.; Feola, G.; Lerner, A. M.; Jain, M.; Montefrio, M.

2013-12-01

The global challenge of sustaining agricultural livelihoods and yields in the face of growing populations and increasing climate change is the topic of intense research. The role of on-the-ground decision-making by individual farmers actually producing food, fuel, and fiber is often studied in individual cases to determine its environmental, economic, and social effects. However, there are few efforts to link across studies in a way that provides opportunities to better understand empirical farmer behavior, design effective policies, and be able to aggregate from case studies to a broader scale. Here we synthesize existing literature to identify four general factors affecting farmer decision-making: local technical and socio-cultural contexts; actors and institutions involved in decision-making; multiple stressors at broader scales; and the temporal gradient of decision-making. We use these factors to compare five cases that illustrate agricultural decision-making and its impacts: cotton and castor farming in Gujarat, India; swidden cultivation of upland rice in the Philippines; potato cultivation in Andean Colombia; winegrowing in Northern California; and maize production in peri-urban central Mexico. These cases span a geographic and economic range of production systems, but we find that we are able to make valid comparisons and draw lessons common across all cases by using the four factors as an organizing principle. We also find that our understanding of why farmers make the decisions they do changes if we neglect to examine even one of the four general factors guiding decision-making. This suggests that these four factors are important to understanding farmer decision-making, and can be used to guide the design and interpretation of future studies, as well as be the subject of further research in and of themselves to promote an agricultural system that is resilient to climate and other global environmental changes.

Mapping social-ecological vulnerability to inform local decision making.

PubMed

Thiault, Lauric; Marshall, Paul; Gelcich, Stefan; Collin, Antoine; Chlous, Frédérique; Claudet, Joachim

2018-04-01

An overarching challenge of natural resource management and biodiversity conservation is that relationships between people and nature are difficult to integrate into tools that can effectively guide decision making. Social-ecological vulnerability offers a valuable framework for identifying and understanding important social-ecological linkages, and the implications of dependencies and other feedback loops in the system. Unfortunately, its implementation at local scales has hitherto been limited due at least in part to the lack of operational tools for spatial representation of social-ecological vulnerability. We developed a method to map social-ecological vulnerability based on information on human-nature dependencies and ecosystem services at local scales. We applied our method to the small-scale fishery of Moorea, French Polynesia, by combining spatially explicit indicators of exposure, sensitivity, and adaptive capacity of both the resource (i.e., vulnerability of reef fish assemblages to fishing) and resource users (i.e., vulnerability of fishing households to the loss of fishing opportunity). Our results revealed that both social and ecological vulnerabilities varied considerably through space and highlighted areas where sources of vulnerability were high for both social and ecological subsystems (i.e., social-ecological vulnerability hotspots) and thus of high priority for management intervention. Our approach can be used to inform decisions about where biodiversity conservation strategies are likely to be more effective and how social impacts from policy decisions can be minimized. It provides a new perspective on human-nature linkages that can help guide sustainability management at local scales; delivers insights distinct from those provided by emphasis on a single vulnerability component (e.g., exposure); and demonstrates the feasibility and value of operationalizing the social-ecological vulnerability framework for policy, planning, and participatory management decisions. © 2017 Society for Conservation Biology.

The Effect of Visual Signals on Spatial Decision Making

ERIC Educational Resources Information Center

Danziger, Shai; Rafal, Robert

2009-01-01

We examined the effect of an irrelevant visual transient on the decision where to look for a hidden object. Participants also performed a conventional "inhibition of return" localization task. In Experiments 1 and 2 the two tasks were blocked and in Experiments 3 and 4 they were randomly interleaved. In every experiment there was a bias to select…

Managing United States public lands in response to climate change: a view from the ground up.

PubMed

Ellenwood, Mikaela S; Dilling, Lisa; Milford, Jana B

2012-05-01

Federal land managers are faced with the task of balancing multiple uses and goals when making decisions about land use and the activities that occur on public lands. Though climate change is now well recognized by federal agencies and their local land and resource managers, it is not yet clear how issues related to climate change will be incorporated into on-the-ground decision making within the framework of multiple use objectives. We conducted a case study of a federal land management agency field office, the San Juan Public Lands Center in Durango, CO, U.S.A., to understand from their perspective how decisions are currently made, and how climate change and carbon management are being factored into decision making. We evaluated three major management sectors in which climate change or carbon management may intersect other use goals: forests, biofuels, and grazing. While land managers are aware of climate change and eager to understand more about how it might affect land resources, the incorporation of climate change considerations into everyday decision making is currently quite limited. Climate change is therefore on the radar screen, but remains a lower priority than other issues. To assist the office in making decisions that are based on sound scientific information, further research is needed into how management activities influence carbon storage and resilience of the landscape under climate change.

Towards representing human behavior and decision making in Earth system models - an overview of techniques and approaches

NASA Astrophysics Data System (ADS)

Müller-Hansen, Finn; Schlüter, Maja; Mäs, Michael; Donges, Jonathan F.; Kolb, Jakob J.; Thonicke, Kirsten; Heitzig, Jobst

2017-11-01

Today, humans have a critical impact on the Earth system and vice versa, which can generate complex feedback processes between social and ecological dynamics. Integrating human behavior into formal Earth system models (ESMs), however, requires crucial modeling assumptions about actors and their goals, behavioral options, and decision rules, as well as modeling decisions regarding human social interactions and the aggregation of individuals' behavior. Here, we review existing modeling approaches and techniques from various disciplines and schools of thought dealing with human behavior at different levels of decision making. We demonstrate modelers' often vast degrees of freedom but also seek to make modelers aware of the often crucial consequences of seemingly innocent modeling assumptions. After discussing which socioeconomic units are potentially important for ESMs, we compare models of individual decision making that correspond to alternative behavioral theories and that make diverse modeling assumptions about individuals' preferences, beliefs, decision rules, and foresight. We review approaches to model social interaction, covering game theoretic frameworks, models of social influence, and network models. Finally, we discuss approaches to studying how the behavior of individuals, groups, and organizations can aggregate to complex collective phenomena, discussing agent-based, statistical, and representative-agent modeling and economic macro-dynamics. We illustrate the main ingredients of modeling techniques with examples from land-use dynamics as one of the main drivers of environmental change bridging local to global scales.

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.

A conceptual framework for negotiating public involvement in municipal waste management decision-making in the UK.

PubMed

Garnett, Kenisha; Cooper, Tim; Longhurst, Philip; Jude, Simon; Tyrrel, Sean

2017-08-01

The technical expertise that politicians relied on in the past to produce cost-effective and environmentally sound solutions no longer provides sufficient justification to approve waste facilities. Local authorities need to find more effective ways to involve stakeholders and communities in decision-making since public acceptance of municipal waste facilities is integral to delivering effective waste strategies. This paper presents findings from a research project that explored attitudes towards greater levels of public involvement in UK waste management decision-making. The study addressed questions of perception, interests, the decision context, the means of engagement and the necessary resources and capacity for adopting a participatory decision process. Adopting a mixed methods approach, the research produced an empirical framework for negotiating the mode and level of public involvement in waste management decision-making. The framework captures and builds on theories of public involvement and the experiences of practitioners, and offers guidance for integrating analysis and deliberation with public groups in different waste management decision contexts. Principles in the framework operate on the premise that the decision about 'more' and 'better' forms of public involvement can be negotiated, based on the nature of the waste problem and wider social context of decision-making. The collection of opinions from the wide range of stakeholders involved in the study has produced new insights for the design of public engagement processes that are context-dependent and 'fit-for-purpose'; these suggest a need for greater inclusivity in the case of contentious technologies and high levels of uncertainty regarding decision outcomes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Limits to relational autonomy--the Singaporean experience.

PubMed

Krishna, Lalit Kumar Radha; Watkinson, Deborah S; Beng, Ng Lee

2015-05-01

Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted Western led atomistic concepts of autonomy. Evidence suggests that despite a growing infusion of Western influence, there is still little to indicate any major shift to individual decision making, particularly in light of the way society and healthcare are structured. Similarly, the lack of employing a shared decision-making model and data that discredit the notion that the complex psychosocial and cultural factors that affect the decision making may be considered "content neutral" not only prevents the application of relational autonomy but questions the viability of the values behind the Principle of Respect for Autonomy. Taking into account local data and drawing upon a wider concept of personhood that extends beyond prevailing family-centric ideals along with the complex interests that are focused upon the preservation of the unique nature of personhood that arises from the Ring Theory of Personhood, we propose and "operationalize" the employing of an authoritative welfare-based approach, within the confines of best interest decision making, to better meet the current care needs within Singapore. © The Author(s) 2014.

How organizational context affects bioethical decision-making: pharmacists' management of gatekeeping processes in retail and hospital settings.

PubMed

Chiarello, Elizabeth

2013-12-01

Social science studies of bioethics demonstrate that ethics are highly contextual, functioning differently across local settings as actors make daily decisions "on the ground." Sociological studies that demonstrate the key role organizations play in shaping ethical decision-making have disproportionately focused on physicians and nurses working in hospital settings where they contend with life and death issues. This study broadens our understanding of the contexts of ethical decision-making by empirically examining understudied healthcare professionals - pharmacists - working in two organizational settings, retail and hospital, where they act as gatekeepers to regulated goods and services as they contend with ethical issues ranging from the serious to the mundane. This study asks: How do organizations shape pharmacists' identification, negotiation, and resolution of ethical challenges; in other words, how do organizations shape pharmacists' gatekeeping processes? Based on 95 semi-structured interviews with U.S. pharmacists practicing in retail and hospital pharmacies conducted between September 2009 and May 2011, this research finds that organizations influence ethical decision-making by shaping how pharmacists construct four gatekeeping processes: medical, legal, fiscal, and moral. Each gatekeeping process manifests differently across organizations due to how these settings structure inter-professional power dynamics, proximity to patients, and means of accessing information. Findings suggest new directions for theorizing about ethical decision-making in medical contexts by drawing attention to new ethical actors, new organizational settings, an expanded definition of ethical challenges, and a broader conceptualization of gatekeeping. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

USGS Publications Warehouse

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

2014-01-01

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

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

PubMed

Goeree, Ron; Diaby, Vakaramoko

2013-12-01

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

Automated integration of wireless biosignal collection devices for patient-centred decision-making in point-of-care systems

PubMed Central

Menychtas, Andreas; Tsanakas, Panayiotis

2016-01-01

The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging. PMID:27222731

Automated integration of wireless biosignal collection devices for patient-centred decision-making in point-of-care systems.

PubMed

Menychtas, Andreas; Tsanakas, Panayiotis; Maglogiannis, Ilias

2016-03-01

The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging.

Near-Port Communities

EPA Pesticide Factsheets

Information to help near-port community leaders participate effectively in the decision-making process by increasing the understanding of the role of ports, how ports can impact local land use, economic trends, and environment.

Correlation of neural activity with behavioral kinematics reveals distinct sensory encoding and evidence accumulation processes during active tactile sensing.

PubMed

Delis, Ioannis; Dmochowski, Jacek P; Sajda, Paul; Wang, Qi

2018-07-15

Many real-world decisions rely on active sensing, a dynamic process for directing our sensors (e.g. eyes or fingers) across a stimulus to maximize information gain. Though ecologically pervasive, limited work has focused on identifying neural correlates of the active sensing process. In tactile perception, we often make decisions about an object/surface by actively exploring its shape/texture. Here we investigate the neural correlates of active tactile decision-making by simultaneously measuring electroencephalography (EEG) and finger kinematics while subjects interrogated a haptic surface to make perceptual judgments. Since sensorimotor behavior underlies decision formation in active sensing tasks, we hypothesized that the neural correlates of decision-related processes would be detectable by relating active sensing to neural activity. Novel brain-behavior correlation analysis revealed that three distinct EEG components, localizing to right-lateralized occipital cortex (LOC), middle frontal gyrus (MFG), and supplementary motor area (SMA), respectively, were coupled with active sensing as their activity significantly correlated with finger kinematics. To probe the functional role of these components, we fit their single-trial-couplings to decision-making performance using a hierarchical-drift-diffusion-model (HDDM), revealing that the LOC modulated the encoding of the tactile stimulus whereas the MFG predicted the rate of information integration towards a choice. Interestingly, the MFG disappeared from components uncovered from control subjects performing active sensing but not required to make perceptual decisions. By uncovering the neural correlates of distinct stimulus encoding and evidence accumulation processes, this study delineated, for the first time, the functional role of cortical areas in active tactile decision-making. Copyright © 2018 Elsevier Inc. All rights reserved.

A heuristic framework for understanding the role of participatory decision making in community-based non-profits.

PubMed

Bess, Kimberly D; Perkins, Douglas D; Cooper, Daniel G; Jones, Diana L

2011-06-01

This paper explores the role of member participation in decision-making (PDM) from an organizational learning (OL) perspective. Community-based organizations (CBOs) serve as mediators between the individual and the local community, often providing the means for community member participation and benefiting organizationally from members' input. Community psychologists have recognized these benefits; however, the field has paid less attention to the role participation plays in increasing CBOs' capacity to meet community needs. We present a framework for exploring how CBO contextual factors influence the use of participatory decision-making structures and practices, and how these affect OL. We then use the framework to examine PDM in qualitative case study analysis of four CBOs: a youth development organization, a faith-based social action coalition, a low-income neighborhood organization, and a large human service agency. We found that organizational form, energy, and culture each had a differential impact on participation in decision making within CBOs. We highlight how OL is constrained in CBOs and document how civic aims and voluntary membership enhanced participation and learning.

Chronic motivational state interacts with task reward structure in dynamic decision-making.

PubMed

Cooper, Jessica A; Worthy, Darrell A; Maddox, W Todd

2015-12-01

Research distinguishes between a habitual, model-free system motivated toward immediately rewarding actions, and a goal-directed, model-based system motivated toward actions that improve future state. We examined the balance of processing in these two systems during state-based decision-making. We tested a regulatory fit hypothesis (Maddox & Markman, 2010) that predicts that global trait motivation affects the balance of habitual- vs. goal-directed processing but only through its interaction with the task framing as gain-maximization or loss-minimization. We found support for the hypothesis that a match between an individual's chronic motivational state and the task framing enhances goal-directed processing, and thus state-based decision-making. Specifically, chronic promotion-focused individuals under gain-maximization and chronic prevention-focused individuals under loss-minimization both showed enhanced state-based decision-making. Computational modeling indicates that individuals in a match between global chronic motivational state and local task reward structure engaged more goal-directed processing, whereas those in a mismatch engaged more habitual processing. Copyright © 2015 Elsevier Inc. All rights reserved.

Zero-sum politics, the Herbert thesis, and the Ryan White CARE Act: lessons learned from the local side of AIDS.

PubMed

Slack, J

2001-01-01

This study examines the dynamics of grass-roots decision-making processes involved in the implementation of the Ryan White CARE Act. Providing social services to persons with HIV/AIDS, the CARE act requires participation of all relevant groups, including representatives of the HIV/AIDS and gay communities. Decision-making behavior is explored by applying a political (zero-sum) model and a bureaucratic (the Herbert Thesis) model. Using qualitative research techniques, the Kern County (California) Consortium is used as a case study. Findings shed light on the decision-making behavior of social service organizations characterized by intense advocacy and structured on the basis of volunteerism and non-hierarchical relationships. Findings affirm bureaucratic behavior predicted by the Herbert Thesis and also discern factors which seem to trigger more conflictual zero-sum behavior.

ACHP | Community Revitalization Policy Statement Comment Period Now Open

Science.gov Websites

comments they might provide to the ACHP: How can the principles in the draft Policy Statement help ? How will the principles in the draft Policy Statement establish a framework for decision making when Officers and Certified Local Governments apply the principles in their review of local revitalization

A Comparison of Local Empowerment in Education: Porto Alegre, Brazil and Chicago, USA

ERIC Educational Resources Information Center

Edwards, D. Brent, Jr.

2010-01-01

Democratization of decision-making processes and increased local involvement are mentioned regularly as desirable ways to proceed in education policy reform. Nevertheless, the limited publications examining reforms for more democratic organization of school districts have tended to focus on isolated examples and very specific aspects of that…

Development of an Online Hazards Atlas to Improve Disaster Awareness

ERIC Educational Resources Information Center

Battersby, Sarah E.; Mitchell, Jerry T.; Cutter, Susan L.

2011-01-01

Understanding the causes, effects and geographic patterns of local hazards is important for helping individuals make educated decisions about how to respond to their threat. Unfortunately, it is often difficult to find comprehensive sources of information about local hazards. In this paper, we discuss the development of an online hazards atlas for…

Local Assessment: Using Genre Analysis to Validate Directed Self-Placement

ERIC Educational Resources Information Center

Gere, Anne Ruggles; Aull, Laura; Escudero, Moises Damian Perales; Lancaster, Zak; Lei, Elizabeth Vander

2013-01-01

Grounded in the principle that writing assessment should be locally developed and controlled, this article describes a study that contextualizes and validates the decisions that students make in the modified Directed Self-Placement (DSP) process used at the University of Michigan. The authors present results of a detailed text analysis of…

Science for action at the local landscape scale

Treesearch

Paul Opddam; Joan Iverson Nassauer; Zhifang Wang; Christian Albert; Gary Bentrup; Jean-Christophe Castella; Clive McAlpine; Jianguo Liu; Stephen Sheppard; Simon Swaffield

2013-01-01

For landscape ecology to produce knowledge relevant to society, it must include considerations of human culture and behavior, extending beyond the natural sciences to synthesize with many other disciplines. Furthermore, it needs to be able to support landscape change processes which increasingly take the shape of deliberative and collaborative decision making by local...

Effect of Wind Farm Noise on Local Residents’ Decision to Adopt Mitigation Measures

PubMed Central

Botelho, Anabela; Bernardo, Carlos; Dias, Hernâni; Pinto, Lígia M. Costa

2017-01-01

Wind turbines’ noise is frequently pointed out as the reason for local communities’ objection to the installation of wind farms. The literature suggests that local residents feel annoyed by such noise and that, in many instances, this is significant enough to make them adopt noise-abatement interventions on their homes. Aiming at characterizing the relationship between wind turbine noise, annoyance, and mitigating actions, we propose a novel conceptual framework. The proposed framework posits that actual sound pressure levels of wind turbines determine individual homes’ noise-abatement decisions; in addition, the framework analyzes the role that self-reported annoyance, and perception of noise levels, plays on the relationship between actual noise pressure levels and those decisions. The application of this framework to a particular case study shows that noise perception and annoyance constitutes a link between the two. Importantly, however, noise also directly affects people’s decision to adopt mitigating measures, independently of the reported annoyance. PMID:28696404

Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania.

PubMed

Shayo, Elizabeth H; Norheim, Ole F; Mboera, Leonard E G; Byskov, Jens; Maluka, Stephen; Kamuzora, Peter; Blystad, Astrid

2012-06-07

Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people's needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual's opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Existing challenges related to individuals' influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in decision-making processes. This simultaneously implies an emphasis on assuring the distribution of information, training and education so that individuals can participate fully in informed decision making.

Understanding communication pathways to foster community engagement for health improvement in North West Pakistan.

PubMed

Lhussier, Monique; Lowe, Nicola; Westaway, Elizabeth; Dykes, Fiona; McKeown, Mick; Munir, Akhtar; Tahir, Saba; Zaman, Mukhtiar

2016-07-18

This paper describes the community engagement process undertaken to ascertain the focus, development and implementation of an intervention to improve iodised salt consumption in rural communities in North West Pakistan. The Jirga is a traditional informal structure, which gathers men respected within their community and acts in a governing and decision-making capacity in the Pukhtoon culture. The Jirga system had a dual purpose for the study: to access men from the community to discuss the importance of iodised salt, and as an engagement process for the intervention. A number of qualitative data collection activities were undertaken, with Jirga members and their wives, male and female outreach workers and two groups of women, under and over 40 years old. The aim of these was to highlight the communication channels and levers of influence on health behaviour, which were multiple and complex and all needed to be taken into consideration in order to ensure successful and locally sensitive community engagement. Communication channels are described within local families and the communities around them. The key influential role of the Jirga is highlighted as linked both to the standing of its members and the community cohesion ethos that it embodies. Engaging Jirga members in discussions about iodised salt was key in designing an intervention that would activate the most influential levers to decision making in the community. Gendered decision-making processes within the household have been highlighted as restricting women's autonomy. Whilst in one respect our data confirm this, a more complex hierarchy of decisional power has been highlighted, whereby the concept of 'wisdom'- an amalgamation of age, experience and education- presents important possibilities. Community members with the least autonomy are the youngest uneducated females, who rely on a web of socially and culturally determined ways to influence decision-making. The major lines of communication and influence in the local community described are placed within the wider literature on community engagement in health improvement. The process of maximisation of local cultural knowledge as part of a community engagement effort is one that has application well beyond the particular setting of this study.

Trading quality for relevance: non-health decision-makers’ use of evidence on the social determinants of health

PubMed Central

McGill, Elizabeth; Egan, Matt; Petticrew, Mark; Mountford, Lesley; Milton, Sarah; Whitehead, Margaret; Lock, Karen

2015-01-01

Objectives Local government services and policies affect health determinants across many sectors such as planning, transportation, housing and leisure. Researchers and policymakers have argued that decisions affecting wider determinants of health, well-being and inequalities should be informed by evidence. This study explores how information and evidence are defined, assessed and utilised by local professionals situated beyond the health sector, but whose decisions potentially affect health: in this case, practitioners working in design, planning and maintenance of the built environment. Design A qualitative study using three focus groups. A thematic analysis was undertaken. Setting The focus groups were held in UK localities and involved local practitioners working in two UK regions, as well as in Brazil, USA and Canada. Participants UK and international practitioners working in the design and management of the built environment at a local government level. Results Participants described a range of data and information that constitutes evidence, of which academic research is only one part. Built environment decision-makers value empirical evidence, but also emphasise the legitimacy and relevance of less empirical ways of thinking through narratives that associate their work to art and philosophy. Participants prioritised evidence on the acceptability, deliverability and sustainability of interventions over evidence of longer term outcomes (including many health outcomes). Participants generally privileged local information, including personal experiences and local data, but were less willing to accept evidence from contexts perceived to be different from their own. Conclusions Local-level built environment practitioners utilise evidence to make decisions, but their view of ‘best evidence’ appears to prioritise local relevance over academic rigour. Academics can facilitate evidence-informed local decisions affecting social determinants of health by working with relevant practitioners to improve the quality of local data and evaluations, and by advancing approaches to improve the external validity of academic research. PMID:25838508

Getting ocean acidification on decision makers' to-do lists: dissecting the process through case studies

USGS Publications Warehouse

Cooley, Sarah R.; Jewett, Elizabeth B.; Reichert, Julie; Robbins, Lisa L.; Shrestha, Gyami; Wieczorek, Dan; Weisberg, Stephen B.

2015-01-01

Much of the detailed, incremental knowledge being generated by current scientific research on ocean acidification (OA) does not directly address the needs of decision makers, who are asking broad questions such as: Where will OA harm marine resources next? When will this happen? Who will be affected? And how much will it cost? In this review, we use a series of mainly US-based case studies to explore the needs of local to international-scale groups that are making decisions to address OA concerns. Decisions concerning OA have been made most naturally and easily when information needs were clearly defined and closely aligned with science outputs and initiatives. For decisions requiring more complex information, the process slows dramatically. Decision making about OA is greatly aided (1) when a mixture of specialists participates, including scientists, resource users and managers, and policy and law makers; (2) when goals can be clearly agreed upon at the beginning of the process; (3) when mixed groups of specialists plan and create translational documents explaining the likely outcomes of policy decisions on ecosystems and natural resources; (4) when regional work on OA fits into an existing set of priorities concerning climate or water quality; and (5) when decision making can be reviewed and enhanced.

What do decision makers learn from public forums on climate-related hazards and resilience?

NASA Astrophysics Data System (ADS)

Weller, N.; Farooque, M.; Sittenfeld, D.

