On the Lawfulness of the Decision to Terminate Memory Search

ERIC Educational Resources Information Center

Harbison, J. Isaiah; Dougherty, Michael R.; Davelaar, Eddy J.; Fayyad, Basma

2009-01-01

Nearly every memory retrieval episode ends with a decision to terminate memory search. Yet, no research has investigated whether these search termination decisions are systematic, let alone whether they are made consistent with a particular rule. In the present paper, we used a modified free-recall paradigm to examine the decision to terminate…

29 CFR 500.262 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

29 CFR 500.262 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

29 CFR 500.262 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

29 CFR 500.262 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

29 CFR 500.262 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

A MDMP for All Seasons: Modifying the MDMP for Success

DTIC Science & Technology

2004-05-26

4 Rational Decision - Making Theory ............................................................................. 5 Limited Rationality ... making instead of using the MDMP, which is an analytical decision - making process. Limited rationality and analytical decision - making will be discussed...limited rationality decision - making theories. FM 5.0 defines fundamentals of planning, such as commander’s involvement and developing creative plans

[The framing effect: medical implications].

PubMed

Mazzocco, Ketti; Cherubini, Paolo; Rumiati, Rino

2005-01-01

Over the last 20 years, many studies explored how the way information is presented modifies choices. This sort of effect, referred to as "framing effects", typically consists of the inversion of choices when presenting structurally identical decision problems in different ways. It is a common assumption that physicians are unaffected (or less affected) by the surface description of a decision problem, because they are formally trained in medical decision making. However, several studies showed that framing effects occur even in the medical field. The complexity and variability of these effects are remarkable, making it necessary to distinguish among different framing effects, depending on whether the effect is obtained by modifying adjectives (attribute framing), goals of a behavior (goal framing), or the probability of an outcome (risky choice framing). A further reason for the high variability of the framing effects seems to be the domain of the decision problem, with different effects occurring in prevention decisions, disease-detection decisions, and treatment decisions. The present work reviews the studies on framing effects, in order to summarize them and clarify their possible role in medical decision making.

East London Modified-Broset as Decision-Making Tool to Predict Seclusion in Psychiatric Intensive Care Units.

PubMed

Loi, Felice; Marlowe, Karl

2017-01-01

Seclusion is a last resort intervention for management of aggressive behavior in psychiatric settings. There is no current objective and practical decision-making instrument for seclusion use on psychiatric wards. Our aim was to test the predictive and discriminatory characteristics of the East London Modified-Broset (ELMB), to delineate its decision-making profile for seclusion of adult psychiatric patients, and second to benchmark it against the psychometric properties of the Broset Violence Checklist (BVC). ELMB, an 8-item modified version of the 6-item BVC, was retrospectively employed to evaluate the seclusion decision-making process on two Psychiatric Intensive Care Units (patients n  = 201; incidents n  = 2,187). Data analyses were carried out using multivariate regression and Receiver Operating Characteristic (ROC) curves. Predictors of seclusion were: physical violence toward staff/patients OR = 24.2; non-compliance with PRN (pro re nata) medications OR = 9.8; and damage to hospital property OR = 2.9. ROC analyses indicated that ELMB was significantly more accurate that BVC, with higher sensitivity, specificity, and positive likelihood ratio. Results were similar across gender. The ELMB is a sensitive and specific instrument that can be used to guide the decision-making process when implementing seclusion.

East London Modified-Broset as Decision-Making Tool to Predict Seclusion in Psychiatric Intensive Care Units

PubMed Central

Loi, Felice; Marlowe, Karl

2017-01-01

Seclusion is a last resort intervention for management of aggressive behavior in psychiatric settings. There is no current objective and practical decision-making instrument for seclusion use on psychiatric wards. Our aim was to test the predictive and discriminatory characteristics of the East London Modified-Broset (ELMB), to delineate its decision-making profile for seclusion of adult psychiatric patients, and second to benchmark it against the psychometric properties of the Broset Violence Checklist (BVC). ELMB, an 8-item modified version of the 6-item BVC, was retrospectively employed to evaluate the seclusion decision-making process on two Psychiatric Intensive Care Units (patients n = 201; incidents n = 2,187). Data analyses were carried out using multivariate regression and Receiver Operating Characteristic (ROC) curves. Predictors of seclusion were: physical violence toward staff/patients OR = 24.2; non-compliance with PRN (pro re nata) medications OR = 9.8; and damage to hospital property OR = 2.9. ROC analyses indicated that ELMB was significantly more accurate that BVC, with higher sensitivity, specificity, and positive likelihood ratio. Results were similar across gender. The ELMB is a sensitive and specific instrument that can be used to guide the decision-making process when implementing seclusion. PMID:29046647

Decision Modeling for Socio-Cultural Data

DTIC Science & Technology

2011-02-01

REFERENCES [1] Malczewski, J. (1999) GIS and Multicriteria Decision Analysis . John Wiley and Sons, New York. [2] Ehrgott, M., and Gandibleux, X. (Eds...up, nonexclusive, irrevocable worldwide license to use , modify, reproduce, release, perform, display, or disclose the work by or on behalf of the...criteria decision analysis (MCDA), into a geospatial environment to support decision making for campaign management. Our development approach supports

Effect of Health Literacy on Decision-Making Preferences among Medically Underserved Patients.

PubMed

Seo, Joann; Goodman, Melody S; Politi, Mary; Blanchard, Melvin; Kaphingst, Kimberly A

2016-05-01

Participation in the decision-making process and health literacy may both affect health outcomes; data on how these factors are related among diverse groups are limited. This study examined the relationship between health literacy and decision-making preferences in a medically underserved population. We analyzed a sample of 576 primary care patients. Multivariable logistic regression was used to examine the independent association of health literacy (measured by the Rapid Estimate of Adult Literacy in Medicine-Revised) and patients' decision-making preferences (physician directed or patient involved), controlling for age, race/ethnicity, and gender. We tested whether having a regular doctor modified this association. Adequate health literacy (odds ratio [OR] = 1.7;P= 0.009) was significantly associated with preferring patient-involved decision making, controlling for age, race/ethnicity, and gender. Having a regular doctor did not modify this relationship. Males were significantly less likely to prefer patient-involved decision making (OR = 0.65;P= 0.024). Findings suggest health literacy affects decision-making preferences in medically underserved patients. More research is needed on how factors, such as patient knowledge or confidence, may influence decision-making preferences, particularly for those with limited health literacy. © The Author(s) 2016.

Willingness-to-pay for steelhead trout fishing: Implications of two-step consumer decisions with short-run endowments

NASA Astrophysics Data System (ADS)

McKean, John R.; Johnson, Donn; Taylor, R. Garth

2010-09-01

Choice of the appropriate model of economic behavior is important for the measurement of nonmarket demand and benefits. Several travel cost demand model specifications are currently in use. Uncertainty exists over the efficacy of these approaches, and more theoretical and empirical study is warranted. Thus travel cost models with differing assumptions about labor markets and consumer behavior were applied to estimate the demand for steelhead trout sportfishing on an unimpounded reach of the Snake River near Lewiston, Idaho. We introduce a modified two-step decision model that incorporates endogenous time value using a latent index variable approach. The focus is on the importance of distinguishing between short-run and long-run consumer decision variables in a consistent manner. A modified Barnett two-step decision model was found superior to other models tested.

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.

Decision-Making Involvement of Individuals with Dementia

ERIC Educational Resources Information Center

Menne, Heather L.; Whitlatch, Carol J.

2007-01-01

Purpose: Research underscores how autonomy and decision-making involvement may help to enhance the quality of life of older adults; however, individuals with dementia are often excluded from decision making that is related to their daily functioning. In this study we use a modified version of the Stress Process Model to consider the stress process…

Passionate Rationalism: The Role of Emotion in Decision Making

ERIC Educational Resources Information Center

Lakomski, Gabriele; Evers, Colin W.

2010-01-01

Purpose: The purpose of this paper is to argue that emotion has a central role to play in rational decision making based on recent research in the neuroanatomy of emotion. As a result, traditional rational decision-making theories, including Herbert Simon's modified model of satisficing that sharply demarcates emotions and values from rationality…

Effects of Direct and Indirect Instruction on Fostering Decision-Making Competence in Socioscientific Issues

ERIC Educational Resources Information Center

Bottcher, Florian; Meisert, Anke

2013-01-01

In this study the effects of different learning environments on the promotion of decision-making competence for the socioscientific issue of genetically modified crops is investigated. The comparison focuses on direct vs. indirect instructions. Therefore on the one hand a sophisticated decision-making strategy was presented to the directly…

Pattern of eyelid motion predictive of decision errors during drowsiness: oculomotor indices of altered states.

PubMed

Lobb, M L; Stern, J A

1986-08-01

Sequential patterns of eye and eyelid motion were identified in seven subjects performing a modified serial probe recognition task under drowsy conditions. Using simultaneous EOG and video recordings, eyelid motion was divided into components above, within, and below the pupil and the durations in sequence were recorded. A serial probe recognition task was modified to allow for distinguishing decision errors from attention errors. Decision errors were found to be more frequent following a downward shift in the gaze angle which the eyelid closing sequence was reduced from a five element to a three element sequence. The velocity of the eyelid moving over the pupil during decision errors was slow in the closing and fast in the reopening phase, while on decision correct trials it was fast in closing and slower in reopening. Due to the high variability of eyelid motion under drowsy conditions these findings were only marginally significant. When a five element blink occurred, the velocity of the lid over pupil motion component of these endogenous eye blinks was significantly faster on decision correct than on decision error trials. Furthermore, the highly variable, long duration closings associated with the decision response produced slow eye movements in the horizontal plane (SEM) which were more frequent and significantly longer in duration on decision error versus decision correct responses.

A Descriptive Study of Decision-Making Conversations during Pediatric Intensive Care Unit Family Conferences.

PubMed

Smith, Michael A; Clayman, Marla L; Frader, Joel; Arenson, Melanie; Haber-Barker, Natalie; Ryan, Claire; Emanuel, Linda; Michelson, Kelly

2018-06-19

Little is known about how decision-making conversations occur during pediatric intensive care unit (PICU) family conferences (FCs). Describe the decision-making process and implementation of shared decision making (SDM) during PICU FCs. Observational study. University-based tertiary care PICU, including 31 parents and 94 PICU healthcare professionals involved in FCs. We recorded, transcribed, and analyzed 14 PICU FCs involving decision-making discussions. We used a modified grounded theory and content analysis approach to explore the use of traditionally described stages of decision making (DM) (information exchange, deliberation, and determining a plan). We also identified the presence or absence of predefined SDM elements. DM involved the following modified stages: information exchange; information-oriented deliberation; plan-oriented deliberation; and determining a plan. Conversations progressed through stages in a nonlinear manner. For the main decision discussed, all conferences included a presentation of the clinical issues, treatment alternatives, and uncertainty. A minority of FCs included assessing the family's understanding (21%), assessing the family's need for input from others (28%), exploring the family's desired decision-making role (35%), and eliciting the family's opinion (42%). In the FCs studied, we found that DM is a nonlinear process. We also found that several SDM elements that could provide information about parents' perspectives and needs did not always occur, identifying areas for process improvement.

Older driver failures of attention at intersections: using change blindness methods to assess turn decision accuracy.

PubMed

Caird, Jeff K; Edwards, Christopher J; Creaser, Janet I; Horrey, William J

2005-01-01

A modified version of the flicker technique to induce change blindness was used to examine the effects of time constraints on decision-making accuracy at intersections on a total of 62 young (18-25 years), middle-aged (26-64 years), young-old (65-73 years), and old-old (74+ years) drivers. Thirty-six intersection photographs were manipulated so that one object (i.e., pedestrian, vehicle, sign, or traffic control device) in the scene would change when the images were alternated for either 5 or 8 s using the modified flicker method. Young and middle-aged drivers made significantly more correct decisions than did young-old and old-old drivers. Logistic regression analysis of the data indicated that age and/or time were significant predictors of decision performance in 14 of the 36 intersections. Actual or potential applications of this research include driving assessment and crash investigation.

Decision making on fitness landscapes

NASA Astrophysics Data System (ADS)

Arthur, R.; Sibani, P.

2017-04-01

We discuss fitness landscapes and how they can be modified to account for co-evolution. We are interested in using the landscape as a way to model rational decision making in a toy economic system. We develop a model very similar to the Tangled Nature Model of Christensen et al. that we call the Tangled Decision Model. This is a natural setting for our discussion of co-evolutionary fitness landscapes. We use a Monte Carlo step to simulate decision making and investigate two different decision making procedures.

29 CFR 502.41 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 502.41...-Hearing Procedures § 502.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare... shall also include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part...

29 CFR 501.41 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Decision and order of Administrative Law Judge. 501.41... § 501.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare, within 60 days after... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

29 CFR 501.41 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 501.41... § 501.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare, within 60 days after... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

29 CFR 503.50 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 503.50... Procedures § 503.50 Decision and order of Administrative Law Judge. (a) The ALJ will prepare, within 60 days... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

29 CFR 501.41 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 501.41... § 501.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare, within 60 days after... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

29 CFR 501.41 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 501.41... § 501.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare, within 60 days after... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

29 CFR 503.50 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 503.50... Procedures § 503.50 Decision and order of Administrative Law Judge. (a) The ALJ will prepare, within 60 days... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

29 CFR 502.41 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Decision and order of Administrative Law Judge. 502.41...-Hearing Procedures § 502.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare... shall also include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part...

29 CFR 502.41 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 502.41...-Hearing Procedures § 502.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare... shall also include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part...

29 CFR 502.41 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 502.41...-Hearing Procedures § 502.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare... shall also include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part...

29 CFR 503.50 - Decision and order of Administrative Law Judge.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 503.50... Procedures § 503.50 Decision and order of Administrative Law Judge. (a) The ALJ will prepare, within 60 days... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

Theory of the decision/problem state

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

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

An Empirical Test of the Modified C Index and SII, O*NET, and DHOC Occupational Code Classifications

ERIC Educational Resources Information Center

Dik, Bryan J.; Hu, Ryan S. C.; Hansen, Jo-Ida C.

2007-01-01

The present study investigated new approaches for assessing Holland's congruence hypothesis by (a) developing and applying four sets of decision rules for assigning Holland codes of varying lengths for purposes of computing Eggerth and Andrew's modified C index; (b) testing the modified C index computed using these four approaches against Brown…

30 CFR 550.270 - What decisions will BOEM make on the DPP or DOCD and within what timeframe?

Code of Federal Regulations, 2014 CFR

2014-07-01

... MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Dpp Or Docd § 550.270 What decisions... provide monitoring information. (2) Require you to modify your proposed DPP or DOCD, It fails to make...

The effect of threat of litigation on forensic pathologist diagnostic decision making.

PubMed

Oliver, William Russell

2011-12-01

Recent litigation involving medical examiners has caused concern over certifying deaths. We administered a survey of 716 medical examiners regarding the effects of the threat of litigation. Two hundred twenty-two medical examiners responded (31%). Of those who responded, approximately 13.5% admitted to having modified their diagnostic findings due to threat of litigation, and approximately 32.5% stated these considerations would affect their decisions in the future. Physicians who indicated they had or would modify their diagnoses expressed more concern over the possibility of litigation. Chiefs of services were less likely than staff members to indicate changing diagnoses. Practitioners whose jurisdictions included rural areas were significantly more likely to indicate that litigation considerations would affect their diagnoses in the future, although this was not true with those who had already modified their diagnoses. No correlation was found with elected versus appointed positions, accreditation status, sex, race, geographic location, or board certification. Although very few medical examiners have actually been sued because of their diagnoses, a demonstrated threat of litigation has a substantial effect on diagnostic decision making.

A Practical Tutorial on Modified Condition/Decision Coverage

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J.; Veerhusen, Dan S.; Chilenski, John J.; Rierson, Leanna K.

2001-01-01

This tutorial provides a practical approach to assessing modified condition/decision coverage (MC/DC) for aviation software products that must comply with regulatory guidance for DO-178B level A software. The tutorial's approach to MC/DC is a 5-step process that allows a certification authority or verification analyst to evaluate MC/DC claims without the aid of a coverage tool. In addition to the MC/DC approach, the tutorial addresses factors to consider in selecting and qualifying a structural coverage analysis tool, tips for reviewing life cycle data related to MC/DC, and pitfalls common to structural coverage analysis.

Use of modified Delphi to plan knowledge translation for decision makers: an application in the field of advanced practice nursing.

PubMed

Carter, Nancy; Lavis, John N; MacDonald-Rencz, Sandra

2014-01-01

Disseminating research to decision makers is difficult. Interaction between researchers and decision makers can identify key messages and processes for dissemination. To gain agreement on the key findings from a synthesis on the integration of advanced practice nurses, we used a modified Delphi process. Nursing decision makers contributed ideas via e-mail, discussed and clarified ideas face to face, and then prioritized statements. Sixteen (89%) participated and 14 (77%) completed the final phase. Priority key messages were around access to care and outcomes. The majority identified "NPs increase access to care" and "NPs and CNSs improve patient and system outcomes" as priority messaging statements. Participants agreed policy makers and the public were target audiences for messages. Consulting with policy makers provided the necessary context to develop tailored policy messages and is a helpful approach for research dissemination. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

A Modified Decision Tree Algorithm Based on Genetic Algorithm for Mobile User Classification Problem

PubMed Central

Liu, Dong-sheng; Fan, Shu-jiang

2014-01-01

In order to offer mobile customers better service, we should classify the mobile user firstly. Aimed at the limitations of previous classification methods, this paper puts forward a modified decision tree algorithm for mobile user classification, which introduced genetic algorithm to optimize the results of the decision tree algorithm. We also take the context information as a classification attributes for the mobile user and we classify the context into public context and private context classes. Then we analyze the processes and operators of the algorithm. At last, we make an experiment on the mobile user with the algorithm, we can classify the mobile user into Basic service user, E-service user, Plus service user, and Total service user classes and we can also get some rules about the mobile user. Compared to C4.5 decision tree algorithm and SVM algorithm, the algorithm we proposed in this paper has higher accuracy and more simplicity. PMID:24688389

Instructional Cues Modify Performance on the Iowa Gambling Task

ERIC Educational Resources Information Center

Balodis, Iris M.; MacDonald, Tara K.; Olmstead, Mary C.

2006-01-01

The current study investigated whether acute alcohol intoxication produces impaired decision-making on tasks assessing ventromedial prefrontal (VMF) cortex functioning and impulsive responding. Participants completed the Iowa Gambling Task (IGT), a decision-making test targeting the VMF, and the Newman Perseveration Task (NT), a measure of…

15 CFR 17.26 - Adjudicatory.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Commerce and Foreign Trade Office of the Secretary of Commerce LICENSING OF GOVERNMENT-OWNED INVENTIONS IN... Secretary shall render a final written decision on behalf of the Department based upon the appeal file which... form the basis of the determination. The final decision may uphold, overrule, or modify the Director's...

Principals' Attitudes toward the Inclusion of Students with Disabilities

ERIC Educational Resources Information Center

Stith, Angelnet L.

2013-01-01

The quantitative correlation study investigated 50 Virginia's elementary principals' attitudes toward the inclusion of students with disabilities and principals' training, experience, placement decision, and state assessment decision in special education. The data was collected using the modified version of Principal and Inclusion Survey tool.…

Direct Allocation Costing: Informed Management Decisions in a Changing Environment.

ERIC Educational Resources Information Center

Mancini, Cesidio G.; Goeres, Ernest R.

1995-01-01

It is argued that colleges and universities can use direct allocation costing to provide quantitative information needed for decision making. This method of analysis requires institutions to modify traditional ideas of costing, looking to the private sector for examples of accurate costing techniques. (MSE)

Incompetent Patients, Substitute Decision Making, and Quality of Life: Some Ethical Considerations

PubMed Central

Kluge, Eike-Henner W.

2008-01-01

One of the most difficult situations facing physicians involves decision making by substitute decision makers for patients who have never been competent. This paper begins with a brief examination of the ethics of substitute decision making for previously competent patients. It then applies the results to substitute decision making for patients who have never been competent, and critically analyzes 5 models of substitute decision making for such patients, showing why each either contravenes basic ethical principles or fails to guarantee the use of ethically appropriate values. It concludes by sketching a modified objective reasonable person standard for substitute decision making that avoids valuational difficulties and allows for a protocol that satisfies ethical principles. PMID:19099031

Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach.

PubMed

Batterham, Philip J; Christensen, Helen; Mackinnon, Andrew J

2009-11-22

Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

Dissociation between decision-making under risk and decision-making under ambiguity in premanifest and manifest Huntington's disease.

PubMed

Adjeroud, Najia; Besnard, Jeremy; Verny, Christophe; Prundean, Adriana; Scherer, Clarisse; Gohier, Bénédicte; Bonneau, Dominique; Massioui, Nicole El; Allain, Philippe

2017-08-01

We investigated decision-making under ambiguity (DM-UA) and decision making under risk (DM-UR) in individuals with premanifest and manifest Huntington's disease (HD). Twenty individuals with premanifest HD and 23 individuals with manifest HD, on one hand, and 39 healthy individuals divided into two control groups, on the other, undertook a modified version of the Iowa Gambling Task (IGT), an adaptation of a DM-UA task, and a modified version of the Game of Dice Task (GDT), an adaptation of a DM-UR task. Participants also filled in a questionnaire of impulsivity and responded to cognitive tests specifically designed to assess executive functions. Compared to controls, individuals with premanifest HD were unimpaired in performing executive tests as well as in decision-making tasks, except for the Stroop task. In contrast, individuals with manifest HD were impaired in both the IGT and executive tasks, but not in the GDT. No sign of impulsivity was observed in individuals with premanifest or manifest HD. Our results suggest that the progression of HD impairs DM-UA without affecting DM-UR, and indicate that decision-making abilities are preserved during the premanifest stage of HD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Modifying sales summaries can aid forest products industries

Treesearch

G. B. Harpole

1976-01-01

This Note illustrates how a sales summary can be modified to separately identify changes in sales realization caused by changes in market prices and by changes in the product mix sold. With this information, a sales summary can become a helpful record to gage effects of past production and marketing decisions.

Nature of Science and Decision-Making

ERIC Educational Resources Information Center

Khishfe, Rola

2012-01-01

The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were…

30 CFR 550.234 - How do I submit a modified EP or resubmit a disapproved EP, and when will BOEM make a decision?

Code of Federal Regulations, 2012 CFR

2012-07-01

... ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Ep § 550.234 How do I submit a...

30 CFR 250.234 - How do I submit a modified EP or resubmit a disapproved EP, and when will MMS make a decision?

Code of Federal Regulations, 2010 CFR

2010-07-01

... MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Ep § 250.234 How do I submit a...

30 CFR 550.234 - How do I submit a modified EP or resubmit a disapproved EP, and when will BOEM make a decision?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Ep § 550.234 How do I submit a...

30 CFR 550.234 - How do I submit a modified EP or resubmit a disapproved EP, and when will BOEM make a decision?

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Ep § 550.234 How do I submit a...

76 FR 12271 - Human Reliability Program: Identification of Reviewing Official

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-07

... authority to issue a final written decision to recertify or revoke the certification of an individual in the... and facilitates timely final agency decision-making. This amendment modifies internal agency... identify, in a timely manner, individuals whose judgment may be impaired by physical or mental/personality...

Attitudes of Students and Practitioners Regarding Ethical Acceptability of Accounting Transactions

ERIC Educational Resources Information Center

Fischer, Mary; Marsh, Treba; Hunt, George L.

2013-01-01

This study reports the findings of a study assessing the acceptability differences in decisions made by Certified Public Accounting practitioners (CPA) and students studying to become CPAs. The study responds to researchers' call for additional research on topics related to accounting decision ethics. Modified managerial and accounting recognition…

Nature of Science and Decision-Making

NASA Astrophysics Data System (ADS)

Khishfe, Rola

2012-01-01

The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were taught by their regular science teacher. The treatment comprised a four-week unit about genetic engineering. Two groups (one regular and one honors), referred to as comparison groups, received instruction in genetic engineering and how to formulate arguments and make decisions related to this controversial issue. The other two groups (one regular and one honors), referred to as treatment groups, received instruction in genetic engineering and how to apply NOS aspects as they formulate arguments and make decisions in relation to this controversial issue. Chi-square analyses showed significant differences between the comparison and the treatment groups in relation to the understandings of four NOS aspects. There were no differences in their decisions, but there were differences in their DM factors in the context of the controversial socioscientific issue about genetically modified food. These results are discussed in light of the relationship between students' understandings of NOS and their DM related to controversial socioscientific issues.

A Practical Approach to Modified Condition/Decision Coverage

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J.; Veerhusem, Dan S.

2001-01-01

Testing of software intended for safety-critical applications in commercial transport aircraft must achieve modified condition/decision coverage (MC/DC) of the software structure. This requirement causes anxiety for many within the aviation software community. Results of a survey of the aviation software industry indicate that many developers believe that meeting the MC/DC requirement is difficult, and the cost is exorbitant. Some of the difficulties stem, no doubt, from the scant information available on the subject. This paper provides a practical 5-step approach for assessing MC/DC for aviation software products, and an analysis of some types of errors expected to be caught when MC/DC is achieved1.

Decision-making process of Kala Azar care: results from a qualitative study carried out in disease endemic areas of Nepal

PubMed Central

2013-01-01

Background Analysis of consumer decision making in the health sector is a complex process of comparing feasible alternatives and evaluating the levels of satisfaction associated with the relevant options. This paper makes an attempt to understand how and why consumers make specific decisions, what motivates them to adopt a specific health intervention, and what features they find attractive in each of the options. Method The study used a descriptive-explanatory design to analyze the factors determining the choices of healthcare providers. Information was collected through focus group discussions and in-depth interviews. Results The results suggest that the decision making related to seeking healthcare for Kala Azar (KA) treatment is a complex, interactive process. Patients and family members follow a well-defined road map for decision making. The process of decision making starts from the recognition of healthcare needs and is then modified by a number of other factors, such as indigenous knowledge, healthcare alternatives, and available resources. Household and individual characteristics also play important roles in facilitating the process of decision making. The results from the group discussions and in-depth interviews are consistent with the idea that KA patients and family members follow the rational approach of weighing the costs against the benefits of using specific types of medical care. Conclusion The process of decision making related to seeking healthcare follows a complex set of steps and many of the potential factors affect the decision making in a non-linear fashion. Our analysis suggests that it is possible to derive a generalized road map of the decision-making process starting from the recognition of healthcare needs, and then modifying it to show the influences of indigenous knowledge, healthcare alternatives, and available resources. PMID:23849617

Decision-making process of Kala Azar care: results from a qualitative study carried out in disease endemic areas of Nepal.

PubMed

Adhikari, Shiva Raj; Supakankunti, Siripen; Khan, M Mahmud

2013-07-12

Analysis of consumer decision making in the health sector is a complex process of comparing feasible alternatives and evaluating the levels of satisfaction associated with the relevant options. This paper makes an attempt to understand how and why consumers make specific decisions, what motivates them to adopt a specific health intervention, and what features they find attractive in each of the options. The study used a descriptive-explanatory design to analyze the factors determining the choices of healthcare providers. Information was collected through focus group discussions and in-depth interviews. The results suggest that the decision making related to seeking healthcare for Kala Azar (KA) treatment is a complex, interactive process. Patients and family members follow a well-defined road map for decision making. The process of decision making starts from the recognition of healthcare needs and is then modified by a number of other factors, such as indigenous knowledge, healthcare alternatives, and available resources. Household and individual characteristics also play important roles in facilitating the process of decision making. The results from the group discussions and in-depth interviews are consistent with the idea that KA patients and family members follow the rational approach of weighing the costs against the benefits of using specific types of medical care. The process of decision making related to seeking healthcare follows a complex set of steps and many of the potential factors affect the decision making in a non-linear fashion. Our analysis suggests that it is possible to derive a generalized road map of the decision-making process starting from the recognition of healthcare needs, and then modifying it to show the influences of indigenous knowledge, healthcare alternatives, and available resources.

Scoring and setting pass/fail standards for an essay certification examination in nurse-midwifery.

PubMed

Fullerton, J T; Greener, D L; Gross, L J

1992-03-01

Examination for certification or licensure of health professionals (credentialing) in the United States is almost exclusively of the multiple choice format. The certification examination for entry into the practice of the profession of nurse-midwifery has, however, used a modified essay format throughout its twenty-year history. The examination has recently undergone a revision in the method for score interpretation and for pass/fail decision-making. The revised method, described in this paper, has important implications for all health professional credentialing agencies which use modified essay, oral or practical methods of competency assessment. This paper describes criterion-referenced scoring, the process of constructing the essay items, the methods for assuring validity and reliability for the examination, and the manner of standard setting. In addition, two alternative methods for increasing the validity of the pass/fail decision are evaluated, and the rationale for decision-making about marginal candidates is described.

Specifying, Installing and Maintaining Built-Up and Modified Bitumen Roofing Systems.

ERIC Educational Resources Information Center

Hobson, Joseph W.

2000-01-01

Examines built-up, modified bitumen, and hybrid combinations of the two roofing systems and offers advise on how to assure high- quality performance and durability when using them. Included is a glossary of commercial roofing terms and asphalt roofing resources to aid in making decisions on roofing and systems product selection. (GR)

Issues of Spatial and Temporal Scale in Modeling the Effects of Field Operatiions on Soil Properties

USDA-ARS?s Scientific Manuscript database

Tillage is an important procedure for modifying the soil environment in order to enhance crop growth and conserve soil and water resources. Process-based models of crop production are widely used in decision support, but few explicitly simulate tillage. The Cropping Systems Model (CSM) was modified ...

33 CFR 331.6 - Filing an appeal.

Code of Federal Regulations, 2010 CFR

2010-07-01

... objections to the permit. The district engineer, upon evaluation of the applicant's objections, may: Modify... such modified permit to the applicant, enclosing an NAP fact sheet and an RFA form as well. Should the... an NAP fact sheet, RFA form, and a copy of the decision document for the project. If the district...

Modifying the Curriculum: Teaching Clinical Students about Caring for Patients with Disabilities.

ERIC Educational Resources Information Center

Ettinger, Ellen Richter

2002-01-01

Examines how the curricula of optometry programs can be modified to prepare graduates to meet the needs of patients from special populations. Addresses student attitudes and the clinical encounter, including the case history, clinical examination, clinical decision making and determination of patient management plans, and case discussion of the…

76 FR 75876 - Record of Decision for the Modification of the Groton Generation Station Interconnection...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

...) received a request from Basin Electric Power Cooperative (Basin Electric) to modify its Large Generator Interconnection Agreement (LGIA) with Basin Electric for the Groton Generation Station to eliminate current... considered the environmental impacts and has decided to modify its LGIA with Basin Electric for the Groton...

From accuracy to patient outcome and cost-effectiveness evaluations of diagnostic tests and biomarkers: an exemplary modelling study

PubMed Central

2013-01-01

Background Proper evaluation of new diagnostic tests is required to reduce overutilization and to limit potential negative health effects and costs related to testing. A decision analytic modelling approach may be worthwhile when a diagnostic randomized controlled trial is not feasible. We demonstrate this by assessing the cost-effectiveness of modified transesophageal echocardiography (TEE) compared with manual palpation for the detection of atherosclerosis in the ascending aorta. Methods Based on a previous diagnostic accuracy study, actual Dutch reimbursement data, and evidence from literature we developed a Markov decision analytic model. Cost-effectiveness of modified TEE was assessed for a life time horizon and a health care perspective. Prevalence rates of atherosclerosis were age-dependent and low as well as high rates were applied. Probabilistic sensitivity analysis was applied. Results The model synthesized all available evidence on the risk of stroke in cardiac surgery patients. The modified TEE strategy consistently resulted in more adapted surgical procedures and, hence, a lower risk of stroke and a slightly higher number of life-years. With 10% prevalence of atherosclerosis the incremental cost-effectiveness ratio was €4,651 and €481 per quality-adjusted life year in 55-year-old men and women, respectively. In all patients aged 65 years or older the modified TEE strategy was cost saving and resulted in additional health benefits. Conclusions Decision analytic modelling to assess the cost-effectiveness of a new diagnostic test based on characteristics, costs and effects of the test itself and of the subsequent treatment options is both feasible and valuable. Our case study on modified TEE suggests that it may reduce the risk of stroke in cardiac surgery patients older than 55 years at acceptable cost-effectiveness levels. PMID:23368927

Factors influencing parents' decision-making when sending children with respiratory tract infections to nursery.

PubMed

Carroll, Fran E; Rooshenas, Leila; Owen-Smith, Amanda; Al-Janabi, Hareth; Hollinghurst, Sandra; Hay, Alastair D

2016-06-01

Many families rely on formal day care provision, which can be problematic when children are unwell. Attendance in these circumstances may impact on the transmission of infections in both day care and the wider community. Thirty-one semi-structured interviews were conducted to investigate how parents make decisions about nursery care when children are unwell. Topics for discussion included: illness attitudes, current practice during childhood illness and potential nursery policy changes that could affect decision-making. A combination of illness perceptions and external factors affected decision-making. Parents: (i) considered the severity of respiratory and non-respiratory symptoms differently, and stated that while most other contagious illnesses required nursery exclusion, coughs/colds did not; (ii) said decisions were not solely based on nursery policy, but on practical challenges such as work absences, financial penalties and alternative care availability; (iii) identified modifiable nursery policy factors that could potentially help parents keep unwell children at home, potentially reducing transmission of infectious illness. Decision-making is a complex interaction between the child's illness, personal circumstance and nursery policy. Improving our understanding of the modifiable aspects of nursery policies and the extent to which these factors affect decision-making could inform the design and implementation of interventions to reduce the transmission of infectious illness and the associated burden on NHS services. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sensitivity to reward and punishment in Parkinson's disease: an analysis of behavioral patterns using a modified version of the Iowa gambling task.

PubMed

Kobayakawa, Mutsutaka; Tsuruya, Natsuko; Kawamura, Mitsuru

2010-08-01

Studies using the Iowa gambling task (IGT) have shown that patients with Parkinson's disease (PD) make disadvantageous choices characterized by immediate large rewards and delayed larger punishments. These results can be interpreted in two ways: either PD patients are hypersensitive to immediate outcomes and/or insensitive to delayed consequences or PD patients are hypersensitive to rewards and/or insensitive to punishments. In this study, we used a modified IGT in which selection of cards from the disadvantageous decks leads to immediate, small punishments and delayed, smaller rewards and selection of cards from the advantageous decks leads to immediate, large punishments and delayed larger rewards. We then compared the results obtained using this modified IGT with those obtained using the original IGT. If the PD patients were hypersensitive to the immediate outcomes of decisions, they would make disadvantageous choices in both the original and the modified IGTs. Differences between the results of the original and modified tasks would indicate impairments in balancing reward and punishment. In our analysis, PD patients selected advantageous decks and gained as much as normal subjects during the modified IGT, but they selected disadvantageous decks during the original IGT. These results indicate that the decision-making difficulties of PD patients are caused by their inability to balance reward and punishment and their hypersensitivity to reward and/or insensitivity to punishment.

The effect of small-sided games with different levels of opposition on the tactical behaviour of young footballers with different levels of sport expertise.

PubMed

Práxedes, Alba; Moreno, Alberto; Gil-Arias, Alexander; Claver, Fernando; Del Villar, Fernando

2018-01-01

To optimize players' tactical abilities, coaches need to design training sessions with representative learning tasks, such as, small-sided games. Moreover, it is necessary to adapt the complexity of the tasks to the skill level of the athletes to maximally improve their perceptual, visual and attentive abilities. The objective of this study was to analyze the effect of two teaching programs, each utilizing modified games with varied levels of opposition, on decision-making and action execution in young players with different levels of sports expertise. 19 football players (U12), separated into two ability groups (Average versus Low skill-level), participated in a series of training sessions that were spread over 4 phases: Pre-intervention 1, Intervention 1 (teaching program based on modified games with numerical superiority in attack), Pre-intervention 2 and Intervention 2 (teaching program based on modified games with numerical equality). Each intervention phase lasted 14 sessions. Decision-making and the execution of pass action during league matches over the same period were evaluated using the Game Performance Evaluation Tool (GPET). The Average skill-level group showed significant differences after the first intervention in decision-making and execution of the pass action (decision-making, p = .015; execution, p = .031), but not after the second intervention (decision-making, p = 1.000; execution, p = 1.000). For the Low skill-level group, significant differences were only observed in the execution of passing between the first and last phases (p = .014). These findings seem to indicate that for groups with an average level of expertise, training with numerical superiority in attack provides players with more time to make better decisions and to better execute actions. However, for lower-level groups programs may take longer to facilitate improvement. Nevertheless, numerical equality did not result in improvement for either group.

Decision Support in Diabetes Care: The Challenge of Supporting Patients in Their Daily Living Using a Mobile Glucose Predictor.

PubMed

Pérez-Gandía, Carmen; García-Sáez, Gema; Subías, David; Rodríguez-Herrero, Agustín; Gómez, Enrique J; Rigla, Mercedes; Hernando, M Elena

2018-03-01

In type 1 diabetes mellitus (T1DM), patients play an active role in their own care and need to have the knowledge to adapt decisions to their daily living conditions. Artificial intelligence applications can help people with type 1 diabetes in decision making and allow them to react at time scales shorter than the scheduled face-to-face visits. This work presents a decision support system (DSS), based on glucose prediction, to assist patients in a mobile environment. The system's impact on therapeutic corrective actions has been evaluated in a randomized crossover pilot study focused on interprandial periods. Twelve people with type 1 diabetes treated with insulin pump participated in two phases: In the experimental phase (EP) patients used the DSS to modify initial corrective decisions in presence of hypoglycemia or hyperglycemia events. In the control phase (CP) patients were asked to follow decisions without knowing the glucose prediction. A telemedicine platform allowed participants to register monitoring data and decisions and allowed endocrinologists to supervise data at the hospital. The study period was defined as a postprediction (PP) time window. After knowing the glucose prediction, participants modified the initial decision in 20% of the situations. No statistically significant differences were found in the PP Kovatchev's risk index change (-1.23 ± 11.85 in EP vs -0.56 ± 6.06 in CP). Participants had a positive opinion about the DSS with an average score higher than 7 in a usability questionnaire. The DSS had a relevant impact in the participants' decision making while dealing with T1DM and showed a high confidence of patients in the use of glucose prediction.

Early decision-analytic modeling - a case study on vascular closure devices.

PubMed

Brandes, Alina; Sinner, Moritz F; Kääb, Stefan; Rogowski, Wolf H

2015-10-27

As economic considerations become more important in healthcare reimbursement, decisions about the further development of medical innovations need to take into account not only medical need and potential clinical effectiveness, but also cost-effectiveness. Already early in the innovation process economic evaluations can support decisions on development in specific indications or patient groups by anticipating future reimbursement and implementation decisions. One potential concept for early assessment is value-based pricing. The objective is to assess the feasibility of value-based pricing and product design for a hypothetical vascular closure device in the pre-clinical stage which aims at decreasing bleeding events. A deterministic decision-analytic model was developed to estimate the cost-effectiveness of established vascular closure devices from the perspective of the Statutory Health Insurance system. To identify early benchmarks for pricing and product design, three strategies of determining the product's value are explored: 1) savings from complications avoided by the new device; 2) valuation of the avoided complications based on an assumed willingness-to-pay-threshold (the efficiency frontier approach); 3) value associated with modifying the care pathways within which the device would be applied. Use of established vascular closure devices is dominated by manual compression. The hypothetical vascular closure device reduces overall complication rates at higher costs than manual compression. Maximum cost savings of only about €4 per catheterization could be realized by applying the hypothetical device. Extrapolation of an efficiency frontier is only possible for one subgroup where vascular closure devices are not a dominated strategy. Modifying care in terms of same-day discharge of patients treated with vascular closure devices could result in cost savings of €400-600 per catheterization. It was partially feasible to calculate value-based prices for the novel closure device which can be used to inform product design. However, modifying the care pathway may generate much more value from the payers' perspective than modifying the device per se. Manufacturers should thus explore the feasibility of combining reimbursement of their product with arrangements that make same-day discharge attractive also for hospitals. Due to the early nature of the product, the results are afflicted with substantial uncertainty.

Implementation of a cystic fibrosis lung transplant referral patient decision aid in routine clinical practice: an observational study.

PubMed

Stacey, Dawn; Vandemheen, Katherine L; Hennessey, Rosamund; Gooyers, Tracy; Gaudet, Ena; Mallick, Ranjeeta; Salgado, Josette; Freitag, Andreas; Berthiaume, Yves; Brown, Neil; Aaron, Shawn D

2015-02-07

The decision to have lung transplantation as treatment for end-stage lung disease from cystic fibrosis (CF) has benefits and serious risks. Although patient decision aids are effective interventions for helping patients reach a quality decision, little is known about implementing them in clinical practice. Our study evaluated a sustainable approach for implementing a patient decision aid for adults with CF considering referral for lung transplantation. A prospective pragmatic observational study was guided by the Knowledge-to-Action Framework. Healthcare professionals in all 23 Canadian CF clinics were eligible. We surveyed participants regarding perceived barriers and facilitators to patient decision aid use. Interventions tailored to address modifiable identified barriers included training, access to decision aids, and conference calls. The primary outcome was >80% use of the decision aid in year 2. Of 23 adult CF clinics, 18 participated (78.2%) and 13 had healthcare professionals attend training. Baseline barriers were healthcare professionals' inadequate knowledge for supporting patients making decisions (55%), clarifying patients' values for outcomes of options (58%), and helping patients handle conflicting views of others (71%). Other barriers were lack of time (52%) and needing to change how transplantation is discussed (42%). Baseline facilitators were healthcare professionals feeling comfortable discussing bad transplantation outcomes (74%), agreeing the decision aid would be easy to experiment with (71%) and use in the CF clinic (87%), and agreeing that using the decision aid would not require reorganization of the CF clinic (90%). After implementing the decision aid with interventions tailored to the barriers, decision aid use increased from 29% at baseline to 85% during year 1 and 92% in year 2 (p < 0.001). Compared to baseline, more healthcare professionals at the end of the study were confident in supporting decision-making (p = 0.03) but continued to feel inadequate ability with supporting patients to handle conflicting views (p = 0.01). Most Canadian CF clinics agreed to participate in the study. Interventions were used to target identified modifiable barriers to using the patient decision aid in routine CF clinical practice. CF clinics reported using it with almost all patients in the second year.

Age differences in attention toward decision-relevant information: education matters.

PubMed

Xing, Cai; Isaacowitz, Derek

2011-01-01

Previous studies suggested that older adults are more likely to engage in heuristic decision-making than young adults. This study used eye tracking technique to examine young adults' and highly educated older adults' attention toward two types of decision-relevant information: heuristic cue vs. factual cues. Surprisingly, highly educated older adults showed the reversed age pattern-they looked more toward factual cues than did young adults. This age difference disappeared after controlling for educational level. Additionally, education correlated with attentional pattern to decision-relevant information. We interpret this finding as an indication of the power of education: education may modify what are thought to be "typical" age differences in decision-making, and education may influence young and older people's decision-making via different paths.

The Importance of Source: A Mixed Methods Analysis of Undergraduate Students' Attitudes toward Genetically Modified Food

ERIC Educational Resources Information Center

Ruth, Taylor K.; Rumble, Joy N.; Gay, Keegan D.; Rodriguez, Mary T.

2016-01-01

Even though science says genetically modified (GM) foods are safe, many consumers remain skeptical of the technology. Additionally, the scientific community has trouble communicating to the public, causing consumers to make uninformed decisions. The Millennial Generation will have more buying power than any other generation before them, and more…

Genetically Modified Crops and Nuisance: Exploring the Role of Precaution in Private Law

ERIC Educational Resources Information Center

Craik, Neil; Culver, Keith; Siebrasse, Norman

2007-01-01

This article critically considers calls for the precautionary principle to inform judicial decision making in a private law context in light of the Hoffman litigation, where it is alleged that the potential for genetic contamination from genetically modified (GM) crops causes an unreasonable interference with the rights of organic farmers to use…

78 FR 27476 - Pirelli Tire LLC, Grant of Petition for Decision of Inconsequential Noncompliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... complete or partial tire identification number (TIN) on the inner tire sidewall as required by paragraphs... being modified or have been modified to ensure that the appropriate TIN information is contained on both... visibility of the full TIN on the outboard sidewall: Pirelli's internal policy allows dealers to sell these...

States' Accommodations Policies and Development of Alternate Assessments Based on Modified Achievement Standards: A Discriminant Analysis

ERIC Educational Resources Information Center

Lazarus, Sheryl S.; Cormier, Damien C.; Thurlow, Martha L.

2011-01-01

The characteristics of a state's accommodations policy may affect a state's decision about whether to develop an alternate assessment based on modified achievement standards (AA-MAS). A very restrictive accommodations policy may make it more difficult for some students to participate in the state's regular assessment used for accountability…

30 CFR 250.233 - What decisions will MMS make on the EP and within what timeframe?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., REGULATION, AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Ep § 250.233 What..., including those to provide monitoring information. (2) Require you to modify your proposed EP The Regional...

OPEN SYSTEM THEORY AND CHANGE IN VOCATIONAL PROGRAMS OF IDAHO SECONDARY SCHOOLS.

ERIC Educational Resources Information Center

HEGER, ROBERT J.

THE DECISION-MAKING PROCESS OF SUPERINTENDENTS AS RELATED TO THE SYSTEM THEORY OF ADMINISTRATIVE CHANGE WAS THE CENTRAL FOCUS OF THIS STUDY. SPECIFIC OBJECTIVES WERE (1) TO ANALYZE SUPERINTENDENTS' DECISION MAKING AS RELATED TO MODIFYING AND INITIATING VOCATIONAL EDUCATION PROGRAMS IN IDAHO, (2) TO TEST A THEORY OF ADMINISTRATIVE CHANGE AS RELATED…

Teaching evolution, the Kansas School Board of Education, and the democratization of science

NASA Astrophysics Data System (ADS)

Lin, Johnny Wei-Bing

In the August 1st Republican primaries for the Kansas State Board of Education, three board members were defeated who voted for the 1999 decision to remove most references regarding evolution from state education standards. This makes it likely that the board will in some way overturn or modify the 1999 decision.

Using Primary Sources to Teach Civil War History: A Case Study in Pedagogical Decision Making

ERIC Educational Resources Information Center

Snook, David L.

2017-01-01

This exploratory study combined the process of modified analytic induction with a mixed methods approach to analyze various factors that affected or might have affected participating teachers' decisions to use or not use various primary source based teaching strategies to teach historical thinking skills. Four participating eighth and ninth grade…

77 FR 69501 - Certain DC-DC Controllers and Products Containing Same; Decision To Affirm-in-Part, Reverse-in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-698 (Enforcement Proceeding)] Certain DC-DC Controllers and Products Containing Same; Decision To Affirm-in-Part, Reverse-in-Part, Modify-in... 1930, as amended, 19 U.S.C. 1337, and in section 210.75 of the Commission's Rules of Practice and...

What Risk Assessments of Genetically Modified Organisms Can Learn from Institutional Analyses of Public Health Risks

PubMed Central

Rajan, S. Ravi; Letourneau, Deborah K.

2012-01-01

The risks of genetically modified organisms (GMOs) are evaluated traditionally by combining hazard identification and exposure estimates to provide decision support for regulatory agencies. We question the utility of the classical risk paradigm and discuss its evolution in GMO risk assessment. First, we consider the problem of uncertainty, by comparing risk assessment for environmental toxins in the public health domain with genetically modified organisms in the environment; we use the specific comparison of an insecticide to a transgenic, insecticidal food crop. Next, we examine normal accident theory (NAT) as a heuristic to consider runaway effects of GMOs, such as negative community level consequences of gene flow from transgenic, insecticidal crops. These examples illustrate how risk assessments are made more complex and contentious by both their inherent uncertainty and the inevitability of failure beyond expectation in complex systems. We emphasize the value of conducting decision-support research, embracing uncertainty, increasing transparency, and building interdisciplinary institutions that can address the complex interactions between ecosystems and society. In particular, we argue against black boxing risk analysis, and for a program to educate policy makers about uncertainty and complexity, so that eventually, decision making is not the burden that falls upon scientists but is assumed by the public at large. PMID:23193357

What risk assessments of genetically modified organisms can learn from institutional analyses of public health risks.

PubMed

Rajan, S Ravi; Letourneau, Deborah K

2012-01-01

The risks of genetically modified organisms (GMOs) are evaluated traditionally by combining hazard identification and exposure estimates to provide decision support for regulatory agencies. We question the utility of the classical risk paradigm and discuss its evolution in GMO risk assessment. First, we consider the problem of uncertainty, by comparing risk assessment for environmental toxins in the public health domain with genetically modified organisms in the environment; we use the specific comparison of an insecticide to a transgenic, insecticidal food crop. Next, we examine normal accident theory (NAT) as a heuristic to consider runaway effects of GMOs, such as negative community level consequences of gene flow from transgenic, insecticidal crops. These examples illustrate how risk assessments are made more complex and contentious by both their inherent uncertainty and the inevitability of failure beyond expectation in complex systems. We emphasize the value of conducting decision-support research, embracing uncertainty, increasing transparency, and building interdisciplinary institutions that can address the complex interactions between ecosystems and society. In particular, we argue against black boxing risk analysis, and for a program to educate policy makers about uncertainty and complexity, so that eventually, decision making is not the burden that falls upon scientists but is assumed by the public at large.

Method and apparatus for determining and utilizing a time-expanded decision network

NASA Technical Reports Server (NTRS)

de Weck, Olivier (Inventor); Silver, Matthew (Inventor)

2012-01-01

A method, apparatus and computer program for determining and utilizing a time-expanded decision network is presented. A set of potential system configurations is defined. Next, switching costs are quantified to create a "static network" that captures the difficulty of switching among these configurations. A time-expanded decision network is provided by expanding the static network in time, including chance and decision nodes. Minimum cost paths through the network are evaluated under plausible operating scenarios. The set of initial design configurations are iteratively modified to exploit high-leverage switches and the process is repeated to convergence. Time-expanded decision networks are applicable, but not limited to, the design of systems, products, services and contracts.

Forced-choice decision-making in modified trolley dilemma situations: a virtual reality and eye tracking study.

PubMed

Skulmowski, Alexander; Bunge, Andreas; Kaspar, Kai; Pipa, Gordon

2014-01-01

Based on the frameworks of dual-process theories, we examined the interplay between intuitive and controlled cognitive processes related to moral and social judgments. In a virtual reality (VR) setting we performed an experiment investigating the progression from fast, automatic decisions towards more controlled decisions over multiple trials in the context of a sacrificing scenario. We repeatedly exposed participants to a modified ten-to-one version and to three one-to-one versions of the trolley dilemma in VR and varied avatar properties, such as their gender and ethnicity, and their orientation in space. We also investigated the influence of arousing music on decisions. Our experiment replicated the behavioral pattern observed in studies using text versions of the trolley dilemma, thereby validating the use of virtual environments in research on moral judgments. Additionally, we found a general tendency towards sacrificing male individuals which correlated with socially desirable responding. As indicated by differences in response times, the ten-to-one version of the trolley dilemma seems to be faster to decide than decisions requiring comparisons based on specific avatar properties as a result of differing moral content. Building upon research on music-based emotion induction, we used music to induce emotional arousal on a physiological level as measured by pupil diameter. We found a specific temporal signature displaying a peak in arousal around the moment of decision. This signature occurs independently of the overall arousal level. Furthermore, we found context-dependent gaze durations during sacrificing decisions, leading participants to look prolonged at their victim if they had to choose between avatars differing in gender. Our study confirmed that moral decisions can be explained within the framework of dual-process theories and shows that pupillometric measurements are a promising tool for investigating affective responses in dilemma situations.

Improving the food waste composting facilities site selection for sustainable development using a hybrid modified MADM model.

