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

PubMed

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

2016-12-01

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

Nuclear facility decommissioning and site remedial actions: A selected bibliography, Volume 18. Part 1B: Citations with abstracts, sections 10 through 16

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

NONE

1997-09-01

This bibliography contains 3,638 citations with abstracts of documents relevant to environmental restoration, nuclear facility decontamination and decommissioning (D and D), uranium mill tailings management, and site remedial actions. The bibliography contains scientific, technical, financial, and regulatory information that pertains to DOE environmental restoration programs. The citations are separated by topic into 16 sections, including (1) DOE Environmental Restoration Program; (2) DOE D and D Program; (3) Nuclear Facilities Decommissioning; (4) DOE Formerly Utilized sites Remedial Action Program; (5) NORM-Contaminated Site Restoration; (6) DOE Uranium Mill Tailings Remedial Action Project; (7) Uranium Mill Tailings Management; (8) DOE Site-Wide Remedial Actions;more » (9) DOE Onsite Remedial Action Projects; (10) Contaminated Site Remedial Actions; (11) DOE Underground Storage Tank Remediation; (12) DOE Technology Development, Demonstration, and Evaluation; (13) Soil Remediation; (14) Groundwater Remediation; (15) Environmental Measurements, Analysis, and Decision-Making; and (16) Environmental Management Issues.« less

"If it's worth my time, i will make the time": school-based providers' decision-making about participating in an evidence-based psychotherapy consultation program.

PubMed

Lyon, Aaron R; Ludwig, Kristy; Romano, Evalynn; Leonard, Skyler; Stoep, Ann Vander; McCauley, Elizabeth

2013-11-01

This study evaluated influences on school-based clinicians' decision-making surrounding participation in a modular psychotherapy training and consultation program lasting one academic year. Clinicians were recruited from three participation groups: those who never engaged, those who engaged and then discontinued, and those who participated fully. Qualitative interviews explored influences on initial and continued participation, as well as differences in decision-making by participation group, knowledge about evidence-based practices, and attitudes toward evidence-based practices. Eight major themes were identified: time, practice utility, intervention/training content, training process, attitudes toward training, social influences, commitment to training, and expectations. Some themes were discussed universally across all comparison groups, while others varied in frequency or content. Recommendations for increasing participation are presented, based on the findings.

Informed decision-making with and for people with dementia: Developing and pilot testing an education program for legal representatives (PRODECIDE).

PubMed

Lühnen, Julia; Mühlhauser, Ingrid; Richter, Tanja

2017-01-01

Background People living with dementia are often appointed a legal representative, to support and protect their ethical and legal rights to informed healthcare decisions. However, legal representatives usually have no qualifications in healthcare. Objective The aim of this study was to explore decision-making processes with participation of legal representatives and, resulting from this, to develop and pilot test an education program for legal representatives in Germany. Methods We conducted interviews with legal representatives and senior citizens about decision-making processes in healthcare, with special focus on percutaneous endoscopic gastrostomy, physical restraints, and prescription of antipsychotics for people with dementia. We generated a curriculum based on systematic literature searches and the results of these interviews. We tested the education program for comprehensibility, feasibility, usability, and acceptance. Results Personal interviews with voluntary ( n = 12) and professional ( n = 12) representatives, and senior citizens ( n = 14) were conducted. Preferences, attitudes, and wishes regarding percutaneous endoscopic gastrostomy, physical restraints, and antipsychotics, and the process of decision-making, were heterogeneous. A structural approach is lacking. The education program proxy-decison-making (PRODECIDE) comprises four modules: (A) decision-making processes and methods; (B-D) evidence-based knowledge about percutaneous endoscopic gastrostomy, physical restraints, and antipsychotics. We conducted eight trainings with 47 legal representatives. PRODECIDE was well accepted. Comprehensibility of contents and materials was rated high. The program seems feasible for implementation. Conclusion PRODECIDE seems suitable to improve the decision-making processes of legal representatives in Germany. Implementation will be appropriate if efficacy is proven; a randomized controlled trial is currently underway.

Evolving the US Climate Resilience Toolkit to Support a Climate-Smart Nation

NASA Astrophysics Data System (ADS)

Tilmes, C.; Niepold, F., III; Fox, J. F.; Herring, D.; Dahlman, L. E.; Hall, N.; Gardiner, N.

2015-12-01

Communities, businesses, resource managers, and decision-makers at all levels of government need information to understand and ameliorate climate-related risks. Likewise, climate information can expose latent opportunities. Moving from climate science to social and economic decisions raises complex questions about how to communicate the causes and impacts of climate variability and change; how to characterize and quantify vulnerabilities, risks, and opportunities faced by communities and businesses; and how to make and implement "win-win" adaptation plans at local, regional, and national scales. A broad coalition of federal agencies launched the U.S. Climate Resilience Toolkit (toolkit.climate.gov) in November 2014 to help our nation build resilience to climate-related extreme events. The site's primary audience is planners and decision makers in business, resource management, and government (at all levels) who seek science-based climate information and tools to help them in their near- and long-term planning. The Executive Office of the President assembled a task force of dozens of subject experts from across the 13 agencies of the U.S. Global Change Research Program to guide the site's development. The site's ongoing evolution is driven by feedback from the target audience. For example, based on feedback, climate projections will soon play a more prominent role in the site's "Climate Explorer" tool and case studies. The site's five-step adaptation planning process is being improved to better facilitate people getting started and to provide clear benchmarks for evaluating progress along the way. In this session, we will share lessons learned from a series of user engagements around the nation and evidence that the Toolkit couples climate information with actionable decision-making processes in ways that are helping Americans build resilience to climate-related stressors.

Models of Shared Leadership: Evolving Structures and Relationships.

ERIC Educational Resources Information Center

Hallinger, Philip; Richardson, Don

Current reform efforts, focusing on teacher empowerment, are based on the belief that lasting school improvement will occur when teachers become more involved in professional decision-making at the school site. Presented in this document are four conceptually distinct models of teacher involvement in schoolwide decision-making, identified on the…

Tampa Bay Ecosystem Services Demonstration Pilot Phase 2 web site

EPA Science Inventory

The value of nature's benefits is difficult to consider in environmental decision-making since ecosystem goods and services are usually not well measured or quantified in economic terms. The Tampa Bay Estuary Program, Tampa Bay Regional Planning Council, the U.S. Environmental Pr...

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

PubMed

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

2004-01-01

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

RCRA/UST, Superfund, and EPCRA hotline training module. Introduction to superfund community involvement. Directive

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

NONE

1996-03-01

This module covers EPA`s Superfund community involvement program, a set of requirements under the National Contingency Plan (NCP) designed to ensure that public is informed about site conditions and given the opportunity to comment on the proposed remedy of a Superfund site. The NCP serves to uphold the public`s right to voice opinions and express concerns about Superfund site activities. EPA must involve communities throughout Superfund process - particularly at critical decision-making steps in the process.

One Step at a Time: SBM as an Incremental Process.

ERIC Educational Resources Information Center

Conrad, Mark

1995-01-01

Discusses incremental SBM budgeting and answers questions regarding resource equity, bookkeeping requirements, accountability, decision-making processes, and purchasing. Approaching site-based management as an incremental process recognizes that every school system engages in some level of site-based decisions. Implementation can be gradual and…

Campus-Level Decision-Making Practices: Principals and Teachers Differ in Their Views

ERIC Educational Resources Information Center

Noel, Cindi; Slate, John R.; Brown, Michelle; Tejeda-Delgado, Carmen

2009-01-01

With the implementation of site-based decision-making occurring in schools, the extent to which teachers perceive their involvement in decisions on planning, budgeting, curriculum, staffing patterns, staff development, and campus-level organization and the extent to which teachers' views of their involvement in these activities are congruent with…

DECISION-MAKING ALIGNED WITH RAPID-CYCLE EVALUATION IN HEALTH CARE.

PubMed

Schneeweiss, Sebastian; Shrank, William H; Ruhl, Michael; Maclure, Malcolm

2015-01-01

Availability of real-time electronic healthcare data provides new opportunities for rapid-cycle evaluation (RCE) of health technologies, including healthcare delivery and payment programs. We aim to align decision-making processes with stages of RCE to optimize the usefulness and impact of rapid results. Rational decisions about program adoption depend on program effect size in relation to externalities, including implementation cost, sustainability, and likelihood of broad adoption. Drawing on case studies and experience from drug safety monitoring, we examine how decision makers have used scientific evidence on complex interventions in the past. We clarify how RCE alters the nature of policy decisions; develop the RAPID framework for synchronizing decision-maker activities with stages of RCE; and provide guidelines on evidence thresholds for incremental decision-making. In contrast to traditional evaluations, RCE provides early evidence on effectiveness and facilitates a stepped approach to decision making in expectation of future regularly updated evidence. RCE allows for identification of trends in adjusted effect size. It supports adapting a program in midstream in response to interim findings, or adapting the evaluation strategy to identify true improvements earlier. The 5-step RAPID approach that utilizes the cumulating evidence of program effectiveness over time could increase policy-makers' confidence in expediting decisions. RCE enables a step-wise approach to HTA decision-making, based on gradually emerging evidence, reducing delays in decision-making processes after traditional one-time evaluations.

Modelling decision-making by pilots

NASA Technical Reports Server (NTRS)

Patrick, Nicholas J. M.

1993-01-01

Our scientific goal is to understand the process of human decision-making. Specifically, a model of human decision-making in piloting modern commercial aircraft which prescribes optimal behavior, and against which we can measure human sub-optimality is sought. This model should help us understand such diverse aspects of piloting as strategic decision-making, and the implicit decisions involved in attention allocation. Our engineering goal is to provide design specifications for (1) better computer-based decision-aids, and (2) better training programs for the human pilot (or human decision-maker, DM).

Advanced consequence management program: challenges and recent real-world implementations

NASA Astrophysics Data System (ADS)

Graser, Tom; Barber, K. S.; Williams, Bob; Saghir, Feras; Henry, Kurt A.

2002-08-01

The Enhanced Consequence Management, Planning and Support System (ENCOMPASS) was developed under DARPA's Advanced Consequence Management program to assist decision-makers operating in crisis situations such as terrorist attacks using conventional and unconventional weapons and natural disasters. ENCOMPASS provides the tools for first responders, incident commanders, and officials at all levels to share vital information and consequently, plan and execute a coordinated response to incidents of varying complexity and size. ENCOMPASS offers custom configuration of components with capabilities ranging from map-based situation assessment, situation-based response checklists, casualty tracking, and epidemiological surveillance. Developing and deploying such a comprehensive system posed significant challenges for DARPA program management, due to an inherently complex domain, a broad spectrum of customer sites and skill sets, an often inhospitable runtime environment, demanding development-to-deployment transition requirements, and a technically diverse and geographically distributed development team. This paper introduces ENCOMPASS and explores these challenges, followed by an outline of selected ENCOMPASS deployments, demonstrating how ENCOMPASS can enhance consequence management in a variety real world contexts.

Decision-making processes for the uptake and implementation of family-based therapy by eating disorder treatment teams: a qualitative study.

PubMed

Kimber, Melissa; Couturier, Jennifer; Jack, Susan; Niccols, Alison; Van Blyderveen, Sherry; McVey, Gail

2014-01-01

To explore the decision-making processes involved in the uptake and implementation of evidence-based treatments (EBTs), namely, family-based treatment (FBT), among therapists and their administrators within publically funded eating disorder treatment programs in Ontario, Canada. Fundamental qualitative description guided sampling, data collection, and analytic decisions. Forty therapists and 11 administrators belonging to a network of clinicians treating eating disorders completed an in-depth interview regarding the decision-making processes involved in EBT uptake and implementation within their organizations. Content analysis and the constant comparative technique were used to analyze interview transcripts, with 20% of the data independently double-coded by a second coder. Therapists and their administrators identified the importance of an inclusive change culture in evidence-based practice (EBP) decision-making. Each group indicated reluctance to make EBP decisions in isolation from the other. Additionally, participants identified seven stages of decision-making involved in EBT adoption, beginning with exposure to the EBT model and ending with evaluating the impact of the EBT on patient outcomes. Support for a stage-based decision-making process was in participants' indication that the stages were needed to demonstrate that they considered the costs and benefits of making a practice change. Participants indicated that EBTs endorsed by the Provincial Network for Eating Disorders or the Academy for Eating Disorders would more likely be adopted. Future work should focus on integrating the important decision-making processes identified in this study with known implementation models to increase the use of low-cost and effective treatments, such as FBT, within eating disorder treatment programs. Copyright © 2013 Wiley Periodicals, Inc.

Canadian Innovations in Siting Hazardous Waste Management Facilities

PubMed

Kuhn; Ballard

1998-07-01

/ Siting hazardous waste facilities is an extremely complex and difficult endeavor. Public aversion to the construction of these facilities in or near their community often results in concerted opposition, referred to as the NIMBY syndrome. For the most part, siting processes do not fail because of inadequate environmental or technical considerations, but because of the adversarial decision-making strategies employed by the proponents. Innovative siting processes used in the provinces of Alberta and Manitoba offer tangible evidence of the successful application of an innovative siting approach based on the principles of decentralization of decision-making authority and full and meaningful public involvement. The purpose of this paper is to evaluate four Canadian siting processes from the perspective of public participation and access to decision-making authority. Examples of siting processes related to hazardous waste management facilities are provided from the provinces of Alberta, Manitoba, British Columbia, and Ontario. Siting has evolved from approaches dominated by top-down decision making to increasing decentralized and pluralistic approaches. Focusing on social and political concerns of potentially affected communities and on the process of decision making itself are fundamental to achieving siting success. In Alberta initially, and later in Manitoba, this new "open approach" to siting has resulted in the construction of the first two comprehensive hazardous waste treatment facilities in Canada.KEY WORDS: Hazardous waste facilities; Siting methodologies; Public participation

Implementing community-based education in basic nursing education programs in South Africa.

PubMed

Mtshali, N G

2009-03-01

Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community-based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementation and evaluation of Community-based Educational (CBE) programmes tended to be haphazard, uncoordinated and ineffective, resulting in poor student motivation. Therefore the purpose of this study was to analyse the implementation of community-based education in basic nursing education programmes in South Africa. Strauss and Corbin's (1990) grounded theory approach guided the research process. Data were collected by means of observation, interviews and document analysis. The findings revealed that collaborative decision-making involving all stakeholders was crucial especially during the curriculum planning phase. Furthermore, special criteria should be used when selecting community learning sites to ensure that the selected sites are able to facilitate the development of required graduate competencies. Collaborative effort, true partnership between academic institutions and communities, as well as government support and involvement emerged as necessary conditions for the successful implementation of community-based education programmes.

Selection of adequate site location during early stages of construction project management: A multi-criteria decision analysis approach

NASA Astrophysics Data System (ADS)

Marović, Ivan; Hanak, Tomaš

2017-10-01

In the management of construction projects special attention should be given to the planning as the most important phase of decision-making process. Quality decision-making based on adequate and comprehensive collaboration of all involved stakeholders is crucial in project’s early stages. Fundamental reasons for existence of this problem arise from: specific conditions of construction industry (final products are inseparable from the location i.e. location has a strong influence of building design and its structural characteristics as well as technology which will be used during construction), investors’ desires and attitudes, and influence of socioeconomic and environment aspects. Considering all mentioned reasons one can conclude that selection of adequate construction site location for future investment is complex, low structured and multi-criteria problem. To take into account all the dimensions, the proposed model for selection of adequate site location is devised. The model is based on AHP (for designing the decision-making hierarchy) and PROMETHEE (for pairwise comparison of investment locations) methods. As a result of mixing basis feature of both methods, operational synergies can be achieved in multi-criteria decision analysis. Such gives the decision-maker a sense of assurance, knowing that if the procedure proposed by the presented model has been followed, it will lead to a rational decision, carefully and systematically thought out.

Computer-aided decision making.

Treesearch

Keith M. Reynolds; Daniel L. Schmoldt

2006-01-01

Several major classes of software technologies have been used in decisionmaking for forest management applications over the past few decades. These computer-based technologies include mathematical programming, expert systems, network models, multi-criteria decisionmaking, and integrated systems. Each technology possesses unique advantages and disadvantages, and has...

The provision of information and informed decision-making on prenatal screening for Down syndrome: a questionnaire- and register-based survey in a non-selected population.

PubMed

Schoonen, Marleen; Wildschut, Hajo; Essink-Bot, Marie-Louise; Peters, Ingrid; Steegers, Eric; de Koning, Harry

2012-06-01

Evaluating the information provision procedure about prenatal screening for Down syndrome, using informed decision-making as a quality-indicator. Questionnaire- and register-based surveys. Midwives associated with 59 midwifery practices completed process data for 6435 pregnancies. Pregnant women (n=510) completed questionnaires on informed decision-making. Midwives offered information to 98.5% of women; 62.6% of them wished to receive information, of these, 81.9% actually received information. Decision-relevant knowledge was adequate in 89.0% of responding women. Knowledge about Down syndrome was less adequate than knowledge about the screening program. Participants in the screening program had higher knowledge scores on Down syndrome and on the screening program than non-participants. Of the women who intended to participate (35.8%), 3.1% had inadequate knowledge. A total of 75.5% of women made an informed decision; 94.3% of women participating in the screening program, and 64.9% of women not participating. This quality assurance study showed high levels of informed decision-making and a relatively low participation rate in the national screening program for Down syndrome in the Netherlands. Knowledge of the Down syndrome condition needs to be improved. This evaluation may serve as a pilot study for quality monitoring studies at a national level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A public health decision support system model using reasoning methods.

PubMed

Mera, Maritza; González, Carolina; Blobel, Bernd

2015-01-01

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

Developing and Testing an Online Tool for Teaching GIS Concepts Applied to Spatial Decision-Making

ERIC Educational Resources Information Center

Carver, Steve; Evans, Andy; Kingston, Richard

2004-01-01

The development and testing of a Web-based GIS e-learning resource is described. This focuses on the application of GIS for siting a nuclear waste disposal facility and the associated principles of spatial decision-making using Boolean and weighted overlay methods. Initial student experiences in using the system are analysed as part of a research…

Active fans and grizzly bears: Reducing risks for wilderness campers

NASA Astrophysics Data System (ADS)

Sakals, M. E.; Wilford, D. J.; Wellwood, D. W.; MacDougall, S. A.

2010-03-01

Active geomorphic fans experience debris flows, debris floods and/or floods (hydrogeomorphic processes) that can be hazards to humans. Grizzly bears ( Ursus arctos) can also be a hazard to humans. This paper presents the results of a cross-disciplinary study that analyzed both hydrogeomorphic and grizzly bear hazards to wilderness campers on geomorphic fans along a popular hiking trail in Kluane National Park and Reserve in southwestern Yukon Territory, Canada. Based on the results, a method is proposed to reduce the risks to campers associated with camping on fans. The method includes both landscape and site scales and is based on easily understood and readily available information regarding weather, vegetation, stream bank conditions, and bear ecology and behaviour. Educating wilderness campers and providing a method of decision-making to reduce risk supports Parks Canada's public safety program; a program based on the principle of user self-sufficiency. Reducing grizzly bear-human conflicts complements the efforts of Parks Canada to ensure a healthy grizzly bear population.

Modelling a flows in supply chain with analytical models: Case of a chemical industry

NASA Astrophysics Data System (ADS)

Benhida, Khalid; Azougagh, Yassine; Elfezazi, Said

2016-02-01

This study is interested on the modelling of the logistics flows in a supply chain composed on a production sites and a logistics platform. The contribution of this research is to develop an analytical model (integrated linear programming model), based on a case study of a real company operating in the phosphate field, considering a various constraints in this supply chain to resolve the planning problems for a better decision-making. The objectives of this model is to determine and define the optimal quantities of different products to route, to and from the various entities in the supply chain studied.

An Evaluation of DOE-EM Public Participation Programs

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

Bradbury, Judith A.; Branch, Kristi M.; Malone, Elizabeth L.

This report evaluates the scope and effectiveness of the public participation pr ograms, including Site-Specific Advisory Boards (SSABs), at seven U.S. Departmen t of Energy (DOE) sites: Fernald, Hanford, Los Alamos, Nevada, Oak Ridge, Paduc ah, and Savannah River. The primary purpose of the study is to assist both DOE Field and Headquarters managers in reviewing and understanding lessons learned o ver the past decade concerning public participation programs administered by the DOE Office of Environmental Management (EM). The evaluation provides a snapsh ot of selected EM public participation programs at a particular point of time. It is based onmore » interviews and site visits conducted between January and June 200 2- a time of change within the program. The study focuses on public participati on programs that incorporate a variety of activities and address a wide range of individual site activities and decisions. It uses the Acceptability Diamond as an evaluative framework to answer questions about stakeholders' experiences wit h, and assessment of, DOE-EM's public participation programs. The Acceptability Diamond, which was developed by researchers from the Pacific Northwest National Laboratory in previous research, identifies four program dimensions - substanti ve issues, decision-making process, relationships, and accountability - that det ermine the effectiveness of an agency's interactions with local communities. Es sentially, a public participation program may be deemed effective to the extent that it provides for open disclosure and addresses all four acceptability dimens ions in ways that are appropriate and effective for a particular community and s ituation. This framework provides a guide for agencies to 1) set objectives, 2) design public participation and oversight programs, and 3) set criteria for eva luating program effectiveness. In the current study, where the framework is use d as a means of assessing program effectiveness, the focus is on stakeholders' p erspectives of public participation: on the nature of DOE-EM's public disclosure and the four interrelated dimensions of DOE-EM's interactions with its neighbor ing communities« less

Effectiveness of a Case-Based Computer Program on Students' Ethical Decision Making.

PubMed

Park, Eun-Jun; Park, Mihyun

2015-11-01

The aim of this study was to test the effectiveness of a case-based computer program, using an integrative ethical decision-making model, on the ethical decision-making competency of nursing students in South Korea. This study used a pre- and posttest comparison design. Students in the intervention group used a computer program for case analysis assignments, whereas students in the standard group used a traditional paper assignment for case analysis. The findings showed that using the case-based computer program as a complementary tool for the ethics courses offered at the university enhanced students' ethical preparedness and satisfaction with the course. On the basis of the findings, it is recommended that nurse educators use a case-based computer program as a complementary self-study tool in ethics courses to supplement student learning without an increase in course hours, particularly in terms of analyzing ethics cases with dilemma scenarios and exercising ethical decision making. Copyright 2015, SLACK Incorporated.

Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role.

PubMed

Trees, April R; Ohs, Jennifer E; Murray, Meghan C

2017-06-07

End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker's role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making.

Linking data to decision-making: applying qualitative data analysis methods and software to identify mechanisms for using outcomes data.

PubMed

Patel, Vaishali N; Riley, Anne W

2007-10-01

A multiple case study was conducted to examine how staff in child out-of-home care programs used data from an Outcomes Management System (OMS) and other sources to inform decision-making. Data collection consisted of thirty-seven semi-structured interviews with clinicians, managers, and directors from two treatment foster care programs and two residential treatment centers, and individuals involved with developing the OMS; and observations of clinical and quality management meetings. Case study and grounded theory methodology guided analyses. The application of qualitative data analysis software is described. Results show that although staff rarely used data from the OMS, they did rely on other sources of systematically collected information to inform clinical, quality management, and program decisions. Analyses of how staff used these data suggest that improving the utility of OMS will involve encouraging staff to participate in data-based decision-making, and designing and implementing OMS in a manner that reflects how decision-making processes operate.

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

NASA Astrophysics Data System (ADS)

Zhu, Yue-he; Luo, Ya-zhong

2016-10-01

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

A decision-making process model of young online shoppers.

PubMed

Lin, Chin-Feng; Wang, Hui-Fang

2008-12-01

Based on the concepts of brand equity, means-end chain, and Web site trust, this study proposes a novel model called the consumption decision-making process of adolescents (CDMPA) to understand adolescents' Internet consumption habits and behavioral intention toward particular sporting goods. The findings of the CDMPA model can help marketers understand adolescents' consumption preferences and habits for developing effective Internet marketing strategies.

Implications of Climate Change for State Bioassessment ...

EPA Pesticide Factsheets

This draft report uses biological data collected by four states in wadeable rivers and streams to examine the components of state and tribal bioassessment and biomonitoring programs that may be vulnerable to climate change. The study investigates the potential to identify biological response signals to climate change within existing bioassessment data sets; analyzes how biological responses can be categorized and interpreted; and assesses how they may influence decision-making processes. The analyses suggest that several biological indicators may be used to detect climate change effects and such indicators can be used by state bioassessment programs to document changes at high-quality reference sites. The study investigates the potential to identify biological response signals to climate change within existing bioassessment data sets; analyzes how biological responses can be categorized and interpreted; and assesses how they may influence decision-making processes.

Conservation and restoration of forested wetlands: new techniques and perspectives

Treesearch

James Johnston; Steve Hartley; Antonio Martucci

2000-01-01

A partnership of state and federal agencies and private organizations is developing advanced spatial analysis techniques applied for conservation and restoration of forested wetlands. The project goal is to develop an application to assist decisionmakers in defining the eligibility of land sites for entry in the Wetland Reserve Program (WRP) of the U.S. Department of...

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

Goins, L.F.; Webb, J.R.; Cravens, C.D.

This publication contains 1035 abstracted references on environmental restoration, nuclear facility decommissioning, uranium mill tailings management, and site remedial actions. These citations constitute the thirteenth in a series of reports prepared annually for the US Department of Energy (DOE) Environmental Restoration programs. Citations to foreign and domestic literature of all types. There are 13 major sections of the publication, including: (1) DOE Decontamination and Decommissioning Program; (2) Nuclear Facilities Decommissioning; (3) DOE Formerly Utilized Sites Remedial Action Program; (4) DOE Uranium Mill Tailings Remedial Action Project; (5) Uranium Mill Tailings Management; (6) DOE Environmental Restoration Program; (7) DOE Site-Specific Remedialmore » Actions; (8) Contaminated Site Restoration; (9) Remediation of Contaminated Soil and Groundwater; (10) Environmental Data Measurements, Management, and Evaluation; (11) Remedial Action Assessment and Decision-Making; (12) Technology Development and Evaluation; and (13) Environmental and Waste Management Issues. Bibliographic references are arranged in nine subject categories by geographic location and then alphabetically by first author, corporate affiliation, or publication title. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, subject category, and key word.« less

Effects of Using a Web-Based Individualized Education Program Decision-Making Tutorial

ERIC Educational Resources Information Center

Shriner, James G.; Carty, Susan J.; Rose, Chad A.; Shogren, Karrie A.; Kim, Myungjin; Trach, John S.

2013-01-01

This study explored the effects of a web-based decision support system ("Tutorial") for writing standards-based Individualized Education Programs (IEPs). A total of 35 teachers and 154 students participated across two academic years. Participants were assigned to one of three intervention groups based on level of "Tutorial"…

Nuclear facility decommissioning and site remedial actions: A selected bibliography, Volume 13: Part 1, Main text

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

Goins, L.F.; Webb, J.R.; Cravens, C.D.

1992-09-01

This publication contains 1035 abstracted references on environmental restoration, nuclear facility decommissioning, uranium mill tailings management, and site remedial actions. These citations constitute the thirteenth in a series of reports prepared annually for the US Department of Energy (DOE) Environmental Restoration programs. Citations to foreign and domestic literature of all types. There are 13 major sections of the publication, including: (1) DOE Decontamination and Decommissioning Program; (2) Nuclear Facilities Decommissioning; (3) DOE Formerly Utilized Sites Remedial Action Program; (4) DOE Uranium Mill Tailings Remedial Action Project; (5) Uranium Mill Tailings Management; (6) DOE Environmental Restoration Program; (7) DOE Site-Specific Remedialmore » Actions; (8) Contaminated Site Restoration; (9) Remediation of Contaminated Soil and Groundwater; (10) Environmental Data Measurements, Management, and Evaluation; (11) Remedial Action Assessment and Decision-Making; (12) Technology Development and Evaluation; and (13) Environmental and Waste Management Issues. Bibliographic references are arranged in nine subject categories by geographic location and then alphabetically by first author, corporate affiliation, or publication title. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, subject category, and key word.« less

Reasoning and Action: Implementation of a Decision-Making Program in Sport.

PubMed

Gil-Arias, Alexander; Moreno, M Perla; García-Mas, Alex; Moreno, Alberto; García-González, Luíz; Del Villar, Fernando

2016-09-20

The objective of this study was to apply a decision training programme, based on the use of video-feedback and questioning, in real game time, in order to improve decision-making in volleyball attack actions. A three-phase quasi-experimental design was implemented: Phase A (pre-test), Phase B (Intervention) and Phase C (Retention). The sample was made up of 8 female Under-16 volleyball players, who were divided into two groups: experimental group (n = 4) and control group (n = 4). The independent variable was the decision training program, which was applied for 11 weeks in a training context, more specifically in a 6x6 game situation. The player had to analyze the reasons and causes of the decision taken. The dependent variable was decision-making, which was assessed based on systematic observation, using the "Game Performance Assessment Instrument" (GPAI) (Oslin, Mitchell, & Griffin, 1998). Results showed that, after applying the decision training program, the experimental group showed a significantly higher average percentage of successful decisions than the control group F(1, 6) = 11.26; p = .015; η2 p = .652; 95% CI [056, 360]. These results highlight the need to complement the training process with cognitive tools such as video-feedback and questioning in order to improve athletes' decision-making.

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

PubMed

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

2012-11-01

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

Utilizing Technology to Examine the Impacts of Academic Program Plans on Faculty Staffing Levels. AIR 1984 Annual Forum Paper.

ERIC Educational Resources Information Center

Spiro, Louis M.; Campbell, Jill F.

The development and use of a campus-based computerized faculty staffing model is described. In addition to considering market demands for current and proposed programs, decisionmakers need to consider how program development, modification, and elimination affect the total college faculty resource base. The application of computer technology,…

An Ecosystem Service Evaluation Tool to Support Ridge-to-Reef Management and Conservation in Hawaii

NASA Astrophysics Data System (ADS)

Oleson, K.; Callender, T.; Delevaux, J. M. S.; Falinski, K. A.; Htun, H.; Jin, G.

2014-12-01

Faced with increasing anthropogenic stressors and diverse stakeholders, local managers are adopting a ridge-to-reef and multi-objective management approach to restore declining coral reef health state. An ecosystem services framework, which integrates ecological indicators and stakeholder values, can foster more applied and integrated research, data collection, and modeling, and thus better inform the decision-making process and realize decision outcomes grounded in stakeholders' values. Here, we describe a research program that (i) leverages remotely sensed and empirical data to build an ecosystem services-based decision-support tool geared towards ridge-to-reef management; and (ii) applies it as part of a structured, value-based decision-making process to inform management in west Maui, a NOAA coral reef conservation priority site. The tool links terrestrial and marine biophysical models in a spatially explicit manner to quantify and map changes in ecosystem services delivery resulting from management actions, projected climate change impacts, and adaptive responses. We couple model outputs with localized valuation studies to translate ecosystem service outcomes into benefits and their associated socio-cultural and/or economic values. Managers can use this tool to run scenarios during their deliberations to evaluate trade-offs, cost-effectiveness, and equity implications of proposed policies. Ultimately, this research program aims at improving the effectiveness, efficiency, and equity outcomes of ecosystem-based management. This presentation will describe our approach, summarize initial results from the terrestrial modeling and economic valuations for west Maui, and highlight how this decision support tool benefits managers in west Maui.

Use of a Virtual Learning Platform for Distance-Based Simulation in an Acute Care Nurse Practitioner Curriculum.

PubMed

Carman, Margaret; Xu, Shu; Rushton, Sharron; Smallheer, Benjamin A; Williams, Denise; Amarasekara, Sathya; Oermann, Marilyn H

Acute care nurse practitioner (ACNP) programs that use high-fidelity simulation as a teaching tool need to consider innovative strategies to provide distance-based students with learning experiences that are comparable to those in a simulation laboratory. The purpose of this article is to describe the use of virtual simulations in a distance-based ACNP program and student performance in the simulations. Virtual simulations using iSimulate were integrated into the ACNP course to promote the translation of content into a clinical context and enable students to develop their knowledge and decision-making skills. With these simulations, students worked as a team, even though they were at different sites from each other and from the faculty, to manage care of an acutely ill patient. The students were assigned to simulation groups of 4 students each. One week before the simulation, they reviewed past medical records. The virtual simulation sessions were recorded and then evaluated. The evaluation tools assessed 8 areas of performance and included key behaviors in each of these areas to be performed by students in the simulation. More than 80% of the student groups performed the key behaviors. Virtual simulations provide a learning platform that allows live interaction between students and faculty, at a distance, and application of content to clinical situations. With simulation, learners have an opportunity to practice assessment and decision-making in emergency and high-risk situations. Simulations not only are valuable for student learning but also provide a nonthreatening environment for staff to practice, receive feedback on their skills, and improve their confidence.

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

PubMed

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

2016-08-01

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

Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study.

PubMed

Jack, Susan M; Dobbins, Maureen; Sword, Wendy; Novotna, Gabriela; Brooks, Sandy; Lipman, Ellen L; Niccols, Alison

2011-11-07

Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. A descriptive qualitative study was conducted to explore: 1) the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2) how decision makers at different levels report using research evidence; and 3) factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence, knowledge brokering, and for partnering with universities. Resources are required to maintain web-based databases of searchable evidence to facilitate access to research evidence. A need exists to address the perception that there is a paucity of research evidence available to inform program decisions. Finally, there is a need to consider how experiential knowledge influences decision-making and what guidance research evidence has to offer regarding the implementation of different treatment approaches within the field of addictions.

Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study

PubMed Central

2011-01-01

Background Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. Methods A descriptive qualitative study was conducted to explore: 1) the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2) how decision makers at different levels report using research evidence; and 3) factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Results Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. Conclusions There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence, knowledge brokering, and for partnering with universities. Resources are required to maintain web-based databases of searchable evidence to facilitate access to research evidence. A need exists to address the perception that there is a paucity of research evidence available to inform program decisions. Finally, there is a need to consider how experiential knowledge influences decision-making and what guidance research evidence has to offer regarding the implementation of different treatment approaches within the field of addictions. PMID:22059528

An Exploration of the Relationship between Clinical Decision-Making Ability and Educational Preparation among New Graduate Nurses

ERIC Educational Resources Information Center

Blount, Kamilah V.

2013-01-01

This study examined the impact of accelerated nursing direct entry master's programs on the development of clinical decision-making skills of new graduate nurses that completed the Performance Based Development System (PBDS) assessment during the study period of 2008-2012 at a healthcare organization. Healthcare today is practiced in a…

Ethical Decisions in Experience-Based Training and Development Programs.

ERIC Educational Resources Information Center

Gass, Michael A.; Wurdinger, Scott

1993-01-01

Illustrates how principle and virtue ethics can be applied to decision-making processes in experience-based training and development programs. Principle ethics is guided by predetermined rules and assumes that issues being examined are somewhat similar in context, whereas virtue ethics assumes that "correct behavior" is determined from…

A Paradigm Shift toward Evidence-Based Clinical Practice: Developing a Performance Assessment

ERIC Educational Resources Information Center

Wentworth, Nancy; Erickson, Lynnette B.; Lawrence, Barbara; Popham, J. Aaron; Korth, Byran

2009-01-01

The Clinical Practice Assessment System (CPAS), developed in response to teacher preparation program accreditation requirements, represents a paradigm shift of one university toward data-based decision-making in teacher education programs. The new assessment system is a scale aligned with INTASC Standards, which allows for observation and…

The Role of the Environmental Management Site Specific Advisory Board under the Federal Advisory Committee Act, With Emphasis on the Northern New Mexico Citizens' Advisory Board - 12482

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

Santistevan, Menice B.

2012-07-01

The Environmental Management Site Specific Advisory Board (EM SSAB) is comprised of eight Citizens' Advisory Boards, chartered under the Federal Advisory Committee Act (FACA) by the Assistant Secretary for Environmental Management for the U. S. Department of Energy (DOE). The purpose of the EM SSAB is to provide the DOE with recommendations regarding Environmental Management issues from legacy waste produced at major sites across the DOE Complex. The Northern New Mexico Citizens' Advisory Board (NNMCAB) is the site specific advisory board to the DOE on issues of environmental monitoring, remediation, waste management and long-term stewardship at Los Alamos National Laboratorymore » (LANL). The other boards are located at: Hanford, Idaho, Nevada, Paducah, Portsmouth, Oak Ridge and Savannah River. Using broad citizen outreach and input, the SSAB provides an official mechanism for the citizenry at each of these sites to monitor current activities affecting the region and also to have input into the prioritization of future activities. 'The mission of the EM SSAB is to more directly involve stakeholders in EM Planning and decision-making processes for the nuclear weapons complex cleanup. DOE has various means of involving the public in its planning and decision-making processes; the EM SSAB is only one component of EM's public participation program, and is not intended to be an exclusive means of public participation. It is the policy of DOE and EM to conduct it programs in an open and responsive manner, thereby encouraging and providing the opportunity for public participation in its planning and decision-making processes. EM SSAB members are appointed to a two year term and may serve up to three terms. During this time, members are able to hear many presentation from subject matter experts, attend several site tours at their site and across the DOE complex and are able to express their concerns and give input to the prioritization of clean up at each site. It is an excellent education and it is hoped that these members will go out to their communities, friends and family and discuss these issues in an informed manner. Many times our citizens rely only on newspaper articles or the Internet, which are sometimes replete with fear and misinformation. The more stakeholders are able to be truly informed, the more accurate the discourse will be at each of the DOE sites. (author)« less

Lessons Learned for Collaborative Clinical Content Development

PubMed Central

Collins, S.A.; Bavuso, K.; Zuccotti, G.; Rocha, R.A.

2013-01-01

Background Site-specific content configuration of vendor-based Electronic Health Records (EHRs) is a vital step in the development of standardized and interoperable content that can be used for clinical decision-support, reporting, care coordination, and information exchange. The multi-site, multi-stakeholder Acute Care Documentation (ACD) project at Partners Healthcare Systems (PHS) aimed to develop highly structured clinical content with adequate breadth and depth to meet the needs of all types of acute care clinicians at two academic medical centers. The Knowledge Management (KM) team at PHS led the informatics and knowledge management effort for the project. Objectives We aimed to evaluate the role, governance, and project management processes and resources for the KM team’s effort as part of the standardized clinical content creation. Methods We employed the Center for Disease Control’s six step Program Evaluation Framework to guide our evaluation steps. We administered a forty-four question, open-ended, semi-structured voluntary survey to gather focused, credible evidence from members of the KM team. Qualitative open-coding was performed to identify themes for lessons learned and concluding recommendations. Results Six surveys were completed. Qualitative data analysis informed five lessons learned and thirty specific recommendations associated with the lessons learned. The five lessons learned are: 1) Assess and meet knowledge needs and set expectations at the start of the project; 2) Define an accountable decision-making process; 3) Increase team meeting moderation skills; 4) Ensure adequate resources and competency training with online asynchronous collaboration tools; 5) Develop focused, goal-oriented teams and supportive, consultative service based teams. Conclusions Knowledge management requirements for the development of standardized clinical content within a vendor-based EHR among multi-stakeholder teams and sites include: 1) assessing and meeting informatics knowledge needs, 2) setting expectations and standardizing the process for decision-making, and 3) ensuring the availability of adequate resources and competency training. PMID:23874366

Transshipment site selection using the AHP and TOPSIS approaches under fuzzy environment.

PubMed

Onüt, Semih; Soner, Selin

2008-01-01

Site selection is an important issue in waste management. Selection of the appropriate solid waste site requires consideration of multiple alternative solutions and evaluation criteria because of system complexity. Evaluation procedures involve several objectives, and it is often necessary to compromise among possibly conflicting tangible and intangible factors. For these reasons, multiple criteria decision-making (MCDM) has been found to be a useful approach to solve this kind of problem. Different MCDM models have been applied to solve this problem. But most of them are basically mathematical and ignore qualitative and often subjective considerations. It is easier for a decision-maker to describe a value for an alternative by using linguistic terms. In the fuzzy-based method, the rating of each alternative is described using linguistic terms, which can also be expressed as triangular fuzzy numbers. Furthermore, there have not been any studies focused on the site selection in waste management using both fuzzy TOPSIS (technique for order preference by similarity to ideal solution) and AHP (analytical hierarchy process) techniques. In this paper, a fuzzy TOPSIS based methodology is applied to solve the solid waste transshipment site selection problem in Istanbul, Turkey. The criteria weights are calculated by using the AHP.

Integrated obesity care management system -implementation and research protocol

PubMed Central

Baillargeon, Jean-Patrice; Carpentier, André; Donovan, Denise; Fortin, Martin; Grant, Andrew; Simoneau-Roy, Judith; St-Cyr-Tribble, Denise; Xhignesse, Mariane; Langlois, Marie-France

2007-01-01

Background Nearly 50% of Canadians are overweight and their number is increasing rapidly. The majority of obese subjects are treated by primary care physicians (PCPs) who often feel uncomfortable with the management of obesity. The current research proposal is aimed at the development and implementation of an innovative, integrated, interdisciplinary obesity care management system involving both primary and secondary care professionals. Methods We will use both action and evaluative research in order to achieve the following specific objectives. The first one is to develop and implement a preceptorship-based continuing medical education (CME) program complemented by a web site for physicians and nurses working in Family Medicine Groups (FMGs). This CME will be based on needs assessment and will be validated by one FMG using questionnaires and semi structured interviews. Also, references and teaching tools will be available for participants on the web site. Our second objective is to establish a collaborative intra and inter-regional interdisciplinary network to enable on-going expertise update and networking for FMG teams. This tool consists of a discussion forum and monthly virtual meetings of all participants. Our third objective is to evaluate the implementation of our program for its ability to train 8 FMGs per year, the access and utilization of electronic tools and the participants' satisfaction. This will be measured with questionnaires, web logging tools and group interviews. Our fourth objective is to determine the impact for the participants regarding knowledge and expertise, attitudes and perceptions, self-efficacy for the management of obesity, and changes in FMG organization for obesity management. Questionnaires and interviews will be used for this purpose. Our fifth objective is to deliver transferable knowledge for health professionals and decision-makers. Strategies and pitfalls of setting up this program will also be identified. Conclusion This project is relevant to health system's decision-makers who are confronted with an important increase in the prevalence of obesity. It is therefore critical to develop strategies allowing the management of obesity in the 1st line setting. Results of this research project could therefore influence health care organization in the field of obesity but also eventually for other chronic diseases. PMID:17927835

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

PubMed

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

Developing a video intervention to model effective patient-physician communication and health-related decision-making skills for a multiethnic audience.

PubMed

Richter, D L; Greaney, M L; McKeown, R E; Cornell, C E; Littleton, M A; Pulley, L; Groff, J Y; Byrd, T L; Herman, C J

2001-01-01

The ENDOW study is a multisite, community-based project designed to improve decision-making and patient-physician communication skills for midlife African-American, white, and Hispanic women facing decisions about hysterectomy. Based on results of initial focus groups, a patient education video was developed in English and Spanish to serve as the centerpiece of various interventions. The video uses community women to model appropriate decision-making and patient-physician communication skills. Women in the target populations rated the video as useful to very useful and would recommend it to others. The use of theory-driven approaches and pilot testing of draft products resulted in the production of a well-accepted, useful video suitable for diverse populations in intervention sites in several states.

78 FR 53765 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... patients, such as evidence-based medicine guidelines, best practice guidelines, and shared decision-making... consider a broad variety of evidence for evaluating the nature and impact of each site's interventions...

The Juvenile and Adolescent Substance Abuse Prevention Program: An Evaluation

ERIC Educational Resources Information Center

Talpade, Medha; Lynch, Diane; Lattimore, Barbara; Graham, Ashlee

2008-01-01

The Juvenile and Adolescent Substance Abuse Prevention Program (JASAP) is a curriculum-based prevention and health promotion program for youth between the ages of 13 to 18 years in Fulton County, Georgia. The program was established in 2007 to promote healthy decision-making skills that would eventually lead to informed choices and decisions…

URBAN DECISION MAKING - THE FINDINGS FROM A CONFERENCE (CHICAGO, NOVEMBER 5-12, 1965). APPLICATIONS OF HUMAN RELATIONS LABORATORY TRAINING, NUMBER 1, 1967.

ERIC Educational Resources Information Center

FRANKLIN, PAULA; FRANKLIN, RICHARD

THIS NATIONAL TRAINING LABORATORIES (NTL) CONFERENCE, DEPARTING SOMEWHAT FROM ITS USUAL EXPERIENCE-BASED LEARNING PROGRAMS, FOCUSED LABORATORY TRAINING METHODS ON THE DECISION-MAKING PROCESS IN URBAN COMMUNITY PROBLEM SOLVING. THE CONFERENCE PRESENTED THEORY, INFORMATION, AND OPINION ON THE NATURE OF CITIES AND THEIR DECISION-MAKING PROCESSES.…

Visualizing Decision-making Behaviours in Agent-based Autonomous Spacecraft

NASA Technical Reports Server (NTRS)

North, Steve; Hennessy, Joseph F. (Technical Monitor)

2003-01-01

The authors will report initial progress on the PIAudit project as a Research Resident Associate Program. The objective of this research is to prototype a tool for visualizing decision-making behaviours in autonomous spacecraft. This visualization will serve as an information source for human analysts. The current visualization prototype for PIAudit combines traditional Decision Trees with Weights of Evidence.

Career Decision-Making Difficulties among High School Students: From the Perception of Career Counselors and High School Principals

ERIC Educational Resources Information Center

Williams, Kellie

2013-01-01

Purpose: The purpose of this comparative research study was to determine the perceptions of career counselors and principals on the types of career decision-making difficulties experienced by high school students and the extent to which a large-scale high school technology-based career development program addresses these difficulties, using the…

Temporal Dynamics and Spatial Patterns of Aedes aegypti Breeding Sites, in the Context of a Dengue Control Program in Tartagal (Salta Province, Argentina).

PubMed

Espinosa, Manuel; Weinberg, Diego; Rotela, Camilo H; Polop, Francisco; Abril, Marcelo; Scavuzzo, Carlos Marcelo

2016-05-01

Since 2009, Fundación Mundo Sano has implemented an Aedes aegypti Surveillance and Control Program in Tartagal city (Salta Province, Argentina). The purpose of this study was to analyze temporal dynamics of Ae. aegypti breeding sites spatial distribution, during five years of samplings, and the effect of control actions over vector population dynamics. Seasonal entomological (larval) samplings were conducted in 17,815 fixed sites in Tartagal urban area between 2009 and 2014. Based on information of breeding sites abundance, from satellite remote sensing data (RS), and by the use of Geographic Information Systems (GIS), spatial analysis (hotspots and cluster analysis) and predictive model (MaxEnt) were performed. Spatial analysis showed a distribution pattern with the highest breeding densities registered in city outskirts. The model indicated that 75% of Ae. aegypti distribution is explained by 3 variables: bare soil coverage percentage (44.9%), urbanization coverage percentage(13.5%) and water distribution (11.6%). This results have called attention to the way entomological field data and information from geospatial origin (RS/GIS) are used to infer scenarios which could then be applied in epidemiological surveillance programs and in the determination of dengue control strategies. Predictive maps development constructed with Ae. aegypti systematic spatiotemporal data, in Tartagal city, would allow public health workers to identify and target high-risk areas with appropriate and timely control measures. These tools could help decision-makers to improve health system responses and preventive measures related to vector control.

Temporal Dynamics and Spatial Patterns of Aedes aegypti Breeding Sites, in the Context of a Dengue Control Program in Tartagal (Salta Province, Argentina)

PubMed Central

Espinosa, Manuel; Weinberg, Diego; Rotela, Camilo H.; Polop, Francisco; Abril, Marcelo; Scavuzzo, Carlos Marcelo

2016-01-01

Background Since 2009, Fundación Mundo Sano has implemented an Aedes aegypti Surveillance and Control Program in Tartagal city (Salta Province, Argentina). The purpose of this study was to analyze temporal dynamics of Ae. aegypti breeding sites spatial distribution, during five years of samplings, and the effect of control actions over vector population dynamics. Methodology/Principal Findings Seasonal entomological (larval) samplings were conducted in 17,815 fixed sites in Tartagal urban area between 2009 and 2014. Based on information of breeding sites abundance, from satellite remote sensing data (RS), and by the use of Geographic Information Systems (GIS), spatial analysis (hotspots and cluster analysis) and predictive model (MaxEnt) were performed. Spatial analysis showed a distribution pattern with the highest breeding densities registered in city outskirts. The model indicated that 75% of Ae. aegypti distribution is explained by 3 variables: bare soil coverage percentage (44.9%), urbanization coverage percentage(13.5%) and water distribution (11.6%). Conclusions/Significance This results have called attention to the way entomological field data and information from geospatial origin (RS/GIS) are used to infer scenarios which could then be applied in epidemiological surveillance programs and in the determination of dengue control strategies. Predictive maps development constructed with Ae. aegypti systematic spatiotemporal data, in Tartagal city, would allow public health workers to identify and target high-risk areas with appropriate and timely control measures. These tools could help decision-makers to improve health system responses and preventive measures related to vector control. PMID:27223693

Implementing Competency-Based Education: Challenges, Strategies, and a Decision-Making Framework

ERIC Educational Resources Information Center

Dragoo, Amie; Barrows, Richard

2016-01-01

The number of competency-based education (CBE) degree programs has increased rapidly over the past five years, yet there is little research on CBE program development. This study utilized conceptual models of higher education change and a qualitative methodology to analyze the strategies and challenges in implementing CBE business degree programs…

Demonstrating Support for the Formative and Summative Assessment Paradigm in a School-Based Intensive Mental Health Program

ERIC Educational Resources Information Center

Puddy, Richard W.; Boles, Richard E.; Dreyer, Meredith L.; Maikranz, Julie; Roberts, Michael C.; Vernberg, Eric M.

2008-01-01

We illustrate the use of formative and summative assessment in evaluating a therapeutic classroom program for children with serious emotional disturbances. Information was analyzed based on data gathered for clinical decision-making during treatment (formative assessment) and measurement of outcomes at discharge (summative assessment) from a…

Clinical decision-making among new graduate nurses attending residency programs in Saudi Arabia.

PubMed

Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

2016-02-01

This study examined the impact of residency programs on clinical decision-making of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. This descriptive study employed a convenience sample (N=98) of new graduate nurses from three hospitals in Saudi Arabia. A self-administered questionnaire was used to collect data. Clinical decision-making skills were measured using the Clinical Decision Making in Nursing Scale. Descriptive statistics, independent t-tests, and multiple linear regression analysis were utilized to examine the effect of residency programs on new graduate nurses' clinical decision-making skills. On average, resident nurses had significantly higher levels of clinical decision-making skills than non-residents (t=23.25, p=0.000). Enrollment in a residency program explained 86.9% of the variance in total clinical decision making controlling for age and overall grade point average. The findings of this study support evidence in the nursing literature conducted primarily in the US and Europe that residency programs have a positive influence on new graduate nurses' clinical decision-making skills. This is the first study to examine the impact of residency programs on clinical decision-making among new Saudi graduate nurses who completed a residency program. The findings of this study underscore the need for the development and implementation of residency programs for all new nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

Gis-Based Site Selection for Underground Natural Resources Using Fuzzy Ahp-Owa

NASA Astrophysics Data System (ADS)

Sabzevari, A. R.; Delavar, M. R.

2017-09-01

Fuel consumption has significantly increased due to the growth of the population. A solution to address this problem is the underground storage of natural gas. The first step to reach this goal is to select suitable places for the storage. In this study, site selection for the underground natural gas reservoirs has been performed using a multi-criteria decision-making in a GIS environment. The "Ordered Weighted Average" (OWA) operator is one of the multi-criteria decision-making methods for ranking the criteria and consideration of uncertainty in the interaction among the criteria. In this paper, Fuzzy AHP_OWA (FAHP_OWA) is used to determine optimal sites for the underground natural gas reservoirs. Fuzzy AHP_OWA considers the decision maker's risk taking and risk aversion during the decision-making process. Gas consumption rate, temperature, distance from main transportation network, distance from gas production centers, population density and distance from gas distribution networks are the criteria used in this research. Results show that the northeast and west of Iran and the areas around Tehran (Tehran and Alborz Provinces) have a higher attraction for constructing a natural gas reservoir. The performance of the used method was also evaluated. This evaluation was performed using the location of the existing natural gas reservoirs in the country and the site selection maps for each of the quantifiers. It is verified that the method used in this study is capable of modeling different decision-making strategies used by the decision maker with about 88 percent of agreement between the modeling and test data.