2017-12-01

Public engagement around climate resilience efforts can foster learning for both public audiences and decision makers. On the one hand, public audiences learn about environmental hazards and strategies to increase community resilience through effective public engagement. On the other, decision makers and scientists learn about community members' values and priorities and their relation to environmental hazards and resilience strategies. Evidence from other public engagement efforts involving decision makers suggests that decision maker involvement results in reflection by officials on their own values, capacities, and roles. However, few public engagement exercises evaluate impacts on decision makers. As part of the Science Center Public Forums project, which aims to conduct public forums in eight cities across the country on resiliency to drought, heat, extreme precipitation, and sea level rise, we sought to 1) build partnerships with local decision makers and scientists around public forums and 2) explore how decision makers and scientists interacted with the planning and undertaking of those public forums. We held workshops with decision makers and scientists to inform forum content and identify local resilience issues. We will conduct interviews with local decision makers regarding their involvement in forum planning, their reflections and takeaways from the forum itself, and their perspectives on the value of public engagement for policy making. We will present our model of engagement with decision makers, initial findings from interviews, and lessons learned from connecting decision makers and scientists to public engagement efforts.

Getting State Education Data Right: What We Can Learn from Tennessee

ERIC Educational Resources Information Center

Jones, Joseph; Southern, Kyle

2011-01-01

Federal education policy in recent years has encouraged state and local education agencies to embrace data use and analysis in decision-making, ranging from policy development and implementation to performance evaluation. The capacity of these agencies to make effective and methodologically sound use of collected data for these purposes remains an…

18 CFR 1311.10 - How does TVA make efforts to accommodate intergovernmental viewpoints?

Code of Federal Regulations, 2013 CFR

2013-04-01

... contact (including any regional or local office delegated a review and comment role by the state process... General Manager has reviewed the decision and determined that, because of unusual circumstances, the... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true How does TVA make...

18 CFR 1311.10 - How does TVA make efforts to accommodate intergovernmental viewpoints?

Code of Federal Regulations, 2010 CFR

2010-04-01

... contact (including any regional or local office delegated a review and comment role by the state process... General Manager has reviewed the decision and determined that, because of unusual circumstances, the... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false How does TVA make...

18 CFR 1311.10 - How does TVA make efforts to accommodate intergovernmental viewpoints?

Code of Federal Regulations, 2014 CFR

2014-04-01

... contact (including any regional or local office delegated a review and comment role by the state process... General Manager has reviewed the decision and determined that, because of unusual circumstances, the... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false How does TVA make...

18 CFR 1311.10 - How does TVA make efforts to accommodate intergovernmental viewpoints?

Code of Federal Regulations, 2012 CFR

2012-04-01

... contact (including any regional or local office delegated a review and comment role by the state process... General Manager has reviewed the decision and determined that, because of unusual circumstances, the... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false How does TVA make...

18 CFR 1311.10 - How does TVA make efforts to accommodate intergovernmental viewpoints?

Code of Federal Regulations, 2011 CFR

2011-04-01

... contact (including any regional or local office delegated a review and comment role by the state process... General Manager has reviewed the decision and determined that, because of unusual circumstances, the... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false How does TVA make...

Dashboard visualizations: Supporting real-time throughput decision-making.

PubMed

Franklin, Amy; Gantela, Swaroop; Shifarraw, Salsawit; Johnson, Todd R; Robinson, David J; King, Brent R; Mehta, Amit M; Maddow, Charles L; Hoot, Nathan R; Nguyen, Vickie; Rubio, Adriana; Zhang, Jiajie; Okafor, Nnaemeka G

2017-07-01

Providing timely and effective care in the emergency department (ED) requires the management of individual patients as well as the flow and demands of the entire department. Strategic changes to work processes, such as adding a flow coordination nurse or a physician in triage, have demonstrated improvements in throughput times. However, such global strategic changes do not address the real-time, often opportunistic workflow decisions of individual clinicians in the ED. We believe that real-time representation of the status of the entire emergency department and each patient within it through information visualizations will better support clinical decision-making in-the-moment and provide for rapid intervention to improve ED flow. This notion is based on previous work where we found that clinicians' workflow decisions were often based on an in-the-moment local perspective, rather than a global perspective. Here, we discuss the challenges of designing and implementing visualizations for ED through a discussion of the development of our prototype Throughput Dashboard and the potential it holds for supporting real-time decision-making. Copyright © 2017. Published by Elsevier Inc.

An exploratory cluster randomised controlled trial of knowledge translation strategies to support evidence-informed decision-making in local governments (The KT4LG study).

PubMed

Waters, Elizabeth; Armstrong, Rebecca; Swinburn, Boyd; Moore, Laurence; Dobbins, Maureen; Anderson, Laurie; Petticrew, Mark; Clark, Rachel; Conning, Rebecca; Moodie, Marj; Carter, Robert

2011-01-13

Childhood overweight and obesity is the most prevalent and, arguably, politically complex child health problem internationally. Governments, communities and industry have important roles to play, and are increasingly expected to deliver an evidence-informed system-wide prevention program. However, efforts are impeded by a lack of organisational access to and use of research evidence. This study aims to identify feasible, acceptable and ideally, effective knowledge translation (KT) strategies to increase evidence-informed decision-making in local governments, within the context of childhood obesity prevention as a national policy priority. This paper describes the methods for KT4LG, a cluster randomised controlled trial which is exploratory in nature, given the limited evidence base and methodological advances. KT4LG aims to examine a program of KT strategies to increase the use of research evidence in informing public health decisions in local governments. KT4LG will also assess the feasibility and acceptability of the intervention. The intervention program comprises a facilitated program of evidence awareness, access to tailored research evidence, critical appraisal skills development, networking and evidence summaries and will be compared to provision of evidence summaries alone in the control program. 28 local governments were randomised to intervention or control, using computer generated numbers, stratified by budget tertile (high, medium or low). Questionnaires will be used to measure impact, costs, and outcomes, and key informant interviews will be used to examine processes, feasibility, and experiences. Policy tracer studies will be included to examine impact of intervention on policies within relevant government policy documents. Knowledge translation intervention studies with a focus on public health and prevention are very few in number. Thus, this study will provide essential data on the experience of program implementation and evaluation of a system-integrated intervention program employed within the local government public health context. Standardised programs of system, organisational and individual KT strategies have not been described or rigorously evaluated. As such, the findings will make a significant contribution to understanding whether a facilitated program of KT strategies hold promise for facilitating evidence-informed public health decision making within complex multisectoral government organisations. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12609000953235.

Identifying Effective and Sustainable Measures for Community-Based Environmental Monitoring

NASA Astrophysics Data System (ADS)

McKay, Ariana J.; Johnson, Chris J.

2017-09-01

Resource development projects typically result in monitoring programs that fail to fully consider the values and participation of surrounding communities. Also, monitoring protocols for single environmental values can be insufficient for addressing the cumulative impacts of resource development. Community-based environmental monitoring (CBEM) has emerged as a way to meaningfully include local citizens in the decision-making process and assessment of the development of natural resources. Our research explored how to develop effective and sustainable CBEM. Interviews were conducted with staff from 15 CBEM programs established across Canada to identify criteria of what constitutes effective CBEM. Results demonstrate that CBEM offers an effective, locally adapted, and culturally applicable approach to facilitate community participation in natural resource management and to track environmental change. Benefits of CBEM include: locally relevant monitoring protocols, inclusion of cumulative impacts, better informed decision-making, and increased awareness and collaboration amongst community, governments, and proponents. Challenges associated with CBEM are cost, capacity, longevity, distribution of results, and establishing credibility. This research validates the use of CBEM for improving resource management.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 6: investigating methods to identify, prioritise, implement and evaluate disinvestment projects in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Brooke, Vanessa; Dyer, Tim; Waller, Cara; King, Richard; Ramsey, Wayne; Mortimer, Duncan

2017-05-25

This is the sixth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE program was established to investigate a systematic, integrated, evidence-based approach to disinvestment within a large Australian health service. This paper describes the methods employed in undertaking pilot disinvestment projects. It draws a number of lessons regarding the strengths and weaknesses of these methods; particularly regarding the crucial first step of identifying targets for disinvestment. Literature reviews, survey, interviews, consultation and workshops were used to capture and process the relevant information. A theoretical framework was adapted for evaluation and explication of disinvestment projects, including a taxonomy for the determinants of effectiveness, process of change and outcome measures. Implementation, evaluation and costing plans were developed. Four literature reviews were completed, surveys were received from 15 external experts, 65 interviews were conducted, 18 senior decision-makers attended a data gathering workshop, 22 experts and local informants were consulted, and four decision-making workshops were undertaken. Mechanisms to identify disinvestment targets and criteria for prioritisation and decision-making were investigated. A catalogue containing 184 evidence-based opportunities for disinvestment and an algorithm to identify disinvestment projects were developed. An Expression of Interest process identified two potential disinvestment projects. Seventeen additional projects were proposed through a non-systematic nomination process. Four of the 19 proposals were selected as pilot projects but only one reached the implementation stage. Factors with potential influence on the outcomes of disinvestment projects are discussed and barriers and enablers in the pilot projects are summarised. This study provides an in-depth insight into the experience of disinvestment in one local healthcare service. To our knowledge, this is the first paper to report the process of disinvestment from identification, through prioritisation and decision-making, to implementation and evaluation, and finally explication of the processes and outcomes.

Localized microstimulation of primate pregenual cingulate cortex induces negative decision-making.

PubMed

Amemori, Ken-ichi; Graybiel, Ann M

2012-05-01

The pregenual anterior cingulate cortex (pACC) has been implicated in human anxiety disorders and depression, but the circuit-level mechanisms underlying these disorders are unclear. In healthy individuals, the pACC is involved in cost-benefit evaluation. We developed a macaque version of an approach-avoidance decision task used to evaluate anxiety and depression in humans and, with multi-electrode recording and cortical microstimulation, we probed pACC function as monkeys performed this task. We found that the macaque pACC has an opponent process-like organization of neurons representing motivationally positive and negative subjective value. Spatial distribution of these two neuronal populations overlapped in the pACC, except in one subzone, where neurons with negative coding were more numerous. Notably, microstimulation in this subzone, but not elsewhere in the pACC, increased negative decision-making, and this negative biasing was blocked by anti-anxiety drug treatment. This cortical zone could be critical for regulating negative emotional valence and anxiety in decision-making.

Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda.

PubMed

Nabyonga-Orem, Juliet; Mijumbi, Rhona

2015-03-08

Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors' views regarding what evidence they deemed appropriate to guide health policy development. Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. © 2015 by Kerman University of Medical Sciences.

Task allocation among multiple intelligent robots

NASA Technical Reports Server (NTRS)

Gasser, L.; Bekey, G.

1987-01-01

Researchers describe the design of a decentralized mechanism for allocating assembly tasks in a multiple robot assembly workstation. Currently, the approach focuses on distributed allocation to explore its feasibility and its potential for adaptability to changing circumstances, rather than for optimizing throughput. Individual greedy robots make their own local allocation decisions using both dynamic allocation policies which propagate through a network of allocation goals, and local static and dynamic constraints describing which robots are elibible for which assembly tasks. Global coherence is achieved by proper weighting of allocation pressures propagating through the assembly plan. Deadlock avoidance and synchronization is achieved using periodic reassessments of local allocation decisions, ageing of allocation goals, and short-term allocation locks on goals.

District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia.

PubMed

Avan, Bilal Iqbal; Berhanu, Della; Umar, Nasir; Wickremasinghe, Deepthi; Schellenberg, Joanna

2016-09-01

Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India's extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Improved monitoring framework for local planning in the water, sanitation and hygiene sector: From data to decision-making.

PubMed

Garriga, Ricard Giné; de Palencia, Alejandro Jiménez Fdez; Foguet, Agustí Pérez

2015-09-01

Today, a vast proportion of people still lack a simple pit latrine and a source of safe drinking water. To help end this appalling state of affairs, there is a pressing need to provide policymakers with evidences which may be the basis of effective planning, targeting and prioritization. Two major challenges often hinder this process: i) lack of reliable data to identify which areas are most in need; and ii) inadequate instruments for decision-making support. In tackling previous shortcomings, this paper proposes a monitoring framework to compile, analyze, interpret and disseminate water, sanitation and hygiene information. In an era of decentralization, where decision-making moves to local governments, we apply such framework at the local level. The ultimate goal is to develop appropriate tools for decentralized planning support. To this end, the study first implements a methodology for primary data collection, which combines the household and the waterpoint as information sources. In doing so, we provide a complete picture of the context in which domestic WASH services are delivered. Second, the collected data are analyzed to underline the emerging development challenges. The use of simple planning indicators serves as the basis to i) reveal which areas require policy attention, and to ii) identify the neediest. Third, a classification process is proposed to prioritize among various populations. Three different case studies from East and Southern African countries are presented. Results indicate that accurate and comprehensive data, if adequately exploited through simple instruments, may be the basis of effective targeting and prioritization, which are central to sector planning. The application of the proposed framework in the real world, however, is to a certain extent elusive; and we point out to conclude two specific challenges that remain unaddressed, namely the upgrade of existing decision-making processes to enhance transparency and inclusiveness, and the development of data updating mechanisms. Copyright © 2015 Elsevier B.V. All rights reserved.

District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia

PubMed Central

Avan, Bilal Iqbal; Berhanu, Della; Umar, Nasir; Wickremasinghe, Deepthi; Schellenberg, Joanna

2016-01-01

Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India’s extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. PMID:27591204

Central Office Supports for Data-Driven Talent Management Decisions: Evidence from the Implementation of New Systems for Measuring Teacher Effectiveness

ERIC Educational Resources Information Center

Grissom, Jason A.; Rubin, Mollie; Neumerski, Christine M.; Cannata, Marisa; Drake, Timothy A.; Goldring, Ellen; Schuermann, Patrick

2017-01-01

School districts increasingly push school leaders to utilize multiple measures of teacher effectiveness, such as observation ratings or value-added scores, in making talent management decisions, including teacher hiring, assignment, support, and retention, but we know little about the local conditions that promote or impede these processes. We…

Localism and Teacher Labor Markets: How Geography and Decision Making May Contribute to Inequality

ERIC Educational Resources Information Center

Engel, Mimi; Cannata, Marisa

2015-01-01

A wide body of evidence indicates that there is a large inequality in the distribution of teachers across schools. Relatedly, recent research has revealed a number of important dimensions of teacher labor markets in the United States. We review the literature in two of these areas: the geography of teacher labor markets and the decision-making…

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2012 CFR

2012-07-01

... minimizing the use of natural resources, and by improving planning and decision-making processes to avoid...) Integrating the NEPA process in the early stages of planning to ensure that decisions reflect environmental... site. The exclusion applies only if: (i) The structure and proposed use comply with local planning and...

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2013 CFR

2013-07-01

... minimizing the use of natural resources, and by improving planning and decision-making processes to avoid...) Integrating the NEPA process in the early stages of planning to ensure that decisions reflect environmental... site. The exclusion applies only if: (i) The structure and proposed use comply with local planning and...

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2014 CFR

2014-07-01

... minimizing the use of natural resources, and by improving planning and decision-making processes to avoid...) Integrating the NEPA process in the early stages of planning to ensure that decisions reflect environmental... site. The exclusion applies only if: (i) The structure and proposed use comply with local planning and...

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2011 CFR

2011-07-01

... minimizing the use of natural resources, and by improving planning and decision-making processes to avoid...) Integrating the NEPA process in the early stages of planning to ensure that decisions reflect environmental... site. The exclusion applies only if: (i) The structure and proposed use comply with local planning and...

Assessing the Usefulness of the Decision Framework for Identifying and Selecting Knowledge Management Projects

DTIC Science & Technology

2005-03-01

team-wide accountability and rewards Functional focus Group accountability and rewards Employee-owner interest conflicts Process focus Lack of...Collaborative and cross-functional work Incompatible IT Need to share Compartmentalization of functional groups Localized decision making Centralized...Steps are: • Step 1: Analyze Corporate Strategic Objectives Using SWOT (Strengths, Weaknesses, Opportunities, Threats) Methodology • Step 2

The Voice of the Patient Methodology: A Novel Mixed-Methods Approach to Identifying Treatment Goals for Men with Prostate Cancer.

PubMed

Saigal, Christopher S; Lambrechts, Sylvia I; Seenu Srinivasan, V; Dahan, Ely

2017-06-01

Many guidelines advocate the use of shared decision making for men with newly diagnosed prostate cancer. Decision aids can facilitate the process of shared decision making. Implicit in this approach is the idea that physicians understand which elements of treatment matter to patients. Little formal work exists to guide physicians or developers of decision aids in identifying these attributes. We use a mixed-methods technique adapted from marketing science, the 'Voice of the Patient', to describe and identify treatment elements of value for men with localized prostate cancer. We conducted semi-structured interviews with 30 men treated for prostate cancer in the urology clinic of the West Los Angeles Veteran Affairs Medical Center. We used a qualitative analysis to generate themes in patient narratives, and a quantitative approach, agglomerative hierarchical clustering, to identify attributes of treatment that were most relevant to patients making decisions about prostate cancer. We identified five 'traditional' prostate cancer treatment attributes: sexual dysfunction, bowel problems, urinary problems, lifespan, and others' opinions. We further identified two novel treatment attributes: a treatment's ability to validate a sense of proactivity and the need for an incision (separate from risks of surgery). Application of a successful marketing technique, the 'Voice of the Customer', in a clinical setting elicits non-obvious attributes that highlight unique patient decision-making concerns. Use of this method in the development of decision aids may result in more effective decision support.

Healthy Cities: facilitating the active participation and empowerment of local people.

PubMed

Dooris, Mark; Heritage, Zoe

2013-10-01

Community participation and empowerment are key values underpinning the European WHO Healthy Cities initiative, now in its fifth phase. This paper provides a brief overview of the history, policy context, and theory relating to community participation and empowerment. Drawing on Phase IV evaluation data, it presents the findings in relation to the four quadrants of Davidson's Wheel of Participation--information, consultation, participation in decision making, and empowerment. The large majority of European Healthy Cities have mechanisms in place to provide information for and to consult with local people. Most also demonstrate a commitment to enabling community participation in decision-making and to empowering citizens. Within this context, the evaluation highlighted a diversity of approaches and revealed varied perspectives on how participation and empowerment can be integrated within city leadership and governance processes. The paper concludes by suggesting that there is a need to strengthen future evaluative research to better understand how and why the Healthy Cities approach makes a difference.

Decision Making in Rangelands: An Integrated Modeling Approach to Resilience and Change

NASA Astrophysics Data System (ADS)

Galvin, K. A.; Ojima, D. S.; Boone, R. B.

2007-12-01

Rangelands comprise approximately 25% of the earth's surface and these landscapes support more than 20 million people and most of the world's charismatic megafauna. Most of the people who live in these regions of the world herd domestic livestock and some do limited cultivation so they are dependent directly on the environment for their livelihoods. But change is rapidly changing the environments upon which these people depend through such factors as population pressures, land use and land tenure changes, climate variability, and policy changes which fragment their resources and thus their ability to earn a living. How can we understand change in this linked human-environment system? The study of complex biophysical and human systems can be greatly assisted by appropriate simulation models that integrate what is known about ecological and human decision-making processes. We have developed an integrated modeling system for Kajiado, Kenya where land use management decisions have implications for economics and the ecosystem. In this paper we look at how land use decisions, that is, livestock movement patterns have implications for societal economics and ecosystem services. Research that focuses on local behavior is important because it is at that level where fundamental decisions are made regarding events like extreme climate and changes such as land tenure policy and it is here where resilience is manifested. The notion that broad recommendation domains can be identified for a broad set of people and large regions coping with change is becoming increasingly hard to trust given the spatial and temporal heterogeneity of the systems we are looking at, and the complexity of the world we now live in. Why is this important? The only way the research community is going to make great progress in attaining objectives that do confer resilience (on social and ecological systems) is through much better targeting ability, a large part of which seem to be intimately entwined with understanding how make decisions are made at the local level.

Emergence of β-Band Oscillations in the Aged Rat Amygdala during Discrimination Learning and Decision Making Tasks

PubMed Central

Samson, Rachel D.; Duarte, Leroy; Venkatesh, Anu

2017-01-01

Abstract Older adults tend to use strategies that differ from those used by young adults to solve decision-making tasks. MRI experiments suggest that altered strategy use during aging can be accompanied by a change in extent of activation of a given brain region, inter-hemispheric bilateralization or added brain structures. It has been suggested that these changes reflect compensation for less effective networks to enable optimal performance. One way that communication can be influenced within and between brain networks is through oscillatory events that help structure and synchronize incoming and outgoing information. It is unknown how aging impacts local oscillatory activity within the basolateral complex of the amygdala (BLA). The present study recorded local field potentials (LFPs) and single units in old and young rats during the performance of tasks that involve discrimination learning and probabilistic decision making. We found task- and age-specific increases in power selectively within the β range (15–30 Hz). The increased β power occurred after lever presses, as old animals reached the goal location. Periods of high-power β developed over training days in the aged rats, and was greatest in early trials of a session. β Power was also greater after pressing for the large reward option. These data suggest that aging of BLA networks results in strengthened synchrony of β oscillations when older animals are learning or deciding between rewards of different size. Whether this increased synchrony reflects the neural basis of a compensatory strategy change of old animals in reward-based decision-making tasks, remains to be verified. PMID:29034315

Innovative medical devices and hospital decision making: a study comparing the views of hospital pharmacists and physicians.

PubMed

Billaux, Mathilde; Borget, Isabelle; Prognon, Patrice; Pineau, Judith; Martelli, Nicolas

2016-06-01

Objectives Many university hospitals have developed local health technology assessment processes to guide informed decisions about new medical devices. However, little is known about stakeholders' perceptions and assessment of innovative devices. Herein, we investigated the perceptions regarding innovative medical devices of their chief users (physicians and surgeons), as well as those of hospital pharmacists, because they are responsible for the purchase and management of sterile medical devices. We noted the evaluation criteria used to assess and select new medical devices and suggestions for improving local health technology assessment processes indicated by the interviewees. Methods We randomly selected 18 physicians and surgeons (nine each) and 18 hospital pharmacists from 18 French university hospitals. Semistructured interviews were conducted between October 2012 and August 2013. Responses were coded separately by two researchers. Results Physicians and surgeons frequently described innovative medical devices as 'new', 'safe' and 'effective', whereas hospital pharmacists focused more on economic considerations and considered real innovative devices to be those for which no equivalent could be found on the market. No significant difference in evaluation criteria was found between these groups of professionals. Finally, hospital pharmacists considered the management of conflicts of interests in local health technology assessment processes to be an issue, whereas physicians and surgeons did not. Conclusions The present study highlights differences in perceptions related to professional affiliation. The findings suggest several ways in which current practices for local health technology assessment in French university hospitals could be improved and studied. What is known about the topic? Hospitals are faced with ever-growing demands for innovative and costly medical devices. To help hospital management deal with technology acquisition issues, hospital-based health technology assessment has been developed to support decisions. However, little is known about the different perceptions of innovative medical devices among practitioners and how different perceptions may affect decision making. What does this paper add? This paper compares and understands the perceptions of two groups of health professionals concerning innovative devices in the university hospital environment. What are the implications for practitioners? Such a comparison of viewpoints could facilitate improvements in current practices and decision-making processes in local health technology assessment for these medical products.

The role of muscarinic cholinergic signaling in cost-benefit decision making

NASA Astrophysics Data System (ADS)

Fobbs, Wambura

Animals regularly face decisions that affect both their immediate success and long term survival. Such decisions typically involve some form of cost-benefit analysis and engage a number of high level cognitive processes, including learning, memory and motivational influences. While decision making has been a focus of study for over a century, it's only in the last 20 years that researchers have begun to identify functional neural circuits that subserve different forms of cost-benefit decision making. Even though the cholinergic system is both functionally and anatomically positioned to modulate cost-benefit decision circuits, the contribution of the cholinergic system to decision making has been little studied. In this thesis, I investigated the cognitive and neural contribution of muscarinic cholinergic signaling to cost-benefit decision making. I, first, re-examined the effects of systemic administration of 0.3 mg/kg atropine on delay and probability discounting tasks and found that blockade of muscarinic acetylcholine receptors by atropine induced suboptimal choices (impulsive and risky) in both tasks. Since the effect on delay discounting was restricted to the No Cue version of the delay discounting task, I concluded that muscarinic cholinergic signaling mediates both forms of cost-benefit decision making and is selectively engaged when decisions require valuation of reward options whose costs are not externally signified. Second, I assessed the impact of inactivating the nucleus basalis (NBM) on both forms decision making and the effect of injecting atropine locally into the orbitofrontal cortex (OFC), basolateral amygdala (BLA), or nucleus accumbens (NAc) core during the No Cue version of the delay discounting task. I discovered that although NBM inactivation failed to affect delay discounting, it induced risk aversion in the probability discounting task; and blockade of intra- NAc core, but not intra-OFC or intra-BLA, muscarinic cholinergic signaling lead to increased choice of the delayed reward. While those findings implicate the NBM in supporting risky choices and intra-NAc core muscarinic signaling in discouraging delayed choice, more work is needed to fully elucidate the underlying mechanisms.