PubMed

Liu, Kung-Ming; Lin, Sheng-Hau; Hsieh, Jing-Chzi; Tzeng, Gwo-Hshiung

2018-05-01

With the growth of population and the development of urbanization, waste management has always been a critical global issue. Recently, more and more countries have found that food waste constitutes the majority of municipal waste, if they are disposed of properly, will bring more benefits in sustainable development. Regarding the issue of selecting and improving the location to make the disposal facility towards achieving the aspiration level for sustainable development, since it involves multiple and complicated interaction factors about environment, society, and economy which have to be considered properly in the decision-making process of mutual influence relationship. It is basically a multiple attribute decision making (MADM) issue, a difficult problem which has been obsessing the governments of many countries is widely studied and discussed. This study uses the new hybrid modified MADM model, as follows, first to build an influential network relation map (INRM) via DEMATEL technique, next to confirm the influential weightings via DANP (DEMATEL-based ANP), and then to construct a decision-making model via a hybrid modified VIKOR method to improve and select the location for remaining the best disposal facilities. Finally, an empirical case study is illustrated to demonstrate that the proposed model can be effective and useful. In finding the process of decision making, environmental pollution is the main concern of many people in the area, but actually it is the resistance by the general public that has to be considered with first priority. Copyright © 2018. Published by Elsevier Ltd.

State Perspectives on Implementing, or Choosing Not to Implement, an Alternate Assessment Based on Modified Academic Achievement Standards

ERIC Educational Resources Information Center

Palmer, Porter W.

2009-01-01

Since Federal regulations have given states the option to implement alternate assessments based on modified academic achievement standards (AA-MAS) as part of their accountability systems for a small group of students with disabilities, a number of states have made decisions about whether or not to develop and implement such an assessment.…

Modified Dempster-Shafer approach using an expected utility interval decision rule

NASA Astrophysics Data System (ADS)

Cheaito, Ali; Lecours, Michael; Bosse, Eloi

1999-03-01

The combination operation of the conventional Dempster- Shafer algorithm has a tendency to increase exponentially the number of propositions involved in bodies of evidence by creating new ones. The aim of this paper is to explore a 'modified Dempster-Shafer' approach of fusing identity declarations emanating form different sources which include a number of radars, IFF and ESM systems in order to limit the explosion of the number of propositions. We use a non-ad hoc decision rule based on the expected utility interval to select the most probable object in a comprehensive Platform Data Base containing all the possible identity values that a potential target may take. We study the effect of the redistribution of the confidence levels of the eliminated propositions which otherwise overload the real-time data fusion system; these eliminated confidence levels can in particular be assigned to ignorance, or uniformly added to the remaining propositions and to ignorance. A scenario has been selected to demonstrate the performance of our modified Dempster-Shafer method of evidential reasoning.

Epistemic motivation affects the processing of negative emotional stimuli in interpersonal decisions.

PubMed

Wei, Zhenyu; Ruz, María; Zhao, Zhiying; Zheng, Yong

2015-01-01

The present electrophysiological study investigated the role of the need for cognitive closure (NFC) in emotional processing. The NFC is conceptualized as an epistemic motive that is related to how and why people seek out information in social environments. Event-related potentials were recorded while individuals with high NFC (i.e., low epistemic motivation) or low NFC (i.e., high epistemic motivation) performed a modified Ultimatum Game, in which the emotions of happy or angry game agents were employed to predict their most likely offer. High-NFC participants more closely adhered to the decisions rules of the game than low-NFC individuals did. The electrophysiological results showed that the dispositional NFC modified early perceptual components (N170, N200, and P200). The potentials showed that high-NFC subjects had a processing bias to angry faces, whereas low-NFC individuals exhibited no such effects. These findings indicated that high-NFC individuals were more sensitive to negative emotional stimuli than low-NFC individuals in an interpersonal decision-making task.

Effects of episodic future thinking on discounting: Personalized age-progressed pictures improve risky long-term health decisions.

PubMed

Kaplan, Brent A; Reed, Derek D; Jarmolowicz, David P

2016-03-01

Many everyday choices are associated with both delayed and probabilistic outcomes. The temporal attention hypothesis suggests that individuals' decision making can be improved by focusing attention on temporally distal events and implies that environmental manipulations that bring temporally distal outcomes into focus may alter an individual's degree of discounting. One such manipulation, episodic future thinking, has shown to lower discount rates; however, several questions remain about the applicability of episodic future thinking to domains other than delay discounting. The present experiments examine the effects of a modified episodic-future-thinking procedure in which participants viewed age-progressed computer-generated images of themselves and answered questions related to their future, on probability discounting in the context of both a delayed health gain and loss. Results indicate that modified episodic future thinking effectively altered individuals' degree of discounting in the predicted directions and demonstrate the applicability of episodic future thinking to decision making of socially significant outcomes. © 2015 Society for the Experimental Analysis of Behavior.

Epistemic motivation affects the processing of negative emotional stimuli in interpersonal decisions

PubMed Central

Wei, Zhenyu; Ruz, María; Zhao, Zhiying; Zheng, Yong

2015-01-01

The present electrophysiological study investigated the role of the need for cognitive closure (NFC) in emotional processing. The NFC is conceptualized as an epistemic motive that is related to how and why people seek out information in social environments. Event-related potentials were recorded while individuals with high NFC (i.e., low epistemic motivation) or low NFC (i.e., high epistemic motivation) performed a modified Ultimatum Game, in which the emotions of happy or angry game agents were employed to predict their most likely offer. High-NFC participants more closely adhered to the decisions rules of the game than low-NFC individuals did. The electrophysiological results showed that the dispositional NFC modified early perceptual components (N170, N200, and P200). The potentials showed that high-NFC subjects had a processing bias to angry faces, whereas low-NFC individuals exhibited no such effects. These findings indicated that high-NFC individuals were more sensitive to negative emotional stimuli than low-NFC individuals in an interpersonal decision-making task. PMID:26257698

Consumer Decision-Making Styles for Sport Apparel: Gender Comparisons between College Consumers

ERIC Educational Resources Information Center

Bae, Sungwon; Miller, John

2009-01-01

The purpose of this study was to identify the decision-making styles of college students for sports apparel. Modifying the Consumer Style Inventory (CSI) developed by Sproles and Kendall (1986), a quantitative research design was developed to analyze the effect of seven factors. Eight-hundred and twenty-two subjects composed of 376 male and 446…

30 CFR 250.270 - What decisions will MMS make on the DPP or DOCD and within what timeframe?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., REGULATION, AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Dpp Or Docd § 250.270... provide monitoring information. (2) Require you to modify your proposed DPP or DOCD It fails to make...

RPA Field Simulations:Dilemma Training for Legal and Ethical Decision Making

DTIC Science & Technology

2015-11-07

Simulation  Two phases in RPA Field Simulation – classroom phase and field phase  Purpose: link theoretical understanding/ moral reasoning with...rapid, informed decision-making/ moral behavior IRREGULAR WARFARE  U.S. dominates conventional warfare, but irregular warfare falls under Things...aspects: Mental simulation of action Modify Implement Will it work? MORAL REASONING/BEHAVIOR Military-Leader Responsibility requires

77 FR 76516 - Notice of Availability of the Record of Decision for the Federal Coal Lease Modifications COC...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

...] Notice of Availability of the Record of Decision for the Federal Coal Lease Modifications COC-1362 and... INFORMATION: The ROD covered by this Notice of Availability (NOA) is for modification Federal coal leases in..., to modify Mountain Coal Company's existing Federal coal lease COC-1362 by adding 921 acres and the...

The Many Faces of Compliance: The Supreme Court's Decision in "Horne v. Flores"

ERIC Educational Resources Information Center

Thro, William E.

2009-01-01

At first blush, the Supreme Court's recent decision in "Horne v. Flores" (2009) appears to be about the proper standard for determining when to modify a previous judgment, a topic that would interest only civil procedure geeks. Yet, on closer examination, "Horne" is about giving local and state officials discretion to solve education problems and,…

76 FR 42727 - Notice of Availability of a Record of Decision on the Final Environmental Impact Statement for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... of Decision for the Final Environmental Impact Statement for the General Management Plan (FEIS/GMP... Alternative contained in the FEIS/GMP issued on September 19, 2008. The following course of action will occur... events. This alternative has been modified from the Alternative B presented in the FEIS/GMP as discussed...

Redefining self: patients' decision making about treatment for multiple sclerosis.

PubMed

Lowden, Diane; Lee, Virginia; Ritchie, Judith A

2014-08-01

The treatment of multiple sclerosis (MS) has become possible with the advent of disease-modifying therapies, but little is known about patients' experiences when faced with a complex array of treatment options. The purpose of this phenomenological study was to explore the lived experience of making a first decision about treatment with disease-modifying therapies for relapsing-remitting MS. Nine participants shared their perspectives on negotiating the decision to accept, refuse, or delay treatment. All individuals described a core theme in which decision making about treatment was part of a process of coming to a "redefined self." This core theme included reflections about self-image, quality of life, goals, and being a person with MS. Six common themes supporting this core theme were (a) weighing and deciding what's important, (b) acknowledging the illness as part of oneself, (c) playing the mental game, (d) seeking credible resources, (e) evaluating symptoms and fit with quality of life, and (f) managing the roles and involvement of family. The findings of this study provide a greater understanding about the experience of making a therapeutic choice for those with MS and offer insights for nurses when supporting patients faced with options about treatment.

Enhancing emotion-based learning in decision-making under uncertainty.

PubMed

Alarcón, David; Amián, Josué G; Sánchez-Medina, José A

2015-01-01

The Iowa Gambling Task (IGT) is widely used to study decision-making differences between several clinical and healthy populations. Unlike the healthy participants, clinical participants have difficulty choosing between advantageous options, which yield long-term benefits, and disadvantageous options, which give high immediate rewards but lead to negative profits. However, recent studies have found that healthy participants avoid the options with a higher frequency of losses regardless of whether or not they are profitable in the long run. The aim of this study was to control for the confounding effect of the frequency of losses between options to improve the performance of healthy participants on the IGT. Eighty healthy participants were randomly assigned to the original IGT or a modified version of the IGT that diminished the gap in the frequency of losses between options. The participants who used the modified IGT version learned to make better decisions based on long-term profit, as indicated by an earlier ability to discriminate good from bad options, and took less time to make their choices. This research represents an advance in the study of decision making under uncertainty by showing that emotion-based learning is improved by controlling for the loss-frequency bias effect.

Documenting the decision structure in software development

NASA Technical Reports Server (NTRS)

Wild, J. Christian; Maly, Kurt; Shen, Stewart N.

1990-01-01

Current software development paradigms focus on the products of the development process. Much of the decision making process which produces these products is outside the scope of these paradigms. The Decision-Based Software Development (DBSD) paradigm views the design process as a series of interrelated decisions which involve the identification and articulation of problems, alternates, solutions and justifications. Decisions made by programmers and analysts are recorded in a project data base. Unresolved problems are also recorded and resources for their resolution are allocated by management according to the overall development strategy. This decision structure is linked to the products affected by the relevant decision and provides a process oriented view of the resulted system. Software maintenance uses this decision view of the system to understand the rationale behind the decisions affecting the part of the system to be modified. D-HyperCase, a prototype Decision-Based Hypermedia System is described and results of applying the DBSD approach during its development are presented.

Emotion and the law: a framework for inquiry.

PubMed

Wiener, Richard L; Bornstein, Brian H; Voss, Amy

2006-04-01

This paper draws on research in social and cognitive psychology to show how theories of judgment and decision making that incorporate decision makers' affective responses apply to legal contexts. It takes 2 widely used models of decision making, the rational actor and lens models, and illustrates their utility for understanding legal judgments by using them to interpret research findings on juror decision making, people's obedience to the law (e.g., paying taxes), and eyewitness memory. The paper concludes with a discussion of the advantages of modifying existing approaches to information processing to include the influence of affect on how legal actors reach judgments about law and legal process.

Modeling Adversaries in Counterterrorism Decisions Using Prospect Theory.

PubMed

Merrick, Jason R W; Leclerc, Philip

2016-04-01

Counterterrorism decisions have been an intense area of research in recent years. Both decision analysis and game theory have been used to model such decisions, and more recently approaches have been developed that combine the techniques of the two disciplines. However, each of these approaches assumes that the attacker is maximizing its utility. Experimental research shows that human beings do not make decisions by maximizing expected utility without aid, but instead deviate in specific ways such as loss aversion or likelihood insensitivity. In this article, we modify existing methods for counterterrorism decisions. We keep expected utility as the defender's paradigm to seek for the rational decision, but we use prospect theory to solve for the attacker's decision to descriptively model the attacker's loss aversion and likelihood insensitivity. We study the effects of this approach in a critical decision, whether to screen containers entering the United States for radioactive materials. We find that the defender's optimal decision is sensitive to the attacker's levels of loss aversion and likelihood insensitivity, meaning that understanding such descriptive decision effects is important in making such decisions. © 2014 Society for Risk Analysis.

Modified Navigation Instructions for Spatial Navigation Assistance Systems Lead to Incidental Spatial Learning

PubMed Central

Gramann, Klaus; Hoepner, Paul; Karrer-Gauss, Katja

2017-01-01

Spatial cognitive skills deteriorate with the increasing use of automated GPS navigation and a general decrease in the ability to orient in space might have further impact on independence, autonomy, and quality of life. In the present study we investigate whether modified navigation instructions support incidental spatial knowledge acquisition. A virtual driving environment was used to examine the impact of modified navigation instructions on spatial learning while using a GPS navigation assistance system. Participants navigated through a simulated urban and suburban environment, using navigation support to reach their destination. Driving performance as well as spatial learning was thereby assessed. Three navigation instruction conditions were tested: (i) a control group that was provided with classical navigation instructions at decision points, and two other groups that received navigation instructions at decision points including either (ii) additional irrelevant information about landmarks or (iii) additional personally relevant information (i.e., individual preferences regarding food, hobbies, etc.), associated with landmarks. Driving performance revealed no differences between navigation instructions. Significant improvements were observed in both modified navigation instruction conditions on three different measures of spatial learning and memory: subsequent navigation of the initial route without navigation assistance, landmark recognition, and sketch map drawing. Future navigation assistance systems could incorporate modified instructions to promote incidental spatial learning and to foster more general spatial cognitive abilities. Such systems might extend mobility across the lifespan. PMID:28243219

The dynamics of behavior in modified dictator games

PubMed Central

2017-01-01

We investigate the dynamics of individual pro-social behavior over time. The dynamics are tested by running the same experiment with the same subjects at several points in time. To exclude learning and reputation building, we employ non-strategic decision tasks and a sequential prisoners-dilemma as a control treatment. In the first wave, pro-social concerns explain a high share of individual decisions. Pro-social decisions decrease over time, however. In the final wave, most decisions can be accounted for by assuming pure selfishness. Stable behavior in the sense that subjects stick to their decisions over time is observed predominantly for purely selfish subjects. We offer two explanation for our results: diminishing experimenter demand effects and moral self-licensing. PMID:28448506

Superfund record of decision (EPA Region 2): Hercules Incorporated (Gibbstown Plant), Solid Waste Disposal Area, Operable Unit 3, Greenwich Township, Gloucester County, NJ, January 22, 1966

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

NONE

1996-10-01

This decision document presents the selected remedial action for the Solid Waste Disposal Area (SWDA) - Operable Unit 3, Hercules Incorporated, Higgins Plant (hereinafter Hercules site or site), in Greenwhich Township, Gloucester County, New Jersey. The Record of Decision (ROD) addresses all contaminated media at the SWDA portion of the site including soil and ground water. The selected remedy is a modified version of the `In-Place Containment` remedy of the Porposed Plan.

Helping patients to reach decisions regarding their treatment: Do 'non-directive' approaches cause systematic bias?

PubMed

MacInnes, Joy Anne; Salkovskis, Paul M; Wroe, Abigail; Hope, Tony

2015-11-01

Many patients want help in considering medical information relevant to treatment decisions they have to make or agree to. The present research investigated whether focussing on particular issues relevant to a medical treatment decision (using an apparently non-directive procedure) could systematically bias a treatment decision. In a randomized design, participants (community volunteers, n = 146) were given standard information about treatment of cardiac risk factors by medication (statins). There were four experimental interventions in which the participants focussed on the likely personal relevance of subsets of the information previously given (positive, negative, or mixed aspects) or on irrelevant information. Participants were asked to rate their anticipated likelihood of accepting treatment before and after the experimental intervention. The rating of acceptance of treatment was significantly increased by positive focussing; negative focussing did not significantly alter the decision rating. The results partially replicate similar studies in health screening decisions. Reasons for the differences in results from those obtained in screening studies are considered. It is suggested that negative focussing may have less effect in decisions in which there are few risks. Statement of contribution What is already known on this subject? Decision-making in the context of health behaviour change has been widely described, but there are few experimental studies testing hypothesised strategies. 'Non-directiveness' is often regarded as desirable because it supposedly allows exploration of the decision without influencing it. Previous studies on health screening (but not treatment) have shown that health decision outcomes can be systematically influenced by the way in which a 'non-directive' intervention is implemented. This can be accounted for by a modified subjective expected utility theory previously applied to both health screening and child vaccination decisions. What does this study add? The hypothetical decision about whether or not, in future, to take statins for elevated cholesterol levels was influenced by positive but not by negative focussing. Results were consistent with the theoretical framework. This study extends previous work on influences on the decision to undertake health screening and vaccination to treatment offered as secondary prevention. 'Non-directive' approaches to helping facilitate decisions can modify those decisions, and as such cannot be regarded as non-directive. © 2015 The British Psychological Society.

Advanced Information Technology in Simulation Based Life Cycle Design

NASA Technical Reports Server (NTRS)

Renaud, John E.

2003-01-01

In this research a Collaborative Optimization (CO) approach for multidisciplinary systems design is used to develop a decision based design framework for non-deterministic optimization. To date CO strategies have been developed for use in application to deterministic systems design problems. In this research the decision based design (DBD) framework proposed by Hazelrigg is modified for use in a collaborative optimization framework. The Hazelrigg framework as originally proposed provides a single level optimization strategy that combines engineering decisions with business decisions in a single level optimization. By transforming this framework for use in collaborative optimization one can decompose the business and engineering decision making processes. In the new multilevel framework of Decision Based Collaborative Optimization (DBCO) the business decisions are made at the system level. These business decisions result in a set of engineering performance targets that disciplinary engineering design teams seek to satisfy as part of subspace optimizations. The Decision Based Collaborative Optimization framework more accurately models the existing relationship between business and engineering in multidisciplinary systems design.

Does the Modified Gartland Classification Clarify Decision Making?

PubMed

Leung, Sophia; Paryavi, Ebrahim; Herman, Martin J; Sponseller, Paul D; Abzug, Joshua M

2018-01-01

The modified Gartland classification system for pediatric supracondylar fractures is often utilized as a communication tool to aid in determining whether or not a fracture warrants operative intervention. This study sought to determine the interobserver and intraobserver reliability of the Gartland classification system, as well as to determine whether there was agreement that a fracture warranted operative intervention regardless of the classification system. A total of 200 anteroposterior and lateral radiographs of pediatric supracondylar humerus fractures were retrospectively reviewed by 3 fellowship-trained pediatric orthopaedic surgeons and 2 orthopaedic residents and then classified as type I, IIa, IIb, or III. The surgeons then recorded whether they would treat the fracture nonoperatively or operatively. The κ coefficients were calculated to determine interobserver and intraobserver reliability. Overall, the Wilkins-modified Gartland classification has low-moderate interobserver reliability (κ=0.475) and high intraobserver reliability (κ=0.777). A low interobserver reliability was found when differentiating between type IIa and IIb (κ=0.240) among attendings. There was moderate-high interobserver reliability for the decision to operate (κ=0.691) and high intraobserver reliability (κ=0.760). Decreased interobserver reliability was present for decision to operate among residents. For fractures classified as type I, the decision to operate was made 3% of the time and 27% for type IIa. The decision was made to operate 99% of the time for type IIb and 100% for type III. There is almost full agreement for the nonoperative treatment of Type I fractures and operative treatment for type III fractures. There is agreement that type IIb fractures should be treated operatively and that the majority of type IIa fractures should be treated nonoperatively. However, the interobserver reliability for differentiating between type IIa and IIb fractures is low. Our results validate the Gartland classfication system as a method to help direct treatment of pediatric supracondylar humerus fractures, although the modification of the system, IIa versus IIb, seems to have limited reliability and utility. Terminology based on decision to treat may lead to a more clinically useful classification system in the evaluation and treatment of pediatric supracondylar humerus fractures. Level III-diagnostic studies.

A role of decision-making competency in science learning utilizing a social valuation framework

NASA Astrophysics Data System (ADS)

Katsuo, Akihito

2005-11-01

The role of decision-making in learning performance has been an occasional topic in the research literature in science education, but rarely has it been a central issue in the field. Nonetheless, recent studies regarding the topic in several fields other than education, such as cognitive neuroscience and social choice theory, indicate the fundamental importance(s) of the topic. This study focuses on a possible role of decision-making in science learning. Initially the study was designed to probe the decision-making ability of elementary school children with a modified version of the Iowa Gambling Task (IGT). The experiment involved six Montessori 3rd and 4th grade students as the experimental group and eight public school 3rd and 4th grade students as the control group. The result of the modified IGT revealed a tendency in choice trajectories favoring children at the Montessori school. However, the probabilistic value went below the statistically significant level set by the U test. A further study focused on the impact of better decision-making ability revealed in the first experiment on performances with a science learning module that emphasized collective reasoning. The instruction was based on a set of worksheets with multiple choices on which students were asked to make predictions with and to provide supportive arguments regarding outcomes of experiments introduced in the worksheet. Then the whole class was involved with a real experiment to see which choice was correct. The findings in the study indicated that the Montessori students often obtained higher scores than non-Montessori students in making decision with a tendency of consistency in terms of their choices of the alternatives on the worksheets. The findings of the experiments were supported by a correlational analysis that was performed at the end of study. Although no statistically significant correlations were found, there was a tendency for positively associative shifts between the scores of the modified IGT and the scores for the performances on the science module for the Montessori students.

Using real options analysis to support strategic management decisions

NASA Astrophysics Data System (ADS)

Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

2013-12-01

Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

Who do you trust? The impact of facial emotion and behaviour on decision making

PubMed Central

Campellone, Timothy R.; Kring, Ann M.

2014-01-01

During social interactions, we use available information to guide our decisions, including behaviour and emotional displays. In some situations, behaviour and emotional displays may be incongruent, complicating decision making. This study had two main aims: first, to investigate the independent contributions of behaviour and facial displays of emotion on decisions to trust, and, second, to examine what happens when the information being signalled by a facial display is incongruent with behaviour. Participants played a modified version of the Trust Game in which they learned simulated players’ behaviour with or without concurrent displays of facial emotion. Results indicated that displays of anger, but not happiness, influenced decisions to trust during initial encounters. Over the course of repeated interactions, however, emotional displays consistent with an established pattern of behaviour made independent contributions to decision making, strengthening decisions to trust. When facial display and behaviour were incongruent, participants used current behaviour to inform decision making. PMID:23017055

Transcranial Alternating Current Stimulation Modulates Risky Decision Making in a Frequency-Controlled Experiment

PubMed Central

Awasthi, Bhuvanesh

2017-01-01

Abstract In this study, we investigated the effect of transcranial alternating current stimulation (tACS) on voluntary risky decision making and executive control in humans. Stimulation was delivered online at 5 Hz (θ), 10 Hz (α), 20 Hz (β), and 40 Hz (γ) on the left and right frontal area while participants performed a modified risky decision-making task. This task allowed participants to voluntarily select between risky and certain decisions associated with potential gains or losses, while simultaneously measuring the cognitive control component (voluntary switching) of decision making. The purpose of this experimental design was to test whether voluntary risky decision making and executive control can be modulated with tACS in a frequency-specific manner. Our results revealed a robust effect of a 20-Hz stimulation over the left prefrontal area that significantly increased voluntary risky decision making, which may suggest a possible link between risky decision making and reward processing, underlined by β-oscillatory activity. PMID:29379865

Transcranial Alternating Current Stimulation Modulates Risky Decision Making in a Frequency-Controlled Experiment.

PubMed

Yaple, Zachary; Martinez-Saito, Mario; Feurra, Matteo; Shestakova, Anna; Klucharev, Vasily

2017-01-01

In this study, we investigated the effect of transcranial alternating current stimulation (tACS) on voluntary risky decision making and executive control in humans. Stimulation was delivered online at 5 Hz (θ), 10 Hz (α), 20 Hz (β), and 40 Hz (γ) on the left and right frontal area while participants performed a modified risky decision-making task. This task allowed participants to voluntarily select between risky and certain decisions associated with potential gains or losses, while simultaneously measuring the cognitive control component (voluntary switching) of decision making. The purpose of this experimental design was to test whether voluntary risky decision making and executive control can be modulated with tACS in a frequency-specific manner. Our results revealed a robust effect of a 20-Hz stimulation over the left prefrontal area that significantly increased voluntary risky decision making, which may suggest a possible link between risky decision making and reward processing, underlined by β-oscillatory activity.

An Interactive Decision Support System for Scheduling Fighter Pilot Training

DTIC Science & Technology

2002-03-26

Deitel , H.M. and Deitel , P.J. C: How to Program , 2nd ed., Prentice Hall, 1994. 8. Deitel , H.M. and Deitel , P.J. How to Program Java...Visual Basic Programming language, the Excel tool is modified in several ways. Scheduling Dispatch rules are implemented to automatically generate... programming language, the Excel tool was modified in several ways. Scheduling dispatch rules are implemented to automatically generate

An Analysis of Implementation of the Defense Travel System at the Naval Postgraduate School

DTIC Science & Technology

2002-03-01

processing called the Shared Services Office. The justification for this reorganization decision was to eliminate some inefficiency in the travel process...Table 2 shows the pros, cons, and issues surrounding the decision to create a Shared Services Office. Travel Manager was also modified to submit...service Location/space issues Expertise is centralized Travelers waiting for shared services concept to fail Coordinating the best order for

25 CFR 584.3 - How do I appeal a notice of violation, proposed civil fine assessment, order of temporary closure...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false How do I appeal a notice of violation, proposed civil fine assessment, order of temporary closure, the Chair's decision to void or modify a management contract, the Commission's proposal to remove a certificate of self-regulation, the Chair's decision to approve or object to a tribal gaming regulatory...

25 CFR 585.3 - How do I appeal a notice of violation, proposed civil fine assessment, order of temporary closure...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false How do I appeal a notice of violation, proposed civil fine assessment, order of temporary closure, the Chair's decision to void or modify a management contract, the Commission's proposal to remove a certificate of self regulation, the Chair's decision to approve or object to a tribal gaming regulatory...

Policy-Led Comparative Environmental Risk Assessment of Genetically Modified Crops: Testing for Increased Risk Rather Than Profiling Phenotypes Leads to Predictable and Transparent Decision-Making

PubMed Central

Raybould, Alan; Macdonald, Phil

2018-01-01

We describe two contrasting methods of comparative environmental risk assessment for genetically modified (GM) crops. Both are science-based, in the sense that they use science to help make decisions, but they differ in the relationship between science and policy. Policy-led comparative risk assessment begins by defining what would be regarded as unacceptable changes when the use a particular GM crop replaces an accepted use of another crop. Hypotheses that these changes will not occur are tested using existing or new data, and corroboration or falsification of the hypotheses is used to inform decision-making. Science-led comparative risk assessment, on the other hand, tends to test null hypotheses of no difference between a GM crop and a comparator. The variables that are compared may have little or no relevance to any previously stated policy objective and hence decision-making tends to be ad hoc in response to possibly spurious statistical significance. We argue that policy-led comparative risk assessment is the far more effective method. With this in mind, we caution that phenotypic profiling of GM crops, particularly with omics methods, is potentially detrimental to risk assessment. PMID:29755975

Evaluation and determination of soil remediation schemes using a modified AHP model and its application in a contaminated coking plant.

PubMed

Li, Xingang; Li, Jia; Sui, Hong; He, Lin; Cao, Xingtao; Li, Yonghong

2018-07-05

Soil remediation has been considered as one of the most difficult pollution treatment tasks due to its high complexity in contaminants, geological conditions, usage, urgency, etc. The diversity in remediation technologies further makes quick selection of suitable remediation schemes much tougher even the site investigation has been done. Herein, a sustainable decision support hierarchical model has been developed to select, evaluate and determine preferred soil remediation schemes comprehensively based on modified analytic hierarchy process (MAHP). This MAHP method combines competence model and the Grubbs criteria with the conventional AHP. It not only considers the competence differences among experts in group decision, but also adjusts the big deviation caused by different experts' preference through sample analysis. This conversion allows the final remediation decision more reasonable. In this model, different evaluation criteria, including economic effect, environmental effect and technological effect, are employed to evaluate the integrated performance of remediation schemes followed by a strict computation using above MAHP. To confirm the feasibility of this developed model, it has been tested by a benzene workshop contaminated site in Beijing coking plant. Beyond soil remediation, this MAHP model would also be applied in other fields referring to multi-criteria group decision making. Copyright © 2018 Elsevier B.V. All rights reserved.

Portfolio Analysis Tool

NASA Technical Reports Server (NTRS)

Barth, Tim; Zapata, Edgar; Benjamin, Perakath; Graul, Mike; Jones, Doug

2005-01-01

Portfolio Analysis Tool (PAT) is a Web-based, client/server computer program that helps managers of multiple projects funded by different customers to make decisions regarding investments in those projects. PAT facilitates analysis on a macroscopic level, without distraction by parochial concerns or tactical details of individual projects, so that managers decisions can reflect the broad strategy of their organization. PAT is accessible via almost any Web-browser software. Experts in specific projects can contribute to a broad database that managers can use in analyzing the costs and benefits of all projects, but do not have access for modifying criteria for analyzing projects: access for modifying criteria is limited to managers according to levels of administrative privilege. PAT affords flexibility for modifying criteria for particular "focus areas" so as to enable standardization of criteria among similar projects, thereby making it possible to improve assessments without need to rewrite computer code or to rehire experts, and thereby further reducing the cost of maintaining and upgrading computer code. Information in the PAT database and results of PAT analyses can be incorporated into a variety of ready-made or customizable tabular or graphical displays.

Health-Related Decision-Making in HIV Disease

PubMed Central

Doyle, Katie L.; Woods, Steven Paul; Morgan, Erin E.; Iudicello, Jennifer E.; Cameron, Marizela V.; Gilbert, Paul E.; Beltran, Jessica

2016-01-01

Individuals living with HIV show moderate decision-making deficits, though no prior studies have evaluated the ability to make optimal health-related decisions across the HIV healthcare continuum. Forty-three HIV+ individuals with HIV−associated neurocognitive disorders (HAND+), 50 HIV+ individuals without HAND (HAND−), and 42 HIV− participants were administered two measures of health-related decision-making as part of a comprehensive neuropsychological battery: 1) The Decisional Conflict Scale (DCS), and 2) The Modified UCSD Brief Assessment for Capacity to Consent (UBACC-T). Multiple regression analyses revealed that HAND was an independent predictor of both the DCS and the UBACC-T, such that the HAND+ sample evidenced significantly poorer scores relative to comparison groups. Within the HIV+ sample, poorer health-related decision-making was associated with worse performance on tests of episodic memory, risky decision-making, and health literacy. Findings indicate that individuals with HAND evidence moderate deficits in effectively comprehending and evaluating various health-related choices. PMID:26946300

Led into temptation? Rewarding brand logos bias the neural encoding of incidental economic decisions.

PubMed

Murawski, Carsten; Harris, Philip G; Bode, Stefan; Domínguez D, Juan F; Egan, Gary F

2012-01-01

Human decision-making is driven by subjective values assigned to alternative choice options. These valuations are based on reward cues. It is unknown, however, whether complex reward cues, such as brand logos, may bias the neural encoding of subjective value in unrelated decisions. In this functional magnetic resonance imaging (fMRI) study, we subliminally presented brand logos preceding intertemporal choices. We demonstrated that priming biased participants' preferences towards more immediate rewards in the subsequent temporal discounting task. This was associated with modulations of the neural encoding of subjective values of choice options in a network of brain regions, including but not restricted to medial prefrontal cortex. Our findings demonstrate the general susceptibility of the human decision making system to apparently incidental contextual information. We conclude that the brain incorporates seemingly unrelated value information that modifies decision making outside the decision-maker's awareness.

Judgment and decision making.

PubMed

Mellers, B A; Schwartz, A; Cooke, A D

1998-01-01

For many decades, research in judgment and decision making has examined behavioral violations of rational choice theory. In that framework, rationality is expressed as a single correct decision shared by experimenters and subjects that satisfies internal coherence within a set of preferences and beliefs. Outside of psychology, social scientists are now debating the need to modify rational choice theory with behavioral assumptions. Within psychology, researchers are debating assumptions about errors for many different definitions of rationality. Alternative frameworks are being proposed. These frameworks view decisions as more reasonable and adaptive that previously thought. For example, "rule following." Rule following, which occurs when a rule or norm is applied to a situation, often minimizes effort and provides satisfying solutions that are "good enough," though not necessarily the best. When rules are ambiguous, people look for reasons to guide their decisions. They may also let their emotions take charge. This chapter presents recent research on judgment and decision making from traditional and alternative frameworks.

Experts in offside decision making learn to compensate for their illusory perceptions.

PubMed

Put, Koen; Baldo M, V C; Cravo, André M; Wagemans, Johan; Helsen, Werner F

2013-12-01

In association football, the flash-lag effect appears to be a viable explanation for erroneous offside decision making. Due to this spatiotemporal illusion, assistant referees (ARs) perceive the player who receives the ball ahead of his real position. In this experiment, a laboratory decision-making task was used to demonstrate that international top-class ARs, compared with amateur soccer players, do not have superior perceptual sensitivity. They clearly modify their decision criterion according to the contextual needs and, therefore, show a higher response bias toward not responding to the stimulus, in particular in the most difficult situations. Thus, international ARs show evidence for response-level compensation, resulting in a specific cost (i.e., more misses), which clearly reflects the use of particular (cognitive) strategies. In summary, it appears that experts in offside decision making can be distinguished from novices more on the cognitive or decision-making level than on the perceptual level.

Led into Temptation? Rewarding Brand Logos Bias the Neural Encoding of Incidental Economic Decisions

PubMed Central

Murawski, Carsten; Harris, Philip G.; Bode, Stefan; Domínguez D., Juan F.; Egan, Gary F.

2012-01-01

Human decision-making is driven by subjective values assigned to alternative choice options. These valuations are based on reward cues. It is unknown, however, whether complex reward cues, such as brand logos, may bias the neural encoding of subjective value in unrelated decisions. In this functional magnetic resonance imaging (fMRI) study, we subliminally presented brand logos preceding intertemporal choices. We demonstrated that priming biased participants' preferences towards more immediate rewards in the subsequent temporal discounting task. This was associated with modulations of the neural encoding of subjective values of choice options in a network of brain regions, including but not restricted to medial prefrontal cortex. Our findings demonstrate the general susceptibility of the human decision making system to apparently incidental contextual information. We conclude that the brain incorporates seemingly unrelated value information that modifies decision making outside the decision-maker's awareness. PMID:22479547

Forced-choice decision-making in modified trolley dilemma situations: a virtual reality and eye tracking study

PubMed Central

Skulmowski, Alexander; Bunge, Andreas; Kaspar, Kai; Pipa, Gordon

2014-01-01

Based on the frameworks of dual-process theories, we examined the interplay between intuitive and controlled cognitive processes related to moral and social judgments. In a virtual reality (VR) setting we performed an experiment investigating the progression from fast, automatic decisions towards more controlled decisions over multiple trials in the context of a sacrificing scenario. We repeatedly exposed participants to a modified ten-to-one version and to three one-to-one versions of the trolley dilemma in VR and varied avatar properties, such as their gender and ethnicity, and their orientation in space. We also investigated the influence of arousing music on decisions. Our experiment replicated the behavioral pattern observed in studies using text versions of the trolley dilemma, thereby validating the use of virtual environments in research on moral judgments. Additionally, we found a general tendency towards sacrificing male individuals which correlated with socially desirable responding. As indicated by differences in response times, the ten-to-one version of the trolley dilemma seems to be faster to decide than decisions requiring comparisons based on specific avatar properties as a result of differing moral content. Building upon research on music-based emotion induction, we used music to induce emotional arousal on a physiological level as measured by pupil diameter. We found a specific temporal signature displaying a peak in arousal around the moment of decision. This signature occurs independently of the overall arousal level. Furthermore, we found context-dependent gaze durations during sacrificing decisions, leading participants to look prolonged at their victim if they had to choose between avatars differing in gender. Our study confirmed that moral decisions can be explained within the framework of dual-process theories and shows that pupillometric measurements are a promising tool for investigating affective responses in dilemma situations. PMID:25565997

Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates.

PubMed

Jayanti, Anuradha; Neuvonen, Markus; Wearden, Alison; Morris, Julie; Foden, Philip; Brenchley, Paul; Mitra, Sandip

2015-11-14

Medical decision-making is critical to patient survival and well-being. Patients with end stage renal disease (ESRD) are faced with incrementally complex decision-making throughout their treatment journey. The extent to which patients seek involvement in the decision-making process and factors which influence these in ESRD need to be understood. 535 ESRD patients were enrolled into the cross-sectional study arm and 30 patients who started dialysis were prospectively evaluated. Patients were enrolled into 3 groups- 'predialysis' (group A), 'in-centre' haemodialysis (HD) (group B) and self-care HD (93 % at home-group C) from across five tertiary UK renal centres. The Autonomy Preference Index (API) has been employed to study patient preferences for information-seeking (IS) and decision-making (DM). Demographic, psychosocial and neuropsychometric assessments are considered for analyses. 458 complete responses were available. API items have high internal consistency in the study population (Cronbach's alpha > 0.70). Overall and across individual study groups, the scores for information-seeking and decision-making are significantly different indicating that although patients had a strong preference to be well informed, they were more neutral in their preference to participate in DM (p < 0.05). In the age, education and study group adjusted multiple linear regression analysis, lower age, female gender, marital status; higher API IS scores and white ethnicity background were significant predictors of preference for decision-making. DM scores were subdivided into tertiles to identify variables associated with high (DM > 70: and low DM (≤30) scores. This shows association of higher DM scores with lower age, lower comorbidity index score, higher executive brain function, belonging in the self-caring cohort and being unemployed. In the prospectively studied cohort of predialysis patients, there was no change in decision-making preference scores after commencement of dialysis. ESRD patients prefer to receive information, but this does not always imply active involvement in decision-making. By understanding modifiable and non-modifiable factors which affect patient preferences for involvement in healthcare decision-making, health professionals may acknowledge the need to accommodate individual patient preferences to the extent determined by the individual patient factors.

Effect of clinical decision rules, patient cost and malpractice information on clinician brain CT image ordering: a randomized controlled trial.

PubMed

Gimbel, Ronald W; Pirrallo, Ronald G; Lowe, Steven C; Wright, David W; Zhang, Lu; Woo, Min-Jae; Fontelo, Paul; Liu, Fang; Connor, Zachary

2018-03-12

The frequency of head computed tomography (CT) imaging for mild head trauma patients has raised safety and cost concerns. Validated clinical decision rules exist in the published literature and on-line sources to guide medical image ordering but are often not used by emergency department (ED) clinicians. Using simulation, we explored whether the presentation of a clinical decision rule (i.e. Canadian CT Head Rule - CCHR), findings from malpractice cases related to clinicians not ordering CT imaging in mild head trauma cases, and estimated patient out-of-pocket cost might influence clinician brain CT ordering. Understanding what type and how information may influence clinical decision making in the ordering advanced medical imaging is important in shaping the optimal design and implementation of related clinical decision support systems. Multi-center, double-blinded simulation-based randomized controlled trial. Following standardized clinical vignette presentation, clinicians made an initial imaging decision for the patient. This was followed by additional information on decision support rules, malpractice outcome review, and patient cost; each with opportunity to modify their initial order. The malpractice and cost information differed by assigned group to test the any temporal relationship. The simulation closed with a second vignette and an imaging decision. One hundred sixteen of the 167 participants (66.9%) initially ordered a brain CT scan. After CCHR presentation, the number of clinicians ordering a CT dropped to 76 (45.8%), representing a 21.1% reduction in CT ordering (P = 0.002). This reduction in CT ordering was maintained, in comparison to initial imaging orders, when presented with malpractice review information (p = 0.002) and patient cost information (p = 0.002). About 57% of clinicians changed their order during study, while 43% never modified their imaging order. This study suggests that ED clinician brain CT imaging decisions may be influenced by clinical decision support rules, patient out-of-pocket cost information and findings from malpractice case review. NCT03449862 , February 27, 2018, Retrospectively registered.

Multiobjective Decision Making Policies and Coordination Mechanisms in Hierarchical Organizations: Results of an Agent-Based Simulation

PubMed Central

2014-01-01

This paper analyses how different coordination modes and different multiobjective decision making approaches interfere with each other in hierarchical organizations. The investigation is based on an agent-based simulation. We apply a modified NK-model in which we map multiobjective decision making as adaptive walk on multiple performance landscapes, whereby each landscape represents one objective. We find that the impact of the coordination mode on the performance and the speed of performance improvement is critically affected by the selected multiobjective decision making approach. In certain setups, the performances achieved with the more complex multiobjective decision making approaches turn out to be less sensitive to the coordination mode than the performances achieved with the less complex multiobjective decision making approaches. Furthermore, we present results on the impact of the nature of interactions among decisions on the achieved performance in multiobjective setups. Our results give guidance on how to control the performance contribution of objectives to overall performance and answer the question how effective certain multiobjective decision making approaches perform under certain circumstances (coordination mode and interdependencies among decisions). PMID:25152926

29 CFR 500.263 - Authority of the Secretary.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Administrative Law Judge § 500.263 Authority of the Secretary. The Secretary may modify or vacate the Decision... inconsistent with a policy or precedent established by the Department of Labor, (b) Encompasses determinations...

Study of application of adaptive systems to the exploration of the solar system. Volume 2: Survey of solar system missions

NASA Technical Reports Server (NTRS)

1973-01-01

Ways in which human intelligence might be simulated onboard an unmanned mission to achieve some of the decision making capability or adaptability of the manned mission are examined. The relative cost and simplicity advantages of the unmanned spacecraft missions are emphasized. Reliable techniques for making onboard decisions and for modifying mission science operations in response to the findings are analyzed.

Shared decision making for patients living with inflammatory arthritis.

PubMed

Palmer, Deborah; El Miedany, Yasser

Providing adequate care for people with inflammatory arthritis is an ongoing challenge. In recent years significant progress has been made in the treatment of inflammatory arthritic conditions. The availability of a wide range of disease-modifying anti-rheumatic drugs as well as biologic therapies has not only improved treatment, but also made treatment decisions much more complex. This wider range of improved treatment options happened at the same time as a clear move towards patient-centred care and implementing shared decision making for both medical and surgical conditions. Implementing shared decision making has been reported to be associated with higher satisfaction and better adherence to therapy. Electronic shared decision making has more recently been suggested as a tool for clinical practice. The aim of this article is to look at further integrating shared decision making in standard rheumatology practice in view of the available evidence and the outcomes of a study looking at a recently developed patient shared decision guide.

Racial and ethnic variation in partner perspectives about the breast cancer treatment decision-making experience.

PubMed

Lillie, Sarah E; Janz, Nancy K; Friese, Christopher R; Graff, John J; Schwartz, Kendra; Hamilton, Ann S; Gay, Brittany Bartol; Katz, Steven J; Hawley, Sarah T

2014-01-01

To characterize the perspectives of partners (husbands or significant others) of patients with breast cancer in the treatment decision-making process and to evaluate racial and ethnic differences in decision outcomes. A cross-sectional survey. Los Angeles, CA, and Detroit, MI. 517 partners of a population-based sample of patients with breast cancer four years post-treatment. A self-administered mailed questionnaire. Chi-square tests and logistic regression were used to assess associations between race and ethnicity and decision outcomes. Decision regret and three elements of the decision process: information received, actual involvement, and desired involvement. Most partners reported receiving sufficient information (77%), being involved in treatment decisions (74%), and having sufficient involvement (73%). Less-acculturated Hispanic partners were more likely than their Caucasian counterparts to report high decision regret (45% versus 14%, p<0.001). Factors significantly associated (p<0.05) with high decision regret were insufficient receipt of treatment information, low involvement in decision making, and a desire for more involvement. Partners were generally positive regarding their perspectives about participating in the breast cancer treatment decision-making process. However, less acculturated Hispanic partners were most vulnerable to decision regret. In addition, high decision regret was associated with modifiable elements of the decision-making process. Attention should be paid to ensuring racial and ethnic minority partners are sufficiently involved in breast cancer treatment decisions and receive decision support.

50 CFR 221.60 - What are the requirements for the ALJ's decision?

Code of Federal Regulations, 2010 CFR

2010-10-01

... make the findings of fact (such as rulings on materiality and on the admissibility of evidence); and... preliminary condition or prescription should be adopted, modified, or rejected, or whether any proposed...

7 CFR 1.660 - What are the requirements for the ALJ's decision?

Code of Federal Regulations, 2010 CFR

2010-01-01

... to make the findings of fact (such as rulings on materiality and on the admissibility of evidence... preliminary condition or prescription should be adopted, modified, or rejected, or whether any proposed...

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

PubMed

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

2017-01-01

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

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

PubMed Central

2012-01-01

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

The modified "Rockfall Hazard Rating System": a new tool for roads risk assessment

NASA Astrophysics Data System (ADS)

Budetta, P.

2003-04-01

This paper contains a modified method for the analysis of rockfall hazard along roads and motorways. The method is derived from that one developed by Pierson et alii at the Oregon State Highway Division. The Rockfall Hazard Rating System (RHRS) provides a rational way to make informed decisions on where and how to spend construction funds. An exponential scoring graph is used to represent the increase in hazard that is reflected in the nine categories forming the classification (slope height, ditch effectiveness, average vehicle risk, percent of decision site distance, roadway width, geological character, quantity of rockfall/event, climate and rock fall history). The resulting total score contains the essential elements regarding the evaluation of the consequences ("cost of failure"). In the modified method, the rating for the categories "ditch effectiveness", "decision sight distance", "rodway width", "geologic characteristic" and "climate and water circulation" have been rendered more easy and objective. The main modifications regard the introduction of the Romana's Slope Mass Rating improving the estimate of the geologic characteristics, of the volume of the potentially unstable blocks and underground water circulation. Other modifications regard the scoring determination for the categories "decision sight distance" and "road geometry". For these categories, the Italian National Council's standards (CNR) have been used. The method must be applied in both the traffic directions because the percentage of reduction in the "decision sight distance" greatly affects the results. An application of the method to a 2-km-long section of the Sorrentine road (n° 145) in Southern Italy was pointed out. A high traffic intensity affects the entire section of the road and rockfalls periodically cause casualties, as well as a large amount of damage and traffic interruptions. The method was applied on seven cross section traces of slopes adjacent to the Sorrentine road and the total final scores range between 275 and 450. For these slopes, the analysis shows that the risk is unacceptable and it must reduced using urgent remedial works. Further applications in other geological environments are welcomed.

Development of a Shared Decision Making coding system for analysis of patient-healthcare provider encounters

PubMed Central

Clayman, Marla L.; Makoul, Gregory; Harper, Maya M.; Koby, Danielle G.; Williams, Adam R.

2012-01-01

Objectives Describe the development and refinement of a scheme, Detail of Essential Elements and Participants in Shared Decision Making (DEEP-SDM), for coding Shared Decision Making (SDM) while reporting on the characteristics of decisions in a sample of patients with metastatic breast cancer. Methods The Evidence-Based Patient Choice instrument was modified to reflect Makoul and Clayman’s Integrative Model of SDM. Coding was conducted on video recordings of 20 women at the first visit with their medical oncologists after suspicion of disease progression. Noldus Observer XT v.8, a video coding software platform, was used for coding. Results The sample contained 80 decisions (range: 1-11), divided into 150 decision making segments. Most decisions were physician-led, although patients and physicians initiated similar numbers of decision-making conversations. Conclusion DEEP-SDM facilitates content analysis of encounters between women with metastatic breast cancer and their medical oncologists. Despite the fractured nature of decision making, it is possible to identify decision points and to code each of the Essential Elements of Shared Decision Making. Further work should include application of DEEP-SDM to non-cancer encounters. Practice Implications: A better understanding of how decisions unfold in the medical encounter can help inform the relationship of SDM to patient-reported outcomes. PMID:22784391

Do Amnesic Patients with Korsakoff's Syndrome Use Feedback when Making Decisions under Risky Conditions? An Experimental Investigation with the Game of Dice Task with and without Feedback

ERIC Educational Resources Information Center

Brand, Matthias; Pawlikowski, Mirko; Labudda, Kirsten; Laier, Christian; von Rothkirch, Nadine; Markowitsch, Hans J.

2009-01-01

We investigated the role of feedback processing in decision making under risk conditions in 50 patients with amnesia in the course of alcoholic Korsakoff's syndrome (KS). Half of the patients were administered the Game of Dice Task (GDT) and the remaining 25 patients were examined with a modified version of the GDT in which no feedback was…

Different contributions of internal reviewers and external experts to labelling decisions on therapeutic indications in new drug reviews in Japan.

PubMed

Yokota, M; Kusama, M; Matsuki, N; Ono, S

2013-12-01

External experts play an important role in shaping regulatory decisions in the new drug review process in the United States, Europe and Japan. No rigorous study has been performed addressing how and to what extent external experts, in contrast to internal reviewers in the agency, influence the regulatory decisions during new drug reviews. We examined their contributions in Japanese regulatory reviews in contrast to the internal reviewers, focusing on the labelling decision on therapeutic indications. With the data set of 219 new molecular entities (NMEs) approved in Japan from 2000 to 2009, we observed how proposed indications in labelling were modified in a stepwise manner during the review process and conducted multinomial logistic analysis to examine the possible mechanism behind. We found that interim assessment of indications by the internal reviewers was modified substantially by the influence of the external experts in about 20% of the 219 NMEs. Our analysis suggested that internal reviewers provided their opinion mainly based on strict review discipline, whereas external experts added flexibility and reality to their reviews. Our analysis revealed different evaluations between internal reviewers and external experts during regulatory discussions in new drug reviews and how the external panel contributes to changing internal decisions. This study provides a new and quantitative approach to better label setting by emphasizing the contributions of each stakeholder in new drug reviews, which would improve the efficiency, quality and transparency of new drug reviews to enhance public health. © 2013 John Wiley & Sons Ltd.

Parental decisions following prenatal diagnosis of sex chromosome aneuploidy in Hong Kong.

PubMed

So, Po Lam; Cheng, Kwun Yue Yvonne; Cheuk, Kwan Yiu; Chiu, Wan Kam; Mak, Shui Lam; Mok, Sau Lan; Lo, Tsz Kin; Yung, Wai Kuen; Lo, Fai Man; Chung, Hon Yin Brian; Kan, Sik Yau Anita; Lee, Chin Peng; Tang, Hoi Yin Mary

2017-12-01

According to the published work, pregnancy termination rates due to prenatal diagnosis of fetal sex chromosome aneuploidies (SCA) vary widely. Some potentially modifiable and non-modifiable factors have been reported to be associated with parental decision. This study aimed to evaluate the rate of pregnancy termination for fetal SCA and the factors influencing parents' decisions in Hong Kong. This was a 21-year retrospective cohort study of parents' decisions following prenatal diagnosis of SCA. Univariate and multivariate analyses for the association between demographic factors, prenatal factors, or counseling provided and decision-making were conducted. The study included 399 pregnancies with prenatal diagnosis of SCA and the overall termination rate was 55.6% (91.7%, 48.0%, 23.4%, 4.8%, and 22.7% for 45,X, 47,XXY, 47,XXX, 47,XYY, and mosaicism, respectively). Pregnancies with ultrasound abnormalities were associated with higher termination rates than pregnancies with normal ultrasound findings (91.3% vs 28.3%, P < 0.0001). From multivariate regression analysis on 226 pregnancies with normal ultrasound examination, a higher likelihood to terminate was found in pregnancies affected by 45,X and 47,XXY (adjusted odds ratio, 4.72, P < 0.0001). Increased maternal age and history of infertility were associated with lower likelihood to terminate (adjusted odds ratio, 0.9, P = 0.012; and 5.12, P = 0.038, respectively). The pregnancy termination rate declined over time. A significant correlation was found between the termination of SCA-affected pregnancy and the presence of fetal sonographic abnormalities, type of SCA, maternal age, and presence of infertility. © 2017 Japan Society of Obstetrics and Gynecology.