Remedial investigation report on the Melton Valley watershed at Oak Ridge National Laboratory, Oak Ridge, Tennessee. Volume 3: Appendix C

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

NONE

The Melton Valley watershed presents a multifaceted management and decision-making challenge because of the very heterogeneous conditions that exist with respect to contaminant type, disposal unit age, mode of disposal, release mechanism, and potential risk-producing pathways. The investigation presented here has assembled relevant site data in the geographic context with the intent of enabling program managers and decision-makers to understand site conditions and evaluate the necessity, relative priority, and scope of potential remedial actions. The industrial and recreational exposure scenarios are used to provide a risk assessment reference context to evaluate levels of contamination in surface water, groundwater, soil, andmore » sediment within each subbasin of the Melton Valley watershed. All available analytical results for the media of interest that could be qualified for use in the risk assessment were screened to determine carcinogenic risk values and noncarcinogenic hazard indexes and to identify the chemicals of concern (COCs) for each evaluated media in each subbasin.« less

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

NASA Astrophysics Data System (ADS)

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

2016-04-01

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

School/Community-Based Management Revisited in the Pacific. PREL Briefing Paper.

ERIC Educational Resources Information Center

Koki, Stan

Across the United States, School/Community-Based Management (SCBM), also called site-based management, is gaining support. The effects of SCBM in some Pacific-region schools are detailed. SCBM arose in response to mandates giving decision-making powers to the people who have to carry out educational initiatives. One evaluation of SCBM…

How to use multi-criteria decision analysis methods for reimbursement decision-making in healthcare: a step-by-step guide.

PubMed

Diaby, Vakaramoko; Goeree, Ron

2014-02-01

In recent years, the quest for more comprehensiveness, structure and transparency in reimbursement decision-making in healthcare has prompted the research into alternative decision-making frameworks. In this environment, multi-criteria decision analysis (MCDA) is arising as a valuable tool to support healthcare decision-making. In this paper, we present the main MCDA decision support methods (elementary methods, value-based measurement models, goal programming models and outranking models) using a case study approach. For each family of methods, an example of how an MCDA model would operate in a real decision-making context is presented from a critical perspective, highlighting the parameters setting, the selection of the appropriate evaluation model as well as the role of sensitivity and robustness analyses. This study aims to provide a step-by-step guide on how to use MCDA methods for reimbursement decision-making in healthcare.

Designing a rapid response program to support evidence-informed decision-making in the Americas region: using the best available evidence and case studies.

PubMed

Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Barreto, Jorge; Reveiz, Ludovic; Lavis, John N

2016-08-18

The objective of this work was to inform the design of a rapid response program to support evidence-informed decision-making in health policy and practice for the Americas region. Specifically, we focus on the following: (1) What are the best methodological approaches for rapid reviews of the research evidence? (2) What other strategies are needed to facilitate evidence-informed decision-making in health policy and practice? and (3) How best to operationalize a rapid response program? The evidence used to inform the design of a rapid response program included (i) two rapid reviews of methodological approaches for rapid reviews of the research evidence and strategies to facilitate evidence-informed decision-making, (ii) supplementary literature in relation to the "shortcuts" that could be considered to reduce the time needed to complete rapid reviews, (iii) four case studies, and (iv) supplementary literature to identify additional operational issues for the design of the program. There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting them. Better reporting of rapid review methods is needed. The literature found in relation to shortcuts will be helpful in choosing shortcuts that maximize timeliness while minimizing the impact on quality. Evidence for other strategies that can be used concurrently to facilitate the uptake of research evidence, including evidence drawn from rapid reviews, is presented. Operational issues that need to be considered in designing a rapid response program include the implications of a "user-pays" model, the importance of recruiting staff with the right mix of skills and qualifications, and ensuring that the impact of the model on research use in decision-making is formally evaluated. When designing a new rapid response program, greater attention needs to be given to specifying the rapid review methods and reporting these in sufficient detail to allow a quality assessment. It will also be important to engage in other strategies to facilitate the uptake of the rapid reviews and to evaluate the chosen model in order to make refinements and add to the evidence base for evidence-informed decision-making.

Participants' perceptions of the 1997-1998 Missouri State Parks Passport Program

Treesearch

Yi-Jin Ye; Jaclyn Card

2002-01-01

Service quality is increasingly important to park managers. Recreation and park evaluation measures the implementation and outcome of programs for decision-making. Decisions based on evaluations are often concerned with improving the quality of the program for participants. The purpose of the study was to evaluate the Missouri State Parks Passport Program (MSPPP) by...

Involving youth in program decision-making: how common and what might it do for youth?

PubMed

Akiva, Thomas; Cortina, Kai S; Smith, Charles

2014-11-01

The strategy of sharing program decision-making with youth in youth programs, a specific form of youth-adult partnership, is widely recommended in practitioner literature; however, empirical study is relatively limited. We investigated the prevalence and correlates of youth program decision-making practices (e.g., asking youth to help decide what activities are offered), using single-level and multilevel methods with a cross-sectional dataset of 979 youth attending 63 multipurpose after-school programs (average age of youth = 11.4, 53 % female). The prevalence of such practices was relatively high, particularly for forms that involved low power sharing such as involving youth in selecting the activities a program offers. Hierarchical linear modeling revealed positive associations between youth program decision-making practices and youth motivation to attend programs. We also found positive correlations between decision-making practices and youth problem-solving efficacy, expression efficacy, and empathy. Significant interactions with age suggest that correlations with problem solving and empathy are more pronounced for older youth. Overall, the findings suggest that involving youth in program decision-making is a promising strategy for promoting youth motivation and skill building, and in some cases this is particularly the case for older (high school-age) youth.

The Purpose and Scope of Pedagogy in Pharmaceutical Education.

PubMed

Nakamura, Akihiro

2017-01-01

The WHO and International Pharmaceutical Federation (FIP) introduced the concept of the "seven-star pharmacist" in which a pharmacist is described as a caregiver, communicator, decision-maker, teacher, lifelong learner, leader and manager. In six-year pharmaceutical education programs, which have been provided in schools of pharmacy since 2006, 5th year students participate in on-site practice experiences in hospitals and community pharmacies. Thus, Japanese pharmacists also began to have a role in pharmaceutical education as teachers in clinical settings. Not only pharmacists in clinical settings, but also faculty members of pharmacy schools, had not previously been familiar with evidence-based education, and therefore they often teach in the way they were taught. Since research on teaching and learning has not been well developed in Japanese pharmaceutical education, both the model core curriculum for six-year programs and the subject benchmark statement for four-year programs are based on insufficient scientific evidence. We should promote the scholarship of teaching and learning, which promotes teaching as a scholarly endeavor and a worthy subject for research. In this review, I will summarize the needs and expectations for the establishment of pedagogy in pharmaceutical education.

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.

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

PubMed

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

2017-01-01

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

Ethical Leadership and Moral Literacy: Incorporating Ethical Dilemmas in a Case-­Based Pedagogy

ERIC Educational Resources Information Center

Jenlink, Patrick M.; Jenlink, Karen Embry

2015-01-01

In this paper the authors examine an ethical dilemma approach to case-based pedagogy for leadership preparation, which was used in a doctoral studies program. Specifically, the authors argue that preparing educational leaders for the ethical dilemmas and moral decision-making that define schools requires assessing current programs and pedagogical…

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

Onuet, Semih; Soner, Selin

Site selection is an important issue in waste management. Selection of the appropriate solid waste site requires consideration of multiple alternative solutions and evaluation criteria because of system complexity. Evaluation procedures involve several objectives, and it is often necessary to compromise among possibly conflicting tangible and intangible factors. For these reasons, multiple criteria decision-making (MCDM) has been found to be a useful approach to solve this kind of problem. Different MCDM models have been applied to solve this problem. But most of them are basically mathematical and ignore qualitative and often subjective considerations. It is easier for a decision-maker tomore » describe a value for an alternative by using linguistic terms. In the fuzzy-based method, the rating of each alternative is described using linguistic terms, which can also be expressed as triangular fuzzy numbers. Furthermore, there have not been any studies focused on the site selection in waste management using both fuzzy TOPSIS (technique for order preference by similarity to ideal solution) and AHP (analytical hierarchy process) techniques. In this paper, a fuzzy TOPSIS based methodology is applied to solve the solid waste transshipment site selection problem in Istanbul, Turkey. The criteria weights are calculated by using the AHP.« less

Data Decision-Making and Program-Wide Implementation of the Pyramid Model. Roadmap to Effective Intervention Practices #7

ERIC Educational Resources Information Center

Fox, Lise; Veguilla, Myrna; Perez Binder, Denise

2014-01-01

The Technical Assistance Center on Social Emotional Intervention for Young Children (TACSEI) Roadmap on "Data Decision-Making and Program-Wide Implementation of the Pyramid Model" provides programs with guidance on how to collect and use data to ensure the implementation of the Pyramid Model with fidelity and decision-making that…

Development and pilot testing of a psychosocial intervention program for young breast cancer survivors.

PubMed

Ahmed, Kauser; Marchand, Erica; Williams, Victoria; Coscarelli, Anne; Ganz, Patricia A

2016-03-01

To describe the development, pilot testing, and dissemination of a psychosocial intervention addressing concerns of young breast cancer survivors (YBCS). Intervention development included needs assessment with community organizations and interviews with YBCS. Based on evidence-based models of treatment, the intervention included tools for managing anxiety, fear of recurrence, tools for decision-making, and coping with sexuality/relationship issues. After pilot testing in a university setting, the program was disseminated to two community clinical settings. The program has two distinct modules (anxiety management and relationships/sexuality) that were delivered in two sessions; however, due to attrition, an all day workshop evolved. An author constructed questionnaire was used for pre- and post-intervention evaluation. Post-treatment scores showed an average increase of 2.7 points on a 10 point scale for the first module, and a 2.3 point increase for the second module. Qualitative feedback surveys were also collected. The two community sites demonstrated similar gains among their participants. The intervention satisfies an unmet need for YBCS and is a possible model of integrating psychosocial intervention with oncology care. This program developed standardized materials which can be disseminated to other organizations and potentially online for implementation within community settings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Building a Co-Created Citizen Science Program with Community Members Neighboring a Hazardous Waste Site

NASA Astrophysics Data System (ADS)

Ramirez-Andreotta, M.; Brusseau, M. L. L.; Artiola, J. F.; Maier, R. M.; Gandolfi, A. J.

2015-12-01

A research project that is only expert-driven may ignore the role of local knowledge in research, often gives low priority to the development of a comprehensive strategy to engage the community, and may not deliver the results of the study to the community in an effective way. To date, only a limited number of co-created citizen science projects, where community members are involved in most or all steps of the scientific process, have been initiated at contaminated sites and even less in conjunction with risk communication. Gardenroots: The Dewey-Humboldt AZ Garden Project was a place-based, co-created citizen science project where community members and researchers together: defined the question for study, developed hypotheses, collected environmental samples, disseminated results broadly, translated the results into action, and posed new research questions. This co-created environmental research project produced new data and addressed an additional exposure route (consumption of vegetables grown in soils with elevated arsenic levels) that was not being evaluated in the current site assessment. Furthermore, co-producing science led to both individual learning and social-ecological outcomes. This approach illustrates the benefits of a co-created citizen-science program in addressing the complex problems that arise in communities neighboring a hazardous waste sites. Such a project increased the community's involvement in regional environmental assessment and decision-making, which has the potential to help mitigate environmental exposures and thereby reduce associated risks.

Zero-Based Budgeting.

ERIC Educational Resources Information Center

Wichowski, Chester

1979-01-01

The zero-based budgeting approach is designed to achieve the greatest benefit with the fewest undesirable consequences. Seven basic steps make up the zero-based decision-making process: (1) identifying program goals, (2) classifying goals, (3) identifying resources, (4) reviewing consequences, (5) developing decision packages, (6) implementing a…

Network-Based Management Procedures.

ERIC Educational Resources Information Center

Buckner, Allen L.

Network-based management procedures serve as valuable aids in organizational management, achievement of objectives, problem solving, and decisionmaking. Network techniques especially applicable to educational management systems are the program evaluation and review technique (PERT) and the critical path method (CPM). Other network charting…

Informed decision-making with and for people with dementia - efficacy of the PRODECIDE education program for legal representatives: protocol of a randomized controlled trial (PRODECIDE-RCT).

PubMed

Lühnen, Julia; Haastert, Burkhard; Mühlhauser, Ingrid; Richter, Tanja

2017-09-15

In Germany, the guardianship system provides adults who are no longer able to handle their own affairs a court-appointed legal representative, for support without restriction of legal capacity. Although these representatives only rarely are qualified in healthcare, they nevertheless play decisive roles in the decision-making processes for people with dementia. Previously, we developed an education program (PRODECIDE) to address this shortcoming and tested it for feasibility. Typical, autonomy-restricting decisions in the care of people with dementia-namely, using percutaneous endoscopic gastrostomy (PEG) or physical restrains (PR), or the prescription of antipsychotic drugs (AP)-were the subject areas trained. The training course aims to enhance the competency of legal representatives in informed decision-making. In this study, we will evaluate the efficacy of the PRODECIDE education program. A randomized controlled trial with a six-month follow-up will be conducted to compare the PRODECIDE education program with standard care, enrolling legal representatives (N = 216). The education program lasts 10 h and comprises four modules: A, decision-making processes and methods; and B, C and D, evidence-based knowledge about PEG, PR and AP, respectively. The primary outcome measure is knowledge, which is operationalized as the understanding of decision-making processes in healthcare affairs and in setting realistic expectations about benefits and harms of PEG, PR and AP in people with dementia. Secondary outcomes are sufficient and sustainable knowledge and percentage of persons concerned affected by PEG, FEM or AP. A qualitative process evaluation will be performed. Additionally, to support implementation, a concept for translating the educational contents into e-learning modules will be developed. The study results will show whether the efficacy of the education program could justify its implementation into the regular training curricula for legal representatives. Additionally, it will determine whether an e-learning course provides a valuable backup or even alternative learning strategy. TRN: ISRCTN17960111 , Date: 01/06/2017.

The Impact of School-Based Decision Making: A Case Study.

ERIC Educational Resources Information Center

Etheridge, Carol Plata; Hall, Mary Lee

As a last resort to catalyze change in its innercity schools, Memphis City School District (Tennessee) designated seven schools as school-based decision-making (SBDM) sites in April 1989. In the same month, Memphis State University researchers were appointed official observers/researchers of SBDM implementation. Not to be confused with…

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

PubMed Central

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-01-01

Background: Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods: The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results: The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion: This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care) perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability. PMID:29179292

Comparison of Computer-based Clinical Decision Support Systems and Content for Diabetes Mellitus.

PubMed

Kantor, M; Wright, A; Burton, M; Fraser, G; Krall, M; Maviglia, S; Mohammed-Rajput, N; Simonaitis, L; Sonnenberg, F; Middleton, B

2011-01-01

Computer-based clinical decision support (CDS) systems have been shown to improve quality of care and workflow efficiency, and health care reform legislation relies on electronic health records and CDS systems to improve the cost and quality of health care in the United States; however, the heterogeneity of CDS content and infrastructure of CDS systems across sites is not well known. We aimed to determine the scope of CDS content in diabetes care at six sites, assess the capabilities of CDS in use at these sites, characterize the scope of CDS infrastructure at these sites, and determine how the sites use CDS beyond individual patient care in order to identify characteristics of CDS systems and content that have been successfully implemented in diabetes care. We compared CDS systems in six collaborating sites of the Clinical Decision Support Consortium. We gathered CDS content on care for patients with diabetes mellitus and surveyed institutions on characteristics of their site, the infrastructure of CDS at these sites, and the capabilities of CDS at these sites. The approach to CDS and the characteristics of CDS content varied among sites. Some commonalities included providing customizability by role or user, applying sophisticated exclusion criteria, and using CDS automatically at the time of decision-making. Many messages were actionable recommendations. Most sites had monitoring rules (e.g. assessing hemoglobin A1c), but few had rules to diagnose diabetes or suggest specific treatments. All sites had numerous prevention rules including reminders for providing eye examinations, influenza vaccines, lipid screenings, nephropathy screenings, and pneumococcal vaccines. Computer-based CDS systems vary widely across sites in content and scope, but both institution-created and purchased systems had many similar features and functionality, such as integration of alerts and reminders into the decision-making workflow of the provider and providing messages that are actionable recommendations.

MoCog1: A computer simulation of recognition-primed human decision making

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

This report describes the successful results of the first stage of a research effort to develop a 'sophisticated' computer model of human cognitive behavior. Most human decision-making is of the experience-based, relatively straight-forward, largely automatic, type of response to internal goals and drives, utilizing cues and opportunities perceived from the current environment. This report describes the development of the architecture and computer program associated with such 'recognition-primed' decision-making. The resultant computer program was successfully utilized as a vehicle to simulate findings that relate how an individual's implicit theories orient them toward particular goals, with resultant cognitions, affects, and behavior in response to their environment. The present work is an expanded version and is based on research reported while the author was an employee of NASA ARC.

Understanding Complexity and Self-Organization in a Defense Program Management Organization (Experimental Design)

DTIC Science & Technology

2016-03-18

SPONSORED REPORT SERIES Understanding Complexity and Self - Organization in a Defense Program Management Organization (Experimental Design...experiment will examine the decision-making process within the program office and the self - organization of key program office personnel based upon formal...and informal communications links. Additionally, we are interested in the effects of this self - organizing process on the organization’s shared

Comparing Methods for Prioritising Protected Areas for Investment: A Case Study Using Madagascar’s Dry Forest Reptiles

PubMed Central

Gardner, Charlie J.; Raxworthy, Christopher J.; Metcalfe, Kristian; Raselimanana, Achille P.; Smith, Robert J.; Davies, Zoe G.

2015-01-01

There are insufficient resources available to manage the world’s existing protected area portfolio effectively, so the most important sites should be prioritised in investment decision-making. Sophisticated conservation planning and assessment tools developed to identify locations for new protected areas can provide an evidence base for such prioritisations, yet decision-makers in many countries lack the institutional support and necessary capacity to use the associated software. As such, simple heuristic approaches such as species richness or number of threatened species are generally adopted to inform prioritisation decisions. However, their performance has never been tested. Using the reptile fauna of Madagascar’s dry forests as a case study, we evaluate the performance of four site prioritisation protocols used to rank the conservation value of 22 established and candidate protected areas. We compare the results to a benchmark produced by the widely-used systematic conservation planning software Zonation. The four indices scored sites on the basis of: i) species richness; ii) an index based on species’ Red List status; iii) irreplaceability (a key metric in systematic conservation planning); and, iv) a novel Conservation Value Index (CVI), which incorporates species-level information on endemism, representation in the protected area system, tolerance of habitat degradation and hunting/collection pressure. Rankings produced by the four protocols were positively correlated to the results of Zonation, particularly amongst high-scoring sites, but CVI and Irreplaceability performed better than Species Richness and the Red List Index. Given the technological capacity constraints experienced by decision-makers in the developing world, our findings suggest that heuristic metrics can represent a useful alternative to more sophisticated analyses, especially when they integrate species-specific information related to extinction risk. However, this can require access to, and understanding of, more complex species data. PMID:26162073

Computer-based diagnostic decisionmaking.

PubMed

Miller, R A

1987-12-01

The three decisionmaking aids described by the authors attack the generic problem of "see no evil, hear no evil, speak no evil"--improving the detection, diagnosis, and therapy of psychiatric disorders in the primary care setting. The three systems represent interventions at different steps in the process of providing appropriate care to psychiatric patients. The DSPW system of Robins and Marcus offers the potential of increasing the recognition of psychiatric disease in the physician's office. Politser's IDS program is representative of the sort of sophisticated microcomputer-based decisionmaking support tools that will become available to physicians in the not-too-distant future. Erdman's study of the impact of explanation capabilities on the acceptability of therapy recommending systems points out the need for careful scientific evaluations of features added to diagnostic and therapeutic systems.

Different bees, different needs: how nest-site requirements have shaped the decision-making processes in homeless honeybees (Apis spp.).

PubMed

Beekman, Madeleine; Oldroyd, Benjamin P

2018-05-19

During reproductive swarming, a honeybee swarm needs to decide on a new nest site and then move to the chosen site collectively. Most studies of swarming and nest-site selection are based on one species, Apis mellifera Natural colonies of A. mellifera live in tree cavities. The quality of the cavity is critical to the survival of a swarm. Other honeybee species nest in the open, and have less strict nest-site requirements, such as the open-nesting dwarf honeybee Apis florea Apis florea builds a nest comprised of a single comb suspended from a twig. For a cavity-nesting species, there is only a limited number of potential nest sites that can be located by a swarm, because suitable sites are scarce. By contrast, for an open-nesting species, there is an abundance of equally suitable twigs. While the decision-making process of cavity-nesting bees is geared towards selecting the best site possible, open-nesting species need to coordinate collective movement towards areas with potential nest sites. Here, we argue that the nest-site selection processes of A. florea and A. mellifera have been shaped by each species' specific nest-site requirements. Both species use the same behavioural algorithm, tuned to allow each species to solve their species-specific problem.This article is part of the theme issue 'Collective movement ecology'. © 2018 The Author(s).

Preparing for Decision-Making: Training for Effective School-Based Budgeting in Los Angeles, Chicago, and Denver.

ERIC Educational Resources Information Center

Lauber, Diana; Warden, Christine

So that New York City could build on the experiences of other large cities as it implemented Performance Driven Budgeting (PDB) in the schools, a study was conducted of the school based budgeting training in Los Angeles, Chicago, and Denver. These districts have from 6 to 10 years experience in site-based budgeting. The study is based on…

Idea Project Final Report, A Sequential Hypothesis Testing-Based Decision-Making System For Freeway Incident Response

DOT National Transportation Integrated Search

1995-10-01

THIS INVESTIGATION WAS COMPLETED AS PART OF THE ITS-IDEA PROGRAM WHICH IS ONE OF THREE IDEA PROGRAMS MANAGED BY THE TRANSPORTATION RESEARCH BOARD (TRB) TO FOSTER INNOVATIONS IN SURFACE TRANSPORTATION. IT FOCUSES ON PRODUCTS AND RESULT FOR THE DEVELOP...

75 FR 6689 - Sustainable Communities Planning Grant Program Advance Notice and Request for Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-10

... greater and more broad-based support of community development and investment decisions. However, these... and to expand opportunities for stakeholders to engage in decision-making, HUD is seeking comments on... its partners to better understand how this Program can support cooperative regional planning efforts...

40 CFR 230.98 - Mitigation banks and in-lieu fee programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... must be planned and designed to be self-sustaining over time, but some active management and... based approach, to the extent practicable, while still meeting the decision-making time frames specified... watershed approach to the extent practicable in reviewing proposed mitigation banks and in-lieu fee programs...

40 CFR 230.98 - Mitigation banks and in-lieu fee programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... must be planned and designed to be self-sustaining over time, but some active management and... based approach, to the extent practicable, while still meeting the decision-making time frames specified... watershed approach to the extent practicable in reviewing proposed mitigation banks and in-lieu fee programs...

40 CFR 230.98 - Mitigation banks and in-lieu fee programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... must be planned and designed to be self-sustaining over time, but some active management and... based approach, to the extent practicable, while still meeting the decision-making time frames specified... watershed approach to the extent practicable in reviewing proposed mitigation banks and in-lieu fee programs...

40 CFR 230.98 - Mitigation banks and in-lieu fee programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... must be planned and designed to be self-sustaining over time, but some active management and... based approach, to the extent practicable, while still meeting the decision-making time frames specified... watershed approach to the extent practicable in reviewing proposed mitigation banks and in-lieu fee programs...

40 CFR 230.98 - Mitigation banks and in-lieu fee programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... must be planned and designed to be self-sustaining over time, but some active management and... based approach, to the extent practicable, while still meeting the decision-making time frames specified... watershed approach to the extent practicable in reviewing proposed mitigation banks and in-lieu fee programs...

The Development of Trust in Residential Environmental Education Programs

ERIC Educational Resources Information Center

Ardoin, Nicole M.; DiGiano, Maria L.; O'Connor, Kathleen; Podkul, Timothy E.

2017-01-01

Trust, a relational phenomenon that is an important building block of interpersonal relationships and within society, can also be an intermediary outcome of field-based environmental education programs. Trust creates a foundation for collaboration and decision-making, which are core to many ultimate outcomes of environmental education. Yet,…

A web-based multicriteria evaluation of spatial trade-offs between environmental and economic implications from hydraulic fracturing in a shale gas region in Ohio.

PubMed

Liu, X; Gorsevski, P V; Yacobucci, M M; Onasch, C M

2016-06-01

Planning of shale gas infrastructure and drilling sites for hydraulic fracturing has important spatial implications. The evaluation of conflicting and competing objectives requires an explicit consideration of multiple criteria as they have important environmental and economic implications. This study presents a web-based multicriteria spatial decision support system (SDSS) prototype with a flexible and user-friendly interface that could provide educational or decision-making capabilities with respect to hydraulic fracturing site selection in eastern Ohio. One of the main features of this SDSS is to emphasize potential trade-offs between important factors of environmental and economic ramifications from hydraulic fracturing activities using a weighted linear combination (WLC) method. In the prototype, the GIS-enabled analytical components allow spontaneous visualization of available alternatives on maps which provide value-added features for decision support processes and derivation of final decision maps. The SDSS prototype also facilitates nonexpert participation capabilities using a mapping module, decision-making tool, group decision module, and social media sharing tools. The logical flow of successively presented forms and standardized criteria maps is used to generate visualization of trade-off scenarios and alternative solutions tailored to individual user's preferences that are graphed for subsequent decision-making.

Using an innovative criteria weighting tool for stakeholders involvement to rank MSW facility sites with the AHP.

PubMed

De Feo, Giovanni; De Gisi, Sabino

2010-11-01

The main aim of this study was to verify the efficacy of using an innovative criteria weighting tool (the "priority scale") for stakeholders involvement to rank a list of suitable municipal solid waste (MSW) facility sites with the multi-criteria decision-making (MCDM) technique known as analytic hierarchy process (AHP). One of the main objectives of the study was to verify the behaviour of the "priority scale" with both technical and non-technical decision-makers. All over the world, the siting of MSW treatment or disposal plants is a complex process involving politicians, technicians as well as citizens, where stakeholders who are not effectively involved strongly oppose (or even obstruct) the realization of new facilities. In this study, in order to pursue both the technical (select the best site) and social aims (all the stakeholders have to give their aware contribution), the use of the "priority scale" is suggested as a tool to easily collect non-contradictory criteria preferences by the various decision-makers. Every decision-maker filled in "priority scale", which was subsequently uploaded in the AHP tool in order to indirectly calculate the individual priority of alternatives given by each stakeholder (not using group aggregation techniques). The proposed method was applied to the siting of a composting plant in an area suffering from a serious MSW emergency, which has lasted for over 15 years, in the Campania Region, in Southern Italy. The best site (the "first choice") was taken as the one that appeared the most times at the first place of each decision-maker ranking list. The involved technical and non-technical decision-makers showed the same behaviour in (indirectly) selecting the best site as well as in terms of the most appraised criteria ("absence of areas of the highest value for natural habitats and species of plants and animals"). Moreover, they showed the same AHP inconsistency ratio as well as the same behaviour in comparison with a "balanced decision-maker" (who assigns identical weights to all the considered criteria). Therefore, the proposed criteria weighting tool could be widely as well as easily used for stakeholders involvement to rank MSW facility sites (or other kinds of alternatives) with the AHP or with other MCDM techniques, taking or not into consideration group aggregation methods. Copyright © 2010 Elsevier Ltd. All rights reserved.

Couple decision making and use of cultural scripts in Malawi.

PubMed

Mbweza, Ellen; Norr, Kathleen F; McElmurry, Beverly

2008-01-01

To examine the decision-making processes of husband and wife dyads in matrilineal and patrilineal marriage traditions of Malawi in the areas of money, food, pregnancy, contraception, and sexual relations. Qualitative grounded theory using simultaneous interviews of 60 husbands and wives (30 couples). Data were analyzed according to the guidelines of simultaneous data collection and analysis. The analysis resulted in development of core categories and categories of decision-making process. Data matrixes were used to identify similarities and differences within couples and across cases. Most couples reported using a mix of final decision-making approaches: husband-dominated, wife-dominated, and shared. Gender based and nongender based cultural scripts provided rationales for their approaches to decision making. Gender based cultural scripts (husband-dominant and wife-dominant) were used to justify decision-making approaches. Non-gender based cultural scripts (communicating openly, maintaining harmony, and children's welfare) supported shared decision making. Gender based cultural scripts were used in decision making more often among couples from the district with a patrilineal marriage tradition and where the husband had less than secondary school education and was not formally employed. Nongender based cultural scripts to encourage shared decision making can be used in designing culturally tailored reproductive health interventions for couples. Nurses who work with women and families should be aware of the variations that occur in actual couple decision-making approaches. Shared decision making can be used to encourage the involvement of men in reproductive health programs.

The OSIRIS-REx Mission Sample Site Selection Process

NASA Astrophysics Data System (ADS)

Beshore, Edward C.; Lauretta, Dante

2014-11-01

In September of 2016, the OSIRIS-REx (Origins, Spectral Interpretation, Resource Identification, Security, REgolith eXplorer) spacecraft will depart for asteroid (101955) Bennu, and in doing so, will turn an important corner in the exploration of the solar system. After arriving at Bennu in the fall of 2018, OSIRIS-REx will undertake a program of observations designed to select a site suitable for retrieving a sample that will be returned to the Earth in 2023. The third mission in NASA’s New Frontiers program, OSIRIS-REx will return over 60 grams from Bennu’s surface.OSIRIS-REx is unique because the science team will have an operational role to play in preparing data products needed to select a sample site. These include products used to ensure flight system safety — topographic maps and shape models, temperature measurements, maps of hazards — as well as assessments of sampleability and science value. The timing and production of these will be presented, as will the high-level decision-making tools and processes for the interim and final site selection processes.

Decision support in vaccination policies.

PubMed

Piso, B; Wild, C

2009-10-09

Looking across boarders reveals that the national immunization programs of various countries differ in their vaccination schedules and decisions regarding the implementation and funding of new vaccines. The aim of this review is to identify decision aids and crucial criteria for a rational decision-making process on vaccine introduction and to develop a theoretical framework for decision-making based on available literature. Systematic literature search supplemented by hand-search. We identified five published decision aids for vaccine introduction and program planning in industrialized countries. Their comparison revealed an overall similarity with some differences in the approach as well as criteria. Burden of disease and vaccine characteristics play a key role in all decision aids, but authors vary in their views on the significance of cost-effectiveness analyses. Other relevant factors that should be considered before vaccine introduction are discussed to highly differing extents. These factors include the immunization program itself as well as its conformity with other programs, its feasibility, acceptability, and equity, as well as ethical, legal and political considerations. Assuming that the most comprehensive framework possible will not provide a feasible tool for decision-makers, we suggest a stepwise procedure. Though even the best rational approach and most comprehensive evaluation is limited by remaining uncertainties, frameworks provide at least a structured approach to evaluate the various aspects of vaccine implementation decision-making. This process is essential in making consistently sound decisions and will facilitate the public's confidence in the decision and its realization.

Family involvement in medical decision-making: Perceptions of nursing and psychology students.

PubMed

Itzhaki, Michal; Hildesheimer, Galya; Barnoy, Sivia; Katz, Michael

2016-05-01

Family members often rely on health care professionals to guide and support them through the decision-making process. Although family involvement in medical decisions should be included in the preservice curriculum for the health care professions, perceptions of students in caring professions on family involvement in medical decision-making have not yet been examined. To examine the perceptions of nursing and psychology students on family involvement in medical decision-making for seriously ill patients. A descriptive cross-sectional design was used. First year undergraduate nursing and psychology students studying for their Bachelor of Arts degree were recruited. Perceptions were assessed with a questionnaire constructed based on the Multi-Attribute Utility Theory (MAUT), which examines decision-maker preferences. The questionnaire consisted of two parts referring to the respondent once as the patient and then as the family caregiver. Questionnaires were completed by 116 nursing students and 156 psychology students. Most were of the opinion that family involvement in decision-making is appropriate, especially when the patient is incapable of making decisions. Nursing students were more inclined than psychology students to think that financial, emotional, and value-based considerations should be part of the family's involvement in decision-making. Both groups of students perceived the emotional consideration as most acceptable, whereas the financial consideration was considered the least acceptable. Nursing and psychology students perceive family involvement in medical decision-making as appropriate. In order to train students to support families in the process of decision-making, further research should examine Shared Decision-Making (SDM) programs, which involve patient and clinician collaboration in health care decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Challenges and Research Agenda of School Leadership in Taiwan

ERIC Educational Resources Information Center

Pan, Hui-Ling Wendy; Chen, Peiying

2011-01-01

Throughout the world, rapid political and economic change has applied enormous pressure on educators addressing leadership and accountability measures to improve instructional practices and student performance. Decentralisation of central authority regarding school site-based decision-making has drastically changed the educational environment in…

The Implementation of Kentucky's School-Based Decision Making Program.

ERIC Educational Resources Information Center

Kentucky Univ., Lexington. Inst. on Education Reform.

This report describes what schools and educators across Kentucky are doing to implement school reform in school-based decision-making based on the Kentucky Education Reform Act of 1990 (KERA). The School-Based Decision Making (SBDM) component of KERA is a decentralized governance structure that vests great authority in SBDM councils operating at…

Data-Driven Decision Making in Out-of-School Time Programs. Part 6 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Organization-Level Activities. Research-to-Results Brief. Publication #2009-34

ERIC Educational Resources Information Center

Bandy, Tawana; Burkhauser, Mary; Metz, Allison J. R.

2009-01-01

Although many program managers look to data to inform decision-making and manage their programs, high-quality program data may not always be available. Yet such data are necessary for effective program implementation. The use of high-quality data facilitates program management, reduces reliance on anecdotal information, and ensures that data are…

Citizen Groups and Scientific Decisionmaking: Does Public Participation Influence Environmental Outcomes?

ERIC Educational Resources Information Center

Daley, Dorothy M.

2007-01-01

This paper explores the influence of local community groups on agency decisionmaking at hazardous waste sites nationwide. The central purpose of this research is to examine the relative influence of two forms of public participation at Superfund sites: Community Advisory Groups (CAGs) and Technical Assistance Grants (TAGs). When citizens mobilize…

Early Childhood Program Evaluations: A Decision-Maker's Guide

ERIC Educational Resources Information Center

National Forum on Early Childhood Program Evaluation, 2007

2007-01-01

Increasing demands for evidence-based early childhood services and the need by policymakers to know whether a program is effective or whether it warrants a significant investment of public and/or private funds--coupled with the often-politicized debate around these topics--make it imperative for policymakers and civic leaders to have independent…

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

PubMed

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

2013-12-01

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

Nuclear facility decommissioning and site remedial actions: A selected bibliography, Vol. 18. Part 2. Indexes

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

NONE

1997-09-01

This bibliography contains 3638 citations with abstracts of documents relevant to environmental restoration, nuclear facility decontamination and decommissioning (D&D), uranium mill tailings management, and site remedial actions. This report is the eighteenth in a series of bibliographies prepared annually for the U.S. Department of Energy (DOE) Office of Environmental Restoration. Citations to foreign and domestic literature of all types - technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions - have been included in Part 1 of the report. The bibliography contains scientific, technical, financial, and regulatory information that pertains to DOE environmentalmore » restoration programs. The citations are separated by topic into 16 sections, including (1) DOE Environmental Restoration Program; (2) DOE D&D Program; (3) Nuclear Facilities Decommissioning; (4) DOE Formerly Utilized Sites Remedial Action Programs; (5) NORM-Contaminated Site Restoration; (6) DOE Uranium Mill Tailings Remedial Action Project; (7) Uranium Mill Tailings Management; (8) DOE Site-Wide Remedial Actions; (9) DOE Onsite Remedial Action Projects; (10) Contaminated Site Remedial Actions; (11) DOE Underground Storage Tank Remediation; (12) DOE Technology Development, Demonstration, and Evaluations; (13) Soil Remediation; (14) Groundwater Remediation; (15) Environmental Measurements, Analysis, and Decision-Making; and (16) Environmental Management Issues. Within the 16 sections, the citations are sorted by geographic location. If a geographic location is not specified, the citations are sorted according to the document title. In Part 2 of the report, indexes are provided for author, author affiliation, selected title phrase, selected title word, publication description, geographic location, and keyword.« less

Engaging and Empowering the National Park Service to apply Earth Observations to Management Decisions

NASA Astrophysics Data System (ADS)

Clayton, A.; Ross, K. W.; Crepps, G.; Childs-Gleason, L. M.; Ruiz, M. L.; Rogers, L.; Allsbrook, K. N.

2017-12-01

Since 2015, the NASA DEVELOP National Program has partnered with the National Park Service (NPS) engaging more than 120 program participants, working on over 22 projects across approximately 27 unique park units. These projects examined a variety of cultural and environmental concerns facing the NPS including landscape disturbance, invasive species mapping, archaeological site preservation, and water resources monitoring. DEVELOP, part of NASA's Applied Sciences' Capacity Building program, conducts 10-week feasibility projects which demonstrate the utility of NASA's Earth observations as an additional tool for decision-making processes. This presentation will highlight several of these projects and discuss the progress of capacity building working with individual, regional, and institutional elements within the National Park Service.

[Implementation of telemedicine programs in Spain: experience of the main actors involved in the decision-making process].

PubMed

Mahtani Chugani, Vinita; Martín Fernández, Roberto Luis; Soto Pedre, Enrique; Yanes López, Virginia; Serrano Aguilar, Pedro

2009-01-01

To identify the main benefits and risks related to the implementation of telemedicine programs in Spain, based on the experience of the actors influencing the decision-making process. We performed a qualitative study based on audiotaped semi-structured telephone interviews. Eleven interviews were carried out, and the perspective of four physicians, three administrators, two researchers and two telecommunications industry workers were included. Theoretical sampling was used and thematic inductive analysis was performed. The following factors were identified as necessary to successfully resolve problems by using telemedicine programs: the commitment of the persons involved, technological aspects, economic and institutional support, acceptance by healthcare professionals and patients, the existence of protocols adjusted to the context, the need for information and training prior to the development of telemedicine programs, a forward-looking approach, routine use and full acceptance of telemedicine programs in the organization, and the need to defend equity for professionals and users. Successfully developing a telemedicine program requires a favorable environment in which risk can be foreseen. The main key element seems to be the human factor. The factors identified in this study should be considered when developing strategies to increase the chances of success of telemedicine programs in Spain.

Evidence-based management - healthcare manager viewpoints.

PubMed

Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

2018-06-11

Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

SYNTHESIS OF SPATIAL DATA FOR DECISION-MAKING

EPA Science Inventory

EPA'S Regional Vulnerability Assessment Program (ReVA) has developed a web-based statistical tool that synthesizes available spatial data into indices of condition, vulnerability (risk, considering cumulative effects), and feasibility of management options. The Environmental Deci...

Do small swarms have an advantage when house hunting? The effect of swarm size on nest-site selection by Apis mellifera.

PubMed

Schaerf, T M; Makinson, J C; Myerscough, M R; Beekman, M

2013-10-06

Reproductive swarms of honeybees are faced with the problem of finding a good site to establish a new colony. We examined the potential effects of swarm size on the quality of nest-site choice through a combination of modelling and field experiments. We used an individual-based model to examine the effects of swarm size on decision accuracy under the assumption that the number of bees actively involved in the decision-making process (scouts) is an increasing function of swarm size. We found that the ability of a swarm to choose the best of two nest sites decreases as swarm size increases when there is some time-lag between discovering the sites, consistent with Janson & Beekman (Janson & Beekman 2007 Proceedings of European Conference on Complex Systems, pp. 204-211.). However, when simulated swarms were faced with a realistic problem of choosing between many nest sites discoverable at all times, larger swarms were more accurate in their decisions than smaller swarms owing to their ability to discover nest sites more rapidly. Our experimental fieldwork showed that large swarms invest a larger number of scouts into the decision-making process than smaller swarms. Preliminary analysis of waggle dances from experimental swarms also suggested that large swarms could indeed discover and advertise nest sites at a faster rate than small swarms.

Do small swarms have an advantage when house hunting? The effect of swarm size on nest-site selection by Apis mellifera

PubMed Central

Schaerf, T. M.; Makinson, J. C.; Myerscough, M. R.; Beekman, M.

2013-01-01

Reproductive swarms of honeybees are faced with the problem of finding a good site to establish a new colony. We examined the potential effects of swarm size on the quality of nest-site choice through a combination of modelling and field experiments. We used an individual-based model to examine the effects of swarm size on decision accuracy under the assumption that the number of bees actively involved in the decision-making process (scouts) is an increasing function of swarm size. We found that the ability of a swarm to choose the best of two nest sites decreases as swarm size increases when there is some time-lag between discovering the sites, consistent with Janson & Beekman (Janson & Beekman 2007 Proceedings of European Conference on Complex Systems, pp. 204–211.). However, when simulated swarms were faced with a realistic problem of choosing between many nest sites discoverable at all times, larger swarms were more accurate in their decisions than smaller swarms owing to their ability to discover nest sites more rapidly. Our experimental fieldwork showed that large swarms invest a larger number of scouts into the decision-making process than smaller swarms. Preliminary analysis of waggle dances from experimental swarms also suggested that large swarms could indeed discover and advertise nest sites at a faster rate than small swarms. PMID:23904590

Reliability of Smartphone-Based Instant Messaging Application for Diagnosis, Classification, and Decision-making in Pediatric Orthopedic Trauma.

PubMed

Stahl, Ido; Katsman, Alexander; Zaidman, Michael; Keshet, Doron; Sigal, Amit; Eidelman, Mark

2017-07-11

Smartphones have the ability to capture and send images, and their use has become common in the emergency setting for transmitting radiographic images with the intent to consult an off-site specialist. Our objective was to evaluate the reliability of smartphone-based instant messaging applications for the evaluation of various pediatric limb traumas, as compared with the standard method of viewing images of a workstation-based picture archiving and communication system (PACS). X-ray images of 73 representative cases of pediatric limb trauma were captured and transmitted to 5 pediatric orthopedic surgeons by the Whatsapp instant messaging application on an iPhone 6 smartphone. Evaluators were asked to diagnose, classify, and determine the course of treatment for each case over their personal smartphones. Following a 4-week interval, revaluation was conducted using the PACS. Intraobserver agreement was calculated for overall agreement and per fracture site. The overall results indicate "near perfect agreement" between interpretations of the radiographs on smartphones compared with computer-based PACS, with κ of 0.84, 0.82, and 0.89 for diagnosis, classification, and treatment planning, respectively. Looking at the results per fracture site, we also found substantial to near perfect agreement. Smartphone-based instant messaging applications are reliable for evaluation of a wide range of pediatric limb fractures. This method of obtaining an expert opinion from the off-site specialist is immediately accessible and inexpensive, making smartphones a powerful tool for doctors in the emergency department, primary care clinics, or remote medical centers, enabling timely and appropriate treatment for the injured child. This method is not a substitution for evaluation of the images in the standard method over computer-based PACS, which should be performed before final decision-making.

Federated health information architecture: Enabling healthcare providers and policymakers to use data for decision-making.

PubMed

Kumar, Manish; Mostafa, Javed; Ramaswamy, Rohit

2018-05-01

Health information systems (HIS) in India, as in most other developing countries, support public health management but fail to enable healthcare providers to use data for delivering quality services. Such a failure is surprising, given that the population healthcare data that the system collects are aggregated from patient records. An important reason for this failure is that the health information architecture (HIA) of the HIS is designed primarily to serve the information needs of policymakers and program managers. India has recognised the architectural gaps in its HIS and proposes to develop an integrated HIA. An enabling HIA that attempts to balance the autonomy of local systems with the requirements of a centralised monitoring agency could meet the diverse information needs of various stakeholders. Given the lack of in-country knowledge and experience in designing such an HIA, this case study was undertaken to analyse HIS in the Bihar state of India and to understand whether it would enable healthcare providers, program managers and policymakers to use data for decision-making. Based on a literature review and data collected from interviews with key informants, this article proposes a federated HIA, which has the potential to improve HIS efficiency; provide flexibility for local innovation; cater to the diverse information needs of healthcare providers, program managers and policymakers; and encourage data-based decision-making.

Automated dredging and disposal alternatives management system (ADDAMS). Environmental effects of dredging. Technical note

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

NONE

This technical note describes the current capabilities and availability of the Automated Dredging and Disposal Alternatives Management System (ADDAMS). The technical note replaces the earlier Technical Note EEDP-06-12, which should be discarded. Planning, design, and management of dredging and dredged material disposal projects often require complex or tedious calculations or involve complex decision-making criteria. In addition, the evaluations often must be done for several disposal alternatives or disposal sites. ADDAMS is a personal computer (PC)-based system developed to assist in making such evaluations in a timely manner. ADDAMS contains a collection of computer programs (applications) designed to assist in managingmore » dredging projects. This technical note describes the system, currently available applications, mechanisms for acquiring and running the system, and provisions for revision and expansion.« less

Linguistic Multi-Attribute Group Decision Making with Risk Preferences and Its Use in Low-Carbon Tourism Destination Selection.

PubMed

Lin, Hui; Wang, Zhou-Jing

2017-09-17

Low-carbon tourism plays an important role in carbon emission reduction and environmental protection. Low-carbon tourism destination selection often involves multiple conflicting and incommensurate attributes or criteria and can be modelled as a multi-attribute decision-making problem. This paper develops a framework to solve multi-attribute group decision-making problems, where attribute evaluation values are provided as linguistic terms and the attribute weight information is incomplete. In order to obtain a group risk preference captured by a linguistic term set with triangular fuzzy semantic information, a nonlinear programming model is established on the basis of individual risk preferences. We first convert individual linguistic-term-based decision matrices to their respective triangular fuzzy decision matrices, which are then aggregated into a group triangular fuzzy decision matrix. Based on this group decision matrix and the incomplete attribute weight information, a linear program is developed to find an optimal attribute weight vector. A detailed procedure is devised for tackling linguistic multi-attribute group decision making problems. A low-carbon tourism destination selection case study is offered to illustrate how to use the developed group decision-making model in practice.

Linguistic Multi-Attribute Group Decision Making with Risk Preferences and Its Use in Low-Carbon Tourism Destination Selection

PubMed Central

Lin, Hui; Wang, Zhou-Jing

2017-01-01

Low-carbon tourism plays an important role in carbon emission reduction and environmental protection. Low-carbon tourism destination selection often involves multiple conflicting and incommensurate attributes or criteria and can be modelled as a multi-attribute decision-making problem. This paper develops a framework to solve multi-attribute group decision-making problems, where attribute evaluation values are provided as linguistic terms and the attribute weight information is incomplete. In order to obtain a group risk preference captured by a linguistic term set with triangular fuzzy semantic information, a nonlinear programming model is established on the basis of individual risk preferences. We first convert individual linguistic-term-based decision matrices to their respective triangular fuzzy decision matrices, which are then aggregated into a group triangular fuzzy decision matrix. Based on this group decision matrix and the incomplete attribute weight information, a linear program is developed to find an optimal attribute weight vector. A detailed procedure is devised for tackling linguistic multi-attribute group decision making problems. A low-carbon tourism destination selection case study is offered to illustrate how to use the developed group decision-making model in practice. PMID:28926985

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

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

Hiroyoshi Ueda; Katsuhiko Ishiguro; Kazumi Kitayama

2007-07-01

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

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

PubMed Central

Heidari, Mohammad; Shahbazi, Sara

2016-01-01

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

Decision-making in honeybee swarms based on quality and distance information of candidate nest sites.

PubMed

Laomettachit, Teeraphan; Termsaithong, Teerasit; Sae-Tang, Anuwat; Duangphakdee, Orawan

2015-01-07

In the nest-site selection process of honeybee swarms, an individual bee performs a waggle dance to communicate information about direction, quality, and distance of a discovered site to other bees at the swarm. Initially, different groups of bees dance to represent different potential sites, but eventually the swarm usually reaches an agreement for only one site. Here, we model the nest-site selection process in honeybee swarms of Apis mellifera and show how the swarms make adaptive decisions based on a trade-off between the quality and distance to candidate nest sites. We use bifurcation analysis and stochastic simulations to reveal that the swarm's site distance preference is moderate>near>far when the swarms choose between low quality sites. However, the distance preference becomes near>moderate>far when the swarms choose between high quality sites. Our simulations also indicate that swarms with large population size prefer nearer sites and, in addition, are more adaptive at making decisions based on available information compared to swarms with smaller population size. Copyright © 2014 Elsevier Ltd. All rights reserved.

Natural Capital Management: An Evolutionary Paradigm for Sustainable Restoration Investment - 13455

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

Koetz, Maureen T.

2013-07-01

Unlike other forms of capital assets (built infrastructure, labor, financial capital), the supply of usable or accessible air, land, and water elements (termed Natural Capital Assets or NCA) available to enterprise processes is structurally shrinking due to increased demand and regulatory restriction. This supply/demand imbalance is affecting all forms of public and private enterprise (including Federal Facilities) in the form of encroachment, production limits, cost increases, and reduced competitiveness. Department of Energy (DOE) sites are comprised of significant stocks of NCA that function as both conserved capital (providing ecosystem services and other reserve capacity), and as natural infrastructure (supporting majormore » Federal enterprise programs). The current rubric of 'Environmental Stewardship' provides an unduly constrained management paradigm that is focused largely on compliance process metrics, and lacks a value platform for quantifying, documenting, and sustainably re-deploying re-capitalized natural asset capacity and capability. By adopting value-based system concepts similar to built infrastructure accounting and information management, 'stewarded' natural assets relegated to liability- or compliance-focused outcomes become 're-capitalized' operational assets able to support new or expanded mission. This growing need for new accounting and management paradigms to capture natural capital value is achieving global recognition, most recently by the United Nations, world leaders, and international corporations at the Rio+20 Summit in June of 2012. Natural Capital Asset Management (NCAM){sup TM} is such an accounting framework tool. Using a quantification-based design, NCAM{sup TM} provides inventory, capacity and value data to owners or managers of natural assets such as the DOE that parallel comparable information systems currently used for facility assets. Applied to Environmental Management (EM) and other DOE program activities, the natural asset capacity and value generated by EM projects and other investment and operational programming can be recorded and then allocated to mission and/or ecosystem needs as part of overall site, complex, and Federal decision-making. NCAM{sup TM} can also document post-restoration asset capability and value for use in weighing loss mitigation and ecosystem damage claims arising from past operational activities. A prototype NCAM{sup TM} evaluation developed at the Savannah River Site (SRS) demonstrates use of this framework as an advanced paradigm for NCA accounting and decision-making for the larger DOE complex and other enterprise using natural capital in operations. Applying a quantified value paradigm, the framework catalogues the results of activities that sustain, restore, and modernize natural assets for enterprise-wide value beyond that of compliance milestones. Capturing and assigning recapitalization value using NCAM{sup TM} concepts and tools improves effective reuse of taxpayer-sustained assets, records ecosystem service value, enables mission and enterprise optimization, and assures the sustainability of shared natural capital assets in regional pools vital to both complex sites and local and regional economies. (authors)« less

Cleaning up contaminated wood-treating sites. Background paper

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

NONE

This report identifies technologies available for organic hazardous waste cleanup at woodtreating sites throughout the country. OTA has identified a range of such technologies that have been selected in the past and could be applied to other sites in the future. The applicability of a technology to a particular Superfund site has to be based on many site-specific factors. Nevertheless, it is clear that a number of the approaches identified by OTA may be appropriate and could prove useful if more detailed site-specific studies and tests were done. Although this study focused on the Texarkana site, decisionmakers and the publicmore » could benefit from this analysis in selecting future cleanup strategies for other sites.« less

Involving Teachers in Charter School Governance: A Guide for State Policymakers

ERIC Educational Resources Information Center

Sam, Cecilia

2008-01-01

This guide for state policymakers examines teacher involvement in charter school governance. Teacher involvement is defined to include the gamut of decision-making roles not typically afforded teachers in traditional public schools, including founding schools, serving on governing boards, and engaging in site-based collective bargaining. Different…

The use of video-based patient education for shared decision-making in the treatment of prostate cancer.