The future of transportation starts here

DOT National Transportation Integrated Search

1998-05-01

The report provides the U.S. DOT Intelligent Transportation Systems deployment community with information describing transportation investment decision-making at the state and local level and specific insight into the ITS deployment opportunities and...

Consolidated asset management for Minnesota local agencies.

DOT National Transportation Integrated Search

2016-06-01

Transportation agencies are increasingly turning their attention to transportation asset management (TAM), a systematic process for tracking the conditions of physical infrastructure to make better decisions about its maintenance. TAM is mandated by ...

Minnesota Local Agency Pavement Marking : Mining Existing Data

DOT National Transportation Integrated Search

2017-11-01

Pavement marking is important for safety. Maximizing pavement marking performance in terms of increased retroreflectivity, within limited budget constraints, allows agencies to make better decisions toward providing more effective pavement marking pe...

New Forms of Managerial Education in Knowledge Society

NASA Astrophysics Data System (ADS)

Maly, Milan

Paper illustrates the ways of knowledge sharing in transition companies in two main topics: the methods of knowledge management of local managers in joint ventures with foreign partners from free market countries and the development of leadership behavior and decision making styles in privatized companies in the Czech Republic. Lack of previous experience is the main reason for the adoption of different ways of managerial education. Several systems like the tandem, distant learning, mixed, foreign and hired managerial systems are analyzed, and the role of both partners, local and foreign managers, is specified. The analysis of leadership behavior and decision-making styles specifying five levels of participation. Czech managers consider it to be appropriate to use a more autocratic style than a participative one. Only in a few cases, mostly in joint ventures, can we see some elements of the partnership style.

Subthalamic Neural Activity Patterns Anticipate Economic Risk Decisions in Gambling

PubMed Central

Rosa, M.; Carpaneto, J.; Priori, A.

2018-01-01

Abstract Economic decision-making is disrupted in individuals with gambling disorder, an addictive behavior observed in Parkinson’s disease (PD) patients receiving dopaminergic therapy. The subthalamic nucleus (STN) is involved in the inhibition of impulsive behaviors; however, its role in impulse control disorders and addiction is still unclear. Here, we recorded STN local field potentials (LFPs) in PD patients with and without gambling disorder during an economic decision-making task. Reaction times analysis showed that for all patients, the decision whether to risk preceded task onset. We compared then for both groups the STN LFP preceding high- and low-risk economic decisions. We found that risk avoidance in gamblers correlated with larger STN LFP low-frequency (<12-Hz) fluctuations preceding task onset. In particular, the amplitude of low-frequency LFP fluctuations carried significant information about future decisions. Decisions of patients not affected by gambling disorder were instead not correlated with pretask STN LFP. Our results suggest that STN activity preceding task onset affects risk decisions by preemptively inhibiting attraction to high but unlikely rewards in favor of a long-term payoff. PMID:29445770

How to Reach Decision Makers: Build a network of educators and practitioners with common goals

NASA Astrophysics Data System (ADS)

Boudrias, M. A.; Estrada, M.; Anders, S.; Silva-Send, N. J.; Gershunov, A.

2013-12-01

In San Diego County, the Climate Education Partners (CEP) includes climate scientists, science educators, behavioral scientists, environmental practitioners and community organizations that are dedicated to providing local decision makers (elected officials, business leaders, community leaders) with sound climate science learning opportunities and resources that promote informed decision making. Their work over the past three years has found that effective climate education programs are designed for specific audiences with tailored information that is relevant to them, while simultaneously building community efficacy, identity and values. An integrated approach that blends rigorous scientific facts, local climate change impact, and social science education theory is contributing towards the development of a cadre of engaged leaders and communities. To track project progress and to inform the project strategy, local Key Influentials are being interviewed to gauge their current understanding of climate change and their interest in either becoming messengers to their community or becoming the portal to their constituency. Innovation comes from productive collaboration. For this reason, CEP has been working with leading scientists (climatologists, hydrologists, meteorologists, ecologists), environmental groups, museums and zoos, media experts and government agencies (Water Authority, CalFire) to develop and refine a program of learning activities and resources geared specifically for Key Influentials. For example, a water tour has been designed to bring 25 key influential leaders in San Diego County to a dam, a pumping station and a reservoir and provide climate change facts, impacts and potential solutions to the critical issue of water supply for the San Diego Region. While learning local facts about the causes and impacts of climate change, participants also learn about what they can do (increasing efficacy), that they can be a part of a solution centered community (building identity), and that everything - the education and the use of this knowledge to promote informed decisions - is connected to doing what is best for the next generation (tying learning to values). In addition, CEP developed locally focused videos, one on heat waves and one on water resources, which are being experimentally tested for their impact on informed decision-making and utilized with various KI audiences. Climate Education Partners is finding that linking excellent science with healthy community partnerships is resulting in San Diego leaders and their communities making more informed decisions on how to adapt to climate change and preserve the quality of life enjoyed in San Diego for all future generations.

The Role of Federal Government for Climate Adaptation in the Urban Context: Results of a workshop (Invited)

NASA Astrophysics Data System (ADS)

Buizer, J.; Chhetri, N.; Roy, M.

2010-12-01

Extreme weather events in urban areas such as torrential rainfall in Chicago and London, floods in Boston and Elbe and heat waves in Europe have shed stark light on cities’ vulnerability to the effects of climate change. At the same time, cities themselves are significant net contributors to GHG’s attributable to climatic changes through the built environment (e.g. housing, roads, and parking lots), transport, consumption and recreation. In the arid region of southwestern United States, issues associated with the adequacy of water resources, urban heat island, and air quality best exemplify these contributions. This duality - cities as impacted by, and contributors to extreme climatic patterns induced by climate change, and the specific climate information needed for decision-making by city planners - provided the impetus for a two-day workshop in January 2009. Organized by Arizona State University, the workshop included city managers, planners, private sector stakeholders, water managers, researchers, and Federal program managers. The aim was to identify information needs, and data and research gaps, as well as to design strategies to address climate uncertainty. Two key approaches discussed were: a) building multiple, flexible scenarios and modeling efforts that enable decision-makers to plan for a number of possible futures, and b) matching Federal climate assets to local, regional and sectoral needs through continuous collaboration that supports decision-making within the social, economic, and political context of the place. Federal leadership in facilitating, coordinating and informing efforts that nurture the creative intellectual capacity of cities to produce integrated solutions to mitigate the effects of and adapt to climate change will go a long way in addressing urban climate adaptation in the United States. Participants outlined a number of concerns and suggestions for Federal government leaders and services associated with a national climate network. Concerns included a broad range of issues, including flood protection, sea level rise, extreme events, infrastructure investment decisions, water supply, storm-water and wastewater management, public education and outreach. Suggestions included an in-depth exploration of new roles for federal agencies, as well as new partnerships with state and local entities, the private sector, and non-governmental entities; developing specialized communicators and trusted information brokers who can connect federal science agencies to local decision makers; and integrating federal decision making with local implementation.

Comments on localized and integral localized approximations in spherical coordinates

NASA Astrophysics Data System (ADS)

Gouesbet, Gérard; Lock, James A.

2016-08-01

Localized approximation procedures are efficient ways to evaluate beam shape coefficients of laser beams, and are particularly useful when other methods are ineffective or inefficient. Comments on these procedures are, however, required in order to help researchers make correct decisions concerning their use. This paper has the flavor of a short review and takes the opportunity to attract the attention of the readers to a required refinement of terminology.

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

Impact of clinical and health services research projects on decision-making: a qualitative study.

PubMed

Solans-Domènech, Maite; Adam, Paula; Guillamón, Imma; Permanyer-Miralda, Gaietà; Pons, Joan M V; Escarrabill, Joan

2013-05-10

This article reports on the impact assessment experience of a funding program of non-commercial clinical and health services research. The aim was to assess the level of implementation of results from a subgroup of research projects (on respiratory diseases), and to detect barriers (or facilitators) in the translation of new knowledge to informed decision-making. A qualitative study was performed. The sample consisted of six projects on respiratory diseases funded by the Agency for Health Quality and Assessment of Catalonia between 1996 and 2004. Semi-structured interviews to key informants including researchers and healthcare decision-makers were carried out. Interviews were recorded, transcribed verbatim and analysed on an individual (key informant) and group (project) basis. In addition, the differences between achieved and expected impacts were described. Twenty-three semi-structured interviews were conducted. Most participants indicated changes in health services or clinical practice had resulted from research. The channels used to transfer new knowledge were mainly conventional ones, but also in less explicit ways, such as with the involvement of local scientific societies, or via debates and discussions with colleagues and local leaders. The barriers and facilitators identified were mostly organizational (in research management, and clinical and healthcare practice), although there were also some related to the nature of the research as well as personal factors. Both the expected and achieved impacts enabled the identification of the gaps between what is expected and what is truly achieved. In this study and according to key informants, the impact of these research projects on decision-making can be direct (the application of a finding or innovation) or indirect, contributing to a more complex change in clinical practice and healthcare organization, both having other contextual factors. The channels used to transfer this new knowledge to clinical practice are complex. Local scientific societies and the relationships between researchers and decision-makers can play a very important role. Specifically, the relationships between managers and research teams and the mutual knowledge of their activity have shown to be effective in applying research funding to practice and decision-making. Finally the facilitating factors and barriers identified by the respondents are closely related to the idiosyncrasy of the human relations between the different stakeholders involved.

Impact of clinical and health services research projects on decision-making: a qualitative study

PubMed Central

2013-01-01

Background This article reports on the impact assessment experience of a funding program of non-commercial clinical and health services research. The aim was to assess the level of implementation of results from a subgroup of research projects (on respiratory diseases), and to detect barriers (or facilitators) in the translation of new knowledge to informed decision-making. Methods A qualitative study was performed. The sample consisted of six projects on respiratory diseases funded by the Agency for Health Quality and Assessment of Catalonia between 1996 and 2004. Semi-structured interviews to key informants including researchers and healthcare decision-makers were carried out. Interviews were recorded, transcribed verbatim and analysed on an individual (key informant) and group (project) basis. In addition, the differences between achieved and expected impacts were described. Results Twenty-three semi-structured interviews were conducted. Most participants indicated changes in health services or clinical practice had resulted from research. The channels used to transfer new knowledge were mainly conventional ones, but also in less explicit ways, such as with the involvement of local scientific societies, or via debates and discussions with colleagues and local leaders. The barriers and facilitators identified were mostly organizational (in research management, and clinical and healthcare practice), although there were also some related to the nature of the research as well as personal factors. Both the expected and achieved impacts enabled the identification of the gaps between what is expected and what is truly achieved. Conclusions In this study and according to key informants, the impact of these research projects on decision-making can be direct (the application of a finding or innovation) or indirect, contributing to a more complex change in clinical practice and healthcare organization, both having other contextual factors. The channels used to transfer this new knowledge to clinical practice are complex. Local scientific societies and the relationships between researchers and decision-makers can play a very important role. Specifically, the relationships between managers and research teams and the mutual knowledge of their activity have shown to be effective in applying research funding to practice and decision-making. Finally the facilitating factors and barriers identified by the respondents are closely related to the idiosyncrasy of the human relations between the different stakeholders involved. PMID:23663364

Is local participation always optimal for sustainable action? The costs of consensus-building in Local Agenda 21.

PubMed

Brandt, Urs Steiner; Svendsen, Gert Tinggaard

2013-11-15

Is local participation always optimal for sustainable action? Here, Local Agenda 21 is a relevant case as it broadly calls for consensus-building among stakeholders. Consensus-building is, however, costly. We show that the costs of making local decisions are likely to rapidly exceed the benefits. Why? Because as the number of participants grows, the more likely it is that the group will include individuals who have an extreme position and are unwilling to make compromises. Thus, the net gain of self-organization should be compared with those of its alternatives, for example voting, market-solutions, or not making any choices at all. Even though the informational value of meetings may be helpful to policy makers, the model shows that it also decreases as the number of participants increase. Overall, the result is a thought provoking scenario for Local Agenda 21 as it highlights the risk of less sustainable action in the future. Copyright © 2013 Elsevier Ltd. All rights reserved.

Low Decision Space Means No Decentralization in Fiji Comment on "Decentralisation of Health Services in Fiji: A Decision Space Analysis".

PubMed

Faguet, Jean-Paul

2016-06-22

Mohammed, North, and Ashton find that decentralization in Fiji shifted health-sector workloads from tertiary hospitals to peripheral health centres, but with little transfer of administrative authority from the centre. Decision-making in five functional areas analysed remains highly centralized. They surmise that the benefits of decentralization in terms of services and outcomes will be limited. This paper invokes Faguet's (2012) model of local government responsiveness and accountability to explain why this is so - not only for Fiji, but in any country that decentralizes workloads but not the decision space of local governments. A competitive dynamic between economic and civic actors that interact to generate an open, competitive politics, which in turn produces accountable, responsive government can only occur where real power and resources have been devolved to local governments. Where local decision space is lacking, by contrast, decentralization is bound to fail because it has not really happened in the first place. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Employer health insurance and local labor market conditions.

PubMed

Marquis, M S; Long, S H

2001-01-01

Theory suggests that an employer's decisions about the amount of health insurance included in the compensation package may be influenced by the practices of other employers in the market. We test the role of local market conditions on decisions of small employers to offer insurance and their dollar contribution to premiums using data from two large national surveys of employers. These employers are more likely to offer insurance and to make greater contributions in communities with tighter labor markets, less concentrated labor purchasers, greater union penetration, and a greater share of workers in big business and a small share in regulated industries. However, our data do not support the notion that marginal tax rates affect employers' offer decision or contributions.

The influence of expert opinions on the selection of wastewater treatment alternatives: a group decision-making approach.

PubMed

Kalbar, Pradip P; Karmakar, Subhankar; Asolekar, Shyam R

2013-10-15

The application of multiple-attribute decision-making (MADM) to real life decision problems suggests that avoiding the loss of information through scenario-based approaches and including expert opinions in the decision-making process are two major challenges that require more research efforts. Recently, a wastewater treatment technology selection effort has been made with a 'scenario-based' method of MADM. This paper focuses on a novel approach to incorporate expert opinions into the scenario-based decision-making process, as expert opinions play a major role in the selection of treatment technologies. The sets of criteria and the indicators that are used consist of both qualitative and quantitative criteria. The group decision-making (GDM) approach that is implemented for aggregating expert opinions is based on an analytical hierarchy process (AHP), which is the most widely used MADM method. The pairwise comparison matrices (PCMs) for qualitative criteria are formed based on expert opinions, whereas, a novel approach is proposed for generating PCMs for quantitative criteria. It has been determined that the experts largely prefer natural treatment systems because they are more sustainable in any scenario. However, PCMs based on expert opinions suggest that advanced technologies such as the sequencing batch reactor (SBR) can also be appropriate for a given decision scenario. The proposed GDM approach is a rationalized process that will be more appropriate in realistic scenarios where multiple stakeholders with local and regional societal priorities are involved in the selection of treatment technology. Copyright © 2013 Elsevier Ltd. All rights reserved.

Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making

PubMed Central

Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

2008-01-01

Background In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Methods Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Results Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Conclusion Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health. PMID:19094194

Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making.

PubMed

Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

2008-12-18

In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health.

Federal Policy to Local Level Decision-Making: Data Driven Education Planning in Nigeria

ERIC Educational Resources Information Center

Iyengar, Radhika; Mahal, Angelique R.; Felicia, Ukaegbu-Nnamchi Ifeyinwa; Aliyu, Balaraba; Karim, Alia

2015-01-01

This article discusses the implementation of local level education data-driven planning as implemented by the Office of the Senior Special Assistant to the President of Nigeria on the Millennium Development Goals (OSSAP-MDGs) in partnership with The Earth Institute, Columbia University. It focuses on the design and implementation of the…

Leadership, Control, Communication and Comprehension: Key Factors in Successful Implementation of SBDM.

ERIC Educational Resources Information Center

Etheridge, Carol Plata; And Others

This study examines the effects of principal leadership styles on the development of the working styles of seven local school councils in Memphis (Tennessee) during their first 15 months of operation. The successful implementation of a school-based decision making (SBDM) management model depends upon the ability of the local school council to…

Decentralization in Educational Governance and Its Challenges in Korea: Focused on Policy Conflicts between Central and Local Government in Education

ERIC Educational Resources Information Center

Cha, Sung-Hyun

2016-01-01

Decentralization of educational governance is characterized by the recent education reform in Korea. With the election of progressive superintendents and local council members, educational policy conflicts have often occurred and deepened in the process of decision-making and implementation of policies such as School Violence Prevention, National…

Policy Matters: An Analysis of District-Level Efforts to Increase the Identification of Underrepresented Learners

ERIC Educational Resources Information Center

McBee, Matthew T.; Shaunessy, Elizabeth; Matthews, Michael S.

2012-01-01

Policies delegating control of educational policy to the local level are widespread, yet there has been little examination of the effects of such distributed decision making in the area of advanced education programming. We used propensity score matching to examine the effectiveness of locally developed policies for identifying intellectually…

Young Children as Active Citizens in Local Government: Possibilities and Challenges from an Australian Perspective

ERIC Educational Resources Information Center

Bartholomaeus, Clare; Gregoric, Carolyn; Krieg, Susan

2016-01-01

Despite considerable research and discussion regarding children and young people's rights and citizenship, the participation of young children in community decision-making is still limited. In this exploratory research, a case study is reported on how ideas about young children as active citizens are interpreted within one local government…

Florida City & County Government. A Teacher Handbook for the High School Level.

ERIC Educational Resources Information Center

Gutierrez, Robert; And Others

Designed to remedy student's lack of opportunity to learn about the decision making process at the city or county government levels, this teacher handbook focuses on local government in Florida. The subject areas around which units and corresponding lessons are developed include: (1) the foundations of local government, history, legal roles, home…

Low- and Moderate-Income Solar Policy Basics | State, Local, and Tribal

Science.gov Websites

scores, which can make attaining a loan for solar investments difficult. Even in cases where loans are translate into having less control over decisions about rooftop solar and utilities. Even in cases where LMI program) to increase local solar deployment. In other cases, CDFIs and CDEs can directly facilitate

Trends in federal land acquisition, protection strategies, and planning

Treesearch

Warren Brown

1980-01-01

In the past, Federal land acquisition has been one of the most popular ways to protect outstanding natural resources and provide recreational opportunities. Federal purchase, maintenance, and operation can help take pressure off the State or local budget. Federal involvement also can provide a way for local officials to avoid making some tough decisions about...

Building trust in natural resource management within local communities: a case study of the Midewin National Tallgrass Prairie

Treesearch

Mae A. Davenport; Jessica E. Leahy; Dorothy H. Anderson; Pamela J. Jakes

2007-01-01

Communities neighboring federally protected natural areas regularly weigh the costs and benefits of the administering agency's programs and policies. While most agencies integrate public opinion into decision making, efforts to standardize and formalize public involvement have left many local communities feeling marginalized, spurring acrimony and opposition. A...

Decentralizing Education in Transition Societies: Case Studies from Central and Eastern Europe. WBI Learning Resources Series.

ERIC Educational Resources Information Center

Fiszbein, Ariel, Ed.

This book is about education system reform in Central and Eastern Europe, with emphasis on decentralization and management. In the past, local authorities served as implementation arms of the central ministry, while finance and decision-making were controlled by the central government, leaving local communities with little influence. New education…

Bottom-up responses to environmental and social impact assessments: A case study from Guatemala

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

Aguilar-Støen, Mariel, E-mail: mariel.stoen@sum.uio.no; Hirsch, Cecilie; Department of International Environment and Development, Norwegian University of Life Sciences

In this article we take a closer look at resistance to the practice of Environmental Impact Assessment (EIA) in mining and energy projects in Guatemala. Collectivities resisting mining and hydropower projects in Guatemala are increasingly using the evaluations of EIAs conducted by international independent professionals. Reaching out to international experts is facilitated by local communities' engagements in transnational networks bringing together activists, NGOs, scientists, journalists and others. We argue that resistance movements resort to international professionals to challenge the limits imposed on them by the national legislation and institutional arrangements as well as by the way in which EIAs aremore » performed in the country. Further, the engagements in networks that facilitate access to knowledge contribute to strengthen the legitimacy of communities' claims. Challenges to and complaints about EIAs are ways in which affected communities try to reclaim their right to participate in decision-making related to their local environment and the development of their communities. Both complaints about EIAs and the use of transnational networks to attain better participation in decision making processes at local levels, illustrated in this study for Guatemala, are common responses to the advancement of extractive industries and hydropower development across Latin America. The widespread of initiatives to challenge EIAs involving international experts in the region show that EIAs have become a sort of a transnational battleground. - Highlights: • Communities’ opposition to extractive projects is rooted in lack of participation in decision-making, including EIAs • Experts’ evaluations of approved EIAs confirm communities’ claims of poor practices in the public sector • Research presented here shows that local communities linked to transnational networks are able to scale up their demands.« less

Organizational structure and job satisfaction in public health nursing.

PubMed

Campbell, Sara L; Fowles, Eileen R; Weber, B Jan

2004-01-01

The purpose of this descriptive study was to describe the characteristics and relationship of organizational structure and job satisfaction in public health nursing. A significant relationship was found between organizational structure variables and job satisfaction for public health nurses employed in down state Illinois local health departments. The findings of this study suggest that work environments in which supervisors and subordinates consult together concerning job tasks and decisions, and in which individuals are involved with peers in decision making and task definition, are positively related to job satisfaction. This information will assist nurse administrators in development of work structures that support participative decision making and enhance job satisfaction, critical to retaining and attracting a well-qualified public health nurse workforce.

There Are at Least Two Kinds of Probability Matching: Evidence from a Secondary Task

ERIC Educational Resources Information Center

Otto, A. Ross; Taylor, Eric G.; Markman, Arthur B.

2011-01-01

Probability matching is a suboptimal behavior that often plagues human decision-making in simple repeated choice tasks. Despite decades of research, recent studies cannot find agreement on what choice strategies lead to probability matching. We propose a solution, showing that two distinct local choice strategies--which make different demands on…

"Make My Day, Shoot a Teacher": Tactics of Inclusion and Exclusion, and the Contestation of Community in a Rural School-Community Conflict

ERIC Educational Resources Information Center

McHenry-Sorber, Erin; Schafft, Kai A.

2015-01-01

Far from being the harmonious and homogenous communities of popular imagination, rural communities often are characterised by stark differences in class-situated values over education philosophy and financing. These differences can produce contentious political environments, vastly complexifying local decision-making, including school district…

Self-Organized Transport System

DOT National Transportation Integrated Search

2009-09-28

This report presents the findings of the simulation model for a self-organized transport system where traffic lights communicate with neighboring traffic lights and make decisions locally to adapt to traffic conditions in real time. The model is insp...

Burn Wise - What You Can Do

EPA Pesticide Factsheets

Within this site you will find information for consumers to make informed decisions about what it means to burn wise. State & local agencies learn to improve air quality in their communities through changeout programs and education.

Erratum To: Indigenous Frameworks for Observing and Responding to Climate Change in Alaska

NASA Technical Reports Server (NTRS)

Cochran, Patricia; Huntington, Orville H.; Pungowiyi, Caleb; Tom, Stanley; Chapin, F. Stuart, III; Huntington, Henry P.; Maynard, Nancy G.; Trainor, Sarah F.