Rheumatoid Arthritis Patients' Motivations for Accepting or Resisting Disease-Modifying Antirheumatic Drug Treatment Regimens.

PubMed

Shaw, Yomei; Metes, Ilinca D; Michaud, Kaleb; Donohue, Julie M; Roberts, Mark S; Levesque, Marc C; Chang, Judy C

2018-04-01

Patient refusal of and nonadherence to treatment with disease-modifying antirheumatic drugs (DMARDs) can adversely affect disease outcomes in rheumatoid arthritis (RA). This qualitative study describes how RA patients' feelings in response to experiences and information affected their decisions to accept (agree to adopt, initiate, and implement) or resist (refuse, avoid, and discontinue) DMARD treatment regimens. A total of 48 RA patients were interviewed about their experiences making decisions about DMARDs. The interviews were transcribed, coded, and analyzed for themes related to their internal motivations for accepting or resisting treatment regimens, using a narrative analysis approach. In addition to feelings about the necessity and dangers of medications, patients' feelings towards their identity as an ill person, the act of taking medication, and the decision process itself were important drivers of patient's decisions. For patients' motivations to accept treatment regimens, 2 themes emerged: a desire to return to a normal life, and fear of future disability due to RA. For motivations to resist treatment regimens, 5 themes emerged: fear of medications, maintaining control over health, denial of sick identity, disappointment with treatment, and feeling overwhelmed by the cognitive burden of deciding. Feelings in response to experiences and information played a major role in how patients weighed the benefits and costs of treatment options, suggesting that addressing patients' feelings may be important when rheumatologists counsel about therapeutic options. Further research is needed to learn how best to address patients' feelings throughout the treatment decision-making process. © 2017, American College of Rheumatology.

Ten years of the International Patient Decision Aid Standards Collaboration: evolution of the core dimensions for assessing the quality of patient decision aids

PubMed Central

2013-01-01

In 2003, the International Patient Decision Aid Standards (IPDAS) Collaboration was established to enhance the quality and effectiveness of patient decision aids by establishing an evidence-informed framework for improving their content, development, implementation, and evaluation. Over this 10 year period, the Collaboration has established: a) the background document on 12 core dimensions to inform the original modified Delphi process to establish the IPDAS checklist (74 items); b) the valid and reliable IPDAS instrument (47 items); and c) the IPDAS qualifying (6 items), certifying (6 items + 4 items for screening), and quality criteria (28 items). The objective of this paper is to describe the evolution of the IPDAS Collaboration and discuss the standardized process used to update the background documents on the theoretical rationales, evidence and emerging issues underlying the 12 core dimensions for assessing the quality of patient decision aids. PMID:24624947

Job strain, occupational category, and hypertension prevalence: The Multi-Ethnic Study of Atherosclerosis

PubMed Central

Landsbergis, Paul A.; Diez-Roux, Ana V.; Fujishiro, Kaori; Baron, Sherry; Kaufman, Joel D.; Meyer, John D.; Koutsouras, George; Shimbo, Daichi; Shrager, Sandi; Stukovsky, Karen Hinckley; Szklo, Moyses

2015-01-01

Objective To assess associations of occupational categories and job characteristics with prevalent hypertension. Methods We analyzed 2,517 Multi-Ethnic Study of Atherosclerosis (MESA) participants, working 20+ hours per week, in 2002–4. Results Higher job decision latitude was associated with a lower prevalence of hypertension, prevalence ratio (PR)=0.78 (95% CI 0.66–0.91) for the top vs. bottom quartile of job decision latitude. However, associations differed by occupation: decision latitude was associated with a higher prevalence of hypertension in healthcare support occupations (interaction p=.02). Occupation modified associations of gender with hypertension: a higher prevalence of hypertension in women (vs men) was observed in healthcare support and in blue-collar occupations (interaction p=.03). Conclusions Lower job decision latitude is associated with hypertension prevalence in many occupations. Further research is needed to determine reasons for differential impact of decision latitude and gender on hypertension across occupations. PMID:26539765

A model for making project funding decisions at the National Cancer Institute.

PubMed

Hall, N G; Hershey, J C; Kessler, L G; Stotts, R C

1992-01-01

This paper describes the development of a model for making project funding decisions at The National Cancer Institute (NCI). The American Stop Smoking Intervention Study (ASSIST) is a multiple-year, multiple-site demonstration project, aimed at reducing smoking prevalence. The initial request for ASSIST proposals was answered by about twice as many states as could be funded. Scientific peer review of the proposals was the primary criterion used for funding decisions. However, a modified Delphi process made explicit several criteria of secondary importance. A structured questionnaire identified the relative importance of these secondary criteria, some of which we incorporated into a composite preference function. We modeled the proposal funding decision as a zero-one program, and adjusted the preference function and available budget parametrically to generate many suitable outcomes. The actual funding decision, identified by our model, offers significant advantages over manually generated solutions found by experts at NCI.

[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.

43 CFR 45.60 - What are the requirements for the ALJ's decision?

Code of Federal Regulations, 2010 CFR

2010-10-01

... law necessary to make the findings of fact (such as rulings on materiality and on the admissibility of... whether any preliminary condition or prescription should be adopted, modified, or rejected, or whether any...

Evaluating the 2008 consensus conference on genetically modified foods in Taiwan.

PubMed

Fan, Mei-Fang

2015-07-01

Genetically modified foods have become one of the most popular topics for deliberative exercises involving ordinary citizens worldwide. This paper examines the Taiwanese consensus conference on GM foods held in June 2008, and the implications and limitations of the public deliberations. The consensus conference facilitated multiparty dialogues and enhanced citizens' knowledge, and affected their attitudes. This study demonstrates the ways contextual factors have influenced the outcome of the citizens' deliberative practices, including the government's conventional technocratic decision-making style, the strong influence of the U.S. government, the political and technological culture, the government's framing of economic development concerns, and a lack of pressure from civil society to compel the government to formally respond to their concerns. The consensus conference had a limited effect on policy decision-making, and seemed to serve as a socio-political experiment. © The Author(s) 2013.

Patient-specific risk factors for infection in arthroplasty procedure.

PubMed

Marmor, S; Kerroumi, Y

2016-02-01

All patients are not equally at risk when it comes to postoperative infections, whether the risks are related to the environment or the patient. Patient-specific infection risk factors for arthroplasty should be a focal point during the preoperative consultation as they impact the treatment decision. Eighty percent of patients have at least one modifiable infection risk factor. These risk factors must be corrected preoperatively whenever possible so that the patient is operated under the best possible conditions, with the lowest possible infection risk. The screenings and preoperative preparations are multidisciplinary but must also involve the patient. The information provided to the patient must match the patient's infectious risk profile. This lecture will review every infection risk factor, whether it is modifiable or not, and then suggest how the treatment decision should be adapted to each patient's infection risk. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Outsourcing within aerospace manufacturing enterprises: A phenomenological study and outsourcing leadership model

NASA Astrophysics Data System (ADS)

Sampson, Enrique, Jr.

Many aerospace workers believe transferring work projects abroad has an erosive effect on the U.S. aerospace industry (Pritchard, 2002). This qualitative phenomenological study examines factors for outsourcing decisions and the perceived effects of outsourcing on U.S. aerospace workers. The research sample consists of aerospace industry leaders and nonleaders from the East Coast, Midwest, and West Coast of the United States. Moustakas' modified van Kaam methods of analysis (1994) and Decision Explorer analysis software were applied to the interview transcripts. Resultant data identified five core themes: communication, best value, opportunities, cost, and offset consideration. The themes provided the framework for a model designed to assist leaders in making effective decisions and communicating the benefits of those decisions when considering outsourcing of work projects.

Civil commitment as a "street-level" bureaucracy: case-load, professionalization and administration.

PubMed

Wunsch, J S; Teply, L L; Zimmerman, J; Peters, G W

1981-01-01

This article applies street-level bureaucracy theories to "coping" patterns of behavior that developed in an involuntary commitment system. Daily procedures and routines of five Nebraska county boards of mental health and the attitudes of their members were studied. The results showed that the urban, high case-load, professionally-oriented board informally modified statutory procedures significantly to reduce face-to-face client contact, limit the scope of its decisions, and displace responsibility for the most ambiguous decisions to the treatment facility and board psychiatrist. Rural, low case-load, less professionally-specialized boards also modified the statutory procedures, but conducted the commitment process in a far more ambiguous, open-ended, and tense system with substantial face-to-face client contact. Both urban and rural boards had multifaceted role definitions; rural boards, however, had a more open-ended perception of their functions, and attempted more actively to modify antisocial behavior and redirect board subjects to sources of social counseling. Therefore, understanding street-level "coping" behavior in an actual commitment context is important to develop realistic changes in civil commitment systems and to preclude informal procedures that reduce a commitment system's effectiveness or undermine a proposed patient' s rights.

Decision aid prototype development for parents considering adenotonsillectomy for their children with sleep disordered breathing.

PubMed

Maguire, Erin; Hong, Paul; Ritchie, Krista; Meier, Jeremy; Archibald, Karen; Chorney, Jill

2016-11-04

To describe the process involved in developing a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing. A paper-based decision aid prototype was developed using the framework proposed by the International Patient Decision Aids Standards Collaborative. The decision aid focused on two main treatment options: watchful waiting and adenotonsillectomy. Usability was assessed with parents of pediatric patients and providers with qualitative content analysis of semi-structured interviews, which included open-ended user feedback. A steering committee composed of key stakeholders was assembled. A needs assessment was then performed, which confirmed the need for a decision support tool. A decision aid prototype was developed and modified based on semi-structured qualitative interviews and a scoping literature review. The prototype provided information on the condition, risk and benefits of treatments, and values clarification. The prototype underwent three cycles of accessibility, feasibility, and comprehensibility testing, incorporating feedback from all stakeholders to develop the final decision aid prototype. A standardized, iterative methodology was used to develop a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing. The decision aid prototype appeared feasible, acceptable and comprehensible, and may serve as an effective means of improving shared decision-making.

The conscious mind and its emergent properties; an analysis based on decision theory.

PubMed

Morris, James A

2011-08-01

The process of conscious and unconscious decision making is analyzed using decision theory. An essential part of an optimum decision strategy is the assessment of values and costs associated with correct and incorrect decisions. In the case of unconscious decisions this involves an automatic process akin to computation using numerical values. But for conscious decisions the conscious mind must experience the outcome of the decision as pleasure or pain. It is suggested that the rules of behavior are programmed in our genes but modified by experience of the society in which we are reared. Our unconscious then uses the rules to reward or punish our conscious mind for the decisions it makes. This is relevant to concepts of altruism and religion in society. It is consistent with the observation that we prefer beauty to utility. The decision theory equations also explain the paradox that a single index of happiness can be applied in society. The symptoms of mental illness can be due to appropriate or inappropriate action by the unconscious. The former indicates a psychological conflict between conscious and unconscious decision making. Inappropriate action indicates that a pathological process has switched on genetic networks that should be switched off. Copyright © 2011 Elsevier Ltd. All rights reserved.

Determinants of judgment and decision making quality: the interplay between information processing style and situational factors

PubMed Central

Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

2015-01-01

A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions. PMID:26284011

Separating Business Logic from Medical Knowledge in Digital Clinical Workflows Using Business Process Model and Notation and Arden Syntax.

PubMed

de Bruin, Jeroen S; Adlassnig, Klaus-Peter; Leitich, Harald; Rappelsberger, Andrea

2018-01-01

Evidence-based clinical guidelines have a major positive effect on the physician's decision-making process. Computer-executable clinical guidelines allow for automated guideline marshalling during a clinical diagnostic process, thus improving the decision-making process. Implementation of a digital clinical guideline for the prevention of mother-to-child transmission of hepatitis B as a computerized workflow, thereby separating business logic from medical knowledge and decision-making. We used the Business Process Model and Notation language system Activiti for business logic and workflow modeling. Medical decision-making was performed by an Arden-Syntax-based medical rule engine, which is part of the ARDENSUITE software. We succeeded in creating an electronic clinical workflow for the prevention of mother-to-child transmission of hepatitis B, where institution-specific medical decision-making processes could be adapted without modifying the workflow business logic. Separation of business logic and medical decision-making results in more easily reusable electronic clinical workflows.

Public health decisions: Actions and consequences☆

PubMed Central

Pohl, H.R.; Jones, D.E.; Holler, J.S.; Murray, H.E.

2017-01-01

The goal of public health is to promote the best possible health for the whole population. Public health issues are numerous and can be unbelievably complex in form, scope, and possible consequence. Most public health decisions involve assessing several different options, weighing the respective benefits and risks of those options, and making difficult decisions that hopefully provide the greatest benefit to the affected populations. Many risk management decisions involve a variety of societal factors which modify risk assessment choices. The purpose of this paper is to point out difficulties in making decisions that impact public health. The intent of such decisions is to improve public health, but as illustrated in the paper, there can be unintended adverse consequences. Such unplanned issues require continued attention and efforts for responsible officials in the protection of environmental public health. This article presents examples of such events, when in the past, it was necessary to assess and regulate a number of potentially hazardous chemicals commonly used as insecticides, gasoline additives, and wood preservatives. PMID:25092130

Determinants of judgment and decision making quality: the interplay between information processing style and situational factors.

PubMed

Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

2015-01-01

A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions.

Fuzzy Linear Programming and its Application in Home Textile Firm

NASA Astrophysics Data System (ADS)

Vasant, P.; Ganesan, T.; Elamvazuthi, I.

2011-06-01

In this paper, new fuzzy linear programming (FLP) based methodology using a specific membership function, named as modified logistic membership function is proposed. The modified logistic membership function is first formulated and its flexibility in taking up vagueness in parameter is established by an analytical approach. The developed methodology of FLP has provided a confidence in applying to real life industrial production planning problem. This approach of solving industrial production planning problem can have feedback with the decision maker, the implementer and the analyst.

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

PubMed

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

2017-09-01

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

Roofing Source File.

ERIC Educational Resources Information Center

American School & University, 1998

1998-01-01

Provides guidelines for school administrators to aid in the selection of school-roofing systems, and information required to make specification and purchasing decisions. Low-slope roofing systems are examined, as are multiply systems such as modified bitumen, EPDM, thermoplastic, metal, and foam. (GR)

Green Infrastructure Models and Tools

EPA Science Inventory

The objective of this project is to modify and refine existing models and develop new tools to support decision making for the complete green infrastructure (GI) project lifecycle, including the planning and implementation of stormwater control in urban and agricultural settings,...

Affective decision-making moderates the effects of automatic associations on alcohol use among drug offenders.

PubMed

Cappelli, Christopher; Ames, Susan; Shono, Yusuke; Dust, Mark; Stacy, Alan

2017-09-01

This study used a dual-process model of cognition in order to investigate the possible influence of automatic and deliberative processes on lifetime alcohol use in a sample of drug offenders. The objective was to determine if automatic/implicit associations in memory can exert an influence over an individual's alcohol use and if decision-making ability could potentially modify the influence of these associations. 168 participants completed a battery of cognitive tests measuring implicit alcohol associations in memory (verb generation) as well as their affective decision-making ability (Iowa Gambling Task). Structural equation modeling procedures were used to test the relationship between implicit associations, decision-making, and lifetime alcohol use. Results revealed that among participants with lower levels of decision-making, implicit alcohol associations more strongly predicted higher lifetime alcohol use. These findings provide further support for the interaction between a specific decision function and its influence over automatic processes in regulating alcohol use behavior in a risky population. Understanding the interaction between automatic associations and decision processes may aid in developing more effective intervention components.

Neural mechanisms of social decision-making in the primate amygdala.

PubMed

Chang, Steve W C; Fagan, Nicholas A; Toda, Koji; Utevsky, Amanda V; Pearson, John M; Platt, Michael L

2015-12-29

Social decisions require evaluation of costs and benefits to oneself and others. Long associated with emotion and vigilance, the amygdala has recently been implicated in both decision-making and social behavior. The amygdala signals reward and punishment, as well as facial expressions and the gaze of others. Amygdala damage impairs social interactions, and the social neuropeptide oxytocin (OT) influences human social decisions, in part, by altering amygdala function. Here we show in monkeys playing a modified dictator game, in which one individual can donate or withhold rewards from another, that basolateral amygdala (BLA) neurons signaled social preferences both across trials and across days. BLA neurons mirrored the value of rewards delivered to self and others when monkeys were free to choose but not when the computer made choices for them. We also found that focal infusion of OT unilaterally into BLA weakly but significantly increased both the frequency of prosocial decisions and attention to recipients for context-specific prosocial decisions, endorsing the hypothesis that OT regulates social behavior, in part, via amygdala neuromodulation. Our findings demonstrate both neurophysiological and neuroendocrinological connections between primate amygdala and social decisions.

Neural mechanisms of social decision-making in the primate amygdala

PubMed Central

Chang, Steve W. C.; Fagan, Nicholas A.; Toda, Koji; Utevsky, Amanda V.; Pearson, John M.; Platt, Michael L.

2015-01-01

Social decisions require evaluation of costs and benefits to oneself and others. Long associated with emotion and vigilance, the amygdala has recently been implicated in both decision-making and social behavior. The amygdala signals reward and punishment, as well as facial expressions and the gaze of others. Amygdala damage impairs social interactions, and the social neuropeptide oxytocin (OT) influences human social decisions, in part, by altering amygdala function. Here we show in monkeys playing a modified dictator game, in which one individual can donate or withhold rewards from another, that basolateral amygdala (BLA) neurons signaled social preferences both across trials and across days. BLA neurons mirrored the value of rewards delivered to self and others when monkeys were free to choose but not when the computer made choices for them. We also found that focal infusion of OT unilaterally into BLA weakly but significantly increased both the frequency of prosocial decisions and attention to recipients for context-specific prosocial decisions, endorsing the hypothesis that OT regulates social behavior, in part, via amygdala neuromodulation. Our findings demonstrate both neurophysiological and neuroendocrinological connections between primate amygdala and social decisions. PMID:26668400

Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials

PubMed Central

Slosky, Laura E.; Burke, Natasha L.; Siminoff, Laura A.

2014-01-01

Background. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the decision making process beyond the informed consent. The purpose of this study was to evaluate the role of clinician influence and other factors on decision making regarding participation in a randomized clinical trial (RCT). Method. Participants were 76 children under sedation in a PICU and their surrogate decision makers. Measures included the Post Decision Clinician Survey, observer checklist, and post-decision interview. Results. Age of the pediatric patient was related to participation decisions in the RCT such that older children were more likely to be enrolled. Mentioning the sponsoring institution was associated with declining to participate in the RCT. Type of health care provider and overt recommendations to participate were not related to enrollment. Conclusion. Decisions to participate in research by surrogates of children in the PICU appear to relate to child demographics and subtleties in communication; however, no modifiable characteristics were related to increased participation, indicating that the informed consent process may not be compromised in this population. PMID:25161672

The development of an online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making: a usability and pilot study.

PubMed

Reumkens, Kelly; Tummers, Marly H E; Gietel-Habets, Joyce J G; van Kuijk, Sander M J; Aalfs, Cora M; van Asperen, Christi J; Ausems, Margreet G E M; Collée, Margriet; Dommering, Charlotte J; Kets, C Marleen; van der Kolk, Lizet E; Oosterwijk, Jan C; Tjan-Heijnen, Vivianne C G; van der Weijden, Trudy; de Die-Smulders, Christine E M; van Osch, Liesbeth A D M

2018-05-30

An online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making was developed. A two-phase usability test was conducted among 12 couples (N = 22; 2 persons participated without their partner) at risk for hereditary cancer and 15 health care providers. Couples and health care providers expressed similar suggestions for improvements, and evaluated the modified decision aid as acceptable, easy to use, and comprehensible. The final decision aid was pilot tested (N = 16) with paired sample t tests comparing main outcomes (decisional conflict, knowledge, realistic expectations regarding the reproductive options and decision self-efficacy) before (T0), immediately (T1) and 2 weeks after (T2) use of the decision aid. Pilot testing indicated decreased decisional conflict scores, increased knowledge, and improved realistic expectations regarding the reproductive options, at T1 and T2. No effect was found for couples' decision self-efficacy. The positive findings during usability testing were thus reflected in the pilot study. The decision aid will be further evaluated in a nationwide pretest-posttest study to facilitate implementation in the onco-genetic counselling setting. Ultimately, it is expected that the decision aid will enable end-users to make an informed decision.

Practices of US health insurance companies concerning MS therapies interfere with shared decision-making and harm patients.

PubMed

Bourdette, Dennis N; Hartung, Daniel M; Whitham, Ruth H

2016-04-01

The US Food and Drug Administration has registered 13 multiple sclerosis (MS) disease-modifying therapies (DMTs). The medications are not interchangeable as they vary in route of administration, efficacy, and safety profile. Selecting the appropriate MS DMT for individual patients requires shared decision-making between patients and neurologists. To reduce costs, insurance companies acting through pharmacy benefit companies restrict access to MS DMTs through tiered coverage and other regulations. We discuss how policies established by insurance companies that limit access to MS DMTs interfere with the process of shared decision-making and harm patients. We present potential actions that neurologists can take to change how insurance companies manage MS DMTs.

Analytic hierarchy process (AHP) as a tool in asset allocation

NASA Astrophysics Data System (ADS)

Zainol Abidin, Siti Nazifah; Mohd Jaffar, Maheran

2013-04-01

Allocation capital investment into different assets is the best way to balance the risk and reward. This can prevent from losing big amount of money. Thus, the aim of this paper is to help investors in making wise investment decision in asset allocation. This paper proposes modifying and adapting Analytic Hierarchy Process (AHP) model. The AHP model is widely used in various fields of study that are related in decision making. The results of the case studies show that the proposed model can categorize stocks and determine the portion of capital investment. Hence, it can assist investors in decision making process and reduce the risk of loss in stock market investment.

Automation on the Laboratory Bench.

ERIC Educational Resources Information Center

Legrand, M.; Foucard, A.

1978-01-01

A kit is described for use in automation of routine chemical research procedures. The kit uses sensors to evaluate the state of the system, actuators which modify the adjustable parameters, and an organ of decision which uses the information from the sensors. (BB)

Embodied Choice: How Action Influences Perceptual Decision Making

PubMed Central

Lepora, Nathan F.; Pezzulo, Giovanni

2015-01-01

Embodied Choice considers action performance as a proper part of the decision making process rather than merely as a means to report the decision. The central statement of embodied choice is the existence of bidirectional influences between action and decisions. This implies that for a decision expressed by an action, the action dynamics and its constraints (e.g. current trajectory and kinematics) influence the decision making process. Here we use a perceptual decision making task to compare three types of model: a serial decision-then-action model, a parallel decision-and-action model, and an embodied choice model where the action feeds back into the decision making. The embodied model incorporates two key mechanisms that together are lacking in the other models: action preparation and commitment. First, action preparation strategies alleviate delays in enacting a choice but also modify decision termination. Second, action dynamics change the prospects and create a commitment effect to the initially preferred choice. Our results show that these two mechanisms make embodied choice models better suited to combine decision and action appropriately to achieve suitably fast and accurate responses, as usually required in ecologically valid situations. Moreover, embodied choice models with these mechanisms give a better account of trajectory tracking experiments during decision making. In conclusion, the embodied choice framework offers a combined theory of decision and action that gives a clear case that embodied phenomena such as the dynamics of actions can have a causal influence on central cognition. PMID:25849349

Embodied choice: how action influences perceptual decision making.

PubMed

Lepora, Nathan F; Pezzulo, Giovanni

2015-04-01

Embodied Choice considers action performance as a proper part of the decision making process rather than merely as a means to report the decision. The central statement of embodied choice is the existence of bidirectional influences between action and decisions. This implies that for a decision expressed by an action, the action dynamics and its constraints (e.g. current trajectory and kinematics) influence the decision making process. Here we use a perceptual decision making task to compare three types of model: a serial decision-then-action model, a parallel decision-and-action model, and an embodied choice model where the action feeds back into the decision making. The embodied model incorporates two key mechanisms that together are lacking in the other models: action preparation and commitment. First, action preparation strategies alleviate delays in enacting a choice but also modify decision termination. Second, action dynamics change the prospects and create a commitment effect to the initially preferred choice. Our results show that these two mechanisms make embodied choice models better suited to combine decision and action appropriately to achieve suitably fast and accurate responses, as usually required in ecologically valid situations. Moreover, embodied choice models with these mechanisms give a better account of trajectory tracking experiments during decision making. In conclusion, the embodied choice framework offers a combined theory of decision and action that gives a clear case that embodied phenomena such as the dynamics of actions can have a causal influence on central cognition.

Superfund record of decision amendment (EPA Region 3): Tyson Dump Superfund Site, Upper Merion Township, Montgomergy County, PA, July 20, 1996

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

NONE

1996-08-01

The Record of Decision Amendment (`ROD Amendment`) modifies the selected remedy described in the Revised Record of Decision for the Tyson`s Superfund Site (Site) issued by the U.S. Environmental Protection Agency (EPA) on March 31, 1988 (1988 Revised ROD - PB89-233894). In the 1988 Revised ROD, EPA selected a soil vapor extraction (SVE) remedy for lagoon area soils. The SVE system has removed approximately 200,000 pounds of volatile organic compounds (VOCs) from the lagoon area soils. Although several enhancements and modifications have been employed to improve performance, the SVE system will not achieve the cleanup standards specified in the 1988more » Revised ROD. The decision document presents the selected remedial action for the lagoon area soils at the Tyson`s Site.« less

Information Retrieval: A Sequential Learning Process.

ERIC Educational Resources Information Center

Bookstein, Abraham

1983-01-01

Presents decision-theoretic models which intrinsically include retrieval of multiple documents whereby system responds to request by presenting documents to patron in sequence, gathering feedback, and using information to modify future retrievals. Document independence model, set retrieval model, sequential retrieval model, learning model,…

Tennis Coaching: Applying the Game Sense Approach

ERIC Educational Resources Information Center

Pill, Shane; Hewitt, Mitchell

2017-01-01

This article demonstrates the game sense approach for teaching tennis to novice players. In a game sense approach, learning is positioned within modified games to emphasize the way rules shape game behavior, tactical awareness, decision-making and the development of contextualized stroke mechanics.

12 CFR 611.1124 - Territorial adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

....1124 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ORGANIZATION Mergers... apply to any request submitted to the Farm Credit Administration to modify association charters for the... date of the territory transfer to inform the transferor association of their decision to remain with...

49 CFR 1108.5 - Fees and costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., appeals of arbitration decisions, and petitions to modify or vacate an arbitration award will be as set... OF TRANSPORTATION RULES OF PRACTICE ARBITRATION OF CERTAIN DISPUTES SUBJECT TO THE STATUTORY... will bear the expenses of arbitration, including compensation of the arbitrator. Absent an agreement...

An R-peak detection method that uses an SVD filter and a search back system.

PubMed

Jung, Woo-Hyuk; Lee, Sang-Goog

2012-12-01

In this paper, we present a method for detecting the R-peak of an ECG signal by using an singular value decomposition (SVD) filter and a search back system. The ECG signal was detected in two phases: the pre-processing phase and the decision phase. The pre-processing phase consisted of the stages for the SVD filter, Butterworth High Pass Filter (HPF), moving average (MA), and squaring, whereas the decision phase consisted of a single stage that detected the R-peak. In the pre-processing phase, the SVD filter removed noise while the Butterworth HPF eliminated baseline wander. The MA removed the remaining noise of the signal that had gone through the SVD filter to make the signal smooth, and squaring played a role in strengthening the signal. In the decision phase, the threshold was used to set the interval before detecting the R-peak. When the latest R-R interval (RRI), suggested by Hamilton et al., was greater than 150% of the previous RRI, the method of detecting the R-peak in such an interval was modified to be 150% or greater than the smallest interval of the two most latest RRIs. When the modified search back system was used, the error rate of the peak detection decreased to 0.29%, compared to 1.34% when the modified search back system was not used. Consequently, the sensitivity was 99.47%, the positive predictivity was 99.47%, and the detection error was 1.05%. Furthermore, the quality of the signal in data with a substantial amount of noise was improved, and thus, the R-peak was detected effectively. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Translating and culturally adapting the shortened version of the Hospital Ethical Climate Survey (HECS-S) - retaining or modifying validated instruments.

PubMed

Pergert, Pernilla; Bartholdson, Cecilia; Wenemark, Marika; Lützén, Kim; Af Sandeberg, Margareta

2018-05-10

The Hospital Ethical Climate Survey (HECS) was developed in the USA and later shortened (HECS-S). HECS has previously been translated into Swedish and the aim of this study was to describe a process of translating and culturally adapting HECS-S and to develop a Swedish multi-professional version, relevant for paediatrics. Another aim was to describe decisions about retaining versus modifying the questionnaire in order to keep the Swedish version as close as possible to the original while achieving a good functional level and trustworthiness. In HECS-S, the respondents are asked to indicate the veracity of statements. In HECS and HECS-S the labels of the scale range from 'almost never true' to 'almost always true'; while the Swedish HECS labels range from 'never' to 'always'. The procedure of translating and culturally adapting the Swedish version followed the scientific structure of guidelines. Three focus group interviews and three cognitive interviews were conducted with healthcare professionals. Furthermore, descriptive data were used from a previous study with healthcare professionals (n = 89), employing a modified Swedish HECS. Decisions on retaining or modifying items were made in a review group. The Swedish HECS-S consists of 21 items including all 14 items from HECS-S and items added to develop a multi-professional version, relevant for paediatrics. The descriptive data showed that few respondents selected 'never' and 'always'. To obtain a more even distribution of responses and keep Swedish HECS-S close to HECS-S, the original labels were retained. Linguistic adjustments were made to retain the intended meaning of the original items. The word 'respect' was used in HECS-S with two different meanings and was replaced in one of these because participants were concerned that respecting patients' wishes implied always complying with them. The process of developing a Swedish HECS-S included decisions on whether to retain or modify. Only minor adjustments were needed to achieve a good functional level and trustworthiness although some items needed to be added. Adjustments made could be used to also improve the English HECS-S. The results shed further light on the need to continuously evaluate even validated instruments and adapt them before use.

Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior.

PubMed

Kawamoto, Kensaku; Lobach, David F

2003-01-01

Computerized physician order entry (CPOE) systems represent an important tool for providing clinical decision support. In undertaking this systematic review, our objective was to identify the features of CPOE-based clinical decision support systems (CDSSs) most effective at modifying clinician behavior. For this review, two independent reviewers systematically identified randomized controlled trials that evaluated the effectiveness of CPOE-based CDSSs in changing clinician behavior. Furthermore, each included study was assessed for the presence of 14 CDSS features. We screened 10,023 citations and included 11 studies. Of the 10 studies comparing a CPOE-based CDSS intervention against a non-CDSS control group, 7 reported a significant desired change in professional practice. Moreover, meta-regression analysis revealed that automatic provision of the decision support was strongly associated with improved professional practice (adjusted odds ratio, 23.72; 95% confidence interval, 1.75-infiniti). Thus, we conclude that automatic provision of decision support is a critical feature of successful CPOE-based CDSS interventions.

A framework for sensitivity analysis of decision trees.

PubMed

Kamiński, Bogumił; Jakubczyk, Michał; Szufel, Przemysław

2018-01-01

In the paper, we consider sequential decision problems with uncertainty, represented as decision trees. Sensitivity analysis is always a crucial element of decision making and in decision trees it often focuses on probabilities. In the stochastic model considered, the user often has only limited information about the true values of probabilities. We develop a framework for performing sensitivity analysis of optimal strategies accounting for this distributional uncertainty. We design this robust optimization approach in an intuitive and not overly technical way, to make it simple to apply in daily managerial practice. The proposed framework allows for (1) analysis of the stability of the expected-value-maximizing strategy and (2) identification of strategies which are robust with respect to pessimistic/optimistic/mode-favoring perturbations of probabilities. We verify the properties of our approach in two cases: (a) probabilities in a tree are the primitives of the model and can be modified independently; (b) probabilities in a tree reflect some underlying, structural probabilities, and are interrelated. We provide a free software tool implementing the methods described.

Lean production tools and decision latitude enable conditions for innovative learning in organizations: a multilevel analysis.

PubMed

Fagerlind Ståhl, Anna-Carin; Gustavsson, Maria; Karlsson, Nadine; Johansson, Gun; Ekberg, Kerstin

2015-03-01

The effect of lean production on conditions for learning is debated. This study aimed to investigate how tools inspired by lean production (standardization, resource reduction, visual monitoring, housekeeping, value flow analysis) were associated with an innovative learning climate and with collective dispersion of ideas in organizations, and whether decision latitude contributed to these associations. A questionnaire was sent out to employees in public, private, production and service organizations (n = 4442). Multilevel linear regression analyses were used. Use of lean tools and decision latitude were positively associated with an innovative learning climate and collective dispersion of ideas. A low degree of decision latitude was a modifier in the association to collective dispersion of ideas. Lean tools can enable shared understanding and collective spreading of ideas, needed for the development of work processes, especially when decision latitude is low. Value flow analysis played a pivotal role in the associations. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Research on AHP decision algorithms based on BP algorithm

NASA Astrophysics Data System (ADS)

Ma, Ning; Guan, Jianhe

2017-10-01

Decision making is the thinking activity that people choose or judge, and scientific decision-making has always been a hot issue in the field of research. Analytic Hierarchy Process (AHP) is a simple and practical multi-criteria and multi-objective decision-making method that combines quantitative and qualitative and can show and calculate the subjective judgment in digital form. In the process of decision analysis using AHP method, the rationality of the two-dimensional judgment matrix has a great influence on the decision result. However, in dealing with the real problem, the judgment matrix produced by the two-dimensional comparison is often inconsistent, that is, it does not meet the consistency requirements. BP neural network algorithm is an adaptive nonlinear dynamic system. It has powerful collective computing ability and learning ability. It can perfect the data by constantly modifying the weights and thresholds of the network to achieve the goal of minimizing the mean square error. In this paper, the BP algorithm is used to deal with the consistency of the two-dimensional judgment matrix of the AHP.

Regulation of germinal center responses and B-cell memory by the chromatin modifier MOZ.

PubMed

Good-Jacobson, Kim L; Chen, Yunshun; Voss, Anne K; Smyth, Gordon K; Thomas, Tim; Tarlinton, David

2014-07-01

Memory B cells and long-lived bone marrow-resident plasma cells maintain humoral immunity. Little is known about the intrinsic mechanisms that are essential for forming memory B cells or endowing them with the ability to rapidly differentiate upon reexposure while maintaining the population over time. Histone modifications have been shown to regulate lymphocyte development, but their role in regulating differentiation and maintenance of B-cell subsets during an immune response is unclear. Using stage-specific deletion of monocytic leukemia zinc finger protein (MOZ), a histone acetyltransferase, we demonstrate that mutation of this chromatin modifier alters fate decisions in both primary and secondary responses. In the absence of MOZ, germinal center B cells were significantly impaired in their ability to generate dark zone centroblasts, with a concomitant decrease in both cell-cycle progression and BCL-6 expression. In contrast, there was increased differentiation to IgM and low-affinity IgG1(+) memory B cells. The lack of MOZ affected the functional outcome of humoral immune responses, with an increase in secondary germinal centers and a corresponding decrease in secondary high-affinity antibody-secreting cell formation. Therefore, these data provide strong evidence that manipulating epigenetic modifiers can regulate fate decisions during humoral responses, and thus could be targeted for therapeutic intervention.

The interplay between sharing behavior and beliefs about others in children during dictator games.

PubMed

Santamaría-García, Hernando; González-Gadea, María Luz; Di Tella, Rafael; Ibáñez, Agustín; Sigman, Mariano

2018-02-01

Previous studies in adults demonstrated that beliefs and sharing decisions in social scenarios are closely related. However, to date, little is known about the development of this relationship in children. By using a modified dictator game, we assessed sharing behavior and beliefs about others in children between 3 and 12 years old. We performed four studies (N = 376) aimed to assess whether decisions were related to beliefs (Studies 1 and 2) and whether information about the recipient's forced sharing behavior would shape decisions and beliefs (Studies 3 and 4). Results of Studies 1 and 2 showed that beliefs about others' generosity were related to children's sharing behavior. In Studies 3 and 4, we found that only children older than 9 years shared more pieces of candy when they knew that the recipient would be forced to share (cooperative context) than when they knew that the recipient would be forced not to share (noncooperative context). Besides, children older than 6 years did not modify their beliefs about others' generosity according to these social contexts. These results suggest that normative or preconceived beliefs about the functioning of the social world may guide social behavior in children. Copyright © 2017 Elsevier Inc. All rights reserved.

How do sex ratios in China influence marriage decisions and intra-household resource allocation?

PubMed Central

Porter, Maria

2017-01-01

This article examines how imbalanced sex ratios influence marriage decisions and household bargaining. Using data from the 1982 Chinese census, the traditional “availability ratio” is modified to reflect the degree to which men tend to marry women from different cohorts. This ratio reflects the average tendency of men to prefer women who are close in age to women who are several years younger than them by weighting cohort sizes using the proportion of people in the population who marry someone born in a different cohort. Given that men generally marry younger women, this ratio varies independently of the size of one's own birth cohort. Yet, the ratio fluctuates considerably across individuals, as the sizes of birth cohorts in China vary across time and regions. This enables us to examine how variability in such ratios may influence marriage decisions and household bargaining. The findings suggest that women exercise greater bargaining power once married. Results indicate that as women become scarcer in the marriage market, they have healthier sons. Men also delay marriage, and consume less tobacco and alcohol. This paper also highlights how sensitive findings may be to using this modified weighted availability ratio rather than a traditional unweighted availability ratio. PMID:28989332

PCI Choice: Cardiovascular clinicians' perceptions of shared decision making in stable coronary artery disease.

PubMed

Coylewright, Megan; O'Neill, Elizabeth S; Dick, Sara; Grande, Stuart W

2017-06-01

Describe cardiovascular clinicians' perceptions of Shared Decision Making following use of a decision aid (DA) for stable coronary artery disease (CAD) "PCI Choice", in a randomized controlled trial. We conducted a semi-structured qualitative interview study with cardiologists and physician extenders (n=13) after using PCI Choice in practice. Interviews were transcribed then coded. Codes were organized into salient themes. Final themes were determined by consensus with all authors. Most clinicians (70%) had no prior knowledge of SDM or DAs. Mixed views about the role of the DA in the visit were related to misconceptions of how patient education differed from SDM. Qualitative assessment of clinician perceptions generated three themes: 1) Gaps exist in clinician knowledge around SDM; 2) Clinicians are often uncomfortable with modifying baseline practice; and 3) Clinicians express interest in using DAs after initial exposure within a research setting. Use of DAs by clinicians during clinic visits may improve understanding of SDM. Initial use is marked by a reluctance to modify established practice patterns. As clinicians explore new approaches to benefit their patients, there is an opportunity for DAs that provide clinician instruction on core elements of SDM to lead to enhanced SDM in clinical practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Dementia Prevention: optimizing the use of observational data for personal, clinical, and public health decision-making.

PubMed

Dacks, Penny A; Andrieu, Sandrine; Blacker, Deborah; Carman, Aaron J; Green, Allan M; Grodstein, Francine; Henderson, Victor W; James, Bryan D; Lane, Rachel F; Lau, Joseph; Lin, Pei-Jung; Reeves, Barnaby C; Shah, Raj C; Vellas, Bruno; Yaffe, Kristine; Yurko-Mauro, Karin; Shineman, Diana W; Bennett, David A; Fillit, Howard M

2014-02-01

Worldwide, over 35 million people suffer from Alzheimer's disease and related dementias. This number is expected to triple over the next 40 years. How can we improve the evidence supporting strategies to reduce the rate of dementia in future generations? The risk of dementia is likely influenced by modifiable factors such as exercise, cognitive activity, and the clinical management of diabetes and hypertension. However, the quality of evidence is limited and it remains unclear whether specific interventions to reduce these modifiable risk factors can, in turn, reduce the risk of dementia. Although randomized controlled trials are the gold-standard for causality, the majority of evidence for long-term dementia prevention derives from, and will likely continue to derive from, observational studies. Although observational research has some unavoidable limitations, its utility for dementia prevention might be improved by, for example, better distinction between confirmatory and exploratory research, higher reporting standards, investment in effectiveness research enabled by increased data-pooling, and standardized exposure and outcome measures. Informed decision-making by the general public on low-risk health choices that could have broad potential benefits could be enabled by internet-based tools and decision-aids to communicate the evidence, its quality, and the estimated magnitude of effect.

The evaluation and enhancement of quality, environmental protection and seaport safety by using FAHP

NASA Astrophysics Data System (ADS)

Tadic, Danijela; Aleksic, Aleksandar; Popovic, Pavle; Arsovski, Slavko; Castelli, Ana; Joksimovic, Danijela; Stefanovic, Miladin

2017-02-01

The evaluation and enhancement of business processes in any organization in an uncertain environment presents one of the main requirements of ISO 9000:2008 and has a key effect on competitive advantage and long-term sustainability. The aim of this paper can be defined as the identification and discussion of some of the most important business processes of seaports and the performances of business processes and their key performance indicators (KPIs). The complexity and importance of the treated problem call for analytic methods rather than intuitive decisions. The existing decision variables of the considered problem are described by linguistic expressions which are modelled by triangular fuzzy numbers (TFNs). In this paper, the modified fuzzy extended analytic hierarchy process (FAHP) is proposed. The assessment of the relative importance of each pair of performances and their key performance indicators are stated as a fuzzy group decision-making problem. By using the modified fuzzy extended analytic hierarchy process, the fuzzy rank of business processes of a seaport is obtained. The model is tested through an illustrative example with real-life data, where the obtained data suggest measures which should enhance business strategy and improve key performance indicators. The future improvement is based on benchmark and knowledge sharing.

Cognitive Engineering of Advanced Information Technology for Air Force Systems Design and Deployment: Prototype for Air Defense Intelligence and Operations

DTIC Science & Technology

1989-10-01

train members of the eventual decision-making group to have different strategies, called " policies ," for making inferences and/or decisions. For example...group task, the task side of the lens model is structured so that each person must modify his judgment policy by learning from the other person in order...judgment policy ; that is, they would receive in both pictorial and textual form a description of how each person combines information to make a judgment

Complementary and Alternative Therapies in ALS

PubMed Central

Bedlack, Richard S.; Joyce, Nanette; Carter, Gregory T.; Pagononi, Sabrina; Karam, Chafic

2015-01-01

Synopsis Given the severity of their illness and lack of effective disease modifying agents, it is not surprising that most patients with ALS consider trying complementary and alternative therapies. Some of the most commonly considered alternative therapies include special diets, nutritional supplements, cannabis, acupuncture, chelation and energy healing. This chapter reviews these in detail. We also describe 3 models by which physicians may frame discussions about alternative therapies: paternalism, autonomy and shared decision making. Finally, we review a program called ALSUntangled which using shared shared decision making to review alternative therapies for ALS. PMID:26515629

Sexual picture processing interferes with decision-making under ambiguity.

PubMed

Laier, Christian; Pawlikowski, Mirko; Brand, Matthias

2014-04-01

Many people watch sexually arousing material on the Internet in order to receive sexual arousal and gratification. When browsing for sexual stimuli, individuals have to make several decisions, all possibly leading to positive or negative consequences. Decision-making research has shown that decisions under ambiguity are influenced by consequences received following earlier decisions. Sexual arousal might interfere with the decision-making process and should therefore lead to disadvantageous decision-making in the long run. In the current study, 82 heterosexual, male participants watched sexual pictures, rated them with respect to sexual arousal, and were asked to indicate their current level of sexual arousal before and following the sexual picture presentation. Afterwards, subjects performed one of two modified versions of the Iowa Gambling Task in which sexual pictures were displayed on the advantageous and neutral pictures on the disadvantageous card decks or vice versa (n = 41/n = 41). Results demonstrated an increase of sexual arousal following the sexual picture presentation. Decision-making performance was worse when sexual pictures were associated with disadvantageous card decks compared to performance when the sexual pictures were linked to the advantageous decks. Subjective sexual arousal moderated the relationship between task condition and decision-making performance. This study emphasized that sexual arousal interfered with decision-making, which may explain why some individuals experience negative consequences in the context of cybersex use.

Developmental changes in decision making under risk: The role of executive functions and reasoning abilities in 8- to 19-year-old decision makers.

PubMed

Schiebener, Johannes; García-Arias, María; García-Villamisar, Domingo; Cabanyes-Truffino, Javier; Brand, Matthias

2015-01-01

Previous studies have shown that children and adolescents often tend toward risky decisions despite explicit knowledge about the potential negative consequences. This phenomenon has been suggested to be associated with the immaturity of brain areas involved in cognitive control functions. Particularly, "frontal lobe functions," such as executive functions and reasoning, mature until young adulthood and are thought to be involved in age-related changes in decision making under explicit risk conditions. We investigated 112 participants, aged 8-19 years, with a frequently used task assessing decisions under risk, the Game of Dice Task (GDT). Additionally, we administered the Modified Card Sorting Test assessing executive functioning (categorization, cognitive flexibility, and strategy maintenance) as well as the Ravens Progressive Matrices assessing reasoning. The results showed that risk taking in the GDT decreased with increasing age and this effect was not moderated by reasoning but by executive functions: Particularly, young persons with weak executive functioning showed very risky decision making. Thus, the individual maturation of executive functions, associated with areas in the prefrontal cortex, seems to be an important factor in young peoples' behavior in risky decision-making situations.

Decision making under uncertainty, therapeutic inertia, and physicians' risk preferences in the management of multiple sclerosis (DIScUTIR MS).

PubMed

Saposnik, Gustavo; Sempere, Angel Perez; Raptis, Roula; Prefasi, Daniel; Selchen, Daniel; Maurino, Jorge

2016-05-04

The management of multiple sclerosis (MS) is rapidly changing by the introduction of new and more effective disease-modifying agents. The importance of risk stratification was confirmed by results on disease progression predicted by different risk score systems. Despite these advances, we know very little about medical decisions under uncertainty in the management of MS. The goal of this study is to i) identify whether overconfidence, tolerance to risk/uncertainty, herding influence medical decisions, and ii) to evaluate the frequency of therapeutic inertia (defined as lack of treatment initiation or intensification in patients not at goals of care) and its predisposing factors in the management of MS. This is a prospective study comprising a combination of case-vignettes and surveys and experiments from Neuroeconomics/behavioral economics to identify cognitive distortions associated with medical decisions and therapeutic inertia. Participants include MS fellows and MS experts from across Spain. Each participant will receive an individual link using Qualtrics platform(©) that includes 20 case-vignettes, 3 surveys, and 4 behavioral experiments. The total time for completing the study is approximately 30-35 min. Case vignettes were selected to be representative of common clinical encounters in MS practice. Surveys and experiments include standardized test to measure overconfidence, aversion to risk and ambiguity, herding (following colleague's suggestions even when not supported by the evidence), physicians' reactions to uncertainty, and questions from the Socio-Economic Panel Study (SOEP) related to risk preferences in different domains. By applying three different MS score criteria (modified Rio, EMA, Prosperini's scheme) we take into account physicians' differences in escalating therapy when evaluating medical decisions across case-vignettes. The present study applies an innovative approach by combining tools to assess medical decisions with experiments from Neuroeconomics that applies to common scenarios in MS care. Our results will help advance the field by providing a better understanding on the influence of cognitive factors (e.g., overconfidence, aversion to risk and uncertainty, herding) on medical decisions and therapeutic inertia in the management of MS which could lead to better outcomes.

Ready, Set, Change! Development and usability testing of an online readiness for change decision support tool for healthcare organizations.

PubMed

Timmings, Caitlyn; Khan, Sobia; Moore, Julia E; Marquez, Christine; Pyka, Kasha; Straus, Sharon E

2016-02-24

To address challenges related to selecting a valid, reliable, and appropriate readiness assessment measure in practice, we developed an online decision support tool to aid frontline implementers in healthcare settings in this process. The focus of this paper is to describe a multi-step, end-user driven approach to developing this tool for use during the planning stages of implementation. A multi-phase, end-user driven approach was used to develop and test the usability of a readiness decision support tool. First, readiness assessment measures that are valid, reliable, and appropriate for healthcare settings were identified from a systematic review. Second, a mapping exercise was performed to categorize individual items of included measures according to key readiness constructs from an existing framework. Third, a modified Delphi process was used to collect stakeholder ratings of the included measures on domains of feasibility, relevance, and likelihood to recommend. Fourth, two versions of a decision support tool prototype were developed and evaluated for usability. Nine valid and reliable readiness assessment measures were included in the decision support tool. The mapping exercise revealed that of the nine measures, most measures (78 %) focused on assessing readiness for change at the organizational versus the individual level, and that four measures (44 %) represented all constructs of organizational readiness. During the modified Delphi process, stakeholders rated most measures as feasible and relevant for use in practice, and reported that they would be likely to recommend use of most measures. Using data from the mapping exercise and stakeholder panel, an algorithm was developed to link users to a measure based on characteristics of their organizational setting and their readiness for change assessment priorities. Usability testing yielded recommendations that were used to refine the Ready, Set, Change! decision support tool . Ready, Set, Change! decision support tool is an implementation support that is designed to facilitate the routine incorporation of a readiness assessment as an early step in implementation. Use of this tool in practice may offer time and resource-saving implications for implementation.

77 FR 3030 - Twenty-Eighth Meeting: RTCA Special Committee 206: Aeronautical Information and Meteorological...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-20

... and normal definitions Review proposed TOR changes ConUse Review February 7, 2012 ConUse Review... proposed TOR changes and new or modified Sub-groups' roles and responsibilities Decision to release ConUse...] BILLING CODE 4910-13-P ...

12 CFR 747.311 - Relevant considerations.

Code of Federal Regulations, 2010 CFR

2010-01-01

....311 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS..., whether the bond is likely to be revoked, or whether coverage under the bond will be affected adversely as... specific case, appear relevant to the decision to continue in effect, rescind, terminate, or modify a...

A Simplified Decision Support Approach for Evaluating Wetlands Ecosystem Services

EPA Science Inventory

We will be presenting a simplified approach to evaluating ecosystem services provided by freshwater wetlands restoration. Our approach is based on an existing functional assessment approach developed by Golet and Miller for the State of Rhode Island, and modified by Miller for ap...

7 CFR 650.11 - Environmental documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... § 650.4): (1) Environmental assessments (EA) (2) Environmental impact statements (EIS) (3) Notice of intent (NOI) (4) Finding of no significant impact (FNSI) (5) Record of decision (ROD) (b) The format and... regulatory impact analysis as required by Executive Order 12044. This may necessitate modifying the...

Strategies to Reduce Dietary Sodium Intake

PubMed Central

Cobb, Laura K; Appel, Lawrence J; Anderson, Cheryl A.M.

