Decision-making in irrigation networks: Selecting appropriate canal structures using multi-attribute decision analysis.

PubMed

Hosseinzade, Zeinab; Pagsuyoin, Sheree A; Ponnambalam, Kumaraswamy; Monem, Mohammad J

2017-12-01

The stiff competition for water between agriculture and non-agricultural production sectors makes it necessary to have effective management of irrigation networks in farms. However, the process of selecting flow control structures in irrigation networks is highly complex and involves different levels of decision makers. In this paper, we apply multi-attribute decision making (MADM) methodology to develop a decision analysis (DA) framework for evaluating, ranking and selecting check and intake structures for irrigation canals. The DA framework consists of identifying relevant attributes for canal structures, developing a robust scoring system for alternatives, identifying a procedure for data quality control, and identifying a MADM model for the decision analysis. An application is illustrated through an analysis for automation purposes of the Qazvin irrigation network, one of the oldest and most complex irrigation networks in Iran. A survey questionnaire designed based on the decision framework was distributed to experts, managers, and operators of the Qazvin network and to experts from the Ministry of Power in Iran. Five check structures and four intake structures were evaluated. A decision matrix was generated from the average scores collected from the survey, and was subsequently solved using TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) method. To identify the most critical structure attributes for the selection process, optimal attribute weights were calculated using Entropy method. For check structures, results show that the duckbill weir is the preferred structure while the pivot weir is the least preferred. Use of the duckbill weir can potentially address the problem with existing Amil gates where manual intervention is required to regulate water levels during periods of flow extremes. For intake structures, the Neyrpic® gate and constant head orifice are the most and least preferred alternatives, respectively. Some advantages of the Neyrpic® gate are ease of operation and capacity to measure discharge flows. Overall, the application to the Qazvin irrigation network demonstrates the utility of the proposed DA framework in selecting appropriate structures for regulating water flows in irrigation canals. This framework systematically aids the decision process by capturing decisions made at various levels (individual farmers to high-level management). It can be applied to other cases where a new irrigation network is being designed, or where changes in irrigation structures need to be identified to improve flow control in existing networks. Copyright © 2017 Elsevier B.V. All rights reserved.

Realization of high quality production schedules: Structuring quality factors via iteration of user specification processes

NASA Technical Reports Server (NTRS)

Hamazaki, Takashi

1992-01-01

This paper describes an architecture for realizing high quality production schedules. Although quality is one of the most important aspects of production scheduling, it is difficult, even for a user, to specify precisely. However, it is also true that the decision as to whether a scheduler is good or bad can only be made by the user. This paper proposes the following: (1) the quality of a schedule can be represented in the form of quality factors, i.e. constraints and objectives of the domain, and their structure; (2) quality factors and their structure can be used for decision making at local decision points during the scheduling process; and (3) that they can be defined via iteration of user specification processes.

Multicriteria decision analysis: Overview and implications for environmental decision making

USGS Publications Warehouse

Hermans, Caroline M.; Erickson, Jon D.; Erickson, Jon D.; Messner, Frank; Ring, Irene

2007-01-01

Environmental decision making involving multiple stakeholders can benefit from the use of a formal process to structure stakeholder interactions, leading to more successful outcomes than traditional discursive decision processes. There are many tools available to handle complex decision making. Here we illustrate the use of a multicriteria decision analysis (MCDA) outranking tool (PROMETHEE) to facilitate decision making at the watershed scale, involving multiple stakeholders, multiple criteria, and multiple objectives. We compare various MCDA methods and their theoretical underpinnings, examining methods that most realistically model complex decision problems in ways that are understandable and transparent to stakeholders.

The Decision Tree: A Tool for Achieving Behavioral Change.

ERIC Educational Resources Information Center

Saren, Dru

1999-01-01

Presents a "Decision Tree" process for structuring team decision making and problem solving about specific student behavioral goals. The Decision Tree involves a sequence of questions/decisions that can be answered in "yes/no" terms. Questions address reasonableness of the goal, time factors, importance of the goal, responsibilities, safety,…

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

PubMed

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

2016-12-01

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

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

USGS Publications Warehouse

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

2016-01-01

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

Combining cognitive engineering and information fusion architectures to build effective joint systems

NASA Astrophysics Data System (ADS)

Sliva, Amy L.; Gorman, Joe; Voshell, Martin; Tittle, James; Bowman, Christopher

2016-05-01

The Dual Node Decision Wheels (DNDW) architecture concept was previously described as a novel approach toward integrating analytic and decision-making processes in joint human/automation systems in highly complex sociotechnical settings. In this paper, we extend the DNDW construct with a description of components in this framework, combining structures of the Dual Node Network (DNN) for Information Fusion and Resource Management with extensions on Rasmussen's Decision Ladder (DL) to provide guidance on constructing information systems that better serve decision-making support requirements. The DNN takes a component-centered approach to system design, decomposing each asset in terms of data inputs and outputs according to their roles and interactions in a fusion network. However, to ensure relevancy to and organizational fitment within command and control (C2) processes, principles from cognitive systems engineering emphasize that system design must take a human-centered systems view, integrating information needs and decision making requirements to drive the architecture design and capabilities of network assets. In the current work, we present an approach for structuring and assessing DNDW systems that uses a unique hybrid DNN top-down system design with a human-centered process design, combining DNN node decomposition with artifacts from cognitive analysis (i.e., system abstraction decomposition models, decision ladders) to provide work domain and task-level insights at different levels in an example intelligence, surveillance, and reconnaissance (ISR) system setting. This DNDW structure will ensure not only that the information fusion technologies and processes are structured effectively, but that the resulting information products will align with the requirements of human decision makers and be adaptable to different work settings .

Analysis of the decision-making process of nurse managers: a collective reflection.

PubMed

Eduardo, Elizabete Araujo; Peres, Aida Maris; de Almeida, Maria de Lourdes; Roglio, Karina de Dea; Bernardino, Elizabeth

2015-01-01

to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories. qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis. data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model. the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that influence and determine right decisions.

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

PubMed Central

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

2015-01-01

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

Application of construal level and value-belief norm theories to undergraduate decision-making on a wildlife socio-scientific issue

NASA Astrophysics Data System (ADS)

Sutter, A. McKinzie; Dauer, Jenny M.; Forbes, Cory T.

2018-06-01

One aim of science education is to develop scientific literacy for decision-making in daily life. Socio-scientific issues (SSI) and structured decision-making frameworks can help students reach these objectives. This research uses value belief norm (VBN) theory and construal level theory (CLT) to explore students' use of personal values in their decision-making processes and the relationship between abstract and concrete problematization and their decision-making. Using mixed methods, we conclude that the level of abstraction with which students problematise a prairie dog agricultural production and ecosystem preservation issue has a significant relationship to the values students used in the decision-making process. However, neither abstraction of the problem statement nor students' surveyed value orientations were significantly related to students' final decisions. These results may help inform teachers' understanding of students and their use of a structured-decision making tool in a classroom, and aid researchers in understanding if these tools help students remain objective in their analyses of complex SSIs.

Community representation in hospital decision making: a literature review.

PubMed

Murray, Zoë

2015-06-01

Advancing quality in health services requires structures and processes that are informed by consumer input. Although this agenda is well recognised, few researchers have focussed on the establishment and maintenance of customer input throughout the structures and processes used to produce high-quality, safe care. We present an analysis of literature outlining the barriers and enablers involved in community representation in hospital governance. The review aimed to explore how community representation in hospital governance is achieved. Studies spanning 1997-2012 were analysed using Donabedian' s model of quality systems as a guide for categories of interest: structure, in relation to administration of quality; process, which is particularly concerned with cooperation and culture; and outcome, considered, in this case, to be the achievement of effective community representation on quality of care. There are limited published studies on community representation in hospital governance in Australia. What can be gleaned from the literature is: 1) quality subcommittees set up to assist Hospital Boards are a key structure for involving community representation in decision making around quality of care, and 2) there are a number of challenges to effectively developing the process of community representation in hospital governance: ambiguity and the potential for escalated indecision; inadequate value and consideration given to it by decision makers resulting in a lack of time and resources needed to support the community engagement strategy (time, facilitation, budgets); poor support and attitude amongst staff; and consumer issues, such as feeling isolated and intimidated by expert opinion. The analysis indicates that: quality subcommittees set up to assist boards are a key structure for involving community representation in decision making around quality of care. There are clearly a number of challenges to effectively developing the process of community representation in hospital governance, associated with ambiguity, organisational and consumer issues. For an inclusive agenda to real life, work must be done on understanding the representatives' role and the decision making process, adequately supporting the representational process, and developing organisational cooperation and culture regarding community representation.

Decision making in high-velocity environments: implications for healthcare.

PubMed

Stepanovich, P L; Uhrig, J D

1999-01-01

Healthcare can be considered a high-velocity environment and, as such, can benefit from research conducted in other industries regarding strategic decision making. Strategic planning is not only relevant to firms in high-velocity environments, but is also important for high performance and survival. Specifically, decision-making speed seems to be instrumental in differentiating between high and low performers; fast decision makers outperform slow decision makers. This article outlines the differences between fast and slow decision makers, identifies five paralyses that can slow decision making in healthcare, and outlines the role of a planning department in circumventing these paralyses. Executives can use the proposed planning structure to improve both the speed and quality of strategic decisions. The structure uses planning facilitators to avoid the following five paralyses: 1. Analysis. Decision makers can no longer afford the luxury of lengthy, detailed analysis but must develop real-time systems that provide appropriate, timely information. 2. Alternatives. Many alternatives (beyond the traditional two or three) need to be considered and the alternatives must be evaluated simultaneously. 3. Group Think. Decision makers must avoid limited mind-sets and autocratic leadership styles by seeking out independent, knowledgeable counselors. 4. Process. Decision makers need to resolve conflicts through "consensus with qualification," as opposed to waiting for everyone to come on board. 5. Separation. Successful implementation requires a structured process that cuts across disciplines and levels.

Using structured decision making with landowners to address private forest management and parcelization: balancing multiple objectives and incorporating uncertainty

Treesearch

Paige F. B. Ferguson; Michael J. Conroy; John F. Chamblee; Jeffrey Hepinstall-Cymerman

2015-01-01

Parcelization and forest fragmentation are of concern for ecological, economic, and social reasons. Efforts to keep large, private forests intact may be supported by a decision-making process that incorporates landowners’ objectives and uncertainty. We used structured decision making (SDM) with owners of large, private forests in Macon County, North Carolina....

Spatial education: improving conservation delivery through space-structured decision making

USGS Publications Warehouse

Moore, Clinton T.; Shaffer, Terry L.; Gannon, Jill J.

2013-01-01

Adaptive management is a form of structured decision making designed to guide management of natural resource systems when their behaviors are uncertain. Where decision making can be replicated across units of a landscape, learning can be accelerated, and biological processes can be understood in a larger spatial context. Broad-based partnerships among land management agencies, exemplified by Landscape Conservation Cooperatives (conservation partnerships created through the U.S. Department of the Interior), are potentially ideal environments for implementing spatially structured adaptive management programs.

Use of multicriteria decision analysis to address conservation conflicts.

PubMed

Davies, A L; Bryce, R; Redpath, S M

2013-10-01

Conservation conflicts are increasing on a global scale and instruments for reconciling competing interests are urgently needed. Multicriteria decision analysis (MCDA) is a structured, decision-support process that can facilitate dialogue between groups with differing interests and incorporate human and environmental dimensions of conflict. MCDA is a structured and transparent method of breaking down complex problems and incorporating multiple objectives. The value of this process for addressing major challenges in conservation conflict management is that MCDA helps in setting realistic goals; entails a transparent decision-making process; and addresses mistrust, differing world views, cross-scale issues, patchy or contested information, and inflexible legislative tools. Overall we believe MCDA provides a valuable decision-support tool, particularly for increasing awareness of the effects of particular values and choices for working toward negotiated compromise, although an awareness of the effect of methodological choices and the limitations of the method is vital before applying it in conflict situations. © 2013 Society for Conservation Biology.

The Analytical Pragmatic Structure of Procedural Due Process: A Framework for Inquiry in Administrative Decision Making.

ERIC Educational Resources Information Center

Fisher, James E.; Sealey, Ronald W.

The study describes the analytical pragmatic structure of concepts and applies this structure to the legal concept of procedural due process. This structure consists of form, purpose, content, and function. The study conclusions indicate that the structure of the concept of procedural due process, or any legal concept, is not the same as the…

Screening Algorithm to Guide Decisions on Whether to Conduct a Health Impact Assessment

EPA Pesticide Factsheets

Provides a visual aid in the form of a decision algorithm that helps guide discussions about whether to proceed with an HIA. The algorithm can help structure, standardize, and document the decision process.

Thresholds for conservation and management: structured decision making as a conceptual framework

USGS Publications Warehouse

Nichols, James D.; Eaton, Mitchell J.; Martin, Julien; Edited by Guntenspergen, Glenn R.

2014-01-01

changes in system dynamics. They are frequently incorporated into ecological models used to project system responses to management actions. Utility thresholds are components of management objectives and are values of state or performance variables at which small changes yield substantial changes in the value of the management outcome. Decision thresholds are values of system state variables at which small changes prompt changes in management actions in order to reach specified management objectives. Decision thresholds are derived from the other components of the decision process.We advocate a structured decision making (SDM) approach within which the following components are identified: objectives (possibly including utility thresholds), potential actions, models (possibly including ecological thresholds), monitoring program, and a solution algorithm (which produces decision thresholds). Adaptive resource management (ARM) is described as a special case of SDM developed for recurrent decision problems that are characterized by uncertainty. We believe that SDM, in general, and ARM, in particular, provide good approaches to conservation and management. Use of SDM and ARM also clarifies the distinct roles of ecological thresholds, utility thresholds, and decision thresholds in informed decision processes.

Decision-making process of prenatal screening described by pregnant women and their partners.

PubMed

Wätterbjörk, Inger; Blomberg, Karin; Nilsson, Kerstin; Sahlberg-Blom, Eva

2015-10-01

Pregnant women are often faced with having to decide about prenatal screening for Down's syndrome. However, the decision to participate in or refrain from prenatal screening can be seen as an important decision not only for the pregnant woman but also for both the partners. The aim of this study was to explore the couples' processes of decision making about prenatal screening. A total of 37 semi-structured interviews conducted at two time points were analysed using the interpretive description. The study was carried out in Maternal health-care centres, Örebro County Council, Sweden. Fifteen couples of different ages and with different experiences of pregnancy and childbirth were interviewed. Three different patterns of decision making were identified. For the couples in 'The open and communicative decision-making process', the process was straightforward and rational, and the couples discussed the decision with each other. 'The closed and personal decision-making process' showed an immediate and non-communicative decision making where the couples decided each for themselves. The couples showing 'The searching and communicative decision-making process' followed an arduous road in deciding whether to participate or not in prenatal screening and how to cope with the result. The decision-making process was for some couples a fairly straightforward decision, while for others it was a more complex process that required a great deal of consideration. © 2013 John Wiley & Sons Ltd.

Doing what's right: A grounded theory of ethical decision-making in occupational therapy.

PubMed

VanderKaay, Sandra; Letts, Lori; Jung, Bonny; Moll, Sandra E

2018-04-20

Ethical decision-making is an important aspect of reasoning in occupational therapy practice. However, the process of ethical decision-making within the broader context of reasoning is yet to be clearly explicated. The purpose of this study was to advance a theoretical understanding of the process by which occupational therapists make ethical decisions in day-to-day practice. A constructivist grounded theory approach was adopted, incorporating in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings and years of experience. Initially, participants nominated as key informants who were able to reflect on their decision-making processes were recruited. Theoretical sampling informed subsequent stages of data collection. Participants were asked to describe their process of ethical decision-making using scenarios from clinical practice. Interview transcripts were analyzed using a systematic process of initial then focused coding, and theoretical categorization to construct a theory regarding the process of ethical decision-making. An ethical decision-making prism was developed to capture three main processes: Considering the Fundamental Checklist, Consulting Others, and Doing What's Right. Ethical decision-making appeared to be an inductive and dialectical process with the occupational therapist at its core. Study findings advance our understanding of ethical decision-making in day-to-day clinical practice.

Using Decision Structures for Policy Analysis in Software Product-line Evolution - A Case Study

NASA Astrophysics Data System (ADS)

Sarang, Nita; Sanglikar, Mukund A.

Project management decisions are the primary basis for project success (or failure). Mostly, such decisions are based on an intuitive understanding of the underlying software engineering and management process and have a likelihood of being misjudged. Our problem domain is product-line evolution. We model the dynamics of the process by incorporating feedback loops appropriate to two decision structures: staffing policy, and the forces of growth associated with long-term software evolution. The model is executable and supports project managers to assess the long-term effects of possible actions. Our work also corroborates results from earlier studies of E-type systems, in particular the FEAST project and the rules for software evolution, planning and management.

On-Line Modal State Monitoring of Slowly Time-Varying Structures

NASA Technical Reports Server (NTRS)

Johnson, Erik A.; Bergman, Lawrence A.; Voulgaris, Petros G.

1997-01-01

Monitoring the dynamic response of structures is often performed for a variety of reasons. These reasons include condition-based maintenance, health monitoring, performance improvements, and control. In many cases the data analysis that is performed is part of a repetitive decision-making process, and in these cases the development of effective on-line monitoring schemes help to speed the decision-making process and reduce the risk of erroneous decisions. This report investigates the use of spatial modal filters for tracking the dynamics of slowly time-varying linear structures. The report includes an overview of modal filter theory followed by an overview of several structural system identification methods. Included in this discussion and comparison are H-infinity, eigensystem realization, and several time-domain least squares approaches. Finally, a two-stage adaptive on-line monitoring scheme is developed and evaluated.

Engaging stakeholders for adaptive management using structured decision analysis

USGS Publications Warehouse

Irwin, Elise R.; Kathryn, D.; Kennedy, Mickett

2009-01-01

Adaptive management is different from other types of management in that it includes all stakeholders (versus only policy makers) in the process, uses resource optimization techniques to evaluate competing objectives, and recognizes and attempts to reduce uncertainty inherent in natural resource systems. Management actions are negotiated by stakeholders, monitored results are compared to predictions of how the system should respond, and management strategies are adjusted in a “monitor-compare-adjust” iterative routine. Many adaptive management projects fail because of the lack of stakeholder identification, engagement, and continued involvement. Primary reasons for this vary but are usually related to either stakeholders not having ownership (or representation) in decision processes or disenfranchisement of stakeholders after adaptive management begins. We present an example in which stakeholders participated fully in adaptive management of a southeastern regulated river. Structured decision analysis was used to define management objectives and stakeholder values and to determine initial flow prescriptions. The process was transparent, and the visual nature of the modeling software allowed stakeholders to see how their interests and values were represented in the decision process. The development of a stakeholder governance structure and communication mechanism has been critical to the success of the project.

Administrative Decision Making and Resource Allocation.

ERIC Educational Resources Information Center

Sardy, Susan; Sardy, Hyman

This paper considers selected aspects of the systems analysis of administrative decisionmaking regarding resource allocations in an educational system. A model of the instructional materials purchase system is presented. The major components of this model are: environment, input, decision process, conversion structure, conversion process, output,…

Cognitive Structures in Vocational Information Processing and Decision Making.

ERIC Educational Resources Information Center

Nevill, Dorothy D.; And Others

1986-01-01

Tested the assumptions that the structural features of vocational schemas affect vocational information processing and career self-efficacy. Results indicated that effective vocational information processing was facilitated by well-integrated systems that processed information along fewer dimensions. The importance of schematic organization on the…

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

PubMed

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

2016-11-01

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

Roles, processes, and outcomes of interprofessional shared decision-making in a neonatal intensive care unit: A qualitative study.

PubMed

Dunn, Sandra I; Cragg, Betty; Graham, Ian D; Medves, Jennifer; Gaboury, Isabelle

2018-05-01

Shared decision-making provides an opportunity for the knowledge and skills of care providers to synergistically influence patient care. Little is known about interprofessional shared decision-making processes in critical care settings. The aim of this study was to explore interprofessional team members' perspectives about the nature of interprofessional shared decision-making in a neonatal intensive care unit (NICU) and to determine if there are any differences in perspectives across professional groups. An exploratory qualitative approach was used consisting of semi-structured interviews with 22 members of an interprofessional team working in a tertiary care NICU in Canada. Participants identified four key roles involved in interprofessional shared decision-making: leader, clinical experts, parents, and synthesizer. Participants perceived that interprofessional shared decision-making happens through collaboration, sharing, and weighing the options, the evidence and the credibility of opinions put forward. The process of interprofessional shared decision-making leads to a well-informed decision and participants feeling valued. Findings from this study identified key concepts of interprofessional shared decision-making, increased awareness of differing professional perspectives about this process of shared decision-making, and clarified understanding of the different roles involved in the decision-making process in an NICU.

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

PubMed

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

2015-12-01

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

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

PubMed

Fobbs, Wambura C; Mizumori, Sheri J Y

2014-01-01

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

Who decides? The decision-making process of juvenile judges concerning minors with mental disorders.

PubMed

Cappon, Leen

2016-01-01

Previous research on juvenile judges' decision-making process has neglected the role of the different actors involved in judicial procedures. The decision can be considered as a result of information exchange between the different actors involved. The process of making a decision is equally important as the decision itself, especially when the decision considers minors with mental disorders. The presence and the type of interaction determine the information available to the juvenile judges to make their final decision. The overall aim of this study is to gain insight into the role of all actors, including the juvenile judge, in the juvenile judge's decision-making process in cases relating to minors with mental disorders. Semi-structured interviews were carried out with professional actors (n=32), minors (n=31) and parents (n=17). The findings indicated that the judge's decision is overall the result of an interaction between the juvenile judge, the social services investigator and the youth psychiatrist. The other professional actors, the minors and the parents had only a limited role in the decision-making process. The research concludes that the judge's decision-making process should be based on dialogue, and requires enhanced collaboration between the juvenile court and youth psychiatrists from mental health services. Future decision-making research should pay more attention to the interactions of the actors that guide a juvenile judge's decision. Copyright © 2016 Elsevier Ltd. All rights reserved.