2014-01-01

In section 5, item 1 of this article it is stated that: A recent shift in decision-making authority from the politically appointed Board of Game to the Subsistence Division of the Alaska Department of Fish and Game should make these decisions about hunting regulations more responsive to local observations and needs. We now recognize that this shift in regulatory authority to ADF&G never occurred. We hereby correct this error so that wildlife users in Alaska do not come to ADF&G with expectations that this agency has authority to adjust hunting regulations to accommodate climate change.

Decision making in quasi-markets: a pedagogic analysis.

PubMed

Jones, P R; Cullis, J G

1996-04-01

The objective of the 1991 NHS reforms was to reduce "excessive" vertical integration by constructing a quasi-market in which incentive structures and increased availability of information would enable decision makers make better use of resources. There is, however, no overall framework in which to consider the welfare gains which result from the introduction of a quasi-market or the welfare losses which arise from distortions in a quasi-market. This paper offers an analysis which can be applied to illustrate the difficulty of estimating the welfare loss from cream skimming and also to consider the impact of local monopoly.

Building an Evidence-Driven Child Welfare Workforce: A University–Agency Partnership

PubMed Central

Lery, Bridgette; Wiegmann, Wendy; Berrick, Jill Duerr

2016-01-01

The federal government increasingly expects child welfare systems to be more responsive to the needs of their local populations, connect strategies to results, and use continuous quality improvement (CQI) to accomplish these goals. A method for improving decision making, CQI relies on an inflow of high-quality data, up-to-date research evidence, and a robust organizational structure and climate that supports the deliberate use of evidence for decision making. This article describes an effort to build and support these essential system components through one public-private child welfare agency–university partnership. PMID:27429534

Renewable Energy Data, Analysis, and Decisions: A Guide for Practitioners

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

Cox, Sarah L; Lopez, Anthony J; Watson, Andrea C

High-quality renewable energy resource data and other geographic information system (GIS) data are essential for the transition to a clean energy economy that prioritizes local resources, improves resiliency, creates jobs, and promotes energy independence. This guide is intended to support policymakers and planners, as well as technical experts, consultants, and academics in incorporating improved data and analysis into renewable energy decision-making.

The Factors that Influence Data Utilization in Decision-Making: The Case of HIV/AIDS Programs in Mexico

ERIC Educational Resources Information Center

Rodriguez, Daniela Cristina

2011-01-01

In Mexico, as in many other countries, HIV/AIDS strategies are developed at the federal level and implemented at the state level. Local programs are expected to use data, in particular surveillance data, to drive their decisions on programmatic activities and prioritize populations with which the program will engage. Since the early 1980s Mexico…

Hong Kong - The Hong Kong Alliance of Patients' Organizations: Working constructively to increase hospital openness and accountability.

PubMed

2014-01-01

The Hong Kong Alliance of Patients' Organizations (HI(APO) comprises 44 affiliated patient groups who advocate across the region, improving patient experiences and increasing advocacy and awareness. Initially established to increase accountability to patients and representation in a changing health system, the Alliance has worked to expand patient input on local and territorial decision-making by partnering with individual hospitals and increasing links with the Hospital Authority Board. Patients are now represented on most committees affecting patient care and the delivery of health services, and more widely in health care policy decision-making. The Alliance advocates for patients as active and constructive consumers rather than passive recipients of services and lobbies for better representation and involvement in treatment decisions. It has also increased media exposure which has helped to grow representation so that patients are now present on all 11 Authority Committees and are asked for their views. The patient ambassadors programme offers training for patients to be representatives at ward level and within the local hospital committee; and by building constructive relationships over time with hospital partners, HKAPO affiliate organizations have been able to start making improvements in the training of professionals in hospitals and informing staff about patient engagement, advocating for new clinical interventions and a more patient-centred approach.

Community trust reduces myopic decisions of low-income individuals

PubMed Central

Jachimowicz, Jon M.; Chafik, Salah; Munrat, Sabeth; Prabhu, Jaideep C.; Weber, Elke U.

2017-01-01

Why do the poor make shortsighted choices in decisions that involve delayed payoffs? Foregoing immediate rewards for larger, later rewards requires that decision makers (i) believe future payoffs will occur and (ii) are not forced to take the immediate reward out of financial need. Low-income individuals may be both less likely to believe future payoffs will occur and less able to forego immediate rewards due to higher financial need; they may thus appear to discount the future more heavily. We propose that trust in one’s community—which, unlike generalized trust, we find does not covary with levels of income—can partially offset the effects of low income on myopic decisions. Specifically, we hypothesize that low-income individuals with higher community trust make less myopic intertemporal decisions because they believe their community will buffer, or cushion, against their financial need. In archival data and laboratory studies, we find that higher levels of community trust among low-income individuals lead to less myopic decisions. We also test our predictions with a 2-y community trust intervention in rural Bangladesh involving 121 union councils (the smallest rural administrative and local government unit) and find that residents in treated union councils show higher levels of community trust and make less myopic intertemporal choices than residents in control union councils. We discuss the implications of these results for the design of domestic and global policy interventions to help the poor make decisions that could alleviate poverty. PMID:28400516

Reversible inactivation of the lateral hypothalamus reversed high reward choices in cost-benefit decision-making in rats.

PubMed

Karimi, Sara; Mesdaghinia, Azam; Farzinpour, Zahra; Hamidi, Gholamali; Haghparast, Abbas

2017-11-01

The Lateral hypothalamus (LH) is an important component of the networks underlying the control of feeding and other motivated behaviors. Cost-benefit decision-making is mediated largely by the prefrontal cortex (PFC) which strongly innervates the LH. Therefore, in the current study, we conducted a series of experiments to elucidate the role of the perifornical area of the lateral hypothalamus (PeF-LH) in effort and/or delay-based decision-making. We trained different groups of rats in a delay-based and/or an effort-based form of cost-benefit T-maze decision- making task in which they could either choose to pay the cost to obtain a high reward in one arm or could obtain a low reward in the other arm with no cost. During test days, the rats received local injections of either vehicle or lidocaine4% (0.5 μl/side), in the PeF-LH. In an effort-based decision task, PeF-LH inactivation led to decrease in high reward choice. Similarly, in a delay-based decision task animals' preference changed to a low but immediately available reward. This was not caused by a spatial memory or motor deficit. PeF-LH inactivation modified decision behavior. The results imply that PeF-LH is important for allowing the animal to pay a cost to acquire greater rewards. Copyright © 2017 Elsevier Inc. All rights reserved.

Assessment of spatial variation of risks in small populations.

PubMed Central

Riggan, W B; Manton, K G; Creason, J P; Woodbury, M A; Stallard, E

1991-01-01

Often environmental hazards are assessed by examining the spatial variation of disease-specific mortality or morbidity rates. These rates, when estimated for small local populations, can have a high degree of random variation or uncertainty associated with them. If those rate estimates are used to prioritize environmental clean-up actions or to allocate resources, then those decisions may be influenced by this high degree of uncertainty. Unfortunately, the effect of this uncertainty is not to add "random noise" into the decision-making process, but to systematically bias action toward the smallest populations where uncertainty is greatest and where extreme high and low rate deviations are most likely to be manifest by chance. We present a statistical procedure for adjusting rate estimates for differences in variability due to differentials in local area population sizes. Such adjustments produce rate estimates for areas that have better properties than the unadjusted rates for use in making statistically based decisions about the entire set of areas. Examples are provided for county variation in bladder, stomach, and lung cancer mortality rates for U.S. white males for the period 1970 to 1979. PMID:1820268

Disparities in Water and Sewer Services in North Carolina: An Analysis of the Decision-Making Process

PubMed Central

Gibson, Jacqueline MacDonald

2015-01-01

Objectives. We examined the factors that affect access to municipal water and sewer service for unincorporated communities relying on wells and septic tanks. Methods. Using a multisite case study design, we conducted in-depth, semistructured interviews with 25 key informants from 3 unincorporated communities in Hoke, New Hanover, and Transylvania counties, North Carolina, July through September 2013. Interviewees included elected officials, health officials, utility providers, and community members. We coded the interviews in ATLAS.ti to identify common themes. Results. Financing for water and sewer service emerged as the predominant factor that influenced decisions to extend these services. Improved health emerged as a minor factor, suggesting that local officials may not place a high emphasis on the health benefits of extending public water and sewer services. Awareness of failed septic systems in communities can prompt city officials to extend sewer service to these areas; however, failed systems are often underreported. Conclusions. Understanding the health costs and benefits of water and sewer extension and integrating these findings into the local decision-making process may help address disparities in access to municipal services. PMID:26270307

Study protocol: DEcisions in health Care to Introduce or Diffuse innovations using Evidence (DECIDE).

PubMed

Turner, Simon; Morris, Stephen; Sheringham, Jessica; Hudson, Emma; Fulop, Naomi J

2016-04-05

A range of evidence informs healthcare decision-making, from formal research findings to 'soft intelligence' or local data, as well as practical experience or tacit knowledge. However, cultural and organisational factors often prevent the translation of such evidence into practice. Using a multi-level framework, this project will analyse how interactions between the evidence available and processes at the micro (individual/group) and meso (organisational/system) levels influence decisions to introduce or diffuse innovations in acute and primary care within the National Health Service in the UK. This study will use a mixed methods design, combining qualitative and quantitative methods, and involves four interdependent work streams: (1) rapid evidence synthesis of relevant literature with stakeholder feedback; (2) in-depth case studies of 'real-world' decision-making in acute and primary care; (3) a national survey and discrete choice experiment; and (4) development of guidance for decision-makers and evaluators to support the use of evidence in decision-making. This study will enhance the understanding of decision-makers' use of diverse forms of evidence. The findings will provide insights into how and why some evidence does inform decisions to introduce healthcare innovations, and why barriers persist in other cases. It will also quantify decision-makers' preferences, including the 'tipping point' of evidence needed to shift stakeholders' views. Practical guidance will be shared with healthcare decision-makers and evaluators on uses of evidence to enable the introduction and diffusion of innovation.

Opinion Dynamics and Decision of Vote in Bipolar Political Systems

NASA Astrophysics Data System (ADS)

Caruso, Filippo; Castorina, Paolo

A model of the opinion dynamics underlying the political decision is proposed. The analysis is restricted to a bipolar scheme with a possible third political area. The interaction among voters is local but the final decision strongly depends on global effects such as the rating of the governments. As in the realistic case, the individual decision making process is determined by the most relevant personal interests and problems. The phenomenological analysis of the national vote in Italy and Germany has been carried out and a prediction of the next Italian vote as a function of the government rating is presented.

Hospital drug and therapeutics committees in Australia: is there a role for economic evaluation at the institutional level?

PubMed

Gallego, Gisselle

2011-12-01

Decisions about spending on medicines occur at different levels in the Australian health care system. This commentary describes the role of economic evaluation at the institutional (public hospital) level. In contrast to the decisions taken at the level of Federal subsidy (listing on the Pharmaceutical Benefits Scheme) formal pharmacoeonomic data analyses are usually not available, and arguably often not relevant to decision making within the public hospital setting. Future research is needed to develop and explore models of best practice and how to incorporate pharmacoeconomic evidence into local decisions.

Interrater reliability among epilepsy centers: multicenter study of epilepsy surgery.

PubMed

Haut, Sheryl R; Berg, Anne T; Shinnar, Shlomo; Cohen, Hillel W; Bazil, Carl W; Sperling, Michael R; Langfitt, John T; Pacia, Steven V; Walczak, Thaddeus S; Spencer, Susan S

2002-11-01

To measure the interrater reliability of presurgical testing and surgical decisions among epilepsy centers. Seven centers participating in an ongoing, prospective multicenter study of resective epilepsy surgery agreed to conform to a detailed protocol regarding presurgical evaluation and surgery. To assess quality assurance, each center independently reviewed 21 randomly selected surgical cases for preoperative study lateralization and localization, and surgical decisions. Interrater reliability was assessed by using intraclass correlation coefficients (ICCs), validated for use with multiple raters, and calculated in a two-way random model based on absolute agreement. Agreement for ICC values: > or = 0.75, excellent; 0.60-0.74, good; 0.40-0.59, fair; < or = 0.39, poor. One center was excluded for missing data. Agreement was excellent for extracranial EEG lateralization (0.8039), magnetic resonance imaging (MRI) lateralization (0.9521) and localization (0.9130), Wada lateralization (0.9453), and intracranial EEG localization (0.7905). Agreement was good for extracranial EEG localization (0.7384) and neuropsychological testing lateralization (0.7178) and localization (0.6891). Consensus about the decision to perform intracranial monitoring was fair (0.5397), in part reflecting one center's tendency toward intracranial monitoring. Overall agreements on whether to perform surgery (0.8311) and specific surgery recommended (0.8164) were excellent. High interrater reliability among six epilepsy centers was present for interpretation of most components of presurgical testing. Although consensus for the decision to perform intracranial monitoring was only fair, agreements for the ultimate decision about resective surgery and specific choice of resection were excellent. We believe that this study demonstrates the feasibility of implementing multicenter protocols for neurologic management, especially those involving localization, as well as protocols combining study results with clinical decision making.

Fusion of Heterogeneous Intrusion Detection Systems for Network Attack Detection

PubMed Central

Kaliappan, Jayakumar; Thiagarajan, Revathi; Sundararajan, Karpagam

2015-01-01

An intrusion detection system (IDS) helps to identify different types of attacks in general, and the detection rate will be higher for some specific category of attacks. This paper is designed on the idea that each IDS is efficient in detecting a specific type of attack. In proposed Multiple IDS Unit (MIU), there are five IDS units, and each IDS follows a unique algorithm to detect attacks. The feature selection is done with the help of genetic algorithm. The selected features of the input traffic are passed on to the MIU for processing. The decision from each IDS is termed as local decision. The fusion unit inside the MIU processes all the local decisions with the help of majority voting rule and makes the final decision. The proposed system shows a very good improvement in detection rate and reduces the false alarm rate. PMID:26295058

Fusion of Heterogeneous Intrusion Detection Systems for Network Attack Detection.

PubMed

Kaliappan, Jayakumar; Thiagarajan, Revathi; Sundararajan, Karpagam

2015-01-01

An intrusion detection system (IDS) helps to identify different types of attacks in general, and the detection rate will be higher for some specific category of attacks. This paper is designed on the idea that each IDS is efficient in detecting a specific type of attack. In proposed Multiple IDS Unit (MIU), there are five IDS units, and each IDS follows a unique algorithm to detect attacks. The feature selection is done with the help of genetic algorithm. The selected features of the input traffic are passed on to the MIU for processing. The decision from each IDS is termed as local decision. The fusion unit inside the MIU processes all the local decisions with the help of majority voting rule and makes the final decision. The proposed system shows a very good improvement in detection rate and reduces the false alarm rate.

On the generality of age differences in social and nonsocial decision making.

PubMed

Rieger, Matthias; Mata, Rui

2015-03-01

Empirical work with western populations suggests that aging is associated with changes in economic decision making, including, for example, increased prosocial tendencies. We investigated the generality of age effects in social and nonsocial domains by assessing various measures of economic decision making in a rural population from Morocco. We measured age/cohort differences using a number of economic games (risk game, time preferences game, dictator game, trust game, and public goods game) in over 700 participants ranging from 17 to 92 years of age. The results suggest a negative relation between age and risk taking and a concave relation between age and contribution to a public good, but no significant age trends in time preferences, altruism, trust, or trustworthiness. Our results indicate that the relationship between aging and decision making is not universal and is shaped by local culture and the type of task rather than biological factors alone. More research is needed to understand the unique age trends prevalent in specific populations and tasks. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

KNOW ESSENTIALS: a tool for informed decisions in the absence of formal HTA systems.

PubMed

Mathew, Joseph L

2011-04-01

Most developing countries and resource-limited settings lack robust health technology assessment (HTA) systems. Because the development of locally relevant HTA is not immediately viable, and the extrapolation of external HTA is inappropriate, a new model for evaluating health technologies is required. The aim of this study was to describe the development and application of KNOW ESSENTIALS, a tool facilitating evidence-based decisions on health technologies by stakeholders in settings lacking formal HTA systems. Current HTA methodology was examined through literature search. Additional issues relevant to resource-limited settings, but not adequately addressed in current methodology, were identified through further literature search, appraisal of contextually relevant issues, discussion with healthcare professionals familiar with the local context, and personal experience. A set of thirteen elements important for evidence-based decisions was identified, selected and combined into a tool with the mnemonic KNOW ESSENTIALS. Detailed definitions for each element, coding for the elements, and a system to evaluate a given health technology using the tool were developed. Developing countries and resource-limited settings face several challenges to informed decision making. Models that are relevant and applicable in high-income countries are unlikely in such settings. KNOW ESSENTIALS is an alternative that facilitates evidence-based decision making by stakeholders without formal expertise in HTA. The tool could be particularly useful, as an interim measure, in healthcare systems that are developing HTA capacity. It could also be useful anywhere when rapid evidence-based decisions on health technologies are required.

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.

Partnerships that Bridge the Gap Between Research and Impact

NASA Astrophysics Data System (ADS)

Pandya, R. E.; Udu-gama, N.

2015-12-01

Losses from natural hazards continue to grow, despite growing scientific understanding. Similarly, increasing scientific evidence of our vulnerability to human-induced environmental change has little impact on human behavior. From the perspective of community leaders and policy makers, useful research is hard to locate and difficult to translate from academic publications. Making local decisions is complicated by multiple scientific approaches and predictions and a scientific emphasis on the abstract and global over the concrete and local. Collaborative and respectful locally-focused partnerships, in which community leaders and decision makers co-design local solutions with Earth and space scientists, can overcome this research-to-impact gap. These partnerships work best when they use available scientific and community knowledge to make an immediate local impact while also designing research that addresses broadly relevent and emerging priorities. Framed this way, successful partnerships rest on reciprocal volunteerism: for scientists, making an immediate impact with current knowledge is pro-bono work, while the longer term research better aligns with their career advancement. For community leaders this is flipped: immediate actions tie to their professional responsibilities, and participating in research is often extracurricular. The Thriving Earth Exchange has launched several of these local partnerships and is assembling a set of tools and resources that scientists and community leaders can use to advance their work together. We will introduce the institutional partners who help us identify communities willing to enter these partnerships, and describe how we recruit and select willing and able scientists, many from AGU. We will highlight the human-centered skills and values that are important predictors of successful partnerships and show how we nurture them. We will also describe the progress of several existing efforts and the strategies they use to advance their co-design process. We will explore ideas for sharing co-designed solutions between communities, and explore how partnerships can make the inevitable local customization of borrowed solutions more efficient. Finally, we will share some of the solutions these partnerships have developed and describe their impact.

DIY Solar Market Analysis STAT Webinars | State, Local, and Tribal

Science.gov Websites

do they help policymakers? Solar Resource and Technical Potential: Finding, using, and making maps for decision makers PVWatts: New tips and tricks for the latest update Community Solar Scenario Tool

Complementary and Alternative Medicine (CAM) use by Malaysian oncology patients.

PubMed

Farooqui, Maryam; Hassali, Mohamed Azmi; Abdul Shatar, Aishah Knight; Shafie, Asrul Akmal; Seang, Tan Boon; Farooqui, Muhammad Aslam

2012-05-01

The current study sought to evaluate Malaysian oncology patients' decision making about the use of Complementary and Alternative Medicine (CAM) for the management of their care. Patients were interviewed across three major Malaysian ethnic groups, Malay, Chinese and Indian. Thematic content analysis identified four central themes: Conceptualizing CAM, the decision making process; rationale given for selecting or rejecting CAM and barriers to CAM use. Participants generally used the term 'traditional medicine', referred to locally as 'ubat kampung', meaning medicine derived from 'local traditions'. Mixed reactions were shown concerning the effectiveness of CAM to cure cancer and the slow progression of CAM results and treatment costs were cited as major barriers to CAM use. Concerns regarding safety and efficacy of CAM in ameliorating cancer as well as potential interactions with conventional therapies highlighted the importance of patients' knowledge about cancer treatments. Copyright © 2011 Elsevier Ltd. All rights reserved.

Exploring Information Generation and Propagation from the Point of Installation on Construction Jobsites: An SNA/ABM Hybrid Approach

ERIC Educational Resources Information Center

Moore, Heather

2013-01-01

Construction requires the knowledge and experience of craftsmen. The knowledge and experience is gained through local coordination and local adaption at points of installation, which classifies the work as complex production. Information generated at these points of installation can be valuable in understanding how and why workers make decisions,…

Distributed topology control algorithm for multihop wireless netoworks

NASA Technical Reports Server (NTRS)

Borbash, S. A.; Jennings, E. H.

2002-01-01

We present a network initialization algorithmfor wireless networks with distributed intelligence. Each node (agent) has only local, incomplete knowledge and it must make local decisions to meet a predefined global objective. Our objective is to use power control to establish a topology based onthe relative neighborhood graph which has good overall performance in terms of power usage, low interference, and reliability.

Use of survey data to define regional and local priorities for management on national wildlife refuges

Treesearch

John R. Sauer; Jennifer Casey; Harold Laskowski; Jan D. Taylor; Jane Fallon

2005-01-01

National Wildlife Refuges must manage habitats to support a variety of species that often have conflicting needs. To make reasonable management decisions, managers must know what species are priorities for their refuges and the relative importance of the species. Unfortunately, species priorities are often set regionally, but refuges must develop local priorities that...

Local discrepancies in continental scale biomass maps: a case study over forested and non-forested landscapes in Maryland, USA

Treesearch

Wenli Huang; Anu Swatantran; Kristofer Johnson; Laura Duncanson; Hao Tang; Jarlath O' Neil Dunne; George Hurtt; Ralph Dubayah

2015-01-01

Continental-scale aboveground biomass maps are increasingly available, but their estimates vary widely, particularly at high resolution. A comprehensive understanding of map discrepancies is required to improve their effectiveness in carbon accounting and local decision-making. To this end, we compare four continental-scale maps with a recent high-resolution lidar-...

Applying Various Methods of Communicating Science for Community Decision-Making and Public Awareness: A NASA DEVELOP National Program Case Study

NASA Astrophysics Data System (ADS)

Miller, T. N.; Brumbaugh, E. J.; Barker, M.; Ly, V.; Schick, R.; Rogers, L.

2015-12-01

The NASA DEVELOP National Program conducts over eighty Earth science projects every year. Each project applies NASA Earth observations to impact decision-making related to a local or regional community concern. Small, interdisciplinary teams create a methodology to address the specific issue, and then pass on the results to partner organizations, as well as providing them with instruction to continue using remote sensing for future decisions. Many different methods are used by individual teams, and the program as a whole, to communicate results and research accomplishments to decision-makers, stakeholders, alumni, and the general public. These methods vary in scope from formal publications to more informal venues, such as social media. This presentation will highlight the communication techniques used by the DEVELOP program. Audiences, strategies, and outlets will be discussed, including a newsletter, microjournal, video contest, and several others.

Primary and secondary analysis of local elected officials' decisions to support or oppose pharmacy sale of syringes in California.

PubMed

Backes, Glenn; Rose, Valerie J

2010-07-01

Under California law, local governments may authorize pharmacies within their jurisdictions to sell ten or fewer syringes to an adult without prescription, proof of identity, or proof of medical need. Local governments may simultaneously exempt adults from prosecution for violation of state drug paraphernalia codes for possession of ten or fewer syringes for personal use. Both of these provisions are temporary and sunset on December 31, 2010, unless subsequent state legislation amends that date. The objective of our study was to ascertain how and why local policymakers made their decisions regarding non-prescription syringe sale (NPSS). We examined influences on their decisions, including specific messengers and the arguments that were most salient to their decision making. We selected jurisdictions that were geographically representative of California counties; those with and without syringe exchange programs, and those that had passed or rejected NPSS. We conducted nine semi-structured interviews in five jurisdictions. To enrich primary data collection, we analyzed secondary data by reviewing audio, video, and written transcripts of public hearings and newspaper coverage in five jurisdictions, including three jurisdictions without primary interview data. Among proponents of NPSS, we identified common themes, including: (1) public health research provided conclusive evidence for reduction in HIV and hepatitis transmission without problems of crime, drug use, or unsafe discard of syringes; (2) the local health officer was the key to influencing local policymakers; (3) recall of prior debates over syringe exchange served to inform their decision making; and (4) a lack of local opposition or controversy. Common concerns among opponents of NPSS included: (1) that there would be an increase in unsafe discard of syringes; (2) loss of an important law enforcement tool; (3) that drug users were incapable of desired behavior change; and (4) that research was inconclusive, or proved that syringe access would not work in reducing rates of disease. Themes held in common by proponents and opponents of NPSS were identified as well. Syringe access through NPSS is in fact supported by a robust body of public health research and is considered an important component of a comprehensive strategy to reduce HIV and hepatitis transmission. Our study highlights the importance of understanding the perspectives of elected officials in order to ameliorate their concerns without undermining the public health goal of reducing death, disease, and suffering in at-risk communities.