2013-01-01

Opinion Excess sodium intake has an important, if not predominant, role in the pathogenesis of elevated blood pressure, one of the most important modifiable determinants of cardiovascular disease (CVD). In the United States, almost 80% of sodium in the diet comes from packaged and restaurant foods. Given the current food environment, educational efforts such as clinician counseling are useful, but a comprehensive public health approach is necessary to achieve meaningful reductions in sodium intake. A successful approach includes several key strategies, which together will both promote positive decisions by individuals and change the context in which they make those decisions. The strategies include: (1) public education, (2) individual dietary counseling, (3) food labeling, (4) coordinated, voluntary industry sodium reduction, (5) government and private sector food procurement policies, and (6) FDA regulations, as recommended by the Institute of Medicine, to modify sodium’s generally regarded as safe (GRAS) status. Population-wide reduction in sodium intake has the potential to substantially reduce the public burden of preventable CVD and reduce health care costs. PMID:22580974

The development and application of multi-criteria decision-making tool with consideration of uncertainty: the selection of a management strategy for the bio-degradable fraction in the municipal solid waste.

PubMed

El Hanandeh, Ali; El-Zein, Abbas

2010-01-01

A modified version of the multi-criteria decision aid, ELECTRE III has been developed to account for uncertainty in criteria weightings and threshold values. The new procedure, called ELECTRE-SS, modifies the exploitation phase in ELECTRE III, through a new definition of the pre-order and the introduction of a ranking index (RI). The new approach accommodates cases where incomplete or uncertain preference data are present. The method is applied to a case of selecting a management strategy for the bio-degradable fraction in the municipal solid waste of Sydney. Ten alternatives are compared against 11 criteria. The results show that anaerobic digestion (AD) and composting of paper are less environmentally sound options than recycling. AD is likely to out-perform incineration where a market for heating does not exist. Moreover, landfilling can be a sound alternative, when considering overall performance and conditions of uncertainty.

Is Israel ready for disease management?

PubMed

Linden, Ariel

2006-10-01

Approximately 60% of all worldwide deaths are caused by chronic disease resulting from modifiable health behaviors. In the United States, structured programs tailored to identify and modify health behaviors of patients with chronic illness have grown into a robust industry called disease management. DM is premised upon the basic assumption that health services utilization and morbidity can be reduced for those with chronic illness by augmenting traditional episodic medical care services and support between physician visits. Given that Israel and the U.S. have similar demographics in their chronically ill populations, it would make intuitive sense for Israel to replicate efforts made in the U.S. to incorporate DM strategies. This paper provides a conceptual framework of how DM could be integrated within the current organizational structure of the Israeli healthcare system, which is uniquely conducive to the implementation of DM on a population-wide basis. While ultimately the decision to invest in DM lies with stakeholders at various institutional levels in Israel, this paper is intended to provide direction and support for that decision-making process.

Implicit conditioning of faces via the social regulation of emotion: ERP evidence of early attentional biases for security conditioned faces.

PubMed

Beckes, Lane; Coan, James A; Morris, James P

2013-08-01

Not much is known about the neural and psychological processes that promote the initial conditions necessary for positive social bonding. This study explores one method of conditioned bonding utilizing dynamics related to the social regulation of emotion and attachment theory. This form of conditioning involves repeated presentations of negative stimuli followed by images of warm, smiling faces. L. Beckes, J. Simpson, and A. Erickson (2010) found that this conditioning procedure results in positive associations with the faces measured via a lexical decision task, suggesting they are perceived as comforting. This study found that the P1 ERP was similarly modified by this conditioning procedure and the P1 amplitude predicted lexical decision times to insecure words primed by the faces. The findings have implications for understanding how the brain detects supportive people, the flexibility and modifiability of early ERP components, and social bonding more broadly. Copyright © 2013 Society for Psychophysiological Research.

[In the beginning was a relationship].

PubMed

Vanbelle, Guido

2008-01-01

Judgment and actions based on scientific evidence are modified by the unique caregiver-patient relationship. Caregivers relying exclusively upon "rational" decisions in line with evidence-based clinical recommendations avoid their relational responsibility. The "noble" purpose illustrates that decisions to treat can be at the same time pointless and valuable. Dia (through) - logue (knowledge) makes it possible to go beyond informed consent, which holds caregivers responsible for providing information and patients for the decision to treat. Finally, where healing is no longer achievable and autonomy dies away, compassion rather than therapeutic tenacity might be the answer. These examples are explained corresponding to the philosophical ideas of respectively Emmanuel Levinas en Roger Burgraeve (noble purpose), Martin Buber (dialogical thinking) and Daniel C. Dennett (autonomy loss).

Is Regret Theory an alternative basis for estimating the value of healthcare interventions?

PubMed

Smith, R D

1996-08-01

This paper presents an argument for the existence of "regret' influencing the valuation of alternative outcomes when making treatment decisions in healthcare. It is argued that valuation techniques as currently formulated rely upon the axioms of Expected Utility Theory (transitivity and independence). This potentially leads to a misrepresentation of the respondents true preferences over treatment alternatives, and thus results in the potential for "irrational' decisions being observed. A modified version of Regret Theory is outlined, and the results of a tentative empirical analysis provided to illustrate the importance of accounting for regret in the valuation of health states. It is concluded that regret is an important element in individual valuation and decision making in health care.

Psychophysical Models for Signal Detection with Time Varying Uncertainty. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Gai, E.

1975-01-01

Psychophysical models for the behavior of the human operator in detection tasks which include change in detectability, correlation between observations and deferred decisions are developed. Classical Signal Detection Theory (SDT) is discussed and its emphasis on the sensory processes is contrasted to decision strategies. The analysis of decision strategies utilizes detection tasks with time varying signal strength. The classical theory is modified to include such tasks and several optimal decision strategies are explored. Two methods of classifying strategies are suggested. The first method is similar to the analysis of ROC curves, while the second is based on the relation between the criterion level (CL) and the detectability. Experiments to verify the analysis of tasks with changes of signal strength are designed. The results show that subjects are aware of changes in detectability and tend to use strategies that involve changes in the CL's.

Enhancing User Customization through Novel Software Architecture for Utility Scale Solar Siting Software

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

Brant Peery; Sam Alessi; Randy Lee

2014-06-01

There is a need for a spatial decision support application that allows users to create customized metrics for comparing proposed locations of a new solar installation. This document discusses how PVMapper was designed to overcome the customization problem through the development of loosely coupled spatial and decision components in a JavaScript plugin architecture. This allows the user to easily add functionality and data to the system. The paper also explains how PVMapper provides the user with a dynamic and customizable decision tool that enables them to visually modify the formulas that are used in the decision algorithms that convert datamore » to comparable metrics. The technologies that make up the presentation and calculation software stack are outlined. This document also explains the architecture that allows the tool to grow through custom plugins created by the software users. Some discussion is given on the difficulties encountered while designing the system.« less

Vocabulary Development and Maintenance--Descriptors. ERIC Processing Manual, Section VIII (Part 1).

ERIC Educational Resources Information Center

Houston, Jim, Ed.

Comprehensive rules, guidelines, and examples are provided for use by ERIC indexers and lexicographers in developing and maintaining the "Thesaurus of ERIC Descriptors." Evaluation and decision criteria, research procedures, and inputting details for adding new Descriptors are documented. Instructions for modifying existing Thesaurus…

5 CFR 890.1041 - Deciding a contest after a fact-finding proceeding.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Suspension § 890.1041 Deciding a contest after a fact-finding... official shall issue a final written decision that either sustains, modifies, or terminates the suspension...

28 CFR 2.105 - Revocation decisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... condition requiring payment of a fine, restitution, court costs or assessment, and/or court ordered child... finds by a preponderance of the evidence that the parolee has violated one or more conditions of parole..., including where appropriate: (i) Reprimand the parolee; (ii) Modify the parolee's conditions of release; or...

28 CFR 2.105 - Revocation decisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... condition requiring payment of a fine, restitution, court costs or assessment, and/or court ordered child... finds by a preponderance of the evidence that the parolee has violated one or more conditions of parole..., including where appropriate: (i) Reprimand the parolee; (ii) Modify the parolee's conditions of release; or...

28 CFR 2.105 - Revocation decisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... condition requiring payment of a fine, restitution, court costs or assessment, and/or court ordered child... finds by a preponderance of the evidence that the parolee has violated one or more conditions of parole..., including where appropriate: (i) Reprimand the parolee; (ii) Modify the parolee's conditions of release; or...

28 CFR 2.105 - Revocation decisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... condition requiring payment of a fine, restitution, court costs or assessment, and/or court ordered child... finds by a preponderance of the evidence that the parolee has violated one or more conditions of parole..., including where appropriate: (i) Reprimand the parolee; (ii) Modify the parolee's conditions of release; or...

Using the Price Elasticity of Demand in Educational Decision Making.

ERIC Educational Resources Information Center

Smith, Joseph D.; Moracco, Judy N.

1984-01-01

Describes a study and methods used by Navy Campus to choose a funding arrangement that would make the best use of the money available for voluntary educational purposes. Discusses modifying the economic concept of price elasticity to the interests of educationally oriented audiences. (JOW)

"MARK I" MEASUREMENT METHODOLOGY FOR POLLUTION PREVENTION PROGRESS OCCURRING AS A RESULT OF PRODUCT DECISIONS

EPA Science Inventory

A methodology for assessing progress in pollution prevention resulting from product redesign, reformulation or replacement is described. The method compares the pollution generated by the original product with that from the modified or replacement product, taking into account, if...

Development of Decision Support System for Remote Monitoring of PIP Corn

EPA Science Inventory

The EPA is developing a multi-level approach that utilizes satellite and airborne remote sensing to locate and monitor genetically modified corn in the agricultural landscape and pest infestation. The current status of the EPA IRM monitoring program based on remote sensed imager...

Student Speech Rights and the Special Characteristics of the School Environment

ERIC Educational Resources Information Center

Warnick, Bryan R.

2009-01-01

Since the "Tinker" decision, the Supreme Court has maintained that student First Amendment rights are modified by the "special characteristics of the school environment." The nature of these characteristics, however, has not been adequately investigated. The author proposes seven characteristics of schools that are relevant to…

Being Forward Not Backward: Lexical Limits to Masked Priming

ERIC Educational Resources Information Center

Davis, Chris; Kim, Jeesun; Forster, Kenneth I.

2008-01-01

This study investigated whether masked priming is mediated by existing memory representations by determining whether nonwords targets would show repetition priming. To avoid the potential confound that nonword repetition priming would be obscured by a familiarity response bias, the standard lexical decision and naming tasks were modified to make…

76 FR 4939 - John M. Chois; Decision and Order

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-27

... practitioner, and the denial of any pending applications to renew or modify his registration, on the ground... Requested, which was addressed to him at his registered location. Since the date of service of the Order... permitted, by * * * the jurisdiction in which he practices * * * to distribute, dispense, [or] administer...

Agricultural Extension Services and the Issue of Equity in Agricultural Development.

ERIC Educational Resources Information Center

Monu, Erasmus D.

1981-01-01

Reviews experiments in Kenya and Nigeria attempting to modify the progressive-farmer strategy. Success requires that extension services recognize small farmers' ability to make their own rational decisions and involve farmers in planning and implementing extension programs. Available from: Rural Sociological Society, 325 Morgan Hall, University of…

Linking a modified EPIC-based growth model (UPGM) with a component-based watershed model (AGES-W)

USDA-ARS?s Scientific Manuscript database

Agricultural models and decision support systems (DSS) for assessing water use and management are increasingly being applied to diverse geographic regions at different scales. This requires models that can simulate different crops, however, very few plant growth models are available that “easily” ...

Is Retrieval Mediated after Repeated Testing?

ERIC Educational Resources Information Center

Kole, James A.; Healy, Alice F.

2013-01-01

In 2 main experiments, the mediated priming effect was used to determine whether retrieval continues to be mediated after repeated testing. In each experiment, participants used the keyword method to learn French vocabulary, then completed a modified lexical decision task in which they first translated a French word, and then made a lexical…

45 CFR 670.15 - Modification, suspension, and revocation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... published in the Federal Register, within 10 days from the date of the Director's decision. ... revocation. (a) The Director may modify, suspend, or revoke, in whole or in part, any permit issued under..., or any provision of the Act. (b) Whenever the Director proposes any modifications, suspension, or...

Reflections of Turkish International Graduate Students: Studies on Life at a U.S. Midwestern University

ERIC Educational Resources Information Center

Burkholder, Jessica Reno

2014-01-01

A modified version of Moustakas' (1994) method of analyzing phenomenological data was used to illuminate how full-time, single, Turkish international graduate students conceptualized their experiences as international students. The participants detailed common and salient aspects of their experience: personal growth, decisions regarding…

30 CFR 550.273 - How do I submit a modified DPP or DOCD or resubmit a disapproved DPP or DOCD?

Code of Federal Regulations, 2013 CFR

2013-07-01

... MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Dpp Or Docd § 550.273 How do I submit a...

30 CFR 550.273 - How do I submit a modified DPP or DOCD or resubmit a disapproved DPP or DOCD?

Code of Federal Regulations, 2012 CFR

2012-07-01

... MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Review and Decision Process for the Dpp Or Docd § 550.273 How do I submit a...

15 CFR 2007.4 - Publication regarding requests.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Publication regarding requests. 2007.4...)) § 2007.4 Publication regarding requests. (a) Whenever a request is received which conforms to these... publication of any Presidential action modifying the GSP, a summary of the decisions made will be published in...

Gender and Agreement Processing in Children with Developmental Language Disorder

ERIC Educational Resources Information Center

Rakhlin, Natalia; Kornilov, Sergey A.; Grigorenko, Elena L.

2014-01-01

Two experiments tested whether Russian-speaking children with Developmental Language Disorder (DLD) are sensitive to gender agreement when performing a gender decision task. In Experiment 1, the presence of overt gender agreement between verbs and/or adjectival modifiers and postverbal subject nouns memory was varied. In Experiment 2, agreement…

Towards a social psychology-based microscopic model of driver behavior and decision-making : modifying Lewin's field theory

DOT National Transportation Integrated Search

2014-01-01

Central to effective roadway design is the ability to understand how drivers behave as they traverse a segment of : roadway. While simple and complex microscopic models have been used over the years to analyse driver behaviour, : most models: 1.) inc...

77 FR 58488 - Hawaii State Plan for Occupational Safety and Health

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-21

... announces the Occupational Safety and Health Administration's (OSHA) decision to modify the Hawaii State... DEPARTMENT OF LABOR Occupational Safety and Health Administration 29 CFR Part 1952 [Docket ID. OSHA 2012-0029] RIN 1218-AC78 Hawaii State Plan for Occupational Safety and Health AGENCY: Occupational...

77 FR 65363 - New England Fishery Management Council (NEFMC); Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-26

... present an overview of the NEFSC draft Strategic Plan. A question and answer period is scheduled to [[Page... to modify accountability measures (AMs) in the Herring Fishery Management Plan (FMP). A public... measures, will be addressed during the remainder of the day. Decisions may include: specifications for the...

U.S. Army Research Institute Program in Basic Research FY 2005 and FY 2006

DTIC Science & Technology

2007-11-01

designed to tap different levels of processing-from visual attention (measured via eye-tracking) and interpretation through memory and decision-making (e.g...Test ( EFT ; Witkin, 1950; Witkin, Dyk, Faterson, Goodenough, & Karp, 1962) modified for group administration. It measures competence in perceptual field

What's a Parent to Do? Coping with Crisis.

ERIC Educational Resources Information Center

Coleman, Trudy; And Others

This instructional packet is one of a series of five modules that emphasize a systematic decision-making model for common problematic situations. The steps of the model are identifying the problem, gathering information, developing and assessing alternatives, implementing a solution, and evaluating and modifying the solution. Aimed at adult basic…

Managing in a New Era. New Directions for Community Colleges, Number 28.

ERIC Educational Resources Information Center

Lahti, Robert E., Ed.

1979-01-01

Approaches to creative, modified, and new management strategies and practices are offered as justifications for the continued development of effective and responsive community colleges. Judith S. Eaton describes the dangers in isolating academic concerns from management decision processes. Dorothy M. Burns advocates centralization of human…

15 CFR 2007.4 - Publication regarding requests.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Publication regarding requests. 2007.4...)) § 2007.4 Publication regarding requests. (a) Whenever a request is received which conforms to these... publication of any Presidential action modifying the GSP, a summary of the decisions made will be published in...

15 CFR 2007.4 - Publication regarding requests.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Publication regarding requests. 2007.4...)) § 2007.4 Publication regarding requests. (a) Whenever a request is received which conforms to these... publication of any Presidential action modifying the GSP, a summary of the decisions made will be published in...

15 CFR 2007.4 - Publication regarding requests.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Publication regarding requests. 2007.4...)) § 2007.4 Publication regarding requests. (a) Whenever a request is received which conforms to these... publication of any Presidential action modifying the GSP, a summary of the decisions made will be published in...

Spatio-temporal variation in foodscapes modifies deer browsing impact on vegetation

Treesearch

Alejandro A. Royo; David W. Kramer; Karl V. Miller; Nathan P. Nibbelink; Susan L. Stout

2017-01-01

Context. Ungulate browsers often alter plant composition and reduce diversity in forests worldwide, yet our ability to predict browse impact on vegetation remains equivocal. Theory suggests, however, that ungulate distribution and foraging impacts are shaped by scale-dependent decisions based on variation in habitat composition and structure...

Experiments with Cloze Procedure

ERIC Educational Resources Information Center

Evans, Gordon; Haastrup, Kirsten

1976-01-01

The Nordic Test Development Group prepared proficiency tests of English designed to provide reliable information on which to base decisions as to whether a candidate would be able to function in a job as described or whether he could be trained to do so. Two subtests used a modified cloze procedure. (Author/CFM)

The Increased Pluralism and Politicization of Public Education--Coping with Conflict.

ERIC Educational Resources Information Center

Coleman, Peter

Power, or influence, in educational governance is increasingly becoming diffused. Everyone in education now feels relatively powerless. A political model of decision-making, emphasizing consultation with representatives of interest groups is now appropriate. In this model, the school board functions as "meta-mediator." This modifies the…

Decision aids for multiple-decision disease management as affected by weather input errors.

PubMed

Pfender, W F; Gent, D H; Mahaffee, W F; Coop, L B; Fox, A D

2011-06-01

Many disease management decision support systems (DSSs) rely, exclusively or in part, on weather inputs to calculate an indicator for disease hazard. Error in the weather inputs, typically due to forecasting, interpolation, or estimation from off-site sources, may affect model calculations and management decision recommendations. The extent to which errors in weather inputs affect the quality of the final management outcome depends on a number of aspects of the disease management context, including whether management consists of a single dichotomous decision, or of a multi-decision process extending over the cropping season(s). Decision aids for multi-decision disease management typically are based on simple or complex algorithms of weather data which may be accumulated over several days or weeks. It is difficult to quantify accuracy of multi-decision DSSs due to temporally overlapping disease events, existence of more than one solution to optimizing the outcome, opportunities to take later recourse to modify earlier decisions, and the ongoing, complex decision process in which the DSS is only one component. One approach to assessing importance of weather input errors is to conduct an error analysis in which the DSS outcome from high-quality weather data is compared with that from weather data with various levels of bias and/or variance from the original data. We illustrate this analytical approach for two types of DSS, an infection risk index for hop powdery mildew and a simulation model for grass stem rust. Further exploration of analysis methods is needed to address problems associated with assessing uncertainty in multi-decision DSSs.

[Labeling of food containing genetically modified organisms: international policies and Brazilian legislation].

PubMed

Costa, Thadeu Estevam Moreira Maramaldo; Marin, Victor Augustus

2011-08-01

The increase in surface area planted with genetically modified crops, with the subsequent transfer of such crops into the general environment for commercial trade, has raised questions about the safety of these products. The introduction of the Cartagena Protocol on Biosafety has led to the need to produce information and ensure training in this area for the implementation of policies on biosafety and for decision-making on the part of governments at the national, regional and international level. This article presents two main standpoints regarding the labeling of GM products (one adopted by the United States and the other by the European Union), as well as the position adopted by Brazil and its current legislation on labeling and commercial release of genetically modified (GM) products.

'It's just the normal thing to do': exploring parental decision-making about the 'five-in-one' vaccine.

PubMed

Tickner, Sarah; Leman, Patrick J; Woodcock, Alison

2007-10-16

This qualitative study explored parental decision-making about the DTaP/IPV/Hib 'five-in-one' vaccine. Semi-structured interviews were conducted with 22 parents of babies aged between 4 and 13 weeks old, recruited from four practices in southern England. A modified Grounded Theory approach identified that although parents had some concerns, most complied with the recommended programme rather than making an informed decision. Other themes related to perceived importance of immunisation; beliefs about how immunisation works; trust; perceptions of vulnerability; feelings of guilt and responsibility; and practicalities. It is important to explore how parents' attitudes change over the preschool years and to develop ways of addressing uncertainties about immunisation, including the safety of combining antigens and the need for boosters.

Incorporating individual health-protective decisions into disease transmission models: a mathematical framework.

PubMed

Durham, David P; Casman, Elizabeth A

2012-03-07

It is anticipated that the next generation of computational epidemic models will simulate both infectious disease transmission and dynamic human behaviour change. Individual agents within a simulation will not only infect one another, but will also have situational awareness and a decision algorithm that enables them to modify their behaviour. This paper develops such a model of behavioural response, presenting a mathematical interpretation of a well-known psychological model of individual decision making, the health belief model, suitable for incorporation within an agent-based disease-transmission model. We formalize the health belief model and demonstrate its application in modelling the prevalence of facemask use observed over the course of the 2003 Hong Kong SARS epidemic, a well-documented example of behaviour change in response to a disease outbreak.

Incorporating individual health-protective decisions into disease transmission models: a mathematical framework

PubMed Central

Durham, David P.; Casman, Elizabeth A.

2012-01-01

It is anticipated that the next generation of computational epidemic models will simulate both infectious disease transmission and dynamic human behaviour change. Individual agents within a simulation will not only infect one another, but will also have situational awareness and a decision algorithm that enables them to modify their behaviour. This paper develops such a model of behavioural response, presenting a mathematical interpretation of a well-known psychological model of individual decision making, the health belief model, suitable for incorporation within an agent-based disease-transmission model. We formalize the health belief model and demonstrate its application in modelling the prevalence of facemask use observed over the course of the 2003 Hong Kong SARS epidemic, a well-documented example of behaviour change in response to a disease outbreak. PMID:21775324

Clean Air Interstate Rule: Changes and Modeling in AEO2010 (released in AEO2010)

EIA Publications

2010-01-01

On December 23, 2008, the D.C. Circuit Court remanded but did not vacate the Clean Air Interstate Rule (CAIR), overriding its previous decision on February 8, 2008, to remand and vacate CAIR. The December decision, which is reflected in Annual Energy Outlook 2010 (AEO) , allows CAIR to remain in effect, providing time for the Environmental Protection Agency to modify the rule in order to address objections raised by the Court in its earlier decision. A similar rule, referred to as the Clean Air Mercury Rule (CAMR), which was to set up a cap-and-trade system for reducing mercury emissions by approximately 70%, is not represented in the AEO2010 projections, because it was vacated by the D.C. Circuit Court in February 2008.

[The guideline for the treatment of mood disorders in USA and Japan].

PubMed

Higuchi, T

2001-08-01

Recently, the number of available antidepressants has increased dramatically and psychopharmacological treatment is becoming complex. It is important to present some guideline for supporting clinical decision making. Three different kinds of guideline for the treatment of mood disorders, that is, the APA style guideline, the algorithm and the consensus guideline, have been developed in our country. The APA style guideline and the algorithm are basically evidence based and the consensus guideline is developed through the consensus panel format. These guidelines should be used as 'a starting point' for specifying decisions that will be modified occasionally.

[The neural mechanisms of cigarette craving and self-control].

PubMed

Hayashi, Takuya

2014-01-01

A craving for cigarettes or drugs has been believed to be a fundamental psychopathological factor that drives drug-seeking behavior and relapse. Behavioral economics has revealed context-dependent changes in drug craving. Neuroimaging studies have also found craving-related signals that were altered depending on the context of the experiments. A rational decision-making theory modeled such context-dependency and uncovered a pivotal role of the prefrontal cortical circuit in both self-control and craving. Future studies should address how dopaminergic function and stress circuits can modify the function of decision-making circuits, and produce either craving or self-control.

Factors that positively influence breastfeeding duration to 6 months: a literature review.

PubMed

Meedya, Shahla; Fahy, Kathleen; Kable, Ashley

2010-12-01

What modifiable factors positively influence breastfeeding duration to 6 months postpartum? This question was posed in order to be able to develop a midwifery intervention aimed at prolonging breastfeeding. An online literature search was conducted in Medline, CINAHL, Maternity and Infant Care, and Cochrane Database of systematic reviews. The search strategy included the following keywords: breastfeeding, duration, initiation, cessation, factors, intervention, education, partner, intention, confidence, self-efficacy and support. Additional studies were located and extracted from online publications of New South Wales Department of Health, Australia. Bio-psycho-social factors that are positively associated with breastfeeding duration were identified. Modifiable factors that influence women's breastfeeding decisions are: breastfeeding intention, breastfeeding self-efficacy and social support. Existing midwifery breastfeeding promotion strategies often include social support but do not adequately address attempts to modify breastfeeding intention and self-efficacy. The modifiable factors that are positively associated with breastfeeding duration are the woman's breastfeeding intention, her breastfeeding self-efficacy and her social support. Intervention studies to date have focussed on modifying these factors individually with variable results. No interventional studies have been conducted with the aim of positively modifying all three factors simultaneously. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Unbending mind: Individuals with hoarding disorder do not modify decision strategy in response to feedback under risk.

PubMed

Pushkarskaya, Helen; Tolin, David F; Henick, Daniel; Levy, Ifat; Pittenger, Christopher

2018-01-01

Cognitive-behavioral models of hoarding disorder emphasize impairments in information processing and decision making in the genesis of hoarding symptomology. We propose and test the novel hypothesis that individuals with hoarding are maladaptively biased towards a deliberative decision style. While deliberative strategies are often considered normative, they are not always adaptable to the limitations imposed by many real-world decision contexts. We examined decision-making patterns in 19 individuals with hoarding and 19 healthy controls, using a behavioral task that quantifies selection of decision strategies in a novel environment with known probabilities (risk) in response to feedback. Consistent with prior literature, we found that healthy individuals tend to explore different decision strategies in the beginning of the experiment, but later, in response to feedback, they shift towards a compound strategy that balances expected values and risks. In contrast, individuals with hoarding follow a simple, deliberative, risk-neutral, value-based strategy from the beginning to the end of the task, irrespective of the feedback. This seemingly rational approach was not ecologically rational: individuals with hoarding and healthy individuals earned about the same amount of money, but it took individuals with hoarding a lot longer to do it: additional cognitive costs did not lead to additional benefits. Copyright © 2017 Elsevier B.V. All rights reserved.

Decision to abort after a prenatal diagnosis of sex chromosome abnormality: a systematic review of the literature.

PubMed

Jeon, Kwon Chan; Chen, Lei-Shih; Goodson, Patricia

2012-01-01

We performed a systematic review of factors affecting parental decisions to continue or terminate a pregnancy after prenatal diagnosis of a sex chromosome abnormality, as reported in published studies from 1987 to May 2011. Based on the Matrix Method for systematic reviews, 19 studies were found in five electronic databases, meeting specific inclusion/exclusion criteria. Abstracted data were organized in a matrix. Alongside the search for factors influencing parental decisions, each study was judged on its methodological quality and assigned a methodological quality score. Decisions either to terminate or to continue a sex chromosome abnormality-affected pregnancy shared five similar factors: specific type of sex chromosome abnormality, gestational week at diagnosis, parents' age, providers' genetic expertise, and number of children/desire for (more) children. Factors unique to termination decisions included parents' fear/anxiety and directive counseling. Factors uniquely associated with continuation decisions were parents' socioeconomic status and ethnicity. The studies' average methodological quality score was 10.6 (SD = 1.67; range, 8-14). Findings from this review can be useful in adapting and modifying guidelines for genetic counseling after prenatal diagnosis of a sex chromosome abnormality. Moreover, improving the quality of future studies on this topic may allow clearer understanding of the most influential factors affecting parental decisions.

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

PubMed

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

2016-09-01

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

Electrophysiology reveals semantic priming at a short SOA irrespective of depth of prime processing.

PubMed

Küper, Kristina; Heil, Martin

2009-04-03

The otherwise robust behavioral semantic priming effect is reduced to the point of being absent when a letter search has to be performed on the prime word. As a result the automaticity of semantic activation has been called into question. It is unclear, however, in how far automatic processes are even measurable in the letter search priming paradigm as the prime task necessitates a long prime-probe stimulus-onset asynchrony (SOA). In a modified procedure, a short SOA can be realized by delaying the prime task response until after participants have made a lexical decision on the probe. While the absence of lexical decision priming has already been demonstrated in this design it seems premature to draw any definite conclusions from this purely behavioral result since event related potential (ERP) measures have been shown to be a more sensitive index of semantic activation. Using the modified paradigm we thus recorded ERP in addition to lexical decision times. Stimuli were presented at two different SOAs (240 ms vs. 840 ms) and participants performed either a grammatical discrimination (Experiment 1) or a letter search (Experiment 2) on the prime. Irrespective of prime task, the modulation of the N400, the ERP correlate of semantic activation, provided clear-cut evidence of semantic processing at the short SOA. Implications for theories of semantic activation as well as the constraints of the delayed prime task procedure are discussed.

How updating textual clinical practice guidelines impacts clinical decision support systems: a case study with bladder cancer management.

PubMed

Bouaud, Jacques; Séroussi, Brigitte; Brizon, Ambre; Culty, Thibault; Mentré, France; Ravery, Vincent

2007-01-01

Guideline-based clinical decision support systems (CDSSs) can be effective in increasing physician compliance with recommendations. However, the ever growing pace at which medical knowledge is produced requires that clinical practice guidelines (CPGs) be updated regularly. It is therefore mandatory that CDSSs be revised accordingly. The French Association for Urology publishes CPGs on bladder cancer management every 2 years. We studied the impact of the 2004 revision of these guidelines, with respect to the 2002 version with a CDSS, UroDoc. We proposed a typology of knowledge base modifications resulting from the update of CPGs making the difference between practice, clinical conditions and recommendations refinement as opposed to new practice and new recommendations. The number of formalized recommendations increased from 577 in 2002 to 1,081 in 2004. We evaluated the two versions of UroDoc on a randomized sample of patient records. A single new practice that modifies a decision taken in 49% of all recorded decisions leads to a fall from 67% to 46% of the compliance rate of decisions.

Risk taking and adult attention deficit/hyperactivity disorder: A gap between real life behavior and experimental decision making.

PubMed

Pollak, Yehuda; Shalit, Reut; Aran, Adi

2018-01-01

Adults with attention deficit/hyperactivity disorder (ADHD) are prone to suboptimal decision making and risk taking. The aim of this study was to test performance on a theoretically-based probabilistic decision making task in well-characterized adults with and without ADHD, and examine the relation between experimental risk taking and history of real-life risk-taking behavior, defined as cigarette, alcohol, and street drug use. University students with and without ADHD completed a modified version of the Cambridge Gambling Test, in which they had to choose between alternatives varied by level of risk, and reported their history of substance use. Both groups showed similar patterns of risk taking on the experimental decision making task, suggesting that ADHD is not linked to low sensitivity to risk. Past and present substance use was more prevalent in adults with ADHD. These finding question the validity of experimental probabilistic decision making task as a valid model for ADHD-related risk-taking behavior. Copyright © 2017 Elsevier B.V. All rights reserved.

Shared Decision Making and Autonomy Among US Participants with Multiple Sclerosis in the NARCOMS Registry

PubMed Central

Thomas, Nina; Tyry, Tuula; Fox, Robert J.; Salter, Amber

2017-01-01

Background: Treatment decisions in multiple sclerosis (MS) are affected by many factors and are made by the patient, doctor, or both. With new disease-modifying therapies (DMTs) emerging, the complexity surrounding treatment decisions is increasing, further emphasizing the importance of understanding decision-making preferences. Methods: North American Research Committee on Multiple Sclerosis (NARCOMS) Registry participants completed the Fall 2014 Update survey, which included the Control Preferences Scale (CPS). The CPS consists of five images showing different patient/doctor roles in treatment decision making. The images were collapsed to three categories: patient-centered, shared, and physician-centered decision-making preferences. Associations between decision-making preferences and demographic and clinical factors were evaluated using multivariable logistic regression. Results: Of 7009 participants, 79.3% were women and 93.5% were white (mean [SD] age, 57.6 [10.3] years); 56.7% reported a history of relapses. Patient-centered decision making was most commonly preferred by participants (47.9%), followed by shared decision making (SDM; 42.8%). SDM preference was higher for women and those taking DMTs and increased with age and disease duration (all P < .05). Patient-centered decisions were most common for respondents not taking a DMT at the time of the survey and were preferred by those who had no DMT history compared with those who had previously taken a DMT (P < .0001). There was no difference in SDM preference by current MS disease course after adjusting for other disease-related factors. Conclusions: Responders reported most commonly considering their doctor's opinion before making a treatment decision and making decisions jointly with their doctor. DMT use, gender, and age were associated with decision-making preference. PMID:29270088

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making.

PubMed

Toupin-April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte-Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter S

2015-12-01

Despite the importance of shared decision making for delivering patient-centered care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this Outcome Measures in Rheumatology (OMERACT) working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspectives of patients, health professionals, and researchers. We followed the OMERACT Filter 2.0 method to develop a draft core domain set by (1) forming an OMERACT working group; (2) conducting a review of domains of shared decision making; and (3) obtaining opinions of all those involved using a modified nominal group process held at a session activity at the OMERACT 12 meeting. In all, 26 people from Europe, North America, and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the draft core set: (1) identifying the decision, (2) exchanging information, (3) clarifying views, (4) deliberating, (5) making the decision, (6) putting the decision into practice, and (7) assessing the effect of the decision. Contextual factors were also suggested. We proposed a draft core set of shared decision-making domains for OA intervention research studies. Next steps include a workshop at OMERACT 13 to reach consensus on these proposed domains in the wider OMERACT group, as well as to detail subdomains and assess instruments to develop a core outcome measurement set.

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making

PubMed Central

Toupin April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E.; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter

2015-01-01

Objective Despite the importance of shared decision making for delivering patient-centred care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this OMERACT working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspective of patients, health professionals and researchers. Methods We followed the OMERACT Filter 2.0 to develop a draft core domain set, which consisted of: (i) forming an OMERACT working group; (ii) conducting a review of domains of shared decision making; and (iii) obtaining the opinions of stakeholders using a modified nominal group process held at a session activity at the OMERACT 2014 meeting. Results 26 stakeholders from Europe, North America and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the Draft Core Set: 1) Identifying the decision; 2) Exchanging Information; 3) Clarifying views; 4) Deliberating; 5) Making the decision; 6) Putting the decision into practice; and 7) Assessing the impact of the decision. Contextual factors were also suggested. Conclusion We propose a Draft Core Set of shared decision making domains for OA intervention research studies. Next steps include a workshop at OMERACT 2016 to reach consensus on these proposed domains in the wider OMERACT group, as well as detail sub-domains and assess instruments to develop a Core Outcome Measurement Set. PMID:25877502

Decision-making impairments in the context of intact reward sensitivity in schizophrenia.

PubMed

Heerey, Erin A; Bell-Warren, Kimberly R; Gold, James M

2008-07-01

Deficits in motivated behavior and decision-making figure prominently in the behavioral syndrome that characterizes schizophrenia and are difficult both to treat and to understand. One explanation for these deficits is that schizophrenia decreases sensitivity to rewards in the environment. An alternate explanation is that sensitivity to rewards is intact but that poor integration of affective with cognitive information impairs the ability to use this information to guide behavior. We tested reward sensitivity with a modified version of an existing signal detection task with asymmetric reinforcement and decision-making with a probabilistic decision-making task in 40 participants with schizophrenia and 26 healthy participants. Results showed normal sensitivity to reward in participants with schizophrenia but differences in choice patterns on the decision-making task. A logistic regression model of the decision-making data showed that participants with schizophrenia differed from healthy participants in the ability to weigh potential outcomes, specifically potential losses, when choosing between competing response options. Deficits in working memory ability accounted for group differences in ability to use potential outcomes during decision-making. These results suggest that the implicit mechanisms that drive reward-based learning are surprisingly intact in schizophrenia but that poor ability to integrate cognitive and affective information when calculating the value of possible choices might hamper the ability to use such information during explicit decision-making.

Shared Decision Making and Other Variables as Correlates of Satisfaction with Health Care Decisions in a United States National Survey

PubMed Central

Wills, Celia E.; Holloman, Christopher; Olson, Jacklyn; Hechmer, Catherine; Miller, Carla K.; Duchemin, Anne-Marie

2012-01-01

Objective The purpose of this study was to examine the relationship between shared decision-making (SDM) and satisfaction with decision (SWD) within a larger survey of patient decision-making in health care consultations. Methods A randomly selected age-proportionate national sample of adults (aged 21–70 years) stratified on race, ethnicity, and gender (N = 488) was recruited from a health research volunteer registry and completed an online survey with reference to a recent health consultation. Measures included the Shared Decision Making-9 questionnaire (SDM-Q-9), Satisfaction With Decision (SWD) scale, sociodemographic, health, and other standardized decision-making measures. Forward selection weighted multiple regression analysis was used to model correlates of SWD. Results After controlling for sociodemographic variables, SDM-Q-9 total score was associated with SWD, adjusted R2 = .368, p < .001. Three of nine SDM-Q-9 items accounted for significant proportions of variance in SWD. Conclusion SDM was positively associated with SWD and was strongest for three areas of SDM: patients being helped in a health care consultation with understanding information, with treatment preference elicitation, and with weighing options thoroughly. Practice Implications By identifying variables such as SDM that are associated with SWD, health care interventions can better target modifiable factors to enhance satisfaction and other outcomes. PMID:22410642

Shared decision making and other variables as correlates of satisfaction with health care decisions in a United States national survey.

PubMed

Glass, Katherine Elizabeth; Wills, Celia E; Holloman, Christopher; Olson, Jacklyn; Hechmer, Catherine; Miller, Carla K; Duchemin, Anne-Marie

2012-07-01

The purpose of this study was to examine the relationship between shared decision-making (SDM) and satisfaction with decision (SWD) within a larger survey of patient decision-making in health care consultations. A randomly selected age-proportionate national sample of adults (aged 21-70 years) stratified on race, ethnicity, and gender (N=488) was recruited from a health research volunteer registry and completed an online survey with reference to a recent health consultation. Measures included the shared decision making-9 questionnaire (SDM-Q-9), Satisfaction With Decision (SWD) scale, sociodemographic, health, and other standardized decision-making measures. Forward selection weighted multiple regression analysis was used to model correlates of SWD. After controlling for sociodemographic variables, SDM-Q-9 total score was associated with SWD, adjusted R(2)=.368, p<.001. Three of nine SDM-Q-9 items accounted for significant proportions of variance in SWD. SDM was positively associated with SWD and was strongest for three areas of SDM: patients being helped in a health care consultation with understanding information, with treatment preference elicitation, and with weighing options thoroughly. By identifying variables such as SDM that are associated with SWD, health care interventions can better target modifiable factors to enhance satisfaction and other outcomes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Including values in evidence-based policy making for breast screening: An empirically grounded tool to assist expert decision makers.

PubMed

Parker, Lisa

2017-07-01

Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions. The decision making tool provided here is intended to assist with this process. The tool is modified from more general frameworks that are intended to assist with ethical decision making in public health, and informed by data drawn from previous empirical studies on values amongst Australian breast screening experts. It provides a structured format for breast screening committees to consider and discuss the values of themselves and others, suggests relevant topics for further inquiry and highlights areas of need for future research into the values of the public. It enables committees to publicly explain and justify their decisions with reference to values, improving transparency and accountability. It is intended to act alongside practices that seek to accommodate the values of individual women in the informed decision making process for personal decision making about participation in breast screening. Copyright © 2017 Elsevier B.V. All rights reserved.

Relationship between organizational climate and empowerment of nurses in Hong Kong.

PubMed

Mok, Esther; Au-Yeung, Betty

2002-05-01

The authors explore the relationship between organizational climate and empowerment among the nursing staff of a regional hospital in Hong Kong. The main purpose of the study was to apply the modified Spreitzer measure of empowerment in a hospital and to examine the relationship of organizational climate to perceptions of empowerment. From 658 questionnaires sent out, 331 nurses participated in the study with a response rate of 50.3%. Survey measures administered included the modified Litwin and Stringer Organizational Climate Questionnaire (LSOCQ) and the modified Spreitzer empowerment instrument. The relationships between organizational climate and empowerment were examined in a series of bivariate correlational analyses. The final section of the questionnaire asked the respondents to list three elements in the organizational climate that they perceived would further increase their feelings of empowerment. Exploratory factor analysis of the modified LSOCQ resulted in six factors: leadership, working harmony, challenge, recognition, teamwork and decision making. There was a positive correlation between organizational climate and psychological empowerment. Using multiple regression analysis, all the six derived climate factors significantly accounted for 44% of the variance. Among the six predicting factors, leadership and teamwork showed the most positive relationship with psychological empowerment. Responses from the open questions on perception of organizational climate that further enhance nurses' feelings of empowerment were categorized into eight areas. They include leadership, communication, working relationship, recognition, structure, training, teamwork and stress management. The study echoes previous studies in finding that organizational climate and, in particular, supportive leadership and teamwork are related to empowerment. The findings also suggest that the nurses in the study did not put much emphasis on the importance of participative decision making.

Effects of Grammatical Structure of Compound Words on Word Recognition in Chinese

PubMed Central

Cui, Lei; Cong, Fengjiao; Wang, Jue; Zhang, Wenxin; Zheng, Yuwei; Hyönä, Jukka

2018-01-01

Two lexical priming experiments were conducted to examine effects of grammatical structure of Chinese two-constituent compounds on their recognition. The target compound words conformed to two types of grammatical structure: subordinate and coordinative compounds. Subordinate compounds follow a structure where the first constituent modifies the second constituent (e.g., , meaning snowball); here the meaning of the second constituent (head) is modified by the first constituent (modifier). On the other hand, in coordinative compounds both constituents contribute equally to the word meaning (e.g., , wind and rain, meaning storm where the two constituent equally contribute to the word meaning). In Experiment 1 that was a replication attempt of Liu and McBride-Chang (2010), possible priming effects of word structure and semantic relatedness were examined. In lexical decision latencies only a semantic priming effect was observed. In Experiment 2, compound word structure and individual constituents were primed by the prime and target sharing either the first or second constituent. A structure priming effect was obtained in lexical decision times for subordinate compounds when the prime and target compound shared the same constituent. This suggests that a compound word constituent (either the modifier or the head) has to be simultaneously active with the structure information in order for the structure information to exert an effect on compound word recognition in Chinese. For the coordinative compounds the structure priming effect was non-significant. When the meaning of the whole word was primed (Experiment 1), no structure effect was observable. The pattern of results suggests that effects of structure priming are constituent-specific and no general structure priming was observable. PMID:29593594

Determining decision thresholds and evaluating indicators when conservation status is measured as a continuum.

PubMed

Connors, B M; Cooper, A B

2014-12-01

Categorization of the status of populations, species, and ecosystems underpins most conservation activities. Status is often based on how a system's current indicator value (e.g., change in abundance) relates to some threshold of conservation concern. Receiver operating characteristic (ROC) curves can be used to quantify the statistical reliability of indicators of conservation status and evaluate trade-offs between correct (true positive) and incorrect (false positive) classifications across a range of decision thresholds. However, ROC curves assume a discrete, binary relationship between an indicator and the conservation status it is meant to track, which is a simplification of the more realistic continuum of conservation status, and may limit the applicability of ROC curves in conservation science. We describe a modified ROC curve that treats conservation status as a continuum rather than a discrete state. We explored the influence of this continuum and typical sources of variation in abundance that can lead to classification errors (i.e., random variation and measurement error) on the true and false positive rates corresponding to varying decision thresholds and the reliability of change in abundance as an indicator of conservation status, respectively. We applied our modified ROC approach to an indicator of endangerment in Pacific salmon (Oncorhynchus nerka) (i.e., percent decline in geometric mean abundance) and an indicator of marine ecosystem structure and function (i.e., detritivore biomass). Failure to treat conservation status as a continuum when choosing thresholds for indicators resulted in the misidentification of trade-offs between true and false positive rates and the overestimation of an indicator's reliability. We argue for treating conservation status as a continuum when ROC curves are used to evaluate decision thresholds in indicators for the assessment of conservation status. © 2014 Society for Conservation Biology.

Simplified Acute Physiology Score II as Predictor of Mortality in Intensive Care Units: A Decision Curve Analysis.

PubMed

Allyn, Jérôme; Ferdynus, Cyril; Bohrer, Michel; Dalban, Cécile; Valance, Dorothée; Allou, Nicolas

2016-01-01

End-of-life decision-making in Intensive care Units (ICUs) is difficult. The main problems encountered are the lack of a reliable prediction score for death and the fact that the opinion of patients is rarely taken into consideration. The Decision Curve Analysis (DCA) is a recent method developed to evaluate the prediction models and which takes into account the wishes of patients (or surrogates) to expose themselves to the risk of obtaining a false result. Our objective was to evaluate the clinical usefulness, with DCA, of the Simplified Acute Physiology Score II (SAPS II) to predict ICU mortality. We conducted a retrospective cohort study from January 2011 to September 2015, in a medical-surgical 23-bed ICU at University Hospital. Performances of the SAPS II, a modified SAPS II (without AGE), and age to predict ICU mortality, were measured by a Receiver Operating Characteristic (ROC) analysis and DCA. Among the 4.370 patients admitted, 23.3% died in the ICU. Mean (standard deviation) age was 56.8 (16.7) years, and median (first-third quartile) SAPS II was 48 (34-65). Areas under ROC curves were 0.828 (0.813-0.843) for SAPS II, 0.814 (0.798-0.829) for modified SAPS II and of 0.627 (0.608-0.646) for age. DCA showed a net benefit whatever the probability threshold, especially under 0.5. DCA shows the benefits of the SAPS II to predict ICU mortality, especially when the probability threshold is low. Complementary studies are needed to define the exact role that the SAPS II can play in end-of-life decision-making in ICUs.

Simplified Acute Physiology Score II as Predictor of Mortality in Intensive Care Units: A Decision Curve Analysis

PubMed Central

Allyn, Jérôme; Ferdynus, Cyril; Bohrer, Michel; Dalban, Cécile; Valance, Dorothée; Allou, Nicolas

2016-01-01

Background End-of-life decision-making in Intensive care Units (ICUs) is difficult. The main problems encountered are the lack of a reliable prediction score for death and the fact that the opinion of patients is rarely taken into consideration. The Decision Curve Analysis (DCA) is a recent method developed to evaluate the prediction models and which takes into account the wishes of patients (or surrogates) to expose themselves to the risk of obtaining a false result. Our objective was to evaluate the clinical usefulness, with DCA, of the Simplified Acute Physiology Score II (SAPS II) to predict ICU mortality. Methods We conducted a retrospective cohort study from January 2011 to September 2015, in a medical-surgical 23-bed ICU at University Hospital. Performances of the SAPS II, a modified SAPS II (without AGE), and age to predict ICU mortality, were measured by a Receiver Operating Characteristic (ROC) analysis and DCA. Results Among the 4.370 patients admitted, 23.3% died in the ICU. Mean (standard deviation) age was 56.8 (16.7) years, and median (first-third quartile) SAPS II was 48 (34–65). Areas under ROC curves were 0.828 (0.813–0.843) for SAPS II, 0.814 (0.798–0.829) for modified SAPS II and of 0.627 (0.608–0.646) for age. DCA showed a net benefit whatever the probability threshold, especially under 0.5. Conclusion DCA shows the benefits of the SAPS II to predict ICU mortality, especially when the probability threshold is low. Complementary studies are needed to define the exact role that the SAPS II can play in end-of-life decision-making in ICUs. PMID:27741304

Expert Elicitation of Multinomial Probabilities for Decision-Analytic Modeling: An Application to Rates of Disease Progression in Undiagnosed and Untreated Melanoma.

PubMed

Wilson, Edward C F; Usher-Smith, Juliet A; Emery, Jon; Corrie, Pippa G; Walter, Fiona M

2018-06-01

Expert elicitation is required to inform decision making when relevant "better quality" data either do not exist or cannot be collected. An example of this is to inform decisions as to whether to screen for melanoma. A key input is the counterfactual, in this case the natural history of melanoma in patients who are undiagnosed and hence untreated. To elicit expert opinion on the probability of disease progression in patients with melanoma that is undetected and hence untreated. A bespoke webinar-based expert elicitation protocol was administered to 14 participants in the United Kingdom, Australia, and New Zealand, comprising 12 multinomial questions on the probability of progression from one disease stage to another in the absence of treatment. A modified Connor-Mosimann distribution was fitted to individual responses to each question. Individual responses were pooled using a Monte-Carlo simulation approach. Participants were asked to provide feedback on the process. A pooled modified Connor-Mosimann distribution was successfully derived from participants' responses. Feedback from participants was generally positive, with 86% willing to take part in such an exercise again. Nevertheless, only 57% of participants felt that this was a valid approach to determine the risk of disease progression. Qualitative feedback reflected some understanding of the need to rely on expert elicitation in the absence of "hard" data. We successfully elicited and pooled the beliefs of experts in melanoma regarding the probability of disease progression in a format suitable for inclusion in a decision-analytic model. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Does Tropical Cyclone Modification Make Sense? A Decision-Analytic Assessment

NASA Astrophysics Data System (ADS)

Klima, K.; Morgan, M. G.; Grossmann, I.

2009-12-01

Since the demise of project Stormfury in 1983, little attention has been devoted to the possibility of intentionally modifying tropical cyclones (TC). However, following Hurricane Katrina and three other Category 5 hurricanes (Emily, Rita, and Wilma), which together resulted in at least 2,280 deaths and over $120-billion in damages (Blake et al., 2007), the U.S. Department of Homeland Security (DHS) has recently begun to support an effort to identify and evaluate hurricane mitigation strategies through Project HURRMIT ([http://www.ofcm.noaa.gov/ihc09/Presentations/Session10/s10-01Woodley.ppt]). Using a decision analytic framing and FEMA's HAZUS-MH MR3 damage model (http://www.fema.gov/plan/prevent/hazus/]), this paper asks, how sure must one be that an intervention will reduce TC damages before choosing to undertake a program of modification? The analysis is formulated in probabilistic terms, and assesses net benefits. In contrast to a much earlier application of decision analysis to TC-modification (Howard et al., 1972) , this work uses census data on the value of property at risk, and prior distributions on changing storm behavior based on data from hurricanes approaching the east coast of Florida since 1953. Even before considering both issues of liability that may arise from the fact that a modified storm is no longer "an act of God" as well as unforeseen environmental consequences, our results suggest that while TC modification techniques will likely alter TC behavior, one will have to be significantly more confident of the predictability and effectiveness of modification methods before their use can be justified. This work is supported by the Climate Decision Making Center through a cooperative agreement between the National Science Foundation (SES-0345798) and Carnegie Mellon University.

Decentralisation of Health Services in Fiji: A Decision Space Analysis.

PubMed

Mohammed, Jalal; North, Nicola; Ashton, Toni

2015-11-15

Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules) within the decentralised services. Fiji's centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji's deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited. © 2016 by Kerman University of Medical Sciences.