Linking knowledge with action in the pursuit of sustainable water-resources management

PubMed Central

Jacobs, Katharine; Lebel, Louis; Buizer, James; Addams, Lee; Matson, Pamela; McCullough, Ellen; Garden, Po; Saliba, George; Finan, Timothy

2016-01-01

Managing water for sustainable use and economic development is both a technical and a governance challenge in which knowledge production and sharing play a central role. This article evaluates and compares the role of participatory governance and scientific information in decision-making in four basins in Brazil, Mexico, Thailand, and the United States. Water management institutions in each of the basins have evolved during the last 10–20 years from a relatively centralized water-management structure at the state or national level to a decision structure that involves engaging water users within the basins and the development of participatory processes. This change is consistent with global trends in which states increasingly are expected to gain public acceptance for larger water projects and policy changes. In each case, expanded citizen engagement in identifying options and in decision-making processes has resulted in more complexity but also has expanded the culture of integrated learning. International funding for water infrastructure has been linked to requirements for participatory management processes, but, ironically, this study finds that participatory processes appear to work better in the context of decisions that are short-term and easily adjusted, such as water-allocation decisions, and do not work so well for longer-term, high-stakes decisions regarding infrastructure. A second important observation is that the costs of capacity building to allow meaningful stakeholder engagement in water-management decision processes are not widely recognized. Failure to appreciate the associated costs and complexities may contribute to the lack of successful engagement of citizens in decisions regarding infrastructure. PMID:20080611

[Decision process in a multidisciplinary cancer team with limited evidence].

PubMed

Lassalle, R; Marold, J; Schöbel, M; Manzey, D; Bohn, S; Dietz, A; Boehm, A

2014-04-01

The Head and Neck Cancer Tumor Board is a multispeciality comprehensive conference that brings together experts with different backgrounds to make group decisions about the appropriate treatment. Due to the complexity of the patient cases and the collaboration of different medical disciplines most of these decisions have to be made under uncertainty, i. e., with-out knowing all relevant factors and without being quite sure about the outcome. To develop effective team decision making under uncertainty, it is necessary to understand how medical experts perceive and handle uncertainties. The aim of this field study was to develop a knowledge base by exploring additionally the factors that influence group decision making processes. A structured nonparticipant observational study was employed to address the research goal. Video data were analyzed by 2 independent observers using an observation checklist. A total of 20 videotaped case discussions were studied. Observations were complemented by a questionnaire gathering subjective evaluations of board members about the process and quality of their decisions (N=15). The results show that uncertainty is recognized by board members. Reasons for uncertainty may stem from the complexity of the cases (e. g. therapy options) or the assessment from different disciplines coming together at the board. With respect to handling uncertainty and guaranteeing an optimal decision making process potential for improvement could be defined. This pertains to the handling of different levels of competence, the promotion of a positive discussion culture as well as structuring of the decision making process. © Georg Thieme Verlag KG Stuttgart · New York.

Occupational/Career Decision-Making Thought Processes of Adolescents of High Intellectual Ability

ERIC Educational Resources Information Center

Jung, Jae Yup

2017-01-01

Three competing models of the career decision-making thought processes of adolescents of high intellectual ability were tested in this study. Survey data were collected from 664 intellectually gifted Australian adolescents and analyzed using structural equation modeling procedures. The finally accepted, optimal model suggested that, regardless of…

Training conservation practitioners to be better decision makers

USGS Publications Warehouse

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

2015-01-01

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

An Assessment of the Past and Present Decision-Making Process Within an Organization With a Case for a Structural Change.

ERIC Educational Resources Information Center

Rogers, Raymond

The change in the organizational structure and goals of Mount Wachusett Community College (Massachusetts) from its inception to its current state is analyzed with respect to decision-making concerning staffing. At its infancy, the administration is seen as a rational focal structure; a central power grants resources and staff members are afforded…

The Structure of Knowledge and Departmental Social Organization.

ERIC Educational Resources Information Center

Adkinson, Judith

1979-01-01

This case study of three university departments was designed to generate substantive theory about decision-making in academic departments. Homans' social systems theory was used as a framework, and it is shown that the rate of interaction affects the crystallization of norm structures and processes of influence and decision-making. (Author/LBH)

Coding Theory Information Theory and Radar

DTIC Science & Technology

2005-01-01

the design and synthesis of artificial multiagent systems and for the understanding of human decision-making processes. This... altruism that may exist in a complex society. SGT derives its ability to account simultaneously for both group and individual interests from the structure of ...satisficing decision theory as a model of human decision mak- ing. 2 Multi-Attribute Decision Making Many decision problems involve the consideration of

Analysis of flight equipment purchasing practices of representative air carriers

NASA Technical Reports Server (NTRS)

1977-01-01

The process through which representative air carriers decide whether or not to purchase flight equipment was investigated as well as their practices and policies in retiring surplus aircraft. An analysis of the flight equipment investment decision process in ten airlines shows that for the airline industry as a whole, the flight equipment investment decision is in a state of transition from a wholly informal process in earliest years to a much more organized and structured process in the future. Individual air carriers are in different stages with respect to the formality and sophistication associated with the flight equipment investment decision.

Nuclear emergency management procedures in Europe

NASA Astrophysics Data System (ADS)

Carter, Emma

The Chernobyl accident brought to the fore the need for decision-making in nuclear emergency management to be transparent and consistent across Europe. A range of systems to support decision-making in future emergencies have since been developed, but, by and large, with little consultation with potential decision makers and limited understanding of the emergency management procedures across Europe and how they differ. In nuclear emergency management, coordination, communication and information sharing are of paramount importance. There are many key players with their own technical expertise, and several key activities occur in parallel, across different locations. Business process modelling can facilitate understanding through the representation of processes, aid transparency and structure the analysis, comparison and improvement of processes. This work has been conducted as part of a European Fifth Framework Programme project EVATECH, whose aim was to improve decision support methods, models and processes taking into account stakeholder expectations and concerns. It has involved the application of process modelling to document and compare the emergency management processes in four European countries. It has also involved a multidisciplinary approach taking a socio-technical perspective. The use of process modelling did indeed facilitate understanding and provided a common platform, which was not previously available, to consider emergency management processes. This thesis illustrates the structured analysis approach that process modelling enables. Firstly, through an individual analysis for the United Kingdom (UK) model that illustrated the potential benefits for a country. These are for training purposes, to build reflexive shared mental models, to aid coordination and for process improvement. Secondly, through a comparison of the processes in Belgium, Germany, Slovak Republic and the UK. In this comparison of the four processes we observed that the four process models are substantially different in their organisational structure and identified differences in the management of advice, where decisions are made and the communication network style. Another key aspect of this work is that through the structured analysis conducted we were able to develop a framework for the evaluation of DSS from the perspective of process. This work concludes reflecting on the challenges, which the European off-site nuclear emergency community face and suggest direction for future work, with particular reference to a recent conference on the capabilities and challenges of offsite nuclear emergency management, the Salzburg Symposium 2003.

Interactive Management and Updating of Spatial Data Bases

NASA Technical Reports Server (NTRS)

French, P.; Taylor, M.

1982-01-01

The decision making process, whether for power plant siting, load forecasting or energy resource planning, invariably involves a blend of analytical methods and judgement. Management decisions can be improved by the implementation of techniques which permit an increased comprehension of results from analytical models. Even where analytical procedures are not required, decisions can be aided by improving the methods used to examine spatially and temporally variant data. How the use of computer aided planning (CAP) programs and the selection of a predominant data structure, can improve the decision making process is discussed.

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

What is on your mind? Using the perceptual cycle model and critical decision method to understand the decision-making process in the cockpit.

PubMed

Plant, Katherine L; Stanton, Neville A

2013-01-01

Aeronautical decision-making is complex as there is not always a clear coupling between the decision made and decision outcome. As such, there is a call for process-orientated decision research in order to understand why a decision made sense at the time it was made. Schema theory explains how we interact with the world using stored mental representations and forms an integral part of the perceptual cycle model (PCM); proposed here as a way to understand the decision-making process. This paper qualitatively analyses data from the critical decision method (CDM) based on the principles of the PCM. It is demonstrated that the approach can be used to understand a decision-making process and highlights how influential schemata can be at informing decision-making. The reliability of this approach is established, the general applicability is discussed and directions for future work are considered. This paper introduces the PCM, and the associated schema theory, as a framework to structure and explain data collected from the CDM. The reliability of both the method and coding scheme is addressed.

Clarification process: Resolution of decision-problem conditions

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

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

Decision-making in healthcare: a practical application of partial least square path modelling to coverage of newborn screening programmes

PubMed Central

2012-01-01

Background Decision-making in healthcare is complex. Research on coverage decision-making has focused on comparative studies for several countries, statistical analyses for single decision-makers, the decision outcome and appraisal criteria. Accounting for decision processes extends the complexity, as they are multidimensional and process elements need to be regarded as latent constructs (composites) that are not observed directly. The objective of this study was to present a practical application of partial least square path modelling (PLS-PM) to evaluate how it offers a method for empirical analysis of decision-making in healthcare. Methods Empirical approaches that applied PLS-PM to decision-making in healthcare were identified through a systematic literature search. PLS-PM was used as an estimation technique for a structural equation model that specified hypotheses between the components of decision processes and the reasonableness of decision-making in terms of medical, economic and other ethical criteria. The model was estimated for a sample of 55 coverage decisions on the extension of newborn screening programmes in Europe. Results were evaluated by standard reliability and validity measures for PLS-PM. Results After modification by dropping two indicators that showed poor measures in the measurement models’ quality assessment and were not meaningful for newborn screening, the structural equation model estimation produced plausible results. The presence of three influences was supported: the links between both stakeholder participation or transparency and the reasonableness of decision-making; and the effect of transparency on the degree of scientific rigour of assessment. Reliable and valid measurement models were obtained to describe the composites of ‘transparency’, ‘participation’, ‘scientific rigour’ and ‘reasonableness’. Conclusions The structural equation model was among the first applications of PLS-PM to coverage decision-making. It allowed testing of hypotheses in situations where there are links between several non-observable constructs. PLS-PM was compatible in accounting for the complexity of coverage decisions to obtain a more realistic perspective for empirical analysis. The model specification can be used for hypothesis testing by using larger sample sizes and for data in the full domain of health technologies. PMID:22856325

Decision-making in healthcare: a practical application of partial least square path modelling to coverage of newborn screening programmes.

PubMed

Fischer, Katharina E

2012-08-02

Decision-making in healthcare is complex. Research on coverage decision-making has focused on comparative studies for several countries, statistical analyses for single decision-makers, the decision outcome and appraisal criteria. Accounting for decision processes extends the complexity, as they are multidimensional and process elements need to be regarded as latent constructs (composites) that are not observed directly. The objective of this study was to present a practical application of partial least square path modelling (PLS-PM) to evaluate how it offers a method for empirical analysis of decision-making in healthcare. Empirical approaches that applied PLS-PM to decision-making in healthcare were identified through a systematic literature search. PLS-PM was used as an estimation technique for a structural equation model that specified hypotheses between the components of decision processes and the reasonableness of decision-making in terms of medical, economic and other ethical criteria. The model was estimated for a sample of 55 coverage decisions on the extension of newborn screening programmes in Europe. Results were evaluated by standard reliability and validity measures for PLS-PM. After modification by dropping two indicators that showed poor measures in the measurement models' quality assessment and were not meaningful for newborn screening, the structural equation model estimation produced plausible results. The presence of three influences was supported: the links between both stakeholder participation or transparency and the reasonableness of decision-making; and the effect of transparency on the degree of scientific rigour of assessment. Reliable and valid measurement models were obtained to describe the composites of 'transparency', 'participation', 'scientific rigour' and 'reasonableness'. The structural equation model was among the first applications of PLS-PM to coverage decision-making. It allowed testing of hypotheses in situations where there are links between several non-observable constructs. PLS-PM was compatible in accounting for the complexity of coverage decisions to obtain a more realistic perspective for empirical analysis. The model specification can be used for hypothesis testing by using larger sample sizes and for data in the full domain of health technologies.

Persuasion stage in adoption theory: a cognitive response-cognitive structure assessment of source credibility and tax-incentive effects on consumer decision making for residential solar systems. [Suburbs of Baltimore

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

Batory, S.S.

1981-01-01

The research objective was to learn more about the consumer's acceptance or rejection process toward a major residential energy innovation, a solar-generated water heating system. An experiment was conducted that evaluated one aspect of solar's commercialization, the persuasion stage in new-product-adoption decision making. A test of source credibility and monetary incentive effects on the consumer's decision-making processes was carried out. The experiment contained two message sources: the Department of Energy (a high credibility source) and a homebuilder (a moderate credibility source), and three levels of incentives, a tax credit equal to 40% of the solar unit purchase price, a 20%more » tax credit, and no tax credit. Subjects were randomly assigned to either a control group or one of six experimental treatments in a 2 x 3 fixed-effects factorial design. Subjects were 226 adult homeowners drawn from the suburbs of Baltimore, Maryland. The research postulated and tested a process of acceptance or rejection of innovations which was based on a cognitive-response/cognitive-structure paradigm of decision making. This process is called the persuasion stage by adoption theorists. Cognitive responses, beliefs, attitudes, and behavioral measures were the dependent variables. Consumers were shown to confront or debate incoming information by comparing it to their existing cognitive structure. This comparison process generated cognitive responses which led to changes in beliefs, attitudes, and behavior toward the innovation. The findings confirm that the federal government's intervention in the marketplace is having a favorable effect on the adoption decision process toward solar-generated water heating.« less

Past developments and future directions for the AHP in natural resources

Treesearch

Daniel L. Schmoldt; G.A. Mendoza; Jyrki Kangas

2001-01-01

The analytic hierarchy process (AHP) possesses certain characteristics that make it a useful tool for natural resource decision making. The AHP’s capabilities include: participatory decision making, problem structuring and alternative development, group facilitation, consensus building, fairness, qualitative and quantitative information, conflict resolution, decision...

Health technology assessment process of a cardiovascular medical device in four different settings.

PubMed

Olry de Labry Lima, Antonio; Espín Balbino, Jaime; Lemgruber, Alexandre; Caro Martínez, Araceli; García-Mochón, Leticia; Martín Ruiz, Eva; Lessa, Fernanda

2017-10-01

Health technology assessment (HTA) is a tool to help the decision-making process. The aim is to describe methods and processes used in the reimbursement decision making for drug-eluting stents (DES) in four different settings. DES as a technology under study was selected according to different criteria, all of them agreed by a working group. A survey of key informants was designed. DES was evaluated following well-structured HTA processes. Nonetheless, scope for improvement was observed in relation to the data considered for the final decision, the transparency and inclusiveness of the process as well as in the methods employed. An attempt to describe the HTA processes of a well-known medical device.

Informing clinical policy decision-making practices in ambulance services.

PubMed

Muecke, Sandy; Curac, Nada; Binks, Darryn

2013-12-01

This study aims to identify the processes and frameworks that support an evidence-based approach to clinical policy decision-making practices in ambulance services. This literature review focused on: (i) the setting (pre-hospital); and (ii) the process of evidence translation, for studies published after the year 2000. Searches of Medline, CINAHL and Google were undertaken. Reference lists of eligible publications were searched for relevant articles. A total of 954 articles were identified. Of these, 20 full text articles were assessed for eligibility and seven full text articles met the inclusion criteria. Three provided detailed descriptions of the evidence-based practice processes used to inform ambulance service protocol or guideline development or review. There is little published literature that describes the processes involved, and frameworks required, to inform clinical policy decision making within ambulance services. This review found that processes were iterative and involved collaborations across many internal and external stakeholders. In several jurisdictions, these were coordinated by a dedicated team. Success appears dependent on committed leadership and purposive human and structural resources. Although time consuming, structured processes have been developed in some jurisdictions to assist decision-making processes. Further insight is likely to be obtained from literature published by those from other disciplines. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

Prioritization of Stockpile Maintenance with Layered Pareto Fronts

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

Burke, Sarah E.; Anderson-Cook, Christine M.; Lu, Lu

Difficult choices are required for a decision-making process where resources and budgets are increasingly constrained. This study demonstrates a structured decision-making approach using layered Pareto fronts to identify priorities about how to allocate funds between munitions stockpiles based on their estimated reliability, the urgency of needing available units, and the consequences if adequate numbers of units are not available. This case study, while specific to the characteristics of a group of munitions stockpiles, illustrates the general process of structured decision-making based on first identifying appropriate metrics that summarize the important dimensions of the decision, and then objectively eliminating non-contenders frommore » further consideration. Finally, the final subjective stage incorporates user priorities to select the four stockpiles to receive additional maintenance and surveillance funds based on understanding the trade-offs and robustness to various user priorities.« less

Prioritization of Stockpile Maintenance with Layered Pareto Fronts

DOE PAGES

Burke, Sarah E.; Anderson-Cook, Christine M.; Lu, Lu; ...

2017-10-11

Difficult choices are required for a decision-making process where resources and budgets are increasingly constrained. This study demonstrates a structured decision-making approach using layered Pareto fronts to identify priorities about how to allocate funds between munitions stockpiles based on their estimated reliability, the urgency of needing available units, and the consequences if adequate numbers of units are not available. This case study, while specific to the characteristics of a group of munitions stockpiles, illustrates the general process of structured decision-making based on first identifying appropriate metrics that summarize the important dimensions of the decision, and then objectively eliminating non-contenders frommore » further consideration. Finally, the final subjective stage incorporates user priorities to select the four stockpiles to receive additional maintenance and surveillance funds based on understanding the trade-offs and robustness to various user priorities.« less

What is a good medical decision? A research agenda guided by perspectives from multiple stakeholders.

PubMed

Hamilton, Jada G; Lillie, Sarah E; Alden, Dana L; Scherer, Laura; Oser, Megan; Rini, Christine; Tanaka, Miho; Baleix, John; Brewster, Mikki; Craddock Lee, Simon; Goldstein, Mary K; Jacobson, Robert M; Myers, Ronald E; Zikmund-Fisher, Brian J; Waters, Erika A

2017-02-01

Informed and shared decision making are critical aspects of patient-centered care, which has contributed to an emphasis on decision support interventions to promote good medical decision making. However, researchers and healthcare providers have not reached a consensus on what defines a good decision, nor how to evaluate it. This position paper, informed by conference sessions featuring diverse stakeholders held at the 2015 Society of Behavioral Medicine and Society for Medical Decision Making annual meetings, describes key concepts that influence the decision making process itself and that may change what it means to make a good decision: interpersonal factors, structural constraints, affective influences, and values clarification methods. This paper also proposes specific research questions within each of these priority areas, with the goal of moving medical decision making research to a more comprehensive definition of a good medical decision, and enhancing the ability to measure and improve the decision making process.

Averse to Initiative: Risk Management’s Effect on Mission Command

DTIC Science & Technology

2017-05-25

military decision making process (MDMP). Other changes to structure reveal administrative and safety risk information (i.e. personal operated vehicle... decision making , it requires commanders to have the capacity to make an informed , intuitive decision . Uncertainty...analysis. His situation required him to embrace uncertainty, and exercise an informed intuition to make a risk decision to create opportunity

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

PubMed

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

2013-06-03

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

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

PubMed Central

2013-01-01

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

A work-centered cognitively based architecture for decision support: the work-centered infomediary layer (WIL) model

NASA Astrophysics Data System (ADS)

Zachary, Wayne; Eggleston, Robert; Donmoyer, Jason; Schremmer, Serge

2003-09-01

Decision-making is strongly shaped and influenced by the work context in which decisions are embedded. This suggests that decision support needs to be anchored by a model (implicit or explicit) of the work process, in contrast to traditional approaches that anchor decision support to either context free decision models (e.g., utility theory) or to detailed models of the external (e.g., battlespace) environment. An architecture for cognitively-based, work centered decision support called the Work-centered Informediary Layer (WIL) is presented. WIL separates decision support into three overall processes that build and dynamically maintain an explicit context model, use the context model to identify opportunities for decision support and tailor generic decision-support strategies to the current context and offer them to the system-user/decision-maker. The generic decision support strategies include such things as activity/attention aiding, decision process structuring, work performance support (selective, contextual automation), explanation/ elaboration, infosphere data retrieval, and what if/action-projection and visualization. A WIL-based application is a work-centered decision support layer that provides active support without intent inferencing, and that is cognitively based without requiring classical cognitive task analyses. Example WIL applications are detailed and discussed.

Driving with roadmaps and dashboards: using information resources to structure the decision models in service organizations.

PubMed

Chorpita, Bruce F; Bernstein, Adam; Daleiden, Eric L

2008-03-01

This paper illustrates the application of design principles for tools that structure clinical decision-making. If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered. Clinical research trials commonly occur in an environment characterized by structured decision making and expert supports. Technology has great potential to serve mental health organizations by supporting these potentially important contextual features of the research environment, through organization and reporting of clinical data into interpretable information to support decisions and anchor decision-making procedures. This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.

Group decision making with the analytic hierarchy process in benefit-risk assessment: a tutorial.

PubMed

Hummel, J Marjan; Bridges, John F P; IJzerman, Maarten J

2014-01-01

The analytic hierarchy process (AHP) has been increasingly applied as a technique for multi-criteria decision analysis in healthcare. The AHP can aid decision makers in selecting the most valuable technology for patients, while taking into account multiple, and even conflicting, decision criteria. This tutorial illustrates the procedural steps of the AHP in supporting group decision making about new healthcare technology, including (1) identifying the decision goal, decision criteria, and alternative healthcare technologies to compare, (2) structuring the decision criteria, (3) judging the value of the alternative technologies on each decision criterion, (4) judging the importance of the decision criteria, (5) calculating group judgments, (6) analyzing the inconsistency in judgments, (7) calculating the overall value of the technologies, and (8) conducting sensitivity analyses. The AHP is illustrated via a hypothetical example, adapted from an empirical AHP analysis on the benefits and risks of tissue regeneration to repair small cartilage lesions in the knee.