Local level sustainability policies in the Baltic Sea area: Local Agenda 21 within the Union of the Baltic Cities network.

PubMed

Joas, M; Grönholm, B

2001-08-01

Local Agenda 21 (LA21) processes have 2 central goals. i) On the basis of some of the empirical evidence in this study, the primary goal is to improve democratic (environmental) policy-making processes in such a manner that a larger share of the population will be able to participate in planning and decision making and will also be able to understand the consequences of these decisions. ii) The LA21 processes seek to improve (at least indirectly) the broadly defined environmental situation locally in a manner that takes into account both the local and the global contexts. The first part of this article discusses the concept and methods of LA21 and sheds light on the different action areas that are central to the Baltic LA21 processes. In addition, the study will describe and display the LA21 situation within one network of cities, the Union of the Baltic Cities (UBC). Networking, including transfer of information, models and ideas, has been among the main tools for the diffusion of LA21 ideas especially into newly democratized societies. Finally, the article will conclude with an overall assessment of the LA21 situation on the Baltic rim.

Decision-Oriented Health Technology Assessment: One Step Forward in Supporting the Decision-Making Process in Hospitals.

PubMed

Ritrovato, Matteo; Faggiano, Francesco C; Tedesco, Giorgia; Derrico, Pietro

2015-06-01

This article outlines the Decision-Oriented Health Technology Assessment: a new implementation of the European network for Health Technology Assessment Core Model, integrating the multicriteria decision-making analysis by using the analytic hierarchy process to introduce a standardized methodological approach as a valued and shared tool to support health care decision making within a hospital. Following the Core Model as guidance (European network for Health Technology Assessment. HTA core model for medical and surgical interventions. Available from: http://www.eunethta.eu/outputs/hta-core-model-medical-and-surgical-interventions-10r. [Accessed May 27, 2014]), it is possible to apply the analytic hierarchy process to break down a problem into its constituent parts and identify priorities (i.e., assigning a weight to each part) in a hierarchical structure. Thus, it quantitatively compares the importance of multiple criteria in assessing health technologies and how the alternative technologies perform in satisfying these criteria. The verbal ratings are translated into a quantitative form by using the Saaty scale (Saaty TL. Decision making with the analytic hierarchy process. Int J Serv Sci 2008;1:83-98). An eigenvectors analysis is used for deriving the weights' systems (i.e., local and global weights' system) that reflect the importance assigned to the criteria and the priorities related to the performance of the alternative technologies. Compared with the Core Model, this methodological approach supplies a more timely as well as contextualized evidence for a specific technology, making it possible to obtain data that are more relevant and easier to interpret, and therefore more useful for decision makers to make investment choices with greater awareness. We reached the conclusion that although there may be scope for improvement, this implementation is a step forward toward the goal of building a "solid bridge" between the scientific evidence and the final decision maker's choice. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Quantum Leap in Cartography as a requirement of Sustainable Development of the World

NASA Astrophysics Data System (ADS)

Tikunov, Vladimir S.; Tikunova, Iryna N.; Eremchenko, Eugene N.

2018-05-01

Sustainable development is one of the most important challenges for humanity and one of the priorities of the United Nations. Achieving sustainability of the whole World is a main goal of management at all levels - from personal to local to global. Therefore, decision making should be supported by relevant geospatial information system. Nevertheless, classical geospatial products, maps and GIS, violate fundamental demand of `situational awareness' concept, well-known philosophy of decision-making - same representation of situation within a same volume of time and space for all decision-makers. Basic mapping principles like generalization and projections split the universal single model of situation on number of different separate and inconsistent replicas. It leads to wrong understanding of situation and, after all - to incorrect decisions. In another words, quality of the sustainable development depends on effective decision-making support based on universal global scale-independent and projection-independent model. This new way for interacting with geospatial information is a quantum leap in cartography method. It is implemented in the so-called `Digital Earth' paradigm and geospatial services like Google Earth. Com-paring of both methods, as well as possibilities of implementation of Digital Earth in the sustain-able development activities, are discussed.

Decision-Making in Pediatric Transport Team Dispatch Using Script Concordance Testing.

PubMed

Rajapreyar, Prakadeshwari; Marcdante, Karen; Zhang, Liyun; Simpson, Pippa; Meyer, Michael T

2017-11-01

Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. Survey was developed using Script Concordance Testing guidelines. The survey contained 15 transport case vignettes covering 20 scenarios (45 questions). Eleven scenarios assessed impact of intrinsic patient factors (e.g., procedural needs), whereas nine assessed extrinsic factors (e.g., weather). Pediatric Critical Care programs accredited by the Accreditation Council for Graduate Medical Education (the United States). Pediatric Intensivists and senior Critical Care fellows at Pediatric Critical Care programs were the target population with Transport Medical Directors serving as the expert panel. None. Survey results were scored per Script Concordance Testing guidelines. Concordance within groups was assessed using simple percentage agreement. There was little concordance in decision-making by Transport Medical Directors (median Script Concordance Testing percentage score [interquartile range] of 33.9 [30.4-37.3]). In addition, there was no statistically significant difference between the median Script Concordance Testing scores among the senior fellows and Pediatric Intensivists (31.1 [29.6-33.2] vs 29.7 [28.3-32.3], respectively; p = 0.12). Transport Medical Directors were more concordant on reasoning involving intrinsic patient factors rather than extrinsic factors (10/21 vs 4/24). Our study demonstrates pediatric transport team dispatch decision-making discordance by pediatric critical care physicians of varying levels of expertise and experience. Script Concordance Testing at a local level may better elucidate standards in medical decision-making within pediatric critical care physicians. The development of a curriculum, which provides education and trains our workforce on the logistics of pediatric transport team dispatch, would help standardize practice and evaluate outcomes based on decision-making.

Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania

PubMed Central

2012-01-01

Background Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people’s needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual’s opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. Methods The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. Results The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Conclusions Existing challenges related to individuals’ influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in decision-making processes. This simultaneously implies an emphasis on assuring the distribution of information, training and education so that individuals can participate fully in informed decision making. PMID:22676204

Taking the Next Step: Using Water Quality Data in a Decision Support System for County, State, and Federal Land Managers

NASA Astrophysics Data System (ADS)

Raby, K. S.; Williams, M. W.

2004-12-01

Each passing year amplifies the demands placed on communities across the US in terms of population growth, increased tourism, and stresses resulting from escalated use. The conflicting concerns of recreational users, local citizens, environmentalists, and traditional economic interests cause land managers to contend with controversial decisions regarding development and protection of watersheds. Local history and culture, politics, economic goals, and science are all influential factors in land use decision making. Here we report on a scientific study to determine the sensitivity of alpine areas, and the adaptation of this study into a decision support framework. We use water quality data as an indicator of ecosystem health across a variety of alpine and subalpine landscapes, and input this information into a spatially-based decision support tool that planners can use to make informed land use decisions. We develop this tool in a case study in San Juan County, Colorado, a site chosen because its largest town, Silverton, is a small mountain community experiencing a recent surge in tourism and development, and its fragile high elevation locale makes it more sensitive to environmental changes. Extensive field surveys were conducted in priority drainages throughout the county to map the spatial distribution and aerial extent of landscape types during the summers of 2003 and 2004. Surface water samples were collected and analyzed for inorganic and organic solutes, and water quality values were associated with different land covers to enable sensitivity analysis at the landscape scale. Water quality results for each watershed were entered into a module linked to a geographic information system (GIS), which displays maps of sensitive areas based on criteria selected by the user. The decision support system initially incorporates two major water quality parameters: acid neutralizing capacity (ANC) and nitrate (NO3-) concentration, and several categories of sensitivity were created based on ANC and NO3- levels (e.g., pristine, slightly sensitive, moderately sensitive, highly sensitive, sensitive but unimpacted, disturbance impacted). We based threshold concentrations for these water quality parameters on first principles developed at the Niwot Ridge LTER site. Additional parameters such as specific conductance, base cation concentration, sulfate concentration, and dissolved organic carbon concentration may be added for a particular landscape type. Superimposed on this categorization, federal, state, and county planners are able to make decisions about the degree of potential impairment or enhancement produced by a particular project, or the maximum level of acceptable impairment to a particular area. Because water quality parameters are correlated with landscape types, the model returns a map of the watershed, partitioned by landscape type, presenting the sensitivity level of each area. This format provides land use managers with spatial criteria for project implementation.

Local self governance in health - a study of it's functioning in Odisha, India.

PubMed

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

2016-10-31

Local decision making is linked to several service quality improvement parameters. Rogi Kalyan Samitis (RKS) at peripheral decision making health units (DMHU) are composite bodies that are mandated to ensure accountability and transparency in governance, improve quality of services, and facilitate local responsiveness. There is scant literature on the nature of functioning of these institutions in Odisha. This study aimed to assess the perception of RKS members about their roles, involvement and practices with respect to local decision making and management of DMHUs; it further examined perceptual and functional differences between priority and non-priority district set-ups; and identified predictors of involvement of RKS members in local governance of health units. As members of RKS, health service providers, officials in administrative/managerial role, elected representatives, and officials from other departments (including independent members) constituted our study sample. A total of 112 respondents were interviewed across 6 districts, through a multi-stage stratified random sampling; we used a semi-structured interview schedule that comprised mainly of close-ended and some open-ended questions. Descriptive and inferential statistics were used to compare 3 priority (PD) and 3 non-priority districts (NPD), categorized on the basis of Infant Mortality Rate (IMR) estimates of 2011 as proxy of population health. Governance, human resource management, financial management and quality improvement functions were studied in detail. Opinion about various individual and organizational factors in local self-governance and predictors of involvement were identified. The socio-demographic profile and composition of respondents were comparable between PD and NPD. Majority of respondents were 'satisfied' with their current roles in the governance of local health institutions. About one-fourth opined that the amount of funds allocated to RKS under National Health Mission (NHM) was 'grossly insufficient'. Fifty percent of respondents said they requested for additional funds, last year, and 38.8 % informed that they requested additional funds for purchase of drugs. About 87 % respondents were satisfied with their role in the local governance of the health units (PD = 94.3 % vs. NPD = 80.7 %). Almost all (PD = 98 % vs. NPD = 80.7 %) opined that local decision making helped in improving the performance of health units. For most of the open-ended questions the responses were non-specific. Staggering differences were found between PD and NPD with respect to their involvement in district plan preparation (NPD = 78.9 % vs. PD = 58.5 %), training in plan preparation (NPD = 47.4 % vs. PD = 27.5 %), participation of officials from other departments (PD = 96.9 % vs. NPD = 45.5 %), and inclusion of activities of other sectors (PD = 70.8 % vs. NPD = 41.8 %). Whereas, no significant PD-NPD difference was found about their perceived 'involvement' in undertaking the 12 designated responsibilities. Composite scores on various individual and organizational factors were compared and found to be varying significantly. Through regression, we inferred work experience, qualification and non-monetary incentives as strong determinants of current level of involvement of RKS members in governance and management of health units. Poor knowledge/expectation of RKS members was diluting the decision making process at DMHUs. There is an urgent need to improve their knowledge, understanding and expertise in areas of governance and management practices. A locally-monitored and time-bound capacity building plan could achieve this. Yearly resource allocation for drug procurement needs revision. Specific eligibility criteria based on work experience and qualification may be fixed for RKS membership. Further research may focus on identifying the underlying individual and systemic factors behind such large PD-NPD differences.

Development of a decision support system for tsunami evacuation: application to the Jiyang District of Sanya city in China

NASA Astrophysics Data System (ADS)

Hou, Jingming; Yuan, Ye; Wang, Peitao; Ren, Zhiyuan; Li, Xiaojuan

2017-03-01

Major tsunami disasters often cause great damage in the first few hours following an earthquake. The possible severity of such events requires preparations to prevent tsunami disasters or mitigate them. This paper is an attempt to develop a decision support system for rapid tsunami evacuation for local decision makers. Based on the numerical results database of tsunami disasters, this system can quickly obtain the tsunami inundation and travel time. Because numerical models are calculated in advance, this system can reduce decision-making time. Population distribution, as a vulnerability factor, was analyzed to identify areas of high risk for tsunami disasters. Combined with spatial data, this system can comprehensively analyze the dynamic and static evacuation process and identify problems that negatively impact evacuation, thus supporting the decision-making for tsunami evacuation in high-risk areas. When an earthquake and tsunami occur, this system can rapidly obtain the tsunami inundation and travel time and provide information to assist with tsunami evacuation operations.

Gatekeepers for Pragmatic Clinical Trials

PubMed Central

Whicher, Danielle M.; Miller, Jennifer E.; Dunham, Kelly M.; Joffe, Steven

2015-01-01

To successfully implement a pragmatic clinical trial, investigators need access to numerous resources, including financial support, institutional infrastructure (e.g., clinics, facilities, staff), eligible patients, and patient data. Gatekeepers are people or entities who have the ability to allow or deny access to the resources required to support the conduct of clinical research. Based on this definition, gatekeepers relevant to the United States clinical research enterprise include research sponsors, regulatory agencies, payers, health system and other organizational leadership, research team leadership, human research protections programs, advocacy and community groups, and clinicians. This manuscript provides a framework to help guide gatekeepers’ decision-making related to the use of resources for pragmatic clinical trials. These include (1) concern for the interests of individuals, groups, and communities affected by the gatekeepers’ decisions, including protection from harm and maximization of benefits, (2) advancement of organizational mission and values, and (3) stewardship of financial, human, and other organizational resources. Separate from these ethical considerations, gatekeepers’ actions will be guided by relevant federal, state, and local regulations. This framework also suggests that to further enhance the legitimacy of their decision-making, gatekeepers should adopt transparent processes that engage relevant stakeholders when feasible and appropriate. We apply this framework to the set of gatekeepers responsible for making decisions about resources necessary for pragmatic clinical trials in the United States, describing the relevance of the criteria in different situations and pointing out where conflicts among the criteria and relevant regulations may affect decision-making. Recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding the use of limited and valuable resources. PMID:26374683

Co-producing resilient solutions to climate change: Bridging the gap between science and decision-making around nexus issues

NASA Astrophysics Data System (ADS)

Howarth, C.

2016-12-01

The nexus represents a multi-dimensional means of scientific enquiry encapsulating the complex and non-linear interactions between water, energy, food, environment with the climate, and wider implications for society. These resources are fundamental for human life but are negatively affected by climate change. Methods of analysis, which are currently used, were not built to represent complex systems and are insufficiently equipped to understand positive and negative externalities generated by interactions among different stakeholders involved in the nexus. In addition misalignment between the science that scientists produce and the evidence decision-makers need leads to a range of complexities within the science-policy interface. Adopting a bottom-up, participative approach, the results of five themed workshops organized in the UK (focusing on: shocks and hazards, infrastructure, local economy, governance and governments, finance and insurance) featuring 80 stakeholders from academia, government and industry allow us to map perceptions of opportunities and challenges of better informing decision making on climate change when there is a strong disconnect between the evidence scientists provide and the actions decision makers take. The research identified key areas where gaps could be bridged between science and action and explores how a knowledge co-production approach can help identify opportunities for building a more effective and legitimate policy agenda to face climate risks. Concerns, barriers and opportunities to better inform decision making centred on four themes: communication and collaboration, decision making processes, social and cultural dimensions, and the nature of responses to nexus shocks. In so doing, this analysis provides an assessment of good practice on climate decision-making and highlights opportunities for improvement to bridge gaps in the science-policy interface

High-Resolution Climate Data Visualization through GIS- and Web-based Data Portals

NASA Astrophysics Data System (ADS)

WANG, X.; Huang, G.

2017-12-01

Sound decisions on climate change adaptation rely on an in-depth assessment of potential climate change impacts at regional and local scales, which usually requires finer resolution climate projections at both spatial and temporal scales. However, effective downscaling of global climate projections is practically difficult due to the lack of computational resources and/or long-term reference data. Although a large volume of downscaled climate data has been make available to the public, how to understand and interpret the large-volume climate data and how to make use of the data to drive impact assessment and adaptation studies are still challenging for both impact researchers and decision makers. Such difficulties have become major barriers preventing informed climate change adaptation planning at regional scales. Therefore, this research will explore new GIS- and web-based technologies to help visualize the large-volume regional climate data with high spatiotemporal resolutions. A user-friendly public data portal, named Climate Change Data Portal (CCDP, http://ccdp.network), will be established to allow intuitive and open access to high-resolution regional climate projections at local scales. The CCDP offers functions of visual representation through geospatial maps and data downloading for a variety of climate variables (e.g., temperature, precipitation, relative humidity, solar radiation, and wind) at multiple spatial resolutions (i.e., 25 - 50 km) and temporal resolutions (i.e., annual, seasonal, monthly, daily, and hourly). The vast amount of information the CCDP encompasses can provide a crucial basis for assessing impacts of climate change on local communities and ecosystems and for supporting better decision making under a changing climate.

Multicriteria hierarchical iterative interactive algorithm for organizing operational modes of large heat supply systems

NASA Astrophysics Data System (ADS)

Korotkova, T. I.; Popova, V. I.

2017-11-01

The generalized mathematical model of decision-making in the problem of planning and mode selection providing required heat loads in a large heat supply system is considered. The system is multilevel, decomposed into levels of main and distribution heating networks with intermediate control stages. Evaluation of the effectiveness, reliability and safety of such a complex system is carried out immediately according to several indicators, in particular pressure, flow, temperature. This global multicriteria optimization problem with constraints is decomposed into a number of local optimization problems and the coordination problem. An agreed solution of local problems provides a solution to the global multicriterion problem of decision making in a complex system. The choice of the optimum operational mode of operation of a complex heat supply system is made on the basis of the iterative coordination process, which converges to the coordinated solution of local optimization tasks. The interactive principle of multicriteria task decision-making includes, in particular, periodic adjustment adjustments, if necessary, guaranteeing optimal safety, reliability and efficiency of the system as a whole in the process of operation. The degree of accuracy of the solution, for example, the degree of deviation of the internal air temperature from the required value, can also be changed interactively. This allows to carry out adjustment activities in the best way and to improve the quality of heat supply to consumers. At the same time, an energy-saving task is being solved to determine the minimum required values of heads at sources and pumping stations.

Reconciling the principle of patient autonomy with the practice of informed consent: decision-making about prognostication in uveal melanoma.

PubMed

Cook, Sharon A; Damato, Bertil; Marshall, Ernie; Salmon, Peter

2011-12-01

Influential views on how to protect patient autonomy in clinical care have been greatly shaped by rational and deliberative models of decision-making. Our aim was to understand how the general principle of respecting autonomy can be reconciled with the local reality of obtaining consent in a clinical situation that precludes extended deliberation. We interviewed 22 patients with intraocular melanoma who had been offered cytogenetic tumour typing to indicate whether the tumour was likely to shorten life considerably. They were interviewed before and/or up to 36 months after receiving cytogenetic results. Patients described their decision-making about the test and how they anticipated and used the results. Their accounts were analysed qualitatively, using inconsistencies at a descriptive level to guide interpretative analysis. Patients did not see a decision to be made. For those who accepted testing, their choice reflected trust of what the clinicians offered them. Patients anticipated that a good prognosis would be reassuring, but this response was not evident. Although they anticipated that a poor prognosis would enable end-of-life planning, adverse results were interpreted hopefully. In general, the meaning of the test for patients was not separable from ongoing care. Models of decision-making and associated consent procedures that emphasize patients' active consideration of isolated decision-making opportunities are invalid for clinical situations such as this. Hence, responsibility for ensuring that a procedure protects patients' interests rests with practitioners who offer it and cannot be delegated to patients. © 2010 Blackwell Publishing Ltd.

A strategy for monitoring and managing declines in an amphibian community.

PubMed

Grant, Evan H Campbell; Zipkin, Elise F; Nichols, James D; Campbell, J Patrick

2013-12-01

Although many taxa have declined globally, conservation actions are inherently local. Ecosystems degrade even in protected areas, and maintaining natural systems in a desired condition may require active management. Implementing management decisions under uncertainty requires a logical and transparent process to identify objectives, develop management actions, formulate system models to link actions with objectives, monitor to reduce uncertainty and identify system state (i.e., resource condition), and determine an optimal management strategy. We applied one such structured decision-making approach that incorporates these critical elements to inform management of amphibian populations in a protected area managed by the U.S. National Park Service. Climate change is expected to affect amphibian occupancy of wetlands and to increase uncertainty in management decision making. We used the tools of structured decision making to identify short-term management solutions that incorporate our current understanding of the effect of climate change on amphibians, emphasizing how management can be undertaken even with incomplete information. Estrategia para Monitorear y Manejar Disminuciones en una Comunidad de Anfibios. © 2013 Society for Conservation Biology.

Science-based decision making in a high-risk energy production environment

NASA Astrophysics Data System (ADS)

Weiser, D. A.

2016-12-01

Energy production practices that may induce earthquakes require decisions about acceptable risk before projects begin. How much ground shaking, structural damage, infrastructure damage, or delay of geothermal power and other operations is tolerable? I review a few mitigation strategies as well as existing protocol in several U.S. states. Timely and accurate scientific information can assist in determining the costs and benefits of altering production parameters. These issues can also be addressed with probability estimates of adverse effects ("costs"), frequency of earthquakes of different sizes, and associated impacts of different magnitude earthquakes. When risk management decisions based on robust science are well-communicated to stakeholders, mitigation efforts benefit. Effective communications elements include a) the risks and benefits of different actions (e.g. using a traffic light protocol); b) the factors to consider when determining acceptable risk; and c) the probability of different magnitude events. I present a case example for The Geysers geothermal field in California, to discuss locally "acceptable" and "unacceptable" earthquakes and share nearby communities' responses to smaller and larger magnitude earthquakes. I use the USGS's "Did You Feel It?" data archive to sample how often felt events occur, and how many of those are above acceptable magnitudes (to both local residents and operators). Using this information, I develop a science-based decision-making framework, in the case of potentially risky earthquakes, for lessening seismic risk and other negative consequences. This includes assessing future earthquake probabilities based on past earthquake records. One of my goals is to help characterize uncertainties in a way that they can be managed; to this end, I present simple and accessible approaches that can be used in the decision making process.

Evidence synthesis activities of a hospital evidence-based practice center and impact on hospital decision making.

PubMed

Jayakumar, Kishore L; Lavenberg, Julia A; Mitchell, Matthew D; Doshi, Jalpa A; Leas, Brian; Goldmann, David R; Williams, Kendal; Brennan, Patrick J; Umscheid, Craig A

2016-03-01

Hospital evidence-based practice centers (EPCs) synthesize and disseminate evidence locally, but their impact on institutional decision making is unclear. To assess the evidence synthesis activities and impact of a hospital EPC serving a large academic healthcare system. Descriptive analysis of the EPC's database of rapid systematic reviews since EPC inception (July 2006-June 2014), and survey of report requestors from the EPC's last 4 fiscal years. Descriptive analyses examined requestor and report characteristics; questionnaire examined report usability, impact, and requestor satisfaction (higher scores on 5-point Likert scales reflected greater agreement). The EPC completed 249 evidence reviews since inception. The most common requestors were clinical departments (29%, n = 72), chief medical officers (19%, n = 47), and purchasing committees (14%, n = 35). The most common technologies reviewed were drugs (24%, n = 60), devices (19%, n = 48), and care processes (12%, n = 31). Mean report completion time was 70 days. Thirty reports (12%) informed computerized decision support interventions. More than half of reports (56%, n = 139) were completed in the last 4 fiscal years for 65 requestors. Of the 64 eligible participants, 46 responded (72%). Requestors were satisfied with the report (mean = 4.4), and agreed it was delivered promptly (mean = 4.4), answered the questions posed (mean = 4.3), and informed their final decision (mean = 4.1). This is the first examination of evidence synthesis activities by a hospital EPC in the United States. Our findings suggest hospital EPCs can efficiently synthesize and disseminate evidence addressing a range of clinical topics for diverse stakeholders, and can influence local decision making. © 2015 Society of Hospital Medicine.