Effects of Direct and Indirect Instruction on Fostering Decision-Making Competence in Socioscientific Issues

NASA Astrophysics Data System (ADS)

Böttcher, Florian; Meisert, Anke

2013-04-01

In this study the effects of different learning environments on the promotion of decision-making competence for the socioscientific issue of genetically modified crops is investigated. The comparison focuses on direct vs. indirect instructions. Therefore on the one hand a sophisticated decision-making strategy was presented to the directly instructed experimental group (1) and had to be applied correctly. On the other hand indirectly instructed students had to invent an appropriate strategy by themselves (2) based on the given information and the structure of the problem context. Group discussions are analysed qualitatively in order (1) to outline how the given strategy was understood and its results were reflected on by the students and (2) to explore the characteristics of invented strategies and their degree of complexity. Results indicate that the direct instruction of complex decision-making strategies may lead to a lack of understanding of the decision process when the given strategy is applied and therefore may cause rejection of the final decision. Indirectly instructed students were able to invent sophisticated decision-making strategies containing compensatory trade-offs. It is concluded that when directly instructing complex decision-making strategies, essential parts of reflection have to be integrated in order to gain greater transparency. Accordingly, empirical evidence has been found to consider indirect instruction as a possible way to foster decision-making strategies for complex socioscientific issues even if compensatory procedures are considered to be necessary.

78 FR 35627 - Columbia Gas Transmission, LLC; Notice of Intent To Prepare an Environmental Assessment for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-13

... plans to modify one interconnect in New York, three compressor stations in Pennsylvania and one compressor station in Maryland. The Commission will use this EA in its decision-making process to determine... Compressor Station (Milford, Pennsylvania): Abandon the existing compressors and replace them with two Solar...

Morphological Processing of Chinese Compounds from a Grammatical View

ERIC Educational Resources Information Center

Liu, Phil D.; McBride-Chang, Catherine

2010-01-01

In the present study, morphological structure processing of Chinese compounds was explored using a visual priming lexical decision task among 21 Hong Kong college students. Two compounding structures were compared. The first type was the subordinate, in which one morpheme modifies the other (e.g., [image omitted] ["laam4 kau4",…

Adapting the RoboCup Simulation for Autonomous Vehicle Team Information Fusion and Decision Making Experimentation

DTIC Science & Technology

2010-06-01

researchers outside the government to produce the kinds of algorithms and software that would easily transition into solutions for teams of autonomous ... vehicles for military scenarios. To accomplish this, we began modifying the RoboCup soccer game step-by-step to incorporate rules that simulate these

10 CFR 2.334 - Implementing hearing schedule for proceeding.

Code of Federal Regulations, 2010 CFR

2010-01-01

... proceeding shall, based on information and projections provided by the parties and the NRC staff, take... issuance of its initial decision. (b) Modification of hearing schedule. A hearing schedule may not be modified except upon a finding of good cause by the presiding officer or the Commission. In making such a...

Accelerated Learning Options: A Promising Strategy for States. Policy Insights

ERIC Educational Resources Information Center

Michelau, Demaree

2006-01-01

This issue of Policy Insights draws on findings from WICHE's report Accelerated Learning Options: Moving the Needle on Access and Success, to lay out some of the important policy issues that decision makers might consider when adopting new state policy related to accelerated learning or modifying policies already in existence. The publication…

Intelligent Tutoring System Using Decision Based Learning for Thermodynamic Phase Diagrams

ERIC Educational Resources Information Center

Hagge, Mathew; Amin-Naseri, Mostafa; Jackman, John; Guo, Enruo; Gilbert, Stephen B.; Starns, Gloria; Faidley, Leann

2017-01-01

Students learn when they connect new information to existing understanding or when they modify existing understanding to accept new information. Most current teaching methods focus on trying to get students to solve problems in a manner identical to that of an expert. This study investigates the effectiveness of assessing student understanding…

"What Would Make This a Successful Year for You?" How Students Define Success in College

ERIC Educational Resources Information Center

Jennings, Nancy; Lovett, Suzanne; Cuba, Lee; Swingle, Joe; Lindkvist, Heather

2013-01-01

The New England Consortium on Assessment and Student Learning (NECASL) seeks to understand how students make important decisions during college, assess the extent to which institutional policies and practices foster student learning, and modify those policies and practices accordingly. In this article, the authors analyze interviews with a…

An Evaluation of the Effects of Graphic Aids in Improving Decision Accuracy in a Continuous Treatment Design

ERIC Educational Resources Information Center

Van Norman, Ethan R.; Nelson, Peter M.; Shin, Jae-Eun; Christ, Theodore J.

2013-01-01

Educators, school psychologists, and other professionals must evaluate student progress and decide to continue, modify, or terminate instructional programs to ensure student success. For this purpose, progress-monitoring data are often collected, plotted graphically, and visually analyzed. The current study evaluated the impact of three common…

Exploring Middle School Students' Understanding of Three Conceptual Models in Genetics

ERIC Educational Resources Information Center

Freidenreich, Hava Bresler; Duncan, Ravit Golan; Shea, Nicole

2011-01-01

Genetics is the cornerstone of modern biology and a critical aspect of scientific literacy. Research has shown, however, that many high school graduates lack fundamental understandings in genetics necessary to make informed decisions about issues and emerging technologies in this domain, such as genetic screening, genetically modified foods, etc.…

5 CFR 9701.706 - MSPB appellate procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... is based on a finding of discrimination prohibited under 5 U.S.C. 2302(b)(1), the payment of... discipline in the workplace, an arbitrator, adjudicating official, or MSPB may not modify the penalty imposed... allegations of discrimination, judicial review of any final MSPB order or decision is as prescribed under 5 U...

A FACETS Analysis of Rater Bias in Measuring Japanese Second Language Writing Performance.

ERIC Educational Resources Information Center

Kondo-Brown, Kimi

2002-01-01

Using FACETS, investigates how judgments of trained teacher raters are biased toward certain types of candidates and certain criteria in assessing Japanese second language writing. Explores the potential for using a modified version of a rating scale for norm-referenced decisions about Japanese second language writing ability. (Author/VWL)

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…

Harnessing Teacher Potential as Israel Education Curriculum Developers

ERIC Educational Resources Information Center

Katz, Meredith

2015-01-01

In this article I investigate how one group of teachers deliberated about Israel education with the intention to "modify the myth" as they engaged in curriculum reform. I begin from the idea that curriculum development should be an in-house endeavor that encourages faculty to embrace their roles as curricular decision-makers.…

Dollars Works 2: The Evolution of a Financial Literacy Program

ERIC Educational Resources Information Center

Petersen, Cindy M.; Heins, Rosemary K.; Katras, Mary Jo

2013-01-01

Dollar Works 2 is a comprehensive personal financial education program to help individuals and families strengthen their skills, better manage their personal finances, and make sound decisions about money. This article chronicles the evolution of a curriculum to enhance and modify materials to improve learning and meet the needs of multiple…

An Update on the Status of Anatomical Sciences Education in United States Medical Schools

ERIC Educational Resources Information Center

Drake, Richard L.; McBride, Jennifer M.; Pawlina, Wojciech

2014-01-01

Curricular changes continue at United States medical schools and directors of gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses continue to adjust and modify their offerings. Developing and supplying data related to current trends in anatomical sciences education is important if informed decisions are going to…

Use of Social Welfare Programs and the Disintegration of the Black Nuclear Family.

ERIC Educational Resources Information Center

Jewell, K. Sue

1984-01-01

Social welfare programs contribute to Black women's decisions to terminate their marriages by modifying existing beliefs and values, giving rise to a perception of welfare as a more viable alternative to marital relationships. But welfare is insufficient to enable the maintenance of Black women's preseparation standard of living. (RDN)

Procedures vs. Incentives: The University Promotion System in Italy

ERIC Educational Resources Information Center

Rettore, Enrico; Rocco, Lorenzo; Dal Maso, Carlo

2018-01-01

We evaluate two reforms that modified the procedures of recruitment and promotion in Italian academia to balance the preeminent role of the recruiting school and to counter nepotism. We theoretically derive the decision rule of the evaluation committees and test it against data including information from all selections to associate and full…

Directional Slack-Based Measure for the Inverse Data Envelopment Analysis

PubMed Central

Abu Bakar, Mohd Rizam; Lee, Lai Soon; Jaafar, Azmi B.; Heydar, Maryam

2014-01-01

A novel technique has been introduced in this research which lends its basis to the Directional Slack-Based Measure for the inverse Data Envelopment Analysis. In practice, the current research endeavors to elucidate the inverse directional slack-based measure model within a new production possibility set. On one occasion, there is a modification imposed on the output (input) quantities of an efficient decision making unit. In detail, the efficient decision making unit in this method was omitted from the present production possibility set but substituted by the considered efficient decision making unit while its input and output quantities were subsequently modified. The efficiency score of the entire DMUs will be retained in this approach. Also, there would be an improvement in the efficiency score. The proposed approach was investigated in this study with reference to a resource allocation problem. It is possible to simultaneously consider any upsurges (declines) of certain outputs associated with the efficient decision making unit. The significance of the represented model is accentuated by presenting numerical examples. PMID:24883350

GMOs: building the future on the basis of past experience.

PubMed

Reis, Luiz F L; Van Sluys, Marie-Anne; Garratt, Richard C; Pereira, Humberto M; Teixeira, Mauro M

2006-12-01

Biosafety of genetically modified organisms (GMOs) and their derivatives is still a major topic in the agenda of government and societies worldwide. The aim of this review is to bring into light that data that supported the decision taken back in 1998 as an exercise to stimulate criticism from the scientific community for upcoming discussions and to avoid emotional and senseless arguments that could jeopardize future development in the field. It must be emphasized that Roundup Ready soybean is just one example of how biotechnology can bring in significant advances for society, not only through increased productivity, but also with beneficial environmental impact, thereby allowing more rational use of agricultural pesticides for improvement of the soil conditions. The adoption of agricultural practices with higher yield will also allow better distribution of income among small farmers. New species of genetically modified plants will soon be available and society should be capable of making decisions in an objective and well-informed manner, through collegiate bodies that are qualified in all aspects of biosafety and environmental impact.

Instruments to assess the perception of physicians in the decision-making process of specific clinical encounters: a systematic review

PubMed Central

Légaré, France; Moher, David; Elwyn, Glyn; LeBlanc, Annie; Gravel, Karine

2007-01-01

Background The measurement of processes and outcomes that reflect the complexity of the decision-making process within specific clinical encounters is an important area of research to pursue. A systematic review was conducted to identify instruments that assess the perception physicians have of the decision-making process within specific clinical encounters. Methods For every year available up until April 2007, PubMed, PsycINFO, Current Contents, Dissertation Abstracts and Sociological Abstracts were searched for original studies in English or French. Reference lists from retrieved studies were also consulted. Studies were included if they reported a self-administered instrument evaluating physicians' perceptions of the decision-making process within specific clinical encounters, contained sufficient description to permit critical appraisal and presented quantitative results based on administering the instrument. Two individuals independently assessed the eligibility of the instruments and abstracted information on their conceptual underpinnings, main evaluation domain, development, format, reliability, validity and responsiveness. They also assessed the quality of the studies that reported on the development of the instruments with a modified version of STARD. Results Out of 3431 records identified and screened for evaluation, 26 potentially relevant instruments were assessed; 11 met the inclusion criteria. Five instruments were published before 1995. Among those published after 1995, five offered a corresponding patient version. Overall, the main evaluation domains were: satisfaction with the clinical encounter (n = 2), mutual understanding between health professional and patient (n = 2), mental workload (n = 1), frustration with the clinical encounter (n = 1), nurse-physician collaboration (n = 1), perceptions of communication competence (n = 2), degree of comfort with a decision (n = 1) and information on medication (n = 1). For most instruments (n = 10), some reliability and validity criteria were reported in French or English. Overall, the mean number of items on the modified version of STARD was 12.4 (range: 2 to 18). Conclusion This systematic review provides a critical appraisal and repository of instruments that assess the perception physicians have of the decision-making process within specific clinical encounters. More research is needed to pursue the validation of the existing instruments and the development of patient versions. This will help researchers capture the complexity of the decision-making process within specific clinical encounters. PMID:17937801

Future of electronic health records: implications for decision support.

PubMed

Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

2012-01-01

The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data in real-time for decision support and process automation has the potential to both reduce costs and improve the quality of patient care. © 2012 Mount Sinai School of Medicine.

Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

PubMed

Staszewska, Anna; Zaki, Pearl; Lee, Joon

2017-10-06

Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious illness. ©Anna Staszewska, Pearl Zaki, Joon Lee. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 06.10.2017.

In Situ FTIR and NMR Spectroscopic Investigations on Ruthenium-Based Catalysts for Alkene Hydroformylation.

PubMed

Kubis, Christoph; Profir, Irina; Fleischer, Ivana; Baumann, Wolfgang; Selent, Detlef; Fischer, Christine; Spannenberg, Anke; Ludwig, Ralf; Hess, Dieter; Franke, Robert; Börner, Armin

2016-02-18

Homogeneous ruthenium complexes modified by imidazole-substituted monophosphines as catalysts for various highly efficient hydroformylation reactions were characterized by in situ IR spectroscopy under reaction conditions and NMR spectroscopy. A proper protocol for the preformation reaction from [Ru3 (CO)12] is decisive to prevent the formation of inactive ligand-modified polynuclear complexes. During catalysis, ligand-modified mononuclear ruthenium(0) carbonyls were detected as resting states. Changes in the ligand structure have a crucial impact on the coordination behavior of the ligand and consequently on the catalytic performance. The substitution of CO by a nitrogen atom of the imidazolyl moiety in the ligand is not a general feature, but it takes place when structural prerequisites of the ligand are fulfilled. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Preferences of processing companies for attributes of Swiss milk: a conjoint analysis in a business-to-business market.

PubMed

Boesch, I

2013-04-01

This study aimed to determine key attributes of milk that drive a processor's supply decisions and possibilities for differentiation based on these product attributes. Feedback-driven exploration was applied to derive product attributes relevant to the buying decision. Conjoint analysis with hierarchical Bayes estimation methods was used to determine the relative importance of attributes. Results show that the technical aspects of milk, as well as the price and country of origin, dominate the buying decision. Potential for differentiation was found for environmental and societal attributes as well as freedom from genetically modified products. Product and supplier criteria also provide the potential to segment the market if the price premium is held within limits. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Determinants of Regret in Elderly Dialysis Patients.

PubMed

Tan, Edlyn Gui Fang; Teo, Irene; Finkelstein, Eric A; Chan, Choong Meng

2018-05-07

In Singapore, most elderly end stage renal disease (ESRD) patients choose dialysis over palliative management. However, dialysis may not be the optimal treatment option given only moderate survival benefits and high costs and treatment burden compared to non-dialysis management. Elderly patients may therefore come to regret this decision. This study investigated (1) extent of patients' decision regret after starting dialysis, and (2) potentially modifiable predictors of regret: satisfaction with chronic kidney disease education, decisional conflict, and decision-making involvement. Cross-sectional study of 103 dialysis patients above 70 years old surveyed at Singapore General Hospital's renal medicine clinics between March and June 2017. Participants reported their levels of decision regret on the Decision Regret Scale (DRS), retrospective decisional conflict on the Decisional Conflict Scale, information satisfaction, and decision-making involvement. 81% of participants reported no decision regret (DRS score <50), 11% ambivalence (DRS =50), and 8% regret (DRS >50). In individual DRS items, 19% felt dialysis had done them harm and 16% would not make the same decision again. In multivariable analyses, lower information satisfaction [b = -0.07 (95% CI: -0.13, -0.01)] and decisional conflict [b = 0.004 (95% CI: 0.002, 0.006)] were significantly associated with decision regret. Although majority of elderly dialysis patients were comfortable with their decision to start dialysis, a proportion was ambivalent or regretted this choice. Regret was more likely among those who experienced decisional conflict and/or expressed poorer information satisfaction. Healthcare professionals should recognize these risk factors and take steps to minimize chances of regret among this population subset. This article is protected by copyright. All rights reserved.

Jordanian Physicians' Attitudes toward Disclosure of Cancer Information and Patient Participation in Treatment Decision-making.

PubMed

Obeidat, Rana; Khrais, Huthaifah I

2016-01-01

This study aims to determine the attitude of Jordanian physicians toward disclosure of cancer information, comfort and use of different decision-making approaches, and treatment decision making. A descriptive, comparative research design was used. A convenience sample of 86 Jordanian medical and radiation oncologists and surgeons practicing mainly in oncology was recruited. A modified version of a structured questionnaire was used for data collection. The questionnaire is a valid measure of physicians' views of shared decision making. Almost 91% of all physicians indicated that the doctor should tell the patient and let him/her decide if the family should know of an early-stage cancer diagnosis. Physicians provide abundant information about the extent of the disease, the side effects and benefits of the treatment, and details of the treatment procedures. They also provided less information on the effects of treatment on the sexuality, mood, and family of the patient. Almost 48% of the participating physicians reported using shared decision making as their usual approach for treatment decision making, and 67% reported that they were comfortable with this approach. The main setting of clinical activity was the only factor associated with physicians' usual approach to medical decision making. Moreover, age, years of experience, and main setting of clinical activity were associated with physicians' comfort level with the shared approach. Although Jordanian physicians appreciate patient autonomy, self-determination, and right to information, paternalistic decision making and underuse of the shared decision-making approach persist. Strategies that target both healthcare providers and patients must be employed to promote shared decision making in the Jordanian healthcare system.

IONIO Project: Computer-mediated Decision Support System and Communication in Ocean Science

NASA Astrophysics Data System (ADS)

Oddo, Paolo; Acierno, Arianna; Cuna, Daniela; Federico, Ivan; Galati, Maria Barbara; Awad, Esam; Korres, Gerasimos; Lecci, Rita; Manzella, Giuseppe M. R.; Merico, Walter; Perivoliotis, Leonidas; Pinardi, Nadia; Shchekinova, Elena; Mannarini, Gianandrea; Vamvakaki, Chrysa; Pecci, Leda; Reseghetti, Franco

2013-04-01

A decision Support System is composed by four main steps. The first one is the definition of the problem, the issue to be covered, decisions to be taken. Different causes can provoke different problems, for each of the causes or its effects it is necessary to define a list of information and/or data that are required in order to take the better decision. The second step is the determination of sources from where information/data needed for decision-making can be obtained and who has that information. Furthermore it must be possible to evaluate the quality of the sources to see which of them can provide the best information, and identify the mode and format in which the information is presented. The third step is relying on the processing of knowledge, i.e. if the information/data are fitting for purposes. It has to be decided which parts of the information/data need to be used, what additional data or information is necessary to access, how can information be best presented to be able to understand the situation and take decisions. Finally, the decision making process is an interactive and inclusive process involving all concerned parties, whose different views must be taken into consideration. A knowledge based discussion forum is necessary to reach a consensus. A decision making process need to be examined closely and refined, and modified to meet differing needs over time. The report is presenting legal framework and knowledge base for a scientific based decision support system and a brief exploration of some of the skills that enhances the quality of decisions taken.

Consume, Modify, Share (CMS): The Interplay between Individual Decisions and Structural Network Properties in the Diffusion of Information

PubMed Central

Koren, Hila; Kaminer, Ido

2016-01-01

Widely used information diffusion models such as Independent Cascade Model, Susceptible Infected Recovered (SIR) and others fail to acknowledge that information is constantly subject to modification. Some aspects of information diffusion are best explained by network structural characteristics while in some cases strong influence comes from individual decisions. We introduce reinvention, the ability to modify information, as an individual level decision that affects the diffusion process as a whole. Based on a combination of constructs from the Diffusion of Innovations and the Critical Mass Theories, the present study advances the CMS (consume, modify, share) model which accounts for the interplay between network structure and human behavior and interactions. The model's building blocks include processes leading up to and following the formation of a critical mass of information adopters and disseminators. We examine the formation of an inflection point, information reach, sustainability of the diffusion process and collective value creation. The CMS model is tested on two directed networks and one undirected network, assuming weak or strong ties and applying constant and relative modification schemes. While all three networks are designed for disseminating new knowledge they differ in structural properties. Our findings suggest that modification enhances the diffusion of information in networks that support undirected connections and carries the biggest effect when information is shared via weak ties. Rogers' diffusion model and traditional information contagion models are fine tuned. Our results show that modifications not only contribute to a sustainable diffusion process, but also aid information in reaching remote areas of the network. The results point to the importance of cultivating weak ties, allowing reciprocal interaction among nodes and supporting the modification of information in promoting diffusion processes. These results have theoretical and practical implications for designing networks aimed at accelerating the creation and diffusion of information. PMID:27798636

Consume, Modify, Share (CMS): The Interplay between Individual Decisions and Structural Network Properties in the Diffusion of Information.

PubMed

Koren, Hila; Kaminer, Ido; Raban, Daphne Ruth

2016-01-01

Widely used information diffusion models such as Independent Cascade Model, Susceptible Infected Recovered (SIR) and others fail to acknowledge that information is constantly subject to modification. Some aspects of information diffusion are best explained by network structural characteristics while in some cases strong influence comes from individual decisions. We introduce reinvention, the ability to modify information, as an individual level decision that affects the diffusion process as a whole. Based on a combination of constructs from the Diffusion of Innovations and the Critical Mass Theories, the present study advances the CMS (consume, modify, share) model which accounts for the interplay between network structure and human behavior and interactions. The model's building blocks include processes leading up to and following the formation of a critical mass of information adopters and disseminators. We examine the formation of an inflection point, information reach, sustainability of the diffusion process and collective value creation. The CMS model is tested on two directed networks and one undirected network, assuming weak or strong ties and applying constant and relative modification schemes. While all three networks are designed for disseminating new knowledge they differ in structural properties. Our findings suggest that modification enhances the diffusion of information in networks that support undirected connections and carries the biggest effect when information is shared via weak ties. Rogers' diffusion model and traditional information contagion models are fine tuned. Our results show that modifications not only contribute to a sustainable diffusion process, but also aid information in reaching remote areas of the network. The results point to the importance of cultivating weak ties, allowing reciprocal interaction among nodes and supporting the modification of information in promoting diffusion processes. These results have theoretical and practical implications for designing networks aimed at accelerating the creation and diffusion of information.

Superfund record of decision amendment (EPA Region 5): Woodstock Municipal LF, Woodstock, IL, July 15, 1998

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

NONE

This decision document represents the United States Environmental Protection Agency`s (US EPA) selected final remedial action for the Site located in Woodstock, Illinois. The US EPA, in consultation with the IEPA, is modifying the landfill cap profile, and the requirement to construct a groundwater pump-and-treat system to address residual vinyl chloride contamination in the upper water-bearing unit, down gradient of the landfill. This remedy is intended to be the final action for the site, and addresses all contaminated media, including: contaminated soil, sediment, and groundwater, landfilled wastes, leachate generation and emission of landfill gases.

Decision feedback equalizer for holographic data storage.

PubMed

Kim, Kyuhwan; Kim, Seung Hun; Koo, Gyogwon; Seo, Min Seok; Kim, Sang Woo

2018-05-20

Holographic data storage (HDS) has attracted much attention as a next-generation storage medium. Because HDS suffers from two-dimensional (2D) inter-symbol interference (ISI), the partial-response maximum-likelihood (PRML) method has been studied to reduce 2D ISI. However, the PRML method has various drawbacks. To solve the problems, we propose a modified decision feedback equalizer (DFE) for HDS. To prevent the error propagation problem, which is a typical problem in DFEs, we also propose a reliability factor for HDS. Various simulations were executed to analyze the performance of the proposed methods. The proposed methods showed fast processing speed after training, superior bit error rate performance, and consistency.

Stress effects on framed decisions: there are differences for gains and losses.

PubMed

Pabst, Stephan; Brand, Matthias; Wolf, Oliver T

2013-01-01

Recent studies have shown that acute stress can lead to riskier decision making. Yet, the underlying mechanisms of the stress effects on decisions under risk remain poorly understood. To gain a better understanding of decision-making processes and potential strategy application under stress, we investigated decision making in pure gain and loss domains with unequal expected values (EVs) across alternatives. We conducted an experimental study with a 2 × 2 design (stress vs. no stress and gain domain vs. loss domain). The Trier Social Stress Test (TSST) was utilized to induce acute stress. Controls performed the placebo-TSST (p-TSST). To validate the stress response we measured salivary cortisol and alpha-amylase concentrations. We used a modified version of the Game of Dice Task (GDT) to assess decision-making performance in a gain and a loss domain. Results showed that non-stressed participants made less risky decisions in the gain domain compared to those of the loss domain. This behavior is in accordance with previous studies and indicates the stability of the framing effect in even more complex tasks with changing EVs across alternatives. Stress did not alter risk taking behavior in the gain domain. Yet, in the loss domain stressed participants made less risky decisions compared to controls. Additionally, the data support earlier findings of longer reaction times in loss compared to gain domains due to higher cognitive effort for loss-framed decisions. It is discussed that stress may lead to reduced amygdala activation, which has been found to reduce riskier decisions in a loss domain. With respect to earlier results of riskier decisions in tasks that unite both gain and loss domains, it is discussed whether stress leads to a stronger evaluation of high gains and a neglect of losses.

Older Americans' risk-benefit preferences for modifying the course of Alzheimer disease.

PubMed

Hauber, A Brett; Johnson, F Reed; Fillit, Howard; Mohamed, Ateesha F; Leibman, Christopher; Arrighi, H Michael; Grundman, Michael; Townsend, Raymond J

2009-01-01

Alzheimer disease (AD) is a progressive, ultimately fatal neurodegenerative illness affecting millions of patients, families, and caregivers. Effective disease-modifying therapies for AD are desperately needed, but none currently exist on the market. Thus, accelerating the discovery, development, and approval of new disease-modifying drugs for AD is a high priority for individuals, physicians, and medical decision makers. Potentially disease-modifying drugs likely will have significant therapeutic benefits but also may have treatment-related risks. We quantified older Americans' treatment-related risk tolerance by eliciting their willingness to accept the risk of treatment-related death or permanent severe disability in exchange for modifying the course of AD. A stated-choice survey instrument was administered to 2146 American residents 60 years of age and older. On average, subjects were willing to accept a 1-year risk of treatment-related death or permanent severe disability from stroke of over 30% for a treatment that prevents AD from progressing beyond the mild stage. Thus, most people in this age cohort are willing to accept considerable risks in return for disease-modifying benefits of new AD drugs. These results are consistent with other studies indicating that individuals view AD as a serious, life threatening illness that imposes heavy burdens on both patients and caregivers.

The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

PubMed

Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

2016-09-01

To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group

PubMed Central

Bourmaud, Aurelie; Soler-Michel, Patricia; Oriol, Mathieu; Regnier, Véronique; Tinquaut, Fabien; Nourissat, Alice; Bremond, Alain; Moumjid, Nora; Chauvin, Franck

2016-01-01

Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated. PMID:26883201

Pruning a decision tree for selecting computer-related assistive devices for people with disabilities.

PubMed

Chi, Chia-Fen; Tseng, Li-Kai; Jang, Yuh

2012-07-01

Many disabled individuals lack extensive knowledge about assistive technology, which could help them use computers. In 1997, Denis Anson developed a decision tree of 49 evaluative questions designed to evaluate the functional capabilities of the disabled user and choose an appropriate combination of assistive devices, from a selection of 26, that enable the individual to use a computer. In general, occupational therapists guide the disabled users through this process. They often have to go over repetitive questions in order to find an appropriate device. A disabled user may require an alphanumeric entry device, a pointing device, an output device, a performance enhancement device, or some combination of these. Therefore, the current research eliminates redundant questions and divides Anson's decision tree into multiple independent subtrees to meet the actual demand of computer users with disabilities. The modified decision tree was tested by six disabled users to prove it can determine a complete set of assistive devices with a smaller number of evaluative questions. The means to insert new categories of computer-related assistive devices was included to ensure the decision tree can be expanded and updated. The current decision tree can help the disabled users and assistive technology practitioners to find appropriate computer-related assistive devices that meet with clients' individual needs in an efficient manner.

75 FR 64296 - Revised Record of Decision for Offer of Conditional Commitment for a Loan Guarantee for, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-19

... Energy (DOE), Loan Programs Office (LP) and Bonneville Power Administration (BPA). ACTION: Revised Record..., Oregon. This ROD revises a previous BPA ROD approving the interconnection of the Wind Project to the... Project for: The issuance by BPA of modified Large Generator Interconnection Agreements (LGIAs); and the...

PDM and the Internet: A Look at Product Management and Its Internet Opportunities.

ERIC Educational Resources Information Center

Mendel, Alan

1997-01-01

Discusses the impact of internet technology on product data management (PDM) vendor's and the users' purchasing decisions. Internet users anticipate graphical user interface (GUI) and two-way communication which allow users to enter and modify data as well as access it. Examines PDM and the Internet: price and performance, the World Wide Web,…

Meeting Students' Needs on the Titanic: Lessons Learned While Closing a Campus.

ERIC Educational Resources Information Center

Hanna, Kathryn L.

In March 1991, the Regents of the University of Minnesota voted to close the two-year campus at Waseca (UMW) campus effective June 1992. Student needs were the overriding factor in administrative decision making during the final year. It was necessary to continue current services in a "normal," if modified, fashion, while at the same…

75 FR 51124 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-18

...-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing and Immediate Effectiveness of Proposed Rule Change Relating to Amendments to FINRA Rule 2360 To Extend the Time To Submit a Contrary Exercise Advice and the Time for a Final Exercise Decision in the Event of a Modified Close of...

A Comparison of Web-Based Standard Setting and Monitored Standard Setting.

ERIC Educational Resources Information Center

Harvey, Anne L.; Way, Walter D.

Standard setting, when carefully done, can be an expensive and time-consuming process. The modified Angoff method and the benchmark method, as utilized in this study, employ representative panels of judges to provide recommended passing scores to standard setting decision-makers. It has been considered preferable to have the judges meet in a…

76 FR 67205 - Notice of Intent To Prepare an Amendment to the Cascade-Siskiyou National Monument Resource...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... . Fax: (541) 618-2400, Attention: Kathy Minor. Mail or hand delivery: Bureau of Land Management, Medford District Office, 3040 Biddle Road, Medford, Oregon 97504, Attention: Kathy Minor. Documents pertinent to... amendment and associated EA will modify land tenure adjustment decisions in the CSNM RMP to allow for land...

76 FR 71369 - Robert G. Crummie, M.D.; Decision and Order

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-60] Robert G. Crummie, M.D... Registration, BC2964965, issued to Robert G. Crummie, M.D., be, and it hereby is, revoked. I further order that any pending application of Robert G. Crummie, M.D., to renew or modify his registration, be, and it...

Inferential Processing and Meta-Knowledge as the Bases for Property Inclusion in Combined Concepts

ERIC Educational Resources Information Center

Gagne, Christina L.; Spalding, Thomas L.

2011-01-01

Past research has found that the judged likelihood of properties of modified nouns (baby ducks have webbed feet) is reduced relative to unmodified nouns (ducks have webbed feet). Experiments 1-3 replicate the modification effect and demonstrate that this effect is obtained when participants make dichotomous decisions about the truth of such…

School Funding in Ohio: From "DeRolph" to the Evidence-Based Model (EBM) and beyond

ERIC Educational Resources Information Center

Pittner, Nicholas A.; Carleton, Melissa M.; Casto, Cassandra

2010-01-01

Beginning in 1997, a series of Ohio Supreme Court decisions ruled that Ohio's school foundation-based funding system was unconstitutional. Despite judicially mandated reform directives, little change was made until recently when Ohio adopted a modified Evidence-Based Model (EBM) into its statutory funding scheme. Ohio's EBM is intended to remedy…

Linguistic Analysis of Constructed Student Responses in CAI.

ERIC Educational Resources Information Center

Simmons, Robert F.

Protosynthex III (PSIII) is a language processing system developed as an (as yet inadequate) experimental vehicle for testing student responses, with a view to constructing a model of an automated tutor. A version of the PLANIT system was modified so that a human tutor could be used to make instructional decisions in response to students'…

Morphological Structure Processing during Word Recognition and Its Relationship to Character Reading among Third-Grade Chinese Children

ERIC Educational Resources Information Center

Liu, Duo; McBride-Chang, Catherine

2014-01-01

In the present study, we explored the characteristics of morphological structure processing during word recognition among third grade Chinese children and its possible relationship with Chinese character reading. By using the modified priming lexical decision paradigm, a significant morphological structure priming effect was found in the subject…

Ecological risk assessment to support fuels treatment project decisions

Treesearch

Jay O' Laughlin

2010-01-01

Risk is a combined statement of the probability that something of value will be damaged and some measure of the damage’s adverse effect. Wildfires burning in the uncharacteristic fuel conditions now typical throughout the Western United States can damage ecosystems and adversely affect environmental conditions. Wildfire behavior can be modified by prefire fuel...

Understanding "Serious Videogame" storyline and genre preferences related to game immersion among low-income ethnically diverse urban and rural adolescents

USDA-ARS?s Scientific Manuscript database

Researchers and non-profit organizations have embraced various media, because they help school-aged children acquire knowledge and develop decision-making ski11s. Serious videogames (i.e., games designed to entertain and educate, train or change behavior) may be effective at modifying youth health b...

Sequence-sensitive exemplar and decision-bound accounts of speeded-classification performance in a modified Garner-tasks paradigm.

PubMed

Little, Daniel R; Wang, Tony; Nosofsky, Robert M

2016-09-01

Among the most fundamental results in the area of perceptual classification are the "correlated facilitation" and "filtering interference" effects observed in Garner's (1974) speeded categorization tasks: In the case of integral-dimension stimuli, relative to a control task, single-dimension classification is faster when there is correlated variation along a second dimension, but slower when there is orthogonal variation that cannot be filtered out (e.g., by attention). These fundamental effects may result from participants' use of a trial-by-trial bypass strategy in the control and correlated tasks: The observer changes the previous category response whenever the stimulus changes, and maintains responses if the stimulus repeats. Here we conduct modified versions of the Garner tasks that eliminate the availability of a pure bypass strategy. The fundamental facilitation and interference effects remain, but are still largely explainable in terms of pronounced sequential effects in all tasks. We develop sequence-sensitive versions of exemplar-retrieval and decision-bound models aimed at capturing the detailed, trial-by-trial response-time distribution data. The models combine assumptions involving: (i) strengthened perceptual/memory representations of stimuli that repeat across consecutive trials, and (ii) a bias to change category responses on trials in which the stimulus changes. These models can predict our observed effects and provide a more complete account of the underlying bases of performance in our modified Garner tasks. Copyright © 2016 Elsevier Inc. All rights reserved.

NASA-modified precipitation products to improve USEPA nonpoint source water quality modeling for the Chesapeake Bay.

PubMed

Nigro, Joseph; Toll, David; Partington, Ed; Ni-Meister, Wenge; Lee, Shihyan; Gutierrez-Magness, Angelica; Engman, Ted; Arsenault, Kristi

2010-01-01

The USEPA has estimated that over 20,000 water bodies within the United States do not meet water quality standards. One of the regulations in the Clean Water Act of 1972 requires states to monitor the total maximum daily load, or the amount of pollution that can be carried by a water body before it is determined to be "polluted," for any watershed in the United States (Copeland, 2005). In response to this mandate, the USEPA developed Better Assessment Science Integrating Nonpoint Sources (BASINS) as a decision support tool for assessing pollution and to guide the decision-making process for improving water quality. One of the models in BASINS, the Hydrological Simulation Program-Fortran (HSPF), computes continuous streamflow rates and pollutant concentration at each basin outlet. By design, precipitation and other meteorological data from weather stations serve as standard model input. In practice, these stations may be unable to capture the spatial heterogeneity of precipitation events, especially if they are few and far between. An attempt was made to resolve this issue by substituting station data with NASA-modified/NOAA precipitation data. Using these data within HSPF, streamflow was calculated for seven watersheds in the Chesapeake Bay Basin during low flow periods, convective storm periods, and annual flows. In almost every case, the modeling performance of HSPF increased when using the NASA-modified precipitation data, resulting in better streamflow statistics and, potentially, in improved water quality assessment.

A qualitative study assessing patient perspectives in the process of decision-making on disease modifying therapies (DMT's) in multiple sclerosis (MS).

PubMed

Ceuninck van Capelle, Archibald de; Meide, Hanneke van der; Vosman, Frans J H; Visser, Leo H

2017-01-01

Physicians commonly advise patients to begin disease modifying therapies (DMT's) shortly after the establishment of a diagnosis of Multiple Sclerosis (MS) to prevent further relapses and disease progression. However, little is known about the meaning for patients going through the process of the diagnosis of MS and of making decisions on DMT's in early MS. To explore the patient perspective on using DMT's for MS. Methods: Ten participants with a recent (< 2 years) relapsing-remitting MS diagnosis were interviewed. Seven of them were using DMT's at the time of the interview. All interviews were transcribed and analyzed using a hermeneutical-phenomenological approach. The analysis revealed the following themes: (1) Constant confrontation with the disease, (2) Managing inevitable decline, (3) Hope of delaying the progression of the disease, and, (4) The importance of social support. The themes show that patients associate the recommendation to begin DMT's (especially injectable DMT's) with views about their bodies as well as their hopes about the future. Both considering and adhering to treatment are experienced by patients as not only matters of individual and rational deliberation, but also as activities that are lived within a web of relationships with relatives and friends. From the patient perspective, the use of DMT's is not a purely rational and individual experience. More attention to the use of DMT's as relational and lived phenomena will improve the understanding of the process of decision-making for DMT's in MS.

Evaluation of a Modified Debate Exercise Adapted to the Pedagogy of Team-Based Learning

PubMed Central

Yang, Haoshu; Gupta, Vasudha

2018-01-01

Objective. To assess the impact of a debate exercise on self-reported evidence of student learning in literature evaluation, evidence-based decision making, and oral presentation. Methods. Third-year pharmacy students in a required infectious disease therapeutics course participated in a modified debate exercise that included a reading assignment and readiness assessment tests consistent with team-based learning (TBL) pedagogy. Peer and faculty assessment of student learning was accomplished with a standardized rubric. A pre- and post-debate survey was used to assess self-reported perceptions of abilities to perform skills outlined by the learning objectives. Results. The average individual readiness assessment score was 93.5% and all teams scored 100% on their team readiness assessments. Overall student performance on the debates was also high with an average score of 88.2% prior to extra credit points. Of the 95 students, 88 completed both pre- and post-surveys (93% participation rate). All learning objectives were associated with a statistically significant difference between pre- and post-debate surveys with the majority of students reporting an improvement in self-perceived abilities. Approximately two-thirds of students enjoyed the debates exercise and believed it improved their ability to make and defend clinical decisions. Conclusion. A debate format adapted to the pedagogy of TBL was well-received by students, documented high achievement in assessment of skills, and improved students’ self-reported perceptions of abilities to evaluate the literature, develop evidence-based clinical decisions, and deliver an effective oral presentation.

An integrated multi-criteria scenario evaluation web tool for participatory land-use planning in urbanized areas: The Ecosystem Portfolio Model

USGS Publications Warehouse

Labiosa, Bill; Forney, William M.; Hearn,, Paul P.; Hogan, Dianna M.; Strong, David R.; Swain, Eric D.; Esnard, Ann-Margaret; Mitsova-Boneva, D.; Bernknopf, R.; Pearlstine, Leonard; Gladwin, Hugh

2013-01-01

Land-use land-cover change is one of the most important and direct drivers of changes in ecosystem functions and services. Given the complexity of the decision-making, there is a need for Internet-based decision support systems with scenario evaluation capabilities to help planners, resource managers and communities visualize, compare and consider trade-offs among the many values at stake in land use planning. This article presents details on an Ecosystem Portfolio Model (EPM) prototype that integrates ecological, socio-economic information and associated values of relevance to decision-makers and stakeholders. The EPM uses a multi-criteria scenario evaluation framework, Geographic Information Systems (GIS) analysis and spatially-explicit land-use/land-cover change-sensitive models to characterize changes in important land-cover related ecosystem values related to ecosystem services and functions, land parcel prices, and community quality-of-life (QoL) metrics. Parameters in the underlying models can be modified through the interface, allowing users in a facilitated group setting to explore simultaneously issues of scientific uncertainty and divergence in the preferences of stakeholders. One application of the South Florida EPM prototype reported in this article shows the modeled changes (which are significant) in aggregate ecological value, landscape patterns and fragmentation, biodiversity potential and ecological restoration potential for current land uses compared to the 2050 land-use scenario. Ongoing refinements to EPM, and future work especially in regard to modifiable sea level rise scenarios are also discussed.

Implementing reduced-risk integrated pest management in fresh-market cabbage: influence of sampling parameters, and validation of binomial sequential sampling plans for the cabbage looper (Lepidoptera Noctuidae).

PubMed

Burkness, Eric C; Hutchison, W D

2009-10-01

Populations of cabbage looper, Trichoplusiani (Lepidoptera: Noctuidae), were sampled in experimental plots and commercial fields of cabbage (Brasicca spp.) in Minnesota during 1998-1999 as part of a larger effort to implement an integrated pest management program. Using a resampling approach and the Wald's sequential probability ratio test, sampling plans with different sampling parameters were evaluated using independent presence/absence and enumerative data. Evaluations and comparisons of the different sampling plans were made based on the operating characteristic and average sample number functions generated for each plan and through the use of a decision probability matrix. Values for upper and lower decision boundaries, sequential error rates (alpha, beta), and tally threshold were modified to determine parameter influence on the operating characteristic and average sample number functions. The following parameters resulted in the most desirable operating characteristic and average sample number functions; action threshold of 0.1 proportion of plants infested, tally threshold of 1, alpha = beta = 0.1, upper boundary of 0.15, lower boundary of 0.05, and resampling with replacement. We found that sampling parameters can be modified and evaluated using resampling software to achieve desirable operating characteristic and average sample number functions. Moreover, management of T. ni by using binomial sequential sampling should provide a good balance between cost and reliability by minimizing sample size and maintaining a high level of correct decisions (>95%) to treat or not treat.

Behavioral and neurophysiological correlates of regret in rat decision-making on a neuroeconomic task

PubMed Central

Steiner, Adam P.; Redish, A. David

2014-01-01

Summary Disappointment entails the recognition that one did not get the value one expected. In contrast, regret entails the recognition that an alternate (counterfactual) action would have produced a more valued outcome. Thus, the key to identifying regret is the representation of that counterfactual option in situations in which a mistake has been made. In humans, the orbitofrontal cortex is active during expressions of regret, and humans with damage to the orbitofrontal cortex do not express regret. In rats and non-human primates, both the orbitofrontal cortex and the ventral striatum have been implicated in decision-making, particularly in representations of expectations of reward. In order to examine representations of regretful situations, we recorded neural ensembles from orbitofrontal cortex and ventral striatum in rats encountering a spatial sequence of wait/skip choices for delayed delivery of different food flavors. We were able to measure preferences using an economic framework. Rats occasionally skipped low-cost choices and then encountered a high-cost choice. This sequence economically defines a potential regret-inducing instance. In these situations, rats looked backwards towards the lost option, the cells within the orbitofrontal cortex and ventral striatum represented that missed action, rats were more likely to wait for the long delay, and rats rushed through eating the food after that delay. That these situations drove rats to modify their behavior suggests that regret-like processes modify decision-making in non-human mammals. PMID:24908102

Multicriteria Personnel Selection by the Modified Fuzzy VIKOR Method

PubMed Central

Alguliyev, Rasim M.; Aliguliyev, Ramiz M.; Mahmudova, Rasmiyya S.

2015-01-01

Personnel evaluation is an important process in human resource management. The multicriteria nature and the presence of both qualitative and quantitative factors make it considerably more complex. In this study, a fuzzy hybrid multicriteria decision-making (MCDM) model is proposed to personnel evaluation. This model solves personnel evaluation problem in a fuzzy environment where both criteria and weights could be fuzzy sets. The triangular fuzzy numbers are used to evaluate the suitability of personnel and the approximate reasoning of linguistic values. For evaluation, we have selected five information culture criteria. The weights of the criteria were calculated using worst-case method. After that, modified fuzzy VIKOR is proposed to rank the alternatives. The outcome of this research is ranking and selecting best alternative with the help of fuzzy VIKOR and modified fuzzy VIKOR techniques. A comparative analysis of results by fuzzy VIKOR and modified fuzzy VIKOR methods is presented. Experiments showed that the proposed modified fuzzy VIKOR method has some advantages over fuzzy VIKOR method. Firstly, from a computational complexity point of view, the presented model is effective. Secondly, compared to fuzzy VIKOR method, it has high acceptable advantage compared to fuzzy VIKOR method. PMID:26516634

Diffusion Modelling Reveals the Decision Making Processes Underlying Negative Judgement Bias in Rats.

PubMed

Hales, Claire A; Robinson, Emma S J; Houghton, Conor J

2016-01-01

Human decision making is modified by emotional state. Rodents exhibit similar biases during interpretation of ambiguous cues that can be altered by affective state manipulations. In this study, the impact of negative affective state on judgement bias in rats was measured using an ambiguous-cue interpretation task. Acute treatment with an anxiogenic drug (FG7142), and chronic restraint stress and social isolation both induced a bias towards more negative interpretation of the ambiguous cue. The diffusion model was fit to behavioural data to allow further analysis of the underlying decision making processes. To uncover the way in which parameters vary together in relation to affective state manipulations, independent component analysis was conducted on rate of information accumulation and distances to decision threshold parameters for control data. Results from this analysis were applied to parameters from negative affective state manipulations. These projected components were compared to control components to reveal the changes in decision making processes that are due to affective state manipulations. Negative affective bias in rodents induced by either FG7142 or chronic stress is due to a combination of more negative interpretation of the ambiguous cue, reduced anticipation of the high reward and increased anticipation of the low reward.

GRADE equity guidelines 4: considering health equity in GRADE guideline development: evidence to decision process.

PubMed

Pottie, Kevin; Welch, Vivian; Morton, Rachael; Akl, Elie A; Eslava-Schmalbach, Javier H; Katikireddi, Vittal; Singh, Jasvinder; Moja, Lorenzo; Lang, Eddy; Magrini, Nicola; Thabane, Lehana; Stanev, Roger; Matovinovic, Elizabeth; Snellman, Alexandra; Briel, Matthias; Shea, Beverly; Tugwell, Peter; Schunemann, Holger; Guyatt, Gordon; Alonso-Coello, Pablo

2017-10-01

The aim of this paper is to provide detailed guidance on how to incorporate health equity within the GRADE (Grading Recommendations Assessment and Development Evidence) evidence to decision process. We developed this guidance based on the GRADE evidence to decision framework, iteratively reviewing and modifying draft documents, in person discussion of project group members and input from other GRADE members. Considering the impact on health equity may be required, both in general guidelines and guidelines that focus on disadvantaged populations. We suggest two approaches to incorporate equity considerations: (1) assessing the potential impact of interventions on equity and (2) incorporating equity considerations when judging or weighing each of the evidence to decision criteria. We provide guidance and include illustrative examples. Guideline panels should consider the impact of recommendations on health equity with attention to remote and underserviced settings and disadvantaged populations. Guideline panels may wish to incorporate equity judgments across the evidence to decision framework. This is the fourth and final paper in a series about considering equity in the GRADE guideline development process. This series is coming from the GRADE equity subgroup. Copyright © 2017 Elsevier Inc. All rights reserved.

Cross-Border Healthcare Requests to Publicly Funded Healthcare Insurance: Empirical Analysis.

PubMed

Stewart Ferreira, Lydia

2016-02-01

Despite the legal authority to confirm, override or modify healthcare insurance decisions made by physicians and government officials, health tribunal decisions have not been empirically analyzed. Using a novel quantitative methodology, all 387 Health Services Appeal and Review Board written and publicly available electronic decisions released over a five-year time period were statistically analyzed with respect to Ontario public health insurance requests for global cross-border healthcare. The statistical results found that patients knew their diagnosis prior to requesting cross-border healthcare, and 84% of patients requested specific northern US facilities for specific treatment. Two specific healthcare facilities in the US were requested for either surgery or assessments. A significant number of patients were seeking cross-border healthcare for pain treatment. This research challenges the assumption that cross-border treatment requests result only from domestic delay when instead patients are seeking specific treatments at specific facilities. This novel quantitative research methodology and data source of written and publicly available electronic Health Services Appeal and Review Board decisions should be used to inform policy decision regarding the utilization and evaluation of Canada's healthcare system and publicly funded healthcare insurance. Copyright © 2016 Longwoods Publishing.

History matching through dynamic decision-making

PubMed Central

Maschio, Célio; Santos, Antonio Alberto; Schiozer, Denis; Rocha, Anderson

2017-01-01

History matching is the process of modifying the uncertain attributes of a reservoir model to reproduce the real reservoir performance. It is a classical reservoir engineering problem and plays an important role in reservoir management since the resulting models are used to support decisions in other tasks such as economic analysis and production strategy. This work introduces a dynamic decision-making optimization framework for history matching problems in which new models are generated based on, and guided by, the dynamic analysis of the data of available solutions. The optimization framework follows a ‘learning-from-data’ approach, and includes two optimizer components that use machine learning techniques, such as unsupervised learning and statistical analysis, to uncover patterns of input attributes that lead to good output responses. These patterns are used to support the decision-making process while generating new, and better, history matched solutions. The proposed framework is applied to a benchmark model (UNISIM-I-H) based on the Namorado field in Brazil. Results show the potential the dynamic decision-making optimization framework has for improving the quality of history matching solutions using a substantial smaller number of simulations when compared with a previous work on the same benchmark. PMID:28582413

Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

PubMed

Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

2018-04-20

Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

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.

Patient satisfaction and regret with decision differ between outcomes in the composite definition of success after reconstructive surgery.

PubMed

Khoder, Waseem; Hom, Emily; Guanzon, Anna; Rose, Sarah; Hale, Douglass; Heit, Michael

2017-04-01

To evaluate patient satisfaction and regret with their decision for reconstructive surgery, and determine if they valued each item equally in the composite definition of success after making the decision for surgery. A list was created including all patients who underwent laparoscopic sacral colpopexy or laparoscopic uterosacrocolpopexy. Patients were placed in mutually exclusive outcome categories (retreatment, symptomatic failure, anatomic failure, and surgical success). Retreatment included any postoperative treatment for urinary incontinence, pelvic organ prolapse including pessary use, or surgery for mesh complications. The validated modified Decision Regret Scale (DRS) and the Satisfaction Decision Scale (SDS) questionnaires were administered by telephone. Higher DRS scores indicate greater regret and higher SDS scores indicate greater satisfaction with the decision for surgery. Of 715 patients, 197 were successfully contacted by telephone following reconstructive surgery and surveyed as study participants. Composite surgical outcomes were available for 150. Information on the need for retreatment was available for all the study participants. Surgery was successful in 101 (67.3 %) of the study participants. Anatomic failure occurred in 14, symptomatic failure occurred in 10, and retreatment was required in 25 of the study participants. Overall, the study participants were more satisfied than regretful with their decision for reconstructive surgery. Regret and satisfaction with their decision differed between outcomes in the composite definition of success after reconstructive surgery. Surgeons and patients should focus on retreatment rates during preoperative outcome discussions because retreatment will result in the least satisfaction and greatest regret with the decision for reconstructive surgery.

Clinical decision making in the recognition of dying: a qualitative interview study.

PubMed

Taylor, Paul; Dowding, Dawn; Johnson, Miriam

2017-01-25

Recognising dying is an essential clinical skill for general and palliative care professionals alike. Despite the high importance, both identification and good clinical care of the dying patient remains extremely difficult and often controversial in clinical practice. This study aimed to answer the question: "What factors influence medical and nursing staff when recognising dying in end-stage cancer and heart failure patients?" This study used a descriptive approach to decision-making theory. Participants were purposively sampled for profession (doctor or nurse), specialty (cardiology or oncology) and grade (senior vs junior). Recruitment continued until data saturation was reached. Semi-structured interviews were conducted with NHS medical and nursing staff in an NHS Trust which contained cancer and cardiology tertiary referral centres. An interview schedule was designed, based on decision-making literature. Interviews were audio-recorded and transcribed and analysed using thematic framework. Data were managed with Atlas.ti. Saturation was achieved with 19 participants (7 seniors; 8 intermediate level staff; 4 juniors). There were 11 oncologists (6 doctors, 5 nurses) and 8 cardiologists (3 doctors, 5 nurses). Six themes were generated: information used; decision processes; modifying factors; implementation; reflecting on decisions and related decisions. The decision process described was time-dependent, ongoing and iterative, and relies heavily on intuition. This study supports the need to recognise the strengths and weaknesses of expertise and intuition as part of the decision process, and of placing the recognition of dying in a time-dependent context. Clinicians should also be prepared to accept and convey the uncertainty surrounding these decisions, both in practice and in communication with patients and carers.