Risk assessment as standard work in design.

PubMed

Morrill, Patricia W

2013-01-01

This case study article examines a formal risk assessment as part of the decision making process for design solutions in high risk areas. The overview of the Failure Modes and Effects Analysis (FMEA) tool with examples of its application in hospital building projects will demonstrate the benefit of those structured conversations. This article illustrates how two hospitals used FMEA when integrating operational processes with building projects: (1) adjacency decision for Intensive Care Unit (ICU); and (2) distance concern for handling of specimens from Surgery to Lab. Both case studies involved interviews that exposed facility solution concerns. Just-in-time studies using the FMEA followed the same risk assessment process with the same workshop facilitator involving structured conversations in analyzing risks. In both cases, participants uncovered key areas of risk enabling them to take the necessary next steps. While the focus of this article is not the actual design solution, it is apparent that the risk assessment brought clarity to the situations resulting in prompt decision making about facility solutions. Hospitals are inherently risky environments; therefore, use of the formal risk assessment process, FMEA, is an opportunity for design professionals to apply more rigor to design decision making when facility solutions impact operations in high risk areas. Case study, decision making, hospital, infection control, strategy, work environment.

Applying the Cognitive Information Processing Approach to Career Problem Solving and Decision Making to Women's Career Development.

ERIC Educational Resources Information Center

McLennan, Natasha A.; Arthur, Nancy

1999-01-01

Outlines an expanded framework of the Cognitive Information Processing (CIP) approach to career problem solving and decision making for career counseling with women. Addresses structural and individual barriers in women's career development and provides practical suggestions for applying and evaluating the CIP approach in career counseling.…

Modeling To Enhance Critical Thinking and Decision Making Skills Development in the Instructional Process: The Social Studies.

ERIC Educational Resources Information Center

Peters, Richard

Students must be actively involved in the process of learning for it to have personal meaning and importance in their lives. Teachers must also become critical thinkers, creative individuals, and decision makers in order to create more challenging learning environments. Teachers need to blend structure and spontaneity into meaningful learning…

Training in Decision-Making Strategies: An Approach to Enhance Students' Competence to Deal with Socio-Scientific Issues

ERIC Educational Resources Information Center

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2013-01-01

Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based…

Decision Making Regarding Access to Training and Development in Medium-Sized Enterprises: An Exploratory Study Using the Critical Incident Technique

ERIC Educational Resources Information Center

Coetzer, Alan; Redmond, Janice; Sharafizad, Jalleh

2012-01-01

Purpose: The purpose of this paper is to develop an understanding of factors that impinge on managerial decision-making processes regarding employee access to structured training and development (T&D) opportunities that are at least partially funded by the firm. Design/methodology/approach: Semi-structured interviews incorporating the Critical…

Structured decision making for managing pneumonia epizootics in bighorn sheep

USGS Publications Warehouse

Sells, Sarah N.; Mitchell, Michael S.; Edwards, Victoria L.; Gude, Justin A.; Anderson, Neil J.

2016-01-01

Good decision-making is essential to conserving wildlife populations. Although there may be multiple ways to address a problem, perfect solutions rarely exist. Managers are therefore tasked with identifying decisions that will best achieve desired outcomes. Structured decision making (SDM) is a method of decision analysis used to identify the most effective, efficient, and realistic decisions while accounting for values and priorities of the decision maker. The stepwise process includes identifying the management problem, defining objectives for solving the problem, developing alternative approaches to achieve the objectives, and formally evaluating which alternative is most likely to accomplish the objectives. The SDM process can be more effective than informal decision-making because it provides a transparent way to quantitatively evaluate decisions for addressing multiple management objectives while incorporating science, uncertainty, and risk tolerance. To illustrate the application of this process to a management need, we present an SDM-based decision tool developed to identify optimal decisions for proactively managing risk of pneumonia epizootics in bighorn sheep (Ovis canadensis) in Montana. Pneumonia epizootics are a major challenge for managers due to long-term impacts to herds, epistemic uncertainty in timing and location of future epizootics, and consequent difficulty knowing how or when to manage risk. The decision tool facilitates analysis of alternative decisions for how to manage herds based on predictions from a risk model, herd-specific objectives, and predicted costs and benefits of each alternative. Decision analyses for 2 example herds revealed that meeting management objectives necessitates specific approaches unique to each herd. The analyses showed how and under what circumstances the alternatives are optimal compared to other approaches and current management. Managers can be confident that these decisions are effective, efficient, and realistic because they explicitly account for important considerations managers implicitly weigh when making decisions, including competing management objectives, uncertainty in potential outcomes, and risk tolerance.

Modelling and Decision Support of Clinical Pathways

NASA Astrophysics Data System (ADS)

Gabriel, Roland; Lux, Thomas

The German health care market is under a rapid rate of change, forcing especially hospitals to provide high-quality services at low costs. Appropriate measures for more effective and efficient service provision are process orientation and decision support by information technology of clinical pathway of a patient. The essential requirements are adequate modelling of clinical pathways as well as usage of adequate systems, which are capable of assisting the complete path of a patient within a hospital, and preferably also outside of it, in a digital way. To fulfil these specifications the authors present a suitable concept, which meets the challenges of well-structured clinical pathways as well as rather poorly structured diagnostic and therapeutic decisions, by interplay of process-oriented and knowledge-based hospital information systems.

Family involvement in cancer treatment decision-making: A qualitative study of patient, family, and clinician attitudes and experiences.

PubMed

Laidsaar-Powell, Rebekah; Butow, Phyllis; Bu, Stella; Charles, Cathy; Gafni, Amiram; Fisher, Alana; Juraskova, Ilona

2016-07-01

Little is known about how family are involved in cancer treatment decision-making. This study aimed to qualitatively explore Australian oncology clinicians', patients', and family members' attitudes towards, and experiences of, family involvement in decision-making. Semi-structured interviews were conducted with 30 cancer patients, 33 family members, 10 oncology nurses and 11 oncologists. Framework analysis methods were used. Three main themes were uncovered: (i) how family are involved in the decision-making process: specific behaviours of family across 5 (extended) decision-making stages; (ii) attitudes towards family involvement in the decision-making process: balancing patient authority with the rights of the family; and (iii) factors influencing family involvement: patient, family, cultural, relationship, and decision. This study highlighted many specific behaviours of family throughout the decision-making process, the complex participant attitudes toward retaining patient authority whilst including the family, and insight into influencing factors. These findings will inform a conceptual framework describing family involvement in decision-making. Clinicians could ascertain participant preferences and remain open to the varying forms of family involvement in decision-making. Given the important role of family in the decision-making process, family inclusive consultation strategies are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Healthcare decisions: a review of children's involvement.

PubMed

Baston, Jenny

2008-04-01

Children's rights, their ability to consent to treatment and their involvement in healthcare decisions have received considerable attention in recent years. There is some evidence to suggest that when children are involved in the decision-making process, they retain a sense of control over their situation. However there are still unresolved issues related to a child's right to decide and nurses may be confused about the extent to which children can and should be involved in decision-making. A code of practice for involving children in decisions was first suggested in 2001 and there is still a need for a consistent, structured and robust method of ensuring that children are included in the decision-making process at all stages of their health care.

EPA Region 9 Guidance for Quality Assurance Program Plans - R9qa/03.2

EPA Pesticide Factsheets

In order for decision makers to have confidence in the quality of environmental data used to support their decisions, the organization must have structured and documented process for quality in place.

Air traffic control specialist decision making and strategic planning : a field survey

DOT National Transportation Integrated Search

2001-03-01

This study investigated Air Traffic Control Specialists' perspective regarding decision making and planning and related cognitive processes such as learning, memory, and situation awareness. The results of 100 semi-structured interviews indicated tha...

A functional difference in information processing between orbitofrontal cortex and ventral striatum during decision-making behaviour.

PubMed

Stott, Jeffrey J; Redish, A David

2014-11-05

Both orbitofrontal cortex (OFC) and ventral striatum (vStr) have been identified as key structures that represent information about value in decision-making tasks. However, the dynamics of how this information is processed are not yet understood. We recorded ensembles of cells from OFC and vStr in rats engaged in the spatial adjusting delay-discounting task, a decision-making task that involves a trade-off between delay to and magnitude of reward. Ventral striatal neural activity signalled information about reward before the rat's decision, whereas such reward-related signals were absent in OFC until after the animal had committed to its decision. These data support models in which vStr is directly involved in action selection, but OFC processes decision-related information afterwards that can be used to compare the predicted and actual consequences of behaviour. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Information processing in decision-making systems.

PubMed

van der Meer, Matthijs; Kurth-Nelson, Zeb; Redish, A David

2012-08-01

Decisions result from an interaction between multiple functional systems acting in parallel to process information in very different ways, each with strengths and weaknesses. In this review, the authors address three action-selection components of decision-making: The Pavlovian system releases an action from a limited repertoire of potential actions, such as approaching learned stimuli. Like the Pavlovian system, the habit system is computationally fast but, unlike the Pavlovian system permits arbitrary stimulus-action pairings. These associations are a "forward'' mechanism; when a situation is recognized, the action is released. In contrast, the deliberative system is flexible but takes time to process. The deliberative system uses knowledge of the causal structure of the world to search into the future, planning actions to maximize expected rewards. Deliberation depends on the ability to imagine future possibilities, including novel situations, and it allows decisions to be taken without having previously experienced the options. Various anatomical structures have been identified that carry out the information processing of each of these systems: hippocampus constitutes a map of the world that can be used for searching/imagining the future; dorsal striatal neurons represent situation-action associations; and ventral striatum maintains value representations for all three systems. Each system presents vulnerabilities to pathologies that can manifest as psychiatric disorders. Understanding these systems and their relation to neuroanatomy opens up a deeper way to treat the structural problems underlying various disorders.

Harnessing expert knowledge: Defining a Bayesian network decision model with limited data-Model structure for the vibration qualification problem

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

Rizzo, Davinia B.; Blackburn, Mark R.

As systems become more complex, systems engineers rely on experts to inform decisions. There are few experts and limited data in many complex new technologies. This challenges systems engineers as they strive to plan activities such as qualification in an environment where technical constraints are coupled with the traditional cost, risk, and schedule constraints. Bayesian network (BN) models provide a framework to aid systems engineers in planning qualification efforts with complex constraints by harnessing expert knowledge and incorporating technical factors. By quantifying causal factors, a BN model can provide data about the risk of implementing a decision supplemented with informationmore » on driving factors. This allows a systems engineer to make informed decisions and examine “what-if” scenarios. This paper discusses a novel process developed to define a BN model structure based primarily on expert knowledge supplemented with extremely limited data (25 data sets or less). The model was developed to aid qualification decisions—specifically to predict the suitability of six degrees of freedom (6DOF) vibration testing for qualification. The process defined the model structure with expert knowledge in an unbiased manner. Finally, validation during the process execution and of the model provided evidence the process may be an effective tool in harnessing expert knowledge for a BN model.« less

Harnessing expert knowledge: Defining a Bayesian network decision model with limited data-Model structure for the vibration qualification problem

DOE PAGES

Rizzo, Davinia B.; Blackburn, Mark R.

2018-03-30

As systems become more complex, systems engineers rely on experts to inform decisions. There are few experts and limited data in many complex new technologies. This challenges systems engineers as they strive to plan activities such as qualification in an environment where technical constraints are coupled with the traditional cost, risk, and schedule constraints. Bayesian network (BN) models provide a framework to aid systems engineers in planning qualification efforts with complex constraints by harnessing expert knowledge and incorporating technical factors. By quantifying causal factors, a BN model can provide data about the risk of implementing a decision supplemented with informationmore » on driving factors. This allows a systems engineer to make informed decisions and examine “what-if” scenarios. This paper discusses a novel process developed to define a BN model structure based primarily on expert knowledge supplemented with extremely limited data (25 data sets or less). The model was developed to aid qualification decisions—specifically to predict the suitability of six degrees of freedom (6DOF) vibration testing for qualification. The process defined the model structure with expert knowledge in an unbiased manner. Finally, validation during the process execution and of the model provided evidence the process may be an effective tool in harnessing expert knowledge for a BN model.« less

Information Processing in Decision-Making Systems

PubMed Central

van der Meer, Matthijs; Kurth-Nelson, Zeb; Redish, A. David

2015-01-01

Decisions result from an interaction between multiple functional systems acting in parallel to process information in very different ways, each with strengths and weaknesses. In this review, the authors address three action-selection components of decision-making: The Pavlovian system releases an action from a limited repertoire of potential actions, such as approaching learned stimuli. Like the Pavlovian system, the habit system is computationally fast but, unlike the Pavlovian system permits arbitrary stimulus-action pairings. These associations are a “forward” mechanism; when a situation is recognized, the action is released. In contrast, the deliberative system is flexible but takes time to process. The deliberative system uses knowledge of the causal structure of the world to search into the future, planning actions to maximize expected rewards. Deliberation depends on the ability to imagine future possibilities, including novel situations, and it allows decisions to be taken without having previously experienced the options. Various anatomical structures have been identified that carry out the information processing of each of these systems: hippocampus constitutes a map of the world that can be used for searching/imagining the future; dorsal striatal neurons represent situation-action associations; and ventral striatum maintains value representations for all three systems. Each system presents vulnerabilities to pathologies that can manifest as psychiatric disorders. Understanding these systems and their relation to neuroanatomy opens up a deeper way to treat the structural problems underlying various disorders. PMID:22492194

Information processing. [in human performance

NASA Technical Reports Server (NTRS)

Wickens, Christopher D.; Flach, John M.

1988-01-01

Theoretical models of sensory-information processing by the human brain are reviewed from a human-factors perspective, with a focus on their implications for aircraft and avionics design. The topics addressed include perception (signal detection and selection), linguistic factors in perception (context provision, logical reversals, absence of cues, and order reversals), mental models, and working and long-term memory. Particular attention is given to decision-making problems such as situation assessment, decision formulation, decision quality, selection of action, the speed-accuracy tradeoff, stimulus-response compatibility, stimulus sequencing, dual-task performance, task difficulty and structure, and factors affecting multiple task performance (processing modalities, codes, and stages).

Examining Challenges Related to the Production of Actionable Climate Knowledge for Adaptation Decision-Making: A Focus on Climate Knowledge System Producers

NASA Astrophysics Data System (ADS)

Ernst, K.; Preston, B. L.; Tenggren, S.; Klein, R.; Gerger-Swartling, Å.

2017-12-01

Many challenges to adaptation decision-making and action have been identified across peer-reviewed and gray literature. These challenges have primarily focused on the use of climate knowledge for adaptation decision-making, the process of adaptation decision-making, and the needs of the decision-maker. Studies on climate change knowledge systems often discuss the imperative role of climate knowledge producers in adaptation decision-making processes and stress the need for producers to engage in knowledge co-production activities and to more effectively meet decision-maker needs. While the influence of climate knowledge producers on the co-production of science for adaptation decision-making is well-recognized, hardly any research has taken a direct approach to analyzing the challenges that climate knowledge producers face when undertaking science co-production. Those challenges can influence the process of knowledge production and may hinder the creation, utilization, and dissemination of actionable knowledge for adaptation decision-making. This study involves semi-structured interviews, focus groups, and participant observations to analyze, identify, and contextualize the challenges that climate knowledge producers in Sweden face as they endeavor to create effective climate knowledge systems for multiple contexts, scales, and levels across the European Union. Preliminary findings identify complex challenges related to education, training, and support; motivation, willingness, and culture; varying levels of prioritization; professional roles and responsibilities; the type and amount of resources available; and professional incentive structures. These challenges exist at varying scales and levels across individuals, organizations, networks, institutions, and disciplines. This study suggests that the creation of actionable knowledge for adaptation decision-making is not supported across scales and levels in the climate knowledge production landscape. Additionally, enabling the production of actionable knowledge for adaptation decision-making requires multi-level effort beyond the individual level.

Exploring the role of religiosity and spirituality in amniocentesis decision-making among Latinas.

PubMed

Seth, Sarah Guerra; Goka, Thomas; Harbison, Andrea; Hollier, Lisa; Peterson, Susan; Ramondetta, Lois; Noblin, Sarah Jane

2011-12-01

Given the complex array of emotional and medical issues that may arise when making a decision about amniocentesis, women may find that their spiritual and/or religious beliefs can comfort and assist their decision-making process. Prior research has suggested that Latinas' spiritual and/or religious beliefs directly influence their amniocentesis decision. A more intimate look into whether Latinas utilize their beliefs during amniocentesis decision-making may provide an opportunity to better understand their experience. The overall goal of this study was to describe the role structured religion and spirituality plays in Latinas' daily lives and to evaluate how religiosity and spirituality influences health care decisions, specifically in prenatal diagnosis. Semi-structured interviews were conducted with eleven women who were invited to describe their religious beliefs and thoughts while considering the option of amniocentesis. All participants acknowledged the influence of religious and/or spiritual beliefs in their everyday lives. Although the women sought comfort and found validation in their beliefs and in their faith in God's will during their amniocentesis decision-making process, results suggest the risk of procedure-related complications played more of a concrete role than their beliefs.

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

NASA Astrophysics Data System (ADS)

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

2012-11-01

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

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

PubMed

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

2017-09-01

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

Prioritization of engineering support requests and advanced technology projects using decision support and industrial engineering models

NASA Technical Reports Server (NTRS)

Tavana, Madjid

1995-01-01

The evaluation and prioritization of Engineering Support Requests (ESR's) is a particularly difficult task at the Kennedy Space Center (KSC) -- Shuttle Project Engineering Office. This difficulty is due to the complexities inherent in the evaluation process and the lack of structured information. The evaluation process must consider a multitude of relevant pieces of information concerning Safety, Supportability, O&M Cost Savings, Process Enhancement, Reliability, and Implementation. Various analytical and normative models developed over the past have helped decision makers at KSC utilize large volumes of information in the evaluation of ESR's. The purpose of this project is to build on the existing methodologies and develop a multiple criteria decision support system that captures the decision maker's beliefs through a series of sequential, rational, and analytical processes. The model utilizes the Analytic Hierarchy Process (AHP), subjective probabilities, the entropy concept, and Maximize Agreement Heuristic (MAH) to enhance the decision maker's intuition in evaluating a set of ESR's.

Safety of clinical and non-clinical decision makers in telephone triage: a narrative review.

PubMed

Wheeler, Sheila Q; Greenberg, Mary E; Mahlmeister, Laura; Wolfe, Nicole

2015-09-01

Patient safety is a persistent problem in telephone triage research; however, studies have not differentiated between clinicians' and non-clinicians' respective safety. Currently, four groups of decision makers perform aspects of telephone triage: clinicians (physicians, nurses), and non-clinicians (emergency medical dispatchers (EMD) and clerical staff). Using studies published between 2002-2012, we applied Donabedian's structure-process-outcome model to examine groups' systems for evidence of system completeness (a minimum measure of structure and quality). We defined system completeness as the presence of a decision maker and four additional components: guidelines, documentation, training, and standards. Defining safety as appropriate referrals (AR) - (right time, right place with the right person), we measured each groups' corresponding AR rate percentages (outcomes). We analyzed each group's respective decision-making process as a safe match to the telephone triage task, based on each group's system structure completeness, process and AR rates (outcome). Studies uniformly noted system component presence: nurses (2-4), physicians (1), EMDs (2), clerical staff (1). Nurses had the highest average appropriate referral (AR) rates (91%), physicians' AR (82% average). Clerical staff had no system and did not perform telephone triage by standard definitions; EMDs may represent the use of the wrong system. Telephone triage appears least safe after hours when decision makers with the least complete systems (physicians, clerical staff) typically manage calls. At minimum, telephone triage decision makers should be clinicians; however, clinicians' safety calls for improvement. With improved training, standards and CDSS quality, the 24/7 clinical call center has potential to represent the national standard. © The Author(s) 2015.

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

Role-Playing in a Consumption Context: An Experiential Learning Activity Focused on the Consumer Decision-Making Process

ERIC Educational Resources Information Center

Thomas, Veronica L.; Magnotta, Sarah R.; Chang, Hua; Steffes, Erin

2018-01-01

Instructors are faced with the challenge of teaching a significant amount of material covering a wide variety of topics in a Principles of Marketing course. In order to present the critical consumer decision-making process concept in a meaningful way while remaining mindful of time constraints, we propose a semi-structured classroom activity that…

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

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

Code of Federal Regulations, 2014 CFR

2014-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

ERIC Educational Resources Information Center

Liu, Duo; McBride-Chang, Catherine

2014-01-01

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

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

PubMed

Chiarello, Elizabeth

2013-12-01

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

Decision modeling for fire incident analysis

Treesearch

Donald G. MacGregor; Armando González-Cabán

2009-01-01

This paper reports on methods for representing and modeling fire incidents based on concepts and models from the decision and risk sciences. A set of modeling techniques are used to characterize key fire management decision processes and provide a basis for incident analysis. The results of these methods can be used to provide insights into the structure of fire...

Dynamic Programming for Structured Continuous Markov Decision Problems

NASA Technical Reports Server (NTRS)

Dearden, Richard; Meuleau, Nicholas; Washington, Richard; Feng, Zhengzhu

2004-01-01

We describe an approach for exploiting structure in Markov Decision Processes with continuous state variables. At each step of the dynamic programming, the state space is dynamically partitioned into regions where the value function is the same throughout the region. We first describe the algorithm for piecewise constant representations. We then extend it to piecewise linear representations, using techniques from POMDPs to represent and reason about linear surfaces efficiently. We show that for complex, structured problems, our approach exploits the natural structure so that optimal solutions can be computed efficiently.