How can the use of data within the immunisation programme be increased in order to improve data quality and ensure greater accountability in the health system? A protocol for implementation science study.

PubMed

Tilahun, Binyam; Teklu, Alemayehu; Mancuso, Arielle; Abebaw, Zeleke; Dessie, Kassahun; Zegeye, Desalegn

2018-05-03

Immunisation remains one of the most important and cost-effective interventions to reduce vaccine-preventable child morbidity, disability and mortality. Health programmes like the Expanded Program of Immunization rely on complex decision-making and strong local level evidence is important to effectively and efficiently utilise limited resources. Lack of data use for decision-making at each level of the health system remains the main challenge in most developing countries. While there is much evidence on data quality and how to improve it, there is a lack of sufficient evidence on why the use of data for decision-making at each level of the health system is low. Herein, we describe a comprehensive implementation science study that will be conducted to identify organisational, technical and individual level factors affecting local data use at each level of the Ethiopian health system. We will apply a mixed methods approach using key informant interviews and document reviews. The qualitative data will be gathered through key informant interviews using a semi-structured guide with open- and closed-ended questions with four categories of respondents, namely decision-makers, data producers, data users and community representatives at the federal, regional, zonal, woreda and community levels of the health system. The document review will be conducted on selected reports and feedback documented at different levels of the health system. Data will be collected from July 2017 to March 2018. Descriptive statistics will be analysed for the quantitative study using SPSS version 20 software and thematic content analysis will be performed for the qualitative part using NVivo software. Appropriate and timely use of health and health-related information for decision-making is an essential element in the process of transforming the health sector. The findings of the study will inform stakeholders at different levels on the institutionalisation of evidence-based practice in immunisation programmes.

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Serving by local consensus in the public service location game.

PubMed

Sun, Yi-Fan; Zhou, Hai-Jun

2016-09-02

We discuss the issue of distributed and cooperative decision-making in a network game of public service location. Each node of the network can decide to host a certain public service incurring in a construction cost and serving all the neighboring nodes and itself. A pure consumer node has to pay a tax, and the collected tax is evenly distributed to all the hosting nodes to remedy their construction costs. If all nodes make individual best-response decisions, the system gets trapped in an inefficient situation of high tax level. Here we introduce a decentralized local-consensus selection mechanism which requires nodes to recommend their neighbors of highest local impact as candidate servers, and a node may become a server only if all its non-server neighbors give their assent. We demonstrate that although this mechanism involves only information exchange among neighboring nodes, it leads to socially efficient solutions with tax level approaching the lowest possible value. Our results may help in understanding and improving collective problem-solving in various networked social and robotic systems.

Serving by local consensus in the public service location game

PubMed Central

Sun, Yi-Fan; Zhou, Hai-Jun

2016-01-01

We discuss the issue of distributed and cooperative decision-making in a network game of public service location. Each node of the network can decide to host a certain public service incurring in a construction cost and serving all the neighboring nodes and itself. A pure consumer node has to pay a tax, and the collected tax is evenly distributed to all the hosting nodes to remedy their construction costs. If all nodes make individual best-response decisions, the system gets trapped in an inefficient situation of high tax level. Here we introduce a decentralized local-consensus selection mechanism which requires nodes to recommend their neighbors of highest local impact as candidate servers, and a node may become a server only if all its non-server neighbors give their assent. We demonstrate that although this mechanism involves only information exchange among neighboring nodes, it leads to socially efficient solutions with tax level approaching the lowest possible value. Our results may help in understanding and improving collective problem-solving in various networked social and robotic systems. PMID:27586793

Serving by local consensus in the public service location game

NASA Astrophysics Data System (ADS)

Sun, Yi-Fan; Zhou, Hai-Jun

2016-09-01

We discuss the issue of distributed and cooperative decision-making in a network game of public service location. Each node of the network can decide to host a certain public service incurring in a construction cost and serving all the neighboring nodes and itself. A pure consumer node has to pay a tax, and the collected tax is evenly distributed to all the hosting nodes to remedy their construction costs. If all nodes make individual best-response decisions, the system gets trapped in an inefficient situation of high tax level. Here we introduce a decentralized local-consensus selection mechanism which requires nodes to recommend their neighbors of highest local impact as candidate servers, and a node may become a server only if all its non-server neighbors give their assent. We demonstrate that although this mechanism involves only information exchange among neighboring nodes, it leads to socially efficient solutions with tax level approaching the lowest possible value. Our results may help in understanding and improving collective problem-solving in various networked social and robotic systems.

Applications of geographic information systems (GIS) for transportation and climate change

DOT National Transportation Integrated Search

2011-08-31

This report describes the current practice and application of GIS technologies for integrating climate change into the transportation decision-making process. It examines how select state, regional, and local agencies are using GIS to analyze, mitiga...

Collective Cellular Decision-Making Gives Developmental Plasticity: A Model of Signaling in Branching Roots

NASA Astrophysics Data System (ADS)

McCleery, W. Tyler; Mohd-Radzman, Nadiatul A.; Grieneisen, Veronica A.

Cells within tissues can be regarded as autonomous entities that respond to their local environment and signaling from neighbors. Cell coordination is particularly important in plants, where root architecture must strategically invest resources for growth to optimize nutrient acquisition. Thus, root cells are constantly adapting to environmental cues and neighbor communication in a non-linear manner. To explain such plasticity, we view the root as a swarm of coupled multi-cellular structures, ''metamers'', rather than as a continuum of identical cells. These metamers are individually programmed to achieve a local objective - developing a lateral root primordia, which aids in local foraging of nutrients. Collectively, such individual attempts may be halted, structuring root architecture as an emergent behavior. Each metamer's decision to branch is coordinated locally and globally through hormone signaling, including processes of controlled diffusion, active polar transport, and dynamic feedback. We present a physical model of the signaling mechanism that coordinates branching decisions in response to the environment. This work was funded by the European Commission 7th Framework Program, Project No. 601062, SWARM-ORGAN.

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

NASA Astrophysics Data System (ADS)

Eni, Yuli; Aryanto, Rudy

2014-03-01

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

Decision-making by surgeons about referral for adjuvant therapy for patients with non-small-cell lung, breast or colorectal cancer: a qualitative study

PubMed Central

Urquhart, Robin; Kendell, Cynthia; Buduhan, Gordon; Rayson, Daniel; Sargeant, Joan; Johnson, Paul; Grunfeld, Eva; Porter, Geoffrey A.

2016-01-01

Background: Because surgeons are the main gatekeepers to oncology services, understanding how they make decisions related to referral for adjuvant therapies is important to optimize referral rates and use of oncology services for patients with potentially curable disease. We examined decision-making by surgeons related to referral to oncology services for patients having undergone curative-intent surgery for non-small-cell lung, breast or colorectal cancer. Methods: We conducted a qualitative study, whose design was guided by the principles of grounded theory. Semi-structured interviews were held with 29 surgeons who performed non-small-cell lung, breast or colorectal cancer surgery in the province of Nova Scotia. Data were collected and analyzed concurrently. Analysis involved an inductive, grounded approach using constant comparative analysis. Data collection and analysis continued until theoretical saturation was reached. Results: Seven factors influenced the surgeons' decision-making related to referral to oncology services: indications and contraindications for therapy; patients' beliefs and preferences; a belief that oncologists are the experts; knowledge of local standards of care; consultation with oncology colleagues; navigating patient logistics (e.g., lodging, caregiving responsibilities, insurance coverage); and system resources and capacity. Interpretation: Our study's findings provide a novel understanding of how surgeons make decisions about oncology referral and point to potential areas for intervention to promote referral to oncology services for patients for whom adjuvant therapy is recommended. PMID:27570760

The process of decision-making in home-care case management: implications for the introduction of universal assessment and information technology.

PubMed

Egan, Mary; Wells, Jennie; Byrne, Kerry; Jaglal, Susan; Stolee, Paul; Chesworth, Bert M; Hillier, Loretta M

2009-07-01

Increasingly, jurisdictions are adopting universal assessment procedures and information technology to aid in healthcare data collection and care planning. Before their potential can be realised, a better understanding is needed of how these systems can best be used to support clinical practice. We investigated the decision-making process and information needs of home-care case managers in Ontario, Canada, prior to the widespread use of universal assessment, with a view of determining how universal assessment and information technology could best support this work. Three focus groups and two individual interviews were conducted; questioning focused on decision-making in the post-acute care of individuals recovering from a hip fracture. We found that case managers' decisional process was one of a clinician-broker, combining clinical expertise and information about local services to support patient goals within the context of limited resources. This process represented expert decision-making, and the case managers valued their ability to carry out non-standardised interviews and override system directives when they noted that data may be misleading. Clear information needs were found in four areas: services available outside of their regions, patient medical information, patient pre-morbid functional status and partner/spouse health and functional status. Implications for the use of universal assessment are discussed. Recommendations are made for further research to determine the impact of universal assessment and information technology on the process and outcome of home-care case manager decision-making.

Computational prediction of multidisciplinary team decision-making for adjuvant breast cancer drug therapies: a machine learning approach.

PubMed

Lin, Frank P Y; Pokorny, Adrian; Teng, Christina; Dear, Rachel; Epstein, Richard J

2016-12-01

Multidisciplinary team (MDT) meetings are used to optimise expert decision-making about treatment options, but such expertise is not digitally transferable between centres. To help standardise medical decision-making, we developed a machine learning model designed to predict MDT decisions about adjuvant breast cancer treatments. We analysed MDT decisions regarding adjuvant systemic therapy for 1065 breast cancer cases over eight years. Machine learning classifiers with and without bootstrap aggregation were correlated with MDT decisions (recommended, not recommended, or discussable) regarding adjuvant cytotoxic, endocrine and biologic/targeted therapies, then tested for predictability using stratified ten-fold cross-validations. The predictions so derived were duly compared with those based on published (ESMO and NCCN) cancer guidelines. Machine learning more accurately predicted adjuvant chemotherapy MDT decisions than did simple application of guidelines. No differences were found between MDT- vs. ESMO/NCCN- based decisions to prescribe either adjuvant endocrine (97%, p = 0.44/0.74) or biologic/targeted therapies (98%, p = 0.82/0.59). In contrast, significant discrepancies were evident between MDT- and guideline-based decisions to prescribe chemotherapy (87%, p < 0.01, representing 43% and 53% variations from ESMO/NCCN guidelines, respectively). Using ten-fold cross-validation, the best classifiers achieved areas under the receiver operating characteristic curve (AUC) of 0.940 for chemotherapy (95% C.I., 0.922-0.958), 0.899 for the endocrine therapy (95% C.I., 0.880-0.918), and 0.977 for trastuzumab therapy (95% C.I., 0.955-0.999) respectively. Overall, bootstrap aggregated classifiers performed better among all evaluated machine learning models. A machine learning approach based on clinicopathologic characteristics can predict MDT decisions about adjuvant breast cancer drug therapies. The discrepancy between MDT- and guideline-based decisions regarding adjuvant chemotherapy implies that certain non-clincopathologic criteria, such as patient preference and resource availability, are factored into clinical decision-making by local experts but not captured by guidelines.

Evolution of a CDC Public Health Research Agenda for Low-Risk Prostate Cancer

PubMed Central

Hall, Ingrid J.; Smith, Judith Lee

2016-01-01

Men with prostate cancer face difficult choices when selecting a therapy for localized prostate cancer. Comparative data from controlled studies are lacking and clinical opinions diverge about the benefits and harms of treatment options. Consequently, there is limited guidance for patients regarding the impact of treatment decisions on quality of life. There are opportunities for public health to intervene at several decision-making points. Information on typical quality of life outcomes associated with specific prostate cancer treatments could help patients select treatment options. From 2003 to present, the Division of Cancer Prevention and Control at CDC has supported projects to explore patient information-seeking behavior post-diagnosis, caregiver and provider involvement in treatment decision making, and patient quality of life following prostate cancer treatment. CDC's work also includes research that explores barriers and facilitators to the presentation of active surveillance as a viable treatment option and promotes equal access to information for men and their caregivers. This article provides an overview of the literature and considerations that initiated establishing a prospective public health research agenda around treatment decision making. Insights gathered from CDC-supported studies are poised to enhance understanding of the process of shared decision making and the influence of patient, caregiver, and provider preferences on the selection of treatment choices. These findings provide guidance about attributes that maximize patient experiences in survivorship, including optimal quality of life and patient and caregiver satisfaction with information, treatment decisions, and subsequent care. PMID:26590643

Combining ecosystem services assessment with structured decision making to support ecological restoration planning.

PubMed

Martin, David M; Mazzotta, Marisa; Bousquin, Justin

2018-04-10

Accounting for ecosystem services in environmental decision making is an emerging research topic. Modern frameworks for ecosystem services assessment emphasize evaluating the social benefits of ecosystems, in terms of who benefits and by how much, to aid in comparing multiple courses of action. Structured methods that use decision analytic-approaches are emerging for the practice of ecological restoration. In this article, we combine ecosystem services assessment with structured decision making to estimate and evaluate measures of the potential benefits of ecological restoration with a case study in the Woonasquatucket River watershed, Rhode Island, USA. We partnered with a local watershed management organization to analyze dozens of candidate wetland restoration sites for their abilities to supply five ecosystem services-flood water retention, scenic landscapes, learning opportunities, recreational opportunities, and birds. We developed 22 benefit indicators related to the ecosystem services as well as indicators for social equity and reliability that benefits will sustain in the future. We applied conceptual modeling and spatial analysis to estimate indicator values for each candidate restoration site. Lastly, we developed a decision support tool to score and aggregate the values for the organization to screen the restoration sites. Results show that restoration sites in urban areas can provide greater social benefits than sites in less urban areas. Our research approach is general and can be used to investigate other restoration planning studies that perform ecosystem services assessment and fit into a decision-making process.

Science for decision making: Transmitting hazard science using catastrophic scenarios

NASA Astrophysics Data System (ADS)

Wein, A.

2010-12-01

The ShakeOut and ARkStorm scenarios are scientifically-based, multi-disciplinary efforts to describe the damages and consequences of large, but plausible, natural disasters for use in emergency management and other planning. The ShakeOut earthquake scenario, completed in 2008, posits the occurrence of a major earthquake on the southern San Andreas Fault. It was used by more than 5,000 emergency personnel in a California statewide exercise, and it underpins the Federal Emergency Management Agency’s (FEMA) Catastrophic Plan for Southern California. The ARkStorm winter storm scenario, to be completed in 2010, posits the occurrence of a statewide disaster like the storm that occurred during 1861-1862. The ARkStorm scenario will culminate with two planning summits comprised of federal and state agencies, because such an event would exceed local response and recovery capabilities. This talk will address the following questions that are critical to transmitting science for decision making with examples and observations from the two scenarios: 1) Who are the end users of the scenarios, what types of decisions can scenarios inform, and how are stakeholders engaged? 2) What forms of information and processes work best to communicate and apply the hazard science? 3) What are the challenges of using science in decision making? 4) What future directions shall we pursue? From my perspective as coordinator of economic consequences analyses for the two scenarios, I will share insights to these questions. Framing stakeholder decisions in terms of scale (e.g., household to State) and disaster phase (e.g., emergency response, recovery, and mitigation) allows us to align methods of stakeholder engagement with stakeholder decision making. For these regional-scale scenarios, the methods of engagement included stakeholder participation in project vision, scenario construction workshops, presentations, conferences, and emergency response and recovery exercises. Champions (self-motivated individuals who took on leadership roles in their communities or industrial sectors), customized and localized analyses, and workshops enhanced the use of hazard science. Examples from the two scenarios will be used to illustrate these points. We experienced several significant challenges in using science to enhance emergency management exercises and community decision making. Some of these challenges include 1) adapting scientific results to exercise format; 2) the special needs of recovery exercises, which can mimic response exercises only with limited success, because recovery is tactical while response is strategic; 3) staff turnover; and 4) limited resources. An important future direction will be to leverage our in-depth knowledge of scenarios, multi-disciplinary network, and stakeholder relations to integrate knowledge about multiple hazards to better inform risk-based decision making for all hazards.

Integrating observations and models to help understanding how flooding impacts upon catchments as a basis for decision making.

NASA Astrophysics Data System (ADS)

Owen, Gareth; Quinn, Paul; O'Donnell, Greg

2014-05-01

This paper explains how flood management projects might be better informed in the future by using more observations and a novel impact modelling tool in a simple transparent framework. The understanding of how local scale impacts propagate downstream to impact on the downstream hydrograph is difficult to determine using traditional rainfall runoff and hydraulic routing methods. The traditional approach to modelling essentially comprises selecting a fixed model structure and then calibrating to an observational hydrograph, which make those model predictions highly uncertain. Here, a novel approach is used in which the structure of the runoff generation is not specified a priori and incorporates expert knowledge. Rather than using externally for calibration, the observed outlet hydrographs are used directly within the model. Essentially the approach involves the disaggregation of the outlet hydrograph by making assumptions about the spatial distribution of runoff generated. The channel network is parameterised through a comparison of the timing of observed hydrographs at a number of nested locations within the catchment. The user is then encouraged to use their expert knowledge to define how runoff is generated locally and what the likely impact of any local mitigation is. Therefore the user can specify any hydrological model or flow estimation method that captures their expertise. Equally, the user is encouraged to install as many instruments as they can afford to cover the catchment network. A Decision Support Matrix (DSM) is used to encapsulate knowledge of the runoff dynamics gained from simulation in a simple visual way and hence to convey the likely impacts that arise from a given flood management scenario. This tool has been designed primarily to inform and educate landowners, catchment managers and decision makers. The DSM outlines scenarios that are likely to increase or decrease runoff rates and allows the user to contemplate the implications and uncertainty of their decisions. The tool can also be used to map the likely changes in flood peak due to land use management options. An example case study will be shown for a 35km2 catchment in Northern England which is prone to flooding. The method encourages end users to instrument and quantify their own catchment network and to make informed, evidence based decisions appropriate to their own flooding problems.

An Exploration of Decision-Making Processes on Infant Delivery Site from the Perspective of Pregnant Women, New Mothers, and Their Families in Northern Karnataka, India.

PubMed

Blanchard, Andrea Katryn; Bruce, Sharon Gail; Jayanna, Krishnamurthy; Gurav, Kaveri; Mohan, Haranahalli L; Avery, Lisa; Moses, Stephen; Blanchard, James Frederick; Ramesh, Banadakoppa M

2015-09-01

This study was conducted to explore the decision-making processes regarding sites for delivery of infants among women, their husbands, and mothers-in-law in a rural area of northern Karnataka state, south India. Qualitative semi-structured, individual in-depth interviews were conducted in 2010 among 110 pregnant women, new mothers, husbands and mothers-in-law. Interviews were conducted by trained local researchers in participants' languages and then translated into English. Decisions were made relationally, as family members weighed their collective attitudes and experiences towards a home, private or public delivery. Patterns of both concordance and discordance between women and their families' preferences for delivery site were present. The voice of pregnant women and new mothers was not always subordinate to that of other family members. Still, the involvement of husbands and mothers-in-law was important in decision-making, indicating the need to consider the influence of household gender and power dynamics. All respondent types also expressed shifts in social context and cultural attitudes towards increasing preference for hospital delivery. An appreciation of the interdependence of family members' roles in delivery site decision-making, and how they are influenced by the socio-cultural context, must be considered in frameworks used to guide the development of relevant interventions to improve the utilization and quality of maternal, neonatal and child health services.

The Future Role of Information Technology in Erosion Modelling

USDA-ARS?s Scientific Manuscript database

Natural resources management and decision-making is a complex process requiring cooperation and communication among federal, state, and local stakeholders balancing biophysical and socio-economic concerns. Predicting soil erosion is common practice in natural resource management for assessing the e...

The right to try.

PubMed

Pearce, Lynne

2015-01-20

Many clinical commissioning groups have ignored 2013 national guidelines requiring them to make IVF available. NICE has recently issued a quality standard to tackle this postcode lottery. Nurses can help by alerting local decision makers to the human and fi nancial cost of infertility.

78 FR 21150 - Notice of Lodging of Proposed Amendment to Consent Decree Under the Clean Water Act

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-09

... forth a phased sequence and schedule for the decision-making process of HRSD and the Localities as they... \\1\\ are evaluating the potential benefits and feasibility of regionalization and consolidation of the...

Does Patient Preference Measurement in Decision Aids Improve Decisional Conflict? A Randomized Trial in Men with Prostate Cancer.

PubMed

Shirk, Joseph D; Crespi, Catherine M; Saucedo, Josemanuel D; Lambrechts, Sylvia; Dahan, Ely; Kaplan, Robert; Saigal, Christopher

2017-12-01

Shared decision making (SDM) has been advocated as an approach to medical decision making that can improve decisional quality. Decision aids are tools that facilitate SDM in the context of limited physician time; however, many decision aids do not incorporate preference measurement. We aim to understand whether adding preference measurement to a standard patient educational intervention improves decisional quality and is feasible in a busy clinical setting. Men with incident localized prostate cancer (n = 122) were recruited from the Greater Los Angeles Veterans Affairs (VA) Medical Center urology clinic, Olive View UCLA Medical Center, and Harbor UCLA Medical Center from January 2011 to May 2015 and randomized to education with a brochure about prostate cancer treatment or software-based preference assessment in addition to the brochure. Men undergoing preference assessment received a report detailing the relative strength of their preferences for treatment outcomes used in review with their doctor. Participants completed instruments measuring decisional conflict, knowledge, SDM, and patient satisfaction with care before and/or after their cancer consultation. Baseline knowledge scores were low (mean 62%). The baseline mean total score on the Decisional Conflict Scale was 2.3 (±0.9), signifying moderate decisional conflict. Men undergoing preference assessment had a significantly larger decrease in decisional conflict total score (p = 0.023) and the Perceived Effective Decision Making subscale (p = 0.003) post consult compared with those receiving education only. Improvements in satisfaction with care, SDM, and knowledge were similar between groups. Individual-level preference assessment is feasible in the clinic setting. Patients with prostate cancer who undergo preference assessment are more certain about their treatment decisions and report decreased levels of decisional conflict when making these decisions.

2018 Cyber Enabled Emerging Technologies Symposium

DTIC Science & Technology

2018-03-08

Principles • Better data = better outcomes • Training > Programming • AI anxiety?... Think IA (Intelligent Assistant) • Ingest much more information • Make...Local Marketing 7 Usage: “Local” / Specific AI • Healthcare (oncology) • Data Mining/Discovery • Chat bots • Personnel • Finance • Sourcing...cognitive- principles / So, Our Priorities for AI Adoption and Ethics • Purpose: human augmentation versus replacement • Human decision-making • Human

Electronic-projecting Moire method applying CBR-technology

NASA Astrophysics Data System (ADS)

Kuzyakov, O. N.; Lapteva, U. V.; Andreeva, M. A.

2018-01-01

Electronic-projecting method based on Moire effect for examining surface topology is suggested. Conditions of forming Moire fringes and their parameters’ dependence on reference parameters of object and virtual grids are analyzed. Control system structure and decision-making subsystem are elaborated. Subsystem execution includes CBR-technology, based on applying case base. The approach related to analysing and forming decision for each separate local area with consequent formation of common topology map is applied.

Making Decisions: Our Global Connection. Lessons for Teaching Citizenship Skills and Concepts Using Local Involvement in World Affairs: Grades 8-12.