PubMed

Gomella, L G; Albertsen, P C; Benson, M C; Forman, J D; Soloway, M S

2000-08-01

Increased consumerism, patient empowerment, and autonomy are creating a health care revolution. In recent years, the public has become better informed and more sophisticated. An extraordinary amount of treatment advice from books, the media, and the Internet is available to patients today, although much of it is confusing or conflicting. Consequently, the traditional, paternalistic doctor-patient relationship is yielding to a more consumerist one. The new dynamic is based on a participatory ethic and a change in the balance of power. This shared decision-making creates a true partnership between professionals and patients, in which each contributes equally to decisions about treatment or care. Evidence suggests that in diseases such as prostate cancer, where there may be a number of appropriate treatment options for a particular patient, shared decision-making may lead to improved clinical and quality-of-life outcomes. This article explores the evolving relationship between the physician and patient, the pros and cons of shared decision-making, and the use of video technology in the clinical setting. The authors review the use of medical decision aids, including a video-based educational program called CHOICES, in the treatment of prostate cancer and other diseases.

Improving Medical Students' Application of Knowledge and Clinical Decision-Making Through a Porcine-Based Integrated Cardiac Basic Science Program.

PubMed

Stott, Martyn Charles; Gooseman, Michael Richard; Briffa, Norman Paul

2016-01-01

Despite the concerted effort of modern undergraduate curriculum designers, the ability to integrate basic sciences in clinical rotations is an ongoing problem in medical education. Students and newly qualified doctors themselves report worry about the effect this has on their clinical performance. There are examples in the literature to support development of attempts at integrating such aspects, but this "vertical integration" has proven to be difficult. We designed an expert-led integrated program using dissection of porcine hearts to improve the use of cardiac basic sciences in clinical medical students' decision-making processes. To our knowledge, this is the first time in the United Kingdom that an animal model has been used to teach undergraduate clinical anatomy to medical students to direct wider application of knowledge. Action research methodology was used to evaluate the local curriculum and assess learners needs, and the agreed teaching outcomes, methods, and delivery outline were established. A total of 18 students in the clinical years of their degree program attended, completing precourse and postcourse multichoice questions examinations and questionnaires to assess learners' development. Student's knowledge scores improved by 17.5% (p = 0.01; students t-test). Students also felt more confident at applying underlying knowledge to decision-making and diagnosis in clinical medicine. An expert teacher (consultant surgeon) was seen as beneficial to students' understanding and appreciation. This study outlines how the development of a teaching intervention using porcine-based methods successfully improved both student's knowledge and application of cardiac basic sciences. We recommend that clinicians fully engage with integrating previously learnt underlying sciences to aid students in developing decision-making and diagnostic skills as well as a deeper approach to learning. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Site action, environmental justice and an urban community: A unique approach at a Superfund site

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

Seppi, P.K.; Richman, L.R.; Wireman, J.M.

1994-12-31

The US Environmental Protection Agency`s (EPA) project at the Diamond Alkali Superfund Site is an example of how technical, environmental justice, and community relations issues all affect actions at a Superfund Site. The Diamond Alkali Superfund Site is divided into two operable units. The site consists of the former pesticides manufacturing facility at 80 and 120 Lister Avenue in Newark, New Jersey, and the adjoining six mile reach of the Passaic River known as the ``Passaic River Study Area``. EPA has negotiated Consent Orders with the Potentially Responsible Party (PRP) to design and construct the selected containment remedy at themore » land-based properties, and to conduct the Remedial Investigation (RI) of the river under EPA oversight. Pesticides, dioxin, polychlorinated biphenyls (PCBs), metals and other hazardous substances have been found at the Site. Evidence indicates that the ecology of the Passaic River has been adversely impacted by the presence of these hazardous substances. The State of New Jersey issued a ban on the consumption of fish and crabs from affected sections of the Passaic River; yet reportedly, many residents still consume seafood from the river. Community relations at the Site had deteriorated because of the community`s lack of trust and loss of confidence in EPA. To address these issues, EPA has implemented an innovative public outreach program to improve how it communicates with racial minority and low-income communities living in the vicinity of the Site, and to involve them in the decision-making process.« less

Strategic analytics: towards fully embedding evidence in healthcare decision-making.

PubMed

Garay, Jason; Cartagena, Rosario; Esensoy, Ali Vahit; Handa, Kiren; Kane, Eli; Kaw, Neal; Sadat, Somayeh

2015-01-01

Cancer Care Ontario (CCO) has implemented multiple information technology solutions and collected health-system data to support its programs. There is now an opportunity to leverage these data and perform advanced end-to-end analytics that inform decisions around improving health-system performance. In 2014, CCO engaged in an extensive assessment of its current data capacity and capability, with the intent to drive increased use of data for evidence-based decision-making. The breadth and volume of data at CCO uniquely places the organization to contribute to not only system-wide operational reporting, but more advanced modelling of current and future state system management and planning. In 2012, CCO established a strategic analytics practice to assist the agency's programs contextualize and inform key business decisions and to provide support through innovative predictive analytics solutions. This paper describes the organizational structure, services and supporting operations that have enabled progress to date, and discusses the next steps towards the vision of embedding evidence fully into healthcare decision-making. Copyright © 2014 Longwoods Publishing.

Error affect inoculation for a complex decision-making task.

PubMed

Tabernero, Carmen; Wood, Robert E

2009-05-01

Individuals bring knowledge, implicit theories, and goal orientations to group meetings. Group decisions arise out of the exchange of these orientations. This research explores how a trainee's exploratory and deliberate process (an incremental theory and learning goal orientation) impacts the effectiveness of individual and group decision-making processes. The effectiveness of this training program is compared with another program that included error affect inoculation (EAI). Subjects were 40 Spanish Policemen in a training course. They were distributed in two training conditions for an individual and group decision-making task. In one condition, individuals received the Self-Guided Exploration plus Deliberation Process instructions, which emphasised exploring the options and testing hypotheses. In the other condition, individuals also received instructions based on Error Affect Inoculation (EAI), which emphasised positive affective reactions to errors and mistakes when making decisions. Results show that the quality of decisions increases when the groups share their reasoning. The AIE intervention promotes sharing information, flexible initial viewpoints, and improving the quality of group decisions. Implications and future directions are discussed.

A multicriteria-based methodology for site prioritisation in sediment management.

PubMed

Alvarez-Guerra, Manuel; Viguri, Javier R; Voulvoulis, Nikolaos

2009-08-01

Decision-making for sediment management is a complex task that incorporates the selections of areas for remediation and the assessment of options for any mitigation required. The application of Multicriteria Analysis (MCA) to rank different areas, according to their need for sediment management, provides a great opportunity for prioritisation, a first step in an integrated methodology that finally aims to assess and select suitable alternatives for managing the identified priority sites. This paper develops a methodology that starts with the delimitation of management units within areas of study, followed by the application of MCA methods that allows ranking of these management units, according to their need for remediation. This proposed process considers not only scientific evidence on sediment quality, but also other relevant aspects such as social and economic criteria associated with such decisions. This methodology is illustrated with its application to the case study area of the Bay of Santander, in northern Spain, highlighting some of the implications of utilising different MCA methods in the process. It also uses site-specific data to assess the subjectivity in the decision-making process, mainly reflected through the assignment of the criteria weights and uncertainties in the criteria scores. Analysis of the sensitivity of the results to these factors is used as a way to assess the stability and robustness of the ranking as a first step of the sediment management decision-making process.

Medical Decision-Making Among Adolescents with Neonatal Brachial Plexus Palsy and their Families: A Qualitative Study

PubMed Central

Squitieri, Lee; Larson, Bradley P.; Chang, Kate W-C; Yang, Lynda J-S.; Chung, Kevin C.

2016-01-01

Background Elective surgical management of neonatal brachial plexus palsy is complex, variable, and often individualized. Little is known about the medical decision-making process among adolescents with NBPP and their families faced with making complex treatment decisions. The experiences of these patients and their parents were analyzed to identify key factors in the decision-making process. Patients and Methods Eighteen adolescents with residual NBPP deficits between the ages of 10 to 17 years along with their parents were included in the present study. A qualitative research design was employed involving the use of separate one hour, in person, semi-structured interviews, which were audio recorded and transcribed. Grounded theory was applied by two independent members of the research team to identify recurrent themes and ultimately create a codebook that was then applied to the data. Results Medical decision-making among adolescents with NBPP and their families is multifaceted and individualized, comprised of both patient and system dependent factors. Four codes pertaining to the medical decision-making process were identified: 1) knowledge acquisition, 2) multidisciplinary care, 3) adolescent autonomy, and 4) patient expectations and treatment desires. Overall, parental decision-making was heavily influenced by system dependent factors, while adolescents largely based their medical decision-making on individual treatment desires to improve function and/or aesthetics. Conclusions There are many areas for improving the delivery of information and health care organization among adolescents with NBPP and their families. We recommend the development of educational interdisciplinary programs and decision aids containing evidence-based management guidelines targeted toward primary care providers and patients. We believe that a computer-based learning module may provide the best avenue to achieve maximum penetrance and convenience of information sharing. PMID:23714810

Improving the Use of Data in Early Reading Intervention Programs in Northwest Florida

ERIC Educational Resources Information Center

Thompson, Carla J.

2012-01-01

Improving student performance for high-need student populations by improving the use of data in decision-making for early reading intervention programs in northwest Florida is the focus of this research to practice effort. The study is conceptually based on using a relational-feedback intervention (RFI) database model in early learning…

Building a co-created citizen science program with gardeners neighboring a superfund site: The Gardenroots case study

PubMed Central

Ramirez-Andreotta, Monica D; Brusseau, Mark L; Artiola, Janick; Maier, Raina M; Gandolfi, A Jay

2014-01-01

A research project that is only expert-driven may ignore the role of local knowledge in research, give low priority to the development of a comprehensive communication strategy to engage the community, and may not deliver the results of the study to the community in an effective way. Objective To demonstrate how a research program can respond to a community research need, establish a community-academic partnership, and build a co-created citizen science program. Methods A place-based, community-driven project was designed where academics and community members maintained a reciprocal dialogue, and together, we: 1) defined the question for study, 2) gathered information, 3) developed hypotheses, 3) designed data collection methodologies, 4) collected environmental samples (soil, irrigation water, and vegetables), 5) interpreted data, 6) disseminated results and translated results into action, and 7) discussed results and asked new questions. Results The co-created environmental research project produced new data and addressed an additional exposure route (consumption of vegetables grown in soils with elevated arsenic levels). Public participation in scientific research improved environmental health assessment, information transfer, and risk communication efforts. Furthermore, incorporating the community in the scientific process produced both individual learning outcomes and community-level outcomes. Conclusions This approach illustrates the benefits of a community-academic co-created citizen-science program in addressing the complex problems that arise in communities neighboring a contaminated site. Such a project can increase the community's involvement in risk communication and decision-making, which ultimately has the potential to help mitigate exposure and thereby reduce associated risk. PMID:25954473

Building a co-created citizen science program with gardeners neighboring a superfund site: The Gardenroots case study.

PubMed

Ramirez-Andreotta, Monica D; Brusseau, Mark L; Artiola, Janick; Maier, Raina M; Gandolfi, A Jay

2015-01-01

A research project that is only expert-driven may ignore the role of local knowledge in research, give low priority to the development of a comprehensive communication strategy to engage the community, and may not deliver the results of the study to the community in an effective way. To demonstrate how a research program can respond to a community research need, establish a community-academic partnership, and build a co-created citizen science program. A place-based, community-driven project was designed where academics and community members maintained a reciprocal dialogue, and together, we: 1) defined the question for study, 2) gathered information, 3) developed hypotheses, 3) designed data collection methodologies, 4) collected environmental samples (soil, irrigation water, and vegetables), 5) interpreted data, 6) disseminated results and translated results into action, and 7) discussed results and asked new questions. The co-created environmental research project produced new data and addressed an additional exposure route (consumption of vegetables grown in soils with elevated arsenic levels). Public participation in scientific research improved environmental health assessment, information transfer, and risk communication efforts. Furthermore, incorporating the community in the scientific process produced both individual learning outcomes and community-level outcomes. This approach illustrates the benefits of a community-academic co-created citizen-science program in addressing the complex problems that arise in communities neighboring a contaminated site. Such a project can increase the community's involvement in risk communication and decision-making, which ultimately has the potential to help mitigate exposure and thereby reduce associated risk.

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana

PubMed Central

Challa, Sneha; Manu, Abubakar; Morhe, Emmanuel; Dalton, Vanessa K.; Loll, Dana; Dozier, Jessica; Zochowski, Melissa K.; Boakye, Andrew; Adanu, Richard; Hall, Kelli Stidham

2018-01-01

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15–24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women’s SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH. PMID:28296626

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana.

PubMed

Challa, Sneha; Manu, Abubakar; Morhe, Emmanuel; Dalton, Vanessa K; Loll, Dana; Dozier, Jessica; Zochowski, Melissa K; Boakye, Andrew; Adanu, Richard; Hall, Kelli Stidham

2018-04-01

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15-24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women's SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH.

Development of Integrated Information System for Travel Bureau Company

NASA Astrophysics Data System (ADS)

Karma, I. G. M.; Susanti, J.

2018-01-01

Related to the effectiveness of decision-making by the management of travel bureau company, especially by managers, information serves frequent delays or incomplete. Although already computer-assisted, the existing application-based is used only handle one particular activity only, not integrated. This research is intended to produce an integrated information system that handles the overall operational activities of the company. By applying the object-oriented system development approach, the system is built with Visual Basic. Net programming language and MySQL database package. The result is a system that consists of 4 (four) separated program packages, including Reservation System, AR System, AP System and Accounting System. Based on the output, we can conclude that this system is able to produce integrated information that related to the problem of reservation, operational and financial those produce up-to-date information in order to support operational activities and decisionmaking process by related parties.

Nicotine replacement therapy decision based on fuzzy multi-criteria analysis

NASA Astrophysics Data System (ADS)

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

2017-08-01

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

Treatment Retention Among Patients Participating in Coordinated Specialty Care for First-Episode Psychosis: a Mixed-Methods Analysis.

PubMed

Hamilton, Jane E; Srivastava, Devika; Womack, Danica; Brown, Ashlie; Schulz, Brian; Macakanja, April; Walker, April; Wu, Mon-Ju; Williamson, Mark; Cho, Raymond Y

2018-06-05

Young adults experiencing first-episode psychosis have historically been difficult to retain in mental health treatment. Communities across the United States are implementing Coordinated Specialty Care to improve outcomes for individuals experiencing first-episode psychosis. This mixed-methods research study examined the relationship between program services and treatment retention, operationalized as the likelihood of remaining in the program for 9 months or more. In the adjusted analysis, male gender and participation in home-based cognitive behavioral therapy were associated with an increased likelihood of remaining in treatment. The key informant interview findings suggest the shared decision-making process and the breadth, flexibility, and focus on functional recovery of the home-based cognitive behavioral therapy intervention may have positively influenced treatment retention. These findings suggest the use of shared decision-making and improved access to home-based cognitive behavioral therapy for first-episode psychosis patients may improve outcomes for this vulnerable population.

Moral distress in rehabilitation professionals: results from a hospital ethics survey.

PubMed

Mukherjee, Debjani; Brashler, Rebecca; Savage, Teresa A; Kirschner, Kristi L

2009-05-01

Moral distress in the rehabilitation setting was examined in a follow-up survey. The survey had 3 goals: (1) to systematically and anonymously gather data about the ethical issues that employees struggle with in their daily work; (2) to raise the visibility of the hospital-based ethics program and resources available to employees; and (3) to prioritize and focus the direction of the program's educational seminars, quality improvement projects, and ethics consultation. Online survey of employees. Urban rehabilitation system of care. The survey was open to all employees; 207 completed the survey. N/A MAIN OUTCOME MEASUREMENTS: N/A CONCLUSIONS: Three broad categories of moral distress were identified: institutional ethics, professional practice, and clinical decision-making. Institutional ethics issues related to the health care environment, such as health care reimbursement pressures and corporate culture. Professional practice issues involved codes of behavior and concepts of professionalism, including patient confidentiality/privacy. Clinical decision-making included such practical dilemmas as conflicts around goal-setting, discharge planning, and assessment of decision-making capacity. An anonymous survey of staff members allowed the hospital ethics program to identify sources of moral distress and prioritize strategies to address them.

Site Management. An Analysis of the Concepts and Fundamental Operational Components Associated with the Delegation of Decision-Making Authority and Control of Resources to the School-Site Level in the California Public School System.

ERIC Educational Resources Information Center

Decker, Erwin A.; And Others

The pros and cons of decentralization of decision-making authority to the school-site level as a public school management technique are intended to serve as an informational summary for the members of the California State Board of Education, and as a resource for school district governing boards and district administrators to use to determine the…

Evidence-Based Decision-Making as a Practice-Based Learning Skill: A Pilot Study

ERIC Educational Resources Information Center

Falzer, Paul R.; Garman, Melissa

2012-01-01

Objectives: As physicians are being trained to adapt their practices to the needs and experience of patients, initiatives to standardize care have been gaining momentum. The resulting conflict can be addressed through a practice-based learning and improvement (PBL) program that develops competency in using treatment guidelines as decision aids and…

When should I attempt my centrally administered summative assessments in the RANZCP competency-based training program?

PubMed

Kealy-Bateman, Warren; Kotze, Beth; Lampe, Lisa

2016-12-01

To provide information relevant to decision-making around the timing of attempting the centrally administered summative assessments in the Royal Australian and New Zealand College of Psychiatrists (RANZCP) 2012 Fellowship Program. We consider the new Competency-Based Fellowship Program of the RANZCP and its underlying philosophy, the trainee trajectory within the program and the role of the supervisor. The relationship between workplace-based and external assessments is discussed. The timing of attempting centrally administered summative assessments is considered within the pedagogical framework of medical competencies development. Although successful completion of all the centrally administered summative assessments requires demonstration of a junior consultant standard of competency, the timing at which this standard will most commonly be achieved is likely to vary from assessment to assessment. There are disadvantages attendant upon prematurely attempting assessments, and trainees are advised to carefully consider the requirements of each assessment and match this against their current level of knowledge and skills. Trainees and supervisors need to be clear about the competencies required for each of the external assessments and match this against the trainee's current competencies to assist in decision-making about the timing of assessments and planning for future learning. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Site Remediation Technology InfoBase: A Guide to Federal Programs, Information Resources, and Publications on Contaminated Site Cleanup Technologies. First Edition

NASA Technical Reports Server (NTRS)

1998-01-01

Table of Contents: Federal Cleanup Programs; Federal Site Remediation Technology Development Assistance Programs; Federal Site Remediation Technology Development Electronic Data Bases; Federal Electronic Resources for Site Remediation Technology Information; Other Electronic Resources for Site Remediation Technology Information; Other Electronic Resources for Site Remediation Technology Information; Selected Bibliography: Federal Publication on Alternative and Innovative Site Remediation; and Appendix: Technology Program Contacts.

GUIDED TOUR OF A WEB-BASED ENVIRONMENTAL DECISION TOOLKIT

EPA Science Inventory

Decision-making regarding the targeting of vulnerable resources and prioritization of actions requires synthesis of data on condition, vulnerability, and feasibility of risk management alternatives. EP A's Regional Vulnerability Assessment (ReV A) Program has evaluated existing a...

Technical approach to groundwater restoration. Final report

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

Not Available

1993-11-01

The Technical Approach to Groundwater Restoration (TAGR) provides general technical guidance to implement the groundwater restoration phase of the Uranium Mill Tailings Remedial Action (UMTRA) Project. The TAGR includes a brief overview of the surface remediation and groundwater restoration phases of the UMTRA Project and describes the regulatory requirements, the National Environmental Policy Act (NEPA) process, and regulatory compliance. A section on program strategy discusses program optimization, the role of risk assessment, the observational approach, strategies for meeting groundwater cleanup standards, and remedial action decision-making. A section on data requirements for groundwater restoration evaluates the data quality objectives (DQO) andmore » minimum data required to implement the options and comply with the standards. A section on sits implementation explores the development of a conceptual site model, approaches to site characterization, development of remedial action alternatives, selection of the groundwater restoration method, and remedial design and implementation in the context of site-specific documentation in the site observational work plan (SOWP) and the remedial action plan (RAP). Finally, the TAGR elaborates on groundwater monitoring necessary to evaluate compliance with the groundwater cleanup standards and protection of human health and the environment, and outlines licensing procedures.« less

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes.

PubMed

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-03-06

Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care) perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Long-term Monitoring Program Optimization for Chlorinated Volatile Organic Compound Plume, Naval Air Station Brunswick, Maine

NASA Astrophysics Data System (ADS)

Calderone, G. M.

2006-12-01

A long-term monitoring program was initiated in 1995 at 6 sites at NAS Brunswick, including 3 National Priorities List (Superfund) sites. Primary contaminants of concern include chlorinated volatile organic compounds, including tetrachloroethane, trichloroethene, and vinyl chloride, in addition to metals. More than 80 submersible pumping systems were installed to facilitate sample collection utilizing the low-flow sampling technique. Long-term monitoring of the groundwater is conducted to assess the effectiveness of remedial measures, and monitor changes in contaminant concentrations in the Eastern Plume Operable Unit. Long-term monitoring program activities include quarterly groundwater sampling and analysis at more than 90 wells across 6 sites; surface water, sediment, seep, and leachate sampling and analysis at 3 sites; landfill gas monitoring; well maintenance; engineering inspections of landfill covers and other sites or evidence of stressed vegetation; water level gauging; and treatment plant sampling and analysis. Significant cost savings were achieved by optimizing the sampling network and reducing sampling frequency from quarterly to semi- annual or annual sampling. As part of an ongoing optimization effort, a geostatistical assessment of the Eastern Plume was conducted at the Naval Air Station, Brunswick, Maine. The geostatistical assessment used 40 monitoring points and analytical data collected over 3 years. For this geostatistical assessment, EA developed and utilized a database of analytical results generated during 3 years of long-term monitoring which was linked to a Geographic Information System to enhance data visualization capacity. The Geographic Information System included themes for groundwater volatile organic compound concentration, groundwater flow directions, shallow and deep wells, and immediate access to point-specific analytical results. This statistical analysis has been used by the site decision-maker and its conclusions supported a significant reduction in the Long-Term Monitoring Program.

Who Defines "Democratic Leadership?": Three High School Principals Respond to Site-Based Reforms.

ERIC Educational Resources Information Center

Brouillette, Liane

1997-01-01

Focuses on behaviors and activities of three high school principals as they respond to district's decision to implement a shared decision-making model designed to give teachers and parents a larger voice. Describes these administrators' varying responses, along with varied ways democratic leadership was multilaterally defined in each school by…

On-the-Spot Problem Solving of Airline Professionals: A Case Study of Sky Business School Personnel Training Program

ERIC Educational Resources Information Center

Nara, Jun

2010-01-01

This research explores how chief cabin crew members of major airlines made their decisions on-the-spot when they had unexpected problems. This research also presents some insights that may improve personnel training programs for future stewardesses and stewards based on the investigation of their decision-making styles. The theoretical framework…

A Simulation Based Methodology to Examine the B-1B’s AN/ALQ-161 Maintenance Process

DTIC Science & Technology

2010-03-01

Paper, 2001). “The Air Force does not think of, or advertise , bombers as interchangeable. The B-1, B-2 and B-52 all have a specific mission area and...Path Modeling ( CPM ), Goal Programming, EOQ, Nonlinear Programming Predictive Models unknown, ill-defined known or under the decision-maker’s

A Simulation Based Methodology to Examine the B-1B’s AN/ALQ-161 Maintenance Process

DTIC Science & Technology

2010-03-01

2001). “The Air Force does not think of, or advertise , bombers as interchangeable. The B-1, B-2 and B-52 all have a specific mission area and 2...Modeling ( CPM ), Goal Programming, EOQ, Nonlinear Programming Predictive Models unknown, ill-defined known or under the decision-maker’s control

Teachers' Delivery Skills and Substance Use Prevention Program Outcomes: The Moderating Role of Students' Need for Cognition and Impulse Decision Making

ERIC Educational Resources Information Center

Giles, Steven M.; Pankratz, Melinda M.; Ringwalt, Christopher; Hansen, William B.; Dusenbury, Linda; Jackson-Newsom, Julia

2010-01-01

The purpose of this study was to extend the literature in both substance use implementation and persuasive health communication by examining the extent to which students' need for cognition and impulsive decision-making moderated the relationship between teachers' classroom communication behavior and program outcomes in an evidence-based middle…

Variability in individual assessment behaviour and its implications for collective decision-making.

PubMed

O'Shea-Wheller, Thomas A; Masuda, Naoki; Sendova-Franks, Ana B; Franks, Nigel R

2017-02-08

Self-organized systems of collective behaviour have been demonstrated in a number of group-living organisms. There is, however, less research relating to how variation in individual assessments may facilitate group decision-making. Here, we investigate this using the decentralized system of collective nest choice behaviour employed by the ant Temnothorax albipennis, combining experimental results with computational modelling. In experiments, isolated workers of this species were allowed to investigate new nest sites of differing quality, and it was found that for any given nest quality, there was wide variation among individuals in the durations that they spent within each nest site. Additionally, individual workers were consistent in spending more time in nest sites of higher quality, and less time in those of lower quality. Hence, the time spent in a new nest site must have included an assessment of nest quality. As nest site visit durations (henceforth termed assessment durations) are linked to recruitment, it is possible that the variability we observed may influence the collective decision-making process of colonies. Thus, we explored this further using a computational model of nest site selection, and found that heterogeneous nest assessments conferred a number of potential benefits. Furthermore, our experiments showed that nest quality assessments were flexible, being influenced by experience of prior options. Our findings help to elucidate the potential mechanisms underlying group behaviour, and highlight the importance of heterogeneity among individuals, rather than precise calibration, in shaping collective decision-making. © 2017 The Author(s).

Toward a Concept of Operations for Aviation Weather Information Implementation in the Evolving National Airspace System

NASA Technical Reports Server (NTRS)

McAdaragh, Raymon M.

2002-01-01

The capacity of the National Airspace System is being stressed due to the limits of current technologies. Because of this, the FAA and NASA are working to develop new technologies to increase the system's capacity which enhancing safety. Adverse weather has been determined to be a major factor in aircraft accidents and fatalities and the FAA and NASA have developed programs to improve aviation weather information technologies and communications for system users The Aviation Weather Information Element of the Weather Accident Prevention Project of NASA's Aviation Safety Program is currently working to develop these technologies in coordination with the FAA and industry. This paper sets forth a theoretical approach to implement these new technologies while addressing the National Airspace System (NAS) as an evolving system with Weather Information as one of its subSystems. With this approach in place, system users will be able to acquire the type of weather information that is needed based upon the type of decision-making situation and condition that is encountered. The theoretical approach addressed in this paper takes the form of a model for weather information implementation. This model addresses the use of weather information in three decision-making situations, based upon the system user's operational perspective. The model also addresses two decision-making conditions, which are based upon the need for collaboration due to the level of support offered by the weather information provided by each new product or technology. The model is proposed for use in weather information implementation in order to provide a systems approach to the NAS. Enhancements to the NAS collaborative decision-making capabilities are also suggested.

Restoring public trust while tearing down site in rural Ohio

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

Schneider, Jerry; Wagner, Jeffrey; Connell, Judy

2007-07-01

In the mid-1980's, the impact of three decades of uranium processing near rural Fernald, Ohio, 18 miles northwest of Cincinnati, became the centre of national public controversy. When a series of incidents at the uranium foundry brought to light the years of contamination to the environment and surrounding farmland communities, local citizens' groups united and demanded a role in determining the plans for cleaning up the site. One citizens' group, Fernald Residents for Environmental Safety and Health (FRESH), formed in 1984 following reports that nearly 300 pounds of enriched uranium oxide had been released from a dust-collector system, and threemore » off-property wells south of the site were contaminated with uranium. For 22 years, FRESH monitored activities at Fernald and participated in the decision-making process with management and regulators. The job of FRESH ended on 19 January this year when the Fernald Site was declared clean of all nuclear contamination and open to public access. It marked the end of a remarkable turnaround in public confidence and trust that had attracted critical reports from around the world. When personnel from Fluor arrived in 1992, the management team thought it understood the issues and concerns of each stakeholder group, and was determined to implement the decommissioning scope of work aggressively, confident that stakeholders would agree with its plans. This approach resulted in strained relationships with opinion leaders during the early months of Fluor's contract. To forge better relationships, the U.S. Department of Energy (DOE) who owns the site, and Fluor embarked on three new strategies based on engaging citizens and interested stakeholder groups in the decision-making process. The first strategy was opening communication channels with site leadership, technical staff, and regulators. This strategy combined a strong public-information program with two-way communications between management and the community, soliciting and encouraging stakeholder participation early in the decision-making process. Fluor's public-participation strategy exceeded the 'check-the-box' approach common within the nuclear-weapons complex, and set a national standard that stands alone today. The second stakeholder-engagement strategy sprang from mending fences with the regulators and the community. The approach for disposing low-level waste was a 25-year plan to ship it off the site. Working with stakeholders, DOE and Fluor were able to convince the community to accept a plan to safely store waste permanently on site, which would save 15 years of cleanup and millions of dollars in cost. The third strategy addressed the potentially long delays in finalizing remedial action plans due to formal public comment periods and State and Federal regulatory approvals. Working closely with the U.S. and Ohio Environmental Protection Agencies (EPA) and other stakeholders, DOE and Fluor were able to secure approvals of five Records of Decision on time - a first for the DOE complex. Developing open and honest relationships with union leaders, the workforce, regulators and community groups played a major role in DOE and Fluor cleaning up and closing the site. Using lessons learned at Fernald, DOE was able to resolve challenges at other sites, including worker transition, labour disputes, and damaged relationships with regulators and the community. It took significant time early in the project to convince the workforce that their future lay in cleanup, not in holding out hope for production to resume. It took more time to repair relationships with Ohio regulators and the local community. Developing these relationships over the years required constant, open communications between site decision makers and stakeholders to identify issues and to overcome potential barriers. Fluor's open public-participation strategy resulted in stakeholder consensus of five remedial-action plans that directed Fernald cleanup. This strategy included establishing a public-participation program that emphasized a shared-decision making process and abandoned the government's traditional, non-participatory 'Decide, Announce, Defend' approach. Fernald's program became a model within the DOE complex for effective public participation. Fluor led the formation of the first DOE site-specific advisory board dedicated to remediation and closure. The board was successful at building consensus on critical issues affecting long-term site remediation, such as cleanup levels, waste disposal and final land use. Fluor created innovative public outreach tools, such as 'Cleanopoly', based on the Monopoly game, to help illustrate complex concepts, including risk levels, remediation techniques, and associated costs. These innovative tools helped DOE and Fluor gain stakeholder consensus on all cleanup plans. To commemorate the outstanding commitment of Fernald stakeholders to this massive environmental-restoration project, Fluor donated $20,000 to build the Weapons to Wetlands Grove overlooking the former 136-acre production area. The grove contains 24 trees, each dedicated to '[a] leader(s) behind the Fernald cleanup'. Over the years, Fluor, through the Fluor Foundation, also invested in educational and humanitarian projects, contributing nearly $2 million to communities in southwestern Ohio, Kentucky and Indiana. Further, to help offset the economic impact of the site's closing to the community, DOE and Fluor promoted economic development in the region by donating excess equipment and property to local schools and townships. This paper discusses the details of the public-involvement program - from inception through maturity - and presents some lessons learned that can be applied to other similar projects. (authors)« less

Enhancing Decision-Making in STSE Education by Inducing Reflection and Self-Regulated Learning

NASA Astrophysics Data System (ADS)

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2017-02-01

Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students' decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on the decision-making processes of others, enhances decision-making competence. In addition, this study examines whether this process is supported by elements of self-regulated learning, i.e., self-reflection regarding one's own performance and the setting of goals for subsequent tasks. A computer-based training program which involves the resolution of socioscientific issues related to sustainable development was developed in two versions: with and without elements of self-regulated learning. Its effects on decision-making competence were analyzed using a pre test-post test follow-up control-group design ( N = 242 high school students). Decision-making competence was assessed using an open-ended questionnaire that focused on three facets: consideration of advantages and disadvantages, metadecision aspects, and reflection on the decision-making processes of others. The findings suggest that students in both training groups incorporated aspects of metadecision into their statements more often than students in the control group. Furthermore, both training groups were more successful in reflecting on the decision-making processes of others. The students who received additional training in self-regulated learning showed greater benefits in terms of metadecision aspects and reflection, and these effects remained significant two months later. Overall, our findings demonstrate that the application of decision-making strategies, combined with reflections on the decision-making process and elements of self-regulated learning, is a fruitful approach in STSE education.

Test and Evaluation Metrics of Crew Decision-Making And Aircraft Attitude and Energy State Awareness

NASA Technical Reports Server (NTRS)

Bailey, Randall E.; Ellis, Kyle K. E.; Stephens, Chad L.

2013-01-01

NASA has established a technical challenge, under the Aviation Safety Program, Vehicle Systems Safety Technologies project, to improve crew decision-making and response in complex situations. The specific objective of this challenge is to develop data and technologies which may increase a pilot's (crew's) ability to avoid, detect, and recover from adverse events that could otherwise result in accidents/incidents. Within this technical challenge, a cooperative industry-government research program has been established to develop innovative flight deck-based counter-measures that can improve the crew's ability to avoid, detect, mitigate, and recover from unsafe loss-of-aircraft state awareness - specifically, the loss of attitude awareness (i.e., Spatial Disorientation, SD) or the loss-of-energy state awareness (LESA). A critical component of this research is to develop specific and quantifiable metrics which identify decision-making and the decision-making influences during simulation and flight testing. This paper reviews existing metrics and methods for SD testing and criteria for establishing visual dominance. The development of Crew State Monitoring technologies - eye tracking and other psychophysiological - are also discussed as well as emerging new metrics for identifying channelized attention and excessive pilot workload, both of which have been shown to contribute to SD/LESA accidents or incidents.

The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm

PubMed Central

Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-01-01

Introduction: Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn’s theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. Methods: In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team’s four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn’s theory. Results: The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. Discussion: This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context. PMID:28435417

The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm.

PubMed

Dogba, Maman Joyce; Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-07-19

Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn's theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team's four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn's theory. The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context.

Systems Operation Studies for Automated Guideway Transit Systems : Summary Report

DOT National Transportation Integrated Search

1980-02-01

In order to examine specific Automated Guideway Transit (AGT) developments and concepts and to build a better knowledge base for future decision-making, UMTA has undertaken a new program of studies and technology investigations called the Urban Mass ...

Assessment of Evidence-based Management Training Program: Application of a Logic Model.

PubMed

Guo, Ruiling; Farnsworth, Tracy J; Hermanson, Patrick M

2016-06-01

The purposes of this study were to apply a logic model to plan and implement an evidence-based management (EBMgt) educational training program for healthcare administrators and to examine whether a logic model is a useful tool for evaluating the outcomes of the educational program. The logic model was used as a conceptual framework to guide the investigators in developing an EBMgt educational training program and evaluating the outcomes of the program. The major components of the logic model were constructed as inputs, outputs, and outcomes/impacts. The investigators delineated the logic model based on the results of the needs assessment survey. Two 3-hour training workshops were delivered to 30 participants. To assess the outcomes of the EBMgt educational program, pre- and post-tests and self-reflection surveys were conducted. The data were collected and analyzed descriptively and inferentially, using the IBM Statistical Package for the Social Sciences (SPSS) 22.0. A paired sample t-test was performed to compare the differences in participants' EBMgt knowledge and skills prior to and after the training. The assessment results showed that there was a statistically significant difference in participants' EBMgt knowledge and information searching skills before and after the training (p< 0.001). Participants' confidence in using the EBMgt approach for decision-making was significantly increased after the training workshops (p< 0.001). Eighty-three percent of participants indicated that the knowledge and skills they gained through the training program could be used for future management decision-making in their healthcare organizations. The overall evaluation results of the program were positive. It is suggested that the logic model is a useful tool for program planning, implementation, and evaluation, and it also improves the outcomes of the educational program.

7 CFR 1940.303 - General policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... other relevant factors in program development and decision-making processes. (b) In assessing the... SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM... decision-makers with both the technical and human aspects of environmental planning. (c) When adverse...

The Lenfest Ocean Program's experience in building institutional support for connecting science and decision-making in marine systems

NASA Astrophysics Data System (ADS)

Bednarek, A.; Close, S.; Curran, K.; Hudson, C.

2017-12-01

Addressing contemporary sustainability challenges requires attention to the integration of scientific knowledge into decision-making and deliberation. However, this remains a challenge in practice. We contend that careful stewardship of this process of integration can result in positive, durable outcomes by reconciling the production and use of scientific knowledge, and improve its relevance and utility to decision-makers. We will share lessons learned from a grantmaking program that has addressed this challenge through programmatic innovations, including by supporting staff devoted to an intermediary role. Over the past 13 years, the Lenfest Ocean Program served in a boundary spanning role by integrating decision-makers into the scoping and outreach of program supported scientific research grants. Program staff engage with decision-makers and influencers to identify policy-relevant research questions and approaches, ensuring that the research direction addresses users' needs. As research progresses, the staff monitor the grant's progress to improve the match between the research and user needs. The process is resource-intensive, however, and raises interesting questions about the role and development of this kind of specialist within different kinds of institutions, including funding agencies. We suggest that nurturing this role as a practice and profession could ultimately help the scientific community more efficiently respond to sustainability challenges.

School-Based Management/Shared Decision-Making: A Study of School Reform in New York City.

ERIC Educational Resources Information Center

Jewell, Kenneth E.; Rosen, Jacqueline L.

School-Based Management/Shared Decision Making is a city-wide program supported by New York City Schools in collaboration with Bank Street College, based on the belief that students, parents, school staff, and communities have unique needs, and that these needs can best be addressed by these persons. Participating schools formed teams of…

PSYCHE: An Object-Oriented Approach to Simulating Medical Education

PubMed Central

Mullen, Jamie A.

1990-01-01

Traditional approaches to computer-assisted instruction (CAI) do not provide realistic simulations of medical education, in part because they do not utilize heterogeneous knowledge bases for their source of domain knowledge. PSYCHE, a CAI program designed to teach hypothetico-deductive psychiatric decision-making to medical students, uses an object-oriented implementation of an intelligent tutoring system (ITS) to model the student, domain expert, and tutor. It models the transactions between the participants in complex transaction chains, and uses heterogeneous knowledge bases to represent both domain and procedural knowledge in clinical medicine. This object-oriented approach is a flexible and dynamic approach to modeling, and represents a potentially valuable tool for the investigation of medical education and decision-making.

Combined Goal Management Training and Mindfulness meditation improve executive functions and decision-making performance in abstinent polysubstance abusers.

PubMed

Alfonso, José P; Caracuel, Alfonso; Delgado-Pastor, Luis C; Verdejo-García, Antonio

2011-08-01

The clinical relevance of neuropsychological deficits in addicted individuals has fostered interest in treatment strategies aimed to effectively target executive and decision-making dysfunction. One of the best-validated interventions for executive dysfunction is Goal Management Training (GMT) (Robertson et al., 2005), an interactive program aimed at improving participants' organization and ability to achieve goals. Mindfulness-based meditation can complement GMT training in order to improve attentional scanning and "reading" of emotional signals involved in adaptive decision-making. In this pilot study we investigated the efficacy of a 7-week program including GMT+Mindfulness (GMT+MF), as compared to standard treatment alone (STx), for reducing executive and decision-making deficits in an outpatient sample of alcohol and polysubstance abusers. Eighteen participants were enrolled in the GMT+MF group, whereas 16 participants formed the STx group; both groups were matched for relevant demographic and clinical variables, and pre-treatment degree of executive dysfunction. Results showed that the individuals enrolled in GMT+MF significantly improved their performance on neuropsychological measures of working memory (Letter Number Sequencing), response inhibition (Stroop) and decision-making (Iowa Gambling Task) after the treatment; whereas individuals enrolled in STx alone failed to show significant changes. These preliminary results indicate that the GMT+MF intervention may be effective in reducing executive and decision-making deficits in polysubstance abusers, and they support future randomized controlled studies aimed at examining the extent to which these improvements may generalize to every day functioning and may affect the capacity of addicted individuals to achieve and maintain abstinence. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Dysfunctional representation of expected value is associated with reinforcement-based decision-making deficits in adolescents with conduct problems.

PubMed

White, Stuart F; Tyler, Patrick M; Erway, Anna K; Botkin, Mary L; Kolli, Venkata; Meffert, Harma; Pope, Kayla; Blair, James R

2016-08-01

Previous work has shown that patients with conduct problems (CP) show impairments in reinforcement-based decision-making. However, studies with patients have not previously demonstrated any relationships between impairment in any of the neurocomputations underpinning reinforcement-based decision-making and specific symptom sets [e.g. level of CP and/or callous-unemotional (CU) traits]. Seventy-two youths [20 female, mean age = 13.81 (SD = 2.14), mean IQ = 102.34 (SD = 10.99)] from a residential treatment program and the community completed a passive avoidance task while undergoing functional MRI. Greater levels of CP were associated with poorer task performance. Reduced representation of expected values (EV) when making avoidance responses within bilateral anterior insula cortex/inferior frontal gyrus (AIC/iFG) and striatum was associated with greater levels of CP but not CU traits. The current data indicate that difficulties in the use of value information to motivate decisions to avoid suboptimal choices are associated with increased levels of CP (though not severity of CU traits). Moreover, they account for the behavioral deficits observed during reinforcement-based decision-making in youth with CP. In short, an individual's relative failure to utilize value information within AIC/iFG to avoid bad choices is associated with elevated levels of CP. © 2016 Association for Child and Adolescent Mental Health.

Siting and Routing Assessment for Solid Waste Management Under Uncertainty Using the Grey Mini-Max Regret Criterion

NASA Astrophysics Data System (ADS)

Chang, Ni-Bin; Davila, Eric

2006-10-01

Solid waste management (SWM) is at the forefront of environmental concerns in the Lower Rio Grande Valley (LRGV), South Texas. The complexity in SWM drives area decision makers to look for innovative and forward-looking solutions to address various waste management options. In decision analysis, it is not uncommon for decision makers to go by an option that may minimize the maximum regret when some determinant factors are vague, ambiguous, or unclear. This article presents an innovative optimization model using the grey mini-max regret (GMMR) integer programming algorithm to outline an optimal regional coordination of solid waste routing and possible landfill/incinerator construction under an uncertain environment. The LRGV is an ideal location to apply the GMMR model for SWM planning because of its constant urban expansion, dwindling landfill space, and insufficient data availability signifying the planning uncertainty combined with vagueness in decision-making. The results give local decision makers hedged sets of options that consider various forms of systematic and event-based uncertainty. By extending the dimension of decision-making, this may lead to identifying a variety of beneficial solutions with efficient waste routing and facility siting for the time frame of 2005 through 2010 in LRGV. The results show the ability of the GMMR model to open insightful scenario planning that can handle situational and data-driven uncertainty in a way that was previously unavailable. Research findings also indicate that the large capital investment of incineration facilities makes such an option less competitive among municipal options for landfills. It is evident that the investment from a municipal standpoint is out of the question, but possible public-private partnerships may alleviate this obstacle.

U.S. EPA Superfund Program's Policy for Community Involvement at Radioactively Contaminated Sites

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

Carey, Pat; Walker, Stuart

2008-01-15

This paper describes the Superfund program's statutory requirements for community involvement. It also discusses the efforts the Superfund program has made that go beyond these statutory requirements to involve communities. The Environmental Protection Agency (EPA) implements the Superfund program under the authority of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA). From the beginning of the Superfund program, Congress envisioned a role for communities. This role has evolved and expanded during the implementation of the Superfund program. Initially, the CERCLA statute had community involvement requirementsmore » designed to inform surrounding communities of the work being done at a site. CERCLA's provisions required 1) development of a community relations plan for each site, 2) establishment of information repositories near each site where all publicly available materials related to the site would be accessible for public inspection, 3) opportunities for the public to comment on the proposed remedy for each site and 4) development of a responsiveness summary responding to all significant comments received on the proposed remedy. In recognition of the need for people living near Superfund sites to be well-informed and involved with decisions concerning sites in their communities, SARA expanded Superfund's community involvement activities in 1986. SARA provided the authority to award Technical Assistance Grants (TAGs) to local communities enabling them to hire independent technical advisors to assist them in understanding technical issues and data about the site. The Superfund Community Involvement Program has sought to effectively implement the statutory community involvement requirements, and to go beyond those requirements to find meaningful ways to involve citizens in the cleanup of sites in their communities. We've structured our program around two main themes, building capacity in staff, and building capacity in Communities. In summary, the Superfund program devotes substantial resources to involving the local community in the site cleanup decision making process. We believe community involvement provides us with highly valuable information that must be available to carefully consider remedial alternatives at a site. We also find our employees enjoy their jobs more. Rather than fighting with an angry public they can work collaboratively to solve the problems created by the hazardous waste sites. We have learned the time and resources we devote at the beginning of a project to developing relationships with the local community, and learning about their issues and concerns is time and resources well spent. We believe the evidence shows this up-front investment helps us make better cleanup decisions, and avoids last minute efforts to work with a hostile community who feels left out of the decision-making process.« less

Systems Operations Studies for Automated Guideway Transit Systems : Discrete Event Simulation Model User's Manual.

DOT National Transportation Integrated Search

1982-06-01

In order to examine specific Automated Guideway Transit (AGT) developments and concepts, and to build a better knowledge base for future decision-making, the Urban Mass Transportation Administration (UMTA) undertook a new program of studies and techn...

The Cooperative Forest Ecosystem Research Program

USGS Publications Warehouse

,

2002-01-01

Changes in priorities for forest management on federal and state lands in the Pacific Northwest have raised many questions about the best ways to manage young-forest stands, riparian areas, and forest landscapes. The Cooperative Forest Ecosystem Research (CFER) Program draws together scientists and managers from the U.S. Geological Survey, Bureau of Land Management, Oregon Department of Forestry, and Oregon State University to find science-based answers to these questions. Managers, researchers, and decisionmakers, working within the CFER program, are helping develop and disseminate the knowledge needed to carry out ecosystem-based management successfully in the Pacific Northwest.

75 FR 31285 - Decision-Making Authority Regarding the Denial, Suspension, or Revocation of a Federal Firearms...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

... No. ATF 17F; AG Order No. 3160-2010 (2008R-10P)] Decision-Making Authority Regarding the Denial... decision-making and to address any case backlogs that may occur. DATES: This rule is effective August 2... Assistant Director (Enforcement Programs and Services). These changes to the decision-making and related...

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

PubMed

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

2010-02-01

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

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

PubMed Central

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

2010-01-01

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

DEVELOPMENT OF A SYSTEMATIC APPROACH TO ACCURATELY MEASURE TRACE LEVELS OF VOCS AND SVOCS IN SOIL AND SEDIMENT WITH HIGH MOISTURE CONTENT

EPA Science Inventory

Risk assessment is a crucial component of the site remediation decision-making process. Some current EPA methods do not have detection limits low enough for risk assessment of many VOCs (e.g., EPA Region 3 Risk Based Concentration levels, EPA Region 9 Preliminary Remediation Goa...

Model-based scenario planning to develop climate change adaptation strategies for rare plant populations in grassland reserves

Treesearch

Laura Phillips-Mao; Susan M. Galatowitsch; Stephanie A. Snyder; Robert G. Haight

2016-01-01

Incorporating climate change into conservation decision-making at site and population scales is challenging due to uncertainties associated with localized climate change impacts and population responses to multiple interacting impacts and adaptation strategies. We explore the use of spatially explicit population models to facilitate scenario analysis, a conservation...

Autonomy and School Improvement: What Do We Know and Where Do We Go from Here?

ERIC Educational Resources Information Center

Honig, Meredith I.; Rainey, Lydia R.

2012-01-01

New "autonomy initiatives" aim to increase schools' decision-making authority as a strategy to leverage school improvement. These policies build on lessons of previous reforms such as site-based management in ways that bode well for their success. However, how are these policies actually faring in implementation? The authors addressed that…

Clinical decision-making of rural novice nurses.

PubMed

Seright, T J

2011-01-01

Nurses in rural settings are often the first to assess and interpret the patient's clinical presentations. Therefore, an understanding of how nurses experience decision-making is important in terms of educational preparation, resource allocation to rural areas, institutional cultures, and patient outcomes. Theory development was based on the in-depth investigation of 12 novice nurses practicing in rural critical access hospitals in a north central state. This grounded theory study consisted of face-to-face interviews with 12 registered nurses, nine of whom were observed during their work day. The participants were interviewed a second time, as a method of member checking, and during this interview they reviewed their transcripts, the emerging themes and categories. Directors of nursing from both the research sites and rural hospitals not involved in the study, experienced researchers, and nurse educators facilitated triangulation of the findings. 'Sociocentric rationalizing' emerged as the central phenomenon and referred to the sense of belonging and agency which impacted the decision-making in this small group of novice nurses in rural critical access hospitals. The observed consequences, which were conceptualized during the axial coding process and were derived from observations and interviews of the 12 novice nurses in this study include: (1) gathering information before making a decision included assessment of: the credibility of co-workers, patients' subjective and objective data, and one's own past and current experiences; (2) conferring with co-workers as a direct method of confirming/denying decisions being made was considered more realistic and expedient than policy books and decision trees; (3) rural practicum clinical experiences, along with support after orientation, provide for transition to the rural nurse role; (4) involved directors of nursing served as both models and protectors of novice nurses placed in high accountability positions early in their careers. These novice nurses were often working with a limited staff, while managing an ever-changing census and acuity of patients. The significance of interdependence and welcoming relationships with their co-workers and directors of nursing was pivotal in the clinical decision-making process. Despite access to a number of resources at their disposal (including policy books, decision trees, standing orders, textbooks, and in some cases internet resources), the 12 nurses in this study indicated collaboration with co-workers was a major means of facilitating their decision-making. Rural novice nurses require facilitation of social skills as much as critical thinking skills both within their programs of nursing and during their new employee orientation; however, decision-making must be guided by more experienced nurses who are willing to mentor novice nurses and advise them to to reflect upon their decisions as they care for patients using evidenced based practice. In a rural setting, this is especially important because novice nurses are tasked early in their career with decision-making, which often involves ill-structured problems set in dynamic and changing environments, in high-stakes situations where patient safety is a concern.

Avian Conservation Areas as a Proxy for Contaminated Soil Remediation

PubMed Central

Lin, Wei-Chih; Lin, Yu-Pin; Anthony, Johnathen; Ding, Tsun-Su

2015-01-01

Remediation prioritization frequently falls short of systematically evaluating the underlying ecological value of different sites. This study presents a novel approach to delineating sites that are both contaminated by any of eight heavy metals and have high habitat value to high-priority species. The conservation priority of each planning site herein was based on the projected distributions of eight protected bird species, simulated using 900 outputs of species distribution models (SDMs) and the subsequent application of a systematic conservation tool. The distributions of heavy metal concentrations were generated using a geostatistical joint-simulation approach. The uncertainties in the heavy metal distributions were quantified in terms of variability among 1000 realization sets. Finally, a novel remediation decision-making approach was presented for delineating contaminated sites in need of remediation based on the spatial uncertainties of multiple realizations and the priorities of conservation areas. The results thus obtained demonstrate that up to 42% of areas of high conservation priority are also contaminated by one or more of the heavy metal contaminants of interest. Moreover, as the proportion of the land for proposed remediated increased, the projected area of the pollution-free habitat also increased. Overall uncertainty, in terms of the false positive contamination rate, also increased. These results indicate that the proposed decision-making approach successfully accounted for the intrinsic trade-offs among a high number of pollution-free habitats, low false positive rates and robustness of expected decision outcomes. PMID:26193297

Feasibility and Acceptability of a Web-Based HIV/STD Prevention Program for Adolescent Girls Targeting Sexual Communication Skills

ERIC Educational Resources Information Center

Widman, L.; Golin, C. E.; Kamke, K.; Massey, J.; Prinstein, M. J.