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

NASA Technical Reports Server (NTRS)

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

1978-01-01

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

What is a good medical decision? A research agenda guided by perspectives from multiple stakeholders

PubMed Central

Hamilton, Jada G.; Lillie, Sarah E.; Alden, Dana L.; Scherer, Laura; Oser, Megan; Rini, Christine; Tanaka, Miho; Baleix, John; Brewster, Mikki; Lee, Simon Craddock; Goldstein, Mary K.; Jacobson, Robert M.; Myers, Ronald E.; Zikmund-Fisher, Brian J.; Waters, Erika A.

2016-01-01

Informed and shared decision making are critical aspects of patient-centered care, which has contributed to an emphasis on decision support interventions to promote good medical decision making. However, researchers and healthcare providers have not reached a consensus on what defines a good decision, nor how to evaluate it. This position paper, informed by conference sessions featuring diverse stakeholders held at the 2015 Society of Behavioral Medicine and Society for Medical Decision Making annual meetings, describes key concepts that influence the decision making process itself and that may change what it means to make a good decision: interpersonal factors, structural constraints, affective influences, and values clarification methods. This paper also proposes specific research questions within each of these priority areas, with the goal of moving medical decision making research to a more comprehensive definition of a good medical decision, and enhancing the ability to measure and improve the decision making process. PMID:27566316

Development of a model to guide decision making in amyotrophic lateral sclerosis multidisciplinary care.

PubMed

Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

2015-10-01

Patients with amyotrophic lateral sclerosis (ALS) face numerous decisions for symptom management and quality of life. Models of decision making in chronic disease and cancer care are insufficient for the complex and changing needs of patients with ALS . The aim was to examine the question: how can decision making that is both effective and patient-centred be enacted in ALS multidisciplinary care? Fifty-four respondents (32 health professionals, 14 patients and eight carers) from two specialized ALS multidisciplinary clinics participated in semi-structured interviews. Interviews were transcribed, coded and analysed thematically. Comparison of stakeholder perspectives revealed six key themes of ALS decision making. These were the decision-making process; patient-centred focus; timing and planning; information sources; engagement with specialized ALS services; and access to non-specialized services. A model, embedded in the specialized ALS multidisciplinary clinic, was derived to guide patient decision making. The model is cyclic, with four stages: 'Participant Engagement'; 'Option Information'; 'Option Deliberation'; and 'Decision Implementation'. Effective and patient-centred decision making is enhanced by the structure of the specialized ALS clinic, which promotes patients' symptom management and quality of life goals. However, patient and carer engagement in ALS decision making is tested by the dynamic nature of ALS, and patient and family distress. Our model optimizes patient-centred decision making, by incorporating patients' cyclic decision-making patterns and facilitating carer inclusion in decision processes. The model captures the complexities of patient-centred decision making in ALS. The framework can assist patients and carers, health professionals, researchers and policymakers in this challenging disease environment. © 2013 John Wiley & Sons Ltd.

Structured Analysis and the Data Flow Diagram: Tools for Library Analysis.

ERIC Educational Resources Information Center

Carlson, David H.

1986-01-01

This article discusses tools developed to aid the systems analysis process (program evaluation and review technique, Gantt charts, organizational charts, decision tables, flowcharts, hierarchy plus input-process-output). Similarities and differences among techniques, library applications of analysis, structured systems analysis, and the data flow…

Integrated Risk-Informed Decision-Making for an ALMR PRISM

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

Muhlheim, Michael David; Belles, Randy; Denning, Richard S.

Decision-making is the process of identifying decision alternatives, assessing those alternatives based on predefined metrics, selecting an alternative (i.e., making a decision), and then implementing that alternative. The generation of decisions requires a structured, coherent process, or a decision-making process. The overall objective for this work is that the generalized framework is adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or no human intervention. The overriding goal of automation is to replace ormore » supplement human decision makers with reconfigurable decision-making modules that can perform a given set of tasks rationally, consistently, and reliably. Risk-informed decision-making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The probabilistic portion of the decision-making engine of the supervisory control system is based on the control actions associated with an ALMR PRISM. Newly incorporated into the probabilistic models are the prognostic/diagnostic models developed by Pacific Northwest National Laboratory. These allow decisions to incorporate the health of components into the decision–making process. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic portion of the decision-making engine uses thermal-hydraulic modeling and components for an advanced liquid-metal reactor Power Reactor Inherently Safe Module. The deterministic multi-attribute decision-making framework uses various sensor data (e.g., reactor outlet temperature, steam generator drum level) and calculates its position within the challenge state, its trajectory, and its margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. The metrics that are evaluated are based on reactor trip set points. The integration of the deterministic calculations using multi-physics analyses and probabilistic safety calculations allows for the examination and quantification of margin recovery strategies. This also provides validation of the control options identified from the probabilistic assessment. Thus, the thermalhydraulics analyses are used to validate the control options identified from the probabilistic assessment. Future work includes evaluating other possible metrics and computational efficiencies, and developing a user interface to mimic display panels at a modern nuclear power plant.« less

A cortical network model of cognitive and emotional influences in human decision making.

PubMed

Nazir, Azadeh Hassannejad; Liljenström, Hans

2015-10-01

Decision making (DM)(2) is a complex process that appears to involve several brain structures. In particular, amygdala, orbitofrontal cortex (OFC) and lateral prefrontal cortex (LPFC) seem to be essential in human decision making, where both emotional and cognitive aspects are taken into account. In this paper, we present a computational network model representing the neural information processing of DM, from perception to behavior. We model the population dynamics of the three neural structures (amygdala, OFC and LPFC), as well as their interaction. In our model, the neurodynamic activity of amygdala and OFC represents the neural correlates of secondary emotion, while the activity of certain neural populations in OFC alone represents the outcome expectancy of different options. The cognitive/rational aspect of DM is associated with LPFC. Our model is intended to give insights on the emotional and cognitive processes involved in DM under various internal and external contexts. Different options for actions are represented by the oscillatory activity of cell assemblies, which may change due to experience and learning. Knowledge and experience of the outcome of our decisions and actions can eventually result in changes in our neural structures, attitudes and behaviors. Simulation results may have implications for how we make decisions for our individual actions, as well as for societal choices, where we take examples from transport and its impact on CO2 emissions and climate change. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Auto-rickshaw: an automated crystal structure determination platform as an efficient tool for the validation of an X-ray diffraction experiment.

PubMed

Panjikar, Santosh; Parthasarathy, Venkataraman; Lamzin, Victor S; Weiss, Manfred S; Tucker, Paul A

2005-04-01

The EMBL-Hamburg Automated Crystal Structure Determination Platform is a system that combines a number of existing macromolecular crystallographic computer programs and several decision-makers into a software pipeline for automated and efficient crystal structure determination. The pipeline can be invoked as soon as X-ray data from derivatized protein crystals have been collected and processed. It is controlled by a web-based graphical user interface for data and parameter input, and for monitoring the progress of structure determination. A large number of possible structure-solution paths are encoded in the system and the optimal path is selected by the decision-makers as the structure solution evolves. The processes have been optimized for speed so that the pipeline can be used effectively for validating the X-ray experiment at a synchrotron beamline.

Decentralized control of Markovian decision processes: Existence Sigma-admissable policies

NASA Technical Reports Server (NTRS)

Greenland, A.

1980-01-01

The problem of formulating and analyzing Markov decision models having decentralized information and decision patterns is examined. Included are basic examples as well as the mathematical preliminaries needed to understand Markov decision models and, further, to superimpose decentralized decision structures on them. The notion of a variance admissible policy for the model is introduced and it is proved that there exist (possibly nondeterministic) optional policies from the class of variance admissible policies. Directions for further research are explored.

Predicting species distributions for conservation decisions

PubMed Central

Guisan, Antoine; Tingley, Reid; Baumgartner, John B; Naujokaitis-Lewis, Ilona; Sutcliffe, Patricia R; Tulloch, Ayesha I T; Regan, Tracey J; Brotons, Lluis; McDonald-Madden, Eve; Mantyka-Pringle, Chrystal; Martin, Tara G; Rhodes, Jonathan R; Maggini, Ramona; Setterfield, Samantha A; Elith, Jane; Schwartz, Mark W; Wintle, Brendan A; Broennimann, Olivier; Austin, Mike; Ferrier, Simon; Kearney, Michael R; Possingham, Hugh P; Buckley, Yvonne M

2013-01-01

Species distribution models (SDMs) are increasingly proposed to support conservation decision making. However, evidence of SDMs supporting solutions for on-ground conservation problems is still scarce in the scientific literature. Here, we show that successful examples exist but are still largely hidden in the grey literature, and thus less accessible for analysis and learning. Furthermore, the decision framework within which SDMs are used is rarely made explicit. Using case studies from biological invasions, identification of critical habitats, reserve selection and translocation of endangered species, we propose that SDMs may be tailored to suit a range of decision-making contexts when used within a structured and transparent decision-making process. To construct appropriate SDMs to more effectively guide conservation actions, modellers need to better understand the decision process, and decision makers need to provide feedback to modellers regarding the actual use of SDMs to support conservation decisions. This could be facilitated by individuals or institutions playing the role of ‘translators’ between modellers and decision makers. We encourage species distribution modellers to get involved in real decision-making processes that will benefit from their technical input; this strategy has the potential to better bridge theory and practice, and contribute to improve both scientific knowledge and conservation outcomes. PMID:24134332

Decision problems in management of construction projects

NASA Astrophysics Data System (ADS)

Szafranko, E.

2017-10-01

In a construction business, one must oftentimes make decisions during all stages of a building process, from planning a new construction project through its execution to the stage of using a ready structure. As a rule, the decision making process is made more complicated due to certain conditions specific for civil engineering. With such diverse decision situations, it is recommended to apply various decision making support methods. Both, literature and hands-on experience suggest several methods based on analytical and computational procedures, some less and some more complex. This article presents the methods which can be helpful in supporting decision making processes in the management of civil engineering projects. These are multi-criteria methods, such as MCE, AHP or indicator methods. Because the methods have different advantages and disadvantages, whereas decision situations have their own specific nature, a brief summary of the methods alongside some recommendations regarding their practical applications has been given at the end of the paper. The main aim of this article is to review the methods of decision support and their analysis for possible use in the construction industry.

Breaking the sound barrier: exploring parents' decision-making process of cochlear implants for their children.

PubMed

Chang, Pamara F

2017-08-01

To understand the dynamic experiences of parents undergoing the decision-making process regarding cochlear implants for their child(ren). Thirty-three parents of d/Deaf children participated in semi-structured interviews. Interviews were digitally recorded, transcribed, and coded using iterative and thematic coding. The results from this study reveal four salient topics related to parents' decision-making process regarding cochlear implantation: 1) factors parents considered when making the decision to get the cochlear implant for their child (e.g., desire to acculturate child into one community), 2) the extent to which parents' communities influence their decision-making (e.g., norms), 3) information sources parents seek and value when decision-making (e.g., parents value other parent's experiences the most compared to medical or online sources), and 4) personal experiences with stigma affecting their decision to not get the cochlear implant for their child. This study provides insights into values and perspectives that can be utilized to improve informed decision-making, when making risky medical decisions with long-term implications. With thorough information provisions, delineation of addressing parents' concerns and encompassing all aspects of the decision (i.e., medical, social and cultural), health professional teams could reduce the uncertainty and anxiety for parents in this decision-making process for cochlear implantation. Copyright © 2017 Elsevier B.V. All rights reserved.

A Neuropsychological Approach to Understanding Risk-Taking for Potential Gains and Losses

PubMed Central

Levin, Irwin P.; Xue, Gui; Weller, Joshua A.; Reimann, Martin; Lauriola, Marco; Bechara, Antoine

2012-01-01

Affective neuroscience has helped guide research and theory development in judgment and decision-making by revealing the role of emotional processes in choice behavior, especially when risk is involved. Evidence is emerging that qualitatively and quantitatively different processes may be involved in risky decision-making for gains and losses. We start by reviewing behavioral work by Kahneman and Tversky (1979) and others, which shows that risk-taking differs for potential gains and potential losses. We then turn to the literature in decision neuroscience to support the gain versus loss distinction. Relying in part on data from a new task that separates risky decision-making for gains and losses, we test a neural model that assigns unique mechanisms for risky decision-making involving potential losses. Included are studies using patients with lesions to brain areas specified as important in the model and studies with healthy individuals whose brains are scanned to reveal activation in these and other areas during risky decision-making. In some cases, there is evidence that gains and losses are processed in different regions of the brain, while in other cases the same region appears to process risk in a different manner for gains and losses. At a more general level, we provide strong support for the notion that decisions involving risk-taking for gains and decisions involving risk-taking for losses represent different psychological processes. At a deeper level, we present mounting evidence that different neural structures play different roles in guiding risky choices in these different domains. Some structures are differentially activated by risky gains and risky losses while others respond uniquely in one domain or the other. Taken together, these studies support a clear functional dissociation between risk-taking for gains and risk-taking for losses, and further dissociation at the neural level. PMID:22347161

Prescribed fire applications: Restoring ecological structure and process in ponderosa pine forests

Treesearch

Michael G. Harrington

1996-01-01

The decision to include the fire process as part of a restoration treatment for a particular forest site is most logically made in conjunction with the decision for a silvicultural treatment. In other words, forest managers do not typically wait to visually or quantitatively evaluate the post harvest site before deciding whether or not to apply fire. Each phase of the...

Clinical decisions for anterior restorations: the concept of restorative volume.

PubMed

Cardoso, Jorge André; Almeida, Paulo Júlio; Fischer, Alex; Phaxay, Somano Luang

2012-12-01

The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered by different manufacturers. The authors reviewed available evidence and integrated their clinical experience to select relevant factors that could provide a logical and practical guideline for restorative decisions in anterior teeth. The presented concept of restorative volume is based on structural, optical, and periodontal factors. Each of these factors will influence the short- and long-term behavior of restorations in terms of esthetics, biology, and function. Despite the marked evolution of esthetic restorative techniques and materials, significant limitations still exist, which should be addressed by researchers. The presented guidelines must be regarded as a mere orientation for risk analysis. A comprehensive individual approach should always be the core of restorative esthetic treatments. The complex decision process for anterior esthetic restorations can be clarified by a systematized examination of structural, optical, and periodontal factors. The basis for the proposed thought process is the concept of restorative volume that is a contemporary interpretation of restoration categories and their application. © 2012 Wiley Periodicals, Inc.

The experiences of family members in the nursing home to hospital transfer decision.

PubMed

Abrahamson, Kathleen; Bernard, Brittany; Magnabosco, Lara; Nazir, Arif; Unroe, Kathleen T

2016-11-15

The objective of this study was to better understand the experiences of family members in the nursing home to hospital transfer decision making process. Semi-structured interviews were conducted with 20 family members who had recently been involved in a nursing home to hospital transfer decision. Family members perceived themselves to play an advocacy role in their resident's care and interview themes clustered within three over-arching categories: Family perception of the nursing home's capacity to provide medical care: Resident and family choices; and issues at 'hand-off' and the hospital. Multiple sub-themes were also identified. Findings from this study contribute to knowledge surrounding the nursing home transfer decision by illuminating the experiences of family members in the transfer decision process.

Toward theoretical understanding of the fertility preservation decision-making process: Examining information processing among young women with cancer

PubMed Central

Hershberger, Patricia E.; Finnegan, Lorna; Altfeld, Susan; Lake, Sara; Hirshfeld-Cytron, Jennifer

2014-01-01

Background Young women with cancer now face the complex decision about whether to undergo fertility preservation. Yet little is known about how these women process information involved in making this decision. Objective The purpose of this paper is to expand theoretical understanding of the decision-making process by examining aspects of information processing among young women diagnosed with cancer. Methods Using a grounded theory approach, 27 women with cancer participated in individual, semi-structured interviews. Data were coded and analyzed using constant-comparison techniques that were guided by five dimensions within the Contemplate phase of the decision-making process framework. Results In the first dimension, young women acquired information primarily from clinicians and Internet sources. Experiential information, often obtained from peers, occurred in the second dimension. Preferences and values were constructed in the third dimension as women acquired factual, moral, and ethical information. Women desired tailored, personalized information that was specific to their situation in the fourth dimension; however, women struggled with communicating these needs to clinicians. In the fifth dimension, women offered detailed descriptions of clinician behaviors that enhance or impede decisional debriefing. Conclusion Better understanding of theoretical underpinnings surrounding women’s information processes can facilitate decision support and improve clinical care. PMID:24552086

Smart algorithms and adaptive methods in computational fluid dynamics

NASA Astrophysics Data System (ADS)

Tinsley Oden, J.

1989-05-01

A review is presented of the use of smart algorithms which employ adaptive methods in processing large amounts of data in computational fluid dynamics (CFD). Smart algorithms use a rationally based set of criteria for automatic decision making in an attempt to produce optimal simulations of complex fluid dynamics problems. The information needed to make these decisions is not known beforehand and evolves in structure and form during the numerical solution of flow problems. Once the code makes a decision based on the available data, the structure of the data may change, and criteria may be reapplied in order to direct the analysis toward an acceptable end. Intelligent decisions are made by processing vast amounts of data that evolve unpredictably during the calculation. The basic components of adaptive methods and their application to complex problems of fluid dynamics are reviewed. The basic components of adaptive methods are: (1) data structures, that is what approaches are available for modifying data structures of an approximation so as to reduce errors; (2) error estimation, that is what techniques exist for estimating error evolution in a CFD calculation; and (3) solvers, what algorithms are available which can function in changing meshes. Numerical examples which demonstrate the viability of these approaches are presented.

Hierarchical semi-numeric method for pairwise fuzzy group decision making.

PubMed

Marimin, M; Umano, M; Hatono, I; Tamura, H

2002-01-01

Gradual improvements to a single-level semi-numeric method, i.e., linguistic labels preference representation by fuzzy sets computation for pairwise fuzzy group decision making are summarized. The method is extended to solve multiple criteria hierarchical structure pairwise fuzzy group decision-making problems. The problems are hierarchically structured into focus, criteria, and alternatives. Decision makers express their evaluations of criteria and alternatives based on each criterion by using linguistic labels. The labels are converted into and processed in triangular fuzzy numbers (TFNs). Evaluations of criteria yield relative criteria weights. Evaluations of the alternatives, based on each criterion, yield a degree of preference for each alternative or a degree of satisfaction for each preference value. By using a neat ordered weighted average (OWA) or a fuzzy weighted average operator, solutions obtained based on each criterion are aggregated into final solutions. The hierarchical semi-numeric method is suitable for solving a larger and more complex pairwise fuzzy group decision-making problem. The proposed method has been verified and applied to solve some real cases and is compared to Saaty's (1996) analytic hierarchy process (AHP) method.

The speed of metacognition: taking time to get to know one's structural knowledge.

PubMed

Mealor, Andy D; Dienes, Zoltan

2013-03-01

The time course of different metacognitive experiences of knowledge was investigated using artificial grammar learning. Experiment 1 revealed that when participants are aware of the basis of their judgments (conscious structural knowledge) decisions are made most rapidly, followed by decisions made with conscious judgment but without conscious knowledge of underlying structure (unconscious structural knowledge), and guess responses (unconscious judgment knowledge) were made most slowly, even when controlling for differences in confidence and accuracy. In experiment 2, short response deadlines decreased the accuracy of unconscious but not conscious structural knowledge. Conversely, the deadline decreased the proportion of conscious structural knowledge in favour of guessing. Unconscious structural knowledge can be applied rapidly but becomes more reliable with additional metacognitive processing time whereas conscious structural knowledge is an all-or-nothing response that cannot always be applied rapidly. These dissociations corroborate quite separate theories of recognition (dual-process) and metacognition (higher order thought and cross-order integration). Copyright © 2012 Elsevier Inc. All rights reserved.

Decision-making about prenatal genetic testing among pregnant Korean-American women.

PubMed

Jun, Myunghee; Thongpriwan, Vipavee; Choi, Jeeyae; Sook Choi, Kyung; Anderson, Gwen

2018-01-01

to understand the prenatal genetic testing decision-making processes among pregnant Korean-American women. a qualitative, descriptive research design. referrals and snowball sampling techniques were used to recruit 10 Korean-American women who had been recommended for amniocentesis during pregnancy in the United States (U.S.). All participants were born in Korea and had immigrated to the U.S. The number of years living in the U.S. ranged from 4 to 11 (M=5.7). various regional areas of the U.S. the researchers conducted face-to-face or phone interviews using semi-structured interview guides. The interviews were conducted in the Korean language and lasted approximately 50-100minutes. The interview guides focused on the decision-making process and experiences with prenatal genetic testing, as well as reflections on the decisions. Four core themes emerged related to the participants' decision-making processes, according to their descriptions. These themes are (1) facing the challenges of decision-making, (2) seeking support, (3) determining one's preferred role in the decision-making process, and (4) feeling uncomfortable with the degree of patient autonomy in U.S. health care. researchers concluded that many distinctive factors influence the decision-making processes used by pregnant Korean-American women. The results have the potential to improve shared decision-making practices regarding prenatal genetic testing. clinicians need to understand the sociocultural underpinnings of pregnant Korean-American immigrants regarding prenatal genetic screening and testing as an initial step to engage these patients in shared decision-making. Published by Elsevier Ltd.

Toward an Ideal Senior High School Governance Structure.

ERIC Educational Resources Information Center

Treslan, D. L.

1979-01-01

This paper delineates six attributes of an ideal high school governance structure: respect, freedom, rationality, flexibility, equality, and involvement of staff and students in the decision-making process. (Author/SJL)

The environmental management problem of Pohorje, Slovenia: A new group approach within ANP - SWOT framework.