ERIC Educational Resources Information Center

Woyach, Robert B.; And Others

Self-contained lessons for use in secondary level social studies, English, and language arts courses will help students understand that they are a part of a global community. Although written for use in Ohio schools, the lessons can easily be adapted for use in other states. Unit 1 shows students how the decisions of people in other countries can…

Intelligence-Led Risk Management for Homeland Security: A Collaborative Approach for a Common Goal

DTIC Science & Technology

2011-12-01

phases of research into a summary analysis of the risk management policy within the homeland security enterprise. The result of the multi-goal policy ...management and policy decisions with emphasis on social aspects and efforts to support local and regional decision making, and to avoid cascading...independent variables. The second order social and economic effects of terrorism have been largely overlooked so far in accounting for the risk from

Providing effective and preferred care closer to home: a realist review of intermediate care.

PubMed

Pearson, Mark; Hunt, Harriet; Cooper, Chris; Shepperd, Sasha; Pawson, Ray; Anderson, Rob

2015-11-01

Intermediate care is one of the number of service delivery models intended to integrate care and provide enhanced health and social care services closer to home, especially to reduce reliance on acute care hospital beds. In order for health and social care practitioners, service managers and commissioners to make informed decisions, it is vital to understand how to implement the admission avoidance and early supported discharge components of intermediate care within the context of local care systems. This paper reports the findings of a theory-driven (realist) review conducted in 2011-2012. A broad range of evidence contained in 193 sources was used to construct a conceptual framework for intermediate care. This framework forms the basis for exploring factors at service user, professional and organisational levels that should be considered when designing and delivering intermediate care services within a particular local context. Our synthesis found that involving service users and their carers in collaborative decision-making about the objectives of care and the place of care is central to achieving the aims of intermediate care. This pivotal involvement of the service user relies on practitioners, service managers and commissioners being aware of the impact that organisational structures at the local level can have on enabling or inhibiting collaborative decision-making and care co-ordination. Through all interactions with service users and their care networks, health and social care professionals should establish the meaning which alternative care environments have for different service users. Doing so means decisions about the best place of care will be better informed and gives service users choice. This in turn is likely to support psychological and social stability, and the attainment of functional goals. At an organisational level, integrated working can facilitate the delivery of intermediate care, but there is not a straightforward relationship between integrated organisational processes and integrated professional practice. © 2015 John Wiley & Sons Ltd.

Turning scientific approaches into practical conservation actions: the case of Comunidad Indigena de Nuevo San Juan Parangaricutiro, Mexico.

PubMed

Velázquez, A; Bocco, G; Torres, A

2001-05-01

Optimum natural resource management and biodiversity conservation are desirable goals. These, however, often exclude each other, since maximum economic benefits have promoted drastic reductions in biodiversity throughout the world. This dilemma confronts local stakeholders, who usually go for maximizing economic inputs, whereas other social (e.g., academic) sectors are favor conservation practices. In this paper we describe the way two scientific approaches--landscape and participatory research--were used to develop sound and durable land use scenarios. These two approaches included expert knowledge of both social and environmental conditions in indigenous communities. Our major emphasis was given to detect spatially explicit land use scenarios and capacity building in order to construct a decision support system operated by stakeholders of the Comunidad Indigena de Nuevo San Juan Parangaricutiro in Mexico. The system for decision-making was fed with data from inventories of both abiotic and biotic biodiversity components. All research, implementation, and monitoring activities were conducted in close collaboration with members of the indigenous community. As a major result we obtained a number of forest alternative uses that favor emerging markets and make this indigenous community less dependent on a single market. Furthermore, skilled members of the community are now running the automated system for decision-making. In conclusion, our results were better expressed as products with direct benefits in local livelihoods rather than pure academic outputs.

Federated health information architecture: Enabling healthcare providers and policymakers to use data for decision-making.

PubMed

Kumar, Manish; Mostafa, Javed; Ramaswamy, Rohit

2018-05-01

Health information systems (HIS) in India, as in most other developing countries, support public health management but fail to enable healthcare providers to use data for delivering quality services. Such a failure is surprising, given that the population healthcare data that the system collects are aggregated from patient records. An important reason for this failure is that the health information architecture (HIA) of the HIS is designed primarily to serve the information needs of policymakers and program managers. India has recognised the architectural gaps in its HIS and proposes to develop an integrated HIA. An enabling HIA that attempts to balance the autonomy of local systems with the requirements of a centralised monitoring agency could meet the diverse information needs of various stakeholders. Given the lack of in-country knowledge and experience in designing such an HIA, this case study was undertaken to analyse HIS in the Bihar state of India and to understand whether it would enable healthcare providers, program managers and policymakers to use data for decision-making. Based on a literature review and data collected from interviews with key informants, this article proposes a federated HIA, which has the potential to improve HIS efficiency; provide flexibility for local innovation; cater to the diverse information needs of healthcare providers, program managers and policymakers; and encourage data-based decision-making.

Involvement in shared decision-making for patients in public specialist outpatient clinics in Hong Kong

PubMed Central

Xu, Richard H; Wong, Eliza LY

2017-01-01

Objective This study is a preliminary exploration of the association between patient involvement in decision-making and patient socioeconomic characteristics and experience in specialist outpatient clinics (SOPCs) in Hong Kong. Methods Cross-sectional telephone interviews were conducted using the Specialist Outpatient Experience Questionnaire (SOPEQ) in 26 Hospital Authority public SOPCs in Hong Kong. The SOPEQ was designed by The School of Public Health and Primary Care at The Chinese University of Hong Kong, fully taking into account both literature review and the local context of the public specialist outpatient system in Hong Kong. A total of 22,525 eligible participants were recruited for the study. Results There were 13,966 valid responses. The results indicated that the patients who had more involvement in decision-making were younger (odds ratio [OR] =2.10; 95% CI 1.75, 2.53), more highly educated (OR =1.67; 95% CI 1.45, 1.93), less likely to be receiving a government allowance (OR =0.61; 95% CI 0.57, 0.65), and less likely to be in the new case group (OR =0.84; 95% CI 0.78, 0.92). Participants living with their families (OR =3.38; 95% CI 2.03, 5.63) or who were unemployed (OR =1.10; 95% CI 1.01, 1.21) had a more decisive role in the decision- making process. Those participants who had been more involved in decision-making and wanted to continue being more involved had greater levels of satisfaction (mean =7.94; P<0.001) and a better health status (OR =0.49; 95% CI 0.41, 0.58). Conclusion Engaging patients in their health care management remains a challenge in improving patient-centered care. Our results suggest that patient engagement is associated with perceived health status and the experience of using a health service. Understanding patients’ characteristics and roles facilitates the development of preferred styles in the decision-making model. PMID:28331297

How do clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation?

PubMed

Giles, Tracey; de Lacey, Sheryl; Muir-Cochrane, Eimear

2018-03-01

To examine how clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation. Family presence during resuscitation has important benefits for family and is supported by professional bodies and the public. Yet, many clinicians restrict family access to patients during resuscitation, and rationales for decision-making are unclear. Secondary analysis of an existing qualitative data set using deductive category application of content analysis. We analysed 20 interview transcripts from 15 registered nurses, two doctors and three paramedics who had experienced family presence during resuscitation in an Australian hospital. The transcripts were analysed for incidents of beneficent decision-making when allowing or denying family presence during resuscitation. Decision-making around family presence during resuscitation occurred in time poor environments and in the absence of local institutional guidelines. Clinicians appeared to be motivated by doing "what's best" for patients and families when allowing or denying family presence during resuscitation. However, their individual interpretations of "what's best" was subjective and did not always coincide with family preferences or with current evidence that promotes family presence during resuscitation as beneficial. The decision to allow or deny family presence during resuscitation is complex, and often impacted by personal preferences and beliefs, setting norms and tensions between clinicians and consumers. As a result, many families are missing the chance to be with their loved ones at the end of life. The introduction of institutional guidelines and policies would help to establish what safe and effective practice consists of, reduce value-laden decision-making and guide beneficent decision-making. These findings highlight current deficits in decision-making around FPDR and could prompt the introduction of clinical guidelines and policies and in turn promote the equitable provision of safe, effective family-centred care during resuscitation events. © 2017 John Wiley & Sons Ltd.

Facilitating access to pre-processed research evidence in public health

PubMed Central

2010-01-01

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

The participation of parents of disabled children and young people in health and social care decisions.

PubMed

McNeilly, P; Macdonald, G; Kelly, B

2017-11-01

There is widespread acceptance that parents should be fully involved in decisions about their son or daughter's health and social care. This is reflected in partnership models of practice as well as local and national policy across the United Kingdom. Previous research indicates that parents' experiences of decision making with professionals are mixed. The research reported here aimed to explore parents' experiences of participating in decisions made with professionals about their disabled son or daughter's care. This research used mixed methods including survey methodology and qualitative in depth interviews. The research was conducted in one Trust in Northern Ireland. Participants were 77 parents of children and young people with a range of impairments aged between 3 and 28 years. Three themes emerged from the data: taking the lead, not knowing, and getting the balance right. Parents wanted to be involved in all aspects of decision making. Although parents reported many examples of good practice, there were also times when they did not feel listened to or did not have enough information to inform decisions. Parents in this research recounted positive as well as negative experiences. Parents took on a protective role when decisions were made about their son or daughter and at times, reported the need to "fight" for their child. The provision of information remains problematic for these families, and at times, this created a barrier to parents' participation in decision making. Partnership approaches to care that recognize parents' expertise are particularly important to parents when decisions are made with professionals. © 2017 John Wiley & Sons Ltd.

Manpower Research Visibility.

ERIC Educational Resources Information Center

Rathbun, Donald L., Ed.; Burwell, Anne, Ed.

These four research reviews should be useful to educators concerned with developing and improving vocational education programs. Reviews include: (1) "Occupational Training Information System" (OTIS) which is concerned with a decision making model for state and local programs and with responsive vocational and technical education, (2)…

Regionalism, Devolution and Education

ERIC Educational Resources Information Center

Bogdanor, Vernon

1977-01-01

Described are effects of political decentralization in the United Kingdom on political and social institutions, particularly education. The author concludes that regionalism could yield advantages of power decentralization, diversity of decision making, and educational systems which are more closely connected to regional and local traditions.…

EPA'S REGIONAL VULNERABILITY ASSESSMENT PROGRAM: TOOLS TO FACILITATE REGIONAL TO LOCAL DECISION-MAKING

EPA Science Inventory

EPA's Regional Vulnerability Assessment (ReVA) program is developing and testing approaches to conducting comparative environmental risk assessments at the regional scale, considering impacts to ecological human, and fiscal health endpoints. It seeks an objective and quantifiable...

U-Form vs. M-Form: How to Understand Decision Autonomy Under Healthcare Decentralization?

PubMed Central

Bustamante, Arturo Vargas

2016-01-01

For more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. Decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. Jalal Mohammed, Nicola North, and Toni Ashton analyze decision autonomy within decentralized services in Fiji. They conclude that the narrow decision space allowed to local entities might have limited the benefits of decentralization on users and providers. To discuss the costs and benefits of healthcare decentralization this paper uses the U-form and M-form typology to further illustrate the role of decision autonomy under healthcare decentralization. This paper argues that when evaluating healthcare decentralization, it is important to determine whether the benefits from decentralization are greater than its costs. The U-form and M-form framework is proposed as a useful typology to evaluate different types of institutional arrangements under healthcare decentralization. Under this model, the more decentralized organizational form (M-form) is superior if the benefits from flexibility exceed the costs of duplication and the more centralized organizational form (U-form) is superior if the savings from economies of scale outweigh the costly decision-making process from the center to the regions. Budgetary and financial autonomy and effective mechanisms to maintain local governments accountable for their spending behavior are key decision autonomy variables that could sway the cost-benefit analysis of healthcare decentralization. PMID:27694684

Choosing and using climate change scenarios for ecological-impact assessments and conservation decisions

USGS Publications Warehouse

Amy K. Snover,; Nathan J. Mantua,; Littell, Jeremy; Michael A. Alexander,; Michelle M. McClure,; Janet Nye,

2013-01-01

Increased concern over climate change is demonstrated by the many efforts to assess climate effects and develop adaptation strategies. Scientists, resource managers, and decision makers are increasingly expected to use climate information, but they struggle with its uncertainty. With the current proliferation of climate simulations and downscaling methods, scientifically credible strategies for selecting a subset for analysis and decision making are needed. Drawing on a rich literature in climate science and impact assessment and on experience working with natural resource scientists and decision makers, we devised guidelines for choosing climate-change scenarios for ecological impact assessment that recognize irreducible uncertainty in climate projections and address common misconceptions about this uncertainty. This approach involves identifying primary local climate drivers by climate sensitivity of the biological system of interest; determining appropriate sources of information for future changes in those drivers; considering how well processes controlling local climate are spatially resolved; and selecting scenarios based on considering observed emission trends, relative importance of natural climate variability, and risk tolerance and time horizon of the associated decision. The most appropriate scenarios for a particular analysis will not necessarily be the most appropriate for another due to differences in local climate drivers, biophysical linkages to climate, decision characteristics, and how well a model simulates the climate parameters and processes of interest. Given these complexities, we recommend interaction among climate scientists, natural and physical scientists, and decision makers throughout the process of choosing and using climate-change scenarios for ecological impact assessment.

How to Choose? Using the Delphi Method to Develop Consensus Triggers and Indicators for Disaster Response.

PubMed

Lis, Rebecca; Sakata, Vicki; Lien, Onora

2017-08-01

To identify key decisions along the continuum of care (conventional, contingency, and crisis) and the critical triggers and data elements used to inform those decisions concerning public health and health care response during an emergency. A classic Delphi method, a consensus-building survey technique, was used with clinicians around Washington State to identify regional triggers and indicators. Additionally, using a modified Delphi method, we combined a workshop and single-round survey with panelists from public health (state and local) and health care coalitions to identify consensus state-level triggers and indicators. In the clinical survey, 122 of 223 proposed triggers or indicators (43.7%) reached consensus and were deemed important in regional decision-making during a disaster. In the state-level survey, 110 of 140 proposed triggers or indicators (78.6%) reached consensus and were deemed important in state-level decision-making during a disaster. The identification of consensus triggers and indicators for health care emergency response is crucial in supporting a comprehensive health care situational awareness process. This can inform the creation of standardized questions to ask health care, public health, and other partners to support decision-making during a response. (Disaster Med Public Health Preparedness. 2017;11:467-472).

Serving her Country: An Analysis of Women’s Enlistment

DTIC Science & Technology

1990-01-01

microdatabase containing many-indivldual and local market variables, make it possible to circumvent the distorting effects of the Qverall demand constraint that...For example, they consider whether labor market forces influence young men and women differently; the ways in which marriage expectations affect the...enlistment decision; whether the role of education expectations differs between the two sexes; and what impact local labor market conditions have on

Do humans make good decisions?

PubMed Central

Summerfield, Christopher; Tsetsos, Konstantinos

2014-01-01

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

Multi-Sector Sustainability Browser (MSSB) User Manual: A ...

EPA Pesticide Factsheets

EPA’s Sustainable and Healthy Communities (SHC) Research Program is developing methodologies, resources, and tools to assist community members and local decision makers in implementing policy choices that facilitate sustainable approaches in managing their resources affecting the built environment, natural environment, and human health. In order to assist communities and decision makers in implementing sustainable practices, EPA is developing computer-based systems including models, databases, web tools, and web browsers to help communities decide upon approaches that support their desired outcomes. Communities need access to resources that will allow them to achieve their sustainability objectives through intelligent decisions in four key sustainability areas: • Land Use • Buildings and Infrastructure • Transportation • Materials Management (i.e., Municipal Solid Waste [MSW] processing and disposal) The Multi-Sector Sustainability Browser (MSSB) is designed to support sustainable decision-making for communities, local and regional planners, and policy and decision makers. Document is an EPA Technical Report, which is the user manual for the Multi-Sector Sustainability Browser (MSSB) tool. The purpose of the document is to provide basic guidance on use of the tool for users

Monitoring for the management of disease risk in animal translocation programmes

USGS Publications Warehouse

Nichols, James D.; Hollmen, Tuula E.; Grand, James B.

2017-01-01

Monitoring is best viewed as a component of some larger programme focused on science or conservation. The value of monitoring is determined by the extent to which it informs the parent process. Animal translocation programmes are typically designed to augment or establish viable animal populations without changing the local community in any detrimental way. Such programmes seek to minimize disease risk to local wild animals, to translocated animals, and in some cases to humans. Disease monitoring can inform translocation decisions by (1) providing information for state-dependent decisions, (2) assessing progress towards programme objectives, and (3) permitting learning in order to make better decisions in the future. Here we discuss specific decisions that can be informed by both pre-release and post-release disease monitoring programmes. We specify state variables and vital rates needed to inform these decisions. We then discuss monitoring data and analytic methods that can be used to estimate these state variables and vital rates. Our discussion is necessarily general, but hopefully provides a basis for tailoring disease monitoring approaches to specific translocation programmes.

Attention and Motivated Response to Simulated Male Advertisement Call Activates Forebrain Dopaminergic and Social Decision-Making Network Nuclei in Female Midshipman Fish.

PubMed

Forlano, Paul M; Licorish, Roshney R; Ghahramani, Zachary N; Timothy, Miky; Ferrari, Melissa; Palmer, William C; Sisneros, Joseph A

2017-10-01

Little is known regarding the coordination of audition with decision-making and subsequent motor responses that initiate social behavior including mate localization during courtship. Using the midshipman fish model, we tested the hypothesis that the time spent by females attending and responding to the advertisement call is correlated with the activation of a specific subset of catecholaminergic (CA) and social decision-making network (SDM) nuclei underlying auditory- driven sexual motivation. In addition, we quantified the relationship of neural activation between CA and SDM nuclei in all responders with the goal of providing a map of functional connectivity of the circuitry underlying a motivated state responsive to acoustic cues during mate localization. In order to make a baseline qualitative comparison of this functional brain map to unmotivated females, we made a similar correlative comparison of brain activation in females who were unresponsive to the advertisement call playback. Our results support an important role for dopaminergic neurons in the periventricular posterior tuberculum and ventral thalamus, putative A11 and A13 tetrapod homologues, respectively, as well as the posterior parvocellular preoptic area and dorsomedial telencephalon, (laterobasal amygdala homologue) in auditory attention and appetitive sexual behavior in fishes. These findings may also offer insights into the function of these highly conserved nuclei in the context of auditory-driven reproductive social behavior across vertebrates. © The Author 2017. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

NASA Wrangler: Automated Cloud-Based Data Assembly in the RECOVER Wildfire Decision Support System

NASA Technical Reports Server (NTRS)

Schnase, John; Carroll, Mark; Gill, Roger; Wooten, Margaret; Weber, Keith; Blair, Kindra; May, Jeffrey; Toombs, William

2017-01-01

NASA Wrangler is a loosely-coupled, event driven, highly parallel data aggregation service designed to take advantageof the elastic resource capabilities of cloud computing. Wrangler automatically collects Earth observational data, climate model outputs, derived remote sensing data products, and historic biophysical data for pre-, active-, and post-wildfire decision making. It is a core service of the RECOVER decision support system, which is providing rapid-response GIS analytic capabilities to state and local government agencies. Wrangler reduces to minutes the time needed to assemble and deliver crucial wildfire-related data.

The use of multi-criteria decision making models in evaluating anesthesia method options in circumcision surgery.

PubMed

Hancerliogullari, Gulsah; Hancerliogullari, Kadir Oymen; Koksalmis, Emrah

2017-01-23

Determining the most suitable anesthesia method for circumcision surgery plays a fundamental role in pediatric surgery. This study is aimed to present pediatric surgeons' perspective on the relative importance of the criteria for selecting anesthesia method for circumcision surgery by utilizing the multi-criteria decision making methods. Fuzzy set theory offers a useful tool for transforming linguistic terms into numerical assessments. Since the evaluation of anesthesia methods requires linguistic terms, we utilize the fuzzy Analytic Hierarchy Process (AHP) and fuzzy Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). Both mathematical decision-making methods are originated from individual judgements for qualitative factors utilizing the pair-wise comparison matrix. Our model uses four main criteria, eight sub-criteria as well as three alternatives. To assess the relative priorities, an online questionnaire was completed by three experts, pediatric surgeons, who had experience with circumcision surgery. Discussion of the results with the experts indicates that time-related factors are the most important criteria, followed by psychology, convenience and duration. Moreover, general anesthesia with penile block for circumcision surgery is the preferred choice of anesthesia compared to general anesthesia without penile block, which has a greater priority compared to local anesthesia under the discussed main-criteria and sub-criteria. The results presented in this study highlight the need to integrate surgeons' criteria into the decision making process for selecting anesthesia methods. This is the first study in which multi-criteria decision making tools, specifically fuzzy AHP and fuzzy TOPSIS, are used to evaluate anesthesia methods for a pediatric surgical procedure.

Do Consultation Psychiatrists, Forensic Psychiatrists, Psychiatry Trainees, and Health Care Lawyers Differ in Opinion on Gray Area Decision-Making Capacity Cases? A Vignette-Based Survey.

PubMed

Armontrout, James; Gitlin, David; Gutheil, Thomas

2016-01-01

Previous research in the area of medical decision-making capacity has demonstrated relatively poor agreement between experienced evaluators in "gray area" cases. We performed a survey to determine the level of agreement about gray area decision-making capacity case scenarios within and between individuals of different professional backgrounds. Participants received a survey consisting of 3 complicated decision-making capacity vignettes with an accompanying "yes/no" question regarding capacity and a certainty scale for each vignette. Participants were identified from mailing lists of professional organizations and local hospitals. We received responses from psychiatry trainees, consultation-liaison psychiatrists, forensic psychiatrists, and lawyers with experience in health care law. Results were analyzed using SPSS. Across the 3 vignettes, the percentage agreeing that the individual described had capacity to refuse medical treatment ranged between 35% and 40% for trainees, 33% and 67% for consult psychiatrists, 41% and 76% for forensic psychiatrists, and 40% and 83% for health care lawyers. Only question 2 reached significance between-group differences (Pearson χ(2) = 11.473, p < 0.01). Across vignettes, trainees were less likely to consider patients to have capacity for decision-making than were forensic psychiatrists and lawyers. As found in previous research, agreement among experienced evaluators appears generally low in gray area capacity cases. It is noteworthy that individuals of different professional backgrounds at times offer divergent between-group opinions on capacity. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Literature review on the structure and operation of Pharmacy and Therapeutics Committees.

PubMed

Durán-García, Esther; Santos-Ramos, Bernardo; Puigventos-Latorre, Francesc; Ortega, Ana

2011-06-01

To review the literature on the structure and operation of hospital Pharmacy and Therapeutics Committees from an international point of view and examine the factors that influence decision-making of these committees. We performed a literature search in the Medline and Embase databases from 1997 to January 2009 with the search terms: formulary system decision making, pharmacy and therapeutics committee, formularies hospital, drug formulary, survey, drug selection and outcome assessment health care. Inclusion criteria were the following: studies analyzing Pharmacy and Therapeutics Committees published in English or Spanish from 1997 to January 2009. Exclusion criteria were: publications which were editorials or opinion pieces, studies relating to one hospital, and studies where full text could not be attained. The analysis was divided into structural/organizational data and data on factors affecting the decision-making process. Seventeen studies met the inclusion criteria. Pharmacy and Therapeutics Committees and formularies were present in more than 90% of the hospitals in four of the five countries examined. Therapeutic interchange programs existed only in two of these countries. The mean number of committee members ranged between six and eight. More than 89% of the committees included a pharmacist. Standard operating procedures were implemented by 89% of the committees. The most influential factors in the decision-making were clinical trial results or drug costs rather than pharmacoeconomic studies. Other local organization-dependent factors were also important. The structure and operating procedures of Hospital Pharmacy and Therapeutics Committees are similar in select Western countries. Information from clinical trials is the most influential factor in the decision-making process.

U-Form vs. M-Form: How to Understand Decision Autonomy Under Healthcare Decentralization? Comment on "Decentralisation of Health Services in Fiji: A Decision Space Analysis".