2017-01-01

Adolescent girls are at substantial risk of sexually transmitted diseases including HIV. To reduce these risks, we developed Health Education And Relationship Training (HEART), a web-based intervention focused on developing sexual assertiveness skills and enhancing sexual decision-making. This study assessed the feasibility and acceptability of…

Teachers' Thoughts on Student Decision Making during Engineering Design Lessons

ERIC Educational Resources Information Center

Meyer, Helen

2018-01-01

In this paper, I share the results of a study of teachers' ideas about student decision-making at entry into a professional development program to integrate engineering into their instruction. The framework for the Engineering Design Process (EDP) was based on a Challenge-Based Learning (CBL) model. The EDP embedded within the CBL model suggests…

Decision-Making in Pediatric Transport Team Dispatch Using Script Concordance Testing.

PubMed

Rajapreyar, Prakadeshwari; Marcdante, Karen; Zhang, Liyun; Simpson, Pippa; Meyer, Michael T

2017-11-01

Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. Survey was developed using Script Concordance Testing guidelines. The survey contained 15 transport case vignettes covering 20 scenarios (45 questions). Eleven scenarios assessed impact of intrinsic patient factors (e.g., procedural needs), whereas nine assessed extrinsic factors (e.g., weather). Pediatric Critical Care programs accredited by the Accreditation Council for Graduate Medical Education (the United States). Pediatric Intensivists and senior Critical Care fellows at Pediatric Critical Care programs were the target population with Transport Medical Directors serving as the expert panel. None. Survey results were scored per Script Concordance Testing guidelines. Concordance within groups was assessed using simple percentage agreement. There was little concordance in decision-making by Transport Medical Directors (median Script Concordance Testing percentage score [interquartile range] of 33.9 [30.4-37.3]). In addition, there was no statistically significant difference between the median Script Concordance Testing scores among the senior fellows and Pediatric Intensivists (31.1 [29.6-33.2] vs 29.7 [28.3-32.3], respectively; p = 0.12). Transport Medical Directors were more concordant on reasoning involving intrinsic patient factors rather than extrinsic factors (10/21 vs 4/24). Our study demonstrates pediatric transport team dispatch decision-making discordance by pediatric critical care physicians of varying levels of expertise and experience. Script Concordance Testing at a local level may better elucidate standards in medical decision-making within pediatric critical care physicians. The development of a curriculum, which provides education and trains our workforce on the logistics of pediatric transport team dispatch, would help standardize practice and evaluate outcomes based on decision-making.

Pilot testing of SHRP 2 reliability data and analytical products: Florida. [supporting datasets

DOT National Transportation Integrated Search

2014-01-01

SHRP 2 initiated the L38 project to pilot test products from five of the programs completed projects. The products support reliability estimation and use based on data analyses, analytical techniques, and decision-making framework. The L38 project...

COLLABORATIVE RESEARCH, MONITORING AND ASSESSMENT IN THE MID-ATLANTIC REGION

EPA Science Inventory

EPA Region 3 to implement a long-term research, monitoring, and assessment program in the Mid-Atlantic region - the Mid-Atlantic Integrated Assessment (MAIA). The MAIA mission is to develop a broad-based partnership to integrate scientific knowledge into the decision-making proc...

77 FR 5155 - Interest Rate Risk Policy and Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

... directors and management; appropriate IRR measurement and monitoring systems; good internal controls; and informed decision-making based on IRR measurement system results. It also provides guidelines for... technical aspects of IRR measurement methods. Of these, some said Appendix B implied a preference for the...

A mixed methods multiple case study of implementation as usual in children’s social service organizations: study protocol

PubMed Central

2013-01-01

Background Improving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care. It is likely that efforts to identify, develop, and refine implementation strategies will be more successful if they are informed by relevant stakeholders and are responsive to the strengths and limitations of the contexts and implementation processes identified in usual care settings. This study will describe: the types of implementation strategies used; how organizational leaders make decisions about what to implement and how to approach the implementation process; organizational stakeholders’ perceptions of different implementation strategies; and the potential influence of organizational culture and climate on implementation strategy selection, implementation decision-making, and stakeholders’ perceptions of implementation strategies. Methods/design This study is a mixed methods multiple case study of seven children’s social service organizations in one Midwestern city in the United States that compose the control group of a larger randomized controlled trial. Qualitative data will include semi-structured interviews with organizational leaders (e.g., CEOs/directors, clinical directors, program managers) and a review of documents (e.g., implementation and quality improvement plans, program manuals, etc.) that will shed light on implementation decision-making and specific implementation strategies that are used to implement new programs and practices. Additionally, focus groups with clinicians will explore their perceptions of a range of implementation strategies. This qualitative work will inform the development of a Web-based survey that will assess the perceived effectiveness, relative importance, acceptability, feasibility, and appropriateness of implementation strategies from the perspective of both clinicians and organizational leaders. Finally, the Organizational Social Context measure will be used to assess organizational culture and climate. Qualitative, quantitative, and mixed methods data will be analyzed and interpreted at the case level as well as across cases in order to highlight meaningful similarities, differences, and site-specific experiences. Discussion This study is designed to inform efforts to develop more effective implementation strategies by fully describing the implementation experiences of a sample of community-based organizations that provide mental health services to youth in one Midwestern city. PMID:23961701

Simulation modelling as a tool for knowledge mobilisation in health policy settings: a case study protocol.

PubMed

Freebairn, L; Atkinson, J; Kelly, P; McDonnell, G; Rychetnik, L

2016-09-21

Evidence-informed decision-making is essential to ensure that health programs and services are effective and offer value for money; however, barriers to the use of evidence persist. Emerging systems science approaches and advances in technology are providing new methods and tools to facilitate evidence-based decision-making. Simulation modelling offers a unique tool for synthesising and leveraging existing evidence, data and expert local knowledge to examine, in a robust, low risk and low cost way, the likely impact of alternative policy and service provision scenarios. This case study will evaluate participatory simulation modelling to inform the prevention and management of gestational diabetes mellitus (GDM). The risks associated with GDM are well recognised; however, debate remains regarding diagnostic thresholds and whether screening and treatment to reduce maternal glucose levels reduce the associated risks. A diagnosis of GDM may provide a leverage point for multidisciplinary lifestyle modification interventions. This research will apply and evaluate a simulation modelling approach to understand the complex interrelation of factors that drive GDM rates, test options for screening and interventions, and optimise the use of evidence to inform policy and program decision-making. The study design will use mixed methods to achieve the objectives. Policy, clinical practice and research experts will work collaboratively to develop, test and validate a simulation model of GDM in the Australian Capital Territory (ACT). The model will be applied to support evidence-informed policy dialogues with diverse stakeholders for the management of GDM in the ACT. Qualitative methods will be used to evaluate simulation modelling as an evidence synthesis tool to support evidence-based decision-making. Interviews and analysis of workshop recordings will focus on the participants' engagement in the modelling process; perceived value of the participatory process, perceived commitment, influence and confidence of stakeholders in implementing policy and program decisions identified in the modelling process; and the impact of the process in terms of policy and program change. The study will generate empirical evidence on the feasibility and potential value of simulation modelling to support knowledge mobilisation and consensus building in health settings.

Career exploration behavior of Korean medical students

PubMed Central

2017-01-01

Purpose This study is to analyze the effects of medical students’ social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. Methods We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. Results First, we noted statistically significant gender and admission type difference in social support, career barriers and career exploration behaviors. Second, social support and career barriers were found to influence career exploration behavior as a mediating variable for career decision-making self-efficacy. Conclusion Social support and career barriers as perceived by medical students influenced their career exploration behavior, with their decision-making self-efficacy serving as a full mediator. Therefore, this study has educational implications for career program development and educational training for career decision-making self-efficacy. PMID:28870020

Identifying Effective and Sustainable Measures for Community-Based Environmental Monitoring

NASA Astrophysics Data System (ADS)

McKay, Ariana J.; Johnson, Chris J.

2017-09-01

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

Space Launch System Complex Decision-Making Process

NASA Technical Reports Server (NTRS)

Lyles, Garry; Flores, Tim; Hundley, Jason; Monk, Timothy; Feldman,Stuart

2012-01-01

The Space Shuttle program has ended and elements of the Constellation Program have either been cancelled or transitioned to new NASA exploration endeavors. The National Aeronautics and Space Administration (NASA) has worked diligently to select an optimum configuration for the Space Launch System (SLS), a heavy lift vehicle that will provide the foundation for future beyond low earth orbit (LEO) large-scale missions for the next several decades. From Fall 2010 until Spring 2011, an SLS decision-making framework was formulated, tested, fully documented, and applied to multiple SLS vehicle concepts at NASA from previous exploration architecture studies. This was a multistep process that involved performing figure of merit (FOM)-based assessments, creating Pass/Fail gates based on draft threshold requirements, performing a margin-based assessment with supporting statistical analyses, and performing sensitivity analysis on each. This paper focuses on the various steps and methods of this process (rather than specific data) that allowed for competing concepts to be compared across a variety of launch vehicle metrics in support of the successful completion of the SLS Mission Concept Review (MCR) milestone.

The Effect of Decision-Making Skill Training Programs on Self-Esteem and Decision-Making Styles

ERIC Educational Resources Information Center

Colakkadioglu, Oguzhan; Celik, D. Billur

2016-01-01

Problem Statement: Decision making is a critical cognitive process in every area of human life. In this process, the individuals play an active role and obtain outputs with their functional use of decision-making skills. Therefore, the decision-making process can affect the course of life, life satisfaction, and the social relations of an…

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.

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.

Indoor Air Contamination from Hazardous Waste Sites: Improving the Evidence Base for Decision-Making.

PubMed

Johnston, Jill; MacDonald Gibson, Jacqueline

2015-11-27

At hazardous waste sites, volatile chemicals can migrate through groundwater and soil into buildings, a process known as vapor intrusion. Due to increasing recognition of vapor intrusion as a potential indoor air pollution source, in 2015 the U.S. Environmental Protection Agency (EPA) released a new vapor intrusion guidance document. The guidance specifies two conditions for demonstrating that remediation is needed: (1) proof of a vapor intrusion pathway; and (2) evidence that human health risks exceed established thresholds (for example, one excess cancer among 10,000 exposed people). However, the guidance lacks details on methods for demonstrating these conditions. We review current evidence suggesting that monitoring and modeling approaches commonly employed at vapor intrusion sites do not adequately characterize long-term exposure and in many cases may underestimate risks. On the basis of this evidence, we recommend specific approaches to monitoring and modeling to account for these uncertainties. We propose a value of information approach to integrate the lines of evidence at a site and determine if more information is needed before deciding whether the two conditions specified in the vapor intrusion guidance are satisfied. To facilitate data collection and decision-making, we recommend a multi-directional community engagement strategy and consideration of environment justice concerns.

Indoor Air Contamination from Hazardous Waste Sites: Improving the Evidence Base for Decision-Making

PubMed Central

Johnston, Jill; MacDonald Gibson, Jacqueline

2015-01-01

At hazardous waste sites, volatile chemicals can migrate through groundwater and soil into buildings, a process known as vapor intrusion. Due to increasing recognition of vapor intrusion as a potential indoor air pollution source, in 2015 the U.S. Environmental Protection Agency (EPA) released a new vapor intrusion guidance document. The guidance specifies two conditions for demonstrating that remediation is needed: (1) proof of a vapor intrusion pathway; and (2) evidence that human health risks exceed established thresholds (for example, one excess cancer among 10,000 exposed people). However, the guidance lacks details on methods for demonstrating these conditions. We review current evidence suggesting that monitoring and modeling approaches commonly employed at vapor intrusion sites do not adequately characterize long-term exposure and in many cases may underestimate risks. On the basis of this evidence, we recommend specific approaches to monitoring and modeling to account for these uncertainties. We propose a value of information approach to integrate the lines of evidence at a site and determine if more information is needed before deciding whether the two conditions specified in the vapor intrusion guidance are satisfied. To facilitate data collection and decision-making, we recommend a multi-directional community engagement strategy and consideration of environment justice concerns. PMID:26633433

A Feasibility Study to Evaluate Wind Energy Potential on the Navajo Nation

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

Terry Battiest

2012-11-30

The project, A Feasibility Study to Evaluate Wind Energy Potential on the Navajo Nation, is funded under a solicitation issued by the U.S. Department of Energy Tribal Energy Program. Funding provided by the grant allowed the Navajo Nation to measure wind potential at two sites, one located within the boundaries of the Navajo Nation and the other off-reservation during the project period (September 5, 2005 - September 30, 2009). The recipient for the grant award is the Navajo Tribal Utility Authority (NTUA). The grant allowed the Navajo Nation and NTUA manage the wind feasibility from initial site selection through themore » decision-making process to commit to a site for wind generation development. The grant activities help to develop human capacity at NTUA and help NTUA to engage in renewable energy generation activities, including not only wind but also solar and biomass. The final report also includes information about development activities regarding the sited included in the grant-funded feasibility study.« less

Design of Cycle 3 of the National Water-Quality Assessment Program, 2013-2022: Part 1: Framework of Water-Quality Issues and Potential Approaches

USGS Publications Warehouse

Rowe, Gary L.; Belitz, Kenneth; Essaid, Hedeff I.; Gilliom, Robert J.; Hamilton, Pixie A.; Hoos, Anne B.; Lynch, Dennis D.; Munn, Mark D.; Wolock, David W.

2010-01-01

In 1991, the U.S. Congress established the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) Program to develop long-term, nationally consistent information on the quality of the Nation's streams and groundwater. Congress recognized the critical need for this information to support scientifically sound management, regulatory, and policy decisions concerning the increasingly stressed water resources of the Nation. The long-term goals of NAWQA are to: (1) assess the status of water-quality conditions in the United States, (2) evaluate long-term trends in water-quality conditions, and (3) link status and trends with an understanding of the natural and human factors that affect water quality. These goals are national in scale, include both surface water and groundwater, and include consideration of water quality in relation to both human uses and aquatic ecosystems. Since 1991, NAWQA assessments and findings have fostered and supported major improvements in the availability and use of unbiased scientific information for decisionmaking, resource management, and planning at all levels of government. These improvements have enabled agencies and stakeholders to cost-effectively address a wide range of water-quality issues related to natural and human influences on the quality of water and potential effects on aquatic ecosystems and human health (http://water.usgs.gov/nawqa/xrel.pdf). NAWQA, like all USGS programs, provides policy relevant information that serves as a scientific basis for decisionmaking related to resource management, protection, and restoration. The information is freely available to all levels of government, nongovernmental organizations, industry, academia, and the public, and is readily accessible on the NAWQA Web site and other diverse formats to serve the needs of the water-resource community at different technical levels. Water-quality conditions in streams and groundwater are described in more than 1,700 publications (available online at http://water.usgs.gov/nawqa/bib/), and are documented by more than 14 million data records representing about 7,600 stream sites, 8,100 wells, and 2,000 water-quality and ecological constituents that are available from the NAWQA data warehouse (http://infotrek.er.usgs.gov/traverse/f?p=NAWQA:HOME:0). The Program promotes collaboration and liaison with government officials, resource managers, industry representatives, and other stakeholders to increase the utility and relevance of NAWQA science to decisionmakers. As part of this effort, NAWQA supports integration of data from other organizations into NAWQA assessments, where appropriate and cost-effective, so that more comprehensive findings are available across geographic and temporal scales.

Decision-Making Theory Applied to Architectural Programming: Some Research Implications.

ERIC Educational Resources Information Center

Green, Meg

The implications of delineating and determining the sequence of programming decisions are shown in the selection of building committee membership. The role relationships of client and architect are discussed in terms of decision-making function. Decision tables are described as aids in problem analysis. Other topics include information and…

Does the Medicare Part D Decision-Making Experience Differ by Rural/Urban Location?

PubMed

Henning-Smith, Carrie; Casey, Michelle; Moscovice, Ira

2017-01-01

Although much has been written about Medicare Part D enrollment, much less is known about beneficiaries' personal experiences with choosing a Part D plan, especially among rural residents. This study sought to address this gap by examining geographic differences in Part D enrollees' perceptions of the plan decision-making process, including their confidence in their choice, their knowledge about the program, and their satisfaction with available information. We used data from the 2012 Medicare Current Beneficiary Survey and included adults ages 65 and older who were enrolled in Part D at the time of the survey (n = 3,706). We used ordered logistic regression to model 4 outcomes based on beneficiaries' perceptions of the Part D decision-making and enrollment process, first accounting only for differences by rurality, then adjusting for sociodemographic, health, and coverage characteristics. Overall, half of all beneficiaries were not very confident in their Part D knowledge. Rural beneficiaries had lower odds of being confident in the plan they chose and in being satisfied with the amount of information available to them during the decision-making process. After adjusting for all covariates, micropolitan residents continued to have lower odds of being confident in the plan that they chose. Policy-makers should pay particular attention to making information about Part D easily accessible for all beneficiaries and to addressing unique barriers that rural residents have in accessing information while making decisions, such as reduced Internet availability. Furthermore, confidence in the decision-making process may be improved by simplifying the Part D program. © 2016 National Rural Health Association.

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

PubMed

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

2013-06-03

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

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

PubMed

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

2017-06-21

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

An Exploration of Decision-Making Processes on Infant Delivery Site from the Perspective of Pregnant Women, New Mothers, and Their Families in Northern Karnataka, India.

PubMed

Blanchard, Andrea Katryn; Bruce, Sharon Gail; Jayanna, Krishnamurthy; Gurav, Kaveri; Mohan, Haranahalli L; Avery, Lisa; Moses, Stephen; Blanchard, James Frederick; Ramesh, Banadakoppa M

2015-09-01

This study was conducted to explore the decision-making processes regarding sites for delivery of infants among women, their husbands, and mothers-in-law in a rural area of northern Karnataka state, south India. Qualitative semi-structured, individual in-depth interviews were conducted in 2010 among 110 pregnant women, new mothers, husbands and mothers-in-law. Interviews were conducted by trained local researchers in participants' languages and then translated into English. Decisions were made relationally, as family members weighed their collective attitudes and experiences towards a home, private or public delivery. Patterns of both concordance and discordance between women and their families' preferences for delivery site were present. The voice of pregnant women and new mothers was not always subordinate to that of other family members. Still, the involvement of husbands and mothers-in-law was important in decision-making, indicating the need to consider the influence of household gender and power dynamics. All respondent types also expressed shifts in social context and cultural attitudes towards increasing preference for hospital delivery. An appreciation of the interdependence of family members' roles in delivery site decision-making, and how they are influenced by the socio-cultural context, must be considered in frameworks used to guide the development of relevant interventions to improve the utilization and quality of maternal, neonatal and child health services.

Development of an Automated Emergency Response System (AERS) for Rail Transit Systems

DOT National Transportation Integrated Search

1984-10-01

As a result of a fire in 1979 at the Bay Area Rapid Transit District (BART), a microprocessor-based information retrieval system was developed to aid in the emergency decision-making process. This system was proposed, designed and programmed by a sup...

Proceedings of the symposium on dwarf mistletoe control through forest management, April 11-13

Treesearch

Robert F. Scharpf; John R. Parmeter

1978-01-01

These Symposium papers cover bases of control, control planning and decisionmaking, control operations and accomplishments, refining and improving control techniques, and pest damage and integrated control. A program summary and a list of literature references on the dwarf mistletoes are included.

Scientists and Stakeholders in the Chesapeake Bay: How the Mid-Atlantic RISA Strengthens Climate Resilience Through Participatory Decision-Making Processes

NASA Astrophysics Data System (ADS)

Knopman, D.; Berg, N.

2017-12-01

The NOAA Mid-Atlantic Regional Integrated Sciences and Assessments (MARISA) program was formed in September 2016 to increase climate resilience in the Mid-Atlantic, with an initial focus on the Chesapeake Bay Watershed. In this talk, we will discuss how the program's unique structure and approach are designed to advance resilience to a changing climate through improved data, place-based decision support, and public engagement. Emphasis will be placed on MARISA's approach to integrating stakeholder perspectives from the onset of decision scoping, through the creation of actionable data sets, and concluding with the co-development of adaptation strategies between the scientific community, decision-makers, and stakeholders. Specific examples of this process involving climate-sensitive decisions and investments regarding water resources, land management, and urban corridors will be discussed.

Noise, cost and speed-accuracy trade-offs: decision-making in a decentralized system

PubMed Central

Marshall, James A.R.; Dornhaus, Anna; Franks, Nigel R.; Kovacs, Tim

2005-01-01

Many natural and artificial decision-making systems face decision problems where there is an inherent compromise between two or more objectives. One such common compromise is between the speed and accuracy of a decision. The ability to exploit the characteristics of a decision problem in order to vary between the extremes of making maximally rapid, or maximally accurate decisions, is a useful property of such systems. Colonies of the ant Temnothorax albipennis (formerly Leptothorax albipennis) are a paradigmatic decentralized decision-making system, and have been shown flexibly to compromise accuracy for speed when making decisions during house-hunting. During emigration, a colony must typically evaluate and choose between several possible alternative new nest sites of differing quality. In this paper, we examine this speed-accuracy trade-off through modelling, and conclude that noise and time-cost of assessing alternative choices are likely to be significant for T. albipennis. Noise and cost of such assessments are likely to mean that T. albipennis' decision-making mechanism is Pareto-optimal in one crucial regard; increasing the willingness of individuals to change their decisions cannot improve collective accuracy overall without impairing speed. We propose that a decentralized control algorithm based on this emigration behaviour may be derived for applications in engineering domains and specify the characteristics of the problems to which it should be suited, based on our new results. PMID:16849234

Decision making technical support study for the US Army's Chemical Stockpile Disposal Program

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

Feldman, D.L.; Dobson, J.E.

1990-08-01

This report examines the adequacy of current command and control systems designed to make timely decisions that would enable sufficient warning and protective response to an accident at the Edgewood area of Aberdeen Proving Ground (APG), Maryland, and at Pine Bluff Arsenal (PBA), Arkansas. Institutional procedures designed to facilitate rapid accident assessment, characterization, warning, notification, and response after the onset of an emergency and computer-assisted decision-making aids designed to provide salient information to on- and-off-post emergency responders are examined. The character of emergency decision making at APG and PBA, as well as potential needs for improvements to decision-making practices, procedures,more » and automated decision-support systems (ADSSs), are described and recommendations are offered to guide equipment acquisition and improve on- and off-post command and control relationships. We recommend that (1) a continued effort be made to integrate on- and off-post command control, and decision-making procedures to permit rapid decision making; (2) the pathways for alert and notification among on- and off-post officials be improved and that responsibilities and chain of command among off-post agencies be clarified; (3) greater attention be given to organizational and social context factors that affect the adequacy of response and the likelihood that decision-making systems will work as intended; and (4) faster improvements be made to on-post ADSSs being developed at APG and PBA, which hold considerable promise for depicting vast amounts of information. Phased development and procurement of computer-assisted decision-making tools should be undertaken to balance immediate needs against available resources and to ensure flexibility, equity among sites, and compatibility among on- and off-post systems. 112 refs., 6 tabs.« less

A Grant Project to Initiate School Counselors' Development of a Multi-Tiered System of Supports Based on Social-Emotional Data

ERIC Educational Resources Information Center

Harrington, Karen; Griffith, Catherine; Gray, Katharine; Greenspan, Scott

2016-01-01

This article provides an overview of a grant project designed to create a district-wide elementary school counseling program with a strong data-based decision-making process. Project goals included building data literacy skills among school counselors and developing the infrastructure to efficiently collect important social-emotional indicators…

Instructional decision making of high school science teachers

NASA Astrophysics Data System (ADS)

Carver, Jeffrey S.

The instructional decision-making processes of high school science teachers have not been well established in the literature. Several models for decision-making do exist in other teaching disciplines, business, computer game programming, nursing, and some fields of science. A model that incorporates differences in science teaching that is consistent with constructivist theory as opposed to conventional science teaching is useful in the current climate of standards-based instruction that includes an inquiry-based approach to teaching science. This study focuses on three aspects of the decision-making process. First, it defines what factors, both internal and external, influence high school science teacher decision-making. Second, those factors are analyzed further to determine what instructional decision-making processes are articulated or demonstrated by the participants. Third, by analyzing the types of decisions that are made in the classroom, the classroom learning environments established as a result of those instructional decisions are studied for similarities and differences between conventional and constructivist models. While the decision-making process for each of these teachers was not clearly articulated by the teachers themselves, the patterns that establish the process were clearly exhibited by the teachers. It was also clear that the classroom learning environments that were established were, at least in part, established as a result of the instructional decisions that were made in planning and implementation of instruction. Patterns of instructional decision-making were different for each teacher as a result of primary instructional goals that were different for each teacher. There were similarities between teachers who exhibited more constructivist epistemological tendencies as well as similarities between teachers who exhibited a more conventional epistemology. While the decisions that will result from these two camps may be different, the six step process for instructional decision-making that was established during this study shows promise for use in both situations.

44 CFR 10.12 - Pre-implementation actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Pre-implementation actions. (a) Decision-making. The Regional Administrator shall ensure that... integrated into the decision-making process. Because of the diversity of FEMA, it is not feasible to describe in this part the decision-making process for each of the various FEMA programs. Proposals and actions...

Decision-making about complementary and alternative medicine by cancer patients: integrative literature review.

PubMed

Weeks, Laura; Balneaves, Lynda G; Paterson, Charlotte; Verhoef, Marja

2014-01-01

Patients with cancer consistently report conflict and anxiety when making decisions about complementary and alternative medicine (CAM) treatment. To design evidence-informed decision-support strategies, a better understanding is needed of how the decision-making process unfolds for these patients during their experience with cancer. We undertook this study to review the research literature regarding CAM-related decision-making by patients with cancer within the context of treatment, survivorship, and palliation. We also aimed to summarize emergent concepts within a preliminary conceptual framework. We conducted an integrative literature review, searching 12 electronic databases for articles published in English that described studies of the process, context, or outcomes of CAM-related decision-making. We summarized descriptive data using frequencies and used a descriptive constant comparative method to analyze statements about original qualitative results, with the goal of identifying distinct concepts pertaining to CAM-related decision-making by patients with cancer and the relationships among these concepts. Of 425 articles initially identified, 35 met our inclusion criteria. Seven unique concepts related to CAM and cancer decision-making emerged: decision-making phases, information-seeking and evaluation, decision-making roles, beliefs, contextual factors, decision-making outcomes, and the relationship between CAM and conventional medical decision-making. CAM decision-making begins with the diagnosis of cancer and encompasses 3 distinct phases (early, mid, and late), each marked by unique aims for CAM treatment and distinct patterns of information-seeking and evaluation. Phase transitions correspond to changes in health status or other milestones within the cancer trajectory. An emergent conceptual framework illustrating relationships among the 7 central concepts is presented. CAM-related decision-making by patients with cancer occurs as a nonlinear, complex, dynamic process. The conceptual framework presented here identifies influential factors within that process, as well as patients' unique needs during different phases. The framework can guide the development and evaluation of theory-based decision-support programs that are responsive to patients' beliefs and preferences.

Return-to-work success despite conflicts: an exploration of decision-making during a work rehabilitation program.

PubMed

Gouin, Marie-Michelle; Coutu, Marie-France; Durand, Marie-José

2017-11-12

Collective decision-making by stakeholders appears important to return-to-work success, yet few studies have explored the processes involved. This study aims to explore the influence of decision-making on return-to-work for workers with musculoskeletal or common mental disorders. This study is a secondary analysis using data from three earlier multiple-case studies that documented decision-making during similar and comparable work rehabilitation programs. Individual interviews were conducted at the end of the program with stakeholders, namely, the disabled workers and representatives of health care professionals, employers, unions and insurers. Verbatims were analysed inductively. The 28 decision-making processes (cases) led to 115 different decisions-making instances and included the following components: subjects of the decisions, stakeholders' concerns and powers, and types of decision-making. No differences were found in decision-making processes relative to the workers' diagnoses or return-to-work status. However, overall analysis of decision-making revealed that stakeholder agreement on a return-to-work goal and acceptance of an intervention plan in which the task demands aligned with the worker's capacities were essential for return-to-work success. These results support the possibility of return-to-work success despite conflictual decision-making processes. In addition to facilitating consensual decisions, future studies should be aimed at facilitating negotiated decisions. Implications for rehabilitation Facilitating decision-making, with the aim of obtaining agreement from all stakeholders on a return-to-work goal and their acceptance of an intervention plan that respects the worker's capacities, is important for return-to-work success. Rehabilitation professionals should constantly be on the lookout for potential conflicts, which may either complicate the reach of an agreement between the stakeholders or constrain return-to-work possibilities. Rehabilitation professionals should also be constantly watching for workers' and employers' return-to-work concerns, as they may change during work rehabilitation, potentially challenging a reached agreement.

The Communication and Bioethical Training (CoBiT) Program for assisting dialysis decision-making in Spanish ACKD units.

PubMed

García-Llana, Helena; Bajo, Maria-Auxiliadora; Barbero, Javier; Selgas, Rafael; Del Peso, Gloria

2017-04-01

Healthcare professionals currently working in Advanced Chronic Kidney Disease (ACKD) units must cope with difficult situations regarding assisting patients with the dialysis decision-making process, and they are often untrained for these conversations. Although we have evidence from the literature that these skills can be learned, few professionals feel confident in this area. A Communication and Bioethical Training (CoBiT) Program for ACKD staff (physicians, nurses and allied health professionals) was developed to improve their ability and self-confidence in conducting these conversations. A four-stage study was conducted: (1) development of the CoBiT program, beginning with the creation of an interdisciplinary focus group (N = 10); (2) design of a questionnaire to assess self-confidence based on the areas identified by the focus group. The face validity of the instrument was tested using an inter-judge methodology (N = 6); (3) design of the format and contents of the program; (4) piloting the program. Thirty-six health professionals took an 8-h workshop based on role-playing methodology. Participants assessed their self-confidence in their communication skills before and after the program using self-report measures. The results show that after the program, participants reported significantly higher levels of self-confidence measured with a five-point Likert scale (p < 0.001). Participants felt that communication with colleagues of other professions significantly increased after the workshop (p = 0.004). The CoBiT program improves ACKD Unit healthcare professionals' self-confidence in their ability to perform a specific communication task.

Improving Public Debate with Television and Social Organization

ERIC Educational Resources Information Center

Magnuson, Osgood T.

1970-01-01

"Town Meeting, an unusual experiment in using television for improving citizen participation in the American democratic process, has given viewers in Minnesota and South Dakota an opportunity to hear about issues and to join in the decision-making." Based on remarks made to the Kettering Conference on Public Television Programming.…

Systematic, Cooperative Evaluation.

ERIC Educational Resources Information Center

Nassif, Paula M.

Evaluation procedures based on a systematic evaluation methodology, decision-maker validity, new measurement and design techniques, low cost, and a high level of cooperation on the part of the school staff were used in the assessment of a public school mathematics program for grades 3-8. The mathematics curriculum was organized into Spirals which…

Assessing Financial Education Methods: Principles vs. Rules-of-Thumb Approaches

ERIC Educational Resources Information Center

Skimmyhorn, William L.; Davies, Evan R.; Mun, David; Mitchell, Brian

2016-01-01

Despite thousands of programs and tremendous public and private interest in improving financial decision-making, little is known about how best to teach financial education. Using an experimental approach, the authors estimated the effects of two different education methodologies (principles-based and rules-of-thumb) on the knowledge,…

Patient Engagement in Community Health Center Leadership: How Does it Happen?

PubMed

Sharma, Anjana E; Huang, Beatrice; Knox, Margae; Willard-Grace, Rachel; Potter, Michael B

2018-05-18

Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs. Qualitative study conducted from August 2016 to June 2017 at community health centers in California, Arizona and Hawaii. We interviewed practice leaders of patient engagement programs at their site. Eligible clinics had patient representatives within their governing board, PAC, or both. We assessed patient demographics, roles and responsibilities of patients participating, and extent of involvement in quality improvement among governing boards versus PACs. We interviewed 19 sites, of which 17 were FQHCs that had governing boards. Of the 17 FQHCs, 11 had also implemented PACs. Two non-FQHC safety-net sites had PACs but did not have governing boards. Governing board members had formal, structured membership responsibilities such as finances and hiring personnel. PAC roles were more flexible, focusing on day-to-day clinic operations. Clinics tended to recruit governing board patient members for their skill set and professional experience; PAC member recruitment focused more on demographic representation of the clinic's patient population. Both groups worked on quality improvement, but governing boards tended to review clinic performance metrics, while PAC members were involved in specific project planning and implementation to improve clinical outcomes and patient experience. Patient involvement in clinic improvement in CHCs includes higher-level decision-making and governance through mechanisms such as governing boards, as well as engagement in day-to-day practice improvement through PACs. These roles offer differing, but valuable insights to clinic programs and policies.

Radiation monitoring systems as a tool for assessment of accidental releases at the Chernobyl and Fukushima NPPs

NASA Astrophysics Data System (ADS)

Shershakov, Vjacheslav; Bulgakov, Vladimir

2013-04-01

The experience gained during mitigation of the consequences of the accidents at the Chernobyl and Fukushima NPPs has shown that what makes different the decision-making in case of nuclear accidents is that the greatest benefit from decision-making can be achieved in the early phase of an accident. Support to such process can be provided only by a real-time decision-making support system. In case of a nuclear accident the analysis of the situation and decision-making is not feasible without an operational radiation monitoring system, international data exchange and automated data processing, and the use of computerized decision-making support systems. With this in mind, in the framework of different international programs on the Chernobyl-related issues numerous projects were undertaken to study and develop a set of methods, algorithms and programs providing effective support to emergency response decision-making, starting from accident occurrence to decision-making regarding countermeasures to mitigate effects of radioactive contamination of the environment. The presentation focuses results of the analysis of radiation monitoring data and, on this basis, refining or, for many short-lived radionuclides, reconstructing the source term, modeling dispersion of radioactivity in the environment and assessing its impacts. The obtained results allowed adding and refining the existing estimates and in some cases reconstructing doses for the public on the territories contaminated as a result of the Chernobyl accident. The activities were implemented in two stages. In the first stage, several scenarios for dispersion of Chernobyl-related radioactivity were developed. For each scenario cesium-137 dispersion was estimated and these estimates were compared with measurement data. In the second stage, the scenario which showed the best agreement of calculations and measurements was used for modeling the dispersion of iodine-131and other short-lived radionuclides. The described approach was used for assessing the consequences at the Fukushima NPP. These results are also provided in the presentation. References 1. Kelly G.N., Ehrhardt J., Shershakov V.M.. Decision Support for Off-Site Emergency Preparedness in Europe. Radiation Protection Dosimetry, Vol. 64 Nos. 1-2, 1996, pp. 129-142. 2. Ehrhardt J., Shershakov V.M. Real-time on-line decision support systems (RODOS) for off-site emergency management following a nuclear accident. EUR 16533, 1996 3. Kelly G.N., Shershakov V.M. (Editors). Environmental contamination, radiation doses and health consequences after the ?hernobyl accident. Radiation Protection Dosimetry. Special Commemorative Issue.Vol. 64, 1996 4. Shershakov V.M. Computer information technology for support of radiation monitoring problems. OECD Proceedings of an International Workshop «Nuclear Emergency Data Management», Zurich, Switzerland, 1998, pp. 377-388 5. Pitkevich V.A., Duba V.V., Ivanov V.K., Tsyb A.F., Shershakov V.M., Golubenkov A.V., Borodin R.V., V.A., Kosykh V.S. Reconstruction of External Dose to the Inhabitants Living in the Contaminated Territory of Russia by the Results of the Accident at the Chernobyl NPP. Health Phys., Vol. 30, No. 1, pp. 54-68, 1995. 6. Shershakov V., Fesenko S., Kryshev I., Semioshkina T. Decision-Aiding Tools for Remediation Strategies. In: Radioactivity in the Environment, Volume 14, Remediation of Contaminated Environments, 2009, pp 41- 120, Elsevier Ltd.

Sediment quality criteria: A review with recommendations for developing criteria for the Hanford Site

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

Driver, C.J.

1994-05-01

Criteria for determining the quality of liver sediment are necessary to ensure that concentrations of contaminants in aquatic systems are within acceptable limits for the protection of aquatic and human life. Such criteria should facilitate decision-making about remediation, handling, and disposal of contaminants. Several approaches to the development of sediment quality criteria (SQC) have been described and include both descriptive and numerical methods. However, no single method measures all impacts at all times to all organisms (U.S. EPA 1992b). The U.S. EPA`s interest is primarily in establishing chemically based, numerical SQC that are applicable nation-wide (Shea 1988). Of the approachesmore » proposed for SQC development, only three are being considered for numerical SQC on a national level. These approaches include an Equilibrium Partitioning Approach, a site-specific method using bioassays (the Apparent Effects Threshold Approach), and an approach similar to EPA`s water quality criteria (Pavlou and Weston 1984). Although national (or even regional) criteria address a number of political, litigative, and engineering needs, some researchers feel that protection of benthic communities require site-specific, biologically based criteria (Baudo et al. 1990). This is particularly true for areas where complex mixtures of contaminants are present in sediments. Other scientifically valid and accepted procedures for freshwater SQC include a background concentration approach, methods using field or spiked bioassays, a screening level concentration approach, the Apparent Effects Threshold Approach, the Sediment Quality Triad, the International Joint Commission Sediment Assessment Strategy, and the National Status and Trends Program Approach. The various sediment assessment approaches are evaluated for application to the Hanford Reach and recommendations for Hanford Site sediment quality criteria are discussed.« less

Pack-Year Cigarette Smoking History for Determination of Lung Cancer Screening Eligibility. Comparison of the Electronic Medical Record versus a Shared Decision-making Conversation.

PubMed

Modin, Hannah E; Fathi, Joelle T; Gilbert, Christopher R; Wilshire, Candice L; Wilson, Andrew K; Aye, Ralph W; Farivar, Alexander S; Louie, Brian E; Vallières, Eric; Gorden, Jed A

2017-08-01

Implementation of lung cancer screening programs is occurring across the United States. Programs vary in approaches to patient identification and shared decision-making. The eligibility of persons referred to screening programs, the outcomes of eligibility determination during shared decision-making, and the potential for the electronic medical record (EMR) to identify eligible individuals have not been well described. Our objectives were to assess the eligibility of individuals referred for lung cancer screening and compare information extracted from the EMR to information derived from a shared decision-making conversation for the determination of eligibility for lung cancer screening. We performed a retrospective analysis of individuals referred to a centralized lung cancer screening program serving a five-hospital health services system in Seattle, Washington between October 2014 and January 2016. Demographics, referral, and outcomes data were collected. A pack-year smoking history derived from the EMR was compared with the pack-year history obtained during a shared decision-making conversation performed by a licensed nurse professional representing the lung cancer screening program. A total of 423 individuals were referred to the program, of whom 59.6% (252 of 423) were eligible. Of those, 88.9% (224 of 252) elected screening. There was 96.2% (230 of 239) discordance in pack-year smoking history between the EMR and the shared decision-making conversation. The EMR underreported pack-years of smoking for 85.2% (196 of 230) of the participants, with a median difference of 29.2 pack-years. If identification of eligible individuals relied solely on the accuracy of the pack-year smoking history recorded in the EMR, 53.6% (128 of 239) would have failed to meet the 30-pack-year threshold for screening. Many individuals referred for lung cancer screening may be ineligible. Overreliance on the EMR for identification of individuals at risk may lead to missed opportunities for appropriate lung cancer screening.

Oversight mechanisms in public managed care programs: from little oversight to negotiations to shared decision-making.

PubMed

Beinecke, R H

1999-01-01

An expanded range of oversight mechanisms is being adopted to hold public human service programs more accountable to funding sources as well as consumers, family members, and providers. Most of these approaches are hierarchical in nature. Some involve negotiated agreements and each is designed to meet certain goals and functions. Each utilizes different forms of decision-making. Stakeholders prefer to be part of a shared decision-making process. Understanding these underlying premises can help to assess the strengths and weaknesses of each method and can suggest how to most effectively utilize combinations of approaches to improve program performance. Whether we will move toward a new paradigm emphasizing participation and collaboration rather than more formal structural approaches is yet undetermined but will greatly affect how programs are monitored and evaluated in the future.

Temporal competition between differentiation programs determines cell fate choice

NASA Astrophysics Data System (ADS)

Kuchina, Anna; Espinar, Lorena; Cagatay, Tolga; Balbin, Alejandro; Alvarado, Alma; Garcia-Ojalvo, Jordi; Suel, Gurol

2011-03-01

During pluripotent differentiation, cells adopt one of several distinct fates. The dynamics of this decision-making process are poorly understood, since cell fate choice may be governed by interactions between differentiation programs that are active at the same time. We studied the dynamics of decision-making in the model organism Bacillus subtilis by simultaneously measuring the activities of competing differentiation programs (sporulation and competence) in single cells. We discovered a precise switch-like point of cell fate choice previously hidden by cell-cell variability. Engineered artificial crosslinks between competence and sporulation circuits revealed that the precision of this choice is generated by temporal competition between the key players of two differentiation programs. Modeling suggests that variable progression towards a switch-like decision might represent a general strategy to maximize adaptability and robustness of cellular decision-making.

How They Decide: A Case Study Examining the Decision-Making Process for Keeping or Cutting Music in a K-12 Public School District

ERIC Educational Resources Information Center

Major, Marci L.

2013-01-01

This study was designed to examine the decision-making process for keeping or cutting the music program in one selected public school district. Lekbery School District, in the Detroit suburb of Lekbery, Michigan, had not made extreme cuts to the music program in over 10 years, nor had it specifically targeted the music program when budgets cuts…

Site-Specific Rules for Risk Assessment.

ERIC Educational Resources Information Center

Tucker, William; And Others

1994-01-01

This article examines the development of regulatory guidance upon which the technology of risk assessment has matured into a decision-making method of choice. It examines in particular the role of site-specific risk assessment at Superfund sites. (LZ)

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

PubMed Central

2013-01-01

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

Evaluation of healthcare waste treatment/disposal alternatives by using multi-criteria decision-making techniques.

PubMed

Özkan, Aysun

2013-02-01

Healthcare waste should be managed carefully because of infected, pathological, etc. content especially in developing countries. Applied management systems must be the most appropriate solution from a technical, environmental, economic and social point of view. The main objective of this study was to analyse the current status of healthcare waste management in Turkey, and to investigate the most appropriate treatment/disposal option by using different decision-making techniques. For this purpose, five different healthcare waste treatment/disposal alternatives including incineration, microwaving, on-site sterilization, off-site sterilization and landfill were evaluated according to two multi-criteria decision-making techniques: analytic network process (ANP) and ELECTRE. In this context, benefits, costs and risks for the alternatives were taken into consideration. Furthermore, the prioritization and ranking of the alternatives were determined and compared for both methods. According to the comparisons, the off-site sterilization technique was found to be the most appropriate solution in both cases.

Taking Risk Assessment and Management to the Next Level: Program-Level Risk Analysis to Enable Solid Decision-Making on Priorities and Funding

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

Nelson, J. G.; Morton, R. L.; Castillo, C.

2011-02-01

A multi-level (facility and programmatic) risk assessment was conducted for the facilities in the Nevada National Security Site (NNSS) Readiness in Technical Base and Facilities (RTBF) Program and results were included in a new Risk Management Plan (RMP), which was incorporated into the fiscal year (FY) 2010 Integrated Plans. Risks, risk events, probability, consequence(s), and mitigation strategies were identified and captured, for most scope areas (i.e., risk categories) during the facilitated risk workshops. Risk mitigations (i.e., efforts in addition to existing controls) were identified during the facilitated risk workshops when the risk event was identified. Risk mitigation strategies fell intomore » two broad categories: threats or opportunities. Improvement projects were identified and linked to specific risks they mitigate, making the connection of risk reduction through investments for the annual Site Execution Plan. Due to the amount of that was collected, analysis to be performed, and reports to be generated, a Risk Assessment/ Management Tool (RAMtool) database was developed to analyze the risks in real-time, at multiple levels, which reinforced the site-level risk management process and procedures. The RAMtool database was developed and designed to assist in the capturing and analysis of the key elements of risk: probability, consequence, and impact. The RAMtool calculates the facility-level and programmatic-level risk factors to enable a side-by-side comparison to see where the facility manager and program manager should focus their risk reduction efforts and funding. This enables them to make solid decisions on priorities and funding to maximize the risk reduction. A more active risk management process was developed where risks and opportunities are actively managed, monitored, and controlled by each facility more aggressively and frequently. risk owners have the responsibility and accountability to manage their assigned risk in real-time, using the RAMtool database.« less

Service Level Decision-making in Rural Physiotherapy: Development of Conceptual Models.

PubMed

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2016-06-01

Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM. A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities. Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability; contextual influences; layered decision-making; access issues; value and beliefs; and tensions and conflict. Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with clinical decision-making and placing both within the broader healthcare context. The conceptual models provide a way of thinking about decisions informing rural physiotherapy service provision. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Individualized Education Program Team Decisions: A Preliminary Study of Conversations, Negotiations, and Power

ERIC Educational Resources Information Center

Ruppar, Andrea L.; Gaffney, Janet S.

2011-01-01

Given the centrality of the Individualized Education Program (IEP) to services for students with disabilities, the decision-making process during the IEP meeting deserves attention in research and implementation. In this case study, IEP team decision-making is examined as a socially situated practice. Transcripts of an initial evaluation and IEP…

Administrative Decision-Making in a Time of Resource Decline: The Case of California's Beginning Teacher Support and Assessment Program

ERIC Educational Resources Information Center

Reimann, Jason Daniel

2011-01-01

This dissertation is a qualitative study on the decision-making of administrators within California's Beginning Teacher Support and Assessment (BTSA) teacher induction program. The study focuses on examining how declining resources act as a pressure, how well-established research on cutback management predict the behaviors of the BTSA…

A Vision in Progress. The Decision To Establish a Public University at Monterey Bay. An Occasional Paper.

ERIC Educational Resources Information Center

Chance, William

This report describes the decision-making process and problems encountered during the 48 months it took to establish a new university, California State University at Monterey Bay, on the site of Fort Ord, a recently closed military base. After an introduction, the report is organized in four sections, one for each phase of the process. The first…

Comparative costs of family planning services and hospital-based maternity care in Turkey.

PubMed

Cakir, H V; Fabricant, S J; Kircalioğlu, F N

1996-01-01

The costs of running a recently established family planning program in the Turkish social security system were measured and compared with the costs of providing the medical services and nonmedical benefits for pregnant women. The undiscounted cost savings from averting pregnancy were estimated to exceed the program's recurrent costs by 17.6 to 1. Cost savings represent only 1 percent of all of the system's medical expenditures, but the family planning program is in an early stage, and potential savings could influence management decisionmaking regarding investments in specialized maternity hospitals.

Incentives for Optimal Multi-level Allocation of HIV Prevention Resources

PubMed Central

Malvankar, Monali M.; Zaric, Gregory S.

2013-01-01

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

Integrating strategic environmental assessment with industry planning: a case study of the Pasquai-Porcupine forest management plan, Saskatchewan, Canada.

PubMed

Noble, Bram F

2004-03-01

Strategic environmental assessment (SEA) is gaining widespread recognition as a tool for integrating environmental considerations in policy, plan, and program development and decision-making. Notwithstanding the potential of SEA to improve higher-order decision processes, there has been very little attention given to integrating SEA with industry planning practices. As a result, the benefits of SEA have yet to be fully realized among industrial proponents. That said, SEA practice is ongoing, albeit informally and often under a different label, and is proving to be a valuable tool for industry planning and decision-making. Based on a case study of the Pasquai-Porcupine forest management plan in Saskatchewan, Canada, this paper illustrates how an integrated approach to SEA can contribute to industry environmental decision-making and can enhance the quality and deliverability of industry plans.

Improving management of small natural features on private lands by negotiating the science-policy boundary for Maine vernal pools.

PubMed

Calhoun, Aram J K; Jansujwicz, Jessica S; Bell, Kathleen P; Hunter, Malcolm L

2014-07-29

Vernal pools are far more important for providing ecosystem services than one would predict based on their small size. However, prevailing resource-management strategies are not effectively conserving pools and other small natural features on private lands. Solutions are complicated by tensions between private property and societal rights, uncertainties over resource location and function, diverse stakeholders, and fragmented regulatory authority. The development and testing of new conservation approaches that link scientific knowledge, stakeholder decision-making, and conservation outcomes are important responses to this conservation dilemma. Drawing from a 15-y history of vernal pool conservation efforts in Maine, we describe the coevolution of pool conservation and research approaches, focusing on how research-based knowledge was produced and used in support of management decisions. As management shifted from reactive, top-down approaches to proactive and flexible approaches, research shifted from an ecology-focused program to an interdisciplinary program based on social-ecological systems. The most effective strategies for linking scientific knowledge with action changed as the decision-makers, knowledge needs, and context for vernal pool management advanced. Interactions among stakeholders increased the extent to which knowledge was coproduced and shifted the objective of stakeholder engagement from outreach to research collaboration and development of innovative conservation approaches. New conservation strategies were possible because of the flexible, solutions-oriented collaborations and trust between scientists and decision-makers (fostered over 15 y) and interdisciplinary, engaged research. Solutions to the dilemma of conserving small natural features on private lands, and analogous sustainability science challenges, will benefit from repeated negotiations of the science-policy boundary.

Systems identification and the adaptive management of waterfowl in the United States

USGS Publications Warehouse

Williams, B.K.; Nichols, J.D.

2001-01-01

Waterfowl management in the United States is one of the more visible conservation success stories in the United States. It is authorized and supported by appropriate legislative authorities, based on large-scale monitoring programs, and widely accepted by the public. The process is one of only a limited number of large-scale examples of effective collaboration between research and management, integrating scientific information with management in a coherent framework for regulatory decision-making. However, harvest management continues to face some serious technical problems, many of which focus on sequential identification of the resource system in a context of optimal decision-making. The objective of this paper is to provide a theoretical foundation of adaptive harvest management, the approach currently in use in the United States for regulatory decision-making. We lay out the legal and institutional framework for adaptive harvest management and provide a formal description of regulatory decision-making in terms of adaptive optimization. We discuss some technical and institutional challenges in applying adaptive harvest management and focus specifically on methods of estimating resource states for linear resource systems.

Framework for Site Characterization for Monitored Natural Attenuation of Volatile Organic Compounds in Ground Water

EPA Science Inventory

Monitored Natural Attenuation (MNA) is unique among remedial technologies in relying entirely on natural processes to achieve site-specific objectives. Site characterization is essential to provide site-specific data and interpretations for the decision-making process (i.e., to ...

Development and validation of a musculoskeletal physical examination decision-making test for medical students.

PubMed

Bishop, Julie Y; Awan, Hisham M; Rowley, David M; Nagel, Rollin W

2013-01-01

Despite a renewed emphasis among educators, musculoskeletal education is still lacking in medical school and residency training programs. We created a musculoskeletal multiple-choice physical examination decision-making test to assess competency and physical examination knowledge of our trainees. We developed a 20-question test in musculoskeletal physical examination decision-making test with content that most medical students and orthopedic residents should know. All questions were reviewed by ratings of US orthopedic chairmen. It was administered to postgraduate year 2 to 5 orthopedic residents and 2 groups of medical students: 1 group immediately after their 3-week musculoskeletal course and the other 1 year after the musculoskeletal course completion. We hypothesized that residents would score highest, medical students 1 year post-musculoskeletal training lowest, and students immediately post-musculoskeletal training midrange. We administered an established cognitive knowledge test to compare student knowledge base as we expected the scores to correlate. Academic medical center in the Midwestern United States. Orthopedic residents, chairmen, and medical students. Fifty-four orthopedic chairmen (54 of 110 or 49%) responded to our survey, rating a mean overall question importance of 7.12 (0 = Not Important; 5 = Important; 10 = Very Important). Mean physical examination decision-making scores were 89% for residents, 77% for immediate post-musculoskeletal trained medical students, and 59% 1 year post-musculoskeletal trained medical students (F = 42.07, p<0.001). The physical examination decision-making test was found to be internally consistent (Kuder-Richardson Formula 20 = 0.69). The musculoskeletal cognitive knowledge test was 78% for immediate post-musculoskeletal trained students and 71% for the 1 year post-musculoskeletal trained students. The student physical examination and cognitive knowledge scores were correlated (r = 0.54, p<0.001), but were not significantly different for either class. The physical examination decision-making test was found to be internally consistent in exposing the deficiencies of musculoskeletal education skills of our medical students and differentiated between ability levels in musculoskeletal physical examination decision-making (residents vs recently instructed musculoskeletal students vs 1 year post-musculoskeletal instruction). Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Influences on women's decision making about intrauterine device use in Madagascar.