PubMed

Grošelj, Petra; Zadnik Stirn, Lidija

2015-09-15

Environmental management problems can be dealt with by combining participatory methods, which make it possible to include various stakeholders in a decision-making process, and multi-criteria methods, which offer a formal model for structuring and solving a problem. This paper proposes a three-phase decision making approach based on the analytic network process and SWOT (strengths, weaknesses, opportunities and threats) analysis. The approach enables inclusion of various stakeholders or groups of stakeholders in particular stages of decision making. The structure of the proposed approach is composed of a network consisting of an objective cluster, a cluster of strategic goals, a cluster of SWOT factors and a cluster of alternatives. The application of the suggested approach is applied to a management problem of Pohorje, a mountainous area in Slovenia. Stakeholders from sectors that are important for Pohorje (forestry, agriculture, tourism and nature protection agencies) who can offer a wide range of expert knowledge were included in the decision-making process. The results identify the alternative of "sustainable development" as the most appropriate for development of Pohorje. The application in the paper offers an example of employing the new approach to an environmental management problem. This can also be applied to decision-making problems in various other fields. Copyright © 2015 Elsevier Ltd. All rights reserved.

Structuring Disaster Recovery Infrastructure Decisions: Lessons from Boulder County's 2013 Flood Recovery

NASA Astrophysics Data System (ADS)

Clavin, C.; Petropoulos, Z.

2017-12-01

Recovery phase decision making processes, as compared to mitigation and response phase decision making processes, require communities make significant financial and capital decisions in the months after a disaster. Collectively, these investments may significantly contribute to the resilience of a community to future hazards. Pre-disaster administrative decisions are well-established within existing planning processes. Post-event recovery requires community decision makers to quickly evaluate technical proposals and manage significant recovery financial resources to ensure their community rebuilds in a manner that will be more resilient to future events. These technical and administrative hurdles in the aftermath of a disaster create a challenging atmosphere to make sound, scientifically-informed decisions leading to resilient recovery. In September 2013, a 1,000-year rain event that resulted in flooding throughout the Front Range of Colorado, significantly impacting Boulder County. While the event is long past, disaster recovery efforts still continue in parts of Boulder County. Boulder County officials formed a county collaborative that adapted the NIST Community Resilience Planning Guide for Buildings and Infrastructure Systems to facilitate a goals-based multi-criteria decision making process. Rather than use hazard-based information to guide infrastructure design, the county's decision process established time-to-recovery goals for infrastructure systems that were used as criteria for project design. This presentation explores the decision-making process employed by Boulder County to specify design standards for resilient rebuilding of infrastructure systems and examine how this infrastructure planning model could be extrapolated to other situations where there is uncertainty regarding future infrastructure design standards.

Transcendental Political Systems and the Gravity Model

NASA Technical Reports Server (NTRS)

Lock, Connor

2012-01-01

This summer I have been working on an Army Deep Futures Model project named Themis. Themis is a JPL based modeling framework that anticipates possible future states for the world within the next 25 years. The goal of this framework is to determine the likelihood that the US Army will need to intervene on behalf of the US strategic interests. Key elements that are modeled within this tool include the world structure and major decisions that are made by key actors. Each actor makes decisions based on their goals and within the constraints of the structure of the system in which they are located. In my research I have focused primarily on the effects of structures upon the decision-making processes of the actors within them. This research is a natural extension of my major program at Georgetown University, where I am studying the International Political Economy and the structures that make it up. My basic goal for this summer project was to be a helpful asset to the Themis modeling team, with any research done or processes learned constituting a bonus.

Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study.

PubMed

Watanabe, Yoshiko; Takahashi, Miyako; Kai, Ichiro

2008-02-27

Over the last decade, patient involvement in treatment-related decision-making has been widely advocated in Japan, where patient-physician encounters are still under the influence of the long-standing tradition of paternalism. Despite this profound change in clinical practice, studies investigating the actual preferences of Japanese people regarding involvement in treatment-related decision-making are limited. The main objectives of this study were to (1) reveal the actual level of involvement of Japanese cancer patients in the treatment-related decision-making and their overall satisfaction with the decision-making process, and (2) consider the practical implications of increased satisfaction in cancer patients with regard to the decision-making process. We conducted semi-structured interviews with 24 Japanese cancer patients who were recruited from a cancer self-help group in Tokyo. The interviews were qualitatively analysed using the approach described by Lofland and Lofland. The analyses of the patients' interviews focused on 2 aspects: (1) who made treatment-related decisions (the physician or the patient), and (2) the informants' overall satisfaction with the decision-making process. The analyses revealed the following 5 categories of decision-making: 'patient as the active decision maker', 'doctor selection', 'wilfully entrusting the physician', 'compelled decision-making', and 'surrendering decision-making'. While the informants under the first 3 categories were fairly satisfied with the decision-making process, those under the latter 2 were extremely dissatisfied. Informants' views regarding their preferred role in the decision-making process varied substantially from complete physician control to complete patient control; the key factor for their satisfaction was the relation between their preferred involvement in decision-making and their actual level of involvement, irrespective of who the decision maker was. In order to increase patient satisfaction with regard to the treatment-related decision-making process, healthcare professionals in Japan must assess individual patient preferences and provide healthcare accordingly. Moreover, a better environment should be created in hospitals and in society to facilitate patients in expressing their preferences and appropriate resources need to be made available to facilitate their decision-making process.

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.

Exploring the decision-making process in the delivery of physiotherapy in a stroke unit.

PubMed

McGlinchey, Mark P; Davenport, Sally

2015-01-01

The aim of this study was to explore the decision-making process in the delivery of physiotherapy in a stroke unit. A focused ethnographical approach involving semi-structured interviews and observations of clinical practice was used. A purposive sample of seven neurophysiotherapists and four patients participated in semi-structured interviews. From this group, three neurophysiotherapists and four patients were involved in observation of practice. Data from interviews and observations were analysed to generate themes. Three themes were identified: planning the ideal physiotherapy delivery, the reality of physiotherapy delivery and involvement in the decision-making process. Physiotherapists used a variety of clinical reasoning strategies and considered many factors to influence their decision-making in the planning and delivery of physiotherapy post-stroke. These factors included the therapist's clinical experience, patient's presentation and response to therapy, prioritisation, organisational constraints and compliance with organisational practice. All physiotherapists highlighted the importance to involve patients in planning and delivering their physiotherapy. However, there were varying levels of patient involvement observed in this process. The study has generated insight into the reality of decision-making in the planning and delivery of physiotherapy post-stroke. Further research involving other stroke units is required to gain a greater understanding of this aspect of physiotherapy. Implications for Rehabilitation Physiotherapists need to consider multiple patient, therapist and organisational factors when planning and delivering physiotherapy in a stroke unit. Physiotherapists should continually reflect upon how they provide physiotherapy, with respect to the duration, frequency and time of day sessions are delivered, in order to guide current and future physiotherapy delivery. As patients may demonstrate varying levels of participation in deciding and understanding how physiotherapy is delivered, physiotherapists need to adjust how they engage patients in the decision-making process and manage patient expectations accordingly.

Practical Strategies for Integrating Final Ecosystem Goods and ...

EPA Pesticide Factsheets

The concept of Final Ecosystem Goods and Services (FEGS) explicitly connects ecosystem services to the people that benefit from them. This report presents a number of practical strategies for incorporating FEGS, and more broadly ecosystem services, into the decision-making process. Whether a decision process is in early or late stages, or whether a process includes informal or formal decision analysis, there are multiple points where ecosystem services concepts can be integrated. This report uses Structured Decision Making (SDM) as an organizing framework to illustrate the role ecosystem services can play in a values-focused decision-process, including: • Clarifying the decision context: Ecosystem services can help clarify the potential impacts of an issue on natural resources together with their spatial and temporal extent based on supply and delivery of those services, and help identify beneficiaries for inclusion as stakeholders in the deliberative process. • Defining objectives and performance measures: Ecosystem services may directly represent stakeholder objectives, or may be means toward achieving other objectives. • Creating alternatives: Ecosystem services can bring to light creative alternatives for achieving other social, economic, health, or general well-being objectives. • Estimating consequences: Ecosystem services assessments can implement ecological production functions (EPFs) and ecological benefits functions (EBFs) to link decision alt

Opening the Black Box: Cognitive Strategies in Family Practice

PubMed Central

Christensen, Robert E.; Fetters, Michael D.; Green, Lee A.

2005-01-01

PURPOSE We wanted to describe the cognitive strategies used by family physicians when structuring the decision-making tasks of an outpatient visit. METHODS This qualitative study used cognitive task analysis, a structured interview method in which a trained interviewer works individually with expert decision makers to capture their stages and elements of information processing. RESULTS Eighteen family physicians of varying levels of experience participated. Three dominant themes emerged: time pressure, a high degree of variation in task structuring, and varying degrees of task automatization. Based on these data and previous research from the cognitive sciences, we developed a model of novice and expert approaches to decision making in primary care. The model illustrates differences in responses to unexpected opportunity in practice, particularly the expert’s use of attentional surplus (reserve capacity to handle problems) vs the novice’s choice between taking more time or displacing another task. CONCLUSIONS Family physicians have specific, highly individualized cognitive task-structuring approaches and show the decision behavior features typical of expert decision makers in other fields. This finding places constraints on and suggests useful approaches for improving practice. PMID:15798041

MAGDM linear-programming models with distinct uncertain preference structures.

PubMed

Xu, Zeshui S; Chen, Jian

2008-10-01

Group decision making with preference information on alternatives is an interesting and important research topic which has been receiving more and more attention in recent years. The purpose of this paper is to investigate multiple-attribute group decision-making (MAGDM) problems with distinct uncertain preference structures. We develop some linear-programming models for dealing with the MAGDM problems, where the information about attribute weights is incomplete, and the decision makers have their preferences on alternatives. The provided preference information can be represented in the following three distinct uncertain preference structures: 1) interval utility values; 2) interval fuzzy preference relations; and 3) interval multiplicative preference relations. We first establish some linear-programming models based on decision matrix and each of the distinct uncertain preference structures and, then, develop some linear-programming models to integrate all three structures of subjective uncertain preference information provided by the decision makers and the objective information depicted in the decision matrix. Furthermore, we propose a simple and straightforward approach in ranking and selecting the given alternatives. It is worth pointing out that the developed models can also be used to deal with the situations where the three distinct uncertain preference structures are reduced to the traditional ones, i.e., utility values, fuzzy preference relations, and multiplicative preference relations. Finally, we use a practical example to illustrate in detail the calculation process of the developed approach.

Evaluating trade-offs in bull trout reintroduction strategies using structured decision making

USGS Publications Warehouse

Brignon, William R.; Peterson, James T.; Dunham, Jason B.; Schaller, Howard A.; Schreck, Carl B.

2018-01-01

Structured decision making allows reintroduction decisions to be made despite uncertainty by linking reintroduction goals with alternative management actions through predictive models of ecological processes. We developed a decision model to evaluate the trade-offs between six bull trout (Salvelinus confluentus) reintroduction decisions with the goal of maximizing the number of adults in the recipient population without reducing the donor population to an unacceptable level. Sensitivity analyses suggested that the decision identity and outcome were most influenced by survival parameters that result in increased adult abundance in the recipient population, increased juvenile survival in the donor and recipient populations, adult fecundity rates, and sex ratio. The decision was least sensitive to survival parameters associated with the captive-reared population, the effect of naivety on released individuals, and juvenile carrying capacity of the reintroduced population. The model and sensitivity analyses can serve as the foundation for formal adaptive management and improved effectiveness, efficiency, and transparency of bull trout reintroduction decisions.

Big data and high-performance analytics in structural health monitoring for bridge management

NASA Astrophysics Data System (ADS)

Alampalli, Sharada; Alampalli, Sandeep; Ettouney, Mohammed

2016-04-01

Structural Health Monitoring (SHM) can be a vital tool for effective bridge management. Combining large data sets from multiple sources to create a data-driven decision-making framework is crucial for the success of SHM. This paper presents a big data analytics framework that combines multiple data sets correlated with functional relatedness to convert data into actionable information that empowers risk-based decision-making. The integrated data environment incorporates near real-time streams of semi-structured data from remote sensors, historical visual inspection data, and observations from structural analysis models to monitor, assess, and manage risks associated with the aging bridge inventories. Accelerated processing of dataset is made possible by four technologies: cloud computing, relational database processing, support from NOSQL database, and in-memory analytics. The framework is being validated on a railroad corridor that can be subjected to multiple hazards. The framework enables to compute reliability indices for critical bridge components and individual bridge spans. In addition, framework includes a risk-based decision-making process that enumerate costs and consequences of poor bridge performance at span- and network-levels when rail networks are exposed to natural hazard events such as floods and earthquakes. Big data and high-performance analytics enable insights to assist bridge owners to address problems faster.

Representation of economic preferences in the structure and function of the amygdala and prefrontal cortex

PubMed Central

Fermin, Alan S. R.; Sakagami, Masamichi; Kiyonari, Toko; Li, Yang; Matsumoto, Yoshie; Yamagishi, Toshio

2016-01-01

Social value orientations (SVOs) are economic preferences for the distribution of resources – prosocial individuals are more cooperative and egalitarian than are proselfs. Despite the social and economic implications of SVOs, no systematic studies have examined their neural correlates. We investigated the amygdala and dorsolateral prefrontal cortex (DLPFC) structures and functions in prosocials and proselfs by functional magnetic resonance imaging and evaluated cooperative behavior in the Prisoner’s Dilemma game. We found for the first time that amygdala volume was larger in prosocials and positively correlated with cooperation, while DLPFC volume was larger in proselfs and negatively correlated with cooperation. Proselfs’ decisions were marked by strong DLPFC and weak amygdala activity, and prosocials’ decisions were marked by strong amygdala activity, with the DLPFC signal increasing only in defection. Our findings suggest that proselfs’ decisions are controlled by DLPFC-mediated deliberative processes, while prosocials’ decisions are initially guided by automatic amygdala processes. PMID:26876988

A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services.

PubMed

MacDonald-Wilson, Kim L; Hutchison, Shari L; Karpov, Irina; Wittman, Paul; Deegan, Patricia E

2017-04-01

Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.

Structured decision making as a proactive approach to dealing with sea level rise in Florida

USGS Publications Warehouse

Martin, Julien; Fackler, Paul L.; Nichols, James D.; Lubow, Bruce C.; Eaton, Mitchell J.; Runge, Michael C.; Stith, Bradley M.; Langtimm, Catherine A.

2011-01-01

Sea level rise (SLR) projections along the coast of Florida present an enormous challenge for management and conservation over the long term. Decision makers need to recognize and adopt strategies to adapt to the potentially detrimental effects of SLR. Structured decision making (SDM) provides a rigorous framework for the management of natural resources. The aim of SDM is to identify decisions that are optimal with respect to management objectives and knowledge of the system. Most applications of SDM have assumed that the managed systems are governed by stationary processes. However, in the context of SLR it may be necessary to acknowledge that the processes underlying managed systems may be non-stationary, such that systems will be continuously changing. Therefore, SLR brings some unique considerations to the application of decision theory for natural resource management. In particular, SLR is expected to affect each of the components of SDM. For instance, management objectives may have to be reconsidered more frequently than under more stable conditions. The set of potential actions may also have to be adapted over time as conditions change. Models have to account for the non-stationarity of the modeled system processes. Each of the important sources of uncertainty in decision processes is expected to be exacerbated by SLR. We illustrate our ideas about adaptation of natural resource management to SLR by modeling a non-stationary system using a numerical example. We provide additional examples of an SDM approach for managing species that may be affected by SLR, with a focus on the endangered Florida manatee.

Toward Optimal Decision Making among Vulnerable Patients Referred for Cardiac Surgery: A Qualitative Analysis of Patient and Provider Perspectives.

PubMed

Gainer, Ryan A; Curran, Janet; Buth, Karen J; David, Jennie G; Légaré, Jean-Francois; Hirsch, Gregory M

2017-07-01

Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population. Focus groups were held with both providers and former patients. Three focus groups were convened for Coronary Artery Bypass Graft (CABG), Valve, or CABG +Valve patients ≥ 70 y old (2-y post-op, ≤ 8-wk post-op, complicated post-op course) (n = 15). Three focus groups were convened for Intermediate Medical Care Unit (IMCU) nurses, Intensive Care Unit (ICU) nurses, surgeons, anesthesiologists and cardiac intensivists (n = 20). We used a semi-structured interview format to ask questions surrounding the informed consent process. Transcribed audio data was analyzed to develop consistent and comprehensive themes. We identified 5 main themes that influence the decision making process: educational barriers, educational facilitators, patient autonomy and perceived autonomy, patient and family expectations of care, and decision making advocates. All themes were influenced by time constraints experienced in the current consent process. Patient groups expressed a desire to receive information earlier in their care to allow time to identify personal values and preferences in developing plans for treatment. Both groups strongly supported a formal approach for shared decision making with a decisional coach to provide information and facilitate communication with the care team. Identifying the barriers and facilitators to patient and caretaker engagement in decision making is a key step in the development of a structured, patient-centered SDM approach. Intervention early in the decision process, the use of individualized decision aids that employ graphic risk presentations, and a dedicated decisional coach were identified by patients and providers as approaches with a high potential for success. The impact of such a formalized shared decision making process in cardiac surgery on decisional quality will need to be formally assessed. Given the trend toward older and frail patients referred for complex cardiac procedures, the need for an effective shared decision making process is compelling.

Inside the black box of shared decision making: distinguishing between the process of involvement and who makes the decision

PubMed Central

Edwards, Adrian; Elwyn, Glyn

2006-01-01

Abstract Background  Shared decision making has practical implications for everyday health care. However, it stems from largely theoretical frameworks and is not widely implemented in routine practice. Aims  We undertook an empirical study to inform understanding of shared decision making and how it can be operationalized more widely. Method  The study involved patients visiting UK general practitioners already well experienced in shared decision making. After these consultations, semi‐structured telephone interviews were conducted and analysed using the constant comparative method of content analysis. Results  All patients described at least some components of shared decision making but half appeared to perceive the decision as shared and half as ‘patient‐led’. However, patients exhibited some uncertainty about who had made the decision, reflecting different meanings of decision making from those described in the literature. A distinction is indicated between the process of involvement (option portrayal, exchange of information and exploring preferences for who makes the decision) and the actual decisional responsibility (who makes the decision). The process of involvement appeared to deliver benefits for patients, not the action of making the decision. Preferences for decisional responsibility varied during some consultations, generating unsatisfactory interactions when actual decisional responsibility did not align with patient preferences at that stage of a consultation. However, when conducted well, shared decision making enhanced reported satisfaction, understanding and confidence in the decisions. Conclusions  Practitioners can focus more on the process of involving patients in decision making rather than attaching importance to who actually makes the decision. They also need to be aware of the potential for changing patient preferences for decisional responsibility during a consultation and address non‐alignment of patient preferences with the actual model of decision making if this occurs. PMID:17083558

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

PubMed

Mühlbacher, Axel C; Kaczynski, Anika

2016-02-01

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

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2018-12-01

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

Technology Infusion Challenges from a Decision Support Perspective

NASA Technical Reports Server (NTRS)

Adumitroaie, V.; Weisbin, C. R.

2009-01-01

In a restricted science budget environment and increasingly numerous required technology developments, the technology investment decisions within NASA are objectively more and more difficult to make such that the end results are satisfying the technical objectives and all the organizational constraints. Under these conditions it is rationally desirable to build an investment portfolio, which has the highest possible technology infusion rate. Arguably the path to infusion is subject to many influencing factors, but here only the challenges associated with the very initial stages are addressed: defining the needs and the subsequent investment decision-support process. It is conceivable that decision consistency and possibly its quality suffer when the decision-making process has limited or no traceability. This paper presents a structured decision-support framework aiming to provide traceable, auditable, infusion- driven recommendations towards a selection process in which these recommendations are used as reference points in further discussions among stakeholders. In this framework addressing well-defined requirements, different measures of success can be defined based on traceability to specific selection criteria. As a direct result, even by using simplified decision models the likelihood of infusion can be probed and consequently improved.

Resolving structural uncertainty in natural resources management using POMDP approaches

USGS Publications Warehouse

Williams, B.K.

2011-01-01

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

Recent advances in applying decision science to managing national forests

USGS Publications Warehouse

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

2012-01-01

Management of federal public forests to meet sustainability goals and multiple use regulations is an immense challenge. To succeed, we suggest use of formal decision science procedures and tools in the context of structured decision making (SDM). SDM entails four stages: problem structuring (framing the problem and defining objectives and evaluation criteria), problem analysis (defining alternatives, evaluating likely consequences, identifying key uncertainties, and analyzing tradeoffs), decision point (identifying the preferred alternative), and implementation and monitoring the preferred alternative with adaptive management feedbacks. We list a wide array of models, techniques, and tools available for each stage, and provide three case studies of their selected use in National Forest land management and project plans. Successful use of SDM involves participation by decision-makers, analysts, scientists, and stakeholders. We suggest specific areas for training and instituting SDM to foster transparency, rigor, clarity, and inclusiveness in formal decision processes regarding management of national forests.

Stochastic model for fatigue crack size and cost effective design decisions. [for aerospace structures

NASA Technical Reports Server (NTRS)

Hanagud, S.; Uppaluri, B.

1975-01-01

This paper describes a methodology for making cost effective fatigue design decisions. The methodology is based on a probabilistic model for the stochastic process of fatigue crack growth with time. The development of a particular model for the stochastic process is also discussed in the paper. The model is based on the assumption of continuous time and discrete space of crack lengths. Statistical decision theory and the developed probabilistic model are used to develop the procedure for making fatigue design decisions on the basis of minimum expected cost or risk function and reliability bounds. Selections of initial flaw size distribution, NDT, repair threshold crack lengths, and inspection intervals are discussed.

The Faculty Role in Governance: A Historical Analysis of the Influence of The American Association of University Professors and the Middle States Association on Academic Decision Making. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Collins, Valerie Hawkes

This study examined changes in private college governance during the years 1960-90, and at how external forces affected decision making structures and processes and at faculty's powers. The theoretical construct for the study was largely based on H. Mintzberg's (1983) concepts of organizational structure and power. Historical and case study…

Hirarchical emotion calculation model for virtual human modellin - biomed 2010.