Equality of Shapley value and fair proportion index in phylogenetic trees.

PubMed

Fuchs, Michael; Jin, Emma Yu

2015-11-01

The Shapley value and the fair proportion index of phylogenetic trees have been introduced recently for the purpose of making conservation decisions in genetics. Moreover, also very recently, Hartmann (J Math Biol 67:1163-1170, 2013) has presented data which shows that there is a strong correlation between a slightly modified version of the Shapley value (which we call the modified Shapley value) and the fair proportion index. He gave an explanation of this correlation by showing that the contribution of both indices to an edge of the tree becomes identical as the number of taxa tends to infinity. In this note, we show that the Shapley value and the fair proportion index are in fact the same. Moreover, we also consider the modified Shapley value and show that its covariance with the fair proportion index in random phylogenetic trees under the Yule-Harding model and uniform model is indeed close to one.

Listened to, but not heard! The failure to represent the public in genetically modified food policies.

PubMed

Lassen, Jesper

2018-04-01

'In the mid-1990s, a mismatch was addressed between European genetically modified food policy, which focused primarily on risks and economic prospects, and public anxieties, which also included other concerns, and there was a development in European food policy toward the inclusion of what were referred to as "ethical aspects." Using parliamentary debates in Denmark in 2002 and 2015 as a case, this article examines how three storylines of concern that were visible in public discourse at the time were represented by the decision makers in parliament. It shows that core public concerns raising fundamental questions about genetically modified foods, and in particular their perceived unnaturalness, were not considered in the parliamentary debates. It is suggested that the failure of the parliament to represent the public may undermine the legitimacy of politicians and lead to disillusionment with parliamentary government.

Research Funding: the Case for a Modified Lottery.

PubMed

Fang, Ferric C; Casadevall, Arturo

2016-04-12

The time-honored mechanism of allocating funds based on ranking of proposals by scientific peer review is no longer effective, because review panels cannot accurately stratify proposals to identify the most meritorious ones. Bias has a major influence on funding decisions, and the impact of reviewer bias is magnified by low funding paylines. Despite more than a decade of funding crisis, there has been no fundamental reform in the mechanism for funding research. This essay explores the idea of awarding research funds on the basis of a modified lottery in which peer review is used to identify the most meritorious proposals, from which funded applications are selected by lottery. We suggest that a modified lottery for research fund allocation would have many advantages over the current system, including reducing bias and improving grantee diversity with regard to seniority, race, and gender. Copyright © 2016 Fang and Casadevall.

[Genetically modified organisms in food--production, detection and risks].

PubMed

Zeljezić, Davor

2004-11-01

The first genetically modified plant (GMP) was a tobacco resistant to antibiotics in 1983. In 1996, the first genetically altered crop, a delayed-ripening tomato was commercially released. In the year 2003, the estimated global area of GM crops for was 67.7 million hectares. To produce such a plant a gene of interest has to be isolated from the donor. Together with a promoter, terminator sequence and marker gene it has to be introduced into the plant cell which is then stimulated to generate a whole GMP expressing new characteristics (herbicide/insect resistance, delayed ripening). The last few months have seen a strong public debate over genetically modified organisms which has raised scientific, economic, political, and ethical issues. Some questions concerning the safety of GMPs are still to be answered, and decisions about their future should be based on scientifically validated information.

Research Funding: the Case for a Modified Lottery

PubMed Central

Casadevall, Arturo

2016-01-01

ABSTRACT The time-honored mechanism of allocating funds based on ranking of proposals by scientific peer review is no longer effective, because review panels cannot accurately stratify proposals to identify the most meritorious ones. Bias has a major influence on funding decisions, and the impact of reviewer bias is magnified by low funding paylines. Despite more than a decade of funding crisis, there has been no fundamental reform in the mechanism for funding research. This essay explores the idea of awarding research funds on the basis of a modified lottery in which peer review is used to identify the most meritorious proposals, from which funded applications are selected by lottery. We suggest that a modified lottery for research fund allocation would have many advantages over the current system, including reducing bias and improving grantee diversity with regard to seniority, race, and gender. PMID:27073093

Contribution to the meaning and understanding of anticipatory systems

NASA Astrophysics Data System (ADS)

Kljajić, Miroljub

2001-06-01

The present article discusses the cybernetic method in the modelling and understanding of complex systems from the epistemological, semantic as well as psychological point of view. Biological and organisational systems are the most important among complex systems. According to Rosen [1] anticipatory systems is another name for complex systems because, in a way, they function to anticipate the future state in order to preserve its structure and functioning. This paper demonstrates a strong analogy between Rosen's modified definition of anticipatory systems [2] and decision-making through simulation in organisational systems. The possible meaning of several models modified in the anticipatory mode will also be discussed as for example: a) The modified Verhaulst Model and its anticipatory modification in the case of the description of human behavior, b) The Prey-Predator Model, and c) The Evans Market Model under different conditions of the demand and supply function.

Student Decision-Making about a Globally Familiar Socioscientific Issue: The value of sharing and comparing views with international counterparts

NASA Astrophysics Data System (ADS)

Grace, Marcus; Chung Lee, Yeung; Asshoff, Roman; Wallin, Anita

2015-07-01

This paper focuses on the views of 16-17-year-old science students from England, Germany, Hong Kong and Sweden on whale hunting, and their perceptions of the views of their international counterparts. The students were all provided with the same decision-making task, discussed the issue in small groups and then presented their views on video, which were shared with their counterparts. The findings show that the decision-making task served to deepen and modify students' views across all nationalities, and the students generally valued and learned from the sharing of views with students of the same age from around the world. However, an important discovery was that the German students' opinions often ran counter to those from the other 3 locations, and the paper cautions against making broad-sweeping generalisations about students' views on socioscientific issues.

Lives matter. Do votes? Invited commentary on "Black lives matter: Differential mortality and the racial composition of the U.S. electorate, 1970-2004".

PubMed

Purtle, Jonathan

2015-07-01

Racial health disparities in the United States are produced and perpetuated through public policies that differentially allocate risks and resources for health. Elected officials have the ability modify the structural determinants of racial health disparities through policy decisions and, through voting, the electorate can influence the extent to which these policy decisions promote health equity. In this commentary, I synthesize research on the voting behavior of electorates and policy decisions and present strategies to foster sociopolitical environments that are conducive to the implementation and enforcement of racial health disparity reduction initiatives. There is a need for research that contributes to a more comprehensive understanding of the role of voting in health policy making processes and further development of empirically-based policy advocacy strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Low intensity magnetic field influences short-term memory: A study in a group of healthy students.

PubMed

Navarro, Enrique A; Gomez-Perretta, Claudio; Montes, Francisco

2016-01-01

This study analyzes if an external magnetic stimulus (2 kHz and approximately 0.1 μT applied near frontal cortex) influences working memory, perception, binary decision, motor execution, and sustained attention in humans. A magnetic stimulus and a sham stimulus were applied to both sides of the head (frontal cortex close to temporal-parietal area) in young and healthy male test subjects (n = 65) while performing Sternberg's memory scanning task. There was a significant change in reaction time. Times recorded for perception, sustained attention, and motor execution were lower in exposed subjects (P < 0.01). However, time employed in binary decision increased for subjects exposed to magnetic fields. From results, it seems that a low intensity 2 kHz exposure modifies short-term working memory, as well as perception, binary decision, motor execution, and sustained attention. © 2015 Wiley Periodicals, Inc.

Are You Morally Modified?

PubMed Central

Levy, Neil; Douglas, Thomas; Kahane, Guy; Terbeck, Sylvia; Cowen, Philip J.; Hewstone, Miles; Savulescu, Julian

2015-01-01

A number of concerns have been raised about the possible future use of pharmaceuticals designed to enhance cognitive, affective, and motivational processes, particularly where the aim is to produce morally better decisions or behavior. In this article, we draw attention to what is arguably a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are already having unintended effects on these processes, and thus on moral decision making and morally significant behavior. We review current evidence on the moral effects of three widely used drugs or drug types: (i) propranolol, (ii) selective serotonin reuptake inhibitors, and (iii) drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision making and behavior caused by these agents may have important and difficult-to-evaluate consequences, at least at the population level. We argue that the moral effects of these and other widely used pharmaceuticals warrant further empirical research and ethical analysis. PMID:25892904

The Utility of the Frailty Index in Clinical Decision Making.

PubMed

Khatry, K; Peel, N M; Gray, L C; Hubbard, R E

2018-01-01

Using clinical vignettes, this study aimed to determine if a measure of patient frailty would impact management decisions made by geriatricians regarding commonly encountered clinical situations. Electronic surveys consisting of three vignettes derived from cases commonly seen in an acute inpatient ward were distributed to geriatricians. Vignettes included patients being considered for intensive care treatment, rehabilitation, or coronary artery bypass surgery. A frailty index was generated through Comprehensive electronic Geriatric Assessment. For each vignette, respondents were asked to make a recommendation for management, based on either a brief or detailed amount of clinical information and to reconsider their decision after the addition of the frailty index. The study suggests that quantification of frailty might aid the clinical judgment now employed daily to proceed with usual care, or to modify it based on the vulnerability of the person to whom it is aimed.

Consumer attitudes and the governance of food safety.

PubMed

Todt, Oliver; Muñoz, Emilio; González, Marta; Ponce, Gloria; Estévez, Betty

2009-01-01

This paper reports the analysis of a recent study of public perception of food safety governance in Spain, using genetically modified (GM) foods as an indicator. The data make clear that Spanish food consumers are aware of their rights and role in the marketplace. They are critical of current regulatory decision making, which they perceive to be unduly influenced by certain social actors, such as industry. In contrast, consumers demand decisions to be based primarily on scientific opinion, as well as consumer preferences. They want authorities to facilitate informed purchasing decisions, and favor labeling of GM foods mostly on the grounds of their right to know. However, consumers' actual level of knowledge with respect to food technology and food safety remains low. There are several ambivalences as to the real impact of these attitudes on actual consumer behavior (specifically when it comes to organizing themselves or searching out background information).

Bayesian Decision Support for Adaptive Lung Treatments

NASA Astrophysics Data System (ADS)

McShan, Daniel; Luo, Yi; Schipper, Matt; TenHaken, Randall

2014-03-01

Purpose: A Bayesian Decision Network will be demonstrated to provide clinical decision support for adaptive lung response-driven treatment management based on evidence that physiologic metrics may correlate better with individual patient response than traditional (population-based) dose and volume-based metrics. Further, there is evidence that information obtained during the course of radiation therapy may further improve response predictions. Methods: Clinical factors were gathered for 58 patients including planned mean lung dose, and the bio-markers IL-8 and TGF-β1 obtained prior to treatment and two weeks into treatment along with complication outcomes for these patients. A Bayesian Decision Network was constructed using Netica 5.0.2 from Norsys linking these clinical factors to obtain a prediction of radiation induced lung disese (RILD) complication. A decision node was added to the network to provide a plan adaption recommendation based on the trade-off between the RILD prediction and complexity of replanning. A utility node provides the weighting cost between the competing factors. Results: The decision node predictions were optimized against the data for the 58 cases. With this decision network solution, one can consider the decision result for a new patient with specific findings to obtain a recommendation to adaptively modify the originally planned treatment course. Conclusions: A Bayesian approach allows handling and propagating probabilistic data in a logical and principled manner. Decision networks provide the further ability to provide utility-based trade-offs, reflecting non-medical but practical cost/benefit analysis. The network demonstrated illustrates the basic concept, but many other factors may affect these decisions and work on building better models are being designed and tested. Acknowledgement: Supported by NIH-P01-CA59827

Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson's disease patients in a patient-centred clinic.

PubMed

Zizzo, Natalie; Bell, Emily; Lafontaine, Anne-Louise; Racine, Eric

2017-08-01

Patient-centred care is a recommended model of care for Parkinson's disease (PD). It aims to provide care that is respectful and responsive to patient preferences, values and perspectives. Provision of patient-centred care should entail considering how patients want to be involved in their care. To understand the participation preferences of patients with PD from a patient-centred care clinic in health-care decision-making processes. Mixed-methods study with early-stage Parkinson's disease patients from a patient-centred care clinic. Study involved a modified Autonomy Preference Index survey (N=65) and qualitative, semi-structured in-depth interviews, analysed using thematic qualitative content analysis (N=20, purposefully selected from survey participants). Interviews examined (i) the patient preferences for involvement in health-care decision making; (ii) patient perspectives on the patient-physician relationship; and (iii) patient preferences for communication of information relevant to decision making. Preferences for participation in decision making varied between individuals and also within individuals depending on decision type, relational and contextual factors. Patients had high preferences for communication of information, but with acknowledged limits. The importance of communication in the patient-physician relationship was emphasized. Patient preferences for involvement in decision making are dynamic and support shared decision making. Relational autonomy corresponds to how patients envision their participation in decision making. Clinicians may need to assess patient preferences on an on-going basis. Our results highlight the complexities of decision-making processes. Improved understanding of individual preferences could enhance respect for persons and make for patient-centred care that is truly respectful of individual patients' wants, needs and values. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Patients’ priorities for treatment decision making during periods of incapacity: quantitative survey

PubMed Central

RID, ANNETTE; WESLEY, ROBERT; PAVLICK, MARK; MAYNARD, SHARON; ROTH, KATALIN; WENDLER, DAVID

2017-01-01

Objective Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making. Method We employed a self-administered, quantitative survey of patients in a tertiary care center. Results Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants. Significance of Results Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients’ treatment preferences. Clinicians should also discuss and document patients’ priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making. PMID:25273677

Factors influencing and modifying the decision to pursue genetic testing for skin cancer risk.

PubMed

Fogel, Alexander L; Jaju, Prajakta D; Li, Shufeng; Halpern-Felsher, Bonnie; Tang, Jean Y; Sarin, Kavita Y

2017-05-01

Across cancers, the decision to pursue genetic testing is influenced more by subjective than objective factors. However, skin cancer, which is more prevalent, visual, and multifactorial than many other malignancies, may offer different motivations for pursuing such testing. The primary objective was to determine factors influencing the decision to receive genetic testing for skin cancer risk. A secondary objective was to assess the impact of priming with health questions on the decision to receive testing. We distributed anonymous online surveys through ResearchMatch.org to assess participant health, demographics, motivations, and interest in pursuing genetic testing for skin cancer risk. Two surveys with identical questions but different question ordering were used to assess the secondary objective. We received 3783 responses (64% response rate), and 85.8% desired testing. Subjective factors, including curiosity, perceptions of skin cancer, and anxiety, were the most statistically significant determinants of the decision to pursue testing (P < .001), followed by history of sun exposure (odds ratio 1.85, P < .01) and history of skin cancer (odds ratio 0.5, P = .01). Age and family history of skin cancer did not influence this decision. Participants increasingly chose testing if first queried about health behaviors (P < .0001). The decision to pursue hypothetical testing may differ from in-clinic decision-making. Self-selected, online participants may differ from the general population. Surveys may be subject to response bias. The decision to pursue genetic testing for skin cancer is primarily determined by subjective factors, such as anxiety and curiosity. Health factors, including skin cancer history, also influenced decision-making. Priming with consideration of objective health factors can increase the desire to pursue testing. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Patients' priorities for treatment decision making during periods of incapacity: quantitative survey.

PubMed

Rid, Annette; Wesley, Robert; Pavlick, Mark; Maynard, Sharon; Roth, Katalin; Wendler, David

2015-10-01

Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making. We employed a self-administered, quantitative survey of patients in a tertiary care center. Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants. Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients' treatment preferences. Clinicians should also discuss and document patients' priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making.

Value Assessment at the Point of Care: Incorporating Patient Values throughout Care Delivery and a Draft Taxonomy of Patient Values.

PubMed

Armstrong, Melissa J; Mullins, C Daniel

2017-02-01

Incorporation of patient values is a key element of patient-centered care, but consistent incorporation of patient values at the point of care is lacking. Shared decision making encourages incorporation of patient values in decision making, but associated tools often lack guidance on value assessment. In addition, focusing on patient values relating only to specific decisions misses an opportunity for a more holistic approach to value assessment that could impact other aspects of clinical encounters, including health care planning, communication, and stakeholder involvement. In this commentary, we propose a taxonomy of values underlying patient decision making and provide examples of how these impact provision of health care. The taxonomy describes four categories of patient values: global, decisional, situational, and external. Global values are personal values impacting decision making at a universal level and can include value traits and life priorities. Decisional values are the values traditionally conceptualized in decision making, including considerations such as efficacy, toxicity, quality of life, convenience, and cost. Situational values are values tied to a specific moment in time that modify patients' existing global and decisional values. Finally, discussion of external values acknowledges that many patients consider values other than their own when making decisions. Recognizing the breadth of values impacting patient decision making has implications for both overall health care delivery and shared decision making because value assessments focusing only on decisional values may miss important patient considerations. This draft taxonomy highlights different values impacting decision making and facilitates a more complete value assessment at the point of care. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Assessing the usefulness and acceptability of a low health literacy online decision aid about reproductive choices for younger women with breast cancer: the aLLIAnCE pilot study protocol.

PubMed

Peate, Michelle; Smith, Sian Karen; Pye, Victoria; Hucker, Alice; Stern, Catharyn; Stafford, Lesley; Oakman, Catherine; Chin-Lenn, Laura; Shanahan, Kerry; Ratnayake Gamage, Nipuni; Hickey, Martha

2017-01-01

Young women diagnosed with breast cancer may be confronted by many difficult decisions, especially around fertility preservation prior to commencing cancer treatment. The information to be conveyed is complex, and it may be difficult to weigh up the risks and benefits of the different fertility preservation options available. This complexity is compounded by the widespread low levels of literacy and health literacy in Australia, which may result in greater difficulties in understanding available health information and in decision-making. A working group of experts have developed a fertility-related online decision aid for a low health literacy population, guided by health literacy principles. The decision aid will be pilot tested with 30 women diagnosed with early breast cancer between 5 years and 6 months previously. To be eligible, at the time of diagnosis, women must be between 18 and 40 years (inclusive), pre-menopausal, have no history of metastatic disease, have not completed their families, be able to give informed consent and have low health literacy. Participants will be asked to reflect back to the time in which they were diagnosed. Participants will complete a questionnaire before and after reviewing the decision aid to determine the feasibility, use and acceptability of the decision aid. The decision aid will be modified accordingly. Participants may also choose to review a previously developed (high literacy) decision aid and provide feedback in comparison to the low health literacy decision aid. This project represents the first study to develop an online fertility decision aid developed from low health literacy models in the context of breast cancer. It is anticipated that the low health literacy decision aid will be useful and acceptable to young women with low health literacy who have been diagnosed with breast cancer and that it will be preferred over the high literacy decision aid. ACTRN12615001364561p.

Psychophysical Reverse Correlation with Multiple Response Alternatives

PubMed Central

Dai, Huanping; Micheyl, Christophe

2011-01-01

Psychophysical reverse-correlation methods such as the “classification image” technique provide a unique tool to uncover the internal representations and decision strategies of individual participants in perceptual tasks. Over the last thirty years, these techniques have gained increasing popularity among both visual and auditory psychophysicists. However, thus far, principled applications of the psychophysical reverse-correlation approach have been almost exclusively limited to two-alternative decision (detection or discrimination) tasks. Whether and how reverse-correlation methods can be applied to uncover perceptual templates and decision strategies in situations involving more than just two response alternatives remains largely unclear. Here, the authors consider the problem of estimating perceptual templates and decision strategies in stimulus identification tasks with multiple response alternatives. They describe a modified correlational approach, which can be used to solve this problem. The approach is evaluated under a variety of simulated conditions, including different ratios of internal-to-external noise, different degrees of correlations between the sensory observations, and various statistical distributions of stimulus perturbations. The results indicate that the proposed approach is reasonably robust, suggesting that it could be used in future empirical studies. PMID:20695712

Parental perspectives on inpatient versus outpatient management of pediatric febrile neutropenia.

PubMed

Diorio, Caroline; Martino, Julia; Boydell, Katherine Mary; Ethier, Marie-Chantal; Mayo, Chris; Wing, Richard; Teuffel, Oliver; Sung, Lillian; Tomlinson, Deborah

2011-01-01

To describe parent preference for treatment of febrile neutropenia and the key drivers of parental decision making, structured face-to-face interviews were used to elicit parent preferences for inpatient versus outpatient management of pediatric febrile neutropenia. Parents were presented with 4 different scenarios and asked to indicate which treatment option they preferred and to describe reasons for this preference during the face-to-face interview. Comments were recorded in writing by research assistants. A consensus approach to thematic analysis was used to identify themes from the written comments of the research assistants. A total of 155 parents participated in the study. Of these, 80 (51.6%) parents identified hospital-based intravenous treatment as the most preferred treatment scenario for febrile neutropenia. The major themes identified included convenience/disruptiveness, physical health, emotional well-being, and modifiers of parental decision making. Most parents preferred hospital-based treatment for febrile neutropenia. An understanding of issues that influence parental decision making may assist health care workers in planning program implementation and further support families in their decision-making process.

Examining Factors That Influence Donor Motivation among Former Student-Athletes and NCAA DI Classification

ERIC Educational Resources Information Center

Burchette, Brett M.

2013-01-01

The purpose of this study was to identify motivational factors that contribute to the philanthropic decision making of the former NCAA Division I student-athlete. A 47-item survey instrument was modified from a prior study and distributed electronically to 8,461 male and female former student-athletes at three participating NCAA Division I…

Ethical Decision Making in Academic Dishonesty with Application of Modified Theory of Planned Behavior: A Review

ERIC Educational Resources Information Center

Meng, Chan Ling; Othman, Jamilah; D'Silva, Jeffrey Lawrence; Omar, Zoharah

2014-01-01

This conceptual paper studies the application of the Theory of Planned Behavior (TBP) in academic dishonesty with the mediating variable of ethical ideologies. The study reviews literature on the Theory of Planned Behavior and past studies pertaining to academic dishonesty. The paper analyses the relationship of the variables of TPB on academic…

78 FR 76382 - Notice of Cancellation of Environmental Impact Statement for the Norfolk International Airport...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... Norfolk Airport Authority (NAA), the owner and operator of the airport. The additional planning effort by NAA has modified the project purpose and need and refined various project elements, including the need... decision to prepare a federal EIS primarily on NAA's proposal to construct a new Runway 5R/23L in parallel...

77 FR 24200 - Clean Air Act Operating Permit Program; Petitions for Objection to State Operating Permits for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... without requiring preconstruction monitoring for particulate matter less than 10 microns (PM 10 ), sulfur dioxide (SO 2 ), hydrogen sulfide (H 2 S), total reduced sulfur (TRS) and sulfuric acid mist; and (5) LDEQ... in the decision-making process. In the 2011 Petition for the modified title V pig iron permit and for...

Impact of Instructional Decisions on the Effectiveness of Cooperative Learning in Chemistry through Meta-Analysis

ERIC Educational Resources Information Center

Apugliese, Andrew; Lewis, Scott E.

2017-01-01

Meta-analysis can provide a robust description of the impact of educational reforms and also offer an opportunity to explore the conditions where such reforms are more or less effective. This article describes a meta-analysis on the impact of cooperative learning on students' chemistry understanding. Modifiers in the meta-analysis are purposefully…

Did Cuts in State Aid during the Great Recession Lead to Changes in Local Property Taxes?

ERIC Educational Resources Information Center

Chakrabarti, Rajashri; Livingston, Max; Roy, Joydeep

2014-01-01

The Great Recession led to marked declines in state revenue. In this paper we investigate whether (and how) local school districts modified their funding and taxing decisions in response to state aid declines in the post-recession period. Our results reveal school districts responded to state aid cuts in the post-recession period by countering…

Multiscale simulation of a prescribed fire event in the New Jersey Pine Barrens using ARPS-CANOPY

Treesearch

Michael T. Kiefer; Warren E. Heilman; Shiyuan Zhong; Joseph J. Charney; Xindi Bian; Nicholas S. Skowronski; John L. Hom; Kenneth L. Clark; Matthew Patterson; Michael R. Gallagher

2014-01-01

Smoke prediction products are one of the tools used by land management personnel for decision making regarding prescribed fires. This study documents the application to a prescribed fire of a smoke prediction system that employs ARPS-CANOPY, a modified version of the Advanced Regional Prediction System (ARPS) model containing a canopy submodel, as the meteorological...

Concussion Education in U.S. Collegiate Sport: What Is Happening and What Do Athletes Want?

ERIC Educational Resources Information Center

Kroshus, Emily; Baugh, Christine M.

2016-01-01

Concussion education for athletes has the potential to play a role in reducing the health burden of concussions from sport by modifying individual risk-related behaviors. In U.S. collegiate sport, decisions about content and delivery of concussion education are left up to the individual institution. This may result in a high degree of variability…

Help-Seeking Decisions of Battered Women: A Test of Learned Helplessness and Two Stress Theories.

ERIC Educational Resources Information Center

Wauchope, Barbara A.

This study tested the learned helplessness theory, stress theory, and a modified stress theory to determine the best model for predicting the probability that a woman would seek help when she experienced severe violence from a male partner. The probability was hypothesized to increase as the stress of the violence experienced increased. Data were…

The effectiveness of different approaches to media literacy in modifying adolescents' responses to alcohol.

PubMed

Chen, Yi-Chun Yvonnes

2013-01-01

Fearing the negative effect that alcohol advertising might have on adolescents' receptiveness to the consumption of alcohol, health educators have used media literacy as an effective strategy to mitigate the effect of these messages in the media. The present study applied parental mediation to the design and evaluations of a media literacy curriculum that targets alcohol decision-making processes illustrated in the message interpretation process model. The authors conducted a pretest-posttest quasi-experiment of 171 adolescents to examine the effect of a negative evaluative approach and a balanced evaluative approach (a combination of negative and positive evaluative strategies) to media literacy on modifying adolescents' responses to alcohol messages. Results showed that different media literacy approaches had varying degrees of effectiveness on adolescent boys and girls. After receiving a negative media literacy lesson, adolescent boys regarded television characters as less realistic and believed that drinking alcohol had negative consequences. In contrast, adolescent girls benefited more from a balanced evaluative approach as their media skepticism attitude was enhanced. Results suggest that health educators should choose tailored pedagogical approaches that are based on gender to improve decision making regarding alcohol consumption.

Clinical decision-making: heuristics and cognitive biases for the ophthalmologist.

PubMed

Hussain, Ahsen; Oestreicher, James

Diagnostic errors have a significant impact on health care outcomes and patient care. The underlying causes and development of diagnostic error are complex with flaws in health care systems, as well as human error, playing a role. Cognitive biases and a failure of decision-making shortcuts (heuristics) are human factors that can compromise the diagnostic process. We describe these mechanisms, their role with the clinician, and provide clinical scenarios to highlight the various points at which biases may emerge. We discuss strategies to modify the development and influence of these processes and the vulnerability of heuristics to provide insight and improve clinical outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Dental caries and pulpal disease.

PubMed

Zero, Domenick T; Zandona, Andrea Ferreira; Vail, Mychel Macapagal; Spolnik, Kenneth J

2011-01-01

This article reviews the diagnostic process, from the first clinically evident stages of the caries process to development of pulpal pathosis. The caries diagnostic process includes 4 interconnected components-staging caries lesion severity, assessing caries lesion activity, and risk assessments at the patient and tooth surface level - which modify treatment decisions for the patient. Pulpal pathosis is diagnosed as reversible pulpitis, irreversible pulpitis (asymptomatic), irreversible pulpitis (symptomatic), and pulp necrosis. Periapical disease is diagnosed as symptomatic apical periodontitis, asymptomatic apical periodontitis, acute apical abscess, and chronic apical abscess. Ultimately, the goal of any diagnosis should be to achieve better treatment decisions and health outcomes for the patient. Copyright © 2011 Elsevier Inc. All rights reserved.

Prediction of flood abnormalities for improved public safety using a modified adaptive neuro-fuzzy inference system.

PubMed

Aqil, M; Kita, I; Yano, A; Nishiyama, S

2006-01-01

It is widely accepted that an efficient flood alarm system may significantly improve public safety and mitigate economical damages caused by inundations. In this paper, a modified adaptive neuro-fuzzy system is proposed to modify the traditional neuro-fuzzy model. This new method employs a rule-correction based algorithm to replace the error back propagation algorithm that is employed by the traditional neuro-fuzzy method in backward pass calculation. The final value obtained during the backward pass calculation using the rule-correction algorithm is then considered as a mapping function of the learning mechanism of the modified neuro-fuzzy system. Effectiveness of the proposed identification technique is demonstrated through a simulation study on the flood series of the Citarum River in Indonesia. The first four-year data (1987 to 1990) was used for model training/calibration, while the other remaining data (1991 to 2002) was used for testing the model. The number of antecedent flows that should be included in the input variables was determined by two statistical methods, i.e. autocorrelation and partial autocorrelation between the variables. Performance accuracy of the model was evaluated in terms of two statistical indices, i.e. mean average percentage error and root mean square error. The algorithm was developed in a decision support system environment in order to enable users to process the data. The decision support system is found to be useful due to its interactive nature, flexibility in approach, and evolving graphical features, and can be adopted for any similar situation to predict the streamflow. The main data processing includes gauging station selection, input generation, lead-time selection/generation, and length of prediction. This program enables users to process the flood data, to train/test the model using various input options, and to visualize results. The program code consists of a set of files, which can be modified as well to match other purposes. This program may also serve as a tool for real-time flood monitoring and process control. The results indicate that the modified neuro-fuzzy model applied to the flood prediction seems to have reached encouraging results for the river basin under examination. The comparison of the modified neuro-fuzzy predictions with the observed data was satisfactory, where the error resulted from the testing period was varied between 2.632% and 5.560%. Thus, this program may also serve as a tool for real-time flood monitoring and process control.

Strategic decision making under climate change: a case study on Lake Maggiore water system

NASA Astrophysics Data System (ADS)

Micotti, M.; Soncini Sessa, R.; Weber, E.

2014-09-01

Water resources planning processes involve different kinds of decisions that are generally evaluated under a stationary climate scenario assumption. In general, the possible combinations of interventions are mutually compared as single alternatives. However, the ongoing climate change requires us to reconsider this approach. Indeed, what have to be compared are not individual alternatives, but families of alternatives, characterized by the same structural decisions, i.e. by actions that have long-term effects and entail irrevocable changes in the system. The rationale is that the structural actions, once they have been implemented, cannot be easily modified, while the management decisions can be adapted to the evolving conditions. This paper considers this methodological problem in a real case study, in which a strategic decision has to be taken: a new barrage was proposed to regulate Lake Maggiore outflow, but, alternatively, either the present barrage can be maintained with its present regulation norms or with a new one. The problem was dealt with by multi-criteria decision analysis involving many stakeholders and two decision-makers. An exhaustive set of indicators was defined in the participatory process, conducted under the integrated water resource management paradigm, and many efficient (in Pareto sense) regulation policies were identified. The paper explores different formulations of a global index to evaluate and compare the effectiveness of the classes of alternatives under both stationary and changing hydrological scenarios in order to assess their adaptability to the ongoing climate change.

Ethical safety of deep brain stimulation: A study on moral decision-making in Parkinson's disease.

PubMed

Fumagalli, Manuela; Marceglia, Sara; Cogiamanian, Filippo; Ardolino, Gianluca; Picascia, Marta; Barbieri, Sergio; Pravettoni, Gabriella; Pacchetti, Claudio; Priori, Alberto

2015-07-01

The possibility that deep brain stimulation (DBS) in Parkinson's disease (PD) alters patients' decisions and actions, even temporarily, raises important clinical, ethical and legal questions. Abnormal moral decision-making can lead to ethical rules violations. Previous experiments demonstrated the subthalamic (STN) activation during moral decision-making. Here we aim to study whether STN DBS can affect moral decision-making in PD patients. Eleven patients with PD and bilateral STN DBS implant performed a computerized moral task in ON and OFF stimulation conditions. A control group of PD patients without DBS implant performed the same experimental protocol. All patients underwent motor, cognitive and psychological assessments. STN stimulation was not able to modify neither reaction times nor responses to moral task both when we compared the ON and the OFF state in the same patient (reaction times, p = .416) and when we compared DBS patients with those treated only with the best medical treatment (reaction times: p = .408, responses: p = .776). Moral judgment is the result of a complex process, requiring cognitive executive functions, problem-solving, anticipations of consequences of an action, conflict processing, emotional evaluation of context and of possible outcomes, and involving different brain areas and neural circuits. Our data show that STN DBS leaves unaffected moral decisions thus implying relevant clinical and ethical implications for DBS consequences on patients' behavior, on decision-making and on judgment ability. In conclusion, the technique can be considered safe on moral behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Experience of Decision Making in the Care of Children with Palliative Care Needs: The Experiences of Jordanian Mothers.

PubMed

Atout, Maha; Hemingway, Pippa; Seymour, Jane

2017-12-01

The purpose of this study was to explore the experience of decision making in the care of children with palliative care needs in Jordan, from the perspective of their mothers. This study employed a collective qualitative case study approach. Data were collected in 3 pediatric wards in a Jordanian hospital. The study used 2 data collection methods: participant observation (197 observational hours) and 56 semi-structured interviews with 24 mothers, 12 physicians and 20 nurses. The findings show how Jordanian mothers seek to transfer the role of decision making to physicians, as they perceive themselves to be unable to make decisions about critical issues related to the treatment of their children. Mothers had a widespread apprehension of "future guilt," especially when they feared that any decisions they might make could have an adverse impact on their children. Contrary to the predominant pattern, some mothers took a proactive approach towards decision making about their children's treatment. These mothers requested detailed information from primary physicians and sought different sources of knowledge such as second opinions, reading online resources, or talking to other parents who had a child with similar circumstances. The study concludes that mothers prefer to involve physicians in decisions about their children's healthcare and treatment to eliminate their fear of probable future guilt; this modifies any tendency to autonomously decide for their children. These findings are underpinned by the Jordanian culture in which doctors' opinions are highly regarded.

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

PubMed

Hawryluck, Laura; Sibbald, Robert; Chidwick, Paula

2013-12-01

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

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

PubMed

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

2017-08-01

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

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.

Decision Making in the Balloon Analogue Risk Task (BART): Anterior Cingulate Cortex Signals Loss-Aversion but not the Infrequency of Risky Choices

PubMed Central

Fukunaga, Rena; Brown, Joshua W.; Bogg, Tim

2012-01-01

The inferior frontal gyrus/anterior insula (IFG/AI) and anterior cingulate cortex (ACC) are key regions involved in risk appraisal during decision making, but accounts of how these regions contribute to decision-making under risk remain contested. To help clarify the roles of these and other related regions, we used a modified version of the Balloon Analogue Risk Task (Lejuez et al., 2002) to distinguish between decision-making and feedback-related processes when participants decided to pursue a gain as the probability of loss increased parametrically. Specifically, we set out to test whether ACC and IFG/AI regions correspond to loss-aversion at the time of decision making in a way that is not confounded with either reward-seeking or infrequency effects. When participants chose to discontinue inflating the balloon (win option), we observed greater ACC and mainly bilateral IFG/AI activity at the time of decision as the probability of explosion increased, consistent with increased loss-aversion but inconsistent with an infrequency effect. In contrast, we found robust vmPFC activity when participants chose to continue inflating the balloon (risky option), consistent with reward-seeking. However, in the cingulate and mainly bilateral IFG regions, BOLD activation decreased when participants chose to inflate the balloon as the probability of explosion increased, findings consistent with a reduced loss-aversion signal. Our results highlight the existence of distinct reward-seeking and loss-averse signals during decision-making, as well as the importance of distinguishing decision and feedback signals. PMID:22707378

Conventional consent with opting in versus simplified consent with opting out: an exploratory trial for studies that do not increase patient risk.

PubMed

Rogers, C G; Tyson, J E; Kennedy, K A; Broyles, R S; Hickman, J F

1998-04-01

The objective of this study was to assess a modified consent procedure allowed under federal regulations and developed for studies, particularly clinical trials, that are judged by the Institutional Review Board to reduce or have no effect on patient risk. This was a randomized trial of a conventional consent procedure that required parental signature to give consent (opting in) after a comprehensive disclosure of the rights of participants in research versus a modified consent procedure that required parental signature to refuse consent (opting out) after specific disclosures appropriate when risk is not increased. Consent was sought for a trial of primary follow-up care for disadvantaged infants at high risk, a trial judged by our Institutional Review Board to increase access to care for both groups. A blinded assessor interviewed mothers within 24 hours of the consent decision. Among the 44 mothers interviewed, the modified consent group scored higher than the conventional consent group in recall and understanding of study purpose and methods (47% vs 30%; p < 0.02). Other comparisons provided no evidence that the modified consent procedure was less desirable. Virtually all mothers reported satisfaction. The modified approach may improve communication and facilitate studies judged by the Institutional Review Board to be risk-neutral or risk-reducing. Further evaluation of a modified consent procedure for such studies is warranted.

Applications of modern statistical methods to analysis of data in physical science

NASA Astrophysics Data System (ADS)

Wicker, James Eric

Modern methods of statistical and computational analysis offer solutions to dilemmas confronting researchers in physical science. Although the ideas behind modern statistical and computational analysis methods were originally introduced in the 1970's, most scientists still rely on methods written during the early era of computing. These researchers, who analyze increasingly voluminous and multivariate data sets, need modern analysis methods to extract the best results from their studies. The first section of this work showcases applications of modern linear regression. Since the 1960's, many researchers in spectroscopy have used classical stepwise regression techniques to derive molecular constants. However, problems with thresholds of entry and exit for model variables plagues this analysis method. Other criticisms of this kind of stepwise procedure include its inefficient searching method, the order in which variables enter or leave the model and problems with overfitting data. We implement an information scoring technique that overcomes the assumptions inherent in the stepwise regression process to calculate molecular model parameters. We believe that this kind of information based model evaluation can be applied to more general analysis situations in physical science. The second section proposes new methods of multivariate cluster analysis. The K-means algorithm and the EM algorithm, introduced in the 1960's and 1970's respectively, formed the basis of multivariate cluster analysis methodology for many years. However, several shortcomings of these methods include strong dependence on initial seed values and inaccurate results when the data seriously depart from hypersphericity. We propose new cluster analysis methods based on genetic algorithms that overcomes the strong dependence on initial seed values. In addition, we propose a generalization of the Genetic K-means algorithm which can accurately identify clusters with complex hyperellipsoidal covariance structures. We then use this new algorithm in a genetic algorithm based Expectation-Maximization process that can accurately calculate parameters describing complex clusters in a mixture model routine. Using the accuracy of this GEM algorithm, we assign information scores to cluster calculations in order to best identify the number of mixture components in a multivariate data set. We will showcase how these algorithms can be used to process multivariate data from astronomical observations.

Assessing what to address in science communication.

PubMed

Bruine de Bruin, Wändi; Bostrom, Ann

2013-08-20

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

Ventral striatal response during decision making involving risk and reward is associated with future binge drinking in adolescents.

PubMed

Morales, Angelica M; Jones, Scott A; Ehlers, Alissa; Lavine, Jessye B; Nagel, Bonnie J

2018-05-07

Beginning to engage in heavy alcohol use during adolescence, as opposed to later in life, is associated with elevated risk for a variety of negative consequences, including the development of an alcohol use disorder. Behavioral studies suggest that poor decision making predicts alcohol use during adolescence; however, more research is needed to determine the neurobiological risk factors that underlie this association. Using functional magnetic resonance imaging, brain activation during decision making involving risk and reward was assessed in 47 adolescents (14-15 years old) with no significant history or alcohol or drug use. After baseline assessment, participants completed follow-up interviews every 3 months to assess the duration to onset of binge drinking. Adolescents who made a greater number of risky selections and had greater activation in the nucleus accumbens, precuneus, and occipital cortex during decision making involving greater potential for risk and reward began binge drinking sooner. Findings suggest that heightened activation of reward circuitry during decision making under risk is a neurobiological risk factor for earlier onset of binge drinking. Furthermore, brain activation was a significant predictor of onset to binge drinking, even after controlling for decision-making behavior, suggesting that neurobiological markers may provide additional predictive validity over behavioral assessments. Interventions designed to modify these behavioral and neurobiological risk factors may be useful for curbing heavy alcohol use during adolescence.

Patient decision-making related to antirheumatic drugs in rheumatoid arthritis: the importance of patient trust of physician.

PubMed

Martin, Richard W; Head, Andrew J; René, Jonathan; Swartz, Timothy J; Fiechtner, Justus J; McIntosh, Barbara A; Holmes-Rovner, Margaret

2008-04-01

To explore how rheumatoid arthritis (RA) antirheumatic drug-specific knowledge and numeric literacy, patient trust in physician, and demographic and disease-related factors relate to the confidence of patient decision-making related to disease modifying antirheumatic drugs (DMARD). Data were analyzed from 628 randomly selected patients with RA receiving care in community rheumatology practices, who responded to a multicenter, cross-sectional mail survey. We used multiple regression models to predict patient confidence in DMARD decision-making related to their most recently initiated DMARD. Significant positive correlation was found between confidence in DMARD decision and trust in physician, DMARD-specific knowledge, and disease duration, but not risk-related numeric literacy, sex, or education. Negative correlations were found with disease severity and current bother with DMARD side effects. A multiple linear regression model of confidence in DMARD decision had an overall R = 0.788, R2 = 0.620 (p < 0.001). The 4 dependent variables contributing significantly to the model were female sex, Medicaid insurance status, satisfaction with RA disease control, and trust in physician, with standardized beta = 0.077, -0.089, 0.147, and 0.687, respectively. In this sample of community patients with RA, the patient trust in physician had substantially greater effect on confidence in DMARD decision than DMARD-specific knowledge, disease-related factors, or demographic characteristics.

Neural substrates of reward magnitude, probability, and risk during a wheel of fortune decision-making task.

PubMed

Smith, Bruce W; Mitchell, Derek G V; Hardin, Michael G; Jazbec, Sandra; Fridberg, Daniel; Blair, R James R; Ernst, Monique

2009-01-15

Economic decision-making involves the weighting of magnitude and probability of potential gains/losses. While previous work has examined the neural systems involved in decision-making, there is a need to understand how the parameters associated with decision-making (e.g., magnitude of expected reward, probability of expected reward and risk) modulate activation within these neural systems. In the current fMRI study, we modified the monetary wheel of fortune (WOF) task [Ernst, M., Nelson, E.E., McClure, E.B., Monk, C.S., Munson, S., Eshel, N., et al. (2004). Choice selection and reward anticipation: an fMRI study. Neuropsychologia 42(12), 1585-1597.] to examine in 25 healthy young adults the neural responses to selections of different reward magnitudes, probabilities, or risks. Selection of high, relative to low, reward magnitude increased activity in insula, amygdala, middle and posterior cingulate cortex, and basal ganglia. Selection of low-probability, as opposed to high-probability reward, increased activity in anterior cingulate cortex, as did selection of risky, relative to safe reward. In summary, decision-making that did not involve conflict, as in the magnitude contrast, recruited structures known to support the coding of reward values, and those that integrate motivational and perceptual information for behavioral responses. In contrast, decision-making under conflict, as in the probability and risk contrasts, engaged the dorsal anterior cingulate cortex whose role in conflict monitoring is well established. However, decision-making under conflict failed to activate the structures that track reward values per se. Thus, the presence of conflict in decision-making seemed to significantly alter the pattern of neural responses to simple rewards. In addition, this paradigm further clarifies the functional specialization of the cingulate cortex in processes of decision-making.

Online, Interactive Option Grid Patient Decision Aids and their Effect on User Preferences.

PubMed

Scalia, Peter; Durand, Marie-Anne; Kremer, Jan; Faber, Marjan; Elwyn, Glyn

2018-01-01

Randomized trials have shown that patient decision aids can modify users' preferred healthcare options, but research has yet to identify the attributes embedded in these tools that cause preferences to shift. The aim of this study was to investigate people's preferences as they used decision aids for 5 health decisions and, for each of the following: 1) determine if using the interactive Option Grid led to a pre-post shift in preferences; 2) determine which frequently asked questions (FAQs) led to preference shifts; 3) determine the FAQs that were rated as the most important as users compared options. Interactive Option Grid decision aids enable users to view attributes of available treatment or screening options, rate their importance, and specify their preferred options before and after decision aid use. The McNemar-Bowker paired test was used to compare stated pre-post preferences. Multinomial logistic regressions were conducted to investigate possible associations between covariates and preference shifts. Overall, 626 users completed the 5 most-used tools: 1) Amniocentesis test: yes or no? ( n = 73); 2) Angina: treatment options ( n = 88); 3) Breast cancer: surgical options ( n = 265); 4) Prostate Specific Antigen (PSA) test: yes or no? ( n = 82); 5) Statins for heart disease risk: yes or no? ( n = 118). The breast cancer, PSA, and statins Option Grid decision aids generated significant preference shifts. Generally, users shifted their preference when presented with the description of the available treatment options, and the risk associated with each option. The use of decision aids for some, but not all health decisions, was accompanied by a shift in user preferences. Users typically valued information associated with risks, and chose more risk averse options after completing the interactive tool.

Confirmatory factor analysis and recommendations for improvement of the Autonomy-Preference-Index (API).

PubMed

Simon, Daniela; Kriston, Levente; Loh, Andreas; Spies, Claudia; Scheibler, Fueloep; Wills, Celia; Härter, Martin

2010-09-01

Validation of the German version of the Autonomy-Preference-Index (API), a measure of patients' preferences for decision making and information seeking. Stepwise confirmatory factor analysis was conducted on a sample of patients (n = 1592) treated in primary care for depression (n = 186), surgical and internal medicine inpatients (n = 811) and patients with minor trauma treated in an emergency department (n = 595). An initial test of the model was done on calculation and validation halves of the sample. Both local and global indexes-of-fit suggested modifications to the scale. The scale was modified and re-tested in the calculation sample and confirmed in the validation sample. Subgroup analyses for age, gender and type of treatment setting were also performed. The confirmatory analysis led to a modified version of the API with better local and global indexes-of-fit for samples of German-speaking patients. Two items of the sub-scale, 'preference for decision-making', and one item of the sub-scale, 'preference for information seeking', showed very low reliability scores and were deleted. Thus, several global indexes-of-fit clearly improved significantly. The modified scale was confirmed on the validation sample with acceptable to good indices of fit. Results of subgroup analyses indicated that no adaptations were necessary. This first confirmatory analysis for a German-speaking population showed that the API was improved by the removal of several items. There were theoretically plausible explanations for this improvement suggesting that the modifications might also be appropriate in English and other language versions.

NASA-Modified Precipitation Products to Improve EPA Nonpoint Source Water Quality Modeling for the Chesapeake Bay

NASA Technical Reports Server (NTRS)

Nigro, Joseph; Toll, David; Partington, Ed; Ni-Meister, Wenge; Lee, Shihyan; Gutierrez-Magness, Angelica; Engman, Ted; Arsenault, Kristi

2010-01-01

The Environmental Protection Agency (EPA) has estimated that over 20,000 water bodies within the United States do not meet water quality standards. Ninety percent of the impairments are typically caused by nonpoint sources. One of the regulations in the Clean Water Act of 1972 requires States to monitor the Total Maximum Daily Load (TMDL), or the amount of pollution that can be carried by a water body before it is determined to be "polluted", for any watershed in the U.S.. In response to this mandate, the EPA developed Better Assessment Science Integrating Nonpoint Sources (BASINS) as a Decision Support Tool (DST) for assessing pollution and to guide the decision making process for improving water quality. One of the models in BASINS, the Hydrological Simulation Program -- Fortran (HSPF), computes daily stream flow rates and pollutant concentration at each basin outlet. By design, precipitation and other meteorological data from weather stations serve as standard model input. In practice, these stations may be unable to capture the spatial heterogeneity of precipitation events especially if they are few and far between. An attempt was made to resolve this issue by substituting station data with NASA modified/NOAA precipitation data. Using these data within HSPF, stream flow was calculated for seven watersheds in the Chesapeake Bay Basin during low flow periods, convective storm periods, and annual flows. In almost every case, the modeling performance of HSPF increased when using the NASA-modified precipitation data, resulting in better stream flow statistics and, ultimately, in improved water quality assessment.

Vascular access choice in incident hemodialysis patients: a decision analysis.

PubMed

Drew, David A; Lok, Charmaine E; Cohen, Joshua T; Wagner, Martin; Tangri, Navdeep; Weiner, Daniel E

2015-01-01

Hemodialysis vascular access recommendations promote arteriovenous (AV) fistulas first; however, it may not be the best approach for all hemodialysis patients, because likelihood of successful fistula placement, procedure-related and subsequent costs, and patient survival modify the optimal access choice. We performed a decision analysis evaluating AV fistula, AV graft, and central venous catheter (CVC) strategies for patients initiating hemodialysis with a CVC, a scenario occurring in over 70% of United States dialysis patients. A decision tree model was constructed to reflect progression from hemodialysis initiation. Patients were classified into one of three vascular access choices: maintain CVC, attempt fistula, or attempt graft. We explicitly modeled probabilities of primary and secondary patency for each access type, with success modified by age, sex, and diabetes. Access-specific mortality was incorporated using preexisting cohort data, including terms for age, sex, and diabetes. Costs were ascertained from the 2010 USRDS report and Medicare for procedure costs. An AV fistula attempt strategy was found to be superior to AV grafts and CVCs in regard to mortality and cost for the majority of patient characteristic combinations, especially younger men without diabetes. Women with diabetes and elderly men with diabetes had similar outcomes, regardless of access type. Overall, the advantages of an AV fistula attempt strategy lessened considerably among older patients, particularly women with diabetes, reflecting the effect of lower AV fistula success rates and lower life expectancy. These results suggest that vascular access-related outcomes may be optimized by considering individual patient characteristics. Copyright © 2015 by the American Society of Nephrology.

Evaluation of a Dispatcher's Route Optimization Decision Aid to Avoid Aviation Weather Hazards

NASA Technical Reports Server (NTRS)

Dorneich, Michael C.; Olofinboba, Olu; Pratt, Steve; Osborne, Dannielle; Feyereisen, Thea; Latorella, Kara

2003-01-01

This document describes the results and analysis of the formal evaluation plan for the Honeywell software tool developed under the NASA AWIN (Aviation Weather Information) 'Weather Avoidance using Route Optimization as a Decision Aid' project. The software tool aims to provide airline dispatchers with a decision aid for selecting optimal routes that avoid weather and other hazards. This evaluation compares and contrasts route selection performance with the AWIN tool to that of subjects using a more traditional dispatcher environment. The evaluation assesses gains in safety, in fuel efficiency of planned routes, and in time efficiency in the pre-flight dispatch process through the use of the AWIN decision aid. In addition, we are interested in how this AWIN tool affects constructs that can be related to performance. The construct of Situation Awareness (SA), workload, trust in an information system, and operator acceptance are assessed using established scales, where these exist, as well as through the evaluation of questionnaire responses and subject comments. The intention of the experiment is to set up a simulated operations area for the dispatchers to work in. They will be given scenarios in which they are presented with stored company routes for a particular city-pair and aircraft type. A diverse set of external weather information sources is represented by a stand-alone display (MOCK), containing the actual historical weather data typically used by dispatchers. There is also the possibility of presenting selected weather data on the route visualization tool. The company routes have not been modified to avoid the weather except in the case of one additional route generated by the Honeywell prototype flight planning system. The dispatcher will be required to choose the most appropriate and efficient flight plan route in the displayed weather conditions. The route may be modified manually or may be chosen from those automatically displayed.