PubMed

Gottert, Ann; Jacquin, Karin; Rahaivondrafahitra, Bakoly; Moracco, Kathryn; Maman, Suzanne

2015-04-01

We explored influences on decision making about intrauterine device (IUD) use among women in the Women's Health Project (WHP), managed by Population Services International in Madagascar. We conducted six small group photonarrative discussions (n=18 individuals) and 12 individual in-depth interviews with women who were IUD users and nonusers. All participants had had contact with WHP counselors in three sites in Madagascar. Data analysis involved creating summaries of each transcript, coding in Atlas.ti and then synthesizing findings in a conceptual model. We identified three stages of women's decision making about IUD use, and specific forms of social support that seemed helpful at each stage. During the first stage, receiving correct information from a trusted source such as a counselor conveys IUD benefits and corrects misinformation, but lingering fears about the method often appeared to delay method adoption among interested women. During the second stage, hearing testimony from satisfied users and receiving ongoing emotional support appeared to help alleviate these fears. During the third stage, accompaniment by a counselor or peer seemed to help some women gain confidence to go to the clinic to receive the IUD. Identifying and supplying the types of social support women find helpful at different stages of the decision-making process could help program managers better respond to women's staged decision-making process about IUD use. This qualitative study suggests that women in Madagascar perceive multiple IUD benefits but also fear the method even after misinformation is corrected, leading to a staged decision-making process about IUD use. Programs should identify and supply the types of social support that women find helpful at each stage of decision making. Copyright © 2015 Elsevier Inc. All rights reserved.

Fostering Culturally and Developmentally Responsive Teaching through Improvisational Practice

ERIC Educational Resources Information Center

Graue, Elizabeth; Whyte, Kristin; Delaney, Kate Kresin

2014-01-01

In this article we explore an effort to rethink curricular decision-making with a group of public pre-K teachers working in a context of curriculum escalation and commitment to play-based pedagogy. Through a professional development program designed to support developmentally and culturally responsive early mathematics, we examine how teachers…

Experiences of Teacher Evaluation Systems on High School Physical Education Programs

ERIC Educational Resources Information Center

Phillips, Sharon R.; Mercier, Kevin; Doolittle, Sarah

2017-01-01

Primary objective: Teacher evaluation is being revamped by policy-makers. The marginalized status of physical education has protected this subject area from reform for many decades, but in our current era of system-wide, data-based decision-making, physical education is no longer immune. Standardized and local testing, together with structured…

The Structure of Student Decision-Making at Community Colleges. CCRC Brief. Number 49

ERIC Educational Resources Information Center

Scott-Clayton, Judith

2011-01-01

Based on a longer review, this Brief summarizes research evidence and theoretical discussion regarding whether community college students are more likely to persist and succeed in programs that are tightly and consciously structured, with relatively little room for individuals to deviate from paths toward completion, and with limited bureaucratic…

Improving the Quality of Nursing Documentation in Home Health Care Setting

ERIC Educational Resources Information Center

Obioma, Chidiadi

2017-01-01

Poor nursing documentation of patient care was identified in daily nurse visit notes in a health care setting. This problem affects effective communication of patient status with other clinicians, thereby jeopardizing clinical decision-making. The purpose of this evidence-based project was to determine the impact of a retraining program on the…

Navigating Your Way through the Research Jungle

ERIC Educational Resources Information Center

Bauer, Scott; Brazer, David

2012-01-01

These days, information overload seems to be the normal state of existence. School leaders are inundated with descriptions of best practices and programs that work. They are exhorted to use evidence in all facets of decision-making and to employ research-based strategies to improve schools. Of course, research findings are seldom definitive, and…

Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

Case-based ethics instruction: the influence of contextual and individual factors in case content on ethical decision-making.

PubMed

Bagdasarov, Zhanna; Thiel, Chase E; Johnson, James F; Connelly, Shane; Harkrider, Lauren N; Devenport, Lynn D; Mumford, Michael D

2013-09-01

Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sense making processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed.

Applying Various Methods of Communicating Science for Community Decision-Making and Public Awareness: A NASA DEVELOP National Program Case Study

NASA Astrophysics Data System (ADS)

Miller, T. N.; Brumbaugh, E. J.; Barker, M.; Ly, V.; Schick, R.; Rogers, L.

2015-12-01

The NASA DEVELOP National Program conducts over eighty Earth science projects every year. Each project applies NASA Earth observations to impact decision-making related to a local or regional community concern. Small, interdisciplinary teams create a methodology to address the specific issue, and then pass on the results to partner organizations, as well as providing them with instruction to continue using remote sensing for future decisions. Many different methods are used by individual teams, and the program as a whole, to communicate results and research accomplishments to decision-makers, stakeholders, alumni, and the general public. These methods vary in scope from formal publications to more informal venues, such as social media. This presentation will highlight the communication techniques used by the DEVELOP program. Audiences, strategies, and outlets will be discussed, including a newsletter, microjournal, video contest, and several others.

The Adaptability of Career Decision-Making Profiles: Associations with Self-Efficacy, Emotional Difficulties, and Decision Status

ERIC Educational Resources Information Center

Gadassi, Reuma; Gati, Itamar; Wagman-Rolnick, Halleli

2013-01-01

The present study investigated a new model for characterizing the way individuals make career decisions (career decision-making profiles [CDMP]). Using data from 285 students in a preacademic program, the present study assessed the association of the CDMP's dimensions with the Emotional and Personality-related Career decision-making Difficulties…

Assessment of eight HPV vaccination programs implemented in lowest income countries.

PubMed

Ladner, Joël; Besson, Marie-Hélène; Hampshire, Rachel; Tapert, Lisa; Chirenje, Mike; Saba, Joseph

2012-05-23

Cervix cancer, preventable, continues to be the third most common cancer in women worldwide, especially in lowest income countries. Prophylactic HPV vaccination should help to reduce the morbidity and mortality associated with cervical cancer. The purpose of the study was to describe the results of and key concerns in eight HPV vaccination programs conducted in seven lowest income countries through the Gardasil Access Program (GAP). The GAP provides free HPV vaccine to organizations and institutions in lowest income countries. The HPV vaccination programs were entirely developed, implemented and managed by local institutions. Institutions submitted application forms with institution characteristics, target population, communication delivery strategies. After completion of the vaccination campaign (3 doses), institutions provided a final project report with data on doses administered and vaccination models. Two indicators were calculated, the program vaccination coverage and adherence. Qualitative data were also collected in the following areas: government and community involvement; communication, and sensitization; training and logistics resources, and challenges. A total of eight programs were implemented in seven countries. The eight programs initially targeted a total of 87,580 girls, of which 76,983 received the full 3-dose vaccine course, with mean program vaccination coverage of 87.8%; the mean adherence between the first and third doses of vaccine was 90.9%. Three programs used school-based delivery models, 2 used health facility-based models, and 3 used mixed models that included schools and health facilities. Models that included school-based vaccination were most effective at reaching girls aged 9-13 years. Mixed models comprising school and health facility-based vaccination had better overall performance compared with models using just one of the methods. Increased rates of program coverage and adherence were positively correlated with the number of vaccination sites. Qualitative key insights from the school models showed a high level of coordination and logistics to facilitate vaccination administration, a lower risk of girls being lost to follow-up and vaccinations conducted within the academic year limit the number of girls lost to follow-up. Mixed models that incorporate both schools and health facilities appear to be the most effective at delivering HPV vaccine. This study provides lessons for development of public health programs and policies as countries go forward in national decision-making for HPV vaccination.

Assessment of eight HPV vaccination programs implemented in lowest income countries

PubMed Central

2012-01-01

Background Cervix cancer, preventable, continues to be the third most common cancer in women worldwide, especially in lowest income countries. Prophylactic HPV vaccination should help to reduce the morbidity and mortality associated with cervical cancer. The purpose of the study was to describe the results of and key concerns in eight HPV vaccination programs conducted in seven lowest income countries through the Gardasil Access Program (GAP). Methods The GAP provides free HPV vaccine to organizations and institutions in lowest income countries. The HPV vaccination programs were entirely developed, implemented and managed by local institutions. Institutions submitted application forms with institution characteristics, target population, communication delivery strategies. After completion of the vaccination campaign (3 doses), institutions provided a final project report with data on doses administered and vaccination models. Two indicators were calculated, the program vaccination coverage and adherence. Qualitative data were also collected in the following areas: government and community involvement; communication, and sensitization; training and logistics resources, and challenges. Results A total of eight programs were implemented in seven countries. The eight programs initially targeted a total of 87,580 girls, of which 76,983 received the full 3-dose vaccine course, with mean program vaccination coverage of 87.8%; the mean adherence between the first and third doses of vaccine was 90.9%. Three programs used school-based delivery models, 2 used health facility-based models, and 3 used mixed models that included schools and health facilities. Models that included school-based vaccination were most effective at reaching girls aged 9-13 years. Mixed models comprising school and health facility-based vaccination had better overall performance compared with models using just one of the methods. Increased rates of program coverage and adherence were positively correlated with the number of vaccination sites. Qualitative key insights from the school models showed a high level of coordination and logistics to facilitate vaccination administration, a lower risk of girls being lost to follow-up and vaccinations conducted within the academic year limit the number of girls lost to follow-up. Conclusion Mixed models that incorporate both schools and health facilities appear to be the most effective at delivering HPV vaccine. This study provides lessons for development of public health programs and policies as countries go forward in national decision-making for HPV vaccination. PMID:22621342

Telemedicine and electronic health information for clinical continuity in a mobile surgery program.

PubMed

Mora, Francisco; Cone, Stephen; Rodas, Edgar; Merrell, Ronald C

2006-06-01

An intermittent surgical services program in rural Ecuador was able to benefit from close collaboration between surgeons and primary care physicians through the use of telemedicine technologies. Inexpensive telemedicine workstations capable of patient documentation, imaging, and video-conferencing at extremely low bandwidth were established in collaborative primary care sites in rural Ecuador. Patients were screened for intermittent surgical services by primary caregivers according to the surgeons' guidelines. Real-time and store-and-forward telemedicine allowed appropriate collaborative, informed decision-making. Surgery was performed, and postoperative care was similarly handled by on-site, familiar primary caregivers. To date, this system has been used in more than 124 patient encounters (74 preoperative and 50 postoperative visits). The system allowed advance screening of patients on the part of the surgeons, leading to cancellations for 9 patients. Postoperatively, the system allowed 100% concurrence in postoperative diagnoses between the primary caregivers and the surgeons. Inexpensive, low-bandwidth telemedicine solutions can support intermittent surgical services by providing patients to have contact with specialist care through their familiar, local primary caregivers.

Providing guidance for genomics-based cancer treatment decisions: insights from stakeholder engagement for post-prostatectomy radiation therapy.

PubMed

Abe, James; Lobo, Jennifer M; Trifiletti, Daniel M; Showalter, Timothy N

2017-08-24

Despite the emergence of genomics-based risk prediction tools in oncology, there is not yet an established framework for communication of test results to cancer patients to support shared decision-making. We report findings from a stakeholder engagement program that aimed to develop a framework for using Markov models with individualized model inputs, including genomics-based estimates of cancer recurrence probability, to generate personalized decision aids for prostate cancer patients faced with radiation therapy treatment decisions after prostatectomy. We engaged a total of 22 stakeholders, including: prostate cancer patients, urological surgeons, radiation oncologists, genomic testing industry representatives, and biomedical informatics faculty. Slides were at each meeting to provide background information regarding the analytical framework. Participants were invited to provide feedback during the meeting, including revising the overall project aims. Stakeholder meeting content was reviewed and summarized by stakeholder group and by theme. The majority of stakeholder suggestions focused on aspects of decision aid design and formatting. Stakeholders were enthusiastic about the potential value of using decision analysis modeling with personalized model inputs for cancer recurrence risk, as well as competing risks from age and comorbidities, to generate a patient-centered tool to assist decision-making. Stakeholders did not view privacy considerations as a major barrier to the proposed decision aid program. A common theme was that decision aids should be portable across multiple platforms (electronic and paper), should allow for interaction by the user to adjust model inputs iteratively, and available to patients both before and during consult appointments. Emphasis was placed on the challenge of explaining the model's composite result of quality-adjusted life years. A range of stakeholders provided valuable insights regarding the design of a personalized decision aid program, based upon Markov modeling with individualized model inputs, to provide a patient-centered framework to support for genomic-based treatment decisions for cancer patients. The guidance provided by our stakeholders may be broadly applicable to the communication of genomic test results to patients in a patient-centered fashion that supports effective shared decision-making that represents a spectrum of personal factors such as age, medical comorbidities, and individual priorities and values.

Strategic Moments: IDENTIFYING OPPORTUNITIES TO ENGAGE CLIENTS IN ATTENDING CARDIAC REHABILITATION AND MAINTAINING LIFESTYLE CHANGES.

PubMed

Fletcher, Susan Marilyn; McBurney, Helen

2016-01-01

There has been extensive investigation of attendance rates at cardiac rehabilitation (CR) but little attention to client reasoning around attendance. This study explored decision-making drivers for attendance or nonattendance at CR programs in rural Victoria, Australia. All new patients referred to the CR programs at either the local hospital or community health service over a 6-month period were invited to participate and were interviewed before, after, and at 6 months post-CR. Content analysis was used to identify and group common themes that emerged from the semistructured interviews. Eighty-four of the 114 patients referred agreed to participate in the study. Multiple barriers or facilitators affected the decisions of all clients. Three themes were identified that reflected the participant decision-making experience: (1) invitation and information about participation in CR; (2) person-centered approach to CR provision; and (3) ongoing support needs. Significant decision-making points identified were after the cardiac event; before and after hospital-based CR; before and after community-based CR; and at 6 months after the cardiac event. At any time there is a risk that the client can become lost or disengaged in the service system, but providing contact at these points can allow them to reengage. This study provided the opportunity to hear participant voices, describing their decisions around CR attendance after a cardiac event. They highlighted the complexity of issues confronting them and suggested improvements to optimize their attendance and to maintain lifestyle changes.

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

PubMed

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

2017-01-01

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

Effluent trading in river systems through stochastic decision-making process: a case study.

PubMed

Zolfagharipoor, Mohammad Amin; Ahmadi, Azadeh

2017-09-01

The objective of this paper is to provide an efficient framework for effluent trading in river systems. The proposed framework consists of two pessimistic and optimistic decision-making models to increase the executability of river water quality trading programs. The models used for this purpose are (1) stochastic fallback bargaining (SFB) to reach an agreement among wastewater dischargers and (2) stochastic multi-criteria decision-making (SMCDM) to determine the optimal treatment strategy. The Monte-Carlo simulation method is used to incorporate the uncertainty into analysis. This uncertainty arises from stochastic nature and the errors in the calculation of wastewater treatment costs. The results of river water quality simulation model are used as the inputs of models. The proposed models are used in a case study on the Zarjoub River in northern Iran to determine the best solution for the pollution load allocation. The best treatment alternatives selected by each model are imported, as the initial pollution discharge permits, into an optimization model developed for trading of pollution discharge permits among pollutant sources. The results show that the SFB-based water pollution trading approach reduces the costs by US$ 14,834 while providing a relative consensus among pollutant sources. Meanwhile, the SMCDM-based water pollution trading approach reduces the costs by US$ 218,852, but it is less acceptable by pollutant sources. Therefore, it appears that giving due attention to stability, or in other words acceptability of pollution trading programs for all pollutant sources, is an essential element of their success.

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

PubMed

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

2018-05-30

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

Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 1).

PubMed

Mañós, M; Giralt, J; Rueda, A; Cabrera, J; Martinez-Trufero, J; Marruecos, J; Lopez-Pousa, A; Rodrigo, J P; Castelo, B; Martínez-Galán, J; Arias, F; Chaves, M; Herranz, J J; Arrazubi, V; Baste, N; Castro, A; Mesía, R

2017-07-01

Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists must deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers several specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved. Copyright © 2017. Published by Elsevier Ltd.

Sexual Assertiveness Skills and Sexual Decision-Making in Adolescent Girls: Randomized Controlled Trial of an Online Program.

PubMed

Widman, Laura; Golin, Carol E; Kamke, Kristyn; Burnette, Jeni L; Prinstein, Mitchell J

2018-01-01

To evaluate the efficacy of an interactive, Web-based sexual health program (Health Education and Relationship Training [HEART]) for developing sexual assertiveness skills and enhancing sexual decision-making in adolescent girls. Participants were 222 tenth-grade girls (mean age = 15.2; 38% White, 29% Hispanic, 25% Black) in the Southeastern United States who were randomized in fall 2015 to the HEART intervention or an attention-matched control. We assessed participants at pretest, immediate posttest, and 4-month follow-up. Both groups had similar demographic and sexual behavior characteristics at pretest. At immediate posttest, girls who completed the HEART program demonstrated better sexual assertiveness skills measured with a behavioral task, higher self-reported assertiveness, intentions to communicate about sexual health, knowledge regarding HIV and other sexually transmitted diseases (STDs), safer sex norms and attitudes, and condom self-efficacy compared with the control condition. At 4-month follow-up, group differences remained in knowledge regarding HIV and other STDs, condom attitudes, and condom self-efficacy. This brief online sexual health program can improve short-term outcomes among adolescent girls and offers an exciting new option in the growing array of digital health interventions available to youths. NCT02579135.

TECHNICAL APPROACHES TO CHARACTERIZING AND REDEVELOPING BROWNFIELDS SITES: MUNICIPAL LANDFILLS AND ILLEGAL DUMPS

EPA Science Inventory

The guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the private sector to address issues related to the redevelopment of Brownfields sites, specifically, municipal landfill and illegal dump sites. The document helps use...

Change is hard: What science teachers are telling us about reform and teacher learning of innovative practices

NASA Astrophysics Data System (ADS)

Davis, Kathleen S.

2003-01-01

Over the last decade, significant efforts have been made to bring change to science classrooms. Educational researchers (Anderson, R. D., & Helms, J. V. (2001). Journal of Research in Science Teaching, 38(1), 3-16.) have pointed to the need to examine reform efforts systemically to understand the pathways and impediments to successful reform. This study provides a critical analysis of the implementation of an innovative science curriculum at a middle school site. In particular, the author explores the issues that surround teacher learning of new practices including the structures, policies, and practices that were in place within the reform context that supported or impeded teacher learning. Parallels are drawn between student and teacher learning and the importance of autonomy and decision-making structures for both populations of learners. Findings presented include (1) how staff development with constructivist underpinnings facilitated teacher learning; (2) how regular and frequent opportunities for interactions with colleagues and outside support personnel contributed to teacher learning; (3) how the decline of such interactive forums and the continuation of old decision-making structures restricted the development of teacher knowledge, expertise, and a common vision of the science program; and (4) how the process of field-testing at this site limited the incorporation of teachers' prior knowledge and impacted teacher acquisition of new knowledge and skills.

External factors affecting decision-making and use of evidence in an Australian public health policy environment.

PubMed

Zardo, Pauline; Collie, Alex; Livingstone, Charles

2014-05-01

This study examined external factors affecting policy and program decision-making in a specific public health policy context: injury prevention and rehabilitation compensation in the Australian state of Victoria. The aim was twofold: identify external factors that affect policy and program decision-making in this specific context; use this evidence to inform targeting of interventions aimed at increasing research use in this context. Qualitative interviews were undertaken from June 2011 to January 2012 with 33 employees from two state government agencies. Key factors identified were stakeholder feedback and action, government and ministerial input, legal feedback and action, injured persons and the media. The identified external factors were able to significantly influence policy and program decision-making processes: acting as both barriers and facilitators, depending on the particular issue at hand. The factors with the most influence were the Minister and government, lawyers, and agency stakeholders, particularly health providers, trade unions and employer groups. This research revealed that interventions aimed at increasing use of research in this context must target and harness the influence of these groups. This research provides critical insights for researchers seeking to design interventions to increase use of research in policy environments and influence decision-making in Victorian injury prevention and rehabilitation compensation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Knowledge, perceptions, and decision-making about human papillomavirus vaccination among Korean American women: A focus group study

PubMed Central

Kim, Kyounghae; Kim, Boyoung; Choi, Eunsuk; Song, Youngshin; Han, Hae-Ra

2014-01-01

Objective As one of the fastest growing ethnic minority groups in the United States, Korean American (KA) women experience a heightened cervical cancer burden. The advent of the human papillomavirus (HPV) vaccine offers an unprecedented opportunity to eliminate cervical cancer disparities in KA women. Yet, the uptake of HPV vaccine among KA adolescents remains suboptimal. Hence, we set out to explore knowledge, perceptions, and decision-making about HPV vaccination among KA women. Methods We conducted four focus groups of 26 KA women who participated in a community-based randomized controlled trial to promote breast and cervical cancer screening. Focus group data were analyzed using qualitative content analysis. Results Four main themes emerged from the focus groups: (1) limited awareness and knowledge of HPV vaccine, (2) perceptions and beliefs about HPV vaccination (acceptance, negative perceptions, ambivalence), (3) patterns of decision-making about HPV vaccination (hierarchical, peer-influenced, autonomous, and collaborative), and (4) promoting HPV education and information-sharing in the Korean community. Conclusion KA women are generally favorable toward HPV vaccination but lack awareness and knowledge about HPV. Culturally tailored HPV education programs based on KA women’s decision-making patterns and effective information-sharing by trustworthy sources in comfortable environments are suggested strategies to promote HPV vaccination in the KA community. The findings point to the need for a multi-level approach to addressing linguistic, cultural, and system barriers that the recent immigrant community faces in promoting HPV vaccinations. In the development of targeted interventions for KA women, educational strategies and patterns of decision-making need to be considered. PMID:25747518

Barriers to electric energy efficiency in Ghana

NASA Astrophysics Data System (ADS)

Berko, Joseph Kofi, Jr.

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

The Relationship between Career Decision-Making Self-Efficacy and Perceived Career Barriers in the Career Decision Making of Selected Community College Students

ERIC Educational Resources Information Center

Kelly, Rosemary Ritter

2010-01-01

This study explored the differences between career decision-making self-efficacy (CDMSE) and perceived career barriers of students enrolled in the applied technology program compared to those enrolled in a college transfer program at a southeastern urban community college. Participants in the ex-post facto cross-sectional survey included 787…

Manager`s views of public involvement

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

Branch, K.M.; Heerwagen, J.; Bradbury, J.

1995-12-01

Four issues commonly form the framework for debates about the acceptability of proposed projects or technologies--the substantive decision or technological choice; the treatment of the community by the proponent organization; the way the decision-making process has been structured and managed; and the status of institutional safeguards and protection. One of the clear messages of cultural theory is that differences in perspectives are a normal and inevitable part of society, and that attempts to resolve differences by persuasion are not likely to work. These findings are useful when considering the goals and possibilities of public involvement as a decision-making tool, andmore » when designing or evaluating public involvement training programs for managers. The research reported here examines the viewpoints and concerns of managers and decision-makers about the four issues identified above, with particular emphasis on their perspectives and concerns about opening decision-making processes to the public and about managers` roles and responsibilities for structuring and managing open decision-making processes. Implications of these findings for public involvement training for managers is also discussed. The data presented in this paper were obtained from face-to-face interviews with managers and decision-makers with experience managing a variety of hazardous waste management decision-making processes. We conducted these interviews in the course of four separate research projects: needs assessments to support the design and development of a public involvement training program for managers; a study of community residents` and managers` perspectives on the chemical stockpile disposal program; an evaluation of the effectiveness of public involvement training for managers in the Department of Energy; and a study to develop indicators of the benefits and costs of public involvement.« less

Essential Resources for Implementation and Sustainability of Evidence-Based Health Promotion Programs: A Mixed Methods Multi-Site Case Study.

PubMed

Dattalo, M; Wise, M; Ford Ii, J H; Abramson, B; Mahoney, J

2017-04-01

As of October 2016, use of federal Older Americans Act funds for health promotion and disease prevention will be restricted to the Administration on Aging's criteria for high-level evidence-based health promotion programs. Dissemination of these programs to rural communities remains limited. Therefore a strong need exists to identify strategies that facilitate program implementation and sustainability. The objective of this study was to compare organizational readiness and implementation strategies used by rural communities that achieved varying levels of success in sustaining evidence-based health promotion programs for older adults. We utilized a qualitative multi-site case study design to analyze the longitudinal experiences of eight rural sites working to implement evidence-based health promotion program over 3 years (8/2012-7/2015). Multiple sources of data (interviews, documents, reports, surveys) from each site informed the analysis. We used conventional content analysis to conduct a cross-case comparison to identify common features of rural counties that successfully implemented and sustained their target evidence-based health promotion program. Readiness to implement evidence-based programs as low at baseline as all site leaders described needing to secure additional resources for program implementation. Sites that successfully utilized six essential resources implemented and sustained greater numbers of workshops: (1) External Partnerships, (2) Agency Leadership Commitment, (3) Ongoing Source of Workshop Leaders, (4) Health Promotion Coordination Tasks Assigned to Specific Staff, (5) Organizational Stability, and (6) Change Team Engagement. The six essential resources described in this study can help rural communities assess their readiness to implement health promotion programs and work secure the resources necessary for successful implementation.

DECISION ANALYSIS OF INCINERATION COSTS IN SUPERFUND SITE REMEDIATION

EPA Science Inventory

This study examines the decision-making process of the remedial design (RD) phase of on-site incineration projects conducted at Superfund sites. Decisions made during RD affect the cost and schedule of remedial action (RA). Decision analysis techniques are used to determine the...

TECHNICAL APPROACHES TO CHARACTERIZING AND CLEANING UP BROWNFIELDS SITES: PULP AND PAPER MILLS

EPA Science Inventory

This guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the private sector to address issues related to the redevelopment of Brownfields sites, specifically pulp and paper mills sites. The document helps users to understan...

Curriculum Analytics: Application of Social Network Analysis for Improving Strategic Curriculum Decision-Making in a Research-Intensive University

ERIC Educational Resources Information Center

Dawson, Shane; Hubball, Harry

2014-01-01

This paper provides insight into the use of curriculum analytics to enhance learning-centred curricula in diverse higher education contexts. Engagement in evidence-based practice to evaluate and monitor curricula is vital to the success and sustainability of efforts to reform undergraduate and graduate programs. Emerging technology-enabled inquiry…

From Assessment to Annual Goal: Engaging a Decision-Making Process in Writing Measurable IEPs

ERIC Educational Resources Information Center

Capizzi, Andrea M.

2008-01-01

Despite federal regulations requiring measurable individualized education programs (IEPs), IEPs are often vague and unfocused, making them difficult to use in guiding instructional planning. Although a well-written IEP can be time consuming and labor intensive, a clearly written IEP, based on documented student needs, can and should be a guidepost…

A Collaborative Data Chat: Teaching Summative Assessment Data Use in Pre-Service Teacher Education

ERIC Educational Resources Information Center

Piro, Jody S.; Dunlap, Karen; Shutt, Tammy

2014-01-01

As the quality of educational outputs has been problematized, accountability systems have driven reform based upon summative assessment data. These policies impact the ways that educators use data within schools and subsequently, how teacher education programs may adjust their curricula to teach data-driven decision-making to inform instruction.…

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

ERIC Educational Resources Information Center

Guthrie, Tammy Reutzel

2017-01-01

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

DEVELOPMENT OF A SYSTEMATIC APPROACH TO ...

EPA Pesticide Factsheets

Risk assessment is a crucial component of the site remediation decision-making process. Some current EPA methods do not have detection limits low enough for risk assessment of many VOCs (e.g., EPA Region 3 Risk Based Concentration levels, EPA Region 9 Preliminary Remediation Goals, state-specified concentration levels). The magnitude of this problem was described in a paper recently presented at a University of Massachusetts Remediation Conference with the conclusion that the resolution of this issue is critical for valid human health and ecological risk assessments. Likewise, the difficulty of obtaining complete extraction of water-soluble VOCs and semi-volatile organic compounds (SVOCs) makes the generation of reliable and reproducible data a serious concern in site characterization and risk assessment programs.This poster presents findings of the development of an analytical method which uses thermal desorption combined with dual gas chromatography/mass spectrometry (GC/MS) to extract and accurately measure low levels of VOCs and SVOCs in soil and sediment samples with medium to high moisture content. Thermal extraction was selected for examination because the technique is simpler and more efficient than the present EPA purge-and-trap methods, and all water-soluble compounds are amenable to the procedure. Efforts were made to modify commonly used instrumentation (e.g., Archon

Community Response to Concentrating Solar Power in the San Luis Valley: October 9, 2008 - March 31, 2010

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

Farhar, B. C.; Hunter, L. M.; Kirkland, T. M.

2010-06-01

This report is about the social acceptance of utility-scale concentrating solar power (CSP) plants in the San Luis Valley, approximately 200 miles southwest of Denver, Colorado. The research focused on social factors that may facilitate and impede the adoption and implementation of CSP. During the winter of 2008-2009, interviews were conducted with a purposive sample of 25 CSP-related stakeholders inside and outside the Valley. Interviews focused on the perceived advantages and disadvantages of siting a hypothetical 100-MW CSP facility in the Valley, the level of community support and opposition to CSP development, and related issues, such as transmission. State policymore » recommendations based on the findings include developing education programs for Valley residents, integrating Valley decision makers into an energy-water-land group, providing training for Valley decision makers, offering workforce training, evaluating models of taxation, and forming landholder energy associations. In addition, the SLV could become a laboratory for new approaches to CSP facility and transmission siting decision-making. The author recommends that outside stakeholders address community concerns and engage Valley residents in CSP decisions. Engaging the residents in CSP and transmission decisions, the author says, should take parallel significance with the investment in solar technology.« less

Tourism climatology for camping: a case study of two Ontario parks (Canada)

NASA Astrophysics Data System (ADS)

Hewer, Micah J.; Scott, Daniel; Gough, William A.

2015-08-01

Climate and weather act as central motivators for the travel decisions of tourists. Due to their seasonality, these factors determine the availability and quality of certain outdoor recreational activities. Park visitation in Ontario, Canada, has been identified as a weather sensitive tourism and recreation activity. This study used a survey-based approach to identify and compare stated weather preferences and thresholds, as well as weather-related decision-making for campers at two provincial parks in Ontario, Canada. The two parks were selected for differing physical and environmental characteristics (forested lake versus coastal beach). Statistically significant differences were detected between the two parks in relation to the importance of weather and weather-based decision-making. Specific temperatures that were considered ideal and thresholds that were too cool and too warm were identified for both parks, both during the day and the night. Heavy rain and strong winds were the most influential factors in weather-related decision-making and on-site behavioural adaptations. Beach campers placed greater importance on the absence of rain and the presence of comfortable temperatures compared to forest campers. In addition, beach campers were more likely to leave the park early due to incremental weather changes. The results of this study suggest that beach campers are more sensitive to weather than forest campers.

Integrating student-focused career planning into undergraduate gerontology programs.

PubMed

Manoogian, Margaret M; Cannon, Melissa L

2018-04-02

As our global older adult populations are increasing, university programs are well-positioned to produce an effective, gerontology-trained workforce (Morgan, 2012; Silverstein & Fitzgerald, 2017). A gerontology curriculum comprehensively can offer students an aligned career development track that encourages them to: (a) learn more about themselves as a foundation for negotiating career paths; (b) develop and refine career skills; (c) participate in experiential learning experiences; and (d) complete competency-focused opportunities. In this article, we discuss a programmatic effort to help undergraduate gerontology students integrate development-based career planning and decision-making into their academic programs and achieve postgraduation goals.

Systematic teaching method to enhance the effectiveness of training for paragonimiasis.

PubMed

Zhang, Jian; Zhang, Xilin; Huang, Fusheng; Xu, Wenyue

2013-01-01

The clinical symptoms of human paragonimiasis are complex and variable, and patients can easily be misdiagnosed. Pagumogonimus skrjabini is the species causing this disease found only in China. A 2002 epidemiological survey showed that the rate of paragonimiasis was 21·96% in the migration areas of the Three-Gorge Reservoir, Chongqing, China. Therefore, there is a need to train medical workers to treat individuals in these areas. The Third Military Medical University (TMMU) in Chongqing built a comprehensive and systematic teaching method, which included teaching students about the basic biology of the organism, guiding students to use appropriate diagnostic tests and participate in scientific research to develop diagnostic kits, and visiting endemic areas to provide on-site teaching. The use of on-site teaching is an innovative approach for training undergraduate medical students in human parasitology. Three improvements were implemented during the on-site teaching component of the program: (1) systematizing the learning process; (2) integrating formal knowledge with clinical experience; and (3) enhancing students' knowledge of medical ethics. Based on a survey, 95% of students believed that this systematic teaching system gave them a more comprehensive grasp of knowledge on P. skrjabini, and graduate students were able to provide early diagnosis of P. skrjabini cases in this remote region. Students also participated in the research and development of a P. skrjabini diagnostic kit, for which a patent has been applied, and during the on-site teaching process, data were collected for the government and health sector to assist in public-health planning and decision-making for this disease.

Distinction between Externally vs. Internally Guided Decision-Making: Operational Differences, Meta-Analytical Comparisons and Their Theoretical Implications

PubMed Central

Nakao, Takashi; Ohira, Hideki; Northoff, Georg

2012-01-01

Most experimental studies of decision-making have specifically examined situations in which a single less-predictable correct answer exists (externally guided decision-making under uncertainty). Along with such externally guided decision-making, there are instances of decision-making in which no correct answer based on external circumstances is available for the subject (internally guided decision-making). Such decisions are usually made in the context of moral decision-making as well as in preference judgment, where the answer depends on the subject’s own, i.e., internal, preferences rather than on external, i.e., circumstantial, criteria. The neuronal and psychological mechanisms that allow guidance of decisions based on more internally oriented criteria in the absence of external ones remain unclear. This study was undertaken to compare decision-making of these two kinds empirically and theoretically. First, we reviewed studies of decision-making to clarify experimental–operational differences between externally guided and internally guided decision-making. Second, using multi-level kernel density analysis, a whole-brain-based quantitative meta-analysis of neuroimaging studies was performed. Our meta-analysis revealed that the neural network used predominantly for internally guided decision-making differs from that for externally guided decision-making under uncertainty. This result suggests that studying only externally guided decision-making under uncertainty is insufficient to account for decision-making processes in the brain. Finally, based on the review and results of the meta-analysis, we discuss the differences and relations between decision-making of these two types in terms of their operational, neuronal, and theoretical characteristics. PMID:22403525

Improving management of small natural features on private lands by negotiating the science–policy boundary for Maine vernal pools

PubMed Central

Calhoun, Aram J. K.; Jansujwicz, Jessica S.; Bell, Kathleen P.; Hunter, Malcolm L.

2014-01-01

Vernal pools are far more important for providing ecosystem services than one would predict based on their small size. However, prevailing resource-management strategies are not effectively conserving pools and other small natural features on private lands. Solutions are complicated by tensions between private property and societal rights, uncertainties over resource location and function, diverse stakeholders, and fragmented regulatory authority. The development and testing of new conservation approaches that link scientific knowledge, stakeholder decision-making, and conservation outcomes are important responses to this conservation dilemma. Drawing from a 15-y history of vernal pool conservation efforts in Maine, we describe the coevolution of pool conservation and research approaches, focusing on how research-based knowledge was produced and used in support of management decisions. As management shifted from reactive, top-down approaches to proactive and flexible approaches, research shifted from an ecology-focused program to an interdisciplinary program based on social–ecological systems. The most effective strategies for linking scientific knowledge with action changed as the decision-makers, knowledge needs, and context for vernal pool management advanced. Interactions among stakeholders increased the extent to which knowledge was coproduced and shifted the objective of stakeholder engagement from outreach to research collaboration and development of innovative conservation approaches. New conservation strategies were possible because of the flexible, solutions-oriented collaborations and trust between scientists and decision-makers (fostered over 15 y) and interdisciplinary, engaged research. Solutions to the dilemma of conserving small natural features on private lands, and analogous sustainability science challenges, will benefit from repeated negotiations of the science–policy boundary. PMID:25002496

Systematic Analysis of the Decision Rules of Traditional Chinese Medicine

PubMed Central

Bin-Rong, Ma; Xi-Yuan, Jiang; Su-Ming, Liso; Huai-ning, Zhu; Xiu-ru, Lin

1981-01-01

Chinese traditional medicine has evolved over many centuries, and has accumulated a body of observed relationships between symptoms, signs and prognoses, and the efficacy of alternative treatments and prescriptions. With the assistance of a computer-based clinical data base for recording the diagnostic and therapeutic practice of skilled practitioners of Chinese traditional medicine, a systematic program is being conducted to identify and define the clinical decision-making rules that underlie current practice.

Development, implementation and evaluation of an evidence-based program for introduction of new health technologies and clinical practices in a local healthcare setting.

PubMed

Harris, Claire; Garrubba, Marie; Allen, Kelly; King, Richard; Kelly, Cate; Thiagarajan, Malar; Castleman, Beverley; Ramsey, Wayne; Farjou, Dina

2015-12-28

This paper reports the process of establishing a transparent, accountable, evidence-based program for introduction of new technologies and clinical practices (TCPs) in a large Australian healthcare network. Many countries have robust evidence-based processes for assessment of new TCPs at national level. However many decisions are made by local health services where the resources and expertise to undertake health technology assessment (HTA) are limited and a lack of structure, process and transparency has been reported. An evidence-based model for process change was used to establish the program. Evidence from research and local data, experience of health service staff and consumer perspectives were incorporated at each of four steps: identifying the need for change, developing a proposal, implementation and evaluation. Checklists assessing characteristics of success, factors for sustainability and barriers and enablers were applied and implementation strategies were based on these findings. Quantitative and qualitative methods were used for process and outcome evaluation. An action research approach underpinned ongoing refinement to systems, processes and resources. A Best Practice Guide developed from the literature and stakeholder consultation identified seven program components: Governance, Decision-Making, Application Process, Monitoring and Reporting, Resources, Administration, and Evaluation and Quality Improvement. The aims of transparency and accountability were achieved. The processes are explicit, decisions published, outcomes recorded and activities reported. The aim of ascertaining rigorous evidence-based information for decision-making was not achieved in all cases. Applicants proposing new TCPs provided the evidence from research literature and local data however the information was often incorrect or inadequate, overestimating benefits and underestimating costs. Due to these limitations the initial application process was replaced by an Expression of Interest from applicants followed by a rigorous HTA by independent in-house experts. The program is generalisable to most health care organisations. With one exception, the components would be achievable with minimal additional resources; the lack of skills and resources required for HTA will limit effective application in many settings. A toolkit containing details of the processes and sample materials is provided to facilitate replication or local adaptation by those wishing to establish a similar program.

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

PubMed

Teimoury, Ebrahim; Jabbarzadeh, Armin; Babaei, Mohammadhosein

2017-01-01

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

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

PubMed Central

Jabbarzadeh, Armin; Babaei, Mohammadhosein

2017-01-01

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

Data-Based Decision-Making: Developing a Method for Capturing Teachers' Understanding of CBM Graphs

ERIC Educational Resources Information Center

Espin, Christine A.; Wayman, Miya Miura; Deno, Stanley L.; McMaster, Kristen L.; de Rooij, Mark

2017-01-01

In this special issue, we explore the decision-making aspect of "data-based decision-making". The articles in the issue address a wide range of research questions, designs, methods, and analyses, but all focus on data-based decision-making for students with learning difficulties. In this first article, we introduce the topic of…

The Internet and the therapeutic education of patients: A systematic review of the literature.

PubMed

Gremeaux, V; Coudeyre, E

2010-12-01

To evaluate from a review of the literature the interest of using the Internet as a tool for the therapeutic education of patients. A systematic review of Pubmed was carried out using the key words: the Internet, or World Wide Web and patient education, or patient preference, or self-care. The search was restricted to articles in English published between 1990 and 2009. References to the selected articles were also analyzed. Only randomized controlled studies were retained. Thirty-nine articles concerning 20 different diseases met the inclusion criteria and were analyzed. Different types of programs were proposed: informative, interactive, cognitive-behavioral and programs concerning self-management of the disease and the treatment. These different approaches were sometimes compared. The use of quality Internet sites made it possible to induce beneficial changes in lifestyle habits, and to diminish subjective and/or objective symptom severity in chronic invalidating diseases when used as a complement to traditional management. By using the Internet, patients were also able to improve decision-making skills to a degree that was at least as good as that obtained using traditional paper documents. The Internet is an effective complementary tool that can contribute to improving therapeutic education. Nonetheless, healthcare professionals should work with patients to create quality sites that correspond more closely to their expectations. It is also essential for learned societies such as the SOFMER to invest in therapeutic education on the Internet to make quality therapeutic education modules based on factual medical data and complying with good practices available on line. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Linguistic multi-criteria decision-making with representing semantics by programming

NASA Astrophysics Data System (ADS)

Yang, Wu-E.; Ma, Chao-Qun; Han, Zhi-Qiu

2017-01-01

A linguistic multi-criteria decision-making method is introduced. In this method, a maximising discrimination programming assigns the semanteme values to linguistic variables to represent their semantics. Incomplete preferences from using linguistic information are expressed by the constraints of the model. Such assignment can amplify the difference between alternatives. Thus, the discrimination of the decision model is increased, which facilitates the decision-maker to rank or order the alternatives for making a decision. We also discuss the parameter setting and its influence, and use an application example to illustrate the proposed method. Further, the results with three types of semantic structure highlight the ability of the method in handling different semantic structures.

Classification and disease prediction via mathematical programming

NASA Astrophysics Data System (ADS)

Lee, Eva K.; Wu, Tsung-Lin

2007-11-01

In this chapter, we present classification models based on mathematical programming approaches. We first provide an overview on various mathematical programming approaches, including linear programming, mixed integer programming, nonlinear programming and support vector machines. Next, we present our effort of novel optimization-based classification models that are general purpose and suitable for developing predictive rules for large heterogeneous biological and medical data sets. Our predictive model simultaneously incorporates (1) the ability to classify any number of distinct groups; (2) the ability to incorporate heterogeneous types of attributes as input; (3) a high-dimensional data transformation that eliminates noise and errors in biological data; (4) the ability to incorporate constraints to limit the rate of misclassification, and a reserved-judgment region that provides a safeguard against over-training (which tends to lead to high misclassification rates from the resulting predictive rule) and (5) successive multi-stage classification capability to handle data points placed in the reserved judgment region. To illustrate the power and flexibility of the classification model and solution engine, and its multigroup prediction capability, application of the predictive model to a broad class of biological and medical problems is described. Applications include: the differential diagnosis of the type of erythemato-squamous diseases; predicting presence/absence of heart disease; genomic analysis and prediction of aberrant CpG island meythlation in human cancer; discriminant analysis of motility and morphology data in human lung carcinoma; prediction of ultrasonic cell disruption for drug delivery; identification of tumor shape and volume in treatment of sarcoma; multistage discriminant analysis of biomarkers for prediction of early atherosclerois; fingerprinting of native and angiogenic microvascular networks for early diagnosis of diabetes, aging, macular degeneracy and tumor metastasis; prediction of protein localization sites; and pattern recognition of satellite images in classification of soil types. In all these applications, the predictive model yields correct classification rates ranging from 80% to 100%. This provides motivation for pursuing its use as a medical diagnostic, monitoring and decision-making tool.

Site-Based Management: Implications for Risk Management?

ERIC Educational Resources Information Center

Dunklee, Dennis R.

1990-01-01

Site-based school management opens the possibility of problems in districtwide risk management and liability prevention programs. Describes a program to transfer prevention law and risk management strategies to individual school sites. Cautions that only duly authorized agents of local school boards can commit boards to contractual obligations.…

Structuring Historic Site-Based History Laboratories for Teacher Education

ERIC Educational Resources Information Center

Baron, Christine

2014-01-01

Providing training for pre-service teachers at historic sites necessitates a reorientation for historic site-based teacher education programs away from strict content learning towards programs that emphasize the modeling of disciplinary problem solving and transfer learning. Outlined here is a History Lab model for teacher education that uses the…

Water quality monitoring strategies - A review and future perspectives.

PubMed

Behmel, S; Damour, M; Ludwig, R; Rodriguez, M J

2016-11-15

The reliable assessment of water quality through water quality monitoring programs (WQMPs) is crucial in order for decision-makers to understand, interpret and use this information in support of their management activities aiming at protecting the resource. The challenge of water quality monitoring has been widely addressed in the literature since the 1940s. However, there is still no generally accepted, holistic and practical strategy to support all phases of WQMPs. The purpose of this paper is to report on the use cases a watershed manager has to address to plan or optimize a WQMP from the challenge of identifying monitoring objectives; selecting sampling sites and water quality parameters; identifying sampling frequencies; considering logistics and resources to the implementation of actions based on information acquired through the WQMP. An inventory and critique of the information, approaches and tools placed at the disposal of watershed managers was proposed to evaluate how the existing information could be integrated in a holistic, user-friendly and evolvable solution. Given the differences in regulatory requirements, water quality standards, geographical and geological differences, land-use variations, and other site specificities, a one-in-all solution is not possible. However, we advance that an intelligent decision support system (IDSS) based on expert knowledge that integrates existing approaches and past research can guide a watershed manager through the process according to his/her site-specific requirements. It is also necessary to tap into local knowledge and to identify the knowledge needs of all the stakeholders through participative approaches based on geographical information systems and adaptive survey-based questionnaires. We believe that future research should focus on developing such participative approaches and further investigate the benefits of IDSS's that can be updated quickly and make it possible for a watershed manager to obtain a timely, holistic view and support for every aspect of planning and optimizing a WQMP. Copyright © 2016 Elsevier B.V. All rights reserved.

Stakeholder Participation in Freshwater Monitoring and Evaluation Programs: Applying Thresholds of Potential Concern within Environmental Flows

NASA Astrophysics Data System (ADS)

Conallin, John; McLoughlin, Craig A.; Campbell, Josh; Knight, Roger; Bright, Troy; Fisher, Ian

2018-03-01

The complex nature of freshwater systems provides challenges for incorporating evidence-based techniques into management. This paper investigates the potential of participatory evidence-based techniques to involve local stakeholders and make decisions based on different "knowledge" sources within adaptive management programs. It focuses on the application of thresholds of potential concern (TPC) within strategic adaptive management (SAM) for facilitating inclusive decision-making. The study is based on the case of the Edward-Wakool (E-W) "Fish and Flows" SAM project in the Murray-Darling River Basin, Australia. We demonstrate the application of TPCs for improving collaborative decision-making within the E-W, associated with environmental watering requirements, and other natural resource management programs such as fish stocking. The development of TPCs in the E-W fish and flows SAM project helped improve stakeholder involvement and understanding of the system, and also the effectiveness of the implemented management interventions. TPCs ultimately helped inform environmental flow management activities. The TPC process complemented monitoring that was already occurring in the system and provided a mechanism for linking formal and informal knowledge to form explicit and measurable endpoints from objectives. The TPC process faced challenges due to the perceived reduction in scientific rigor within initial TPC development and use. However, TPCs must remain tangible to managers and other stakeholders, in order to aid in the implementation of adaptive management. Once accepted by stakeholders, over time TPCs should be reviewed and refined in order to increase their scientific rigor, as new information is generated.

Linguistic hesitant fuzzy multi-criteria decision-making method based on evidential reasoning

NASA Astrophysics Data System (ADS)

Zhou, Huan; Wang, Jian-qiang; Zhang, Hong-yu; Chen, Xiao-hong

2016-01-01

Linguistic hesitant fuzzy sets (LHFSs), which can be used to represent decision-makers' qualitative preferences as well as reflect their hesitancy and inconsistency, have attracted a great deal of attention due to their flexibility and efficiency. This paper focuses on a multi-criteria decision-making approach that combines LHFSs with the evidential reasoning (ER) method. After reviewing existing studies of LHFSs, a new order relationship and Hamming distance between LHFSs are introduced and some linguistic scale functions are applied. Then, the ER algorithm is used to aggregate the distributed assessment of each alternative. Subsequently, the set of aggregated alternatives on criteria are further aggregated to get the overall value of each alternative. Furthermore, a nonlinear programming model is developed and genetic algorithms are used to obtain the optimal weights of the criteria. Finally, two illustrative examples are provided to show the feasibility and usability of the method, and comparison analysis with the existing method is made.

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

PubMed

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

2015-03-11

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

Green Remediation Best Management Practices: Overview of EPA's Methodology to Address the Environmental Footprint of Site Cleanup

EPA Pesticide Factsheets

Contaminated site cleanups involving complex activities may benefit from a detailed environmental footprint analysis to inform decision-making about application of suitable best management practices for greener cleanups.

A Conceptual Methodology for Assessing Acquisition Requirements Robustness against Technology Uncertainties

NASA Astrophysics Data System (ADS)

Chou, Shuo-Ju

2011-12-01

In recent years the United States has shifted from a threat-based acquisition policy that developed systems for countering specific threats to a capabilities-based strategy that emphasizes the acquisition of systems that provide critical national defense capabilities. This shift in policy, in theory, allows for the creation of an "optimal force" that is robust against current and future threats regardless of the tactics and scenario involved. In broad terms, robustness can be defined as the insensitivity of an outcome to "noise" or non-controlled variables. Within this context, the outcome is the successful achievement of defense strategies and the noise variables are tactics and scenarios that will be associated with current and future enemies. Unfortunately, a lack of system capability, budget, and schedule robustness against technology performance and development uncertainties has led to major setbacks in recent acquisition programs. This lack of robustness stems from the fact that immature technologies have uncertainties in their expected performance, development cost, and schedule that cause to variations in system effectiveness and program development budget and schedule requirements. Unfortunately, the Technology Readiness Assessment process currently used by acquisition program managers and decision-makers to measure technology uncertainty during critical program decision junctions does not adequately capture the impact of technology performance and development uncertainty on program capability and development metrics. The Technology Readiness Level metric employed by the TRA to describe program technology elements uncertainties can only provide a qualitative and non-descript estimation of the technology uncertainties. In order to assess program robustness, specifically requirements robustness, against technology performance and development uncertainties, a new process is needed. This process should provide acquisition program managers and decision-makers with the ability to assess or measure the robustness of program requirements against such uncertainties. A literature review of techniques for forecasting technology performance and development uncertainties and subsequent impacts on capability, budget, and schedule requirements resulted in the conclusion that an analysis process that coupled a probabilistic analysis technique such as Monte Carlo Simulations with quantitative and parametric models of technology performance impact and technology development time and cost requirements would allow the probabilities of meeting specific constraints of these requirements to be established. These probabilities of requirements success metrics can then be used as a quantitative and probabilistic measure of program requirements robustness against technology uncertainties. Combined with a Multi-Objective Genetic Algorithm optimization process and computer-based Decision Support System, critical information regarding requirements robustness against technology uncertainties can be captured and quantified for acquisition decision-makers. This results in a more informed and justifiable selection of program technologies during initial program definition as well as formulation of program development and risk management strategies. To meet the stated research objective, the ENhanced TEchnology Robustness Prediction and RISk Evaluation (ENTERPRISE) methodology was formulated to provide a structured and transparent process for integrating these enabling techniques to provide a probabilistic and quantitative assessment of acquisition program requirements robustness against technology performance and development uncertainties. In order to demonstrate the capabilities of the ENTERPRISE method and test the research Hypotheses, an demonstration application of this method was performed on a notional program for acquiring the Carrier-based Suppression of Enemy Air Defenses (SEAD) using Unmanned Combat Aircraft Systems (UCAS) and their enabling technologies. The results of this implementation provided valuable insights regarding the benefits and inner workings of this methodology as well as its limitations that should be addressed in the future to narrow the gap between current state and the desired state.

Advance care planning--a multi-centre cluster randomised clinical trial: the research protocol of the ACTION study.