PubMed

Zhao, Yue; Wright, David

2010-01-01

This paper introduces a new emotion generation method for virtual human modelling. The method includes a novel hierarchical emotion structure, a group of emotion calculation equations and a simple heuristics decision making mechanism, which enables virtual humans to perform emotionally in real-time according to their internal and external factors. Emotion calculation equations used in this research were derived from psychologic emotion measurements. Virtual humans can utilise the information in virtual memory and emotion calculation equations to generate their own numerical emotion states within the hierarchical emotion structure. Those emotion states are important internal references for virtual humans to adopt appropriate behaviours and also key cues for their decision making. A simple heuristics theory is introduced and integrated into decision making process in order to make the virtual humans decision making more like a real human. A data interface which connects the emotion calculation and the decision making structure together has also been designed and simulated to test the method in Virtools environment.

Morphological Processing of Chinese Compounds from a Grammatical View

ERIC Educational Resources Information Center

Liu, Phil D.; McBride-Chang, Catherine

2010-01-01

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

Thinking strategies used by Registered Nurses during emergency department triage.

PubMed

Göransson, Katarina E; Ehnfors, Margareta; Fonteyn, Marsha E; Ehrenberg, Anna

2008-01-01

This paper is a report of a study to describe and compare thinking strategies and cognitive processing in the emergency department triage process by Registered Nurses with high and low triage accuracy. Sound clinical reasoning and accurate decision-making are integral parts of modern nursing practice and are of vital importance during triage in emergency departments. Although studies have shown that individual and contextual factors influence the decisions of Registered Nurses in the triage process, others have failed to explain the relationship between triage accuracy and clinical experience. Furthermore, no study has shown the relationship between Registered Nurses' thinking strategies and their triage accuracy. Using the 'think aloud' method, data were collected in 2004-2005 from 16 RNs working in Swedish emergency departments who had previously participated in a study examining triage accuracy. Content analysis of the data was performed. The Registered Nurses used a variety of thinking strategies, ranging from searching for information, generating hypotheses to stating propositions. They structured the triage process in several ways, beginning by gathering data, generating hypotheses or allocating acuity ratings. Comparison of participants' use of thinking strategies and the structure of the triage process based on their previous triage accuracy revealed only slight differences. The wide range of thinking strategies used by Registered Nurses when performing triage indicates that triage decision-making is complex. Further research is needed to ascertain which skills are most important in triage decision-making.

Wishful Thinking? Inside the Black Box of Exposure Assessment.

PubMed

Money, Annemarie; Robinson, Christine; Agius, Raymond; de Vocht, Frank

2016-05-01

Decision-making processes used by experts when undertaking occupational exposure assessment are relatively unknown, but it is often assumed that there is a common underlying method that experts employ. However, differences in training and experience of assessors make it unlikely that one general method for expert assessment would exist. Therefore, there are concerns about formalizing, validating, and comparing expert estimates within and between studies that are difficult, if not impossible, to characterize. Heuristics on the other hand (the processes involved in decision making) have been extensively studied. Heuristics are deployed by everyone as short-cuts to make the often complex process of decision-making simpler, quicker, and less burdensome. Experts' assessments are often subject to various simplifying heuristics as a way to reach a decision in the absence of sufficient data. Therefore, investigating the underlying heuristics or decision-making processes involved may help to shed light on the 'black box' of exposure assessment. A mixed method study was conducted utilizing both a web-based exposure assessment exercise incorporating quantitative and semiqualitative elements of data collection, and qualitative semi-structured interviews with exposure assessors. Qualitative data were analyzed using thematic analysis. Twenty-five experts completed the web-based exposure assessment exercise and 8 of these 25 were randomly selected to participate in the follow-up interview. Familiar key themes relating to the exposure assessment exercise emerged; 'intensity'; 'probability'; 'agent'; 'process'; and 'duration' of exposure. However, an important aspect of the detailed follow-up interviews revealed a lack of structure and order with which participants described their decision making. Participants mostly described some form of an iterative process, heavily relying on the anchoring and adjustment heuristic, which differed between experts. In spite of having undertaken comparable training (in occupational hygiene or exposure assessment), experts use different methods to assess exposure. Decision making appears to be an iterative process with heavy reliance on the key heuristic of anchoring and adjustment. Using multiple experts to assess exposure while providing some form of anchoring scenario to build from, and additional training in understanding the impact of simple heuristics on the process of decision making, is likely to produce a more methodical approach to assessment; thereby improving consistency and transparency in expert exposure assessment. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Experienced General Music Teachers' Instructional Decision Making

ERIC Educational Resources Information Center

Johnson, Daniel C.; Matthews, Wendy K.

2017-01-01

The purpose of this descriptive study was to explore experienced general music teachers' decision-making processes. Participants included seven experienced, American general music teachers who contributed their views during two phases of data collection: (1) responses to three classroom scenarios; and (2) in-depth, semi-structured, follow-up…

DATA QUALITY OBJECTIVE SUMMARY REPORT FOR THE 105 K EAST ION EXCHANGE COLUMN MONOLITH

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

JOCHEN, R.M.

2007-08-02

The 105-K East (KE) Basin Ion Exchange Column (IXC) cells, lead caves, and the surrounding vault are to be removed as necessary components in implementing ''Hanford Federal Facility Agreement and Consent Order'' (Ecology et al. 2003) milestone M-034-32 (Complete Removal of the K East Basin Structure). The IXCs consist of six units located in the KE Basin, three in operating positions in cells and three stored in a lead cave. Methods to remove the IXCs from the KE Basin were evaluated in KBC-28343, ''Disposal of K East Basin Ion Exchange Column Evaluation''. The method selected for removal was grouting themore » six IXCs into a single monolith for disposal at the Environmental Restoration Disposal Facility (ERDF). Grout will be added to the IXC cells, IXC lead caves containing spent IXCs, and in the spaces between the lead cave walls and metal skin, to immobilize the contaminants, provide self-shielding, minimize void space, and provide a structurally stable waste form. The waste to be offered for disposal is the encapsulated monolith defined by the exterior surfaces of the vault and the lower surface of the underlying slab. This document presents summary of the data quality objective (DQO) process establishing the decisions and data required to support decision-making activities for the disposition of the IXC monolith. The DQO process is completed in accordance with the seven-step planning process described in EPA QA/G-4, ''Guidance for the Data Quality Objectives Process'', which is used to clarify and study objectives; define the appropriate type, quantity, and quality of data; and support defensible decision-making. The DQO process involves the following steps: (1) state the problem; (2) identify the decision; (3) identify the inputs to the decision; (4) define the boundaries of the study; (5) develop a decision rule (DR); (6) specify tolerable limits on decision errors; and (7) optimize the design for obtaining data.« less

Adaptive harvest management of North American waterfowl populations - recent successes and future prospects

USGS Publications Warehouse

Nichols, J.D.; Runge, M.C.; Johnson, F.A.; Williams, B.K.; Schodde, Richard; Hannon, Susan; Scheiffarth, Gregor; Bairlein, Franz

2006-01-01

The history of North American waterfowl harvest management has been characterized by attempts to use population monitoring data to make informed harvest management decisions. Early attempts can be characterized as intuitive decision processes, and later efforts were guided increasingly by population models and associated predictions. In 1995, a formal adaptive management process was implemented, and annual decisions about duck harvest regulations in the United States are still based on this process. This formal decision process is designed to deal appropriately with the various forms of uncertainty that characterize management decisions, environmental uncertainty, structural uncertainty, partial controllability and partial observability. The key components of the process are (1) objectives, (2) potential management actions, (3) model(s) of population response to management actions, (4) credibility measures for these models, and (5) a monitoring program. The operation of this iterative process is described, and a brief history of a decade of its use is presented. Future challenges range from social and political issues such as appropriate objectives and management actions, to technical issues such as multispecies management, geographic allocation of harvest, and incorporation of actions that include habitat acquisition and management.

Option generation in decision making: ideation beyond memory retrieval

PubMed Central

Del Missier, Fabio; Visentini, Mimì; Mäntylä, Timo

2015-01-01

According to prescriptive decision theories, the generation of options for choice is a central aspect of decision making. A too narrow representation of the problem may indeed limit the opportunity to evaluate promising options. However, despite the theoretical and applied significance of this topic, the cognitive processes underlying option generation are still unclear. In particular, while a cued recall account of option generation emphasizes the role of memory and executive control, other theoretical proposals stress the importance of ideation processes based on various search and thinking processes. Unfortunately, relevant behavioral evidence on the cognitive processes underlying option generation is scattered and inconclusive. In order to reach a better understanding, we carried out an individual-differences study employing a wide array of cognitive predictors, including measures of episodic memory, semantic memory, cognitive control, and ideation fluency. The criterion tasks consisted of three different poorly-structured decision-making scenarios, and the participants were asked to generate options to solve these problems. The main criterion variable of the study was the number of valid options generated, but also the diversity and the quality of generated options were examined. The results showed that option generation fluency and diversity in the context of ill-structured decision making are supported by ideation ability even after taking into account the effects of individual differences in several other aspects of cognitive functioning. Thus, ideation processes, possibly supported by search and thinking processes, seem to contribute to option generation beyond basic associative memory retrieval. The findings of the study also indicate that generating more options may have multifaceted consequences for choice, increasing the quality of the best option generated but decreasing the mean quality of the options in the generated set. PMID:25657628

Option generation in decision making: ideation beyond memory retrieval.

PubMed

Del Missier, Fabio; Visentini, Mimì; Mäntylä, Timo

2014-01-01

According to prescriptive decision theories, the generation of options for choice is a central aspect of decision making. A too narrow representation of the problem may indeed limit the opportunity to evaluate promising options. However, despite the theoretical and applied significance of this topic, the cognitive processes underlying option generation are still unclear. In particular, while a cued recall account of option generation emphasizes the role of memory and executive control, other theoretical proposals stress the importance of ideation processes based on various search and thinking processes. Unfortunately, relevant behavioral evidence on the cognitive processes underlying option generation is scattered and inconclusive. In order to reach a better understanding, we carried out an individual-differences study employing a wide array of cognitive predictors, including measures of episodic memory, semantic memory, cognitive control, and ideation fluency. The criterion tasks consisted of three different poorly-structured decision-making scenarios, and the participants were asked to generate options to solve these problems. The main criterion variable of the study was the number of valid options generated, but also the diversity and the quality of generated options were examined. The results showed that option generation fluency and diversity in the context of ill-structured decision making are supported by ideation ability even after taking into account the effects of individual differences in several other aspects of cognitive functioning. Thus, ideation processes, possibly supported by search and thinking processes, seem to contribute to option generation beyond basic associative memory retrieval. The findings of the study also indicate that generating more options may have multifaceted consequences for choice, increasing the quality of the best option generated but decreasing the mean quality of the options in the generated set.

Integrated model for assessing the cost and CO2 emission (IMACC) for sustainable structural design in ready-mix concrete.

PubMed

Hong, Taehoon; Ji, Changyoon; Park, Hyoseon

2012-07-30

Cost has traditionally been considered the most important factor in the decision-making process. Recently, along with the consistent interest in environmental problems, environmental impact has also become a key factor. Accordingly, there is a need to develop a method that simultaneously reflects the cost and environmental impact in the decision-making process. This study proposed an integrated model for assessing the cost and CO(2) emission (IMACC) at the same time. IMACC is a model that assesses the cost and CO(2) emission of the various structural-design alternatives proposed in the structural-design process. To develop the IMACC, a standard on assessing the cost and CO(2) emission generated in the construction stage was proposed, along with the CO(2) emission factors in the structural materials, based on such materials' strengths. Moreover, using the economic and environmental scores that signify the cost and CO(2) emission reduction ratios, respectively, a method of selecting the best design alternative was proposed. To verify the applicability of IMACC, practical application was carried out. Structural designs were assessed, each of which used 21, 24, 27, and 30 MPa ready-mix concrete (RMC). The use of IMACC makes it easy to verify what the best design is. Results show the one that used 27 MPa RMC was the best design. Therefore, the proposed IMACC can be used as a tool for supporting the decision-making process in selecting the best design alternative. Copyright © 2012 Elsevier Ltd. All rights reserved.

Decision Accuracy in Computer-Mediated versus Face-to-Face Decision-Making Teams.

PubMed

Hedlund; Ilgen; Hollenbeck

1998-10-01

Changes in the way organizations are structured and advances in communication technologies are two factors that have altered the conditions under which group decisions are made. Decisions are increasingly made by teams that have a hierarchical structure and whose members have different areas of expertise. In addition, many decisions are no longer made via strictly face-to-face interaction. The present study examines the effects of two modes of communication (face-to-face or computer-mediated) on the accuracy of teams' decisions. The teams are characterized by a hierarchical structure and their members differ in expertise consistent with the framework outlined in the Multilevel Theory of team decision making presented by Hollenbeck, Ilgen, Sego, Hedlund, Major, and Phillips (1995). Sixty-four four-person teams worked for 3 h on a computer simulation interacting either face-to-face (FtF) or over a computer network. The communication mode had mixed effects on team processes in that members of FtF teams were better informed and made recommendations that were more predictive of the correct team decision, but leaders of CM teams were better able to differentiate staff members on the quality of their decisions. Controlling for the negative impact of FtF communication on staff member differentiation increased the beneficial effect of the FtF mode on overall decision making accuracy. Copyright 1998 Academic Press.

Improving conservation of Florida manatees (Trichechus manatus latirostris): conceptualization and contributions toward a regional warm-water network management strategy for sustainable winter habitat.

PubMed

Flamm, Richard Owen; Reynolds, John Elliot; Harmak, Craig

2013-01-01

We used southwestern Florida as a case study to lay the groundwork for an intended and organized decision-making process for managing warm-water habitat needed by endangered manatees to survive winters in Florida. Scientists and managers have prioritized (a) projecting how the network of warm-water sites will change over the next 50 years as warmed industrial discharges may expire and as flows of natural springs are reduced through redirection of water for human uses, and (b) mitigating such changes to prevent undue consequences to manatees. Given the complexities introduced by manatee ecology; agency organizational structure; shifting public demands; fluctuating resource availability; and managing within interacting cultural, social, political, and environmental contexts, it was clear that a structured decision process was needed. To help promote such a process, we collected information relevant to future decisions including maps of known and suspected warm-water sites and prototyped a characterization of sites and networks. We propose steps that would lead to models that might serve as core tools in manatee/warm-water decision-making, and we summarized topics relevant for informed decision-making (e.g., manatee spatial cognition, risk of cold-stress morbidity and mortality, and human dimensions). A major impetus behind this effort is to ensure proactively that robust modeling tools are available well in advance of the anticipated need for a critical management decision.

Improving Conservation of Florida Manatees ( Trichechus manatus latirostris): Conceptualization and Contributions Toward a Regional Warm-Water Network Management Strategy for Sustainable Winter Habitat

NASA Astrophysics Data System (ADS)

Flamm, Richard Owen; Reynolds, John Elliot; Harmak, Craig

2013-01-01

We used southwestern Florida as a case study to lay the groundwork for an intended and organized decision-making process for managing warm-water habitat needed by endangered manatees to survive winters in Florida. Scientists and managers have prioritized (a) projecting how the network of warm-water sites will change over the next 50 years as warmed industrial discharges may expire and as flows of natural springs are reduced through redirection of water for human uses, and (b) mitigating such changes to prevent undue consequences to manatees. Given the complexities introduced by manatee ecology; agency organizational structure; shifting public demands; fluctuating resource availability; and managing within interacting cultural, social, political, and environmental contexts, it was clear that a structured decision process was needed. To help promote such a process, we collected information relevant to future decisions including maps of known and suspected warm-water sites and prototyped a characterization of sites and networks. We propose steps that would lead to models that might serve as core tools in manatee/warm-water decision-making, and we summarized topics relevant for informed decision-making (e.g., manatee spatial cognition, risk of cold-stress morbidity and mortality, and human dimensions). A major impetus behind this effort is to ensure proactively that robust modeling tools are available well in advance of the anticipated need for a critical management decision.

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

PubMed

Tjerbo, Trond

2009-11-20

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

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

PubMed Central

2009-01-01

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

A Structured Decision Approach for Integrating and Analyzing Community Perspectives in Re-Use Planning of Vacant Properties in Cleveland, Ohio

EPA Science Inventory

An integrated GIS-based, multi-attribute decision model deployed in a web-based platform is presented enabling an iterative, spatially explicit and collaborative analysis of relevant and available information for repurposing vacant land. The process incorporated traditional and ...

Exploring Effective Academic Governance at a Canadian University

ERIC Educational Resources Information Center

Lougheed, Patrick; Pidgeon, Michelle

2016-01-01

In Canada, only 44% of members of academic governance bodies at universities feel that their boards are effective decision-making bodies (Jones, Shanahan, & Goyan, 2004). In this study, we examined the views of senators at a British Columbia university regarding their senate's effectiveness in decision-making, including structures, processes,…

IT Strategy and Decision-Making: A Comparison of Four Universities

ERIC Educational Resources Information Center

Wilmore, Andrew

2014-01-01

Universities are increasingly dependent on information technology (IT) to support delivery of their objectives. It is crucial, therefore, that the IT investments made lead to successful outcomes. This study analyses the governance structures and decision-making processes used to approve and prioritise IT projects. Factors influencing an…

Reflections on New Configurations in Campus Governance.

ERIC Educational Resources Information Center

Wise, W. Max

Changes in college government generally incorporate the following features: (1) they provide structural means for the expression of opinion, (often the right to vote) to representatives of groups hitherto underrepresented or unrepresented on decision-making bodies; (2) they are intended to make the decision-making process more explicit, and more…

Planning effectiveness may grow on fault trees.

PubMed

Chow, C W; Haddad, K; Mannino, B

1991-10-01

The first step of a strategic planning process--identifying and analyzing threats and opportunities--requires subjective judgments. By using an analytical tool known as a fault tree, healthcare administrators can reduce the unreliability of subjective decision making by creating a logical structure for problem solving and decision making. A case study of 11 healthcare administrators showed that an analysis technique called prospective hindsight can add to a fault tree's ability to improve a strategic planning process.

Utilization of multiple-criteria decision analysis (MCDA) to support healthcare decision-making FIFARMA, 2016

PubMed Central

Drake, Julia I.; de Hart, Juan Carlos Trujillo; Monleón, Clara; Toro, Walter; Valentim, Joice

2017-01-01

ABSTRACT Background and objectives:   MCDA is a decision-making tool with increasing use in the healthcare sector, including HTA (Health Technology Assessment). By applying multiple criteria, including innovation, in a comprehensive, structured and explicit manner, MCDA fosters a transparent, participative, consistent decision-making process taking into consideration values of all stakeholders. This paper by FIFARMA (Latin American Federation of Pharmaceutical Industry) proposes the deliberative (partial) MCDA as a more pragmatic, agile approach, especially when newly implemented. Methods: Literature review including real-world examples of effective MCDA implementation in healthcare decision making in both the public and private sector worldwide and in LA. Results and conclusion: It is the view of FIFARMA that MCDA should strongly be considered as a tool to support HTA and broader healthcare decision making such as the contracts and tenders process in order to foster transparency, fairness, and collaboration amongst stakeholders. PMID:29081919

[A model for shared decision-making with frail older patients: consensus reached using Delphi technique].

PubMed

van de Pol, M H J; Fluit, C R M G; Lagro, J; Lagro-Janssen, A L M; Olde Rikkert, M G M

2017-01-01

To develop a model for shared decision-making with frail older patients. Online Delphi forum. We used a three-round Delphi technique to reach consensus on the structure of a model for shared decision-making with older patients. The expert panel consisted of 16 patients (round 1), and 59 professionals (rounds 1-3). In round 1, the panel of experts was asked about important steps in the process of shared decision-making and the draft model was introduced. Rounds 2 and 3 were used to adapt the model and test it for 'importance' and 'feasibility'. Consensus for the dynamic shared decision-making model as a whole was achieved for both importance (91% panel agreement) and feasibility (76% panel agreement). Shared decision-making with older patients is a dynamic process. It requires a continuous supportive dialogue between health care professional and patient.

A qualitative study of nulliparous women's decision making on mode of delivery under China's two-child policy.

PubMed

Gu, Chunyi; Zhu, Xinli; Ding, Yan; Setterberg Simone; Wang, Xiaojiao; Tao, Hua; Zhang, Yu

2018-07-01

To explore nulliparous women's perceptions of decision making regarding mode of delivery under China's two-child policy. Qualitative descriptive design with in-depth semi-structured interviews. Postnatal wards at a tertiary specialized women's hospital in Shanghai, China. 21 nulliparous women 2-3 days postpartum were purposively sampled until data saturation. In-depth semi-structured interviews were conducted between October 8th, 2015 and January 31st, 2016. Two overarching descriptive categories were identified: (1) women's decision-making process: stability versus variability, and (2) factors affecting decision making: variety versus interactivity. Four key themes emerged from each category: (1) initial decision making with certainty: anticipated trial of labour, failed trial of labour, 'shy away' and compromise, anticipated caesarean delivery; (2) initial decision making with uncertainty: anticipated trial of labour, failed trial of labour, 'shy away' and compromise; (3) internal factors affecting decision making: knowledge and attitude, and childbirth self-efficacy; and (4) external factors affecting decision making: social support, and the situational environment. At the initial period of China's two-child policy, nulliparous women have perceived their decision-making process regarding mode of delivery as one with complexity and uncertainty, influenced by both internal and external factors. This may have implications for the obstetric setting to develop a well-designed decision support system for pregnant women during the entire pregnancy periods. And it is recommended that care providers should assess women's preferences for mode of delivery from early pregnancy and provide adequate perinatal support and continuity of care for them. Copyright © 2018 Elsevier Ltd. All rights reserved.

Surgical Consultation as Social Process: Implications for Shared Decision Making.