Effect of continuous theta burst stimulation of the right dorsolateral prefrontal cortex on cerebral blood flow changes during decision making.

PubMed

Cho, Sang Soo; Pellecchia, Giovanna; Ko, Ji Hyun; Ray, Nicola; Obeso, Ignacio; Houle, Sylvain; Strafella, Antonio P

2012-04-01

Decision making is a cognitive function relaying on a complex neural network. In particular, the right dorsolateral prefrontal cortex (DLPFC) plays a key role within this network. We used positron emission tomography (PET) combined with continuous theta burst transcranial magnetic stimulation (cTBS) to investigate neuronal and behavioral changes in normal volunteers while performing a delay discounting (DD) task. We aimed to test whether stimulation of right DLPFC would modify the activation pattern of the neural circuit underlying decision making during the DD task and influence discounting behavior. We found that cTBS of the right DLPFC influenced decision making by reducing impulsivity and inducing participants to favor large but delayed rewards instead of immediate but small rewards. Stimulation also affected activation in several prefrontal areas associated with DD. In particular, we observed a reduced regional cerebral blood flow (rCBF) in the ipsilateral DLPFC (BA 46) extending into the rostral part of the prefrontal cortex (BA 10) as well as a disrupted relationship between impulsivity (k-value) and rCBF in these and other prefrontal areas. These findings suggest that transcranial magnetic stimulation of the DLPFC influences the neural network underlying impulsive decision making behavior. Copyright © 2012 Elsevier Inc. All rights reserved.

Diffusion Modelling Reveals the Decision Making Processes Underlying Negative Judgement Bias in Rats

PubMed Central

Hales, Claire A.; Robinson, Emma S. J.; Houghton, Conor J.

2016-01-01

Human decision making is modified by emotional state. Rodents exhibit similar biases during interpretation of ambiguous cues that can be altered by affective state manipulations. In this study, the impact of negative affective state on judgement bias in rats was measured using an ambiguous-cue interpretation task. Acute treatment with an anxiogenic drug (FG7142), and chronic restraint stress and social isolation both induced a bias towards more negative interpretation of the ambiguous cue. The diffusion model was fit to behavioural data to allow further analysis of the underlying decision making processes. To uncover the way in which parameters vary together in relation to affective state manipulations, independent component analysis was conducted on rate of information accumulation and distances to decision threshold parameters for control data. Results from this analysis were applied to parameters from negative affective state manipulations. These projected components were compared to control components to reveal the changes in decision making processes that are due to affective state manipulations. Negative affective bias in rodents induced by either FG7142 or chronic stress is due to a combination of more negative interpretation of the ambiguous cue, reduced anticipation of the high reward and increased anticipation of the low reward. PMID:27023442

Adapting a Driving Simulator to Study Pedestrians' Street-Crossing Decisions: A Feasibility Study.

PubMed

Jäger, M; Nyffeler, T; Müri, R; Mosimann, U P; Nef, T

2015-01-01

The decision when to cross a street safely is a challenging task that poses high demands on perception and cognition. Both can be affected by normal aging, neurodegenerative disorder, and brain injury, and there is an increasing interest in studying street-crossing decisions. In this article, we describe how driving simulators can be modified to study pedestrians' street-crossing decisions. The driving simulator's projection system and the virtual driving environment were used to present street-crossing scenarios to the participants. New sensors were added to measure when the test person starts to cross the street. Outcome measures were feasibility, usability, task performance, and visual exploration behavior, and were measured in 15 younger persons, 15 older persons, and 5 post-stroke patients. The experiments showed that the test is feasible and usable, and the selected difficulty level was appropriate. Significant differences in the number of crashes between young participants and patients (p = .001) as well as between healthy older participants and patients (p = .003) were found. When the approaching vehicle's speed is high, significant differences between younger and older participants were found as well (p = .038). Overall, the new test setup was well accepted, and we demonstrated that driving simulators can be used to study pedestrians' street-crossing decisions.

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).

Selective decision-making deficits in at-risk gamblers

PubMed Central

Grant, Jon Edgar; Chamberlain, Samuel Robin; Schreiber, Liana Renne Nelson; Odlaug, Brian Lawrence; Kim, Suck Won

2011-01-01

Despite reasonable knowledge of pathological gambling (PG), little is known of its cognitive antecedents. We evaluated decision-making and impulsivity characteristics in people at risk of developing PG using neuropsychological tests. Non-treatment seeking volunteers (18-29 years) who gamble ≥5 times/year were recruited from the general community, and split into two groups: those “at risk” of developing PG (n=74) and those social, non-problem gamblers (n=112). Participants undertook the Cambridge Gamble and Stop-signal tasks and were assessed with the Mini-International Neuropsychiatric Interview and the Yale Brown Obsessive Compulsive Scale Modified for Pathological Gambling. On the Cambridge Gamble task, the at- risk subjects gambled more points overall, were more likely to go bankrupt, and made more irrational decisions under situations of relative risk ambiguity. On the Stop-signal task, at- risk gamblers did not differ from the social, non-problem gamblers in terms of motor impulse control (stop-signal reaction times). Findings suggest that selective cognitive dysfunction may already be present in terms of decision-making in at-risk gamblers, even before psychopathology arises. These findings implicate selective decision-making deficits and dysfunction of orbitofronto-limbic circuitry in the chain of pathogenesis between social, non-problematic and pathological gambling. PMID:21715016

Cognitive decision modelling of emotion-based learning impairment in schizophrenia: the role of awareness.

PubMed

Cella, Matteo; Dymond, Simon; Cooper, Andrew; Turnbull, Oliver H

2012-03-30

Individuals with schizophrenia often lack insight or awareness. Resulting impairment has been observed in various cognitive domains and, recently, linked to problems in emotion-based learning. The Iowa Gambling Task (IGT) has been used to assess emotion-based decision-making in patients with schizophrenia, but results have been inconclusive. The current study further investigates emotion-based decision-making in schizophrenia by elucidating the unique contribution of awareness. Twenty-five patients with schizophrenia and 24 healthy controls were assessed with a modified version of the IGT recording awareness at regular intervals. Symptom assessment, medication and medical history were recorded for the clinical group. Patients with schizophrenia underperformed on the IGT compared to controls. Subjective awareness levels were significantly lower in the schizophrenia group and were associated with hallucination severity. Cognitive decision modelling further indicated that patients with schizophrenia had impaired attention to losses, compared to controls. This parameter was positively correlated with awareness. We also found that positive symptoms altered awareness levels and suggest that this disruption may contribute to sub-optimal decision-making. Overall, a lack of awareness may be an important aspect in understanding impaired social cognitive functioning and emotion-based learning observed in schizophrenia. Copyright © 2011 Elsevier Ltd. All rights reserved.

Rational decision-making in inhibitory control.

PubMed

Shenoy, Pradeep; Yu, Angela J

2011-01-01

An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability.

A Novel Group Decision-Making Method Based on Sensor Data and Fuzzy Information.

PubMed

Bai, Yu-Ting; Zhang, Bai-Hai; Wang, Xiao-Yi; Jin, Xue-Bo; Xu, Ji-Ping; Su, Ting-Li; Wang, Zhao-Yang

2016-10-28

Algal bloom is a typical phenomenon of the eutrophication of rivers and lakes and makes the water dirty and smelly. It is a serious threat to water security and public health. Most scholars studying solutions for this pollution have studied the principles of remediation approaches, but few have studied the decision-making and selection of the approaches. Existing research uses simplex decision-making information which is highly subjective and uses little of the data from water quality sensors. To utilize these data and solve the rational decision-making problem, a novel group decision-making method is proposed using the sensor data with fuzzy evaluation information. Firstly, the optimal similarity aggregation model of group opinions is built based on the modified similarity measurement of Vague values. Secondly, the approaches' ability to improve the water quality indexes is expressed using Vague evaluation methods. Thirdly, the water quality sensor data are analyzed to match the features of the alternative approaches with grey relational degrees. This allows the best remediation approach to be selected to meet the current water status. Finally, the selection model is applied to the remediation of algal bloom in lakes. The results show this method's rationality and feasibility when using different data from different sources.

Rational Decision-Making in Inhibitory Control

PubMed Central

Shenoy, Pradeep; Yu, Angela J.

2011-01-01

An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability. PMID:21647306

Do choosing wisely tools meet criteria for patient decision aids? A descriptive analysis of patient materials

PubMed Central

Légaré, France; Hébert, Jessica; Goh, Larissa; Lewis, Krystina B; Leiva Portocarrero, Maria Ester; Robitaille, Hubert; Stacey, Dawn

2016-01-01

Objectives Choosing Wisely is a remarkable physician-led campaign to reduce unnecessary or harmful health services. Some of the literature identifies Choosing Wisely as a shared decision-making approach. We evaluated the patient materials developed by Choosing Wisely Canada to determine whether they meet the criteria for shared decision-making tools known as patient decision aids. Design Descriptive analysis of all Choosing Wisely Canada patient materials. Data source In May 2015, we selected all Choosing Wisely Canada patient materials from its official website. Main outcomes and measures Four team members independently extracted characteristics of the English materials using the International Patient Decision Aid Standards (IPDAS) modified 16-item minimum criteria for qualifying and certifying patient decision aids. The research team discussed discrepancies between data extractors and reached a consensus. Descriptive analysis was conducted. Results Of the 24 patient materials assessed, 12 were about treatments, 11 were about screening and 1 was about prevention. The median score for patient materials using IPDAS criteria was 10/16 (range: 8–11) for screening topics and 6/12 (range: 6–9) for prevention and treatment topics. Commonly missed criteria were stating the decision (21/24 did not), providing balanced information on option benefits/harms (24/24 did not), citing evidence (24/24 did not) and updating policy (24/24 did not). Out of 24 patient materials, only 2 met the 6 IPDAS criteria to qualify as patient decision aids, and neither of these 2 met the 6 certifying criteria. Conclusions Patient materials developed by Choosing Wisely Canada do not meet the IPDAS minimal qualifying or certifying criteria for patient decision aids. Modifications to the Choosing Wisely Canada patient materials would help to ensure that they qualify as patient decision aids and thus as more effective shared decision-making tools. PMID:27566638

On formally integrating science and policy: walking the walk

USGS Publications Warehouse

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

2015-01-01

The contribution of science to the development and implementation of policy is typically neither direct nor transparent.  In 1995, the U.S. Fish and Wildlife Service (FWS) made a decision that was unprecedented in natural resource management, turning to an unused and unproven decision process to carry out trust responsibilities mandated by an international treaty.  The decision process was adopted for the establishment of annual sport hunting regulations for the most economically important duck population in North America, the 6 to 11 million mallards Anas platyrhynchos breeding in the mid-continent region of north-central United States and central Canada.  The key idea underlying the adopted decision process was to formally embed within it a scientific process designed to reduce uncertainty (learn) and thus make better decisions in the future.  The scientific process entails use of models to develop predictions of competing hypotheses about system response to the selected action at each decision point.  These prediction not only are used to select the optimal management action, but also are compared with the subsequent estimates of system state variables, providing evidence for modifying degrees of confidence in, and hence relative influence of, these models at the next decision point.  Science and learning in one step are formally and directly incorporated into the next decision, contrasting with the usual ad hoc and indirect use of scientific results in policy development and decision-making.  Application of this approach over the last 20 years has led to a substantial reduction in uncertainty, as well as to an increase in transparency and defensibility of annual decisions and a decrease in the contentiousness of the decision process.  As resource managers are faced with increased uncertainty associated with various components of global change, this approach provides a roadmap for the future scientific management of natural resources.  

Public preferences for engagement in Health Technology Assessment decision-making: protocol of a mixed methods study.

PubMed

Wortley, Sally; Tong, Allison; Lancsar, Emily; Salkeld, Glenn; Howard, Kirsten

2015-07-14

Much attention in recent years has been given to the topic of public engagement in health technology assessment (HTA) decision-making. HTA organizations spend substantial resources and time on undertaking public engagement, and numerous studies have examined challenges and barriers to engagement in the decision-making process however uncertainty remains as to optimal methods to incorporate the views of the public in HTA decision-making. Little research has been done to ascertain whether current engagement processes align with public preferences and to what extent their desire for engagement is dependent on the question being asked by decision-makers or the characteristics of the decision. This study will examine public preferences for engagement in Australian HTA decision-making using an exploratory mixed methods design. The aims of this study are to: 1) identify characteristics about HTA decisions that are important to the public in determining whether public engagement should be undertaken on a particular topic, 2) determine which decision characteristics influence public preferences for the extent, or type of public engagement, and 3) describe reasons underpinning these preferences. Focus group participants from the general community, aged 18-70 years, will be purposively sampled from the Australian population to ensure a wide range of demographic groups. Each focus group will include a general discussion on public engagement as well as a ranking exercise using a modified nominal group technique (NGT). The NGT will inform the design of a discrete choice study to quantitatively assess public preferences for engagement in HTA decision-making. The proposed research seeks to investigate under what circumstances and how the public would like their views and preferences to be considered in health technology assessments. HTA organizations regularly make decisions about when and how public engagement should occur but without consideration of the public's preferences on the method and extent of engagement. This information has the potential to assist decision-makers in tailoring engagement approaches, and may be particularly useful in decisions with potential for conflict where clarification of public values and preferences could strengthen the decision-making process.

"Maybe the Algae Was from the Filter": Maybe and Similar Modifiers as Mediational Tools and Indicators of Uncertainty and Possibility in Children's Science Talk

ERIC Educational Resources Information Center

Kirch, Susan A.; Siry, Christina A.

2012-01-01

Uncertainty is an essential component of scientific inquiry and it also permeates our daily lives. Understanding how to identify, evaluate, resolve and live in the presence of uncertainty is important for decision-making strategies and engaging in transformative actions. In contrast, confidence and certainty are prized in elementary school…

Differences in Eighth Grade Science Student and Teacher Perceptions of Students' Level of Input into Academic Planning and Decision Making

ERIC Educational Resources Information Center

Chapman, Jarrett Michael

2014-01-01

Teachers are expected to improve their planning, instruction, and assessment as they progress through their career. An important component to teachers knowing what to modify in their teaching style is being able to solicit meaningful feedback from students. This mixed-methods study was conducted to provide teachers with a quantitative method to…

Narrative, Visual Model and Dragon Culture: A Narrative Analysis of Value Presentation in Two Movies Preferred by Chinese Adolescents. Research Bulletin 98.

ERIC Educational Resources Information Center

Jin, He

A narrative study was conducted of the visual models in two movies preferred by Chinese adolescents in two schools (n=152). The two movies studied were "Three Decisive Campaigns" (A Chinese Trilogy) and the American science fiction movie, "Jurassic Park." The modified approach from Bandura's modeling theory and film semiotics…

Concept Modification Approach to Pedestrian Safety: A Strategy for Modifying Young Children's Existing Conceptual Framework of Speed.

ERIC Educational Resources Information Center

Cross, R. T.; Pitkethly, A.

1991-01-01

Research suggests that many children have a concept of speed which is counterproductive to sound road crossing decisions. An attempt at conceptual change through the teaching of a unit on speed to grade one children is described. There is optimism that six- to seven-year-old children can apply classroom experiences to real life situations. (Author)

GM Risk Assessment

NASA Astrophysics Data System (ADS)

Sparrow, Penny A. C.

GM risk assessments play an important role in the decision-making process surrounding the regulation, notification and permission to handle Genetically Modified Organisms (GMOs). Ultimately the role of a GM risk assessment will be to ensure the safe handling and containment of the GMO; and to assess any potential impacts on the environment and human health. A risk assessment should answer all ‘what if’ scenarios, based on scientific evidence.

Development and feasibility testing of decision support for patients who are candidates for a prophylactic implantable defibrillator: a study protocol for a pilot randomized controlled trial

PubMed Central

2013-01-01

Background Patients, identified to be at risk for but who have never experienced a potentially lethal cardiac arrhythmia, have the option of receiving an implantable cardioverter defibrillator (ICD) as prophylaxis against sudden cardiac death - a primary prevention indication. In Canada, there is no clear framework to support patients’ decision-making for these devices. Decision support, using a decision aid, could moderate treatment-related uncertainty and prepare patients to make well-informed decisions. Patient decision aids provide information on treatment options, risks, and benefits, to help patients clarify their values for outcomes of treatment options. The objectives of this research are: 1) develop a decision aid, 2) evaluate the decision aid, and 3) determine the feasibility of conducting a trial. Methods/design A development panel comprised of the core investigative team, health service researchers, decision science experts, cardiovascular healthcare practitioners, and ICD patient representatives will collaborate to provide input on the content and format of the aid. To generate probabilities to include in the aid, we will synthesize primary prevention ICD evidence. To obtain anonymous input about the facts and content, we will employ a modified Delphi process. To evaluate the draft decision aid will invite ICD patients and their families (n = 30) to rate its acceptability. After we evaluate the aid, to determine the feasibility, we will conduct a feasibility pilot randomized controlled trial (RCT) in new ICD candidates (n = 80). Participants will be randomized to receive a decision aid prior to specialist consultation versus usual care. Results from the pilot RCT will determine the feasibility of research processes; inform sample size calculation, measure decision quality (knowledge, values, decision conflict) and the influence of health related quality of life on decision-making. Discussion Our study seeks to develop a decision aid, for patients offered their first ICD for prophylaxis against sudden cardiac death. This paper outlines the background and methods of a pilot randomized trial which will inform a larger multicenter trial. Ultimately, decision support prior to specialist consultation could enhance the decision-making process between patients, physicians, and families, associated with life-prolonging medical devices like the ICD. Trial registration ClinicalTrials.gov: NCT01876173 PMID:24148851

Development and feasibility testing of decision support for patients who are candidates for a prophylactic implantable defibrillator: a study protocol for a pilot randomized controlled trial.

PubMed

Carroll, Sandra L; McGillion, Michael; Stacey, Dawn; Healey, Jeff S; Browne, Gina; Arthur, Heather M; Thabane, Lehana

2013-10-22

Patients, identified to be at risk for but who have never experienced a potentially lethal cardiac arrhythmia, have the option of receiving an implantable cardioverter defibrillator (ICD) as prophylaxis against sudden cardiac death - a primary prevention indication. In Canada, there is no clear framework to support patients' decision-making for these devices. Decision support, using a decision aid, could moderate treatment-related uncertainty and prepare patients to make well-informed decisions. Patient decision aids provide information on treatment options, risks, and benefits, to help patients clarify their values for outcomes of treatment options. The objectives of this research are: 1) develop a decision aid, 2) evaluate the decision aid, and 3) determine the feasibility of conducting a trial. A development panel comprised of the core investigative team, health service researchers, decision science experts, cardiovascular healthcare practitioners, and ICD patient representatives will collaborate to provide input on the content and format of the aid. To generate probabilities to include in the aid, we will synthesize primary prevention ICD evidence. To obtain anonymous input about the facts and content, we will employ a modified Delphi process. To evaluate the draft decision aid will invite ICD patients and their families (n = 30) to rate its acceptability. After we evaluate the aid, to determine the feasibility, we will conduct a feasibility pilot randomized controlled trial (RCT) in new ICD candidates (n = 80). Participants will be randomized to receive a decision aid prior to specialist consultation versus usual care. Results from the pilot RCT will determine the feasibility of research processes; inform sample size calculation, measure decision quality (knowledge, values, decision conflict) and the influence of health related quality of life on decision-making. Our study seeks to develop a decision aid, for patients offered their first ICD for prophylaxis against sudden cardiac death. This paper outlines the background and methods of a pilot randomized trial which will inform a larger multicenter trial. Ultimately, decision support prior to specialist consultation could enhance the decision-making process between patients, physicians, and families, associated with life-prolonging medical devices like the ICD. ClinicalTrials.gov: NCT01876173.

Consumer knowledge and attitudes about genetically modified food products and labelling policy.

PubMed

Vecchione, Melissa; Feldman, Charles; Wunderlich, Shahla

2015-05-01

The purpose of this study was to examine the relationship between consumer knowledge, attitudes and behaviours towards foods containing genetically modified organisms (GMOs) and the prevalence of GMO labelling in northern New Jersey supermarkets. This cross-sectional study surveyed 331 adults, New Jersey supermarket customers (mean age 26 years old, 79.8% women). The results show a strong, positive correlation between consumer attitudes towards foods not containing GMOs and purchasing behaviour (Pearson's r = 0.701, p < 0.001) with lesser correlations between knowledge and behaviour (Pearson's r = 0.593, p < 0.001) and knowledge and attitudes (Pearson's r = 0.413, p < 0.001). GMO labelling would assist consumers in making informed purchase decisions.

Problem formulation in the environmental risk assessment for genetically modified plants

PubMed Central

Wolt, Jeffrey D.; Keese, Paul; Raybould, Alan; Burachik, Moisés; Gray, Alan; Olin, Stephen S.; Schiemann, Joachim; Sears, Mark; Wu, Felicia

2009-01-01

Problem formulation is the first step in environmental risk assessment (ERA) where policy goals, scope, assessment endpoints, and methodology are distilled to an explicitly stated problem and approach for analysis. The consistency and utility of ERAs for genetically modified (GM) plants can be improved through rigorous problem formulation (PF), producing an analysis plan that describes relevant exposure scenarios and the potential consequences of these scenarios. A properly executed PF assures the relevance of ERA outcomes for decision-making. Adopting a harmonized approach to problem formulation should bring about greater uniformity in the ERA process for GM plants among regulatory regimes globally. This paper is the product of an international expert group convened by the International Life Sciences Institute (ILSI) Research Foundation. PMID:19757133

Analysis of Automated Aircraft Conflict Resolution and Weather Avoidance

NASA Technical Reports Server (NTRS)

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

2009-01-01

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

Psychosocial and cultural factors affecting the perceived risk of genetically modified food: an overview of the literature.

PubMed

Finucane, Melissa L; Holup, Joan L

2005-04-01

The rapid globalization of the world economy has increased the need for an astute understanding of cultural differences in perceptions, values, and ways of thinking about new food technologies. In this paper, we describe how socio-psychological and cultural factors may affect public perceptions of the risk of genetically modified (GM) food. We present psychological, sociological, and anthropological research on risk perception as a framework for understanding cross-national differences in reactions to GM food. Differences in the cultural values and circumstances of people in the US, European countries, and the developing world are examined. The implications of cultural theory for risk communication and decision making about GM food are discussed and directions for future research highlighted.

Automatic Recognition Of Moving Objects And Its Application To A Robot For Picking Asparagus

NASA Astrophysics Data System (ADS)

Baylou, P.; Amor, B. El Hadj; Bousseau, G.

1983-10-01

After a brief description of the robot for picking white asparagus, a statistical study of the different shapes of asparagus tips allowed us to determine certain discriminating parameters to detect the tips as they appear on the silhouette of the mound of earth. The localisation was done stereometrically with the help of two cameras. As the robot carrying the system of vision-localisation moves, the images are altered and decision cri-teria modified. A study of the image from mobile objects produced by both tube and CCD came-ras was carried out. A simulation of this phenomenon has been achieved in order to determine the modifications concerning object shapes, thresholding levels and decision parameters in function of the robot speed.

Discovering body site and severity modifiers in clinical texts

PubMed Central

Dligach, Dmitriy; Bethard, Steven; Becker, Lee; Miller, Timothy; Savova, Guergana K

2014-01-01

Objective To research computational methods for discovering body site and severity modifiers in clinical texts. Methods We cast the task of discovering body site and severity modifiers as a relation extraction problem in the context of a supervised machine learning framework. We utilize rich linguistic features to represent the pairs of relation arguments and delegate the decision about the nature of the relationship between them to a support vector machine model. We evaluate our models using two corpora that annotate body site and severity modifiers. We also compare the model performance to a number of rule-based baselines. We conduct cross-domain portability experiments. In addition, we carry out feature ablation experiments to determine the contribution of various feature groups. Finally, we perform error analysis and report the sources of errors. Results The performance of our method for discovering body site modifiers achieves F1 of 0.740–0.908 and our method for discovering severity modifiers achieves F1 of 0.905–0.929. Discussion Results indicate that both methods perform well on both in-domain and out-domain data, approaching the performance of human annotators. The most salient features are token and named entity features, although syntactic dependency features also contribute to the overall performance. The dominant sources of errors are infrequent patterns in the data and inability of the system to discern deeper semantic structures. Conclusions We investigated computational methods for discovering body site and severity modifiers in clinical texts. Our best system is released open source as part of the clinical Text Analysis and Knowledge Extraction System (cTAKES). PMID:24091648

Discovering body site and severity modifiers in clinical texts.

PubMed

Dligach, Dmitriy; Bethard, Steven; Becker, Lee; Miller, Timothy; Savova, Guergana K

2014-01-01

To research computational methods for discovering body site and severity modifiers in clinical texts. We cast the task of discovering body site and severity modifiers as a relation extraction problem in the context of a supervised machine learning framework. We utilize rich linguistic features to represent the pairs of relation arguments and delegate the decision about the nature of the relationship between them to a support vector machine model. We evaluate our models using two corpora that annotate body site and severity modifiers. We also compare the model performance to a number of rule-based baselines. We conduct cross-domain portability experiments. In addition, we carry out feature ablation experiments to determine the contribution of various feature groups. Finally, we perform error analysis and report the sources of errors. The performance of our method for discovering body site modifiers achieves F1 of 0.740-0.908 and our method for discovering severity modifiers achieves F1 of 0.905-0.929. Results indicate that both methods perform well on both in-domain and out-domain data, approaching the performance of human annotators. The most salient features are token and named entity features, although syntactic dependency features also contribute to the overall performance. The dominant sources of errors are infrequent patterns in the data and inability of the system to discern deeper semantic structures. We investigated computational methods for discovering body site and severity modifiers in clinical texts. Our best system is released open source as part of the clinical Text Analysis and Knowledge Extraction System (cTAKES).

A typology of time-scale mismatches and behavioral interventions to diagnose and solve conservation problems

USGS Publications Warehouse

Wilson, Robyn S.; Hardisty, David J.; Epanchin-Niell, Rebecca S.; Runge, Michael C.; Cottingham, Kathryn L.; Urban, Dean L.; Maguire, Lynn A.; Hastings, Alan; Mumby, Peter J.; Peters, Debra P.C.

2016-01-01

Ecological systems often operate on time scales significantly longer or shorter than the time scales typical of human decision making, which causes substantial difficulty for conservation and management in socioecological systems. For example, invasive species may move faster than humans can diagnose problems and initiate solutions, and climate systems may exhibit long-term inertia and short-term fluctuations that obscure learning about the efficacy of management efforts in many ecological systems. We adopted a management-decision framework that distinguishes decision makers within public institutions from individual actors within the social system, calls attention to the ways socioecological systems respond to decision makers’ actions, and notes institutional learning that accrues from observing these responses. We used this framework, along with insights from bedeviling conservation problems, to create a typology that identifies problematic time-scale mismatches occurring between individual decision makers in public institutions and between individual actors in the social or ecological system. We also considered solutions that involve modifying human perception and behavior at the individual level as a means of resolving these problematic mismatches. The potential solutions are derived from the behavioral economics and psychology literature on temporal challenges in decision making, such as the human tendency to discount future outcomes at irrationally high rates. These solutions range from framing environmental decisions to enhance the salience of long-term consequences, to using structured decision processes that make time scales of actions and consequences more explicit, to structural solutions aimed at altering the consequences of short-sighted behavior to make it less appealing. Additional application of these tools and long-term evaluation measures that assess not just behavioral changes but also associated changes in ecological systems are needed.

Decision making in the Balloon Analogue Risk Task (BART): anterior cingulate cortex signals loss aversion but not the infrequency of risky choices.

PubMed

Fukunaga, Rena; Brown, Joshua W; Bogg, Tim

2012-09-01

The inferior frontal gyrus/anterior insula (IFG/AI) and anterior cingulate cortex (ACC) are key regions involved in risk appraisal during decision making, but accounts of how these regions contribute to decision making under risk remain contested. To help clarify the roles of these and other related regions, we used a modified version of the Balloon Analogue Risk Task (Lejuez et al., Journal of Experimental Psychology: Applied, 8, 75-84, 2002) to distinguish between decision-making and feedback-related processes when participants decided to pursue a gain as the probability of loss increased parametrically. Specifically, we set out to test whether the ACC and IFG/AI regions correspond to loss aversion at the time of decision making in a way that is not confounded with either reward-seeking or infrequency effects. When participants chose to discontinue inflating the balloon (win option), we observed greater ACC and mainly bilateral IFG/AI activity at the time of decision as the probability of explosion increased, consistent with increased loss aversion but inconsistent with an infrequency effect. In contrast, we found robust vmPFC activity when participants chose to continue inflating the balloon (risky option), consistent with reward seeking. However, in the cingulate and in mainly bilateral IFG regions, blood-oxygenation-level-dependent activation decreased when participants chose to inflate the balloon as the probability of explosion increased, findings that are consistent with a reduced loss aversion signal. Our results highlight the existence of distinct reward-seeking and loss-averse signals during decision making, as well as the importance of distinguishing between decision and feedback signals.

Impaired Decision-Making, Higher Impulsivity, and Drug Severity in Substance Dependence and Pathological Gambling.

PubMed

Krmpotich, Theodore; Mikulich-Gilbertson, Susan; Sakai, Joseph; Thompson, Laetitia; Banich, Marie T; Tanabe, Jody

2015-01-01

Substance use disorder is characterized by impaired decision making, impulsivity, and risk taking. Pathological gambling shares many of these characteristics, and having both diagnoses may be associated with greater problems than either diagnosis alone. We investigated whether among substance-dependent individuals, comorbid pathological gambling would be associated with worse decision making, greater impulsivity, risk taking, and drug severity. Ninety-six substance-dependent individuals were recruited from a residential treatment program and divided into 1 of the 2 groups depending on whether they met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for pathological gambling (SDPG, n = 26) or not (SD, n = 70). Ninety-two controls were recruited from the community. Participants completed a decision-making task (modified Iowa Gambling Task), measures of impulsivity (Barratt Impulsivity Scale and Delay Discounting), and risk taking (Balloon Analog Risk Task). Decision making was analyzed using a computational model. We tested for group differences using analysis of covariance or Kruskal-Wallis and appropriate post-hoc tests. The groups differed in decision-making parameters (P < 0.001) and self-reported impulsivity (P < 0.001). All post-hoc comparisons were significant on these measures, and indicated stepwise changes in controls, followed by SD, followed by SDPG, with SDPG performing worse on decision making and being more impulsive. Compared with SD, SDPG had greater drug severity (P < 0.001). No group differences were observed in delay discounting or risk taking. Compared with individuals with substance dependence without pathological gambling, those with both disorders demonstrated worse decision making and significantly more drug-related symptoms. When evaluating patients with substance dependence, clinicians should consider diagnostic assessments for gambling, as the co-occurrence of both disorders may impact clinical characteristics.

A typology of time-scale mismatches and behavioral interventions to diagnose and solve conservation problems.

PubMed

Wilson, Robyn S; Hardisty, David J; Epanchin-Niell, Rebecca S; Runge, Michael C; Cottingham, Kathryn L; Urban, Dean L; Maguire, Lynn A; Hastings, Alan; Mumby, Peter J; Peters, Debra P C

2016-02-01

Ecological systems often operate on time scales significantly longer or shorter than the time scales typical of human decision making, which causes substantial difficulty for conservation and management in socioecological systems. For example, invasive species may move faster than humans can diagnose problems and initiate solutions, and climate systems may exhibit long-term inertia and short-term fluctuations that obscure learning about the efficacy of management efforts in many ecological systems. We adopted a management-decision framework that distinguishes decision makers within public institutions from individual actors within the social system, calls attention to the ways socioecological systems respond to decision makers' actions, and notes institutional learning that accrues from observing these responses. We used this framework, along with insights from bedeviling conservation problems, to create a typology that identifies problematic time-scale mismatches occurring between individual decision makers in public institutions and between individual actors in the social or ecological system. We also considered solutions that involve modifying human perception and behavior at the individual level as a means of resolving these problematic mismatches. The potential solutions are derived from the behavioral economics and psychology literature on temporal challenges in decision making, such as the human tendency to discount future outcomes at irrationally high rates. These solutions range from framing environmental decisions to enhance the salience of long-term consequences, to using structured decision processes that make time scales of actions and consequences more explicit, to structural solutions aimed at altering the consequences of short-sighted behavior to make it less appealing. Additional application of these tools and long-term evaluation measures that assess not just behavioral changes but also associated changes in ecological systems are needed. © 2015 Society for Conservation Biology.

Patient Preferences regarding Shared Decision-making in the Emergency Department: Findings from a multi-site survey.

PubMed

Schoenfeld, Elizabeth M; Kanzaria, Hemal K; Quigley, Denise D; Marie, Peter St; Nayyar, Nikita; Sabbagh, Sarah H; Gress, Kyle L; Probst, Marc A

2018-06-13

As Shared Decision-Making (SDM) has received increased attention as a method to improve the patient-centeredness of emergency department (ED) care, we sought to determine patients' desired level of involvement in medical decisions and their perceptions of potential barriers and facilitators to SDM in the ED. We surveyed a cross-sectional sample of adult ED patients at three academic medical centers across the United States. The survey included 32 items regarding patient involvement in medical decisions including a modified Control Preference Scale (CPS) and questions about barriers and facilitators to SDM in the ED. Items were developed and refined based on prior literature and qualitative interviews with ED patients. Research assistants administered the survey in person. Of 797 patients approached, 661 (83%) agreed to participate. Participants were 52% female, 45% white, and 30% Hispanic. The majority of respondents (85-92%, depending on decision type) expressed a desire for some degree of involvement in decision-making in the ED, while 8-15% preferred to leave decision-making to their physician alone. Ninety-eight percent wanted to be involved with decisions when "something serious is going on." The majority of patients (94%) indicated that self-efficacy was not a barrier to SDM in the ED. However, most patients (55%) reported a tendency to defer to the physician's decision-making during an ED visit, with about half reporting they would wait for a physician to ask them to be involved. We found the majority of ED patients in our large, diverse sample wanted to be involved in medical decisions, especially in the case of a "serious" medical problem, and felt that they had the ability to do so. Nevertheless, many patients were unlikely to actively seek involvement and defaulted to allowing the physician to make decisions during the ED visit. After fully explaining the consequences of a decision, clinicians should make an effort to explicitly ascertain patients' desired level of involvement in decision-making. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

How accurate are interpretations of curriculum-based measurement progress monitoring data? Visual analysis versus decision rules.

PubMed

Van Norman, Ethan R; Christ, Theodore J

2016-10-01

Curriculum based measurement of oral reading (CBM-R) is used to monitor the effects of academic interventions for individual students. Decisions to continue, modify, or terminate these interventions are made by interpreting time series CBM-R data. Such interpretation is founded upon visual analysis or the application of decision rules. The purpose of this study was to compare the accuracy of visual analysis and decision rules. Visual analysts interpreted 108 CBM-R progress monitoring graphs one of three ways: (a) without graphic aids, (b) with a goal line, or (c) with a goal line and a trend line. Graphs differed along three dimensions, including trend magnitude, variability of observations, and duration of data collection. Automated trend line and data point decision rules were also applied to each graph. Inferential analyses permitted the estimation of the probability of a correct decision (i.e., the student is improving - continue the intervention, or the student is not improving - discontinue the intervention) for each evaluation method as a function of trend magnitude, variability of observations, and duration of data collection. All evaluation methods performed better when students made adequate progress. Visual analysis and decision rules performed similarly when observations were less variable. Results suggest that educators should collect data for more than six weeks, take steps to control measurement error, and visually analyze graphs when data are variable. Implications for practice and research are discussed. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Facilitating political decisions using species distribution models to assess restoration measures in heavily modified estuaries.

PubMed

Heuner, Maike; Weber, Arnd; Schröder, Uwe; Kleinschmit, Birgit; Schröder, Boris

2016-09-15

The European Water Framework Directive requires a good ecological potential for heavily modified water bodies. This standard has not been reached for most large estuaries by 2015. Management plans for estuaries fall short in linking implementations between restoration measures and underlying spatial analyses. The distribution of emergent macrophytes - as an indicator of habitat quality - is here used to assess the ecological potential. Emergent macrophytes are capable of settling on gentle tidal flats where hydrodynamic stress is comparatively low. Analyzing their habitats based on spatial data, we set up species distribution models with 'elevation relative to mean high water', 'mean bank slope', and 'length of bottom friction' from shallow water up to the vegetation belt as key predictors representing hydrodynamic stress. Effects of restoration scenarios on habitats were assessed applying these models. Our findings endorse species distribution models as crucial spatial planning tools for implementing restoration measures in modified estuaries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Substoichiometric hydroxynonenylation of a single protein recapitulates whole-cell-stimulated antioxidant response.

PubMed

Parvez, Saba; Fu, Yuan; Li, Jiayang; Long, Marcus J C; Lin, Hong-Yu; Lee, Dustin K; Hu, Gene S; Aye, Yimon

2015-01-14

Lipid-derived electrophiles (LDEs) that can directly modify proteins have emerged as important small-molecule cues in cellular decision-making. However, because these diffusible LDEs can modify many targets [e.g., >700 cysteines are modified by the well-known LDE 4-hydroxynonenal (HNE)], establishing the functional consequences of LDE modification on individual targets remains devilishly difficult. Whether LDE modifications on a single protein are biologically sufficient to activate discrete redox signaling response downstream also remains untested. Herein, using T-REX (targetable reactive electrophiles and oxidants), an approach aimed at selectively flipping a single redox switch in cells at a precise time, we show that a modest level (∼34%) of HNEylation on a single target is sufficient to elicit the pharmaceutically important antioxidant response element (ARE) activation, and the resultant strength of ARE induction recapitulates that observed from whole-cell electrophilic perturbation. These data provide the first evidence that single-target LDE modifications are important individual events in mammalian physiology.

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

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

Decision making by urgency gating: theory and experimental support.

PubMed

Thura, David; Beauregard-Racine, Julie; Fradet, Charles-William; Cisek, Paul

2012-12-01

It is often suggested that decisions are made when accumulated sensory information reaches a fixed accuracy criterion. This is supported by many studies showing a gradual build up of neural activity to a threshold. However, the proposal that this build up is caused by sensory accumulation is challenged by findings that decisions are based on information from a time window much shorter than the build-up process. Here, we propose that in natural conditions where the environment can suddenly change, the policy that maximizes reward rate is to estimate evidence by accumulating only novel information and then compare the result to a decreasing accuracy criterion. We suggest that the brain approximates this policy by multiplying an estimate of sensory evidence with a motor-related urgency signal and that the latter is primarily responsible for neural activity build up. We support this hypothesis using human behavioral data from a modified random-dot motion task in which motion coherence changes during each trial.

Expert Consensus for Discharge Referral Decisions Using Online Delphi

PubMed Central

Bowles, Kathy H.; Holmes, John H.; Naylor, Mary D.; Liberatore, Matthew; Nydick, Robert

2003-01-01

This paper describes the results of using a modified Delphi approach designed to achieve consensus from eight discharge planning experts regarding the decision to refer hospitalized older adults for post-discharge follow-up. Experts reviewed 150 cases using an online website designed to facilitate their interaction and efforts to reach agreement on the need for a referral for post-discharge care and the appropriate site for such care. In contrast to an average of eight weeks to complete just 50 cases using the traditional mail method, the first online Delphi round for 150 cases were completed in six weeks. Data provided by experts suggest that online Delphi is a time efficient and acceptable methodology for reaching group consensus. Other benefits include instant access to Delphi decision results, live knowledge of the time requirements and progress of each expert, and cost savings in postage, paper, copying, and storage of paper documents. This online Delphi methodology is highly recommended. PMID:14728143

Rhetorical Use of Inscriptions in Students' Written Arguments About Socioscientific Issues

NASA Astrophysics Data System (ADS)

Xiao, Sihan

2018-05-01

Educators expect that students be able to make informed decisions about science-related problems in their everyday lives. Engaging science in such problems often entails evaluating available evidence for given arguments. This study explores how students use inscriptions as evidence to argue about socioscientific issues. Fifth- and sixth-grade students (N = 102) in two intact classrooms completed written argument tasks in which they were asked to cite given inscriptions to support their decisions about energy use or genetically modified organisms. Qualitative content analyses of these written arguments, which focused on the coordination between inscriptions and claims, show three patterns of rhetorical use of inscriptions: seeing is believing, believing is seeing, and asserting is inferring. What counts as evidence was not the inscriptions per se, but the rhetorical functions they performed in particular arguments. These findings suggest that justifying socioscientific decisions is functionally different from explaining scientific phenomena. Linking these two activities in school may help students more productively engage with science in their everyday lives.

Security training with interactive laser-video-disk technology

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

Wilson, D.

1988-01-01

DOE, through its contractor EG and G Energy Measurements, Inc., has developed a state-of-the-art interactive-video system for use at the Department of Energy's Central Training Academy. Called the Security Training and Evaluation Shooting System (STRESS), the computer-driven decision shooting system employs the latest is laservideo-disk technology. STRESS is designed to provide realistic and stressful training for security inspectors employed by the DOE and its contractors. The system uses wide-screen video projection, sophisticated scenario-branching technology, and customized video scenarios especially designed for the DOE. Firing a weapon that has been modified to shoot ''laser bullets,'' and wearing a special vest thatmore » detects ''hits'': the security inspector encounters adversaries on the wide screen who can shoot or be shot by the inspector in scenarios that demand fast decisions. Based on those decisions, the computer provides instantaneous branching to different scenes, giving the inspector confrontational training with the realism and variability of real life.« less

Adolescent women's contraceptive decision making.

PubMed

Weisman, C S; Plichta, S; Nathanson, C A; Chase, G A; Ensminger, M E; Robinson, J C

1991-06-01

A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed.

Use of Decision Aids with Minority Patients: a Systematic Review.

PubMed

Nathan, Aviva G; Marshall, Imani M; Cooper, Jennifer M; Huang, Elbert S

2016-06-01

One potential approach to reducing health disparities among minorities is through the promotion of shared decision making (SDM). The most commonly studied SDM intervention is the decision aid (DA). While DAs have been extensively studied, we know relatively little about their use in minority populations. We conducted a systematic review to characterize the application and effectiveness of DAs in racial, ethnic, sexual, and gender minorities. We searched PubMed for randomized controlled trials (RCTs) evaluating DAs between 2004 and 2013. We included trials that enrolled adults (> 18 years of age) with > 50 % representation by minority patients. Four reviewers independently assessed 597 initially identified articles, and those with inconclusive results were discussed to consensus. We abstracted decision quality, patient-doctor communication, and clinical treatment decision outcomes. Results were considered significantly modified by the DA if the study reported p < 0.05. We reviewed 18 RCTs of DA interventions in minority populations. The majority of interventions (78 %) addressed cancer screening. The most common mode of delivery for the DAs was personal counseling (46 %), followed by multi-media (29 %), and print materials (25 %). Most of the trials studied racial (78 %) or ethnic (17 %) minorities with only one trial focused on sexual minorities and none on gender minorities. Ten studies tailored their interventions for their minority populations. Comparing intervention vs. control, decision quality outcomes improved in six out of eight studies and patient-doctor communication improved in six out of seven studies. Of the 15 studies that reported on clinical decisions, eight demonstrated significant changes in decisions with DAs. DAs have been effective in improving patient-doctor communication and decision quality outcomes in minority populations and could help address health disparities. However, the existing literature is almost non-existent for sexual and gender minorities and has not included the full breadth of clinical decisions that affect minority populations.

A Grounded Theory Study of Aircraft Maintenance Technician Decision-Making

NASA Astrophysics Data System (ADS)

Norcross, Robert

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

Periodic benefit-risk assessment using Bayesian stochastic multi-criteria acceptability analysis

PubMed Central

Li, Kan; Yuan, Shuai Sammy; Wang, William; Wan, Shuyan Sabrina; Ceesay, Paulette; Heyse, Joseph F.; Mt-Isa, Shahrul; Luo, Sheng

2018-01-01

Benefit-risk (BR) assessment is essential to ensure the best decisions are made for a medical product in the clinical development process, regulatory marketing authorization, post-market surveillance, and coverage and reimbursement decisions. One challenge of BR assessment in practice is that the benefit and risk profile may keep evolving while new evidence is accumulating. Regulators and the International Conference on Harmonization (ICH) recommend performing periodic benefit-risk evaluation report (PBRER) through the product's lifecycle. In this paper, we propose a general statistical framework for periodic benefit-risk assessment, in which Bayesian meta-analysis and stochastic multi-criteria acceptability analysis (SMAA) will be combined to synthesize the accumulating evidence. The proposed approach allows us to compare the acceptability of different drugs dynamically and effectively and accounts for the uncertainty of clinical measurements and imprecise or incomplete preference information of decision makers. We apply our approaches to two real examples in a post-hoc way for illustration purpose. The proposed method may easily be modified for other pre and post market settings, and thus be an important complement to the current structured benefit-risk assessment (sBRA) framework to improve the transparent and consistency of the decision-making process. PMID:29505866

Modeling interactions between political parties and electors

NASA Astrophysics Data System (ADS)

Bagarello, F.; Gargano, F.

2017-09-01

In this paper we extend some recent results on an operatorial approach to the description of alliances between political parties interacting among themselves and with a basin of electors. In particular, we propose and compare three different models, deducing the dynamics of their related decision functions, i.e. the attitude of each party to form or not an alliance. In the first model the interactions between each party and their electors are considered. We show that these interactions drive the decision functions toward certain asymptotic values depending on the electors only: this is the perfect party, which behaves following the electors' suggestions. The second model is an extension of the first one in which we include a rule which modifies the status of the electors, and of the decision functions as a consequence, at some specific time step. In the third model we neglect the interactions with the electors while we consider cubic and quartic interactions between the parties and we show that we get (slightly oscillating) asymptotic values for the decision functions, close to their initial values. This is the real party, which does not listen to the electors. Several explicit situations are considered in details and numerical results are also shown.

Democratic parenting: paradoxical messages in democratic parent education theories

NASA Astrophysics Data System (ADS)

Oryan, Shlomit; Gastil, John

2013-06-01

Some prominent parent education theories in the United States and other Western countries base their educational viewpoint explicitly on democratic values, such as mutual respect, equality and personal freedom. These democratic parenting theories advocate sharing power with children and including them in family decision making. This study presents a textual analysis of two such theories, the Adlerian model of parent education and the Parent Effectiveness Training (PET) model, as they are embodied in two original bestselling textbooks. Through content and argumentation analysis of these influential texts, this study examines the paradoxes inherent in these two theories when they articulate how to implement fully democratic principles within the parent-child relationship. We discover that in spite of their democratic rationale, both books offer communication practices that guide the child to modify misbehaviour, enforce parental power, and manipulate the child to make decisions that follow parental judgment, and thus do not endorse the use of a truly democratic parenting style. We suggest, as an alternative to the democratic parenting style, that parents be introduced to a guardianship management style, in which they do not share authority with children, but seek opportunities for enabling children to make more autonomous decisions and participate in more family decision making.

Advancing Patient-centered Outcomes in Emergency Diagnostic Imaging: A Research Agenda.

PubMed

Kanzaria, Hemal K; McCabe, Aileen M; Meisel, Zachary M; LeBlanc, Annie; Schaffer, Jason T; Bellolio, M Fernanda; Vaughan, William; Merck, Lisa H; Applegate, Kimberly E; Hollander, Judd E; Grudzen, Corita R; Mills, Angela M; Carpenter, Christopher R; Hess, Erik P

2015-12-01

Diagnostic imaging is integral to the evaluation of many emergency department (ED) patients. However, relatively little effort has been devoted to patient-centered outcomes research (PCOR) in emergency diagnostic imaging. This article provides background on this topic and the conclusions of the 2015 Academic Emergency Medicine consensus conference PCOR work group regarding "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The goal was to determine a prioritized research agenda to establish which outcomes related to emergency diagnostic imaging are most important to patients, caregivers, and other key stakeholders and which methods will most optimally engage patients in the decision to undergo imaging. Case vignettes are used to emphasize these concepts as they relate to a patient's decision to seek care at an ED and the care received there. The authors discuss applicable research methods and approaches such as shared decision-making that could facilitate better integration of patient-centered outcomes and patient-reported outcomes into decisions regarding emergency diagnostic imaging. Finally, based on a modified Delphi process involving members of the PCOR work group, prioritized research questions are proposed to advance the science of patient-centered outcomes in ED diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

Human Decisions in Moral Dilemmas are Largely Described by Utilitarianism: Virtual Car Driving Study Provides Guidelines for Autonomous Driving Vehicles.

PubMed

Faulhaber, Anja K; Dittmer, Anke; Blind, Felix; Wächter, Maximilian A; Timm, Silja; Sütfeld, Leon R; Stephan, Achim; Pipa, Gordon; König, Peter

2018-01-22

Ethical thought experiments such as the trolley dilemma have been investigated extensively in the past, showing that humans act in utilitarian ways, trying to cause as little overall damage as possible. These trolley dilemmas have gained renewed attention over the past few years, especially due to the necessity of implementing moral decisions in autonomous driving vehicles (ADVs). We conducted a set of experiments in which participants experienced modified trolley dilemmas as drivers in virtual reality environments. Participants had to make decisions between driving in one of two lanes where different obstacles came into view. Eventually, the participants had to decide which of the objects they would crash into. Obstacles included a variety of human-like avatars of different ages and group sizes. Furthermore, the influence of sidewalks as potential safe harbors and a condition implicating self-sacrifice were tested. Results showed that participants, in general, decided in a utilitarian manner, sparing the highest number of avatars possible with a limited influence by the other variables. Derived from these findings, which are in line with the utilitarian approach in moral decision making, it will be argued for an obligatory ethics setting implemented in ADVs.

Q-learning residual analysis: application to the effectiveness of sequences of antipsychotic medications for patients with schizophrenia.

PubMed

Ertefaie, Ashkan; Shortreed, Susan; Chakraborty, Bibhas

2016-06-15

Q-learning is a regression-based approach that uses longitudinal data to construct dynamic treatment regimes, which are sequences of decision rules that use patient information to inform future treatment decisions. An optimal dynamic treatment regime is composed of a sequence of decision rules that indicate how to optimally individualize treatment using the patients' baseline and time-varying characteristics to optimize the final outcome. Constructing optimal dynamic regimes using Q-learning depends heavily on the assumption that regression models at each decision point are correctly specified; yet model checking in the context of Q-learning has been largely overlooked in the current literature. In this article, we show that residual plots obtained from standard Q-learning models may fail to adequately check the quality of the model fit. We present a modified Q-learning procedure that accommodates residual analyses using standard tools. We present simulation studies showing the advantage of the proposed modification over standard Q-learning. We illustrate this new Q-learning approach using data collected from a sequential multiple assignment randomized trial of patients with schizophrenia. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Brain areas consistently linked to individual differences in perceptual decision-making in younger as well as older adults before and after training.

PubMed

Kühn, Simone; Schmiedek, Florian; Schott, Björn; Ratcliff, Roger; Heinze, Hans-Jochen; Düzel, Emrah; Lindenberger, Ulman; Lövden, Martin

2011-09-01

Perceptual decision-making performance depends on several cognitive and neural processes. Here, we fit Ratcliff's diffusion model to accuracy data and reaction-time distributions from one numerical and one verbal two-choice perceptual-decision task to deconstruct these performance measures into the rate of evidence accumulation (i.e., drift rate), response criterion setting (i.e., boundary separation), and peripheral aspects of performance (i.e., nondecision time). These theoretical processes are then related to individual differences in brain activation by means of multiple regression. The sample consisted of 24 younger and 15 older adults performing the task in fMRI before and after 100 daily 1-hr behavioral training sessions in a multitude of cognitive tasks. Results showed that individual differences in boundary separation were related to striatal activity, whereas differences in drift rate were related to activity in the inferior parietal lobe. These associations were not significantly modified by adult age or perceptual expertise. We conclude that the striatum is involved in regulating response thresholds, whereas the inferior parietal lobe might represent decision-making evidence related to letters and numbers.