PubMed

Rietjens, Judith A C; Korfage, Ida J; Dunleavy, Lesley; Preston, Nancy J; Jabbarian, Lea J; Christensen, Caroline Arnfeldt; de Brito, Maja; Bulli, Francesco; Caswell, Glenys; Červ, Branka; van Delden, Johannes; Deliens, Luc; Gorini, Giuseppe; Groenvold, Mogens; Houttekier, Dirk; Ingravallo, Francesca; Kars, Marijke C; Lunder, Urška; Miccinesi, Guido; Mimić, Alenka; Paci, Eugenio; Payne, Sheila; Polinder, Suzanne; Pollock, Kristian; Seymour, Jane; Simonič, Anja; Johnsen, Anna Thit; Verkissen, Mariëtte N; de Vries, Esther; Wilcock, Andrew; Zwakman, Marieke; van der Heide Pl, Agnes

2016-04-08

Awareness of preferences regarding medical care should be a central component of the care of patients with advanced cancer. Open communication can facilitate this but can occur in an ad hoc or variable manner. Advance care planning (ACP) is a formalized process of communication between patients, relatives and professional caregivers about patients' values and care preferences. It raises awareness of the need to anticipate possible future deterioration of health. ACP has the potential to improve current and future healthcare decision-making, provide patients with a sense of control, and improve their quality of life. We will study the effects of the ACP program Respecting Choices on the quality of life of patients with advanced lung or colorectal cancer. In a phase III multicenter cluster randomised controlled trial, 22 hospitals in 6 countries will be randomised. In the intervention sites, patients will be offered interviews with a trained facilitator. In the control sites, patients will receive care as usual. In total, 1360 patients will be included. All participating patients will be asked to complete questionnaires at inclusion, and again after 2.5 and 4.5 months. If a patient dies within a year after inclusion, a relative will be asked to complete a questionnaire on end-of-life care. Use of medical care will be assessed by checking medical files. The primary endpoint is patients' quality of life at 2.5 months post-inclusion. Secondary endpoints are the extent to which care as received is aligned with patients' preferences, patients' evaluation of decision-making processes, quality of end-of-life care and cost-effectiveness of the intervention. A complementary qualitative study will be carried out to explore the lived experience of engagement with the Respecting Choices program from the perspectives of patients, their Personal Representatives, healthcare providers and facilitators. Transferring the concept of ACP from care of the elderly to patients with advanced cancer, who on average are younger and retain their mental capacity for a larger part of their disease trajectory, is an important next step in an era of increased focus on patient centered healthcare and shared decision-making. International Standard Randomised Controlled Trial Number: ISRCTN63110516. Date of registration: 10/3/2014.

Environmental liability protection and other advantages of voluntary cleanup programs

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

Bost, R.C.; Linton, K.E.

Historically, regulatory agencies have required that contaminated sites be returned to pristine conditions, often at very high costs. Fear of these enormous environmental liabilities has resulted in abandonment of many industrial and commercial properties, referred to as brownfields. The development of Risk-Based Corrective Action programs has provided a means for regulatory agencies to evaluate contaminated sites based on risk to human health and the environment, resulting in more reasonable remedial measures and costs. Governmental bodies have created a more flexible means of addressing contaminated sites using Risk-Based Corrective Action and other incentives to encourage the redevelopment of sites through Voluntarymore » Cleanup Programs. This study describes the development of Voluntary Cleanup Programs, and the successful implementation of Risk-Based Corrective Action with a focus on the states of Texas, Louisiana, and Oklahoma.« less

Expertise transfer for expert system design

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

Boose, J.H.

This book is about the Expertise Transfer System-a computer program which interviews experts and helps them build expert systems, i.e. computer programs that use knowledge from experts to make decisions and judgements under conditions of uncertainty. The techniques are useful to anyone who uses decision-making information based on the expertise of others. The methods can also be applied to personal decision-making. The interviewing methodology is borrowed from a branch of psychology called Personal Construct Theory. It is not necessary to use a computer to take advantage of the techniques from Personal Construction Theory; the fundamental procedures used by the Expertisemore » Transfer System can be performed using paper and pencil. It is not necessary that the reader understand very much about computers to understand the ideas in this book. The few relevant concepts from computer science and expert systems that are needed are explained in a straightforward manner. Ideas from Personal Construct Psychology are also introduced as needed.« less

Development of a Spacecraft Materials Selector Expert System

NASA Technical Reports Server (NTRS)

Pippin, G.; Kauffman, W. (Technical Monitor)

2002-01-01

This report contains a description of the knowledge base tool and examples of its use. A downloadable version of the Spacecraft Materials Selector (SMS) knowledge base is available through the NASA Space Environments and Effects Program. The "Spacecraft Materials Selector" knowledge base is part of an electronic expert system. The expert system consists of an inference engine that contains the "decision-making" code and the knowledge base that contains the selected body of information. The inference engine is a software package previously developed at Boeing, called the Boeing Expert System Tool (BEST) kit.

Conceptual framework for nutrition surveillance systems.

PubMed

Mock, N B; Bertrand, W E

1993-01-01

This article describes the evolution of nutrition surveillance as an intervention strategy and presents a framework for improving the usefulness of nutrition surveillance programs. It seems clear that such programs' impact on nutritional well-being will depend increasingly on their ability to reach and influence decision-makers. Therefore, it is important to consider political and social forces, and also to realize that if a program is too decentralized or too far removed from key decision-makers, its ability to influence resource flows may be limited. It is of course important that the surveillance information provided be appropriate and of good quality. Therefore, the data collected should be analyzed to ensure they are accurate and representative. Once that has been done, relevant findings should be presented in a readily understandable form designed to meet the intended recipients' information needs. Such findings should also be disseminated to all important decision-maker constituencies, including external donors of nutrition assistance and the general public.

The relationship between role preferences in decision-making and level of psychological distress in patients with head and neck cancer.

PubMed

Jabbour, Joe; Dhillon, Haryana M; Shepherd, Heather L; Sundaresan, Puma; Milross, Chris; Clark, Jonathan R

2018-05-28

Is there a relationship between decision-making preferences and psychological distress? Patients who had received treatment for head and neck cancer (HNC) at four institutions within NSW, Australia were invited to complete a single questionnaire. Five hundred and ninety-seven patients completed the questionnaire. The majority of patients (308, 54%) preferred shared decision making. Significant predictors of a preference towards active decision making were education level (OR 2.1 for tertiary, p < 0.001), primary cancer site (OR 1.9 for thyroid compared to salivary gland, p = 0.024) and gender (OR 1.4 for female, p = 0.028). Mean psychological distress score on Kessler 6 (K6) was 9 (Range: 0-28). Significant predictors of psychological distress were age (p < 0.001), gender (p < 0.001), primary site (p < 0.01), and decision preference (p < 0.01). HNC patients who are either tertiary educated or female are more likely to prefer active involvement in decision-making. Psychological distress is more likely in patients actively involved in decision making, younger patients, and in females. Patients experienced paternalistic decision-making, but most preferred active or a shared approached. Clinicians need to be aware of potential for psychological distress in active decision-makers and refer patients for psychosocial support. Copyright © 2018. Published by Elsevier B.V.

Improving Judgment Calls: Using a Normative Model of Human Inference in the Advanced Preparation of Educational Administrators.

ERIC Educational Resources Information Center

Galvin, Patrick; Ogawa, Rodney T.

The conceptual orientation that guides the University of Utah's field-based doctoral program in educational administration is described in this paper, with a focus on making judgments within the decision-making process. The first part explains the rationale for adopting the conceptual orientation and the second part describes the normative model…

Software development to support decision making in the selection of nursing diagnoses and interventions for children and adolescents1

PubMed Central

Silva, Kenya de Lima; Évora, Yolanda Dora Martinez; Cintra, Camila Santana Justo

2015-01-01

Objective: to report the development of a software to support decision-making for the selection of nursing diagnoses and interventions for children and adolescents, based on the nomenclature of nursing diagnoses, outcomes and interventions of a university hospital in Paraiba. Method: a methodological applied study based on software engineering, as proposed by Pressman, developed in three cycles, namely: flow chart construction, development of the navigation interface, and construction of functional expressions and programming development. Result: the software consists of administrative and nursing process screens. The assessment is automatically selected according to age group, the nursing diagnoses are suggested by the system after information is inserted, and can be indicated by the nurse. The interventions for the chosen diagnosis are selected by structuring the care plan. Conclusion: the development of this tool used to document the nursing actions will contribute to decision-making and quality of care. PMID:26487144

Software development to support decision making in the selection of nursing diagnoses and interventions for children and adolescents.

PubMed

Silva, Kenya de Lima; Évora, Yolanda Dora Martinez; Cintra, Camila Santana Justo

2015-01-01

to report the development of a software to support decision-making for the selection of nursing diagnoses and interventions for children and adolescents, based on the nomenclature of nursing diagnoses, outcomes and interventions of a university hospital in Paraiba. a methodological applied study based on software engineering, as proposed by Pressman, developed in three cycles, namely: flow chart construction, development of the navigation interface, and construction of functional expressions and programming development. the software consists of administrative and nursing process screens. The assessment is automatically selected according to age group, the nursing diagnoses are suggested by the system after information is inserted, and can be indicated by the nurse. The interventions for the chosen diagnosis are selected by structuring the care plan. the development of this tool used to document the nursing actions will contribute to decision-making and quality of care.

Decision aids for patients.

PubMed

Lenz, Matthias; Buhse, Susanne; Kasper, Jürgen; Kupfer, Ramona; Richter, Tanja; Mühlhauser, Ingrid

2012-06-01

Patients want to be more involved in medical decision-making. To this end, some decision aids are now available. We present an overview of this subject, in which we explain the terms "shared decision-making", "decision aid", and "evidence-based patient information" and survey information on the available decision aids in German and other languages on the basis of a literature search in MEDLINE, EMBASE and PsycInfo and a current Cochrane Review. We also searched the Internet for providers of decision aids in Germany. Decision aids exist in the form of brochures, decision tables, videos, and computer programs; they address various topics in the prevention, diagnosis, and treatment of disease. They typically contain information on the advantages and disadvantages of the available options, as well as guidance for personal decision-making. They can be used alone or as a part of structured counseling or patient education. Minimal quality standards include an adequate evidence base, completeness, absence of bias, and intelligibility. Our search revealed 12 randomized controlled trials (RCTs) of decision aids in German and 106 RCTs of decision aids in other languages. These trials studied the outcome of the use of decision aids not just with respect to clinical developments, but also with respect to patient knowledge, adherence to treatment regimens, satisfaction, involvement in decision-making, autonomy preference, and decisional conflicts. Only a small fraction of the available decision aids were systematically developed and have been subjected to systematic evaluation. Patients are still not receiving the help in decision-making to which medical ethics entitles them. Structures need to be put in place for the sustainable development, evaluation and implementation of high-quality decision aids.

The use of a cognitive task analysis-based multimedia program to teach surgical decision making in flexor tendon repair.

PubMed

Luker, Kali R; Sullivan, Maura E; Peyre, Sarah E; Sherman, Randy; Grunwald, Tiffany

2008-01-01

The aim of this study was to compare the surgical knowledge of residents before and after receiving a cognitive task analysis-based multimedia teaching module. Ten plastic surgery residents were evaluated performing flexor tendon repair on 3 occasions. Traditional learning occurred between the first and second trial and served as the control. A teaching module was introduced as an intervention between the second and third trial using cognitive task analysis to illustrate decision-making skills. All residents showed improvement in their decision-making ability when performing flexor tendon repair after each surgical procedure. The group improved through traditional methods as well as exposure to our talk-aloud protocol (P > .01). After being trained using the cognitive task analysis curriculum the group displayed a statistically significant knowledge expansion (P < .01). Residents receiving cognitive task analysis-based multimedia surgical curriculum instruction achieved greater command of problem solving and are better equipped to make correct decisions in flexor tendon repair.

Using athletic training clinical education standards in radiography.

PubMed

Giordano, Shelley; Harris, Katherine

2012-01-01

The selection of clinical education sites for radiography students is based on availability, access to radiographic examinations, and appropriate student-to-technologist ratio. Radiography program directors are not required to evaluate sites based on their educational validity (eg, the clinical instructor's knowledge of basic teaching and learning principles, how well the site communicates with the program, or the clinical instructor's involvement in professional organizations). The purpose of this study was to determine if a set of 12 clinical education standards used in athletic training would be applicable and beneficial to radiography program directors when selecting clinical sites for students. A survey concerning the applicability of the athletic training standards to radiography site selection was completed by 270 directors of radiography programs accredited by the Joint Review Committee on Education in Radiologic Technology. The survey results indicated the athletic training clinical education standards were considered applicable to the selection of clinical sites for radiography students and would be beneficial to radiography program directors when selecting sites.

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

NASA Astrophysics Data System (ADS)

Adeleke, Adeyinka

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

Practices for Supporting and Confirming Decision-Making Involved in Kidney and Liver Donation by Related Living Donors in Japan: A Nationwide Survey.

PubMed

Nishimura, K; Kobayashi, S; Tsutsui, J; Kawasaki, H; Katsuragawa, S; Noma, S; Kimura, H; Egawa, H; Yuzawa, K; Umeshita, K; Aikawa, A; Uemoto, S; Takahara, S; Ishigooka, J

2016-03-01

This nationwide survey investigated the actual practices for supporting and confirming the decision-making involved in related living-organ donations in Japan, focusing on organ type and program size differences. Answers to a questionnaire survey were collected from 89 of the 126 (71%) kidney and 30 of the 35 (86%) liver transplantation programs in Japan that were involved in living-donor transplantations in 2013. In 70% of the kidney and 90% of the liver transplantation programs, all donors underwent "third-party" interviews to confirm their voluntariness. The most common third parties were psychiatrists (90% and 83%, respectively). Many programs engaged in practices to support decision-making by donor candidates, including guaranteeing the right to withdraw consent to donate (70% and 100%, respectively) and prescribing a set "cooling-off period" (88% and 100%, respectively). Most donors were offered care by mental health specialists (86% and 93%, respectively). Third parties were designated by more of the larger kidney transplant programs compared with the smaller programs. In conclusion, the actual practices supporting and confirming the decision to donate a living organ varied depending on the organ concerned and the number of patients in the program. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

TECHNICAL APPROACHES TO CHARACTERIZING AND CLEANUP OF AUTOMOTIVE RECYCLING BROWNFIELDS

EPA Science Inventory

The guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the private sector to address issues related to the redevelopment of Brownfields sites, specifically automotive recycling sites. The document helps users to understand...

Reducing inpatient heritable thrombophilia testing using a clinical decision-making tool.

PubMed

Smith, Tyler W; Pi, David; Hudoba, Monika; Lee, Agnes Y Y

2014-04-01

To evaluate the impact of a clinical decision-making tool, designed to educate physicians regarding heritable thrombophilia (HT) testing, on the volume of testing in hospitalised patients in the tertiary care setting. We performed a retrospective cohort study over a 6-year period (2007-2012) at a single tertiary care centre intervention site and two regional control sites. In January 2010, the intervention site instituted a policy change whereby physicians ordering HT testing on inpatients needed to complete a pre-preprinted order (PPO) form that outlined the limitations of HT testing in the hospitalised setting. Failure to complete the PPO within 24 h resulted in test cancellation. Our main outcome measure was the volume of HT testing performed at the three study sites. Introduction of the PPO resulted in a 79.4% (95% CI 71.2% to 87.6%) reduction in factor V Leiden (FVL) testing at the intervention site. This decrease was significantly greater compared with those in the two control teaching hospitals over the same time periods (33.7% and 43.6%; both p<0.001). Reductions in FVL testing postintervention were observed among all ordering specialists. Similar postintervention reductions in testing volumes were observed for antithrombin (57.4%), protein C (61.9%) and protein S (62.2%) activity assays. In a large tertiary care hospital, the introduction of a clinical decision-making tool significantly reduced HT testing in inpatients across clinical specialties. The impact on patient outcome should be assessed in further studies.

Institutional Conservation Program evaluation project: Results of elementary and secondary education survey pretest

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

Collins, N.E.; Carroll, W.L.; Gaines, L.L.

As part of a study of energy conservation efforts in schools and hospitals and an evaluation of the Institutional Conservation Program sponsored by the US Department of Energy, survey instruments that will be sent to large numbers of elementary and secondary schools and school districts were pretested. The survey instruments solicit information on energy conservation activities, decision-making processes, and energy use. The pretest had several purposes, including identification of problems in the survey instruments' formats and in the wording of instructions and questions; it also helped in establishing the sampling strategy for the survey itself. Both site visits and mailingsmore » were used in the pretest. This report covers all aspects of the pretest. Characteristics of the pretest schools, districts, and interviewees are discussed in narrative summaries. Pretest procedures are described and responses to some of the survey questions are provided.« less

A prospective approach to coastal geography from satellite. [technological forecasting

NASA Technical Reports Server (NTRS)

Munday, J. C., Jr.

1981-01-01

A forecasting protocol termed the "prospective approach' was used to examine probable futures relative to coastal applications of satellite data. Significant variables include the energy situation, the national economy, national Earth satellite programs, and coastal zone research, commercial activity, and regulatory activity. Alternative scenarios for the period until 1986 are presented. Possible response by state/local remote sensing centers include operational applications for users, input to geo-base information systems (GIS), development of decision-making algorithms using GIS data, and long term research programs for coastal management using merged satellite and traditional data.

An overview of the effectiveness and efficiency of HIV prevention programs.

PubMed Central

Holtgrave, D R; Qualls, N L; Curran, J W; Valdiserri, R O; Guinan, M E; Parra, W C

1995-01-01

Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly when they are delivered with sufficient resources, intensity, and cultural competency and are based on a firm foundation of behavioral and social science theory and past research. Economic evaluations have found that some of these behaviorally based programs yield net economic benefits to society, and others are likely cost-effective (even if not cost-saving) relative to other health programs. Still, specific improvements should be made in certain HIV prevention programs. PMID:7630989

Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study.

PubMed

Wiener, Renda Soylemez; Koppelman, Elisa; Bolton, Rendelle; Lasser, Karen E; Borrelli, Belinda; Au, David H; Slatore, Christopher G; Clark, Jack A; Kathuria, Hasmeena

2018-02-21

Guidelines recommend, and Medicare requires, shared decision-making between patients and clinicians before referring individuals at high risk of lung cancer for chest CT screening. However, little is known about the extent to which shared decision-making about lung cancer screening is achieved in real-world settings. To characterize patient and clinician impressions of early experiences with communication and decision-making about lung cancer screening and perceived barriers to achieving shared decision-making. Qualitative study entailing semi-structured interviews and focus groups. We enrolled 36 clinicians who refer patients for lung cancer screening and 49 patients who had undergone lung cancer screening in the prior year. Participants were recruited from lung cancer screening programs at four hospitals (three Veterans Health Administration, one urban safety net). Using content analysis, we analyzed transcripts to characterize communication and decision-making about lung cancer screening. Our analysis focused on the recommended components of shared decision-making (information sharing, deliberation, and decision aid use) and barriers to achieving shared decision-making. Clinicians varied in the information shared with patients, and did not consistently incorporate decision aids. Clinicians believed they explained the rationale and gave some (often purposely limited) information about the trade-offs of lung cancer screening. By contrast, some patients reported receiving little information about screening or its trade-offs and did not realize the CT was intended as a screening test for lung cancer. Clinicians and patients alike did not perceive that significant deliberation typically occurred. Clinicians perceived insufficient time, competing priorities, difficulty accessing decision aids, limited patient comprehension, and anticipated patient emotions as barriers to realizing shared decision-making. Due to multiple perceived barriers, patient-clinician conversations about lung cancer screening may fall short of guideline-recommended shared decision-making supported by a decision aid. Consequently, patients may be left uncertain about lung cancer screening's rationale, trade-offs, and process.

A Systematic Process to Facilitate Evidence-Informed Decisionmaking Regarding Program Expansion. The RAND Toolkit, Volume 3

DTIC Science & Technology

2014-01-01

provided for non - commercial use only. Unauthorized posting of RAND electronic documents to a non -RAND website is prohibited. RAND electronic documents...documents to a non -RAND website is prohibited. RAND documents are protected under copyright law. Permission is given to duplicate this document for...the DoD-wide decisionmaking board to focus their review efforts on larger programs or those that function in multiple branches of service, as well as

Career Choices: Reducing Sex-Role Stereotyping in Careers. A Model Career Decision-Making Program to Reduce the Effects of Sex-Role Stereotyping in the Career Choices of Senior High Students. Final Project Performance Report.

ERIC Educational Resources Information Center

Murphy, Jody

A model career decision-making program to reduce the effects of sex-role stereotyping in career choices of senior high school students was conducted at Columbine High School (Lakewood, Colorado). Project goals included the following: (1) to provide students with self-awareness and career-decision-making activities designed to broaden options these…

An application of the rational choice approach to the offending process of sex offenders: a closer look at the decision-making.

PubMed

Beauregard, Eric; Leclerc, Benoît

2007-06-01

Although the study of both offense processes and implicit theories provides in-depth knowledge about the decision-making of sex offenders, these studies focus solely on the internal psychological processes of the offender leading to the commission of a sexual assault. These studies neglect to look specifically at the offender's decision-making during the offense in interaction with the immediate situations encountered at the offense scene, such as the choices of behavior while interacting with the victim in a specific context. Based on a rational choice approach, this study investigates the decision-making involved in the offending process of 69 serial sexual offenders who have committed their crimes against stranger victims. Semi-structured interviews were conducted with offenders in order to identify the rationale behind their actions during the pre-crime phase (premeditation of the crime, estimation of risk of apprehension by the offender, and forensic awareness of the offender), crime phase (use of a weapon, use of restraints, use of a vehicle, and level of force used), and the post-crime phase (event leading to the end of crime and victim release site location choice). Results show that sex offenders, even if traditionally described as "irrational" and impulsive individuals, are capable, up to a certain point, of an analysis of the costs/benefits related to their actions. Moreover, results emphasize the important role of situational factors, such as victim resistance, on the decision-making process of sex offenders. Implications of the results are briefly discussed in regard of clinical practice and crime prevention.

Neural signatures of experience-based improvements in deterministic decision-making.

PubMed

Tremel, Joshua J; Laurent, Patryk A; Wolk, David A; Wheeler, Mark E; Fiez, Julie A

2016-12-15

Feedback about our choices is a crucial part of how we gather information and learn from our environment. It provides key information about decision experiences that can be used to optimize future choices. However, our understanding of the processes through which feedback translates into improved decision-making is lacking. Using neuroimaging (fMRI) and cognitive models of decision-making and learning, we examined the influence of feedback on multiple aspects of decision processes across learning. Subjects learned correct choices to a set of 50 word pairs across eight repetitions of a concurrent discrimination task. Behavioral measures were then analyzed with both a drift-diffusion model and a reinforcement learning model. Parameter values from each were then used as fMRI regressors to identify regions whose activity fluctuates with specific cognitive processes described by the models. The patterns of intersecting neural effects across models support two main inferences about the influence of feedback on decision-making. First, frontal, anterior insular, fusiform, and caudate nucleus regions behave like performance monitors, reflecting errors in performance predictions that signal the need for changes in control over decision-making. Second, temporoparietal, supplementary motor, and putamen regions behave like mnemonic storage sites, reflecting differences in learned item values that inform optimal decision choices. As information about optimal choices is accrued, these neural systems dynamically adjust, likely shifting the burden of decision processing from controlled performance monitoring to bottom-up, stimulus-driven choice selection. Collectively, the results provide a detailed perspective on the fundamental ability to use past experiences to improve future decisions. Copyright © 2016 Elsevier B.V. All rights reserved.

Pulmonologists' Reported Use of Guidelines and Shared Decision-making in Evaluation of Pulmonary Nodules: A Qualitative Study.

PubMed

Wiener, Renda Soylemez; Slatore, Christopher G; Gillespie, Chris; Clark, Jack A

2015-12-01

Selecting a strategy (surveillance, biopsy, resection) for pulmonary nodule evaluation can be complex given the absence of high-quality data comparing strategies and the important tradeoffs among strategies. Guidelines recommend a three-step approach: (1) assess the likelihood of malignancy, (2) evaluate whether the patient is a candidate for invasive intervention, and (3) elicit the patient's preferences and engage in shared decision-making. We sought to characterize how pulmonologists select a pulmonary nodule evaluation strategy and the extent to which they report following the guideline-recommended approach. We conducted semistructured qualitative interviews with 14 pulmonologists who manage patients with pulmonary nodules at four clinical sites. Transcripts of audiorecorded interviews were analyzed using the principles of grounded theory. Pulmonologists reported consistently performing steps 1 and 2 but described diverse approaches to step 3 that ranged from always engaging the patient in decision-making to never doing so. Many described incorporating patients' preferences only in particular circumstances, such as when the patient appeared particularly anxious or was aggressive in questioning management options. Indeed, other factors, including convenience, physician preferences, physician anxiety, malpractice concerns, and physician experience, appeared to drive decision-making as much as, if not more than, patient preferences. Although pulmonologists appear to routinely personalize pulmonary nodule evaluation strategies based on the individual patient's risk-benefit tradeoffs, they may not consistently take patient preferences into account during the decision-making process. In the absence of high-quality evidence regarding the optimal methods of pulmonary nodule evaluation, physicians should strive to ensure that management decisions are consistent with patients' values.

Neural signatures of experience-based improvements in deterministic decision-making

PubMed Central

Tremel, Joshua J.; Laurent, Patryk A.; Wolk, David A.; Wheeler, Mark E.; Fiez, Julie A.

2016-01-01

Feedback about our choices is a crucial part of how we gather information and learn from our environment. It provides key information about decision experiences that can be used to optimize future choices. However, our understanding of the processes through which feedback translates into improved decision-making is lacking. Using neuroimaging (fMRI) and cognitive models of decision-making and learning, we examined the influence of feedback on multiple aspects of decision processes across learning. Subjects learned correct choices to a set of 50 word pairs across eight repetitions of a concurrent discrimination task. Behavioral measures were then analyzed with both a drift-diffusion model and a reinforcement learning model. Parameter values from each were then used as fMRI regressors to identify regions whose activity fluctuates with specific cognitive processes described by the models. The patterns of intersecting neural effects across models support two main inferences about the influence of feedback on decision-making. First, frontal, anterior insular, fusiform, and caudate nucleus regions behave like performance monitors, reflecting errors in performance predictions that signal the need for changes in control over decision-making. Second, temporoparietal, supplementary motor, and putamen regions behave like mnemonic storage sites, reflecting differences in learned item values that inform optimal decision choices. As information about optimal choices is accrued, these neural systems dynamically adjust, likely shifting the burden of decision processing from controlled performance monitoring to bottom-up, stimulus-driven choice selection. Collectively, the results provide a detailed perspective on the fundamental ability to use past experiences to improve future decisions. PMID:27523644

The role of NASA's Water Resources applications area in improving access to water quality-related information and water resources management

NASA Astrophysics Data System (ADS)

Lee, C. M.

2016-02-01

The NASA Applied Sciences Program plays a unique role in facilitating access to remote sensing-based water information derived from US federal assets towards the goal of improving science and evidence-based decision-making in water resources management. The Water Resources Application Area within NASA Applied Sciences works specifically to develop and improve water data products to support improved management of water resources, with partners who are faced with real-world constraints and conditions including cost and regulatory standards. This poster will highlight the efforts and collaborations enabled by this program that have resulted in integration of remote sensing-based information for water quality modeling and monitoring within an operational context.

The role of NASA's Water Resources applications area in improving access to water quality-related information and water resources management

NASA Astrophysics Data System (ADS)

Lee, C. M.

2016-12-01

The NASA Applied Sciences Program plays a unique role in facilitating access to remote sensing-based water information derived from US federal assets towards the goal of improving science and evidence-based decision-making in water resources management. The Water Resources Application Area within NASA Applied Sciences works specifically to develop and improve water data products to support improved management of water resources, with partners who are faced with real-world constraints and conditions including cost and regulatory standards. This poster will highlight the efforts and collaborations enabled by this program that have resulted in integration of remote sensing-based information for water quality modeling and monitoring within an operational context.

The development and implementation of a decision-making capacity assessment model.

PubMed

Parmar, Jasneet; Brémault-Phillips, Suzette; Charles, Lesley

2015-03-01

Decision-making capacity assessment (DMCA) is an issue of increasing importance for older adults. Current challenges need to be explored, and potential processes and strategies considered in order to address issues of DMCA in a more coordinated manner. An iterative process was used to address issues related to DMCA. This began with recognition of challenges associated with capacity assessments (CAs) by staff at Covenant Health (CH). Review of the literature, as well as discussions with and a survey of staff at three CH sites, resulted in determination of issues related to DMCA. Development of a DMCA Model and demonstration of its feasibility followed. A process was proposed with front-end screening/problem- solving, a well-defined standard assessment, and definition of team member roles. A Capacity Assessment Care Map was formulated based on the process. Documentation was developed consisting of a Capacity Assessment Process Worksheet, Capacity Interview Worksheet, and a brochure. Interactive workshops were delivered to familiarize staff with the DMCA Model. A successful demonstration project led to implementation across all sites in the Capital Health region, and eventual provincial endorsement. Concerns identified in the survey and in the literature regarding CA were addressed through the holistic interdisciplinary approach offered by the DMCA Model.

BEING EMOTIONAL DURING DECISION MAKING—GOOD OR BAD? AN EMPIRICAL INVESTIGATION

PubMed Central

SEO, MYEONG-GU; BARRETT, LISA FELDMAN

2008-01-01

This paper examines the link between affective experience and decision-making performance. In a stock investment simulation, 101 stock investors rated their feelings on an Internet Web site while making investment decisions each day for 20 consecutive business days. Contrary to the popular belief that feelings are generally bad for decision making, we found that individuals who experienced more intense feelings achieved higher decision-making performance. Moreover, individuals who were better able to identify and distinguish among their current feelings achieved higher decision-making performance via their enhanced ability to control the possible biases induced by those feelings. PMID:18449361

Print information to inform decisions about mammography screening participation in 16 countries with population-based programs.

PubMed

Zapka, Jane G; Geller, Berta M; Bulliard, Jean-Luc; Fracheboud, Jacques; Sancho-Garnier, Helene; Ballard-Barbash, Rachel

2006-10-01

To profile and compare the content and presentation of written communications related to informed decision-making about mammography. Materials from 16 screening programs organized at the national or regional level were analyzed according to five major information domains suggested by the international literature. A majority of countries provided information on the program (interval, cost and quality). There was considerable variability in comprehensiveness of elements in the domains, e.g., test characteristics (false positive/negative) and pros and cons of screening. The majority noted the likelihood of recall for further tests, few commented on the risks of additional tests or finding unimportant tumors. The audit also found variation in presentation (words and pictures). Presentation of comprehensive, but balanced information on screening benefits and risks is complex and daunting. Issues such as framing effects, coupled with debate about screening efficacy are challenging to the design of effective information tools. The objective of increasing screening prevalence at the population level must be balanced with objectively presenting complete and clear information. Additional research is needed on how information (and mode of presentation) impact screening decisions. Public health officials need to articulate their objectives and review written communication according to important decision-making domains.

Teaching Geography and History through GIS: Application on Greek cultural sites

NASA Astrophysics Data System (ADS)

Skentos, Athanasios; Pavlopoulos, Kosmas; Galani, Apostolia; Theodorakopoulou, Katerina; Kritikos, Giorgos

2013-04-01

This study deals with the presentation of cultural succession in Greek space-time through a GIS application, associated with core concepts of geographic and historical education. Through the specific application students will be able to develop five distinct skills: sense of time-scale, historical and geographic comprehension, spatial analysis and interpretation, ability to perform geo-historical research, and procedure of geo-historical decision-making. The methodology is based on the calibration of a set of criteria for each cultural site that covers the topics of economy, geomorphology, society, religion, art and science. Further analysis of these data forms a geodatabase. In addition, palaeogeographic and historical maps of the cultural sites derived by the geodatabase provide information about temporal and spatial changes. As result, students will be able to develop a multidimensional and interdisciplinary approach, in order to reconstruct the evolution of the site.

Development Impact Assessment Highlights Co-benefits of GHG Mitigation Actions

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

2016-06-01

This EC-LEDS document describes the Development Impact Assessment (DIA) process that explores interactions between development goals and the low emission development strategies. DIA aims to support informed decision-making by considering how policies and programs intended to meet one goal may impact other development priorities. Enhancing Capacity for Low Emission Development Strategies (EC-LEDS) is a flagship U.S. government-led effort that assists countries in developing and implementing LEDS. The program enhances partner country efforts by providing targeting technical assistance and building a shared global knowledge base on LEDS. is a flagship U.S. government-led effort that assists countries in developing and implementing LEDS.more » The program enhances partner country efforts by providing targeting technical assistance and building a shared global knowledge base on LEDS.« less

The dynamics of community and NGO partnership: primary health care experiences in rural Mali.

PubMed

Solomon, Yodit; Ballif-Spanvill, Bonnie; Ward, Carol; Fuhriman, Addie; Widdision-Jones, Kacey

2008-12-01

Utilizing ethnographic research methods, this case study examines the experiences of an NGO-sponsored health care program in rural Mali. The findings indicate that while, in principle, the organization operates from an alternative development base, it has been unable to decentralize the decision-making process and facilitate community dialogue and participation. Numerous problems resulted, including superficial forms of local participation, lack of community ownership, non-remuneration of health workers and midwives, inadequate training, and ultimately, limited program gains. The analyses highlight the complexity and dynamic nature of health program implementation in a developing context, and suggest several factors important to project success. These include drawing on diverse local perspectives, promoting broad-based participation, and providing culturally appropriate ways to include all community members, particularly women.

The Home Instruction Program for Preschool Youngsters (HIPPY).

ERIC Educational Resources Information Center

Baker, Amy J. L.; Piotrkowski, Chaya S.; Brooks-Gunn, Jeanne

1999-01-01

Describes the Home Instruction Program for Preschool Youngsters (HIPPY), a two-year home-based early-education intervention program designed to help parents with limited formal education prepare their children for school. Presents findings from a two-site HIPPY study, a one-site case study, and a three-site qualitative study. (SLD)

On Decision-Making Among Multiple Rule-Bases in Fuzzy Control Systems

NASA Technical Reports Server (NTRS)

Tunstel, Edward; Jamshidi, Mo

1997-01-01

Intelligent control of complex multi-variable systems can be a challenge for single fuzzy rule-based controllers. This class of problems cam often be managed with less difficulty by distributing intelligent decision-making amongst a collection of rule-bases. Such an approach requires that a mechanism be chosen to ensure goal-oriented interaction between the multiple rule-bases. In this paper, a hierarchical rule-based approach is described. Decision-making mechanisms based on generalized concepts from single-rule-based fuzzy control are described. Finally, the effects of different aggregation operators on multi-rule-base decision-making are examined in a navigation control problem for mobile robots.

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

PubMed

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

2017-05-09

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

TECHNICAL APPROACHES TO CHARACTERIZING AND CLEANING UP BROWNFIELDS SITES: RAILROAD YARDS

EPA Science Inventory

This guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the private sector to address issues related to the redevelopment of Brownfields sites, specifically railroad yards. The document helps users to understand the proble...

Improved decision making in construction using virtual site visits.

DOT National Transportation Integrated Search

2003-01-01

This study explored the dynamics of information exchange involving field issues relating to construction and the assistance that a virtual site visit can provide to the field decision-making process. Such a process can be used for inspection and surv...

10 CFR 960.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., evaluation, and decision-making activities associated with the process of site screening, site nomination... repository development. Application means the act of making a finding of compliance or noncompliance with the... the process of fracturing and displacement that produces a fault. Favorable condition means a...

Microfinance participation and contraceptive decision-making: results from a national sample of women in Bangladesh.

PubMed

Murshid, N S; Ely, G E

2016-10-01

Our objective was to assess whether microfinance participation affords greater contraceptive decision-making power to women. Population based secondary data analysis. In this cross-sectional study using nationally representative data from the Bangladesh Demographic and Health Survey 2011 we conducted multinomial logistic regression to estimate the odds of contraceptive decision-making by respondents and their husbands based on microfinance participation. Microfinance participation was measured as a dichotomous variable and contraceptive decision-making was conceptualized based on who made decisions about contraceptive use: respondents only; their partners or husbands only; or both. The odds of decision-making by the respondent, with the reference case being joint decision-making, were higher for microfinance participants, but they were not significant. The odds of decision-making by the husband, with the reference case again being joint decision-making, were significantly lower among men who were partnered with women who participated in microfinance (RRR = 0.70, P < 0.01). Microfinance participation by women allowed men to share decision-making power with their wives that resulted in higher odds of joint decision-making. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

78 FR 2961 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-15

... inform or improve consumer financial decision-making. The Bureau expects to collect qualitative data on... education and empowerment programs, leading to better financial decision-making outcomes for adult consumers... financial decisions. DATES: Written comments are encouraged and must be received on or before March 18, 2013...

24 CFR 58.4 - Assumption authority.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., decision-making, and action that would otherwise apply to HUD under NEPA and other provisions of law that... environmental review, decision-making and action for programs authorized by the Native American Housing... separate decision regarding assumption of responsibilities for each of these Acts and communicate that...

The economic value of Quebec's water fluoridation program.

PubMed

Tchouaket, Eric; Brousselle, Astrid; Fansi, Alvine; Dionne, Pierre Alexandre; Bertrand, Elise; Fortin, Christian

2013-01-01

Dental caries is a major public health problem worldwide, with very significant deleterious consequences for many people. The available data are alarming in Canada and the province of Quebec. The water fluoridation program has been shown to be the most effective means of preventing caries and reducing oral health inequalities. This article analyzes the cost-effectiveness of Quebec's water fluoridation program to provide decision-makers with economic information for assessing its usefulness. An approach adapted from economic evaluation was used to: (1) build a logic model for Quebec's water fluoridation program; (2) determine its implementation cost; and (3) analyze its cost-effectiveness. Documentary analysis was used to build the logic model. Program cost was calculated using data from 13 municipalities that adopted fluoridation between 2002 and 2010 and two that received only infrastructure grants. Other sources were used to collect demographic data and calculate costs for caries treatment including costs associated with travel and lost productivity. The analyses showed the water fluoridation program was cost-effective even with a conservatively estimated 1 % reduction in dental caries. The benefit-cost ratio indicated that, at an expected average effectiveness of 30 % caries reduction, one dollar invested in the program saved $71.05-$82.83 per Quebec's inhabitant in dental costs (in 2010) or more than $560 million for the State and taxpayers. The results showed that the drinking-water fluoridation program produced substantial savings. Public health decision-makers could develop economic arguments to support wide deployment of this population-based intervention whose efficacy and safety have been demonstrated and acknowledged.

The Educational Efficacy of a Values-Based Online Tool in a Public Health Ethics Course

ERIC Educational Resources Information Center

Tripken, Jennifer L.

2016-01-01

Purpose: The purpose of this study was to assess the educational efficacy of an online software decision-making program, The Values Exchange. While ethics is a vital aspect of educating public health professionals, it is both difficult to teach and assess. There is a need to identify best practices in the pedagogy of public health ethics and in…

Examining the Educative Aims and Practices of Decision-Makers in Sport for Development and Peace Organizations

ERIC Educational Resources Information Center

Svensson, Per G.; Hancock, Meg G.; Hums, Mary A.

2016-01-01

Sport for Development and Peace (SDP) policy-makers and practitioners continue to offer ambitious claims regarding the potential role of sport-based programs for promoting social change. Yet, it is important to put sport under a critical lens in order to develop a more balanced and realistic understanding of the role of sport in society. Whether…

Informing vaccine decision-making: A strategic multi-attribute ranking tool for vaccines-SMART Vaccines 2.0.

PubMed

Knobler, Stacey; Bok, Karin; Gellin, Bruce

2017-01-20

SMART Vaccines 2.0 software is being developed to support decision-making among multiple stakeholders in the process of prioritizing investments to optimize the outcomes of vaccine development and deployment. Vaccines and associated vaccination programs are one of the most successful and effective public health interventions to prevent communicable diseases and vaccine researchers are continually working towards expanding targets for communicable and non-communicable diseases through preventive and therapeutic modes. A growing body of evidence on emerging vaccine technologies, trends in disease burden, costs associated with vaccine development and deployment, and benefits derived from disease prevention through vaccination and a range of other factors can inform decision-making and investment in new and improved vaccines and targeted utilization of already existing vaccines. Recognizing that an array of inputs influences these decisions, the strategic multi-attribute ranking method for vaccines (SMART Vaccines 2.0) is in development as a web-based tool-modified from a U.S. Institute of Medicine Committee effort (IOM, 2015)-to highlight data needs and create transparency to facilitate dialogue and information-sharing among decision-makers and to optimize the investment of resources leading to improved health outcomes. Current development efforts of the SMART Vaccines 2.0 framework seek to generate a weighted recommendation on vaccine development or vaccination priorities based on population, disease, economic, and vaccine-specific data in combination with individual preference and weights of user-selected attributes incorporating valuations of health, economics, demographics, public concern, scientific and business, programmatic, and political considerations. Further development of the design and utility of the tool is being carried out by the National Vaccine Program Office of the Department of Health and Human Services and the Fogarty International Center of the National Institutes of Health. We aim to demonstrate the utility of SMART Vaccines 2.0 through the engagement of a community of relevant stakeholders and to identify a limited number of pilot projects to determine explicitly defined attribute preferences and the related data and model requirements that are responsive to user needs and able to improve the use of evidence for vaccine-related decision-making and consequential priorities of vaccination options. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Computer-Based Interactive Multimedia Program to Reduce HIV Transmission for Women with Intellectual Disability

PubMed Central

Delaine, Khaya

2011-01-01

Background Despite recent recognition of the need for preventive sexual health materials for people with intellectual disability (ID), there have been remarkably few health-based interventions designed for people with mild to moderate ID. The purpose of this study was to evaluate the effects of a computer-based interactive multimedia (CBIM) program to teach HIV/AIDS knowledge, skills, and decision-making. Methods Twenty-five women with mild to moderate intellectual disability evaluated the program. The study used a quasi-experimental within-subjects design to assess the efficacy of the CBIM program. Research participants completed five qualitative and quantitative instruments that assessed HIV knowledge, and decision-making skills regarding HIV prevention practices and condom application skills (i.e., demonstration of skills opening a condom and putting it on a model penis). In addition, 18 service providers who work with women with ID reviewed the program and completed a demographics questionnaire and a professional customer satisfaction survey. Results Women with ID showed statistically significant increases from pretest to posttest in all knowledge and skill domains. Furthermore, the statistical gains were accompanied by medium to large effect sizes. Overall, service providers rated the program highly on several outcome measures (stimulation, relevance, and usability). Conclusions The results of this study indicate the CBIM program was effective in increasing HIV/AIDS knowledge and skills among women with ID, who live both semi-independently and independently, in a single-session intervention. Since the CBIM program is not dependent on staff for instructional delivery, it is a highly efficient teaching tool; and CBIM is an efficacious means to provide behavioral health content, compensating for the dearth of available health promotion materials for people with ID. As such, it has a potential for broad distribution and implementation by medical practitioners, and public health offices. People with ID are part of our society, yet continue to be overlooked, particularly in the area of health promotion. Special tools need to be developed in order to address the health disparities experienced by people with ID. PMID:21917052

An evaluation of learning clinical decision-making for early rehabilitation in the ICU via interactive education with audience response system.

PubMed

Toonstra, Amy L; Nelliot, Archana; Aronson Friedman, Lisa; Zanni, Jennifer M; Hodgson, Carol; Needham, Dale M

2017-06-01

Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs. A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience. An audience response system was incorporated to promote interaction and evaluate knowledge before vs. after the educational session. Up to 175 audience members, of 271 in attendance (129 (48%) physical therapists, 51 (19%) occupational therapists, 31 (11%) nursing, 14 (5%) physician, 46 (17%) other), completed both the pre- and post-test questions for each of the six unique patient cases. In four of six patient cases, there was a significant (p< 0.001) increase in identifying the correct answer regarding initiation of rehabilitation activities. This learning effect was similar irrespective of participants' years of experience and clinical discipline. An interactive, case-based, educational session may be effective for increasing short-term knowledge, and identifying knowledge gaps, regarding clinical decision-making for safe rehabilitation of patients in ICUs. Implications for Rehabilitation Lack of knowledge regarding the safety considerations for early rehabilitation of ICU patients is a barrier to implementing early rehabilitation. Interactive educational formats, such as the use of audience response systems, offer a new method of teaching and instantly assessing learning of clinically important information. In a small study, we have shown that an interactive, case-based educational format may be used to effectively teach clinical decision-making for the safe rehabilitation of ICU patients to a diverse audience of clinicians.

Artificial intelligence (AI) based tactical guidance for fighter aircraft

NASA Technical Reports Server (NTRS)

Mcmanus, John W.; Goodrich, Kenneth H.

1990-01-01

A research program investigating the use of artificial intelligence (AI) techniques to aid in the development of a Tactical Decision Generator (TDG) for Within Visual Range air combat engagements is discussed. The application of AI programming and problem solving methods in the development and implementation of the Computerized Logic For Air-to-Air Warfare Simulations (CLAWS), a second generation TDG, is presented. The knowledge-based systems used by CLAWS to aid in the tactical decision-making process are outlined in detail, and the results of tests to evaluate the performance of CLAWS versus a baseline TDG developed in FORTRAN to run in real time in the Langley Differential Maneuvering Simulator, are presented. To date, these test results have shown significant performance gains with respect to the TDG baseline in one-versus-one air combat engagements, and the AI-based TDG software has proven to be much easier to modify and maintain than the baseline FORTRAN TDG programs.

The impact of residency programs on new nurse graduates' clinical decision-making and leadership skills: a systematic review.

PubMed

AL-Dossary, Reem; Kitsantas, Panagiota; Maddox, P J

2014-06-01

Health care institutions have adapted residency programs to help new graduate nurses to become fully competent and transition from a student nurse to an independent practicing nurse and a bedside leader. The study's aim is to review the literature on the impact of residency programs on new graduate nurses' clinical decision-making and leadership skills. An electronic search was conducted between 1980 and 2013 using databases of the scientific literature in Medline, PubMed, Cochrane EPOC, Cumulative Index to Nursing & Allied Health Literature database guide (CINAHL), and PsychInfo using a range of keywords. Information gathered was evaluated for relevance. Thirteen studies that met the inclusion criteria were used in this systematic review. In several studies considered in this review, residency programs were developed to improve new graduates skills and promote their transition into the nursing workforce. In fact, the transition programs reduced turnover in that first year of practice and promoted professional growth of the new graduate such as hand-on nursing skills, clinical decision-making and leadership skills, satisfaction, and retention. There is a need for effective residency programs that are designed to prepare new graduate nurses in providing safe, competent and effective patient care. © 2013.

Tsunami.gov: NOAA's Tsunami Information Portal

NASA Astrophysics Data System (ADS)

Shiro, B.; Carrick, J.; Hellman, S. B.; Bernard, M.; Dildine, W. P.

2014-12-01

We present the new Tsunami.gov website, which delivers a single authoritative source of tsunami information for the public and emergency management communities. The site efficiently merges information from NOAA's Tsunami Warning Centers (TWC's) by way of a comprehensive XML feed called Tsunami Event XML (TEX). The resulting unified view allows users to quickly see the latest tsunami alert status in geographic context without having to understand complex TWC areas of responsibility. The new site provides for the creation of a wide range of products beyond the traditional ASCII-based tsunami messages. The publication of modern formats such as Common Alerting Protocol (CAP) can drive geographically aware emergency alert systems like FEMA's Integrated Public Alert and Warning System (IPAWS). Supported are other popular information delivery systems, including email, text messaging, and social media updates. The Tsunami.gov portal allows NOAA staff to easily edit content and provides the facility for users to customize their viewing experience. In addition to access by the public, emergency managers and government officials may be offered the capability to log into the portal for special access rights to decision-making and administrative resources relevant to their respective tsunami warning systems. The site follows modern HTML5 responsive design practices for optimized use on mobile as well as non-mobile platforms. It meets all federal security and accessibility standards. Moving forward, we hope to expand Tsunami.gov to encompass tsunami-related content currently offered on separate websites, including the NOAA Tsunami Website, National Tsunami Hazard Mitigation Program, NOAA Center for Tsunami Research, National Geophysical Data Center's Tsunami Database, and National Data Buoy Center's DART Program. This project is part of the larger Tsunami Information Technology Modernization Project, which is consolidating the software architectures of NOAA's existing TWC's into a single system. We welcome your feedback to help Tsunami.gov become an effective public resource for tsunami information and a medium to enable better global tsunami warning coordination.

Potential Offshore Wind Energy Areas in California: An Assessment of Locations, Technology, and Costs

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

Musial, Walter; Beiter, Philipp; Tegen, Suzanne

This report summarizes a study of possible offshore wind energy locations, technologies, and levelized cost of energy in the state of California between 2015 and 2030. The study was funded by the U.S. Department of the Interior's Bureau of Ocean Energy Management (BOEM), the federal agency responsible for regulating renewable energy development on the Outer Continental Shelf. It is based on reference wind energy areas where representative technology and performance characteristics were evaluated. These reference areas were identified as sites that were suitable to represent offshore wind cost and technology based on physical site conditions, wind resource quality, known existingmore » site use, and proximity to necessary infrastructure. The purpose of this study is to assist energy policy decision-making by state utilities, independent system operators, state government officials and policymakers, BOEM, and its key stakeholders. The report is not intended to serve as a prescreening exercise for possible future offshore wind development.« less

Environmental Public Health Indicators Impact Report: Data and methods that support environmental public health decision-making by communities

EPA Science Inventory

This report presents the results of twenty competitively funded Science-To-Achieve-Results (STAR) grants in EPA's Environmental Public Health Indicators (EPHI) research program. The grantsdirectly supported health interventions, informed policy and decision-making, and improved t...

Sensory coding of nest-site value in honeybee swarms.

PubMed

Seeley, Thomas D; Visscher, P Kirk

2008-12-01

This study investigates the first stage of the decision-making process of a honeybee swarm as it chooses a nest site: how a scout bee codes the value of a potential nest site in the waggle dances she produces to represent this site. We presented honeybee swarms with a two-alternative choice between a high-value site and a medium-value site and recorded the behavior of individually identifiable scout bees as they reported on these two alternatives. We found that bees performed equally lengthy inspections at the two sites, but that, on the swarm cluster, they performed more dance circuits per bee for the high-value site. We also found that there was much individual-level noise in the coding of site value, but that there were clear population-level differences in total dance circuits produced for the two sites. The first bee to find a site had a high probability of reporting the site with a waggle dance, regardless of its value. This discoverer-should-dance phenomenon may help ensure that a swarm gives attention to all discovered sites. There was rapid decay in the dance response; the number of dance circuits produced by a bee after visiting a site decreased linearly over sequential visits, and eventually each bee ceased visiting her site. This decay, or ;leakage', in the accumulation of bees at a site improves a swarm's decision-making ability by helping a swarm avoid making fast-decision errors.

Creation of a Tool for Assessing Knowledge in Evidence-Based Decision-Making in Practicing Health Care Providers.

PubMed

Spurr, Kathy; Dechman, Gail; Lackie, Kelly; Gilbert, Robert

2016-01-01

Evidence-based decision-making (EBDM) is the process health care providers (HCPs) use to identify and appraise potential evidence. It supports the integration of best research evidence with clinical expertise and patient values into the decision-making process for patient care. Competence in this process is essential to delivery of optimal care. There is no objective tool that assesses EBDM across HCP groups. This research aimed to develop a content valid tool to assess knowledge of the principles of evidence-based medicine and the EBDM process, for use with all HCPs. A Delphi process was used in the creation of the tool. Pilot testing established its content validity with the added benefit of evaluating HCPs' knowledge of EBDM. Descriptive statistics and multivariate mixed models were used to evaluate individual survey responses in total, as well as within each EBDM component. The tool consisted of 26 multiple-choice questions. A total of 12,884 HCPs in Nova Scotia were invited to participate in the web-based validation study, yielding 818 (6.3%) participants, 471 of whom completed all questions. The mean overall score was 68%. Knowledge in one component, integration of evidence with clinical expertise and patient preferences, was identified as needing development across all HCPs surveyed. A content valid tool for assessing HCP EBDM knowledge was created and can be used to support the development of continuing education programs to enhance EBDM competency.