PubMed

Clapp, Justin T; Arriaga, Alexander F; Murthy, Sushila; Raper, Steven E; Schwartz, J Sanford; Barg, Frances K; Fleisher, Lee A

2017-12-12

This qualitative study examines surgical consultation as a social process and assesses its alignment with assumptions of the shared decision-making (SDM) model. SDM stresses the importance of patient preferences and rigorous discussion of therapeutic risks/benefits based on these preferences. However, empirical studies have highlighted discrepancies between SDM and realities of surgical decision making. Qualitative research can inform understanding of the decision-making process and allow for granular assessment of the nature and causes of these discrepancies. We observed consultations between 3 general surgeons and 45 patients considering undergoing 1 of 2 preference-sensitive elective operations: (1) hernia repair, or (2) cholecystectomy. These patients and surgeons also participated in semi-structured interviews. By the time of the consultation, patients and surgeons were predisposed toward certain decisions by preceding events occurring elsewhere. During the visit, surgeons had differential ability to arbitrate surgical intervention and construct the severity of patients' conditions. These upstream dynamics frequently displaced the centrality of the risk/benefit-based consent discussion. The influence of events preceding consultation suggests that decision-making models should account for broader spatiotemporal spans. Given surgeons' authority to define patients' conditions and control service provision, SDM may be premised on an overestimation of patients' power to alter the course of decision making once in a specialist's office. Considering the subordinate role of the risk/benefit discussion in many surgical decisions, it will be important to study if and how the social process of decision making is altered by SDM-oriented decision aids that foreground this discussion.

Quantum stochastic walks on networks for decision-making.

PubMed

Martínez-Martínez, Ismael; Sánchez-Burillo, Eduardo

2016-03-31

Recent experiments report violations of the classical law of total probability and incompatibility of certain mental representations when humans process and react to information. Evidence shows promise of a more general quantum theory providing a better explanation of the dynamics and structure of real decision-making processes than classical probability theory. Inspired by this, we show how the behavioral choice-probabilities can arise as the unique stationary distribution of quantum stochastic walkers on the classical network defined from Luce's response probabilities. This work is relevant because (i) we provide a very general framework integrating the positive characteristics of both quantum and classical approaches previously in confrontation, and (ii) we define a cognitive network which can be used to bring other connectivist approaches to decision-making into the quantum stochastic realm. We model the decision-maker as an open system in contact with her surrounding environment, and the time-length of the decision-making process reveals to be also a measure of the process' degree of interplay between the unitary and irreversible dynamics. Implementing quantum coherence on classical networks may be a door to better integrate human-like reasoning biases in stochastic models for decision-making.

The enactment stage of end-of-life decision-making for children.

PubMed

Sullivan, Jane Elizabeth; Gillam, Lynn Heather; Monagle, Paul Terence

2018-01-11

Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process. A qualitative methodology was used. Semi-structured interviews were conducted with bereaved parents, who had discussed end-of-life decisions for their child who had a life-limiting condition and who had died. Data were thematically analysed. Twenty-five bereaved parents participated. Findings indicate that, despite differences in context, including the child's condition and age, end-of-life decision-making did not end when an end-of-life decision was made. Enacting the decision was the next stage in a process. Time intervals between stages and enactment pathways varied, but the enactment was always distinguishable as a separate stage. Decision enactment involved making further decisions - parents needed to discern the appropriate time to implement their decision to withdraw or withhold life-sustaining medical treatment. Unexpected events, including other people's actions, impacted on parents enacting their decision in the way they had planned. Several parents had to re-implement decisions when their child recovered from serious health issues without medical intervention. Significance of results A novel, critical finding was that parents experienced end-of-life decision-making as a sequence of interconnected stages, the final stage being enactment. The enactment stage involved further decision-making. End-of-life decision-making is better understood as a process rather than a discrete once-off event. The enactment stage has particular emotional and practical implications for parents. Greater understanding of this stage can improve clinician's support for parents as they care for their child.

Wishful Thinking? Inside the Black Box of Exposure Assessment

PubMed Central

Money, Annemarie; Robinson, Christine; Agius, Raymond; de Vocht, Frank

2016-01-01

Background: Decision-making processes used by experts when undertaking occupational exposure assessment are relatively unknown, but it is often assumed that there is a common underlying method that experts employ. However, differences in training and experience of assessors make it unlikely that one general method for expert assessment would exist. Therefore, there are concerns about formalizing, validating, and comparing expert estimates within and between studies that are difficult, if not impossible, to characterize. Heuristics on the other hand (the processes involved in decision making) have been extensively studied. Heuristics are deployed by everyone as short-cuts to make the often complex process of decision-making simpler, quicker, and less burdensome. Experts’ assessments are often subject to various simplifying heuristics as a way to reach a decision in the absence of sufficient data. Therefore, investigating the underlying heuristics or decision-making processes involved may help to shed light on the ‘black box’ of exposure assessment. Methods: A mixed method study was conducted utilizing both a web-based exposure assessment exercise incorporating quantitative and semiqualitative elements of data collection, and qualitative semi-structured interviews with exposure assessors. Qualitative data were analyzed using thematic analysis. Results: Twenty-five experts completed the web-based exposure assessment exercise and 8 of these 25 were randomly selected to participate in the follow-up interview. Familiar key themes relating to the exposure assessment exercise emerged; ‘intensity’; ‘probability’; ‘agent’; ‘process’; and ‘duration’ of exposure. However, an important aspect of the detailed follow-up interviews revealed a lack of structure and order with which participants described their decision making. Participants mostly described some form of an iterative process, heavily relying on the anchoring and adjustment heuristic, which differed between experts. Conclusion: In spite of having undertaken comparable training (in occupational hygiene or exposure assessment), experts use different methods to assess exposure. Decision making appears to be an iterative process with heavy reliance on the key heuristic of anchoring and adjustment. Using multiple experts to assess exposure while providing some form of anchoring scenario to build from, and additional training in understanding the impact of simple heuristics on the process of decision making, is likely to produce a more methodical approach to assessment; thereby improving consistency and transparency in expert exposure assessment. PMID:26764244

A systematic approach to embedded biomedical decision making.

PubMed

Song, Zhe; Ji, Zhongkai; Ma, Jian-Guo; Sputh, Bernhard; Acharya, U Rajendra; Faust, Oliver

2012-11-01

An embedded decision making is a key feature for many biomedical systems. In most cases human life directly depends on correct decisions made by these systems, therefore they have to work reliably. This paper describes how we applied systems engineering principles to design a high performance embedded classification system in a systematic and well structured way. We introduce the structured design approach by discussing requirements capturing, specifications refinement, implementation and testing. Thereby, we follow systems engineering principles and execute each of these processes as formal as possible. The requirements, which motivate the system design, describe an automated decision making system for diagnostic support. These requirements are refined into the implementation of a support vector machine (SVM) algorithm which enables us to integrate automated decision making in embedded systems. With a formal model we establish functionality, stability and reliability of the system. Furthermore, we investigated different parallel processing configurations of this computationally complex algorithm. We found that, by adding SVM processes, an almost linear speedup is possible. Once we established these system properties, we translated the formal model into an implementation. The resulting implementation was tested using XMOS processors with both normal and failure cases, to build up trust in the implementation. Finally, we demonstrated that our parallel implementation achieves the speedup, predicted by the formal model. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Problems and Processes in Medical Encounters: The CASES method of dialogue analysis

PubMed Central

Laws, M. Barton; Taubin, Tatiana; Bezreh, Tanya; Lee, Yoojin; Beach, Mary Catherine; Wilson, Ira B.

2013-01-01

Objective To develop methods to reliably capture structural and dynamic temporal features of clinical interactions. Methods Observational study of 50 audio-recorded routine outpatient visits to HIV specialty clinics, using innovative analytic methods. The Comprehensive Analysis of the Structure of Encounters System (CASES) uses transcripts coded for speech acts, then imposes larger-scale structural elements: threads – the problems or issues addressed; and processes within threads –basic tasks of clinical care labeled Presentation, Information, Resolution (decision making) and Engagement (interpersonal exchange). Threads are also coded for the nature of resolution. Results 61% of utterances are in presentation processes. Provider verbal dominance is greatest in information and resolution processes, which also contain a high proportion of provider directives. About half of threads result in no action or decision. Information flows predominantly from patient to provider in presentation processes, and from provider to patient in information processes. Engagement is rare. Conclusions In this data, resolution is provider centered; more time for patient participation in resolution, or interpersonal engagement, would have to come from presentation. Practice Implications Awareness of the use of time in clinical encounters, and the interaction processes associated with various tasks, may help make clinical communication more efficient and effective. PMID:23391684

Problems and processes in medical encounters: the cases method of dialogue analysis.

PubMed

Laws, M Barton; Taubin, Tatiana; Bezreh, Tanya; Lee, Yoojin; Beach, Mary Catherine; Wilson, Ira B

2013-05-01

To develop methods to reliably capture structural and dynamic temporal features of clinical interactions. Observational study of 50 audio-recorded routine outpatient visits to HIV specialty clinics, using innovative analytic methods. The comprehensive analysis of the structure of encounters system (CASES) uses transcripts coded for speech acts, then imposes larger-scale structural elements: threads--the problems or issues addressed; and processes within threads--basic tasks of clinical care labeled presentation, information, resolution (decision making) and Engagement (interpersonal exchange). Threads are also coded for the nature of resolution. 61% of utterances are in presentation processes. Provider verbal dominance is greatest in information and resolution processes, which also contain a high proportion of provider directives. About half of threads result in no action or decision. Information flows predominantly from patient to provider in presentation processes, and from provider to patient in information processes. Engagement is rare. In this data, resolution is provider centered; more time for patient participation in resolution, or interpersonal engagement, would have to come from presentation. Awareness of the use of time in clinical encounters, and the interaction processes associated with various tasks, may help make clinical communication more efficient and effective. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Assessing the utility of the willingness/prototype model in predicting help-seeking decisions.

PubMed

Hammer, Joseph H; Vogel, David L

2013-01-01

Prior research on professional psychological help-seeking behavior has operated on the assumption that the decision to seek help is based on intentional and reasoned processes. However, research on the dual-process prototype/willingness model (PWM; Gerrard, Gibbons, Houlihan, Stock, & Pomery, 2008) suggests health-related decisions may also involve social reaction processes that influence one's spontaneous willingness (rather than planned intention) to seek help, given conducive circumstances. The present study used structural equation modeling to evaluate the ability of these 2 information-processing pathways (i.e., the reasoned pathway and the social reaction pathway) to predict help-seeking decisions among 182 college students currently experiencing clinical levels of psychological distress. Results indicated that when both pathways were modeled simultaneously, only the social reaction pathway independently accounted for significant variance in help-seeking decisions. These findings argue for the utility of the PWM framework in the context of professional psychological help seeking and hold implications for future counseling psychology research, prevention, and practice. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Literature review on the structure and operation of Pharmacy and Therapeutics Committees.

PubMed

Durán-García, Esther; Santos-Ramos, Bernardo; Puigventos-Latorre, Francesc; Ortega, Ana

2011-06-01

To review the literature on the structure and operation of hospital Pharmacy and Therapeutics Committees from an international point of view and examine the factors that influence decision-making of these committees. We performed a literature search in the Medline and Embase databases from 1997 to January 2009 with the search terms: formulary system decision making, pharmacy and therapeutics committee, formularies hospital, drug formulary, survey, drug selection and outcome assessment health care. Inclusion criteria were the following: studies analyzing Pharmacy and Therapeutics Committees published in English or Spanish from 1997 to January 2009. Exclusion criteria were: publications which were editorials or opinion pieces, studies relating to one hospital, and studies where full text could not be attained. The analysis was divided into structural/organizational data and data on factors affecting the decision-making process. Seventeen studies met the inclusion criteria. Pharmacy and Therapeutics Committees and formularies were present in more than 90% of the hospitals in four of the five countries examined. Therapeutic interchange programs existed only in two of these countries. The mean number of committee members ranged between six and eight. More than 89% of the committees included a pharmacist. Standard operating procedures were implemented by 89% of the committees. The most influential factors in the decision-making were clinical trial results or drug costs rather than pharmacoeconomic studies. Other local organization-dependent factors were also important. The structure and operating procedures of Hospital Pharmacy and Therapeutics Committees are similar in select Western countries. Information from clinical trials is the most influential factor in the decision-making process.

How can clinical practice guidelines be adapted to facilitate shared decision making? A qualitative key-informant study.

PubMed

van der Weijden, Trudy; Pieterse, Arwen H; Koelewijn-van Loon, Marije S; Knaapen, Loes; Légaré, France; Boivin, Antoine; Burgers, Jako S; Stiggelbout, Anne M; Faber, Marjan; Elwyn, Glyn

2013-10-01

To explore how clinical practice guidelines can be adapted to facilitate shared decision making. This was a qualitative key-informant study with group discussions and semi-structured interviews. First, 75 experts in guideline development or shared decision making participated in group discussions at two international conferences. Next, health professionals known as experts in depression or breast cancer, experts on clinical practice guidelines and/or shared decision making, and patient representatives were interviewed (N=20). Using illustrative treatment decisions on depression or breast cancer, we asked the interviewees to indicate as specifically as they could how guidelines could be used to facilitate shared decision making. Interviewees suggested some generic strategies, namely to include a separate chapter on the importance of shared decision making, to use language that encourages patient involvement, and to develop patient versions of guidelines. Recommendation-specific strategies, related to specific decision points in the guideline, were also suggested: These include structuring the presentation of healthcare options to increase professionals' option awareness; structuring the deliberation process between professionals and patients; and providing relevant patient support tools embedded at important decision points in the guideline. This study resulted in an overview of strategies to adapt clinical practice guidelines to facilitate shared decision making. Some strategies seemed more contentious than others. Future research should assess the feasibility and impact of these strategies to make clinical practice guidelines more conducive to facilitate shared decision making.

Helping decision makers frame, analyze, and implement decisions

USGS Publications Warehouse

Runge, Michael C.; McDonald-Madden, Eve

2018-01-01

All decisions have the same recognizable elements. Context, objectives, alternatives, consequences, and deliberation. Decision makers and analysts familiar with these elements can quickly see the underlying structure of a decision.There are only a small number of classes of decisions. These classes differ in the cognitive and scientific challenge they present to the decision maker; the ability to recognize the class of decision leads a decision maker to tools to aid in the analysis.Sometimes we need more information, sometimes we don’t. The role of science in a decision-making process is to provide the predictions that link the alternative actions to the desired outcomes. Investing in more science is only valuable if it helps to choose a better action.Implementation. The successful integration of decision analysis into environmental decisions requires careful attention to the decision, the people, and the institutions involved.

Analysis of decision fusion algorithms in handling uncertainties for integrated health monitoring systems

NASA Astrophysics Data System (ADS)

Zein-Sabatto, Saleh; Mikhail, Maged; Bodruzzaman, Mohammad; DeSimio, Martin; Derriso, Mark; Behbahani, Alireza

2012-06-01

It has been widely accepted that data fusion and information fusion methods can improve the accuracy and robustness of decision-making in structural health monitoring systems. It is arguably true nonetheless, that decision-level is equally beneficial when applied to integrated health monitoring systems. Several decisions at low-levels of abstraction may be produced by different decision-makers; however, decision-level fusion is required at the final stage of the process to provide accurate assessment about the health of the monitored system as a whole. An example of such integrated systems with complex decision-making scenarios is the integrated health monitoring of aircraft. Thorough understanding of the characteristics of the decision-fusion methodologies is a crucial step for successful implementation of such decision-fusion systems. In this paper, we have presented the major information fusion methodologies reported in the literature, i.e., probabilistic, evidential, and artificial intelligent based methods. The theoretical basis and characteristics of these methodologies are explained and their performances are analyzed. Second, candidate methods from the above fusion methodologies, i.e., Bayesian, Dempster-Shafer, and fuzzy logic algorithms are selected and their applications are extended to decisions fusion. Finally, fusion algorithms are developed based on the selected fusion methods and their performance are tested on decisions generated from synthetic data and from experimental data. Also in this paper, a modeling methodology, i.e. cloud model, for generating synthetic decisions is presented and used. Using the cloud model, both types of uncertainties; randomness and fuzziness, involved in real decision-making are modeled. Synthetic decisions are generated with an unbiased process and varying interaction complexities among decisions to provide for fair performance comparison of the selected decision-fusion algorithms. For verification purposes, implementation results of the developed fusion algorithms on structural health monitoring data collected from experimental tests are reported in this paper.

Gendered uncertainty and variation in physicians' decisions for coronary heart disease: the double-edged sword of "atypical symptoms".

PubMed

Welch, Lisa C; Lutfey, Karen E; Gerstenberger, Eric; Grace, Matthew

2012-09-01

Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians' interpretations of patient sex-gender affect diagnostic certainty and, in turn, decision making for coronary heart disease. Data are from a factorial experiment of 256 physicians who viewed 1 of 16 video vignettes with different patient-actors presenting the same symptoms of coronary heart disease. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have "atypical symptoms" as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge.

Gendered Uncertainty and Variation in Physicians’ Decisions for Coronary Heart Disease: The Double-Edged Sword of “Atypical Symptoms”*

PubMed Central

Welch, Lisa C.; Lutfey, Karen E.; Gerstenberger, Eric; Grace, Matthew

2013-01-01

Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians’ interpretations of patient sex/gender affect diagnostic certainty and, in turn, decision making for coronary heart disease (CHD). Data are from a factorial experiment of 256 physicians who viewed one of 16 video vignettes with different patient-actors presenting the same CHD symptoms. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have “atypical symptoms” as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge. PMID:22933590

Apply creative thinking of decision support in electrical nursing record.

PubMed

Hao, Angelica Te-Hui; Hsu, Chien-Yeh; Li-Fang, Huang; Jian, Wen-Shan; Wu, Li-Bin; Kao, Ching-Chiu; Lu, Mei-Show; Chang, Her-Kung

2006-01-01

The nursing process consists of five interrelated steps: assessment, diagnosis, planning, intervention, and evaluation. In the nursing process, the nurse collects a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Computer systems are viewed as tools to expand the capabilities of the nurse's mind. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most fundamental decision support--i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to generate nursing diagnoses from data and how to individualize the care plans still reminds of the nurse. The purpose of this study is to develop a pilot structure in electronic nursing record system integrated with international nursing standard for improving the proficiency and accuracy of plan of care in clinical pathway process. The proposed pilot systems not only assist both student nurses and nurses who are novice in nursing practice, but also experts who need to work in a practice area which they are not familiar with.

Collaborative environmental planning in river management: An application of multicriteria decision analysis in the White River Watershed in Vermont

USGS Publications Warehouse

Hermans, C.; Erickson, J.; Noordewier, T.; Sheldon, A.; Kline, M.

2007-01-01

Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible. ?? 2006 Elsevier Ltd. All rights reserved.

Collaborative environmental planning in river management: an application of multicriteria decision analysis in the White River Watershed in Vermont.

PubMed

Hermans, Caroline; Erickson, Jon; Noordewier, Tom; Sheldon, Amy; Kline, Mike

2007-09-01

Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible.

Decision support methodology to establish priorities on the inspection of structures

NASA Astrophysics Data System (ADS)

Cortes, V. Juliette; Sterlacchini, Simone; Bogaard, Thom; Frigerio, Simone; Schenato, Luca; Pasuto, Alessandro

2014-05-01

For hydro-meteorological hazards in mountain areas, the regular inspection of check dams and bridges is important due to the effect of their functional status on water-sediment processes. Moreover, the inspection of these structures is time consuming for organizations due to their extensive number in many regions. However, trained citizen-volunteers can support civil protection and technical services in the frequency, timeliness and coverage of monitoring the functional status of hydraulic structures. Technicians should evaluate and validate these reports to get an index for the status of the structure. Thus, preventive actions could initiate such as the cleaning of obstructions or to pre-screen potential problems for a second level inspection. This study proposes a decision support methodology that technicians can use to assess an index for three parameters representing the functional status of the structure: a) condition of the structure at the opening of the stream flow, b) level of obstruction at the structure and c) the level of erosion in the stream bank. The calculation of the index for each parameter is based upon fuzzy logic theory to handle ranges in precision of the reports and to convert the linguistic rating scales into numbers representing the structure's status. A weighting method and multi-criteria method (Analytic Hierarchy Process- AHP and TOPSIS), can be used by technicians to combine the different ratings according to the component elements of the structure and the completeness of the reports. Finally, technicians can set decision rules based on the worst rating and a threshold for the functional indexes. The methodology was implemented as a prototype web-based tool to be tested with technicians of the Civil Protection in the Fella basin, Northern Italy. Results at this stage comprise the design and implementation of the web-based tool with GIS interaction to evaluate available reports and to set priorities on the inspection of structures. Keywords Decision-making, Multi-criteria methods, Torrent control structures, Web-based tools.

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.

Application of stochastic multiattribute analysis to assessment of single walled carbon nanotube synthesis processes.

PubMed

Canis, Laure; Linkov, Igor; Seager, Thomas P

2010-11-15

The unprecedented uncertainty associated with engineered nanomaterials greatly expands the need for research regarding their potential environmental consequences. However, decision-makers such as regulatory agencies, product developers, or other nanotechnology stakeholders may not find the results of such research directly informative of decisions intended to mitigate environmental risks. To help interpret research findings and prioritize new research needs, there is an acute need for structured decision-analytic aids that are operable in a context of extraordinary uncertainty. Whereas existing stochastic decision-analytic techniques explore uncertainty only in decision-maker preference information, this paper extends model uncertainty to technology performance. As an illustrative example, the framework is applied to the case of single-wall carbon nanotubes. Four different synthesis processes (arc, high pressure carbon monoxide, chemical vapor deposition, and laser) are compared based on five salient performance criteria. A probabilistic rank ordering of preferred processes is determined using outranking normalization and a linear-weighted sum for different weighting scenarios including completely unknown weights and four fixed-weight sets representing hypothetical stakeholder views. No single process pathway dominates under all weight scenarios, but it is likely that some inferior process technologies could be identified as low priorities for further research.