PubMed

Bustamante, Arturo Vargas

2016-06-07

For more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. Decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. Jalal Mohammed, Nicola North, and Toni Ashton analyze decision autonomy within decentralized services in Fiji. They conclude that the narrow decision space allowed to local entities might have limited the benefits of decentralization on users and providers. To discuss the costs and benefits of healthcare decentralization this paper uses the U-form and M-form typology to further illustrate the role of decision autonomy under healthcare decentralization. This paper argues that when evaluating healthcare decentralization, it is important to determine whether the benefits from decentralization are greater than its costs. The U-form and M-form framework is proposed as a useful typology to evaluate different types of institutional arrangements under healthcare decentralization. Under this model, the more decentralized organizational form (M-form) is superior if the benefits from flexibility exceed the costs of duplication and the more centralized organizational form (U-form) is superior if the savings from economies of scale outweigh the costly decision-making process from the center to the regions. Budgetary and financial autonomy and effective mechanisms to maintain local governments accountable for their spending behavior are key decision autonomy variables that could sway the cost-benefit analysis of healthcare decentralization. © 2016 by Kerman University of Medical Sciences.

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

PubMed

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

2017-01-26

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

The chronometry of risk processing in the human cortex

PubMed Central

Symmonds, Mkael; Moran, Rosalyn J.; Wright, Nicholas D.; Bossaerts, Peter; Barnes, Gareth; Dolan, Raymond J.

2013-01-01

The neuroscience of human decision-making has focused on localizing brain activity correlating with decision variables and choice, most commonly using functional MRI (fMRI). Poor temporal resolution means these studies are agnostic in relation to how decisions unfold in time. Consequently, here we address the temporal evolution of neural activity related to encoding of risk using magnetoencephalography (MEG), and show modulations of electromagnetic power in posterior parietal and dorsomedial prefrontal cortex (DMPFC) which scale with both variance and skewness in a lottery, detectable within 500 ms following stimulus presentation. Electromagnetic responses in somatosensory cortex following this risk encoding predict subsequent choices. Furthermore, within anterior insula we observed early and late effects of subject-specific risk preferences, suggestive of a role in both risk assessment and risk anticipation during choice. The observation that cortical activity tracks specific and independent components of risk from early time-points in a decision-making task supports the hypothesis that specialized brain circuitry underpins risk perception. PMID:23970849

An arm wearable haptic interface for impact sensing on unmanned aerial vehicles

NASA Astrophysics Data System (ADS)

Choi, Yunshil; Hong, Seung-Chan; Lee, Jung-Ryul

2017-04-01

In this paper, an impact monitoring system using fiber Bragg grating (FBG) sensors and vibro-haptic actuators has been introduced. The system is suggested for structural health monitoring (SHM) for unmanned aerial vehicles (UAVs), by making a decision with human-robot interaction. The system is composed with two major subsystems; an on-board system equipped on UAV and an arm-wearable interface for ground pilot. The on-board system acquires impact-induced wavelength changes and performs localization process, which was developed based on arrival time calculation. The arm-wearable interface helps ground pilots to make decision about impact location themselves by stimulating their tactile-sense with motor vibration.

Understanding surgeon decision making in the use of radiotherapy as neoadjuvant treatment in rectal cancer.

PubMed

Ansari, Nabila; Young, Christopher J; Schlub, Timothy E; Dhillon, Haryana M; Solomon, Michael J

2015-12-01

Strong evidence supports the use of neoadjuvant radiotherapy in rectal cancer to improve local control. This randomised controlled trial aimed to determine the effect of clinical and non-clinical factors on decision making by colorectal surgeons in patients with rectal cancer. Two surveys comprising vignettes of alternating short (4) and long (12) cues identified previously as important in rectal cancer, were randomly assigned to all members of the CSSANZ. Respondents chose from three possible treatments: long course chemoradiotherapy (LC), short course radiotherapy (SC) or surgery alone to investigate the effects on surgeon decision and confidence in decisions. Choice data were analysed using multinomial logistic regression models. 106 of 165 (64%) surgeons responded. LC was the preferred treatment choice in 73% of vignettes. Surgeons were more likely to recommend LC over SC (OR 1.79) or surgery alone (OR 1.99) when presented with the shorter, four-cue scenarios. There was no significant difference in confidence in decisions made when surgeons were presented with long cue vignettes (P = 0.57). Significant effects on the choice between LC, SC and surgery alone were tumour stage (P < 0.001), nodal status (P < 0.001), tumour position in the rectum (P < 0.001) and the circumferential location of the tumour (P < 0.001). A T4 tumour was the factor most likely associated with a recommendation against surgery alone (OR 335.96) or SC (OR 61.73). This study shows that clinical factors exert the greatest influence on surgeon decision making, which follows a "fast and frugal" heuristic decision making model. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Challenges and opportunities with standardized monitoring for management decison-making

USDA-ARS?s Scientific Manuscript database

The importance of monitoring for adaptive management of rangelands has been well established. However, the actual use of monitoring data in rangeland management decisions has been modest despite extensive efforts to develop and implement monitoring programs from local to national scales. More effect...

Counter-Commoditization: Decision Making, Language, Localization

ERIC Educational Resources Information Center

Princen, Thomas

2012-01-01

Commoditization seems immutable and unstoppable but, like other social processes, its prevalence is context dependent. The enabling context for commoditization has been cheap fossil fuels, economic growth, and ever-increasing energy and material throughput. In fact, the scientific findings of ecological, climate, footprint, and material flow…

Activity Book. Campaign Countdown.

ERIC Educational Resources Information Center

Learning, 1992

1992-01-01

Presents a handbook of activities to sharpen elementary students' observational and critical thinking skills as they monitor national, local, and classroom elections. Activities teach the steps of sound decision making. Students learn to set up complete classroom or schoolwide elections. A poster describes life in the White House. (SM)

RISK ASSESSMENT/RISK MANAGEMENT AND COMMUNICATION FOR BROWNFIELDS REDEVELOPMENT DECISION MAKING

EPA Science Inventory

Brownfields redevelopment is an integrated process which involves individuals from varied disciplines and with widely varied interest in the project. it involves a group of developers, their financial backers, the local governments who permit the redevelopment of the site or site...

Early Childhood Years: The Social and Cognitive Realms.

ERIC Educational Resources Information Center

DeFord, LouAnn; And Others

1994-01-01

Six brief articles by elementary school teachers in Foxfire's East Tennessee Teachers' Network focus on applying Foxfire core practices in a developmentally appropriate manner in grades K-3, and describe kindergarten journals, student decision making, and projects involving local history and garbage recycling. (SV)

Theme 1 Overview: Living in Communities in the Circumpolar North.

ERIC Educational Resources Information Center

Hodge, Tony

1998-01-01

An eight-nation intergovernmental council concerned with sustainable development in the Arctic conducted workshops on ecosystem health, youth, alternative energy, housing, transportation, and waste management. Seven themes emerged that included community involvement in decision making, consideration of local capacities, development of information…

Local data will help Michigan make better safety investment decisions : research spotlight.

DOT National Transportation Integrated Search

2016-07-01

MDOT staff are aiming to use data-driven processes and practices from the AASHTO Highway Safety Manual (HSM) to estimate the safety impacts of various crash reduction strategies and highway design alternatives, such as adding a median or varying the ...

Primary and Secondary Analysis of Local Elected Officials’ Decisions to Support or Oppose Pharmacy Sale of Syringes in California

PubMed Central

Rose, Valerie J.

2010-01-01

Under California law, local governments may authorize pharmacies within their jurisdictions to sell ten or fewer syringes to an adult without prescription, proof of identity, or proof of medical need. Local governments may simultaneously exempt adults from prosecution for violation of state drug paraphernalia codes for possession of ten or fewer syringes for personal use. Both of these provisions are temporary and sunset on December 31, 2010, unless subsequent state legislation amends that date. The objective of our study was to ascertain how and why local policymakers made their decisions regarding non-prescription syringe sale (NPSS). We examined influences on their decisions, including specific messengers and the arguments that were most salient to their decision making. We selected jurisdictions that were geographically representative of California counties; those with and without syringe exchange programs, and those that had passed or rejected NPSS. We conducted nine semi-structured interviews in five jurisdictions. To enrich primary data collection, we analyzed secondary data by reviewing audio, video, and written transcripts of public hearings and newspaper coverage in five jurisdictions, including three jurisdictions without primary interview data. Among proponents of NPSS, we identified common themes, including: (1) public health research provided conclusive evidence for reduction in HIV and hepatitis transmission without problems of crime, drug use, or unsafe discard of syringes; (2) the local health officer was the key to influencing local policymakers; (3) recall of prior debates over syringe exchange served to inform their decision making; and (4) a lack of local opposition or controversy. Common concerns among opponents of NPSS included: (1) that there would be an increase in unsafe discard of syringes; (2) loss of an important law enforcement tool; (3) that drug users were incapable of desired behavior change; and (4) that research was inconclusive, or proved that syringe access would not work in reducing rates of disease. Themes held in common by proponents and opponents of NPSS were identified as well. Syringe access through NPSS is in fact supported by a robust body of public health research and is considered an important component of a comprehensive strategy to reduce HIV and hepatitis transmission. Our study highlights the importance of understanding the perspectives of elected officials in order to ameliorate their concerns without undermining the public health goal of reducing death, disease, and suffering in at-risk communities. PMID:20352356

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

PubMed

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

2015-03-21

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

An event-related potential study of deception to self preferences.

PubMed

Tu, Shen; Li, Hong; Jou, Jerwen; Zhang, Qinglin; Wang, Ting; Yu, Caiyun; Qiu, Jiang

2009-01-09

The spatiotemporal analysis of brain activation during the execution of deceptive decision-making was performed in 14 normal young adult subjects by using high-density event-related brain potentials (ERPs) with a delayed-response paradigm (subjects were required to hide their true attitudes for a moment). Our results showed that between 400 and 700 ms after stimulus onset, Deceptive items elicited a more negative ERP deflection (N400-700) than Truthful items, and between 1000 and 2000 ms, Deceptive items elicited a more positive ERP deflection (P1000-2000) than Truthful items. Analyses using dipole locations indicated that: (1) the generators of N400-700 were localized in the medial frontal gyrus (GFM) and middle temporal gyrus (GTM), which might be involved in conflict detection and control during deceptive decision-making; and (2) the generators of P1000-2000 were localized near the cuneus (CU) and the cingulate gyrus, which might be involved in conflict coordination in working memory due to deception.

Multiple constraints compromise decision-making about implantable medical devices for individual patients: qualitative interviews with physicians.

PubMed

Gagliardi, Anna R; Ducey, Ariel; Lehoux, Pascale; Turgeon, Thomas; Kolbunik, Jeremy; Ross, Sue; Trbovich, Patricia; Easty, Anthony; Bell, Chaim; Urbach, David R

2017-12-22

Little research has examined how physicians choose medical devices for treating individual patients to reveal if interventions are needed to support decision-making and reduce device-associated morbidity and mortality. This study explored factors that influence choice of implantable device from among available options. A descriptive qualitative approach was used. Physicians who implant orthopedic and cardiovascular devices were identified in publicly available directories and web sites. They were asked how they decided what device to use in a given patient, sources of information they consulted, and how patients were engaged in decision-making. Sampling was concurrent with data collection and analysis to achieve thematic saturation. Data were analyzed using constant comparative technique by all members of the research team. Twenty-two physicians from five Canadian provinces (10 cardiovascular, 12 orthopedic; 8, 10 and 4 early, mid and late career, respectively) were interviewed. Responses did not differ by specialty, geographic region or career stage. Five major categories of themes emerged that all influence decision-making about a range of devices, and often compromise choice of the most suitable device for a given patient, potentially leading to sub-optimal clinical outcomes: lack of evidence on device performance, patient factors, physician factors, organizational and health system factors, and device and device market factors. In the absence of evidence from research or device registries, tacit knowledge from trusted colleagues and less-trusted industry representatives informed device choice. Patients were rarely engaged in decision-making. Physician preference for particular devices was a barrier to acquiring competency in devices potentially more suitable for patients. Access to suitable devices was further limited to the number of comparable devices on the market, local inventory and purchasing contract specifications. This study revealed that decision-making about devices is complex, cognitively challenging and constrained by several factors limiting access to and use of devices that could optimize patient outcomes. Further research is needed to assess the impact of these constraints on clinical outcomes, and develop interventions that optimize decision-making about device choice for treating given patients.

Breaking down hierarchies of decision-making in primates

PubMed Central

Hyafil, Alexandre; Moreno-Bote, Rubén

2017-01-01

Possible options in a decision often organize as a hierarchy of subdecisions. A recent study concluded that perceptual processes in primates mimic this hierarchical structure and perform subdecisions in parallel. We argue that a flat model that directly selects between final choices accounts more parsimoniously for the reported behavioral and neural data. Critically, a flat model is characterized by decision signals integrating evidence at different hierarchical levels, in agreement with neural recordings showing this integration in localized neural populations. Our results point to the role of experience for building integrated perceptual categories where sensory evidence is merged prior to decision. DOI: http://dx.doi.org/10.7554/eLife.16650.001 PMID:28648171

Application of decentralized cooperative problem solving in dynamic flexible scheduling

NASA Astrophysics Data System (ADS)

Guan, Zai-Lin; Lei, Ming; Wu, Bo; Wu, Ya; Yang, Shuzi

1995-08-01

The object of this study is to discuss an intelligent solution to the problem of task-allocation in shop floor scheduling. For this purpose, the technique of distributed artificial intelligence (DAI) is applied. Intelligent agents (IAs) are used to realize decentralized cooperation, and negotiation is realized by using message passing based on the contract net model. Multiple agents, such as manager agents, workcell agents, and workstation agents, make game-like decisions based on multiple criteria evaluations. This procedure of decentralized cooperative problem solving makes local scheduling possible. And by integrating such multiple local schedules, dynamic flexible scheduling for the whole shop floor production can be realized.

Local classifier weighting by quadratic programming.

PubMed

Cevikalp, Hakan; Polikar, Robi

2008-10-01

It has been widely accepted that the classification accuracy can be improved by combining outputs of multiple classifiers. However, how to combine multiple classifiers with various (potentially conflicting) decisions is still an open problem. A rich collection of classifier combination procedures -- many of which are heuristic in nature -- have been developed for this goal. In this brief, we describe a dynamic approach to combine classifiers that have expertise in different regions of the input space. To this end, we use local classifier accuracy estimates to weight classifier outputs. Specifically, we estimate local recognition accuracies of classifiers near a query sample by utilizing its nearest neighbors, and then use these estimates to find the best weights of classifiers to label the query. The problem is formulated as a convex quadratic optimization problem, which returns optimal nonnegative classifier weights with respect to the chosen objective function, and the weights ensure that locally most accurate classifiers are weighted more heavily for labeling the query sample. Experimental results on several data sets indicate that the proposed weighting scheme outperforms other popular classifier combination schemes, particularly on problems with complex decision boundaries. Hence, the results indicate that local classification-accuracy-based combination techniques are well suited for decision making when the classifiers are trained by focusing on different regions of the input space.

Perceptual Biases in Relation to Paranormal and Conspiracy Beliefs.

PubMed

van Elk, Michiel

2015-01-01

Previous studies have shown that one's prior beliefs have a strong effect on perceptual decision-making and attentional processing. The present study extends these findings by investigating how individual differences in paranormal and conspiracy beliefs are related to perceptual and attentional biases. Two field studies were conducted in which visitors of a paranormal conducted a perceptual decision making task (i.e. the face/house categorization task; Experiment 1) or a visual attention task (i.e. the global/local processing task; Experiment 2). In the first experiment it was found that skeptics compared to believers more often incorrectly categorized ambiguous face stimuli as representing a house, indicating that disbelief rather than belief in the paranormal is driving the bias observed for the categorization of ambiguous stimuli. In the second experiment, it was found that skeptics showed a classical 'global-to-local' interference effect, whereas believers in conspiracy theories were characterized by a stronger 'local-to-global interference effect'. The present study shows that individual differences in paranormal and conspiracy beliefs are associated with perceptual and attentional biases, thereby extending the growing body of work in this field indicating effects of cultural learning on basic perceptual processes.

[Biochemical failure after curative treatment for localized prostate cancer].

PubMed

Zouhair, Abderrahim; Jichlinski, Patrice; Mirimanoff, René-Olivier

2005-12-07

Biochemical failure after curative treatment for localized prostate cancer is frequent. The diagnosis of biochemical failure is clear when PSA levels rise after radical prostatectomy, but may be more difficult after external beam radiation therapy. The main difficulty once biochemical failure is diagnosed is to distinguish between local and distant failure, given the low sensitivity of standard work-up exams. Metabolic imaging techniques currently under evaluation may in the future help us to localize the site of failures. There are several therapeutic options depending on the initial curative treatment, each with morbidity risks that should be considered in multidisciplinary decision-making.

Coastal storm monitoring in Virginia

USGS Publications Warehouse

Wicklein, Shaun M.; Bennett, Mark

2014-01-01

Coastal communities in Virginia are prone to flooding, particularly during hurricanes, nor’easters, and other coastal low-pressure systems. These weather systems affect public safety, personal and public property, and valuable infrastructure, such as transportation, water and sewer, and electric-supply networks. Local emergency managers, utility operators, and the public are tasked with making difficult decisions regarding evacuations, road closures, and post-storm recovery efforts as a result of coastal flooding. In coastal Virginia these decisions often are made on the basis of anecdotal knowledge from past events or predictions based on data from monitoring sites located far away from the affected area that may not reflect local conditions. Preventing flood hazards, such as hurricane-induced storm surge, from becoming human disasters requires an understanding of the relative risks that flooding poses to specific communities. The risk to life and property can be very high if decisions about evacuations and road closures are made too late or not at all.

A new approach to implementing decentralized wastewater treatment concepts.

PubMed

van Afferden, Manfred; Cardona, Jaime A; Lee, Mi-Yong; Subah, Ali; Müller, Roland A

2015-01-01

Planners and decision-makers in the wastewater sector are often confronted with the problem of identifying adequate development strategies and most suitable finance schemes for decentralized wastewater infrastructure. This paper research has focused on providing an approach in support of such decision-making. It is based on basic principles that stand for an integrated perspective towards sustainable wastewater management. We operationalize these principles by means of a geographic information system (GIS)-based approach 'Assessment of Local Lowest-Cost Wastewater Solutions'--ALLOWS. The main product of ALLOWS is the identification of cost-effective local wastewater management solutions for any given demographic and physical context. By using universally available input data the tool allows decision-makers to compare different wastewater solutions for any given wastewater situation. This paper introduces the ALLOWS-GIS tool. Its application and functionality are illustrated by assessing different wastewater solutions for two neighboring communities in rural Jordan.

Study on Data Clustering and Intelligent Decision Algorithm of Indoor Localization

NASA Astrophysics Data System (ADS)

Liu, Zexi

2018-01-01

Indoor positioning technology enables the human beings to have the ability of positional perception in architectural space, and there is a shortage of single network coverage and the problem of location data redundancy. So this article puts forward the indoor positioning data clustering algorithm and intelligent decision-making research, design the basic ideas of multi-source indoor positioning technology, analyzes the fingerprint localization algorithm based on distance measurement, position and orientation of inertial device integration. By optimizing the clustering processing of massive indoor location data, the data normalization pretreatment, multi-dimensional controllable clustering center and multi-factor clustering are realized, and the redundancy of locating data is reduced. In addition, the path is proposed based on neural network inference and decision, design the sparse data input layer, the dynamic feedback hidden layer and output layer, low dimensional results improve the intelligent navigation path planning.

Coastal Adaptation Planning for Sea Level Rise and Extremes: A Global Model for Adaptation Decision-making at the Local Level Given Uncertain Climate Projections

NASA Astrophysics Data System (ADS)

Turner, D.

2014-12-01

Understanding the potential economic and physical impacts of climate change on coastal resources involves evaluating a number of distinct adaptive responses. This paper presents a tool for such analysis, a spatially-disaggregated optimization model for adaptation to sea level rise (SLR) and storm surge, the Coastal Impact and Adaptation Model (CIAM). This decision-making framework fills a gap between very detailed studies of specific locations and overly aggregate global analyses. While CIAM is global in scope, the optimal adaptation strategy is determined at the local level, evaluating over 12,000 coastal segments as described in the DIVA database (Vafeidis et al. 2006). The decision to pursue a given adaptation measure depends on local socioeconomic factors like income, population, and land values and how they develop over time, relative to the magnitude of potential coastal impacts, based on geophysical attributes like inundation zones and storm surge. For example, the model's decision to protect or retreat considers the costs of constructing and maintaining coastal defenses versus those of relocating people and capital to minimize damages from land inundation and coastal storms. Uncertain storm surge events are modeled with a generalized extreme value distribution calibrated to data on local surge extremes. Adaptation is optimized for the near-term outlook, in an "act then learn then act" framework that is repeated over the model time horizon. This framework allows the adaptation strategy to be flexibly updated, reflecting the process of iterative risk management. CIAM provides new estimates of the economic costs of SLR; moreover, these detailed results can be compactly represented in a set of adaptation and damage functions for use in integrated assessment models. Alongside the optimal result, CIAM evaluates suboptimal cases and finds that global costs could increase by an order of magnitude, illustrating the importance of adaptive capacity and coastal policy.

Regional Interdependence in Adaptation to Sea Level Rise and Coastal Flooding

NASA Astrophysics Data System (ADS)

Stacey, M. T.; Lubell, M.; Hummel, M.; Wang, R. Q.; Barnard, P.; Erikson, L. H.; Herdman, L.; Pozdnukhov, A.; Sheehan, M.

2017-12-01

Projections of sea level rise may differ in the pace of change, but there is clear consensus that coastal communities will be facing more frequent and severe flooding events in the coming century. As communities adapt to future conditions, infrastructure systems will be developed, modified and abandoned, with important consequences for services and resilience. Whether action or inaction is pursued, the decisions made by an individual community regarding a single infrastructure system have implications that extend spatially and temporally due to geographic and infrastructure system interactions. At the same time, there are a number of barriers to collective or coordinated action that inhibit regional solutions. This interplay between local actions and regional responses is one of the great challenges facing decision-makers grappling with both local and regional climate-change adaptation. In this talk, I present case studies of the San Francisco Bay Area that examine how shoreline infrastructure, transporation sytems and decision-making networks interact to define the regional response to local actions and the local response to regional actions. I will characterize the barriers that exist to regional solutions, and characterize three types of interdependence that may motivate decision-makers to overcome those barriers. Using these examples, I will discuss the importance of interdisciplinary analyses that integrate the natural sciences, engineering and the social science to climate change adaptation more generally.

Streets ahead on safety: young people's participation in decision-making to address the European road injury 'epidemic'.

PubMed

Kimberlee, Richard

2008-05-01

This paper reports on Birmingham City Council's Streets Ahead on Safety project which aims to improve road safety and quality of life in an area of multiple deprivation where 87 000 people from largely Asian, immigrant backgrounds live. A third of residents are under 16 years old and 58% self-define their religion as Muslim. The area has a poor traffic accident record leading to high levels of killed or seriously injured children. Child accidental injury in Europe is reaching 'epidemic' proportions, requiring innovative, ameliorative approaches to redress. Existing UK school-based road safety initiatives rarely extend beyond the 'tokenistic', but this project endeavoured to encourage a highway authority, engineers and road safety officers to provide local young people with opportunities to participate in decision-making in the belief that the active engagement of young service users would lead to more effective and sustainable solutions to accident prevention. Embracing the city's ratification of the UN Convention on the Rights of the Child (1989), this project promoted young people's participation in decision-making around engineering plans for their local community. The project included 405 young people aged 9-11 years who conducted environmental audits, interactive road safety awareness and citizenship training, and engaged as decision-makers. Successful outcomes include increased knowledge of road and community safety issues, and the establishment of young people as stakeholders in the development of their own safety and active engagement with service providers in the development of engineering proposals. This paper highlights the potential dynamics of participation and the dilemmas it poses for relationships between service users and providers, and outlines some of the barriers confronted by young people in learning to be active participants.

Risk Assessment and Decision-Making at the Local Level:?Who does what when, how, and to what extent?

EPA Science Inventory

Problem: Exposure to multiple stressors increases the likelihood of an adverse response in human and ecosystem communities. Challenge: A rigorous and scientifically robust assessment methodology is needed to characterize stressors and receptors of interest, calculate risk estimat...