DEVELOPMENT OF A SAFETY COMMUNICATION AND RECOGNITION PROGRAM FOR CONSTRUCTION

PubMed Central

SPARER, EMILY H.; HERRICK, ROBERT F.; DENNERLEIN, JACK T.

2017-01-01

Leading-indicator–based (e.g., hazard recognition) incentive programs provide an alternative to controversial lagging-indicator–based (e.g., injury rates) programs. We designed a leading-indicator–based safety communication and recognition program that incentivized safe working conditions. The program was piloted for two months on a commercial construction worksite, and then redesigned using qualitative interview and focus group data from management and workers. We then ran the redesigned program for six months on the same worksite. Foremen received detailed weekly feedback from safety inspections, and posters displayed worksite and subcontractor safety scores. In the final program design, the whole site, not individual subcontractors, was the unit of analysis and recognition. This received high levels of acceptance from workers, who noted increased levels of site unity and team-building. This pilot program showed that construction workers value solidarity with others on site, demonstrating the importance of health and safety programs that engage all workers through a reliable and consistent communication infrastructure. PMID:25815741

From Learning to Decision-Making: A Cross-Sectional Survey of a Clinical Pharmacist-Steered Journal Club

PubMed Central

Ismail, Sherine; Al Khansa, Sara; Aseeri, Mohammed; Alhamdan, Hani; Quadri, K. H. Mujtaba

2017-01-01

Journal clubs have been traditionally incorporated into academic training programs to enhance competency in the interpretation of literature. We designed a structured journal club (JC) to improve skills in the interpretation of literature; however, we were not aware of how learners (interns, residents, clinical pharmacists, etc.) would perceive it. We aimed to assess the perception of learners at different levels of pharmacy training. A cross-sectional design was used. A self-administered online survey was emailed to JC attendees from 2010–2014 at King Abdulaziz Medical City, Jeddah, Saudi Arabia. The survey questions included: introduction sessions, topic selection, JC layout, interaction with the moderator, and decision-making skills by clinical pharmacists. The response rate was 58/89 (65%); 52/54 (96%) respondents believed that JC adds to their knowledge in interpreting literature. Topic selection met the core curriculum requirements for credentials exams for 16/36 (44.4%), while 16/22 (73%) presenters had good to excellent interaction with the moderator. JC facilitated decision-making for 10/12 (83%) of clinical pharmacists. The results suggest that clinical pharmacist-steered JC may serve as an effective tool to empower learners at different levels of pharmacy practice, with evidence-based principles for interpretation of literature and guide informed decision-making. PMID:28970415

Supporting Students with Disabilities Entering the Science, Technology, Engineering, and Mathematics Field Disciplines

NASA Astrophysics Data System (ADS)

Dishauzi, Karen M.

Extensive research exists on female, African American, and Hispanic students pursuing Science, Technology, Engineering and Mathematics (STEM) field disciplines. However, little research evaluates students with disabilities and career decision-making relating to STEM field disciplines. This study explored the career decision-making experiences and self-efficacy for students with disabilities. The purpose of this research study was to document experiences and perceptions of students with disabilities who pursue, and may consider pursuing, careers in the STEM field disciplines by exploring the career decision-making self-efficacy of students with disabilities. This study documented the level of influence that the students with disabilities had or may not have had encountered from parents, friends, advisors, counselors, and instructors as they managed their decision-making choice relating to their academic major/career in the STEM or non-STEM field disciplines. A total of 85 respondents of approximately 340 students with disabilities at one Midwestern public university completed a quantitatively designed survey instrument. The Career Decision-Making Self-Efficacy Scale-Short Form by Betz and Hackett was the instrument used, and additional questions were included in the survey. Data analysis included descriptive statistics and analysis of variance. Based upon the results, college students with disabilities are not currently being influenced by individuals and groups of individuals to pursue the STEM field disciplines. This is a cohort of individuals who can be marketed to increase enrollment in STEM programs at academic institutions. This research further found that gender differences at the institution under study did not affect the career decision-making self-efficacy scores. The men did not score any higher in confidence in career decision-making than the women. Disability type did not significantly affect the relationship between the Career Decision-Making Self-Efficacy Total Scores or college major choice. Of the three disability types represented more frequently, the Mental Health disability was found to be a growing disability at the institution under study. This research was found to be beneficial in the documentation of specific levels of influence perceived by students with disabilities from parents, friends, advisors, counselors, and instructors that related to their career decision-making and academic major choices.

NASA Applied Sciences Program Rapid Prototyping Results and Conclusions

NASA Astrophysics Data System (ADS)

Cox, E. L.

2007-12-01

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

Health and medication information resources on the World Wide Web.

PubMed

Grossman, Sara; Zerilli, Tina

2013-04-01

Health care practitioners have increasingly used the Internet to obtain health and medication information. The vast number of Internet Web sites providing such information and concerns with their reliability makes it essential for users to carefully select and evaluate Web sites prior to use. To this end, this article reviews the general principles to consider in this process. Moreover, as cost may limit access to subscription-based health and medication information resources with established reputability, freely accessible online resources that may serve as an invaluable addition to one's reference collection are highlighted. These include government- and organization-sponsored resources (eg, US Food and Drug Administration Web site and the American Society of Health-System Pharmacists' Drug Shortage Resource Center Web site, respectively) as well as commercial Web sites (eg, Medscape, Google Scholar). Familiarity with such online resources can assist health care professionals in their ability to efficiently navigate the Web and may potentially expedite the information gathering and decision-making process, thereby improving patient care.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 5: developing a model for evidence-driven resource allocation in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Green, Sally; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-10

This is the fifth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. This paper synthesises the findings from Phase One of the SHARE Program and presents a model to be implemented and evaluated in Phase Two. Monash Health, a large healthcare network in Melbourne Australia, sought to establish an organisation-wide systematic evidence-based program for disinvestment. In the absence of guidance from the literature, the Centre for Clinical Effectiveness, an in-house 'Evidence Based Practice Support Unit', was asked to explore concepts and practices related to disinvestment, consider the implications for a local health service and identify potential settings and methods for decision-making. Mixed methods were used to capture the relevant information. These included literature reviews; online questionnaire, interviews and structured workshops with a range of stakeholders; and consultation with experts in disinvestment, health economics and health program evaluation. Using the principles of evidence-based change, the project team worked with health service staff, consumers and external experts to synthesise the findings from published literature and local research and develop proposals, frameworks and plans. Multiple influencing factors were extracted from these findings. The implications were both positive and negative and addressed aspects of the internal and external environments, human factors, empirical decision-making, and practical applications. These factors were considered in establishment of the new program; decisions reached through consultation with stakeholders were used to define four program components, their aims and objectives, relationships between components, principles that underpin the program, implementation and evaluation plans, and preconditions for success and sustainability. The components were Systems and processes, Disinvestment projects, Support services, and Program evaluation and research. A model for a systematic approach to evidence-based resource allocation in a local health service was developed. A robust evidence-based investigation of the research literature and local knowledge with a range of stakeholders resulted in rich information with strong consistent messages. At the completion of Phase One, synthesis of the findings enabled development of frameworks and plans and all preconditions for exploration of the four main aims in Phase Two were met.

National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

PubMed

Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

2017-12-01

To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Insights into water managers' perception and handling of uncertainties - a study of the role of uncertainty in practitioners' planning and decision-making

NASA Astrophysics Data System (ADS)

Höllermann, Britta; Evers, Mariele

2017-04-01

Planning and decision-making under uncertainty is common in water management due to climate variability, simplified models, societal developments, planning restrictions just to name a few. Dealing with uncertainty can be approached from two sites, hereby affecting the process and form of communication: Either improve the knowledge base by reducing uncertainties or apply risk-based approaches to acknowledge uncertainties throughout the management process. Current understanding is that science more strongly focusses on the former approach, while policy and practice are more actively applying a risk-based approach to handle incomplete and/or ambiguous information. The focus of this study is on how water managers perceive and handle uncertainties at the knowledge/decision interface in their daily planning and decision-making routines. How they evaluate the role of uncertainties for their decisions and how they integrate this information into the decision-making process. Expert interviews and questionnaires among practitioners and scientists provided an insight into their perspectives on uncertainty handling allowing a comparison of diverse strategies between science and practice as well as between different types of practitioners. Our results confirmed the practitioners' bottom up approach from potential measures upwards instead of impact assessment downwards common in science-based approaches. This science-practice gap may hinder effective uncertainty integration and acknowledgement in final decisions. Additionally, the implementation of an adaptive and flexible management approach acknowledging uncertainties is often stalled by rigid regulations favouring a predict-and-control attitude. However, the study showed that practitioners' level of uncertainty recognition varies with respect to his or her affiliation to type of employer and business unit, hence, affecting the degree of the science-practice-gap with respect to uncertainty recognition. The level of working experience was examined as a cross-cutting property of science and practice with increasing levels of uncertainty awareness and integration among more experienced researchers and practitioners. In conclusion, our study of water managers' perception and handling of uncertainties provides valuable insights for finding routines for uncertainty communication and integration into planning and decision-making processes by acknowledging the divers perceptions among producers, users and receivers of uncertainty information. These results can contribute to more effective integration of hydrological forecast and improved decisions.

An empirical investigation of construction and demolition waste generation rates in Shenzhen city, South China.

PubMed

Lu, Weisheng; Yuan, Hongping; Li, Jingru; Hao, Jane J L; Mi, Xuming; Ding, Zhikun

2011-04-01

The construction and demolition waste generation rates (C&D WGRs) is an important factor in decision-making and management of material waste in any construction site. The present study investigated WGRs by conducting on-site waste sorting and weighing in four ongoing construction projects in Shenzhen city of South China. The results revealed that WGRs ranged from 3.275 to 8.791 kg/m(2) and miscellaneous waste, timber for formwork and falsework, and concrete were the three largest components amongst the generated waste. Based on the WGRs derived from the research, the paper also discussed the main causes of waste in the construction industry and attempted to connect waste generation with specific construction practices. It was recommended that measures mainly including performing waste sorting at source, employing skilful workers, uploading and storing materials properly, promoting waste management capacity, replacing current timber formwork with metal formwork and launching an incentive reward program to encourage waste reduction could be potential solutions to reducing current WGRs in Shenzhen. Although these results were derived from a relatively small sample and so cannot justifiably be generalized, they do however add to the body of knowledge that is currently available for understanding the status of the art of C&D waste management in China. Copyright © 2010 Elsevier Ltd. All rights reserved.

Improving decision speed, accuracy and group cohesion through early information gathering in house-hunting ants.

PubMed

Stroeymeyt, Nathalie; Giurfa, Martin; Franks, Nigel R

2010-09-29

Successful collective decision-making depends on groups of animals being able to make accurate choices while maintaining group cohesion. However, increasing accuracy and/or cohesion usually decreases decision speed and vice-versa. Such trade-offs are widespread in animal decision-making and result in various decision-making strategies that emphasize either speed or accuracy, depending on the context. Speed-accuracy trade-offs have been the object of many theoretical investigations, but these studies did not consider the possible effects of previous experience and/or knowledge of individuals on such trade-offs. In this study, we investigated how previous knowledge of their environment may affect emigration speed, nest choice and colony cohesion in emigrations of the house-hunting ant Temnothorax albipennis, a collective decision-making process subject to a classical speed-accuracy trade-off. Colonies allowed to explore a high quality nest site for one week before they were forced to emigrate found that nest and accepted it faster than emigrating naïve colonies. This resulted in increased speed in single choice emigrations and higher colony cohesion in binary choice emigrations. Additionally, colonies allowed to explore both high and low quality nest sites for one week prior to emigration remained more cohesive, made more accurate decisions and emigrated faster than emigrating naïve colonies. These results show that colonies gather and store information about available nest sites while their nest is still intact, and later retrieve and use this information when they need to emigrate. This improves colony performance. Early gathering of information for later use is therefore an effective strategy allowing T. albipennis colonies to improve simultaneously all aspects of the decision-making process--i.e. speed, accuracy and cohesion--and partly circumvent the speed-accuracy trade-off classically observed during emigrations. These findings should be taken into account in future studies on speed-accuracy trade-offs.

Risk-taking and decision-making in youth: relationships to addiction vulnerability.

PubMed

Balogh, Kornelia N; Mayes, Linda C; Potenza, Marc N

2013-03-01

Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationship to addiction vulnerability in youth. Decision-making and risk-taking behaviors involve brain areas that undergoing developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in additive behaviors.

The Legal Implications of Administrative Decision-Making.

ERIC Educational Resources Information Center

Bender, Louis W.

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

HOW STUDENTS USE VALUES IN DECISION-MAKING.

ERIC Educational Resources Information Center

VARENHORST, BARBARA B.

HIGH SCHOOL STUDENTS ARE EXAMINING AND INTERNALIZING VALUES. THEIR FEAR OF COMMITMENT TO ANYTHING DEVIATING FROM ACCEPTED VALUES MAY HINDER THEIR CLARIFICATION OF PERSONAL GOALS AND VALUES. THE DECISION-MAKING PROCESS SHOULD BE AN IMPORTANT PART OF THE GUIDANCE PROGRAM. STANDARD QUESTIONNAIRES DO NOT PROVIDE INFORMATION ABOUT SPECIFIC FACTORS…

Ethical Behavior & Decision-Making among Graduate Students

ERIC Educational Resources Information Center

French, Jennifer A.

2012-01-01

One-hundred and eleven graduate students enrolled in a clinical psychology training program (PsyD) participated in a research study that examined the ethical decision-making processes and factors that have been proposed to influence behavior (Smith, McGuire, Abbott, & Blau, 1991). Using a two-part questionnaire, data regarding the ethical…

Incorporating Ecosystem Services into Community-level Decision-Making: A San Juan, Puerto Rico Case Study

EPA Science Inventory

EPA’s Office of Research and Development’s Sustainable and Healthy Communities Research Program is developing tools and approaches to incorporate ecosystem goods and services concepts into community-level decision-making. The San Juan Community Study is one of a serie...

Pilot Decision-Making in Irreversible Emergencies

ERIC Educational Resources Information Center

Winter, Scott R.

2013-01-01

The purpose of this study was to determine if a reflexive learning treatment utilizing select case studies could enhance the decision-making of pilots who encounter an irreversible emergency. Participants, who consisted of members of the subject university's professional pilot program, were divided into either a control or experimental group and…

24 CFR 576.404 - Conflicts of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... section who exercises or has exercised any functions or responsibilities with respect to activities assisted under the ESG program, or who is in a position to participate in a decision-making process or gain... withdrawn from his or her functions, responsibilities or the decision-making process with respect to the...

Web-based support as an adjunct to group-based smoking cessation for adolescents

PubMed Central

Mermelstein, Robin; Turner, Lindsey

2008-01-01

Although group-based programs remain the most common treatment approach for adolescent smoking cessation, success rates for these programs have been relatively modest, and their reach may be limited. Web-based adjuncts may be one way to boost the efficacy and reach of group-based approaches. The purpose of this study was to evaluate the effectiveness of enhancing the American Lung Association’s Not on Tobacco program (NOT) with a Web-based adjunct (NOT Plus). Twenty-nine high schools were randomly assigned to either the NOT program alone or to the NOT Plus condition, which included access to a specially designed Web site for teens, along with proactive phone calls from the group facilitator to the participant. Self-reported smoking behavior was obtained at end-of-program and at a 3-month follow-up. Using hierarchical linear modeling, accounting for the clustering of students in schools, and controlling for student gender, grade, race, and baseline smoking rate, there was a marginally significant (p = .06) condition effect at end-of-treatment and a significant effect at 3-month follow-up (p < .05) favoring the NOT Plus condition. Approximately 57% of adolescents reported visiting the Web site, and among the NOT Plus condition, use of the Web site was associated with cessation significantly at end-of-program (p < .05), but not at 3 months. Adolescents in urban schools were more likely to access the Web site than those in rural schools. Participants who visited the Web site rated it positively on several dimensions. Reasons for not using the Web site will be discussed, as well as its value as an adjunct. PMID:17491173

Integrating remotely sensed fires for predicting deforestation for REDD.

PubMed

Armenteras, Dolors; Gibbes, Cerian; Anaya, Jesús A; Dávalos, Liliana M

2017-06-01

Fire is an important tool in tropical forest management, as it alters forest composition, structure, and the carbon budget. The United Nations program on Reducing Emissions from Deforestation and Forest Degradation (REDD+) aims to sustainably manage forests, as well as to conserve and enhance their carbon stocks. Despite the crucial role of fire management, decision-making on REDD+ interventions fails to systematically include fires. Here, we address this critical knowledge gap in two ways. First, we review REDD+ projects and programs to assess the inclusion of fires in monitoring, reporting, and verification (MRV) systems. Second, we model the relationship between fire and forest for a pilot site in Colombia using near-real-time (NRT) fire monitoring data derived from the Moderate Resolution Imaging Spectroradiometer (MODIS). The literature review revealed fire remains to be incorporated as a key component of MRV systems. Spatially explicit modeling of land use change showed the probability of deforestation declined sharply with increasing distance to the nearest fire the preceding year (multi-year model area under the curve [AUC] 0.82). Deforestation predictions based on the model performed better than the official REDD early-warning system. The model AUC for 2013 and 2014 was 0.81, compared to 0.52 for the early-warning system in 2013 and 0.68 in 2014. This demonstrates NRT fire monitoring is a powerful tool to predict sites of forest deforestation. Applying new, publicly available, and open-access NRT fire data should be an essential element of early-warning systems to detect and prevent deforestation. Our results provide tools for improving both the current MRV systems, and the deforestation early-warning system in Colombia. © 2017 by the Ecological Society of America.

Awareness and action for eliminating health care disparities in pain care: Web-based resources.

PubMed

Fan, Ling; Thomas, Melissa; Deitrick, Ginna E; Polomano, Rosemary C

2008-01-01

Evidence shows that disparities in pain care exist, and this problem spans across all health care settings. Health care disparities are complex, and stem from the health system climate, limitations imposed by laws and regulations, and discriminatory practices that are deep seated in biases, stereotypes, and uncertainties surrounding communication and decision-making processes. A search of the Internet identified thousands of Web sites, documents, reports, and educational materials pertaining to health and pain disparities. Web sites for federal agencies, private foundations, and professional and consumer-oriented organizations provide useful information on disparities related to age, race, ethnicity, geography, socioeconomic status, and specific populations. The contents of 10 Web sites are examined for resources to assist health professionals and consumers in better understanding health and pain disparities and ways to overcome them in practice.

A Case Study of Small Group Decision-Making as Influenced by the Abilene Paradox: The ’Challenger’ Mishap

DTIC Science & Technology

1988-05-01

RESEARCH REPORT O A CASE STUDY OF SMALL GROUP DECISION-MAKING AS INFLUENCED BY THE ABILENE PARADOX: N THE " CHALLENGER " MISHAP COMMANDER JAMES Y...1.09_240 AIR WAR COLLEGE AIR UNIVERSITY A CASE STIJI)Y OF SMALL GROUP DECISION-MAKING AS INFLUENCED BY THE ABILENE PARADOX: THE " CHALLENGER " MISHAP by...representing the public and private sectors of leadership in our national space exploration program evaluated the risk associated with known discrepancies

Effective Strategies for School-Based Early Childhood Centers. The Northwest Regional Educational Laboratory Program Report.

ERIC Educational Resources Information Center

Jewett, Janet

Effective strategies for developing early childhood centers in public schools are discussed in this paper, which draws from a research-based literature search and intensive case studies of six Northwest sites. The sites represent a range of rural, suburban, and urban programs; large and small schools; and a variety of program features. The sites…

Pinon Preparation Program (PPP): Meeting the Needs of Rural Native American Students through Site-Based Education Programs.

ERIC Educational Resources Information Center

Prater, Greg; Lewis, Jamie B.

This paper examines the experiences of Navajo college students participating in a site-based teacher preparation program in a remote community on a Navajo Reservation. The 10 students (9 women and 1 man) work as teaching assistants in the Pinon Unified School District (Arizona). Having previously completed required Liberal Studies courses, the…

H.E.A.L.T.H.: Efficacy of an Internet/Population-Based Behavioral Weight Management Program for the U.S. Army

PubMed Central

Stewart, Tiffany; Han, Hongmei; Allen, H. Raymond; Bathalon, COL Gaston; Ryan, Donna H.; Newton, Robert L.; Williamson, Donald A.

2011-01-01

Background A significant number of soldiers exceed the maximum allowable weight standards or have body weights approaching the maximum allowable weight standards. This mandates development of scalable approaches to improve compliance with military weight standards. Methods We developed an intervention that included two components: (1) an Internet-based weight management program (Web site) and (2) a promotion program designed to promote and sustain usage of the Web site. The Web site remained online for 37 months, with the Web site promotion program ending after 25 months. Results Soldiers’ demographics were as follows: mean age, 32 years; body mass index (BMI), 28 kg/m2; 31% female; and 58% Caucasian. Civilian demographics were as follows: mean age, 38 years; BMI, 30 kg/m2; 84% female; and 55% Caucasian. Results indicated that 2417 soldiers and 2147 civilians (N = 4564) registered on the Web site. In the first 25 months (phase 1) of the study, new participants enrolled on the Web site at a rate of 88 (soldiers) and 80 (civilians) per month. After the promotion program was removed (phase 2), new participants enrolled at a rate of 18 (soldiers) and 13 (civilians) per month. Utilization of the Web site was associated with self-reported weight loss (p < .0001). Participants who utilized the Web site more frequently lost more weight (p < .0001). Participants reported satisfaction with the Web site. Conclusions The Web site and accompanying promotion program, when implemented at a military base, received satisfactory ratings and benefited a subset of participants in promoting weight loss. This justifies further examination of effectiveness in a randomized trial setting. PMID:21303642

Developing science policy capacity at the state government level: Planning a science and technology policy fellowship program for Colorado and beyond

NASA Astrophysics Data System (ADS)

Druckenmiller, M. L.

2017-12-01

There is growing recognition of the potential to advance science policy capacity within state legislatures, where there is most often a shortage of professional backgrounds in the natural sciences, technology, engineering, and medicine. Developing such capacity at the state level should be considered a vital component of any comprehensive national scale strategy to strengthen science informed governance. Toward this goal, the Center for Science and Technology Policy Research at the University of Colorado Boulder is leading a strategic planning process for a Science and Technology Policy Fellowship Program within the Colorado state legislature and executive branch agencies. The intended program will place PhD-level scientists and engineers in one-year placements with decision-makers to provide an in-house resource for targeted policy-relevant research. Fellows will learn the intricacies of the state policymaking process, be exposed to opportunities for science to inform decisions, and develop a deeper understanding of key science and technology topics in Colorado, including water resources, wildfire management, and energy. The program's ultimate goals are to help foster a decision-making arena informed by evidence-based information, to develop new leaders adept at bridging science and policymaking realms, and to foster governance that champions the role of science in society. Parallel to efforts in Colorado, groups from nine other states are preparing similar plans, providing opportunities to share approaches across states and to set the stage for increased science and technology input to state legislative agendas nationwide. Importantly, highly successful and sustainable models exist; the American Association for the Advancement of Science (AAAS) has implemented a federally based fellowship program for over 43 years and the California Council for Science and Technology (CCST) has directed a fellowship program for their state's legislature since 2009. AAAS and CCST are now serving as critical and leading partners in creating similar programs across the U.S.

Evaluation of a Decision-Making Curriculum for Teaching Adolescents with Disabilities to Resist Negative Peer Pressure.

PubMed

Khemka, Ishita; Hickson, Linda; Mallory, Sarah B

2016-07-01

This study was designed to assess the impact of a decision-making curriculum (PEER-DM) on the social peer relationship knowledge and self-protective decision-making skills of adolescents with disabilities in hypothetical situations involving negative peer pressure. A randomized design was used to assign students with disabilities from self-contained special education classes to an intervention group (n = 22) or a wait-list control group (n = 20). ANCOVA analyses, using pretest scores as covariates, indicated that students who were trained on PEER-DM had significantly higher effective decision-making action and correct risk perception scores, relative to participants in the control group. This study provides supporting evidence that PEER-DM is a promising intervention for students with disabilities, including those with identified autism spectrum disorders, during transition years to help them develop a better understanding of positive and negative peer relationships and learn systematic decision-making skills for improved handling of social situations in the school and community, especially situations involving negative peer pressure. The study adds credence to using systematic, strategy-based decision making interventions designed to address the cognitive, emotional and motivational processes underlying adolescent decision making in sensitive interpersonal situations involving peer pressure. The study points to the lack of preparedness to handle situations of negative peer pressure as a serious social and health risk for adolescents with disabilities that deserves urgent and concerted attention in transition services programming. Implications for future curriculum-development efforts and replication of treatment findings are discussed. Future research examining disability-specific patterns of decision-making in peer situations and comparisons with typically developing populations is recommended.

Maintenance program decision-making utilizing crash data.

DOT National Transportation Integrated Search

2013-07-01

This document describes methods that may be used by UDOT Maintenance personnel to improve highway safety. Four programs have been recommended using crash data to make more informed decisions concerning maintenance programs as follows: : Snow & Ic...

Superfund and Technology Liaison Program Fact Sheet

EPA Pesticide Factsheets

The Superfund and Technology Liaison (STL) Program was established to facilitate regional access to ORD laboratories, provide technical support, and assist with the integration of science and technology into decision-making for hazardous waste programs.

Computation of Southern Pine Site Index Using a TI-59 Calculator

Treesearch

Robert M. Farrar

1983-01-01

A program is described that permits computation of site index in the field using a Texas Instruments model TI-59 programmable, hand-held, battery-powered calculator. Based on a series of equations developed by R.M. Farrar, Jr., for the site index curves in USDA Miscellaneous Publication 50, the program can accommodate any index base age, tree age, and height within...

Universal school-based substance abuse prevention programs: Modeling targeted mediators and outcomes for adolescent cigarette, alcohol and marijuana use.

PubMed

Stephens, Peggy C; Sloboda, Zili; Stephens, Richard C; Teasdale, Brent; Grey, Scott F; Hawthorne, Richard D; Williams, Joseph

2009-06-01

We examined the relationships among targeted constructs of social influences and competence enhancement prevention curricula and cigarette, alcohol and marijuana use outcomes in a diverse sample of high school students. We tested the causal relationships of normative beliefs, perceptions of harm, attitudes toward use of these substances and refusal, communication, and decision-making skills predicting the self-reported use of each substance. In addition, we modeled the meditation of these constructs through the intentions to use each substance and tested the moderating effects of the skills variables on the relationships between intentions to use and self-reported use of each of these substances. Logistic regression path models were constructed for each of the drug use outcomes. Models were run using the Mplus 5.0 statistical application using the complex sample function to control for the sampling design of students nested within schools; full information maximum likelihood estimates (FIML) were utilized to address missing data. Relationships among targeted constructs and outcomes differed for each of the drugs with communication skills having a potentially iatrogenic effect on alcohol use. Program targets were mediated through the intentions to use these substances. Finally, we found evidence of a moderating effect of decision-making skills on perceptions of harm and attitudes toward use, depending upon the outcome. Prevention curricula may need to target specific drugs. In addition to normative beliefs, perceptions of harm, and refusal and decision-making skills, programs should directly target constructs proximal to behavioral outcomes such as attitudes and intentions. Finally, more research on the effects of communication skills on adolescent substance use should be examined.

Changing patterns of health in communities impacted by a bioenergy project in northern Sierra Leone.

PubMed

Knoblauch, Astrid M; Hodges, Mary H; Bah, Mohamed S; Kamara, Habib I; Kargbo, Anita; Paye, Jusufu; Turay, Hamid; Nyorkor, Emmanuel D; Divall, Mark J; Zhang, Yaobi; Utzinger, Jürg; Winkler, Mirko S

2014-12-01

Large private sector investments in low- and middle-income countries are often critically evaluated with regards to their environmental, social, human rights, and health impacts. A health impact assessment, including a baseline health survey, was commissioned by the Addax Bioenergy Sierra Leone project in 2010. As part of the monitoring, a follow-up survey was conducted three years later. A set of health indicators was assessed at six impacted and two control sites. Most of these indices improved, particularly at the impacted sites. The prevalences of stunting, wasting, and Plasmodium falciparum in children under five years of age decreased significantly at impacted sites (all p < 0.05) and non-significantly at control sites. Anemia in children and in women of reproductive age (15-49 years) decreased significantly at impacted and control sites (p < 0.05 and p < 0.001, respectively). Health facility-based deliveries increased significantly at the impacted sites (p < 0.05). The prevalences of helminth infections in children aged 10-15 years remained approximately at the same levels, although focal increases at the impacted sites were noted. Access to improved sanitation decreased significantly (p < 0.05) at control and non-significantly at impacted sites. Water quality remained poor without significant changes. The epidemiologic monitoring of a bioenergy project provides a useful contribution for evidence-based decision-making.

Changing Patterns of Health in Communities Impacted by a Bioenergy Project in Northern Sierra Leone

PubMed Central

Knoblauch, Astrid M.; Hodges, Mary H.; Bah, Mohamed S.; Kamara, Habib I.; Kargbo, Anita; Paye, Jusufu; Turay, Hamid; Nyorkor, Emmanuel D.; Divall, Mark J.; Zhang, Yaobi; Utzinger, Jürg; Winkler, Mirko S.

2014-01-01

Large private sector investments in low- and middle-income countries are often critically evaluated with regards to their environmental, social, human rights, and health impacts. A health impact assessment, including a baseline health survey, was commissioned by the Addax Bioenergy Sierra Leone project in 2010. As part of the monitoring, a follow-up survey was conducted three years later. A set of health indicators was assessed at six impacted and two control sites. Most of these indices improved, particularly at the impacted sites. The prevalences of stunting, wasting, and Plasmodium falciparum in children under five years of age decreased significantly at impacted sites (all p < 0.05) and non-significantly at control sites. Anemia in children and in women of reproductive age (15–49 years) decreased significantly at impacted and control sites (p < 0.05 and p < 0.001, respectively). Health facility-based deliveries increased significantly at the impacted sites (p < 0.05). The prevalences of helminth infections in children aged 10–15 years remained approximately at the same levels, although focal increases at the impacted sites were noted. Access to improved sanitation decreased significantly (p < 0.05) at control and non-significantly at impacted sites. Water quality remained poor without significant changes. The epidemiologic monitoring of a bioenergy project provides a useful contribution for evidence-based decision-making. PMID:25514152

Visual simulation of offshore liquefied natural gas (lng) terminals in a decision-making context

Treesearch

Brian E. Baird; Stephen R. J. Sheppard; Richard C. Smardon

1979-01-01

Due to legislation passed in 1977, the Coastal Commission tock part in a study analyzing potential offshore Liquified Natural Gas (LNG) sites and the types of terminals that might occupy those sites. The study had to evaluate the engineering feasibility of siting an LNG receiving terminal offshore in relation to the maximum protection of coastal resource provisions...

Application of Artificial Intelligence (AI) Programming Techniques to Tactical Guidance for Fighter Aircraft

NASA Technical Reports Server (NTRS)

McManus, John W.; Goodrich, Kenneth H.

1989-01-01

A research program investigating the use of Artificial Intelligence (AI) techniques to aid in the development of a Tactical Decision Generator (TDG) for Within-Visual-Range (WVR) air combat engagements is discussed. The application of AI methods for development and implementation of the TDG is presented. The history of the Adaptive Maneuvering Logic (AML) program is traced and current versions of the AML program are compared and contrasted with the TDG system. The Knowledge-Based Systems (KBS) used by the TDG to aid in the decision-making process are outlined in detail and example rules are presented. The results of tests to evaluate the performance of the TDG versus a version of AML and versus human pilots in the Langley Differential Maneuvering Simulator (DMS) are presented. To date, these results have shown significant performance gains in one-versus-one air combat engagements, and the AI-based TDG software has proven to be much easier to modify than the updated FORTRAN AML programs.

Environmental Research Translation: Enhancing Interactions with Communities at Contaminated Sites

NASA Astrophysics Data System (ADS)

Ramirez-Andreotta, M.; Brusseau, M. L. L.; Artiola, J. F.; Maier, R. M.; Gandolfi, A. J.

2015-12-01

The characterization and remediation of contaminated sites are complex endeavors fraught with numerous challenges. One particular challenge that is receiving increased attention is the development and encouragement of full participation by communities and community members affected by a given site in all facets of decision-making. Many disciplines have been grappling with the challenges associated with environmental and risk communication, public participation in environmental data generation and decision-making, and increasing community capacity. The concepts and methods developed by these disciplines are reviewed, with a focus on their relevance to the specific dynamics associated with contaminated sites. The contributions of these disciplines are then synthesized and integrated to help develop Environmental Research Translation (ERT), a proposed framework for environmental scientists to promote interaction and communication among involved parties at contaminated sites. This holistic approach is rooted in public participation approaches to science, which includes: a transdisciplinary team, effective collaboration, information transfer, public participation in environmental projects, and a cultural model of risk communication. Although there are challenges associated with the implementation of ERT, it is anticipated that application of this proposed translational science method could promote more robust community participation at contaminated sites.

Environmental Research Translation: Enhancing Interactions with Communities at Contaminated Sites

PubMed Central

Ramirez-Andreotta, Monica D.; Brusseau, Mark L.; Artiola, Janick F.; Maier, Raina M.; Gandolfi, A. Jay

2014-01-01

The characterization and remediation of contaminated sites are complex endeavors fraught with numerous challenges. One particular challenge that is receiving increased attention is the development and encouragement of full participation by communities and community members affected by a given site in all facets of decision-making. Many disciplines have been grappling with the challenges associated with environmental and risk communication, public participation in environmental data generation, and decision-making and increasing community capacity. The concepts and methods developed by these disciplines are reviewed, with a focus on their relevance to the specific dynamics associated with environmental contamination sites. The contributions of these disciplines are then synthesized and integrated to help develop Environmental Research Translation (ERT), a proposed framework for environmental scientists to promote interaction and communication among involved parties at contaminated sites. This holistic approach is rooted in public participation approaches to science, which includes: a transdisciplinary team, effective collaboration, information transfer, public participation in environmental projects, and a cultural model of risk communication. Although there are challenges associated with the implementation of ERT, it is anticipated that application of this proposed translational science method could promote more robust community participation at contaminated sites. PMID:25173762

TECHNICAL APPROACHES TO CHARACTERIZING AND CLEANING UP BROWNFIELDS SITES: GUIDANCE DOCUMENT

EPA Science Inventory

NRMRL-CIN-1741 SAIC. Technical Approaches to Characterizing and Cleaning up Brownfields Sites. EPA/625/R/00/009 (NTIS PB2002-105021) , Available: 68-C7-0011. The guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the p...

A Gibbs sampler for Bayesian analysis of site-occupancy data

USGS Publications Warehouse

Dorazio, Robert M.; Rodriguez, Daniel Taylor

2012-01-01

1. A Bayesian analysis of site-occupancy data containing covariates of species occurrence and species detection probabilities is usually completed using Markov chain Monte Carlo methods in conjunction with software programs that can implement those methods for any statistical model, not just site-occupancy models. Although these software programs are quite flexible, considerable experience is often required to specify a model and to initialize the Markov chain so that summaries of the posterior distribution can be estimated efficiently and accurately. 2. As an alternative to these programs, we develop a Gibbs sampler for Bayesian analysis of site-occupancy data that include covariates of species occurrence and species detection probabilities. This Gibbs sampler is based on a class of site-occupancy models in which probabilities of species occurrence and detection are specified as probit-regression functions of site- and survey-specific covariate measurements. 3. To illustrate the Gibbs sampler, we analyse site-occupancy data of the blue hawker, Aeshna cyanea (Odonata, Aeshnidae), a common dragonfly species in Switzerland. Our analysis includes a comparison of results based on Bayesian and classical (non-Bayesian) methods of inference. We also provide code (based on the R software program) for conducting Bayesian and classical analyses of site-occupancy data.

Risk management for the Space Exploration Initiative

NASA Technical Reports Server (NTRS)

Buchbinder, Ben

1993-01-01

Probabilistic Risk Assessment (PRA) is a quantitative engineering process that provides the analytic structure and decision-making framework for total programmatic risk management. Ideally, it is initiated in the conceptual design phase and used throughout the program life cycle. Although PRA was developed for assessment of safety, reliability, and availability risk, it has far greater application. Throughout the design phase, PRA can guide trade-off studies among system performance, safety, reliability, cost, and schedule. These studies are based on the assessment of the risk of meeting each parameter goal, with full consideration of the uncertainties. Quantitative trade-off studies are essential, but without full identification, propagation, and display of uncertainties, poor decisions may result. PRA also can focus attention on risk drivers in situations where risk is too high. For example, if safety risk is unacceptable, the PRA prioritizes the risk contributors to guide the use of resources for risk mitigation. PRA is used in the Space Exploration Initiative (SEI) Program. To meet the stringent requirements of the SEI mission, within strict budgetary constraints, the PRA structure supports informed and traceable decision-making. This paper briefly describes the SEI PRA process.

Regional decision-making and competitive funding : metropolitan planning organizations and the transportation investments generating economic recovery program.

DOT National Transportation Integrated Search

2014-08-01

Transportation benefits and economic stimulus were behind the creation of the Transportation Investment Generating Economic Recovery (TIGER) program in 2009. New transportation funding programs exist in a landscape of other programs, and in addition ...

Final Report: Pilot Region-Based Optimization Program for Fund-Lead Sites, EPA Region III

EPA Pesticide Factsheets

This report describes a pilot study for a Region-based optimization program, implemented by a Regional Optimization Evaluation Team (ROET) that was conducted in U.S. EPA Region III at Fund-lead sites with pump-and-treat (P&T) systems.

Risk-taking and decision-making in youth: relationships to addiction vulnerability

PubMed Central

Balogh, Kornelia N.; Mayes, Linda C.; Potenza, Marc N.

2013-01-01

Background Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. Methods Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationship to addiction vulnerability in youth. Results Decision-making and risk-taking behaviors involve brain areas that undergoing developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. Conclusions Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in additive behaviors. PMID:24294500

Public Health, Law, and Local Control: Destruction of the US Chemical Weapons Stockpile

PubMed Central

Greenberg, Michael R.

2003-01-01

Destruction of US chemical weapons has begun at one of the 8 sites in the continental United States, was completed on Johnston Island in the Pacific Ocean, and is scheduled to begin in at least 3 other locations during the upcoming year. About 25% of the stockpile and 38% of the munitions had been destroyed as of December 31, 2002. However, the program has become controversial with regard to choice of technology, emergency management, and cost. This controversy is in large part due to efforts by some state and local governments and activist groups to play a more central role in a decisionmaking process that was once fully controlled by the US Army. PMID:12893599

Lessons from scaling up a depression treatment program in primary care in Chile.

PubMed

Araya, Ricardo; Alvarado, Rubén; Sepúlveda, Rodrigo; Rojas, Graciela

2012-09-01

In Chile, the National Depression Detection and Treatment Program (Programa Nacional de Diagnóstico y Tratamiento de la Depresión, PNDTD) in primary care is a rare example of an evidence-based mental health program that was scaled up to the national level in a low- or middle-income country. This retrospective qualitative study aimed to better understand how policymakers made the decision to scale up mental health services to the national level, and to explore the elements, contexts, and processes that facilitated the decision to implement and sustain PNDTD. In-depth semistructured interviews with six key informants selected through intentional sampling were conducted in August-December 2008. Interviewees were senior officers at the Ministry of Health who were directly involved in the decision to scale up the program. Results yielded four elements pivotal to the decisionmaking process: scientific evidence, teamwork and leadership, strategic alliances, and program institutionalization. Each element contributed to building consensus, securing funding, attracting resources, and gaining lasting support from policymakers. Additionally, a review of available documentation led the authors to consider sociopolitical context and use of the media to be important factors. While research evidence for the effectiveness of mental health services in the primary care setting continues to accumulate, low- and middle-income countries should get started on the lengthy process of scaling up by incorporating the elements that led to decisionmaking and implementation of the PNDTD in Chile.

Life Cycle Costing as an Aid in Decision Making

ERIC Educational Resources Information Center

Blake, Robert

1973-01-01

Within an accepted process and measures framework, total program cost over the life of the program, including the life of facility(ies) that house the program, provides a rational decisionmaking environment for the accountable managers. (Author)

Challenges and Opportunities for Developing and Implementing Incentives to Improve Health-Related Behaviors in Older Adults

PubMed Central

Klein, Eran; Karlawish, Jason

2010-01-01

There is growing interest in using patient-directed incentives to change health-related behaviors. Advocates of incentive programs have proposed an ambitious research agenda for moving patient incentive programs forward. Older adults may pose a challenge to such a research agenda. The cognitive and psychological features of this population, in particular, age-related changes in emotional regulation, executive function and cognitive capacities, and a preference for collaborative decision-making raise questions about the suitability of these programs, particularly the structure of current financial incentives, to older adults. Differences in decision-making in older adults need to be accounted for in the design and implementation of financial incentive programs. Financial incentive programs tailored to characteristics of older adult populations may be more likely to improve the lives of older persons and the economic success of programs that serve them. PMID:20863335

Comparison of risk-based decision-support systems for brownfield site rehabilitation: DESYRE and SADA applied to a Romanian case study.

PubMed

Stezar, I C; Pizzol, L; Critto, A; Ozunu, A; Marcomini, A

2013-12-15

Brownfield rehabilitation is an essential step for sustainable land-use planning and management in the European Union. In brownfield regeneration processes, the legacy contamination plays a significant role, firstly because of the persistent contaminants in soil or groundwater which extends the existing hazards and risks well into the future; and secondly, problems from historical contamination are often more difficult to manage than contamination caused by new activities. Due to the complexity associated with the management of brownfield site rehabilitation, Decision Support Systems (DSSs) have been developed to support problem holders and stakeholders in the decision-making process encompassing all phases of the rehabilitation. This paper presents a comparative study between two DSSs, namely SADA (Spatial Analysis and Decision Assistance) and DESYRE (Decision Support System for the Requalification of Contaminated Sites), with the main objective of showing the benefits of using DSSs to introduce and process data and then to disseminate results to different stakeholders involved in the decision-making process. For this purpose, a former car manufacturing plant located in the Brasov area, Central Romania, contaminated chiefly by heavy metals and total petroleum hydrocarbons, has been selected as a case study to apply the two examined DSSs. Major results presented here concern the analysis of the functionalities of the two DSSs in order to identify similarities, differences and complementarities and, thus, to provide an indication of the most suitable integration options. Copyright © 2013 Elsevier Ltd. All rights reserved.

The cost-effectiveness of rapid HIV testing in substance abuse treatment: results of a randomized trial.

PubMed

Schackman, Bruce R; Metsch, Lisa R; Colfax, Grant N; Leff, Jared A; Wong, Angela; Scott, Callie A; Feaster, Daniel J; Gooden, Lauren; Matheson, Tim; Haynes, Louise F; Paltiel, A David; Walensky, Rochelle P

2013-02-01

The President's National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk-reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost-Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio <$100,000/QALY. Policymakers and substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The Cost-effectiveness of Rapid HIV Testing in Substance Abuse Treatment: Results of a Randomized Trial*

PubMed Central

Schackman, Bruce R.; Metsch, Lisa R.; Colfax, Grant N.; Leff, Jared A.; Wong, Angela; Scott, Callie A.; Feaster, Daniel J.; Gooden, Lauren; Matheson, Tim; Haynes, Louise F.; Paltiel, A. David; Walensky, Rochelle P.

2012-01-01

BACKGROUND The President’s National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. METHODS We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. RESULTS Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. CONCLUSIONS A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio <$100,000/QALY. Policymakers and substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. PMID:22971593

Measuring outcomes in children's rehabilitation: a decision protocol.

PubMed

Law, M; King, G; Russell, D; MacKinnon, E; Hurley, P; Murphy, C

1999-06-01

To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation. A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures. A children's rehabilitation center in a city of 50,000. All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology. Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months. Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up). Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change. The "All About Outcomes" software is clinically useful. Further research should evaluate whether using the software affects the use of outcome measures in clinical practice.

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

NASA Technical Reports Server (NTRS)

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

2004-01-01

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

An analytical procedure to assist decision-making in a government research organization

Treesearch

H. Dean Claxton; Giuseppe Rensi

1972-01-01

An analytical procedure to help management decision-making in planning government research is described. The objectives, activities, and restrictions of a government research organization are modeled in a consistent analytical framework. Theory and methodology is drawn from economics and mathe-matical programing. The major analytical aspects distinguishing research...

A Curriculum For Choosing.

ERIC Educational Resources Information Center

Winocur, S. Lee

This guide addresses the problem of decision-making in young children and the effect of a particular curriculum on the improvement of children's ability in this area. The term and the process of decision-making are defined, and career implications are discussed. The last section of the guide outlines a program designed to help teachers assist…

A Cross-National CAI Tool To Support Learning Operations Decision-Making and Market Analysis.

ERIC Educational Resources Information Center

Mockler, Robert J.; Afanasiev, Mikhail Y.; Dologite, Dorothy G.

1999-01-01

Describes bicultural (United States and Russia) development of a computer-aided instruction (CAI) tool to learn management decision-making using information systems technologies. The program has been used with undergraduate and graduate students in both countries; it integrates free and controlled market concepts and combines traditional computer…

Emotional and Personality-Related Aspects of Career Decision-Making Difficulties: Facets of Career Indecisiveness

ERIC Educational Resources Information Center

Gati, Itamar; Gadassi, Reuma; Saka, Noa; Hadadi, Yael; Ansenberg, Neta; Friedmann, Ronit; Asulin-Peretz, Lisa

2011-01-01

The current study investigated the Emotional and Personality-related Career decision-making Difficulties model and questionnaire (EPCD) by studying its associations with various personality measures in three samples: (a) 691 deliberating individuals who entered a career self-help website, (b) 197 students in a university preparatory program, and…

School District Approval for Staff Development: "Garbage Can" Decision-Making.

ERIC Educational Resources Information Center

Furman, Gail Chase

This paper explores the decision-making process leading to school district approval for staff development. A retrospective field study approach was used to investigate the decision of a small, rural school district in eastern Washington (enrollment 2,200) to adopt a comprehensive English composition teaching program throughout the curriculum. This…

Moral Development and Social Worker Ethical Decision-Making

ERIC Educational Resources Information Center

Groessl, Joan

2013-01-01

This study examined both the moral development levels using the Defining Issues Test-2 (DIT--2) and ethical decision-making using the Professional Opinion Scale (POS) of social workers who provide field supervision to students within accredited social work programs in Wisconsin. Using the moral development theory of Kohlberg (1981) which defined…

Risk in fire management decisionmaking: techniques and criteria

Treesearch

Gail Blatternberger; William F. Hyde; Thomas J. Mills

1984-01-01

In the past, decisionmaking in wildland fire management generally has not included a full consideration of the risk and uncertainty that is inherent in evaluating alternatives. Fire management policies in some Federal land management agencies now require risk evaluation. The model for estimating the economic efficiency of fire program alternatives is the minimization...

National GAP Conference 2007-Discussion Groups Report

USGS Publications Warehouse

Ratz, Joan M.; Lamb, Berton Lee

2010-01-01

We led two discussion groups during the 2007 National GAP Conference. These discussion groups provided information to help develop a survey of National Gap Analysis Program (GAP) data users. One group discussed technical issues, and the second group discussed the use of GAP data for decisionmaking. Themes emerging from the technical issues group included concerns about data quality, need for information on how to use data, and passive data distribution. The decisionmaking discussion included a wide range of topics including the need to understand presentation of information, the need to connect with and understand users of data, the revision of GAP's mission, and the adaptability of products and data. The decisionmaking group also raised concerns regarding technical issues. One conclusion is that a deep commitment to ongoing information transfer and support is a key component of success for the GAP program.

Program Alternatives for Linguistically Diverse Students. Educational Practice Report 1.

ERIC Educational Resources Information Center

Genesee, Fred, Ed.

The report looks at programs and approaches for educating students from diverse linguistic and cultural backgrounds. It is intended as a guide for school and district decision-makers to help them identify instructional approaches and programs appropriate to their students' needs. Four program alternatives are discussed: newcomer programs;…

Quantifying and reducing statistical uncertainty in sample-based health program costing studies in low- and middle-income countries.

PubMed

Rivera-Rodriguez, Claudia L; Resch, Stephen; Haneuse, Sebastien

2018-01-01

In many low- and middle-income countries, the costs of delivering public health programs such as for HIV/AIDS, nutrition, and immunization are not routinely tracked. A number of recent studies have sought to estimate program costs on the basis of detailed information collected on a subsample of facilities. While unbiased estimates can be obtained via accurate measurement and appropriate analyses, they are subject to statistical uncertainty. Quantification of this uncertainty, for example, via standard errors and/or 95% confidence intervals, provides important contextual information for decision-makers and for the design of future costing studies. While other forms of uncertainty, such as that due to model misspecification, are considered and can be investigated through sensitivity analyses, statistical uncertainty is often not reported in studies estimating the total program costs. This may be due to a lack of awareness/understanding of (1) the technical details regarding uncertainty estimation and (2) the availability of software with which to calculate uncertainty for estimators resulting from complex surveys. We provide an overview of statistical uncertainty in the context of complex costing surveys, emphasizing the various potential specific sources that contribute to overall uncertainty. We describe how analysts can compute measures of uncertainty, either via appropriately derived formulae or through resampling techniques such as the bootstrap. We also provide an overview of calibration as a means of using additional auxiliary information that is readily available for the entire program, such as the total number of doses administered, to decrease uncertainty and thereby improve decision-making and the planning of future studies. A recent study of the national program for routine immunization in Honduras shows that uncertainty can be reduced by using information available prior to the study. This method can not only be used when estimating the total cost of delivering established health programs but also to decrease uncertainty when the interest lies in assessing the incremental effect of an intervention. Measures of statistical uncertainty associated with survey-based estimates of program costs, such as standard errors and 95% confidence intervals, provide important contextual information for health policy decision-making and key inputs for the design of future costing studies. Such measures are often not reported, possibly because of technical challenges associated with their calculation and a lack of awareness of appropriate software. Modern statistical analysis methods for survey data, such as calibration, provide a means to exploit additional information that is readily available but was not used in the design of the study to significantly improve the estimation of total cost through the reduction of statistical uncertainty.

Quantifying and reducing statistical uncertainty in sample-based health program costing studies in low- and middle-income countries

PubMed Central

Resch, Stephen

2018-01-01

Objectives: In many low- and middle-income countries, the costs of delivering public health programs such as for HIV/AIDS, nutrition, and immunization are not routinely tracked. A number of recent studies have sought to estimate program costs on the basis of detailed information collected on a subsample of facilities. While unbiased estimates can be obtained via accurate measurement and appropriate analyses, they are subject to statistical uncertainty. Quantification of this uncertainty, for example, via standard errors and/or 95% confidence intervals, provides important contextual information for decision-makers and for the design of future costing studies. While other forms of uncertainty, such as that due to model misspecification, are considered and can be investigated through sensitivity analyses, statistical uncertainty is often not reported in studies estimating the total program costs. This may be due to a lack of awareness/understanding of (1) the technical details regarding uncertainty estimation and (2) the availability of software with which to calculate uncertainty for estimators resulting from complex surveys. We provide an overview of statistical uncertainty in the context of complex costing surveys, emphasizing the various potential specific sources that contribute to overall uncertainty. Methods: We describe how analysts can compute measures of uncertainty, either via appropriately derived formulae or through resampling techniques such as the bootstrap. We also provide an overview of calibration as a means of using additional auxiliary information that is readily available for the entire program, such as the total number of doses administered, to decrease uncertainty and thereby improve decision-making and the planning of future studies. Results: A recent study of the national program for routine immunization in Honduras shows that uncertainty can be reduced by using information available prior to the study. This method can not only be used when estimating the total cost of delivering established health programs but also to decrease uncertainty when the interest lies in assessing the incremental effect of an intervention. Conclusion: Measures of statistical uncertainty associated with survey-based estimates of program costs, such as standard errors and 95% confidence intervals, provide important contextual information for health policy decision-making and key inputs for the design of future costing studies. Such measures are often not reported, possibly because of technical challenges associated with their calculation and a lack of awareness of appropriate software. Modern statistical analysis methods for survey data, such as calibration, provide a means to exploit additional information that is readily available but was not used in the design of the study to significantly improve the estimation of total cost through the reduction of statistical uncertainty. PMID:29636964

The Roles of Site-Based Mentors in Educational Leadership Programs

ERIC Educational Resources Information Center

Bowser, Audrey; Hux, Annette; McBride, Jackie; Nichols, Cindy; Nichols, Joe

2014-01-01

This study focused on whether the roles of site based mentors in an educational leadership program were successfully completed. Three hundred eleven internship candidates' portfolios were reviewed to determine whether mentors essentially performed the tasks of collaboration, supervision, and evaluation of their protegees portfolios. A bibliography…

Development of a safety communication and recognition program for construction.