The impact of disappointment in decision making: inter-individual differences and electrical neuroimaging.

PubMed

Tzieropoulos, Hélène; de Peralta, Rolando Grave; Bossaerts, Peter; Gonzalez Andino, Sara L

2011-01-01

Disappointment, the emotion experienced when faced to reward prediction errors (RPEs), considerably impacts decision making (DM). Individuals tend to modify their behavior in an often unpredictable way just to avoid experiencing negative emotions. Despite its importance, disappointment remains much less studied than regret and its impact on upcoming decisions largely unexplored. Here, we adapted the Trust Game to effectively elicit, quantify, and isolate disappointment by relying on the formal definition provided by Bell's in economics. We evaluated the effects of experienced disappointment and elation on future cooperation and trust as well as the rationality and utility of the different behavioral and neural mechanisms used to cope with disappointment. All participants in our game trusted less and particularly expected less from unknown opponents as a result of disappointing outcomes in the previous trial but not necessarily after elation indicating that behavioral consequences of positive and negative RPEs are not the same. A large variance in the tolerance to disappointment was observed across subjects, with some participants needing only a small disappointment to impulsively bias their subsequent decisions. As revealed by high-density EEG recordings the most tolerant individuals - who thought twice before making a decision and earned more money - relied on different neural generators to contend with neutral and unexpected outcomes. This study thus provides some support to the idea that different neural systems underlie reflexive and reflective decisions within the same individuals as predicted by the dual-system theory of social judgment and DM.

Making assessments while taking repeated risks: a pattern of multiple response pathways.

PubMed

Pleskac, Timothy J; Wershbale, Avishai

2014-02-01

Beyond simply a decision process, repeated risky decisions also require a number of cognitive processes including learning, search and exploration, and attention. In this article, we examine how multiple response pathways develop over repeated risky decisions. Using the Balloon Analogue Risk Task (BART) as a case study, we show that 2 different response pathways emerge over the course of the task. The assessment pathway is a slower, more controlled pathway where participants deliberate over taking a risk. The 2nd pathway is a faster, more automatic process where no deliberation occurs. Results imply the slower assessment pathway is taken as choice conflict increases and that the faster automatic response is a learned response. Based on these results, we modify an existing formal cognitive model of decision making during the BART to account for these dual response pathways. The slower more deliberative response process is modeled with a sequential sampling process where evidence is accumulated to a threshold, while the other response is given automatically. We show that adolescents with conduct disorder and substance use disorder symptoms not only evaluate risks differently during the BART but also differ in the rate at which they develop the more automatic response. More broadly, our results suggest cognitive models of judgment decision making need to transition from treating observed decisions as the result of a single response pathway to the result of multiple response pathways that change and develop over time.

Impaired decision making and delayed memory are related with anxiety and depressive symptoms in acromegaly.

PubMed

Crespo, Iris; Santos, Alicia; Valassi, Elena; Pires, Patricia; Webb, Susan M; Resmini, Eugenia

2015-12-01

Evaluation of cognitive function in acromegaly has revealed contradictory findings; some studies report normal cognition in patients with long-term cured acromegaly, while others show attention and memory deficits. Moreover, the presence of affective disorders in these patients is common. Our aim was to evaluate memory and decision making in acromegalic patients and explore their relationship with affective disorders like anxiety and depressive symptoms. Thirty-one patients with acromegaly (mean age 49.5 ± 8.5 years, 14 females and 17 males) and thirty-one healthy controls participated in this study. The Iowa Gambling Task (IGT), Rey Auditory Verbal Learning Test, State-Trait Anxiety Inventory, and Beck Depression Inventory-II (BDI-II) were used to evaluate decision making, verbal memory, anxiety, and depressive symptoms, respectively. Acromegalic patients showed impairments in delayed verbal memory (p < 0.05) and more anxiety and depressive symptoms (p < 0.05) than controls. In the IGT, acromegalic patients presented an altered decision-making strategy compared to controls, choosing a lower number of the safer cards (p < 0.05) and higher number of the riskier cards (p < 0.05). Moreover, multiple correlations between anxiety and depressive symptoms and performance in memory and decision making were found. Impaired delayed memory and decision making observed in acromegalic patients are related to anxiety and depressive symptoms. Providing emotional support to the patients could improve their cognitive function. A key clinical application of this research is the finding that depressive symptoms and anxiety are essentially modifiable factors.

Towards a more open debate about values in decision-making on agricultural biotechnology.

PubMed

Devos, Yann; Sanvido, Olivier; Tait, Joyce; Raybould, Alan

2014-12-01

Regulatory decision-making over the use of products of new technology aims to be based on science-based risk assessment. In some jurisdictions, decision-making about the cultivation of genetically modified (GM) plants is blocked supposedly because of scientific uncertainty about risks to the environment. However, disagreement about the acceptability of risks is primarily a dispute over normative values, which is not resolvable through natural sciences. Natural sciences may improve the quality and relevance of the scientific information used to support environmental risk assessments and make scientific uncertainties explicit, but offer little to resolve differences about values. Decisions about cultivating GM plants will thus not necessarily be eased by performing more research to reduce scientific uncertainty in environmental risk assessments, but by clarifying the debate over values. We suggest several approaches to reveal values in decision-making: (1) clarifying policy objectives; (2) determining what constitutes environmental harm; (3) making explicit the factual and normative premises on which risk assessments are based; (4) better demarcating environmental risk assessment studies from ecological research; (5) weighing the potential for environmental benefits (i.e., opportunities) as well as the potential for environmental harms (i.e., risks); and (6) expanding participation in the risk governance of GM plants. Recognising and openly debating differences about values will not remove controversy about the cultivation of GM plants. However, by revealing what is truly in dispute, debates about values will clarify decision-making criteria.

The Impact of Disappointment in Decision Making: Inter-Individual Differences and Electrical Neuroimaging

PubMed Central

Tzieropoulos, Hélène; de Peralta, Rolando Grave; Bossaerts, Peter; Andino, Sara L. Gonzalez

2011-01-01

Disappointment, the emotion experienced when faced to reward prediction errors (RPEs), considerably impacts decision making (DM). Individuals tend to modify their behavior in an often unpredictable way just to avoid experiencing negative emotions. Despite its importance, disappointment remains much less studied than regret and its impact on upcoming decisions largely unexplored. Here, we adapted the Trust Game to effectively elicit, quantify, and isolate disappointment by relying on the formal definition provided by Bell's in economics. We evaluated the effects of experienced disappointment and elation on future cooperation and trust as well as the rationality and utility of the different behavioral and neural mechanisms used to cope with disappointment. All participants in our game trusted less and particularly expected less from unknown opponents as a result of disappointing outcomes in the previous trial but not necessarily after elation indicating that behavioral consequences of positive and negative RPEs are not the same. A large variance in the tolerance to disappointment was observed across subjects, with some participants needing only a small disappointment to impulsively bias their subsequent decisions. As revealed by high-density EEG recordings the most tolerant individuals – who thought twice before making a decision and earned more money – relied on different neural generators to contend with neutral and unexpected outcomes. This study thus provides some support to the idea that different neural systems underlie reflexive and reflective decisions within the same individuals as predicted by the dual-system theory of social judgment and DM. PMID:21258645

Confirmatory Factor Analysis of Burnout Dimensions: Correlations with Job Stressors and Aspects of Social Support and Job Satisfaction

DTIC Science & Technology

1992-02-01

1986) revision of the Maslach and Jackson (1981) Maslach Burnout Inventory (MBI). Results of confirmatory factor analyses conducted on data... Maslach organizational issues: depersonalization was and Jackson (1981) Maslach Burnout Inventory related to decision-making policies, personal (MBI). The...manage- (1989). The dimensionality of a modified ment interventions to respond to different mani- form of the Maslach Burnout Inventory for festations

Hawaii State Plan for Occupational Safety and Health. Final rule.

PubMed

2012-09-21

This document announces the Occupational Safety and Health Administration's (OSHA) decision to modify the Hawaii State Plan's ``final approval'' determination under Section 18(e) of the Occupational Safety and Health Act (the Act) and to transition to ``initial approval'' status. OSHA is reinstating concurrent federal enforcement authority over occupational safety and health issues in the private sector, which have been solely covered by the Hawaii State Plan since 1984.

78 FR 33106 - Certain Automated Media Library Devices; Decision to Modify In Part a Remand Initial...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-03

... of infringement of certain claims of U.S. Patent No. 6,328,766 (``the '766 patent'') and U.S. Patent... investigation with respect to claims 6 and 11 of the '766 patent and claims 8, 11 and 17-19 of the '581 patent... Respondents with respect to any of the asserted patent claims. On August 20, 2012, the Commission determined...

Modification of the flow pass method as applied to problems of chemistry of planet atmospheres

NASA Technical Reports Server (NTRS)

Parshev, V. A.

1980-01-01

It was shown that the modified flow pass method possesses considerable effectiveness, both in the case when the coefficient of diffusion changes severely in the examined region and in the case when diffusion is the prevalent process, as compared with chemical reactions. The case when a regular pass proves inapplicable, or applicable in a limited interval of the decisive parameters, was examined.

Game-Based Approaches' Pedagogical Principles: Exploring Task Constraints in Youth Soccer.

PubMed

Serra-Olivares, Jaime; González-Víllora, Sixto; García-López, Luis Miguel; Araújo, Duarte

2015-06-27

This study tested the use of two pedagogical principles of Game-based approaches, representation and exaggeration, in the context of game performance of U10 soccer players. Twenty-one players participated in two 3 vs. 3 small-sided games. The first small-sided game was modified by representation. The second small-sided game was modified by enhancing the penetration of the defense tactical problem for invasion games. Decision-making and execution were assessed using the Game Performance Evaluation Tool. No significant differences were observed between games in the number of decision-making units related to keeping possession, nor in those related to penetrating the defense. No significant differences were observed in any execution ability (ball control, passing, dribbling and get free movements). The findings suggested that both games could provide similar degeneracy processes to the players for skill acquisition (specific and contextualized task constraints in which they could develop their game performance and the capability to achieve different outcomes in varying contexts). Probably both games had similar learner-environment dynamics leading players to develop their capabilities for adapting their behaviours to the changing performance situations. More research is necessary, from the ecological dynamics point of view, to determine how we should use small-sided games in Game-based approaches.

A Flexible and Non-instrusive Approach for Computing Complex Structural Coverage Metrics

NASA Technical Reports Server (NTRS)

Whalen, Michael W.; Person, Suzette J.; Rungta, Neha; Staats, Matt; Grijincu, Daniela

2015-01-01

Software analysis tools and techniques often leverage structural code coverage information to reason about the dynamic behavior of software. Existing techniques instrument the code with the required structural obligations and then monitor the execution of the compiled code to report coverage. Instrumentation based approaches often incur considerable runtime overhead for complex structural coverage metrics such as Modified Condition/Decision (MC/DC). Code instrumentation, in general, has to be approached with great care to ensure it does not modify the behavior of the original code. Furthermore, instrumented code cannot be used in conjunction with other analyses that reason about the structure and semantics of the code under test. In this work, we introduce a non-intrusive preprocessing approach for computing structural coverage information. It uses a static partial evaluation of the decisions in the source code and a source-to-bytecode mapping to generate the information necessary to efficiently track structural coverage metrics during execution. Our technique is flexible; the results of the preprocessing can be used by a variety of coverage-driven software analysis tasks, including automated analyses that are not possible for instrumented code. Experimental results in the context of symbolic execution show the efficiency and flexibility of our nonintrusive approach for computing code coverage information

Game-Based Approaches’ Pedagogical Principles: Exploring Task Constraints in Youth Soccer

PubMed Central

Serra-Olivares, Jaime; González-Víllora, Sixto; García-López, Luis Miguel; Araújo, Duarte

2015-01-01

This study tested the use of two pedagogical principles of Game-based approaches, representation and exaggeration, in the context of game performance of U10 soccer players. Twenty-one players participated in two 3 vs. 3 small-sided games. The first small-sided game was modified by representation. The second small-sided game was modified by enhancing the penetration of the defense tactical problem for invasion games. Decision-making and execution were assessed using the Game Performance Evaluation Tool. No significant differences were observed between games in the number of decision-making units related to keeping possession, nor in those related to penetrating the defense. No significant differences were observed in any execution ability (ball control, passing, dribbling and get free movements). The findings suggested that both games could provide similar degeneracy processes to the players for skill acquisition (specific and contextualized task constraints in which they could develop their game performance and the capability to achieve different outcomes in varying contexts). Probably both games had similar learner-environment dynamics leading players to develop their capabilities for adapting their behaviours to the changing performance situations. More research is necessary, from the ecological dynamics point of view, to determine how we should use small-sided games in Game-based approaches. PMID:26240668

Developing a Physiotherapy-Specific Preliminary Clinical Decision-Making Tool for Oxygen Titration: A Modified Delphi Study

PubMed Central

Duong, Michelle; Bertin, Kendra; Henry, Renee; Singh, Deepti; Timmins, Nolla; Brooks, Dina; Mathur, Sunita

2014-01-01

ABSTRACT Purpose: To develop and evaluate a preliminary clinical decision-making tool (CDMT) to assist physiotherapists in titrating oxygen for acutely ill adults in Ontario. Methods: A panel of 14 experienced cardiorespiratory physiotherapists was recruited. Factors relating to oxygen titration were identified using a modified Delphi technique. Four rounds of questionnaires were conducted, during which the goals were to (1) generate factors, (2) reduce factors and debate contentious factors, (3) finalize factors and develop the preliminary CDMT, and (4) evaluate the usability of the tool in a clinical context. Results: The panel reached consensus on a total of 89 factors, which were compiled to create the preliminary CDMT. The global tool reached consensus for sensibility, receiving a mean score of 6/7 on a 7-point Likert-type scale (1=unacceptable; 7=excellent). Five of the nine individual components of evaluation of the tool achieved scores ≥6.0; the remaining four had mean scores between 5.4 and 5.9. Conclusion: This study produced a preliminary CDMT for oxygen titration, which the panel agreed was highly comprehensible and globally sensible. Further research is necessary to evaluate the sensibility and applicability of the tool in a clinical setting. PMID:25125782

Making the Case for Practice-Based Research and the Imperative Role of Design Practitioners.

PubMed

Freihoefer, Kara; Zborowsky, Terri

2017-04-01

The purpose of this article is to justify the need for evidence-based design (EBD) in a research-based architecture and design practice. This article examines the current state of practice-based research (PBR), supports the need for EBD, illustrates PBR methods that can be applied to design work, and explores how findings can be used as a decision-making tool during design and as a validation tool during postoccupancy. As a result, design professions' body of knowledge will advance and practitioners will be better informed to protect the health, safety, and welfare of the society. Furthermore, characteristics of Friedman's progressive research program are used as a framework to examine the current state of PBR in design practice. A modified EBD approach is proposed and showcased with a case study of a renovated inpatient unit. The modified approach demonstrates how a highly integrated project team, especially the role of design practitioners, contributed to the success of utilizing baseline findings and evidence in decision-making throughout the design process. Lastly, recommendations and resources for learning research concepts are provided for practitioners. It is the role of practitioners to pave the way for the next generation of design professionals, as the request and expectation for research become more prevalent in design practice.

Ex post power economic analysis of record of decision operational restrictions at Glen Canyon Dam.

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

Veselka, T. D.; Poch, L. A.; Palmer, C. S.

On October 9, 1996, Bruce Babbitt, then-Secretary of the U.S. Department of the Interior signed the Record of Decision (ROD) on operating criteria for the Glen Canyon Dam (GCD). Criteria selected were based on the Modified Low Fluctuating Flow (MLFF) Alternative as described in the Operation of Glen Canyon Dam, Colorado River Storage Project, Arizona, Final Environmental Impact Statement (EIS) (Reclamation 1995). These restrictions reduced the operating flexibility of the hydroelectric power plant and therefore its economic value. The EIS provided impact information to support the ROD, including an analysis of operating criteria alternatives on power system economics. This exmore » post study reevaluates ROD power economic impacts and compares these results to the economic analysis performed prior (ex ante) to the ROD for the MLFF Alternative. On the basis of the methodology used in the ex ante analysis, anticipated annual economic impacts of the ROD were estimated to range from approximately $15.1 million to $44.2 million in terms of 1991 dollars ($1991). This ex post analysis incorporates historical events that took place between 1997 and 2005, including the evolution of power markets in the Western Electricity Coordinating Council as reflected in market prices for capacity and energy. Prompted by ROD operational restrictions, this analysis also incorporates a decision made by the Western Area Power Administration to modify commitments that it made to its customers. Simulated operations of GCD were based on the premise that hourly production patterns would maximize the economic value of the hydropower resource. On the basis of this assumption, it was estimated that economic impacts were on average $26.3 million in $1991, or $39 million in $2009.« less

Comparison of preferences of healthcare professionals and MS patients for attributes of disease-modifying drugs: A best-worst scaling.

PubMed

Kremer, Ingrid E H; Evers, Silvia M A A; Jongen, Peter J; Hiligsmann, Mickaël

2018-02-01

The choice between disease-modifying drugs (DMDs) for the treatment of multiple sclerosis (MS) becomes more often a shared decision between the patient and the neurologist and MS nurse. This study aimed to assess which DMD attributes are most important for the healthcare professionals in selecting a DMD for a patient. Subsequently, within this perspective, the neurologists' and nurses' perspectives were compared. Lastly, the healthcare professionals' perspective was compared with the patients' perspective to detect any differences that may need attention in the communication about DMDs. A best-worst scaling (BWS) was conducted among 27 neurologists and 33 MS nurses treating patients with MS to determine the importance of 27 DMD attributes. These attributes were identified through three focus groups with MS patients in a previous study (N=19). Relative importance scores (RISs) were estimated for each attribute. Multivariable linear regression analyses were used to compare the different perspectives. According to the neurologists and nurses, safety of the DMD was the most important DMD attribute in the treatment decision, closely followed by effect on disability progression, quality of life and relapse rate. Patients with MS agreed with the importance of the last three attributes, but valued safety significantly lower (b=-2.59, P<.001). This study suggests that, overall, neurologists and nurses regard the same DMD attributes as important as MS patients with the notable exception of safety. This study provides valuable information for the development of interventions to support shared decision making and highlights which attributes of DMDs may need additional attention. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology.

PubMed

Eubank, Breda H; Mohtadi, Nicholas G; Lafave, Mark R; Wiley, J Preston; Bois, Aaron J; Boorman, Richard S; Sheps, David M

2016-05-20

Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1) to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2) to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark "agree" or "disagree" beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways) for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

The GMOseek matrix: a decision support tool for optimizing the detection of genetically modified plants.

PubMed

Block, Annette; Debode, Frédéric; Grohmann, Lutz; Hulin, Julie; Taverniers, Isabel; Kluga, Linda; Barbau-Piednoir, Elodie; Broeders, Sylvia; Huber, Ingrid; Van den Bulcke, Marc; Heinze, Petra; Berben, Gilbert; Busch, Ulrich; Roosens, Nancy; Janssen, Eric; Žel, Jana; Gruden, Kristina; Morisset, Dany

2013-08-22

Since their first commercialization, the diversity of taxa and the genetic composition of transgene sequences in genetically modified plants (GMOs) are constantly increasing. To date, the detection of GMOs and derived products is commonly performed by PCR-based methods targeting specific DNA sequences introduced into the host genome. Information available regarding the GMOs' molecular characterization is dispersed and not appropriately organized. For this reason, GMO testing is very challenging and requires more complex screening strategies and decision making schemes, demanding in return the use of efficient bioinformatics tools relying on reliable information. The GMOseek matrix was built as a comprehensive, online open-access tabulated database which provides a reliable, comprehensive and user-friendly overview of 328 GMO events and 247 different genetic elements (status: 18/07/2013). The GMOseek matrix is aiming to facilitate GMO detection from plant origin at different phases of the analysis. It assists in selecting the targets for a screening analysis, interpreting the screening results, checking the occurrence of a screening element in a group of selected GMOs, identifying gaps in the available pool of GMO detection methods, and designing a decision tree. The GMOseek matrix is an independent database with effective functionalities in a format facilitating transferability to other platforms. Data were collected from all available sources and experimentally tested where detection methods and certified reference materials (CRMs) were available. The GMOseek matrix is currently a unique and very valuable tool with reliable information on GMOs from plant origin and their present genetic elements that enables further development of appropriate strategies for GMO detection. It is flexible enough to be further updated with new information and integrated in different applications and platforms.

The GMOseek matrix: a decision support tool for optimizing the detection of genetically modified plants

PubMed Central

2013-01-01

Background Since their first commercialization, the diversity of taxa and the genetic composition of transgene sequences in genetically modified plants (GMOs) are constantly increasing. To date, the detection of GMOs and derived products is commonly performed by PCR-based methods targeting specific DNA sequences introduced into the host genome. Information available regarding the GMOs’ molecular characterization is dispersed and not appropriately organized. For this reason, GMO testing is very challenging and requires more complex screening strategies and decision making schemes, demanding in return the use of efficient bioinformatics tools relying on reliable information. Description The GMOseek matrix was built as a comprehensive, online open-access tabulated database which provides a reliable, comprehensive and user-friendly overview of 328 GMO events and 247 different genetic elements (status: 18/07/2013). The GMOseek matrix is aiming to facilitate GMO detection from plant origin at different phases of the analysis. It assists in selecting the targets for a screening analysis, interpreting the screening results, checking the occurrence of a screening element in a group of selected GMOs, identifying gaps in the available pool of GMO detection methods, and designing a decision tree. The GMOseek matrix is an independent database with effective functionalities in a format facilitating transferability to other platforms. Data were collected from all available sources and experimentally tested where detection methods and certified reference materials (CRMs) were available. Conclusions The GMOseek matrix is currently a unique and very valuable tool with reliable information on GMOs from plant origin and their present genetic elements that enables further development of appropriate strategies for GMO detection. It is flexible enough to be further updated with new information and integrated in different applications and platforms. PMID:23965170

Inversion of Farmland Soil Moisture in Large Region Based on Modified Vegetation Index

NASA Astrophysics Data System (ADS)

Wang, J. X.; Yu, B. S.; Zhang, G. Z.; Zhao, G. C.; He, S. D.; Luo, W. R.; Zhang, C. C.

2018-04-01

Soil moisture is an important parameter for agricultural production. Efficient and accurate monitoring of soil moisture is an important link to ensure the safety of agricultural production. Remote sensing technology has been widely used in agricultural moisture monitoring because of its timeliness, cyclicality, dynamic tracking of changes in things, easy access to data, and extensive monitoring. Vegetation index and surface temperature are important parameters for moisture monitoring. Based on NDVI, this paper introduces land surface temperature and average temperature for optimization. This article takes the soil moisture in winter wheat growing area in Henan Province as the research object, dividing Henan Province into three main regions producing winter wheat and dividing the growth period of winter wheat into the early, middle and late stages on the basis of phenological characteristics and regional characteristics. Introducing appropriate correction factor during the corresponding growth period of winter wheat, correcting the vegetation index in the corresponding area, this paper establishes regression models of soil moisture on NDVI and soil moisture on modified NDVI based on correlation analysis and compare models. It shows that modified NDVI is more suitable as a indicator of soil moisture because of the better correlation between soil moisture and modified NDVI and the higher prediction accuracy of the regression model of soil moisture on modified NDVI. The research in this paper has certain reference value for winter wheat farmland management and decision-making.

Decisions during Negatively-Framed Messages Yield Smaller Risk-Aversion-Related Brain Activation in Substance-Dependent Individuals

PubMed Central

Fukunaga, Rena; Bogg, Tim; Finn, Peter R.; Brown, Joshua W.

2012-01-01

A sizable segment of addiction research investigates the effects of persuasive message appeals on risky and deleterious behaviors. However, to date, little research has examined how various forms of message framing and corresponding behavioral choices might by mediated by risk-related brain regions. Using event-related functional magnetic resonance imaging, we investigated brain regions hypothesized to mediate the influence of message appeals on decision making in substance-dependent (SD) compared to non-substance-dependent (non-SD) individuals. The Iowa Gambling Task (IGT) was modified to include positively-framed, negatively-framed, and control messages about long-term deck payoffs. In the positively-framed condition, the SD and non-SD groups showed improved decision-making performance that corresponded to higher risk-aversion-related brain activity in the anterior cingulate cortex (ACC) and anterior insula (AI). In contrast, in the negatively-framed condition, the SD group showed poorer performance that corresponded to lower risk-aversion-related brain activity in the AI region. In addition, only the non-SD group showed a positive association between decision quality and greater risk-related activity in the ACC, regardless of message type. The findings suggest substance-dependent individuals may have reduced neurocognitive sensitivity in the ACC and AI regions involved in risk perception and aversion during decision-making, especially in response to framed messages that emphasize reduced prospects for long-term gains. PMID:23148798

A Systematic Literature Review and Research Agenda for Organ Donation Decision Communication.

PubMed

Knox, Kathy; Parkinson, Joy; Pang, Bo; Fujihira, Haruka; David, Patricia; Rundle-Thiele, Sharyn

2017-09-01

This study systematically located and appraised peer-reviewed evidence for the efficacy of strategies to increase organ donation decision communication among adults including an assessment of study quality to guide future research in this field. There is little room to move in strengthening unanimously positive public attitudes toward organ donation. Consequently, researchers have called for a focus on organ donation decision communication to understand modifiable factors to increase organ donation rates. Multiple databases were searched during September 2015, and 44 studies were selected for inclusion. Data concerning participants, design, and outcomes were extracted. Studies were rated for quality and levels of evidence. Although not amenable to meta-analysis, the literature indicates that approximately 50% of adults who are willing to become an organ donor have discussed this decision with family. The majority of research was conducted in a Western context with an overrepresentation of students. Strategies to increase communication include education, motivation, input from lived experience, efforts to address salient audience beliefs, and scheduled reminders or prompts. Intentions and willingness to discuss organ donation were consistently positively related to discussion behavior; however, formative research and experimental studies testing theoretically driven interventions were scarce. There is mixed evidence for the role of demographic and attitudinal characteristics in the success of organ donation communication interventions. Additional theoretically based research is recommended to establish boundary conditions and validate strategies to increase organ donation decision communication among adults.

Can conservation contracts co-exist with change? Payment for ecosystem services in the context of adaptive decision-making and sustainability.

PubMed

Hayes, Tanya; Murtinho, Felipe; Cárdenas Camacho, Luis Mario; Crespo, Patricio; McHugh, Sarah; Salmerón, David

2015-01-01

This paper considers the ability of payment for ecosystem services (PES) programs to operate in the context of dynamic and complex social-ecological systems. Drawing on the experiences of two different PES programs in Latin America, we examine how PES institutions fit with the tenets of adaptive decision-making for sustainable resource management. We identify how the program goals and the connection to the market influence the incentive structure, information gathering, learning and feedback processes, and the structure of decision-making rights, specifically the ability to make and modify resource-use rules. Although limited in their generalizability, findings from the two case studies suggest a tension between the contractual model of PES and adaptive decision-making in natural resource systems. PES programs are not inherently decentralized, flexible management tools, as PES contracts tend to restrict decision-making rights and offer minimal flexibility mechanisms to change resource-use practices over the duration of the contract period. Furthermore, PES design and flexibility is heavily dependent on the goals and mission of the buyer and the respective market. If PES is to facilitate sustainable resource management, greater attention is needed to assess how the institutional design of the PES contracts influence the motivation and capacity of participants and program officers alike to adaptively manage the respective resource systems.

"Best Case/Worst Case": Qualitative Evaluation of a Novel Communication Tool for Difficult in-the-Moment Surgical Decisions.

PubMed

Kruser, Jacqueline M; Nabozny, Michael J; Steffens, Nicole M; Brasel, Karen J; Campbell, Toby C; Gaines, Martha E; Schwarze, Margaret L

2015-09-01

To evaluate a communication tool called "Best Case/Worst Case" (BC/WC) based on an established conceptual model of shared decision-making. Focus group study. Older adults (four focus groups) and surgeons (two focus groups) using modified questions from the Decision Aid Acceptability Scale and the Decisional Conflict Scale to evaluate and revise the communication tool. Individuals aged 60 and older recruited from senior centers (n = 37) and surgeons from academic and private practices in Wisconsin (n = 17). Qualitative content analysis was used to explore themes and concepts that focus group respondents identified. Seniors and surgeons praised the tool for the unambiguous illustration of multiple treatment options and the clarity gained from presentation of an array of treatment outcomes. Participants noted that the tool provides an opportunity for in-the-moment, preference-based deliberation about options and a platform for further discussion with other clinicians and loved ones. Older adults worried that the format of the tool was not universally accessible for people with different educational backgrounds, and surgeons had concerns that the tool was vulnerable to physicians' subjective biases. The BC/WC tool is a novel decision support intervention that may help facilitate difficult decision-making for older adults and their physicians when considering invasive, acute medical treatments such as surgery. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

The Neural Basis of Social Influence in a Dictator Decision.

PubMed

Wei, Zhenyu; Zhao, Zhiying; Zheng, Yong

2017-01-01

Humans tend to reduce inequitable distributions. Previous neuroimaging studies have shown that inequitable decisions are related to brain regions that associated with negative emotion and signaling conflict. In the highly complex human social environment, our opinions and behaviors can be affected by social information. In current study, we used a modified dictator game to investigate the effect of social influence on making an equitable decision. We found that the choices of participants in present task was influenced by the choices of peers. However, participants' decisions were influenced by equitable rather than inequitable group choices. fMRI results showed that brain regions that related to norm violation and social conflict were related to the inequitable social influence. The neural responses in the dorsomedial prefrontal cortex, rostral cingulate zone, and insula predicted subsequent conforming behavior in individuals. Additionally, psychophysiological interaction analysis revealed that the interconnectivity between the dorsal striatum and insula was elevated in advantageous inequity influence versus no-social influence conditions. We found decreased functional connectivity between the medial prefrontal cortex and insula, supplementary motor area, posterior cingulate gyrus and dorsal anterior cingulate cortex in the disadvantageous inequity influence versus no-social influence conditions. This suggests that a disadvantageous inequity influence may decrease the functional connectivity among brain regions that are related to reward processes. Thus, the neural mechanisms underlying social influence in an equitable decision may be similar to those implicated in social norms and reward processing.

Can Conservation Contracts Co-exist with Change? Payment for Ecosystem Services in the Context of Adaptive Decision-Making and Sustainability

NASA Astrophysics Data System (ADS)

Hayes, Tanya; Murtinho, Felipe; Cárdenas Camacho, Luis Mario; Crespo, Patricio; McHugh, Sarah; Salmerón, David

2015-01-01

This paper considers the ability of payment for ecosystem services (PES) programs to operate in the context of dynamic and complex social-ecological systems. Drawing on the experiences of two different PES programs in Latin America, we examine how PES institutions fit with the tenets of adaptive decision-making for sustainable resource management. We identify how the program goals and the connection to the market influence the incentive structure, information gathering, learning and feedback processes, and the structure of decision-making rights, specifically the ability to make and modify resource-use rules. Although limited in their generalizability, findings from the two case studies suggest a tension between the contractual model of PES and adaptive decision-making in natural resource systems. PES programs are not inherently decentralized, flexible management tools, as PES contracts tend to restrict decision-making rights and offer minimal flexibility mechanisms to change resource-use practices over the duration of the contract period. Furthermore, PES design and flexibility is heavily dependent on the goals and mission of the buyer and the respective market. If PES is to facilitate sustainable resource management, greater attention is needed to assess how the institutional design of the PES contracts influence the motivation and capacity of participants and program officers alike to adaptively manage the respective resource systems.

Visualization of decision processes using a cognitive architecture

NASA Astrophysics Data System (ADS)

Livingston, Mark A.; Murugesan, Arthi; Brock, Derek; Frost, Wende K.; Perzanowski, Dennis

2013-01-01

Cognitive architectures are computational theories of reasoning the human mind engages in as it processes facts and experiences. A cognitive architecture uses declarative and procedural knowledge to represent mental constructs that are involved in decision making. Employing a model of behavioral and perceptual constraints derived from a set of one or more scenarios, the architecture reasons about the most likely consequence(s) of a sequence of events. Reasoning of any complexity and depth involving computational processes, however, is often opaque and challenging to comprehend. Arguably, for decision makers who may need to evaluate or question the results of autonomous reasoning, it would be useful to be able to inspect the steps involved in an interactive, graphical format. When a chain of evidence and constraint-based decision points can be visualized, it becomes easier to explore both how and why a scenario of interest will likely unfold in a particular way. In initial work on a scheme for visualizing cognitively-based decision processes, we focus on generating graphical representations of models run in the Polyscheme cognitive architecture. Our visualization algorithm operates on a modified version of Polyscheme's output, which is accomplished by augmenting models with a simple set of tags. We provide example visualizations and discuss properties of our technique that pose challenges for our representation goals. We conclude with a summary of feedback solicited from domain experts and practitioners in the field of cognitive modeling.

The choice of primary energy source including PV installation for providing electric energy to a public utility building - a case study

NASA Astrophysics Data System (ADS)

Radomski, Bartosz; Ćwiek, Barbara; Mróz, Tomasz M.

2017-11-01

The paper presents multicriteria decision aid analysis of the choice of PV installation providing electric energy to a public utility building. From the energy management point of view electricity obtained by solar radiation has become crucial renewable energy source. Application of PV installations may occur a profitable solution from energy, economic and ecologic point of view for both existing and newly erected buildings. Featured variants of PV installations have been assessed by multicriteria analysis based on ANP (Analytic Network Process) method. Technical, economical, energy and environmental criteria have been identified as main decision criteria. Defined set of decision criteria has an open character and can be modified in the dialog process between the decision-maker and the expert - in the present case, an expert in planning of development of energy supply systems. The proposed approach has been used to evaluate three variants of PV installation acceptable for existing educational building located in Poznań, Poland - the building of Faculty of Chemical Technology, Poznań University of Technology. Multi-criteria analysis based on ANP method and the calculation software Super Decisions has proven to be an effective tool for energy planning, leading to the indication of the recommended variant of PV installation in existing and newly erected public buildings. Achieved results show prospects and possibilities of rational renewable energy usage as complex solution to public utility buildings.

Social Expectations Bias Decision-Making in Uncertain Inter-Personal Situations

PubMed Central

Ruz, María; Moser, Anna; Webster, Kristin

2011-01-01

Understanding the role that social cues have on interpersonal choice, and their susceptibility to contextual effects, is of core importance to models of social decision-making. Language, on the other hand, is one of the main means of communication during social interactions in our culture. The present experiments tested whether positive and negative linguistic descriptions of alleged partners in a modified Ultimatum Game biased decisions made to the same set of offers, and whether the contextual uncertainty of the game modulated this biasing effect. The results showed that in an uncertain context, the same offers were accepted with higher probability when they were preceded by positive rather than by negative valenced trait-words. Participants also accepted fair offers with higher probability than unfair offers, but this effect did not interact with the valence of the social descriptive words. In addition, the speed of the decision was affected by valence: acceptance choices were faster when they followed a positive adjective, whereas rejection responses were faster after a negative-valenced word. However, these effects were highly reduced when the uncertainty was eliminated from the game. This suggests that positive and negative relevant social information can bias decisions made to the same pieces of evidence during interpersonal interactions, but that this mainly takes place when the uncertainty associated with the choices is high. PMID:21347404

The economic value of drought information: Application to water resources management decisions in Spain

NASA Astrophysics Data System (ADS)

Garrote, Luis; Sordo, Alvaro; Iglesias, Ana

2016-04-01

Information is valuable when it improves decision-making (e.g., actions can be adjusted to better suit the situation at hand) and enables the mitigation of damage. However, quantifying the value of information is often difficult. Here we explore a general approach to understand the economic value of drought information for water managers framing our approach in the precautionary principle that reminds us that uncertainty is not a reason to postpone or avoid action. We explore how decision making can disregard uncertain effects, taking a short-term approach and focusing instead on the certain costs and benefits of taking action. Two main questions arise: How do we know that advanced drought information is actually helping decisions?; and What is the value of information in the decision process? The approach is applied to several regulated water resources systems in Spain. It first views drought information as a factor in the decision process which can be used by water managers to reduce uncertainty. Second, the value of drought information is the expected gain in a decision outcome (utility) from using additional information. Finally, the gains of improved information are compared with the information collection costs. Here we estimate the value by taking into account the accuracy of the drought information, the subjective probabilities about the value, analyzed as Bayesian probabilities, and the ability or skill of the stakeholders to apply the drought information to modify their actions. Since information may be considered a public good (non-rivalry and non-excludability), it may justify public policy in the provision of information, considering social costs and benefits. The application of the framework to the Spanish case studies shows that information benefits exceeds to costs when drought frequency is 20-40% above normal values; below these values uncertainty in the decisions dominate the results; above these values, the management decisions are limited even with perfect information.

The effect of amount and tangibility of endowment and certainty of recipients on selfishness in a modified dictator game.

PubMed

Chang, Shao-Chuan; Lin, Li-Yun; Horng, Ruey-Yun; Wang, Yau-De

2014-06-01

Taiwanese college students (N = 101) participated in the study to examine the effects of the amount of an endowment, the tangibility of an endowment, and the certainty of the recipient on selfishness in a modified dictator game. Results showed that dictators were more selfish when allocating tangible (money) than less tangible (honor credits) endowments. Selfishness was higher when large amounts of money were involved. The certainty of the recipient was manipulated by whether the recipient was chosen and announced before or after the decision. Unexpectedly, participants were more self-interested in the certain-recipient condition than in the uncertain-recipient condition. In the honor condition, the amount of an endowment and the certainty of the recipient did not affect participants' allocations.

A Diagnostic Model for Dementia in Clinical Practice-Case Methodology Assisting Dementia Diagnosis.

PubMed

Londos, Elisabet

2015-04-02

Dementia diagnosis is important for many different reasons. Firstly, to separate dementia, or major neurocognitive disorder, from MCI (mild cognitive impairment), mild neurocognitive disorder. Secondly, to define the specific underlying brain disorder to aid treatment, prognosis and decisions regarding care needs and assistance. The diagnostic method of dementias is a puzzle of different data pieces to be fitted together in the best possible way to reach a clinical diagnosis. Using a modified case methodology concept, risk factors affecting cognitive reserve and symptoms constituting the basis of the brain damage hypothesis, can be visualized, balanced and reflected against test results as well as structural and biochemical markers. The model's origin is the case method initially described in Harvard business school, here modified to serve dementia diagnostics.

A Diagnostic Model for Dementia in Clinical Practice—Case Methodology Assisting Dementia Diagnosis

PubMed Central

Londos, Elisabet

2015-01-01

Dementia diagnosis is important for many different reasons. Firstly, to separate dementia, or major neurocognitive disorder, from MCI (mild cognitive impairment), mild neurocognitive disorder. Secondly, to define the specific underlying brain disorder to aid treatment, prognosis and decisions regarding care needs and assistance. The diagnostic method of dementias is a puzzle of different data pieces to be fitted together in the best possible way to reach a clinical diagnosis. Using a modified case methodology concept, risk factors affecting cognitive reserve and symptoms constituting the basis of the brain damage hypothesis, can be visualized, balanced and reflected against test results as well as structural and biochemical markers. The model’s origin is the case method initially described in Harvard business school, here modified to serve dementia diagnostics. PMID:26854146

Evaluating postdoctoral dental candidates: assessing the need and recommendations for a national qualifying examination.

PubMed

Brodie, Abby J; Crow, Heidi C; Eber, Robert M; Handysides, Robert; Holexa, Roy; Kiat-amnuay, Sudarat; Spallek, Heiko

2011-06-01

Increasingly, U.S. dental schools report pass/fail grades and do not rank students. In addition, the Joint Commission on National Dental Examinations will report National Board Dental Examination (NBDE) scores as pass/fail after January 1, 2012. This article discusses how these changes will force postdoctoral dental program directors to modify how they assess candidates and how noncognitive evaluations might enhance those assessments. The authors propose developing a national qualifying examination for postdoctoral dental programs that will measure knowledge, decision making, and noncognitive traits including empathy, self-confidence, integrity, and emotional intelligence. Without NBDE scores, class rank, and GPA as a basis for decision making, a single national qualifying examination would assist postdoctoral programs in selecting high-quality candidates based on knowledge, critical thinking skills, and noncognitive traits.

[Forensic-psychiatric criteria for evaluating the capacity to take decisions freely and consciously and to express one's will].

PubMed

Kocur, Józef; Trendak, Wiesława

2009-01-01

The report presents the current views on the development, course, as well as mechanisms underlying some disorders in the sphere of motivational processes, and especially in the sphere of will expression, aspirations and actions. The authors also analyze various aspects of the effect that is exerted by such disorders on such mental and psychosomatic functions that determine the validity of will declaration. The report emphasizes the necessity for separate evaluation of the ability to consciously or freely express will and reach decisions. Another important issue discussed in the paper is the prerequisite of including the effect of a given specific legal situation and factors other than psychopathological that can modify motivation, behavior and actions undertaken by the evaluated person.

The Role of Public Opinion in Shaping Trajectories of Agricultural Biotechnology.

PubMed

Malyska, Aleksandra; Bolla, Robert; Twardowski, Tomasz

2016-07-01

Science and technology are not autonomous entities and research trajectories are largely influenced by public opinion. The role of political decisions becomes especially evident in light of rapidly developing new breeding techniques (NBTs) and other genome editing methods for crop improvement. Decisions on how those new techniques should be regulated may not be based entirely on scientific rationale, and even if it is decided that crops produced by NBTs do not fall under the umbrella of genetically modified organisms (GMOs), their commercialization is by no means certain at this time. If and when adopted regulations do not comply with the public's perception of risks, policy makers will find themselves under pressure to ban or restrict the use of the respective products. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does intuition have a role in psychiatric diagnosis?

PubMed

Srivastava, Anil; Grube, Michael

2009-06-01

Psychiatric diagnosis is invariably guided by self-report. When such self-report is questioned, reliance on formalized testing predominates. The situation is less certain, however, when such methods and clinical "feel", or intuition, conflict. While many argue for the supremacy of actuarial methods, fields such as Management have increasingly emphasized the importance of intuition; Psychiatry, although with few objective tests and reliance on the clinical encounter, offers surprisingly few answers. We explore here the use of intuition in decision-making through a case example and suggest that it is not inferior to other diagnostic methods: intuition should be used to suggest, guide, and modify psychiatric diagnosis. Mostly, there is a need for greater discussion among Psychiatrists including consideration to the clinical, legal, and ethical implications of the use of intuition in psychiatric decision-making.

Data acquisition and path selection decision making for an autonomous roving vehicle. [laser pointing control system for vehicle guidance

NASA Technical Reports Server (NTRS)

Shen, C. N.; YERAZUNIS

1979-01-01

The feasibility of using range/pointing angle data such as might be obtained by a laser rangefinder for the purpose of terrain evaluation in the 10-40 meter range on which to base the guidance of an autonomous rover was investigated. The decision procedure of the rapid estimation scheme for the detection of discrete obstacles has been modified to reinforce the detection ability. With the introduction of the logarithmic scanning scheme and obstacle identification scheme, previously developed algorithms are combined to demonstrate the overall performance of the intergrated route designation system using laser rangefinder. In an attempt to cover a greater range, 30 m to 100 mm, the problem estimating gradients in the presence of positioning angle noise at middle range is investigated.

Automated Decision Tree Classification of Corneal Shape

PubMed Central

Twa, Michael D.; Parthasarathy, Srinivasan; Roberts, Cynthia; Mahmoud, Ashraf M.; Raasch, Thomas W.; Bullimore, Mark A.

2011-01-01

Purpose The volume and complexity of data produced during videokeratography examinations present a challenge of interpretation. As a consequence, results are often analyzed qualitatively by subjective pattern recognition or reduced to comparisons of summary indices. We describe the application of decision tree induction, an automated machine learning classification method, to discriminate between normal and keratoconic corneal shapes in an objective and quantitative way. We then compared this method with other known classification methods. Methods The corneal surface was modeled with a seventh-order Zernike polynomial for 132 normal eyes of 92 subjects and 112 eyes of 71 subjects diagnosed with keratoconus. A decision tree classifier was induced using the C4.5 algorithm, and its classification performance was compared with the modified Rabinowitz–McDonnell index, Schwiegerling’s Z3 index (Z3), Keratoconus Prediction Index (KPI), KISA%, and Cone Location and Magnitude Index using recommended classification thresholds for each method. We also evaluated the area under the receiver operator characteristic (ROC) curve for each classification method. Results Our decision tree classifier performed equal to or better than the other classifiers tested: accuracy was 92% and the area under the ROC curve was 0.97. Our decision tree classifier reduced the information needed to distinguish between normal and keratoconus eyes using four of 36 Zernike polynomial coefficients. The four surface features selected as classification attributes by the decision tree method were inferior elevation, greater sagittal depth, oblique toricity, and trefoil. Conclusions Automated decision tree classification of corneal shape through Zernike polynomials is an accurate quantitative method of classification that is interpretable and can be generated from any instrument platform capable of raw elevation data output. This method of pattern classification is extendable to other classification problems. PMID:16357645

A National Approach to Reimbursement Decision-Making on Drugs for Rare Diseases in Canada? Insights from Across the Ponds.

PubMed

Short, Hilary; Stafinski, Tania; Menon, Devidas

2015-05-01

Regardless of the type of health system or payer, coverage decisions on drugs for rare diseases (DRDs) are challenging. While these drugs typically represent the only active treatment option for a progressive and/or life-threatening condition, evidence of clinical benefit is often limited because of small patient populations and the costs are high. Thus, decisions come with considerable uncertainty and risk. In Canada, interest in developing a pan-Canadian decision-making approach informed by international experiences exists. To develop an inventory of existing policies and processes for making coverage decisions on DRDs around the world. A systematic review of published and unpublished documents describing current policies and processes in the top 20 gross domestic product countries was conducted. Bibliographic databases, the Internet and government/health technology assessment organization websites in each country were searched. Two researchers independently extracted information and tabulated it to facilitate qualitative comparative analyses. Policy experts from each country were contacted and asked to review the information collected for accuracy and completeness. Almost all countries have multiple mechanisms through which coverage for a DRD may be sought. However, they typically begin with a review that follows the same process as drugs for more common conditions (i.e., the centralized review process), although specific submission requirements could differ (e.g., no need to submit a cost-effectiveness analysis). When drugs fail to receive a positive recommendation/decision, they are reconsidered by "safety net"-type programs. Eligibility criteria vary across countries, as do the decision options, which may be applied to individual patients or patient groups. With few exceptions, countries have not created separate centralized review processes for DRDs. Instead, they have modified components of existing mechanisms and added safety nets. Copyright © 2015 Longwoods Publishing.

Using virtual human technology to provide immediate feedback about participants' use of demographic cues and knowledge of their cue use.

PubMed

Wandner, Laura D; Letzen, Janelle E; Torres, Calia A; Lok, Benjamin; Robinson, Michael E

2014-11-01

Demographic characteristics have been found to influence pain management decisions, but limited focus has been placed on participants' reactions to feedback about their use of sex, race, or age to make these decisions. The present study aimed to examine the effects of providing feedback about the use of demographic cues to participants making pain management decisions. Participants (N = 107) viewed 32 virtual human patients with standardized levels of pain and provided ratings for virtual humans' pain intensity and their treatment decisions. Real-time lens model idiographic analyses determined participants' decision policies based on cues used. Participants were subsequently informed about cue use and completed feedback questions. Frequency analyses were conducted on responses to these questions. Between 7.4 and 89.4% of participants indicated awareness of their use of demographic or pain expression cues. Of those individuals, 26.9 to 55.5% believed this awareness would change their future clinical decisions, and 66.6 to 75.9% endorsed that their attitudes affect their imagined clinical practice. Between 66.6 and 79.1% of participants who used cues reported willingness to complete an online tutorial about pain across demographic groups. This study was novel because it provided participants feedback about their cue use. Most participants who used cues indicated willingness to participate in an online intervention, suggesting this technology's utility for modifying biases. This is the first study to make individuals aware of whether a virtual human's sex, race, or age influences their decision making. Findings suggest that a majority of the individuals who were made aware of their use of demographic cues would be willing to participate in an online intervention. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

Avoidant decision making in social anxiety: the interaction of angry faces and emotional responses

PubMed Central

Pittig, Andre; Pawlikowski, Mirko; Craske, Michelle G.; Alpers, Georg W.

2014-01-01

Recent research indicates that angry facial expressions are preferentially processed and may facilitate automatic avoidance response, especially in socially anxious individuals. However, few studies have examined whether this bias also expresses itself in more complex cognitive processes and behavior such as decision making. We recently introduced a variation of the Iowa Gambling Task which allowed us to document the influence of task-irrelevant emotional cues on rational decision making. The present study used a modified gambling task to investigate the impact of angry facial expressions on decision making in 38 individuals with a wide range of social anxiety. Participants were to find out which choices were (dis-) advantageous to maximize overall gain. To create a decision conflict between approach of reward and avoidance of fear-relevant angry faces, advantageous choices were associated with angry facial expressions, whereas disadvantageous choices were associated with happy facial expressions. Results indicated that higher social avoidance predicted less advantageous decisions in the beginning of the task, i.e., when contingencies were still uncertain. Interactions with specific skin conductance responses further clarified that this initial avoidance only occurred in combination with elevated responses before choosing an angry facial expressions. In addition, an interaction between high trait anxiety and elevated responses to early losses predicted faster learning of an advantageous strategy. These effects were independent of intelligence, general risky decision-making, self-reported state anxiety, and depression. Thus, socially avoidant individuals who respond emotionally to angry facial expressions are more likely to show avoidance of these faces under uncertainty. This novel laboratory paradigm may be an appropriate analog for central features of social anxiety. PMID:25324792

Application of TOPSIS and VIKOR improved versions in a multi criteria decision analysis to develop an optimized municipal solid waste management model.

PubMed

Aghajani Mir, M; Taherei Ghazvinei, P; Sulaiman, N M N; Basri, N E A; Saheri, S; Mahmood, N Z; Jahan, A; Begum, R A; Aghamohammadi, N

2016-01-15

Selecting a suitable Multi Criteria Decision Making (MCDM) method is a crucial stage to establish a Solid Waste Management (SWM) system. Main objective of the current study is to demonstrate and evaluate a proposed method using Multiple Criteria Decision Making methods (MCDM). An improved version of Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) applied to obtain the best municipal solid waste management method by comparing and ranking the scenarios. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Besides, Viekriterijumsko Kompromisno Rangiranje (VIKOR) compromise solution method applied for sensitivity analyses. The proposed method can assist urban decision makers in prioritizing and selecting an optimized Municipal Solid Waste (MSW) treatment system. Besides, a logical and systematic scientific method was proposed to guide an appropriate decision-making. A modified TOPSIS methodology as a superior to existing methods for first time was applied for MSW problems. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Next, 11 scenarios of MSW treatment methods are defined and compared environmentally and economically based on the waste management conditions. Results show that integrating a sanitary landfill (18.1%), RDF (3.1%), composting (2%), anaerobic digestion (40.4%), and recycling (36.4%) was an optimized model of integrated waste management. An applied decision-making structure provides the opportunity for optimum decision-making. Therefore, the mix of recycling and anaerobic digestion and a sanitary landfill with Electricity Production (EP) are the preferred options for MSW management. Copyright © 2015 Elsevier Ltd. All rights reserved.