PubMed

Sparer, Emily H; Herrick, Robert F; Dennerlein, Jack T

2015-05-01

Leading-indicator-based (e.g., hazard recognition) incentive programs provide an alternative to controversial lagging-indicator-based (e.g., injury rates) programs. We designed a leading-indicator-based safety communication and recognition program that incentivized safe working conditions. The program was piloted for two months on a commercial construction worksite and then redesigned using qualitative interview and focus group data from management and workers. We then ran the redesigned program for six months on the same worksite. Foremen received detailed weekly feedback from safety inspections, and posters displayed worksite and subcontractor safety scores. In the final program design, the whole site, not individual subcontractors, was the unit of analysis and recognition. This received high levels of acceptance from workers, who noted increased levels of site unity and team-building. This pilot program showed that construction workers value solidarity with others on site, demonstrating the importance of health and safety programs that engage all workers through a reliable and consistent communication infrastructure. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

PubMed

Wahl, Stacy E; Thompson, Anita M

2013-10-01

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

Predicting red wolf release success in the southeastern United States

USGS Publications Warehouse

van Manen, Frank T.; Crawford, Barron A.; Clark, Joseph D.

2000-01-01

Although the red wolf (Canis rufus) was once found throughout the southeastern United States, indiscriminate killing and habitat destruction reduced its range to a small section of coastal Texas and Louisiana. Wolves trapped from 1973 to 1980 were taken to establish a captive breeding program that was used to repatriate 2 mainland and 3 island red wolf populations. We collected data from 320 red wolf releases in these areas and classified each as a success or failure based on survival and reproductive criteria, and whether recaptures were necessary to resolve conflicts with humans. We evaluated the relations between release success and conditions at the release sites, characteristics of released wolves, and release procedures. Although <44% of the variation in release success was explained, model performance based on jackknife tests indicated a 72-80% correct prediction rate for the 4 operational models we developed. The models indicated that success was associated with human influences on the landscape and the level of wolf habituation to humans prior to release. We applied the models to 31 prospective areas for wolf repatriation and calculated an index of release success for each area. Decision-makers can use these models to objectively rank prospective release areas and compare strengths and weaknesses of each.

Neonatal palliative care: developing consensus among neonatologists using the Delphi technique in Portugal.

PubMed

Mendes, Joana C C; Justo da Silva, Lincoln

2013-12-01

Pediatric palliative care in Portugal is improving, but there is still additional work to do concerning programs or guidelines for this subject. In Portugal, physicians are the stakeholders in the decision-making process with reference to the transition to palliative care in the neonatal intensive care unit, and it was considered very important to raise their awareness and motivation about neonatal palliative care. Our research was based on Catlin and Carter's protocol from 2002 and the main goal was to assess neonatologists' willingness to build a palliative care and end-of-life protocol that could be acceptable nationwide. The survey used the Delphi technique and was developed in 3 rounds. The expert panel was composed of 57 participants who represented 41% of the Portuguese neonatologists. The study was conducted via the Internet, based in a researcher-created private Web site, and e-mail was used for data collection and feedback. Neonatologists agreed on 7 areas: (1) planning (medical education, resources, and local), (2) prenatal palliative care, (3) neonatal palliative care criteria, (4) the parents (presenting neonatal palliative care to parents, including then in the daily care of newborns and in family-centered care), (5) physicians' needs, (6) pain and symptom management, and (7) end-of-life care (withholding/withdrawing ventilation and hydration/nutrition).

Using a Theory-guided Learning Collaborative Model to Improve Implementation of EBPs in a State Children’s Mental Health System: A Pilot Study

PubMed Central

Nadeem, Erum; Weiss, Dara; Olin, S. Serene; Hoagwood, Kimberly E.; Horwitz, Sarah M.

2016-01-01

Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices (EBPs). However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements. PMID:27167744

Using a Theory-Guided Learning Collaborative Model to Improve Implementation of EBPs in a State Children's Mental Health System: A Pilot Study.

PubMed

Nadeem, Erum; Weiss, Dara; Olin, S Serene; Hoagwood, Kimberly E; Horwitz, Sarah M

2016-11-01

Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices. However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements.

Cognitive systems at the point of care: The CREDO program.

PubMed

Fox, John

2017-04-01

CREDO is a framework for understanding human expertise and for designing and deploying systems that support cognitive tasks like situation and risk assessment, decision-making, therapy planning and workflow management. The framework has evolved through an extensive program of research on human decision-making and clinical practice. It draws on concepts from cognitive science, and has contributed new results to cognitive theory and understanding of human expertise and knowledge-based AI. These results are exploited in a suite of technologies for designing, implementing and deploying clinical services, early versions of which were reported by Das et al. (1997) [9] and Fox and Das (2000) [26]. A practical outcome of the CREDO program is a technology stack, a key element of which is an agent specification language (PROforma: Sutton and Fox (2003) [55]) which has proved to be a versatile tool for designing point of care applications in many clinical specialties and settings. Since software became available for implementing and deploying PROforma applications many kinds of services have been successfully built and trialed, some of which are in large-scale routine use. This retrospective describes the foundations of the CREDO model, summarizes the main theoretical, technical and clinical contributions, and discusses benefits of the cognitive approach. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Cognitive level and health decision-making in children: A preliminary study.

PubMed

Okwumabua, J O; Okwumabua, T M; Hayes, A; Stovall, K

1994-06-01

The study examines children's stage of cognitive development in relation to their patterns of health decision-making, including their cognitive capabilities in integrating the sequential stages of the decision-making process. A sample of 81 male (N=33) and female (N=48) students were drawn from two urban public schools in West Tennessee. All participants in the study were of African-American descent. The Centers for Disease Control Decision-Making Instrument was used to assess students' decision-making as well as their understanding of the decision-making process. The children's cognitive level was determined by their performance on three Piagetian conservation tasks. Findings revealed that both the preoperational and concrete operational children performed significantly below the formal operational children in terms of total correct responses to the decision-making scenarios. Error type analyses indicated that the preoperational children made more errors involving "skipped step" than did either the concrete or formal operational children. There were no significant differences between children's level of cognitive development and any other error type. Implications for health promotion and disease prevention programs among prevention practitioners who work regularly with children are discussed.

Effort-Based Decision-Making in Schizophrenia.

PubMed

Culbreth, Adam J; Moran, Erin K; Barch, Deanna M

2018-08-01

Motivational impairment has long been associated with schizophrenia but the underlying mechanisms are not clearly understood. Recently, a small but growing literature has suggested that aberrant effort-based decision-making may be a potential contributory mechanism for motivational impairments in psychosis. Specifically, multiple reports have consistently demonstrated that individuals with schizophrenia are less willing than healthy controls to expend effort to obtain rewards. Further, this effort-based decision-making deficit has been shown to correlate with severity of negative symptoms and level of functioning, in many but not all studies. In the current review, we summarize this literature and discuss several factors that may underlie aberrant effort-based decision-making in schizophrenia.

Low Cognitive Impulsivity Is Associated with Better Gain and Loss Learning in a Probabilistic Decision-Making Task

PubMed Central

Cáceres, Pablo; San Martín, René

2017-01-01

Many advances have been made over the last decades in describing, on the one hand, the link between reward-based learning and decision-making, and on the other hand, the link between impulsivity and decision-making. However, the association between reward-based learning and impulsivity remains poorly understood. In this study, we evaluated the association between individual differences in loss-minimizing and gain-maximizing behavior in a learning-based probabilistic decision-making task and individual differences in cognitive impulsivity. We found that low cognitive impulsivity was associated both with a better performance minimizing losses and maximizing gains during the task. These associations remained significant after controlling for mathematical skills and gender as potential confounders. We discuss potential mechanisms through which cognitive impulsivity might interact with reward-based learning and decision-making. PMID:28261137

Low Cognitive Impulsivity Is Associated with Better Gain and Loss Learning in a Probabilistic Decision-Making Task.

PubMed

Cáceres, Pablo; San Martín, René

2017-01-01

Many advances have been made over the last decades in describing, on the one hand, the link between reward-based learning and decision-making, and on the other hand, the link between impulsivity and decision-making. However, the association between reward-based learning and impulsivity remains poorly understood. In this study, we evaluated the association between individual differences in loss-minimizing and gain-maximizing behavior in a learning-based probabilistic decision-making task and individual differences in cognitive impulsivity. We found that low cognitive impulsivity was associated both with a better performance minimizing losses and maximizing gains during the task. These associations remained significant after controlling for mathematical skills and gender as potential confounders. We discuss potential mechanisms through which cognitive impulsivity might interact with reward-based learning and decision-making.

Sun Safety at Work Canada: a multiple case-study protocol to develop sun safety and heat protection programs and policies for outdoor workers.

PubMed

Kramer, Desre M; Tenkate, Thomas; Strahlendorf, Peter; Kushner, Rivka; Gardner, Audrey; Holness, D Linn

2015-07-10

CAREX Canada has identified solar ultraviolet radiation (UV) as the second most prominent carcinogenic exposure in Canada, and over 75 % of Canadian outdoor workers fall within the highest exposure category. Heat stress also presents an important public health issue, particularly for outdoor workers. The most serious form of heat stress is heat stroke, which can cause irreversible damage to the heart, lungs, kidneys, and liver. Although the need for sun and heat protection has been identified, there is no Canada-wide heat and sun safety program for outdoor workers. Further, no prevention programs have addressed both skin cancer prevention and heat stress in an integrated approach. The aim of this partnered study is to evaluate whether a multi-implementation, multi-evaluation approach can help develop sustainable workplace-specific programs, policies, and procedures to increase the use of UV safety and heat protection. This 2-year study is a theory-driven, multi-site, non-randomized study design with a cross-case analysis of 13 workplaces across four provinces in Canada. The first phase of the study includes the development of workplace-specific programs with the support of the intensive engagement of knowledge brokers. There will be a three-points-in-time evaluation with process and impact components involving the occupational health and safety (OHS) director, management, and workers with the goal of measuring changes in workplace policies, procedures, and practices. It will use mixed methods involving semi-structured key informant interviews, focus groups, surveys, site observations, and UV dosimetry assessment. Using the findings from phase I, in phase 2, a web-based, interactive, intervention planning tool for workplaces will be developed, as will the intensive engagement of intermediaries such as industry decision-makers to link to policymakers about the importance of heat and sun safety for outdoor workers. Solar UV and heat are both health and safety hazards. Using an occupational health and safety risk assessment and control framework, Sun Safety at Work Canada will support workplaces to assess their exposure risks, implement control strategies that build on their existing programs, and embed the controls into their existing occupational health and safety system.

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

PubMed Central

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

2018-01-01

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

Availability of pediatric rheumatology training in United States pediatric residencies.

PubMed

Mayer, Michelle L; Brogan, Laura; Sandborg, Christy I

2006-12-15

To characterize the availability of pediatric rheumatology training in general pediatric residencies. We surveyed 195 pediatric residency program directors in the US using a combined Web-based and paper-based survey format. The survey asked directors about the availability of an on-site pediatric rheumatologist in their institution, the availability of formal pediatric rheumatology rotations, and the types of physicians involved in teaching curriculum components related to pediatric rheumatology. Survey responses were analyzed using descriptive and bivariate statistics. Of the 195 program directors surveyed, 127 (65%) responded. More than 40% of responding programs did not have a pediatric rheumatologist on site. Programs with on-site pediatric rheumatologists were significantly more likely than those without on-site pediatric rheumatologists to have an on-site pediatric rheumatology rotation available (94% versus 9%; P < 0.001). Although pediatric rheumatologists' involvement in 4 curriculum areas relevant to pediatric rheumatology is nearly universal in programs with on-site pediatric rheumatologists, nearly two-thirds of programs without on-site pediatric rheumatologists rely on internist rheumatologists, general pediatricians, or other physicians to cover these areas. Programs without pediatric rheumatologists on site are less likely to have pediatric rheumatology rotations and are more likely to rely on internist rheumatologists and nonrheumatologists to address rheumatology-related curriculum components. Lack of exposure to pediatric rheumatology during residency may impede general pediatricians' ability to identify and treat children with rheumatic diseases, undermine resident interest in this field, and perpetuate low levels of supply.

Multi-criteria analysis for municipal solid waste management in a Brazilian metropolitan area.

PubMed

Santos, Simone Machado; Silva, Maisa Mendonça; Melo, Renata Maciel; Gavazza, Savia; Florencio, Lourdinha; Kato, Mario T

2017-10-15

The decision-making process involved in municipal solid waste management (MSWM) must consider more than just financial aspects, which makes it a difficult task in developing countries. The Recife Metropolitan Region (RMR) in the Northeast of Brazil faces a MSWM problem that has been ongoing since the 1970s, with no common solution. In order to direct short-term solutions, three MSWM alternatives were outlined for the RMR, considering the current and future situations, the time and cost involved and social/environmental criteria. A multi-criteria approach, based on the Preference Ranking Organization Method for Enrichment Evaluations (PROMETHEE), was proposed to rank these alternatives. The alternative that included two private landfill sites and seven transfer, sorting and composting stations was confirmed as the most suitable and stable option for short-term MSWM, considering the two scenarios for the criteria weights. Sensitivity analysis was also performed to support the robustness of the results. The implementation of separate collections would minimize the amount of waste buried, while maximizing the useful life of landfill sites and increasing the timeframe of the alternative. Overall, the multi-criteria analysis was helpful and accurate during the alternative selection process, considering the similarities and restrictions of each option, which can lead to difficulties during the decision-making process.

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

PubMed

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

2016-12-01

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

Savings sharing: rewarding staff for responsible decision-making.

PubMed

Jones, Debi

2005-04-01

Shortages of professional nurses create a "buyer's market" in which nurses accept temporary assignments for the highest rates and offer little additional time to the primary employer. Use of temporary personnel use salary dollars at an inordinate rate while offering little continuity or support for the organization's standards. Methods for placing decision-making in the hands of the nurses are needed along with a reward system for establishing a pattern of sound decision-making. The author describes a savings sharing program that is gaining credibility in one organization for addressing both objectives.

Change in excitability of a putative decision-making neuron in Aplysia serves as a mechanism in the decision not to feed following food satiation.

PubMed

Dickinson, Kathy J; Wainwright, Marcy L; Mozzachiodi, Riccardo

2015-03-15

Although decision making is a ubiquitous function, the understanding of its underlying mechanisms remains limited, particularly at the single-cell level. In this study, we used the decision not to feed that follows satiation in the marine mollusk Aplysia to examine the role of putative decision-making neuron B51 in this process. B51 is a neuron in the feeding neural circuit that exhibits decision-making characteristics in vitro, which bias the circuit toward producing the motor programs responsible for biting behavior. Once satiated, Aplysia decided not to bite for a prolonged period of time (≥24h) when presented with a food stimulus that normally elicits feeding in non-satiated animals. Twenty-four hours after satiation, suppressed feeding was accompanied by a significant decrease of B51 excitability compared to the control group of unfed animals. No differences were measured in B51 resting membrane properties or synaptic input to B51 between the satiated and control groups. When B51 properties were measured at a time point in which feeding had recovered from the suppressive effects of satiation (i.e., 96 h after satiation), no difference in B51 excitability was observed between satiated and control groups. These findings indicate that B51 excitability changes in a manner that is coherent with the modifications in biting resulting from food satiation, thus implicating this neuron as a site of plasticity underlying the decision not to bite following food satiation in Aplysia. Copyright © 2014 Elsevier B.V. All rights reserved.

Lecture-based versus problem-based learning in ethics education among nursing students.

PubMed

Khatiban, Mahnaz; Falahan, Seyede Nayereh; Amini, Roya; Farahanchi, Afshin; Soltanian, Alireza

2018-01-01

Moral reasoning is a vital skill in the nursing profession. Teaching moral reasoning to students is necessary toward promoting nursing ethics. The aim of this study was to compare the effectiveness of problem-based learning and lecture-based methods in ethics education in improving (1) moral decision-making, (2) moral reasoning, (3) moral development, and (4) practical reasoning among nursing students. This is a repeated measurement quasi-experimental study. Participants and research context: The participants were nursing students in a University of Medical Sciences in west of Iran who were randomly assigned to the lecture-based (n = 33) or the problem-based learning (n = 33) groups. The subjects were provided nursing ethics education in four 2-h sessions. The educational content was similar, but the training methods were different. The subjects completed the Nursing Dilemma Test before, immediately after, and 1 month after the training. The data were analyzed and compared using the SPSS-16 software. Ethical considerations: The program was explained to the students, all of whom signed an informed consent form at the baseline. The two groups were similar in personal characteristics (p > 0.05). A significant improvement was observed in the mean scores on moral development in the problem-based learning compared with the lecture-based group (p < 0.05). Although the mean scores on moral reasoning improved in both the problem-based learning and the lecture-based groups immediately after the training and 1 month later, the change was significant only in the problem-based learning group (p < 0.05). The mean scores on moral decision-making, practical considerations, and familiarity with dilemmas were relatively similar for the two groups. The use of the problem-based learning method in ethics education enhances moral development among nursing students. However, further studies are needed to determine whether such method improves moral decision-making, moral reasoning, practical considerations, and familiarity with the ethical issues among nursing students.

Establishing a baseline to measure change in political will and the use of data for decision-making in maternal and newborn health in six African countries.

PubMed

Nove, Andrea; Hulton, Louise; Martin-Hilber, Adriane; Matthews, Zoe

2014-10-01

The Evidence for Action (E4A) program assumes that both resource allocation and quality of care can improve via a strategy that combines evidence and advocacy to stimulate accountability. The present paper explains the methods used to collect baseline monitoring data using two tools developed to inform program design in six focus countries. The first tool is designed to understand the extent to which decision-makers have access to the data they need, when they need it, and in meaningful formats, and then to use the data to prioritize, plan, and allocate resources. The second tool seeks the views of people working in the area of maternal and newborn health (MNH) about political will, including: quality of care, the political and financial priority accorded to MNH, and the extent to which MNH decision-makers are accountable to service users. Findings indicate significant potential to improve access to and use of data for decision-making, particularly at subnational levels. Respondents across all six program countries reported lack of access by ordinary citizens to information on the health and MNH budget, and data on MNH outcomes. In all six countries there was a perceived inequity in the distribution of resources and a perception that politicians do not fully understand the priorities of their constituents. Copyright © 2014. Published by Elsevier Ireland Ltd.

Sorting Through the Spheres of Influence: Using Modified Pile Sorting to Describe Who Influences Dairy Farmers' Decision-Making About Safety.

PubMed

Bendixsen, Casper; Barnes, Kathrine; Kieke, Burney; Schenk, Danielle; Simich, Jessica; Keifer, Matthew

2017-01-01

The primary goal of this study was to describe the mutually perceived influence of bankers and insurers on their agricultural clients' decision-making regarding health and safety. Semistructured interviews were conducted with 10 dairy farmers, 11 agricultural bankers, and 10 agricultural insurers from central Wisconsin. Three of the interview questions involved pile sorting. Pile sorting included 5-point Likert-like scales to help participants sort through 32 index cards. Each card represented an individual or group that was thought to possibly affect farmers' decision-making, both generally and about health and safety. Results (photographs of piles of cards quantified into spread sheets, fieldnotes, and interview transcripts) were analyzed with SAS and NVivo. All three groups expressed moderate-to-strong positive opinions about involving agricultural bankers (x2(2) = 2.8155, p = 0.2695), although bankers qualitatively expressed apprehension due to regulations on the industry. Insurance agents received more positive support, particularly from bankers but also from dairy farmers themselves, and expressed more confidence in being involved in designing and implementing a farm safety program. Agricultural bankers and insurers can influence individual farmer's decision-making about health and safety. Both are believed to be good purveyors of safety programs and knowledge, especially when leveraging financial incentives. Insurance agents are thought to be more critical in the design of safety programs. Insurers and bankers being financially tied to safety programs may prove both positive and negative, as farmers may be skeptical about the intention of the incentives, making messaging critical.

Applying the National Surgical Quality Improvement Program risk calculator to patients undergoing colorectal surgery: theory vs reality.

PubMed

Adegboyega, Titilayo O; Borgert, Andrew J; Lambert, Pamela J; Jarman, Benjamin T

2017-01-01

Discussing potential morbidity and mortality is essential to informed decision-making and consent. The American College of Surgery National Surgical Quality Improvement Program developed an online risk calculator (RC) using patient-specific information to determine operative risk. Colorectal procedures at our independent academic medical center from 2010 to 2011 were evaluated. The RC's predicted outcomes were compared with observed outcomes. Statistical analysis included Brier score, Wilcoxon sign rank test, and standardized event ratio. There were 324 patients included. The RC's Brier score was .24 (.015-.219) for predicting mortality and morbidity, respectively. The observed event rate for surgical site infection and any complication was higher than the RC predicted (standardized event ratio 1.9 CI [1.49 to 2.39] and 1.39 CI [1.14 to 1.68], respectively). The observed length of stay was longer than predicted (5.6 vs 6.6 days, P < .001). The RC underestimated the surgical site infection and overall complication rates. The RC is a valuable tool in predicting risk for adverse outcomes; however, institution-specific trends may influence actual risk. Surgeons and institutions must recognize areas where they are outliers from estimated risks and tailor risk discussions accordingly. Copyright © 2016 Elsevier Inc. All rights reserved.

Temporary site selection and decision-making methods: a case study of Tehran, Iran.

PubMed

Omidvar, Babak; Baradaran-Shoraka, Mohammad; Nojavan, Mehdi

2013-07-01

Decisions on selecting an appropriate site for temporary shelter used to be taken in a limited amount of time after a disaster. The need for a systematic method in this area inspired the MADM (multi-attribute decision making) for complex disaster management decisions. This research proposes a model for appropriate and systematic site selection for temporary shelters, before an earthquake, using a geographical information system and MADM based on an earthquake damage assessment. After the effective criteria for site selection of temporary shelters are determined, the geographical layers of these criteria are prepared for Municipal District No.1 of Greater Tehran, the capital of Iran. Given these attributes and the required shelter area (415-610 hectares), 14 zones are proposed initially. Various MADM methods are used for the final selection. The mean of the aggregated ranking results are determined, and 10 of the 14 initial zones are ranked. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Application of Artificial Intelligence (AI) programming techniques to tactical guidance for fighter aircraft

NASA Technical Reports Server (NTRS)

Mcmanus, John W.; Goodrich, Kenneth H.

1989-01-01

A research program investigating the use of Artificial Intelligence (AI) programming techniques to aid in the development of a Tactical Decision Generator (TDG) for Within-Visual-Range (WVR) air combat engagements is discussed. The application of AI methods for development and implementation of the TDG is presented. The history of the Adaptive Maneuvering Logic (AML) program is traced and current versions of the (AML) program is traced and current versions of the AML program are compared and contrasted with the TDG system. The Knowledge-Based Systems (KBS) used by the TDG to aid in the decision-making process are outlined and example rules are presented. The results of tests to evaluate the performance of the TDG against a version of AML and against human pilots in the Langley Differential Maneuvering Simulator (DMS) are presented. To date, these results have shown significant performance gains in one-versus-one air combat engagements.

ICBMs and the environment: Assessments at a base in Kazakhstan

USGS Publications Warehouse

Matzko, J.R.; Butler, B.

1999-01-01

A paper by two U.S. scientists explores the environmental/health hazard posed by abandoned missile launch sites and control facilities (dismantled by 1998 as part of the Nunn-Lugar Cooperative Threat Reduction Program) at an ICBM base in north-central Kazakhstan. It summarizes the findings of Environmental Site Assessment Reports based on a program of water and soil sampling at the sites, with a particular focus on testing for the presence of polychlorinated biphenyls, various toxic metals, and radiation. The study is important in that it documents levels of contamination (and describes abatement measures) at a former Soviet missile base.

Community Development: A 4-H Intern Report.

ERIC Educational Resources Information Center

Scheneman, C. Stephen

State progress reports on the 4-H/Community Development program, a 1973 nationwide Federally sponsored program facilitating youth in community decision-making processes, indicate that the program appears to be evolving into a viable and integral part of the total 4-H program. Although the report describes unique program features of various States,…

Principal Candidates Create Decision-Making Simulations to Prepare for the JOB

ERIC Educational Resources Information Center

Staub, Nancy A.; Bravender, Marlena

2014-01-01

Online simulations offer opportunities for trial and error decision-making. What better tool for a principal than to make decisions when the consequences will not have real-world ramifications. In this study, two groups of graduate students in a principal preparation program taking the same course in the same semester use online simulations…

Decision-Making Rationales among Quebec VET Student Aged 25 and Older

ERIC Educational Resources Information Center

Cournoyer, Louis; Deschenaux, Frédéric

2017-01-01

Each year, a large number of students aged 25 years and over take part in vocational and education training (VET) programs in the Province of Quebec, Canada. The life experiences of many of these adults are marked by complex psychosocial and professional events, which may have influenced their career decision-making processes. This paper aimed to…

An Examination of Accelerated and Basic Baccalaureate Nursing Students' Perceptions of Clinical Decision Making

ERIC Educational Resources Information Center

Krumwiede, Kelly A.

2010-01-01

Developing decision-making skills is essential in education in order to be a competent nurse. The purpose of this study was to examine and compare the perceptions of clinical decision-making skills of students enrolled in accelerated and basic baccalaureate nursing programs. A comparative descriptive research design was used for this study.…

Achieving the Dream, Uncertain Futures: The Postbaccalaureate Decision-Making Process of Latinx Undocumented Students

ERIC Educational Resources Information Center

Lara, Argelia; Nava, Pedro E.

2018-01-01

This qualitative study examined the decision-making process of undocumented college students pursuing graduate degrees, and how their commitment to matriculate in higher education programs is shaped by a myriad of social, familial, financial, and institutional factors. This study drew on 2 years of ethnographic data from a sample of 20…

Beyond the Bureaucratic Model: A Study of Power and Autonomy in Educational Decision-Making

ERIC Educational Resources Information Center

Hanson, Mark

1976-01-01

This paper argues that there are at least two decision-making systems in the school: (1) the first reflects mainly school-wide affairs and lends itself to rational, centrally controlled procedures that restrict behaviors to conform with well-programmed events; and (2) the second reflects mainly classroom affairs and requires flexibility and…

An Assessment of Decision-Making Processes: The Feasibility of Incorporating Climate Change Information into Land Protection Planning (External Review Draft)

EPA Science Inventory

This report was prepared by the Global Change Research Program (GCRP) in the National Center for Environmental Assessment (NCEA) of the Office of Research and Development (ORD) at the U.S. Environmental Protection Agency (EPA). This draft report is a review of decision-making pro...

The Decision-Making Process Used by Central Office Administrators as They Implement Full Day Kindergarten

ERIC Educational Resources Information Center

Palte, Suzanne C.

2014-01-01

The State of Michigan, as of 2012-2013, requires school districts to enroll students in full day kindergarten to receive full funding. This study investigated the decision-making process that was used by public school districts to determine kindergarten programs in their district. Specifically, how did administrators and staff members use the…

An Examination of Factors Influencing Students Selection of Business Majors Using TRA Framework

ERIC Educational Resources Information Center

Kumar, Anil; Kumar, Poonam

2013-01-01

Making decisions regarding the selection of a business major is both very important and challenging for students. An understanding of this decision-making process can be valuable for students, parents, and university programs. The current study applies the Theory of Reasoned Action (TRA) consumer decision-making model to examine factors that…

COMMUNITY CAPACITY BUILDING FOR REVITALIZATION AND SUSTAINABLE REDEVELOPMENT

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

Downing, Melinda; Rosenthall, John; Hudson, Michelle

2003-02-27

Capacity building programs help poor and disadvantaged communities to improve their ability to participate in the environmental decision-making processes. They encourage citizen involvement, and provide the tools that enable them to do so. Capacity building enables communities that would otherwise be excluded to participate in the process, leading to better, and more just decisions. The Department of Energy (DOE) continues to be committed to promoting environmental justice and involving its stakeholders more directly in the planning and decision-making process for environmental cleanup. DOE's Environmental Management Program (EM) is in full support of this commitment. Through its environmental justice project, EMmore » provides communities with the capacity to effectively contribute to a complex technical decision-making process by furnishing access to computers, the Internet, training and technical assistance. DOE's Dr. Samuel P. Massie Chairs of Excellence Program (Massie Chairs) function as technical advisors to many of these community projects. The Massie Chairs consist of nationally and internationally recognized engineers and scientists from nine Historically Black Colleges and Universities (HBCUs) and one Hispanic Serving Institution (HIS). This paper will discuss capacity building initiatives in various jurisdictions.« less

Accessibility and content of individualized adult reconstructive hip and knee/musculoskeletal oncology fellowship web sites.

PubMed

Young, Bradley L; Cantrell, Colin K; Patt, Joshua C; Ponce, Brent A

2018-06-01

Accessible, adequate online information is important to fellowship applicants. Program web sites can affect which programs applicants apply to, subsequently altering interview costs incurred by both parties and ultimately impacting rank lists. Web site analyses have been performed for all orthopaedic subspecialties other than those involved in the combined adult reconstruction and musculoskeletal (MSK) oncology fellowship match. A complete list of active programs was obtained from the official adult reconstruction and MSK oncology society web sites. Web site accessibility was assessed using a structured Google search. Accessible web sites were evaluated based on 21 previously reported content criteria. Seventy-four adult reconstruction programs and 11 MSK oncology programs were listed on the official society web sites. Web sites were identified and accessible for 58 (78%) adult reconstruction and 9 (82%) MSK oncology fellowship programs. No web site contained all content criteria and more than half of both adult reconstruction and MSK oncology web sites failed to include 12 of the 21 criteria. Several programs participating in the combined Adult Reconstructive Hip and Knee/Musculoskeletal Oncology Fellowship Match did not have accessible web sites. Of the web sites that were accessible, none contained comprehensive information and the majority lacked information that has been previously identified as being important to perspective applicants.

[The role of research-based evidence in health system policy decision-making].

PubMed

Patiño, Daniel; Lavis, John N; Moat, Kaelan

2013-01-01

Different models may be used for explaining how research-based evidence is used in healthcare system policy-making. It is argued that models arising from a clinical setting (i.e. evidence-based policy-making model) could be useful regarding some types of healthcare system decision-making. However, such models are "silent" concerning the influence of political contextual factors on healthcare policy-making and are thus inconsistent with decision-making regarding the modification of healthcare system arrangements. Other political science-based models would seem to be more useful for understanding that research is just one factor affecting decision-making and that different types of research-based evidence can be used instrumentally, conceptual or strategically during different policy-making stages.

Priority of a Hesitant Fuzzy Linguistic Preference Relation with a Normal Distribution in Meteorological Disaster Risk Assessment.

PubMed

Wang, Lihong; Gong, Zaiwu

2017-10-10

As meteorological disaster systems are large complex systems, disaster reduction programs must be based on risk analysis. Consequently, judgment by an expert based on his or her experience (also known as qualitative evaluation) is an important link in meteorological disaster risk assessment. In some complex and non-procedural meteorological disaster risk assessments, a hesitant fuzzy linguistic preference relation (HFLPR) is often used to deal with a situation in which experts may be hesitant while providing preference information of a pairwise comparison of alternatives, that is, the degree of preference of one alternative over another. This study explores hesitation from the perspective of statistical distributions, and obtains an optimal ranking of an HFLPR based on chance-restricted programming, which provides a new approach for hesitant fuzzy optimisation of decision-making in meteorological disaster risk assessments.

Prescription Drug Monitoring Programs: Ethical Issues in the Emergency Department.

PubMed

Marco, Catherine A; Venkat, Arvind; Baker, Eileen F; Jesus, John E; Geiderman, Joel M

2016-11-01

Prescription drug monitoring programs are statewide databases available to clinicians to track prescriptions of controlled medications. These programs may provide valuable information to assess the history and use of controlled substances and contribute to clinical decisionmaking in the emergency department (ED). The widespread availability of the programs raises important ethical issues about beneficence, nonmaleficence, respect for persons, justice, confidentiality, veracity, and physician autonomy. In this article, we review the ethical issues surrounding prescription drug monitoring programs and how those issues might be addressed to ensure the proper application of this tool in the ED. Clinical decisionmaking in regard to the appropriate use of opioids and other controlled substances is complex and should take into account all relevant clinical factors, including age, sex, clinical condition, medical history, medication history and potential drug-drug interactions, history of addiction or diversion, and disease state. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... registration information will be posted on the CMS Care Transitions Web site at http://www.cms.gov/DemoProjects...

Supporting decision-making processes for evidence-based mental health promotion.

PubMed

Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian

2011-12-01

The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.

Career Decision-Making Processes of Young Adults With First-Episode Psychosis.

PubMed

Boychuk, Christa; Lysaght, Rosemary; Stuart, Heather

2018-05-01

The first episode of psychosis often emerges during young adulthood, when individuals are pursuing important educational and career goals that can become derailed because of the development of major impairments. Past research has neglected the developmental nature of employment and education decisions that young adults with first-episode psychosis make within the context of their lives. The purpose of this grounded theory study was to advance a model of the career decision-making processes of young adults with first-episode psychosis, and the influences that affect their career decision-making. The career decision-making of young adults with first-episode psychosis emerged as a multistaged, iterative process that unfolded over three phases of illness, and was affected by several internal and environmental influences. These findings suggest the phase of illness and career decision-making stage should be considered in future vocational programming for young adults with first-episode psychosis.

Identifying Decision-Makers’ Science Needs for Adaptation to Climate-Related Impacts on Forest Ecosystem Services

NASA Astrophysics Data System (ADS)

Gordon, E.; Lukas, J.

2009-12-01

Through the Western Water Assessment RISA program, we are conducting a research project that will produce science synthesis information to help local, state, and federal decision-makers in Colorado and Wyoming develop adaptation strategies to deal with climate-related threats to forest ecosystem services, in particular bark beetle infestations and stand-replacing wildfires. We begin by using the problem orientation framework, a policy sciences methodology, to understand how decision-makers can most effectively address policy problems that threaten the attainment of socially accepted goals. By applying this framework to the challenges facing decision-makers, we more accurately identify specific areas where scientific research can improve decision-making. WWA researchers will next begin to connect decision-makers with relevant scientific literature and identify specific areas of future scientific research that will be most effective at addressing their needs.

Facilitating the inclusion of nonmarket values in Bureau of Land Management planning and project assessments—Final report

USGS Publications Warehouse

Huber, Chris; Richardson, Leslie

2016-11-23

Executive SummaryThis report summarizes the results of a series of field-based case studies conducted by the U.S. Geological Survey (USGS) to (1) evaluate the use of nonmarket values in Bureau of Land Management (BLM) planning and project assessments, (2) update existing technical resources for measuring those values, and (3) provide guidance to field staff on the use of nonmarket values. Four BLM pilot sites participated in this effort: Canyons of the Ancients National Monument in Colorado, Red Cliffs and Beaver Dam Wash National Conservation Areas in Utah, BLM’s Taos Field Office in New Mexico, and BLM's Tuscarora Field Office in Nevada. The focus of the case studies was on practical applications of nonmarket valuation. USGS worked directly with BLM field staff at the pilot sites to demonstrate the process of considering nonmarket values in BLM decisionmaking and document the questions, challenges, and opportunities that arise when tying economic language to projects.As part of this effort, a Web-based toolkit, available at https://my.usgs.gov/benefit-transfer/, was updated and expanded to help facilitate benefit transfers (that is, the use of existing economic data to quantify nonmarket values) and qualitative discussions of nonmarket values. A total of 53 new or overlooked nonmarket valuation studies comprising 494 nonmarket value estimates for various recreational activities and the preservation of threatened, endangered, and rare species were added to existing databases within this Benefit Transfer Toolkit. In addition, four meta-regression functions focused on hunting, wildlife viewing, fishing, and trail use recreation were developed and added to the Benefit Transfer Toolkit.Results of this effort demonstrate that there are two main roles for nonmarket valuation in BLM planning. The first is to improve the decisionmaking process by contributing to a more comprehensive comparison of economic benefits and cost when evaluating resource tradeoffs for National Environmental Policy Act analyses. The second is to use economic language and information on economic values, either qualitative or quantitative, to improve the ability to communicate the economic significance of the resources provided by BLM-managed lands. Findings also indicate that the use of existing economic data to quantify nonmarket values (that is, benefit transfer) poses unique challenges because of the scarcity of both resource data and existing valuation studies focused on resources and sites managed by BLM. This highlights the need for improvements in the collection of resource data at BLM sites, especially visitor use data, as well as an opportunity for BLM’s Socioeconomics Program to strategically identify priority areas, in terms of both resources and geographic locations, where primary valuation studies could be conducted and the results used for future benefit transfers. Finally, whereas qualitative discussions of nonmarket values do not facilitate the comparison of monetized values, they can provide a manageable next step forward in providing more comprehensive information on nonmarket values for BLM plans and project assessments. 

Cost effectiveness of pediatric pneumococcal conjugate vaccines: a comparative assessment of decision-making tools.

PubMed

Chaiyakunapruk, Nathorn; Somkrua, Ratchadaporn; Hutubessy, Raymond; Henao, Ana Maria; Hombach, Joachim; Melegaro, Alessia; Edmunds, John W; Beutels, Philippe

2011-05-12

Several decision support tools have been developed to aid policymaking regarding the adoption of pneumococcal conjugate vaccine (PCV) into national pediatric immunization programs. The lack of critical appraisal of these tools makes it difficult for decision makers to understand and choose between them. With the aim to guide policymakers on their optimal use, we compared publicly available decision-making tools in relation to their methods, influential parameters and results. The World Health Organization (WHO) requested access to several publicly available cost-effectiveness (CE) tools for PCV from both public and private provenance. All tools were critically assessed according to the WHO's guide for economic evaluations of immunization programs. Key attributes and characteristics were compared and a series of sensitivity analyses was performed to determine the main drivers of the results. The results were compared based on a standardized set of input parameters and assumptions. Three cost-effectiveness modeling tools were provided, including two cohort-based (Pan-American Health Organization (PAHO) ProVac Initiative TriVac, and PneumoADIP) and one population-based model (GlaxoSmithKline's SUPREMES). They all compared the introduction of PCV into national pediatric immunization program with no PCV use. The models were different in terms of model attributes, structure, and data requirement, but captured a similar range of diseases. Herd effects were estimated using different approaches in each model. The main driving parameters were vaccine efficacy against pneumococcal pneumonia, vaccine price, vaccine coverage, serotype coverage and disease burden. With a standardized set of input parameters developed for cohort modeling, TriVac and PneumoADIP produced similar incremental costs and health outcomes, and incremental cost-effectiveness ratios. Vaccine cost (dose price and number of doses), vaccine efficacy and epidemiology of critical endpoint (for example, incidence of pneumonia, distribution of serotypes causing pneumonia) were influential parameters in the models we compared. Understanding the differences and similarities of such CE tools through regular comparisons could render decision-making processes in different countries more efficient, as well as providing guiding information for further clinical and epidemiological research. A tool comparison exercise using standardized data sets can help model developers to be more transparent about their model structure and assumptions and provide analysts and decision makers with a more in-depth view behind the disease dynamics. Adherence to the WHO guide of economic evaluations of immunization programs may also facilitate this process. Please see related article: http://www.biomedcentral.com/1741-7007/9/55.

76 FR 6653 - Public Housing Capital Fund Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

...; heating system replacements; wall insulation; site-based generation; advanced energy savings technologies...; wall insulation; site-based generation; advanced energy savings technologies, including renewable...

Skill Transfer and Virtual Training for IND Response Decision-Making: Models for Government-Industry Collaboration for the Development of Game-Based Training Tools

DTIC Science & Technology

2016-05-05

Training for IND Response Decision-Making: Models for Government–Industry Collaboration for the Development of Game -Based Training Tools R.M. Seater...Skill Transfer and Virtual Training for IND Response Decision-Making: Models for Government–Industry Collaboration for the Development of Game -Based...unlimited. This page intentionally left blank. iii EXECUTIVE SUMMARY Game -based training tools, sometimes called “serious games ,” are becoming

Artificial Intelligence (AI) Based Tactical Guidance for Fighter Aircraft

NASA Technical Reports Server (NTRS)

McManus, John W.; Goodrich, Kenneth H.

1990-01-01

A research program investigating the use of Artificial Intelligence (AI) techniques to aid in the development of a Tactical Decision Generator (TDG) for Within Visual Range (WVR) air combat engagements is discussed. The application of AI programming and problem solving methods in the development and implementation of the Computerized Logic For Air-to-Air Warfare Simulations (CLAWS), a second generation TDG, is presented. The Knowledge-Based Systems used by CLAWS to aid in the tactical decision-making process are outlined in detail, and the results of tests to evaluate the performance of CLAWS versus a baseline TDG developed in FORTRAN to run in real-time in the Langley Differential Maneuvering Simulator (DMS), are presented. To date, these test results have shown significant performance gains with respect to the TDG baseline in one-versus-one air combat engagements, and the AI-based TDG software has proven to be much easier to modify and maintain than the baseline FORTRAN TDG programs. Alternate computing environments and programming approaches, including the use of parallel algorithms and heterogeneous computer networks are discussed, and the design and performance of a prototype concurrent TDG system are presented.

Integrated Analysis Tools for the NERRS System-Wide Monitoring Program Data

EPA Science Inventory

Standardized monitoring programs have vastly improved the quantity and quality of data that form the basis of environmental decision-making. One example is the NOAA-funded National Estuarine Research Reserve System (NERRS) System-wide Monitoring Program (SWMP) that was implement...

Video-based training to improve perceptual-cognitive decision-making performance of Australian football umpires.

PubMed

Larkin, Paul; Mesagno, Christopher; Berry, Jason; Spittle, Michael; Harvey, Jack

2018-02-01

Decision-making is a central component of the in-game performance of Australian football umpires; however, current umpire training focuses largely on physiological development with decision-making skills development conducted via explicit lecture-style meetings with limited practice devoted to making actual decisions. Therefore, this study investigated the efficacy of a video-based training programme, aimed to provide a greater amount of contextualised visual experiences without explicit instruction, to improve decision-making skills of umpires. Australian football umpires (n = 52) were recruited from metropolitan and regional Division 1 competitions. Participants were randomly assigned to an intervention or control group and classified according to previous umpire game experience (i.e., experienced; less experienced). The intervention group completed a 12-week video-based decision-making training programme, with decision-making performance assessed at pre-training, and 1-week retention and 3-week retention periods. The control group did not complete any video-based training. Results indicated a significant Group (intervention; Control) × Test interaction (F(1, 100) = 3.98; P = 0.02, partial ῆ 2  = 0.074), with follow-up pairwise comparisons indicating significant within-group differences over time for the intervention group. In addition, decision-making performance of the less experienced umpires in the intervention group significantly improved (F(2, 40) = 5.03, P = 0.01, partial ῆ 2  = 0.201). Thus, video-based training programmes may be a viable adjunct to current training programmes to hasten decision-making development, especially for less experienced umpires.

First steps: study protocol for a randomized controlled trial of the effectiveness of the Group Family Nurse Partnership (gFNP) program compared to routine care in improving outcomes for high-risk mothers and their children and preventing abuse

PubMed Central

2013-01-01

Background Evidence from the USA suggests that the home-based Family Nurse Partnership program (FNP), extending from early pregnancy until infants are 24 months, can reduce the risk of child abuse and neglect throughout childhood. FNP is now widely available in the UK. A new variant, Group Family Nurse Partnership (gFNP) offers similar content but in a group context and for a shorter time, until infants are 12 months old. Each group comprises 8 to 12 women with similar expected delivery dates and their partners. Its implementation has been established but there is no evidence of its effectiveness. Methods/Design The study comprises a multi-site randomized controlled trial designed to identify the benefits of gFNP compared to standard care. Participants (not eligible for FNP) must be either aged < 20 years at their last menstrual period (LMP) with one or more previous live births, or aged 20 to 24 at LMP with low educational qualifications and no previous live births. ‘Low educational qualifications’ is defined as not having both Maths and English Language GCSE at grade C or higher or, if they have both, no more than four in total at grade C or higher. Exclusions are: under 20 years and previously received home-based FNP and, in either age group, severe psychotic mental illness or not able to communicate in English. Consenting women are randomly allocated (minimized by site and maternal age group) when between 10 and 16 weeks pregnant to either to the 44 session gFNP program or to standard care after the collection of baseline information. Researchers are blind to group assignment. The primary outcomes at 12 months are child abuse potential based on the revised Adult-Adolescent Parenting Inventory and parent/infant interaction coded using the CARE Index based on a video-taped interaction. Secondary outcomes are maternal depression, parenting stress, health related quality of life, social support, and use of services. Discussion This is the first study of the effectiveness of gFNP in the UK. Results should inform decision-making about its delivery alongside universal services, potentially enabling a wider range of families to benefit from the FNP curriculum and approach to supporting parenting. Trial registration ISRCTN78814904. PMID:24011061

Health professionals' decision-making in wound management: a grounded theory.

PubMed

Gillespie, Brigid M; Chaboyer, Wendy; St John, Winsome; Morley, Nicola; Nieuwenhoven, Paul

2015-06-01

To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice. With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area. A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice. Interviews were conducted with 20 multi-disciplinary participants from nursing, surgery, infection control and wound care who worked at a metropolitan hospital in Australia. Data were collected during 2012-2013. Constant comparative analysis underpinned by Strauss and Corbin's framework was used to identify clinical decision-making processes. The core category was 'balancing practice-based knowledge with evidence-based knowledge'. Participants' clinical practice and actions embedded the following processes: 'utilizing the best available information', 'using a consistent approach in wound assessment' and 'using a multidisciplinary approach'. The substantive theory explains how practice and evidence knowledge was balanced and the variation in use of intuitive practice-based knowledge versus evidence-based knowledge. Participants considered patients' needs and preferences, costs, outcomes, technologies, others' expertise and established practices. Participants' decision-making tended to be more heavily weighted towards intuitive practice-based processes. These findings offer a better understanding of the processes used by health professionals' in their decision-making in wound care. Such an understanding may inform the development of evidence-based interventions that lead to better patient outcomes. © 2014 John Wiley & Sons Ltd.

Development of a clinical prediction model to calculate patient life expectancy: the measure of actuarial life expectancy (MALE).

PubMed

Clarke, M G; Kennedy, K P; MacDonagh, R P

2009-01-01

To develop a clinical prediction model enabling the calculation of an individual patient's life expectancy (LE) and survival probability based on age, sex, and comorbidity for use in the joint decision-making process regarding medical treatment. A computer software program was developed with a team of 3 clinicians, 2 professional actuaries, and 2 professional computer programmers. This incorporated statistical spreadsheet and database access design methods. Data sources included life insurance industry actuarial rating factor tables (public and private domain), Government Actuary Department UK life tables, professional actuarial sources, and evidence-based medical literature. The main outcome measures were numerical and graphical display of comorbidity-adjusted LE; 5-, 10-, and 15-year survival probability; in addition to generic UK population LE. Nineteen medical conditions, which impacted significantly on LE in actuarial terms and were commonly encountered in clinical practice, were incorporated in the final model. Numerical and graphical representations of statistical predictions of LE and survival probability were successfully generated for patients with either no comorbidity or a combination of the 19 medical conditions included. Validation and testing, including actuarial peer review, confirmed consistency with the data sources utilized. The evidence-based actuarial data utilized in this computer program design represent a valuable resource for use in the clinical decision-making process, where an accurate objective assessment of patient LE can so often make the difference between patients being offered or denied medical and surgical treatment. Ongoing development to incorporate additional comorbidities and enable Web-based access will enhance its use further.

Conventional Reduced Risk Pesticide Program

EPA Pesticide Factsheets

Find out about the Conventional Reduced Risk Pesticide Program, which expedites the review and regulatory decision-making process of conventional pesticides that pose less risk to human health and the environment than existing conventional alternatives.

Research Practice Partnerships: A Strategy for Promoting Evidence-Based Decision-Making in Education

ERIC Educational Resources Information Center

Wentworth, Laura; Mazzeo, Christopher; Connolly, Faith

2017-01-01

Background: In the United States, an emphasis on evidence-based decision-making in education has received renewed interest with the recent passage of the Every Student Succeeds Act. However, how best, in practice, to support the use of evidence in educational decision-making remains unclear. Research Practice Partnerships (RPPs) are a popular…

Efficacy of a Pilot Internet-Based Weight Management Program (H.E.A.L.T.H.) and Longitudinal Physical Fitness Data in Army Reserve Soldiers

PubMed Central

Newton, Robert L; Han, Hongmei; Stewart, Tiffany M; Ryan, Donna H; Williamson, Donald A

2011-01-01

Background The primary aims of this article are to describe the utilization of an Internet-based weight management Web site [Healthy Eating, Activity, and Lifestyle Training Headquarters (H.E.A.L.T.H.)] over a 12–27 month period and to describe concurrent weight and fitness changes in Army Reserve soldiers. Methods The H.E.A.L.T.H. Web site was marketed to Army Reserve soldiers via a Web site promotion program for 27 months (phase I) and its continued usage was observed over a subsequent 12-month period (phase II). Web site usage was obtained from the H.E.A.L.T.H. Web site. Weight and fitness data were extracted from the Regional Level Application Software (RLAS). Results A total of 1499 Army Reserve soldiers registered on the H.E.A.L.T.H. Web site. There were 118 soldiers who returned to the H.E.A.L.T.H. Web site more than once. Registration rate reduced significantly following the removal of the Web site promotion program. During phase I, 778 Army Reserve soldiers had longitudinal weight and fitness data in RLAS. Men exceeding the screening table weight gained less weight compared with men below it (p < .007). Percentage change in body weight was inversely associated with change in fitness scores. Conclusions The Web site promotion program resulted in 52% of available Army Reserve soldiers registering onto the H.E.A.L.T.H. Web site, and 7.9% used the Web site more than once. The H.E.A.L.T.H. Web site may be a viable population-based weight and fitness management tool for soldier use. PMID:22027327

Actual and Ideal Decision-Making Processes Utilized in Senior High Schools That Individualize Instruction. Technical Report No. 460.

ERIC Educational Resources Information Center

Watkins, Arthur Noel

The purpose of this study was to identify and describe the decision-making processes in senior high schools that were implementing programs of individualized schooling. Field methodology, including interviews, observations, and analysis of documents, was used to gather data in six senior high schools of varying size located throughout the country,…

The Effects of Conflict, Quality and Time on Small Group Information Use and Behavior in Evaluative Decision-Making Situations.

ERIC Educational Resources Information Center

Pflum, Glenn D.; Brown, Robert D.

This study investigated information needs and use by groups in decision-making processes. Problem contexts were varied by conflict, quality, and time conditions and presented to 89 graduate level education students who simulated school board members making decisions about educational programs. The research hypotheses were: (1) there are no…

Fair Play: Developing Self-Concept and Decision-Making Skills in the Middle School. Implementation Handbook.

ERIC Educational Resources Information Center

Florida State Univ., Tallahassee.

This handbook is designed to assist schools in carrying out the following goals of the Fair Play program: to strengthen and expand students' female or male self-concepts, to increase their decision-making skills, and to increase their academic achievement by changing their stereotypic attitude toward particular content areas. The Fair Play program…

Site Optimization Tracker: Crossley Farm Superfund Site, Hereford and Washington Townships, Berks County, Pennsylvania

EPA Pesticide Factsheets

Pilot Region-Based Optimization Program for Fund-Lead Sites in EPA Region 3. Site Optimization Tracking information for Crossley Farm Superfund Site, Hereford and Washington Townships, Berks County, Pennsylvania.