Comparing perceptual and preferential decision making.

PubMed

Dutilh, Gilles; Rieskamp, Jörg

2016-06-01

Perceptual and preferential decision making have been studied largely in isolation. Perceptual decisions are considered to be at a non-deliberative cognitive level and have an outside criterion that defines the quality of decisions. Preferential decisions are considered to be at a higher cognitive level and the quality of decisions depend on the decision maker's subjective goals. Besides these crucial differences, both types of decisions also have in common that uncertain information about the choice situation has to be processed before a decision can be made. The present work aims to acknowledge the commonalities of both types of decision making to lay bare the crucial differences. For this aim we examine perceptual and preferential decisions with a novel choice paradigm that uses the identical stimulus material for both types of decisions. This paradigm allows us to model the decisions and response times of both types of decisions with the same sequential sampling model, the drift diffusion model. The results illustrate that the different incentive structure in both types of tasks changes people's behavior so that they process information more efficiently and respond more cautiously in the perceptual as compared to the preferential task. These findings set out a perspective for further integration of perceptual and preferential decision making in a single ramework.

The influence of information processing goal pursuit on postdecision affect and behavioral intentions.

PubMed

Laran, Juliano

2010-01-01

Two important forces in human behavior are action and inaction. Although action and inaction are commonly associated with the presence and the absence of behavioral activity, they can also be represented as information processing goals. Action (inaction) goals influence decision effort and increase satisfaction with environments that are structured to allow for more (less) processing (Studies 1 and 2). This increased satisfaction can transfer to the decision (Study 3) and can increase the intent to perform a decision-congruent behavior (Studies 4 and 6). Finally, the author shows escalation of action and inaction goals when they are not achieved (Study 5) and rebound of the alternative goal when the focal goal is achieved (Study 6).

Adaptive Multi-scale PHM for Robotic Assembly Processes

PubMed Central

Choo, Benjamin Y.; Beling, Peter A.; LaViers, Amy E.; Marvel, Jeremy A.; Weiss, Brian A.

2017-01-01

Adaptive multiscale prognostics and health management (AM-PHM) is a methodology designed to support PHM in smart manufacturing systems. As a rule, PHM information is not used in high-level decision-making in manufacturing systems. AM-PHM leverages and integrates component-level PHM information with hierarchical relationships across the component, machine, work cell, and production line levels in a manufacturing system. The AM-PHM methodology enables the creation of actionable prognostic and diagnostic intelligence up and down the manufacturing process hierarchy. Decisions are made with the knowledge of the current and projected health state of the system at decision points along the nodes of the hierarchical structure. A description of the AM-PHM methodology with a simulated canonical robotic assembly process is presented. PMID:28664161

A survey of decision tree classifier methodology

NASA Technical Reports Server (NTRS)

Safavian, S. R.; Landgrebe, David

1991-01-01

Decision tree classifiers (DTCs) are used successfully in many diverse areas such as radar signal classification, character recognition, remote sensing, medical diagnosis, expert systems, and speech recognition. Perhaps the most important feature of DTCs is their capability to break down a complex decision-making process into a collection of simpler decisions, thus providing a solution which is often easier to interpret. A survey of current methods is presented for DTC designs and the various existing issues. After considering potential advantages of DTCs over single-state classifiers, subjects of tree structure design, feature selection at each internal node, and decision and search strategies are discussed.

A survey of decision tree classifier methodology

NASA Technical Reports Server (NTRS)

Safavian, S. Rasoul; Landgrebe, David

1990-01-01

Decision Tree Classifiers (DTC's) are used successfully in many diverse areas such as radar signal classification, character recognition, remote sensing, medical diagnosis, expert systems, and speech recognition. Perhaps, the most important feature of DTC's is their capability to break down a complex decision-making process into a collection of simpler decisions, thus providing a solution which is often easier to interpret. A survey of current methods is presented for DTC designs and the various existing issue. After considering potential advantages of DTC's over single stage classifiers, subjects of tree structure design, feature selection at each internal node, and decision and search strategies are discussed.

PROCRU: A model for analyzing crew procedures in approach to landing

NASA Technical Reports Server (NTRS)

Baron, S.; Muralidharan, R.; Lancraft, R.; Zacharias, G.

1980-01-01

A model for analyzing crew procedures in approach to landing is developed. The model employs the information processing structure used in the optimal control model and in recent models for monitoring and failure detection. Mechanisms are added to this basic structure to model crew decision making in this multi task environment. Decisions are based on probability assessments and potential mission impact (or gain). Sub models for procedural activities are included. The model distinguishes among external visual, instrument visual, and auditory sources of information. The external visual scene perception models incorporate limitations in obtaining information. The auditory information channel contains a buffer to allow for storage in memory until that information can be processed.

Creating Shareable Clinical Decision Support Rules for a Pharmacogenomics Clinical Guideline Using Structured Knowledge Representation.

PubMed

Linan, Margaret K; Sottara, Davide; Freimuth, Robert R

2015-01-01

Pharmacogenomics (PGx) guidelines contain drug-gene relationships, therapeutic and clinical recommendations from which clinical decision support (CDS) rules can be extracted, rendered and then delivered through clinical decision support systems (CDSS) to provide clinicians with just-in-time information at the point of care. Several tools exist that can be used to generate CDS rules that are based on computer interpretable guidelines (CIG), but none have been previously applied to the PGx domain. We utilized the Unified Modeling Language (UML), the Health Level 7 virtual medical record (HL7 vMR) model, and standard terminologies to represent the semantics and decision logic derived from a PGx guideline, which were then mapped to the Health eDecisions (HeD) schema. The modeling and extraction processes developed here demonstrate how structured knowledge representations can be used to support the creation of shareable CDS rules from PGx guidelines.

Reducing uncertainty about objective functions in adaptive management

USGS Publications Warehouse

Williams, B.K.

2012-01-01

This paper extends the uncertainty framework of adaptive management to include uncertainty about the objectives to be used in guiding decisions. Adaptive decision making typically assumes explicit and agreed-upon objectives for management, but allows for uncertainty as to the structure of the decision process that generates change through time. Yet it is not unusual for there to be uncertainty (or disagreement) about objectives, with different stakeholders expressing different views not only about resource responses to management but also about the appropriate management objectives. In this paper I extend the treatment of uncertainty in adaptive management, and describe a stochastic structure for the joint occurrence of uncertainty about objectives as well as models, and show how adaptive decision making and the assessment of post-decision monitoring data can be used to reduce uncertainties of both kinds. Different degrees of association between model and objective uncertainty lead to different patterns of learning about objectives. ?? 2011.

Cognitive representations and cognitive processing of team-specific tactics in soccer.

PubMed

Lex, Heiko; Essig, Kai; Knoblauch, Andreas; Schack, Thomas

2015-01-01

Two core elements for the coordination of different actions in sport are tactical information and knowledge about tactical situations. The current study describes two experiments to learn about the memory structure and the cognitive processing of tactical information. Experiment 1 investigated the storage and structuring of team-specific tactics in humans' long-term memory with regard to different expertise levels. Experiment 2 investigated tactical decision-making skills and the corresponding gaze behavior, in presenting participants the identical match situations in a reaction time task. The results showed that more experienced soccer players, in contrast to less experienced soccer players, possess a functionally organized cognitive representation of team-specific tactics in soccer. Moreover, the more experienced soccer players reacted faster in tactical decisions, because they needed less fixations of similar duration as compared to less experienced soccer players. Combined, these experiments offer evidence that a functionally organized memory structure leads to a reaction time and a perceptual advantage in tactical decision-making in soccer. The discussion emphasizes theoretical and applied implications of the current results of the study.

Cognitive Representations and Cognitive Processing of Team-Specific Tactics in Soccer

PubMed Central

Lex, Heiko; Essig, Kai; Knoblauch, Andreas; Schack, Thomas

2015-01-01

Two core elements for the coordination of different actions in sport are tactical information and knowledge about tactical situations. The current study describes two experiments to learn about the memory structure and the cognitive processing of tactical information. Experiment 1 investigated the storage and structuring of team-specific tactics in humans’ long-term memory with regard to different expertise levels. Experiment 2 investigated tactical decision-making skills and the corresponding gaze behavior, in presenting participants the identical match situations in a reaction time task. The results showed that more experienced soccer players, in contrast to less experienced soccer players, possess a functionally organized cognitive representation of team-specific tactics in soccer. Moreover, the more experienced soccer players reacted faster in tactical decisions, because they needed less fixations of similar duration as compared to less experienced soccer players. Combined, these experiments offer evidence that a functionally organized memory structure leads to a reaction time and a perceptual advantage in tactical decision-making in soccer. The discussion emphasizes theoretical and applied implications of the current results of the study. PMID:25714486

76 FR 24034 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... discussed at workgroup meetings. In turn, CMS' HCPCS workgroup reaches a decision as to whether a change... Level II Codes. As a result, the National Panel was delineated and CMS continued with the decision-making process under its current structure, the CMS HCPCS Workgroup (herein referred to as ``the...

78 FR 39233 - Data Practices, Computer III Further Remand: BOC Provision of Enhanced Services

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

... additional information on the rulemaking process, see the SUPPLEMENTARY INFORMATION section of this document....702 of the Commission's rules and regulations (Computer II Final Decision), 77 FCC 2d 384 (1980... Commission's decision to lift structural separation in Computer III and the implementation of ONA. In light...

The Role of Research and Analysis in Resource Allocation Decisions

ERIC Educational Resources Information Center

Lea, Dennis; Polster, Patty Poppe

2011-01-01

In a time of diminishing resources and increased accountability, it is important for school leaders to make the most of every dollar they spend. One approach to ensuring responsible resource allocation is to closely examine the organizational culture surrounding decision making and provide a structure and process to incorporate research and data…

An Investigation of Employee Involvement Schemes and Governance Structures in Professional Employment.

ERIC Educational Resources Information Center

Douglas, Joel M.

1995-01-01

Employee Involvement Schemes (EIS) are modeled after Western European worker participation models. These are grounded in collaborative labor relations and encourage employees to participate in work place decision-making. If employees, as the term is defined in the National Labor Relations Act, take part in EIS decision-making processes, they may…

The Common Core State Standards Initiative: an Overview

ERIC Educational Resources Information Center

Watt, Michael G.

2011-01-01

The purpose of this study was to evaluate decision making in the Common Core State Standards Initiative as the change process moved from research, development and diffusion activities to adoption of the Common Core State Standards by the states. A decision-oriented evaluation model was used to describe the four stages of planning, structuring,…

Making Data-Driven Decisions: Silent Reading

ERIC Educational Resources Information Center

Trudel, Heidi

2007-01-01

Due in part to conflicting opinions and research results, the practice of sustained silent reading (SSR) in schools has been questioned. After a frustrating experience with SSR, the author of this article began a data-driven decision-making process to gain new insights on how to structure silent reading in a classroom, including a comparison…

Decision-Making Skills for Middle School Students.

ERIC Educational Resources Information Center

Bergmann, Sherrel; Rudman, Gerald J.

Early adolescence is a time when students require adult assistance to become accurate and effective decision makers and problem solvers. Because of the fragmented nature of society, the family structure, and the schooling process, schools need to establish a nonthreatening environment in which students can discuss the issues related to growing up.…

Parents' Decision on Child Labour and School Attendance: Evidence from Iranian Households

ERIC Educational Resources Information Center

Keshavarz Haddad, GholamReza

2017-01-01

In the framework of a household's collective decision processes, this study presents a structural empirical model to test the hypothesis that child labour is compelled by household's poverty and parent's bargaining power against one another. To this end, a measure for mother's intra-household bargaining power is developed. I use Iranian…

CROSS: A GDSS for the Evaluation and Prioritization of Engineering Support Requests and Advanced Technology Projects at NASA

NASA Technical Reports Server (NTRS)

Tavana, Madjid; Lee, Seunghee

1996-01-01

Objective evaluation and prioritization of engineering support requests (ESRs) is a difficult task at the Kennedy Space Center (KSC) Shuttle Project Engineering Office. The difficulty arises from the complexities inherent in the evaluation process and the lack of structured information. The purpose of this project is to implement the consensus ranking organizational support system (CROSS), a multiple criteria decision support system (DSS) developed at KSC that captures the decision maker's beliefs through a series of sequential, rational, and analytical processes. CROSS utilizes the analytic hierarchy process (AHP), subjective probabilities, entropy concept, and maximize agreement heuristic (MAH) to enhance the decision maker's intuition in evaluation ESRs. Some of the preliminary goals of the project are to: (1) revisit the structure of the ground systems working team (GWST) steering committee, (2) develop a template for ESR originators to provide more comple and consistent information to the GSWT steering committee members to eliminate the need for a facilitator, (3) develop an objective and structured process for the initial screening of ESRs, (4) extensive training of the stakeholders and the GWST steering committee to eliminate the need for a facilitator, (5) automate the process as much as possible, (6) create an environment to compile project success factor data on ESRs and move towards a disciplined system that could be used to address supportability threshold issues at the KSC, and (7) investigate the possibility of an organization-wide implementation of CROSS.

“The problem often is that we do not have a family spokesperson but a spokesgroup”: Family Member Informal Roles in End-of-Life Decision-Making in Adult ICUs

PubMed Central

Quinn, Jill R.; Schmitt, Madeline; Baggs, Judith Gedney; Norton, Sally A.; Dombeck, Mary T.; Sellers, Craig R.

2013-01-01

Background To support the process of effective family decision-making, it is important to recognize and understand informal roles various family members may play in the end-of-life decision-making process. Objective The purpose of this study was to describe some informal roles consistently enacted by family members involved in the process of end-of-life decision-making in intensive care units (ICUs). Methods Ethnographic study. Data were collected via participant observation with field notes and semi-structured interviews on four ICUs in an academic health center in the mid-Atlantic United States from 2001 to 2004. The units studied were a medical ICU, a surgical ICU, a burn and trauma ICU, and a cardiovascular ICU. Participants Participants included health care clinicians, patients, and family members. Results Informal roles for family members consistently observed were:, Primary Caregiver, Primary Decision Maker, Family Spokesperson, Out-of-Towner, Patient Wishes Expert, Protector, Vulnerable Member, and Health Care Expert. The identified informal roles were part of family decision making processes, and each role was part of a potentially complicated family dynamic for end-of-life decision-making within the family system, and between the family and health care domains. Conclusions These informal roles reflect the diverse responses to demands for family decision making in what is usually a novel and stressful situation. Identification and description of these family member informal roles can assist clinicians to recognize and understand the functions of these roles in family decision making at the end-of-life, and guide development of strategies to support and facilitate increased effectiveness of family discussions and decision-making processes. PMID:22210699

Power relations and contrasting conceptions of evidence in patient-involvement processes used to inform health funding decisions in Australia.

PubMed

Lopes, Edilene; Carter, Drew; Street, Jackie

2015-06-01

We collected and analysed views of key stakeholders on the processes used to involve patient organisations in health care funding decision making in Australia. We conducted 12 semi-structured interviews with patient organisation representatives and members of Advisory Committees that provide advice to the Australian Department of Health and employ Health Technology Assessment (HTA) as an evaluation framework. Using two theoretical frameworks, we analysed structural and contextual elements pertaining to the involvement processes. The findings reported in this article relate to interviewees' perspectives on contextual elements, analysed using a Foucauldian lens. These elements include: the perspectives of marginalised voices; the diversity of views on what ought to be considered valid evidence in a HTA setting; and the relationships between stakeholders, along with how these relationships impact on involvement processes and the outcomes of those processes. The findings demonstrate that the involvement processes currently used are deemed inadequate by both patient organisation representatives and Advisory Committee members, but for different reasons connected to how different stakeholders conceptualise evidence. Advisory Committee members viewed evidence as encompassing clinical outcomes and patient preferences, whereas patient organisation representatives tended to view evidence as encompassing aspects not directly related to a disease entity, such as the social and emotional aspects of patients' experiences in living with illness. Patient organisation representatives reported interacting with other stakeholders (especially industry) to increase the influence of their conception of evidence on decision making. The use of this strategy by interviewees illustrates how power struggles occur in government decision-making processes which involve both medical expertise and patients' accounts. Such struggles, and the power differentials they reflect, need to be considered by those responsible for designing and implementing meaningful public- and patient-involvement processes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluating models of object-decision priming: evidence from event-related potential repetition effects.

PubMed

Soldan, Anja; Mangels, Jennifer A; Cooper, Lynn A

2006-03-01

This study was designed to differentiate between structural description and bias accounts of performance in the possible/impossible object-decision test. Two event-related potential (ERP) studies examined how the visual system processes structurally possible and impossible objects. Specifically, the authors investigated the effects of object repetition on a series of early posterior components during structural (Experiment 1) and functional (Experiment 2) encoding and the relationship of these effects to behavioral measures of priming. In both experiments, the authors found repetition enhancement of the posterior N1 and N2 for possible objects only. In addition, the magnitude of the N1 repetition effect for possible objects was correlated with priming for possible objects. Although the behavioral results were more ambiguous, these ERP results fail to support bias models that hold that both possible and impossible objects are processed similarly in the visual system. Instead, they support the view that priming is supported by a structural description system that encodes the global 3-dimensional structure of an object.

Training in Decision-making Strategies: An approach to enhance students' competence to deal with socio-scientific issues

NASA Astrophysics Data System (ADS)

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2013-10-01

Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based programme was developed that trains secondary school students (grades 11-13) in decision-making strategies. The main research question is: does training students to use these strategies foster decision-making competence? In addition, the influence of meta-decision aids was examined. Students conducted a task analysis to select an appropriate strategy prior to the decision-making process. Hence, the second research question is: does combining decision-making training with a task analysis enhance decision-making competence at a higher rate? To answer these questions, 386 students were tested in a pre-post-follow-up control-group design that included two training groups (decision-making strategies/decision-making strategies combined with a task analysis) and a control group (decision-making with additional ecological information instead of strategic training). An open-ended questionnaire was used to assess decision-making competence in situations related to sustainable development. The decision-making training led to a significant improvement in the post-test and the follow-up, which was administered three months after the training. Long-term effects on the quality of the students' decisions were evident for both training groups. Gains in competence when reflecting upon the decision-making processes of others were found, to a lesser extent, in the training group that received the additional meta-decision training. In conclusion, training in decision-making strategies is a promising approach to deal with socio-scientific issues related to sustainable development.

Variables, Decisions, and Scripting in Construct

DTIC Science & Technology

2009-09-01

grounded in sociology and cognitive science which seeks to model the processes and situations by which humans interact and share information...Construct is an embodiment of constructuralism (Carley 1986), a theory which posits that human social structures and cognitive structures co-evolve so that...human cognition reflects human social behavior, and that human social behavior simultaneously influences cognitive processes. Recent work with

A fuzzy decision tree for fault classification.

PubMed

Zio, Enrico; Baraldi, Piero; Popescu, Irina C

2008-02-01

In plant accident management, the control room operators are required to identify the causes of the accident, based on the different patterns of evolution of the monitored process variables thereby developing. This task is often quite challenging, given the large number of process parameters monitored and the intense emotional states under which it is performed. To aid the operators, various techniques of fault classification have been engineered. An important requirement for their practical application is the physical interpretability of the relationships among the process variables underpinning the fault classification. In this view, the present work propounds a fuzzy approach to fault classification, which relies on fuzzy if-then rules inferred from the clustering of available preclassified signal data, which are then organized in a logical and transparent decision tree structure. The advantages offered by the proposed approach are precisely that a transparent fault classification model is mined out of the signal data and that the underlying physical relationships among the process variables are easily interpretable as linguistic if-then rules that can be explicitly visualized in the decision tree structure. The approach is applied to a case study regarding the classification of simulated faults in the feedwater system of a boiling water reactor.

Predicting explorative motor learning using decision-making and motor noise.

PubMed

Chen, Xiuli; Mohr, Kieran; Galea, Joseph M

2017-04-01

A fundamental problem faced by humans is learning to select motor actions based on noisy sensory information and incomplete knowledge of the world. Recently, a number of authors have asked whether this type of motor learning problem might be very similar to a range of higher-level decision-making problems. If so, participant behaviour on a high-level decision-making task could be predictive of their performance during a motor learning task. To investigate this question, we studied performance during an explorative motor learning task and a decision-making task which had a similar underlying structure with the exception that it was not subject to motor (execution) noise. We also collected an independent measurement of each participant's level of motor noise. Our analysis showed that explorative motor learning and decision-making could be modelled as the (approximately) optimal solution to a Partially Observable Markov Decision Process bounded by noisy neural information processing. The model was able to predict participant performance in motor learning by using parameters estimated from the decision-making task and the separate motor noise measurement. This suggests that explorative motor learning can be formalised as a sequential decision-making process that is adjusted for motor noise, and raises interesting questions regarding the neural origin of explorative motor learning.

Predicting explorative motor learning using decision-making and motor noise

PubMed Central

Galea, Joseph M.

2017-01-01

A fundamental problem faced by humans is learning to select motor actions based on noisy sensory information and incomplete knowledge of the world. Recently, a number of authors have asked whether this type of motor learning problem might be very similar to a range of higher-level decision-making problems. If so, participant behaviour on a high-level decision-making task could be predictive of their performance during a motor learning task. To investigate this question, we studied performance during an explorative motor learning task and a decision-making task which had a similar underlying structure with the exception that it was not subject to motor (execution) noise. We also collected an independent measurement of each participant’s level of motor noise. Our analysis showed that explorative motor learning and decision-making could be modelled as the (approximately) optimal solution to a Partially Observable Markov Decision Process bounded by noisy neural information processing. The model was able to predict participant performance in motor learning by using parameters estimated from the decision-making task and the separate motor noise measurement. This suggests that explorative motor learning can be formalised as a sequential decision-making process that is adjusted for motor noise, and raises interesting questions regarding the neural origin of explorative motor learning. PMID:28437451

A Semantic Constraint on Syntactic Parsing.

ERIC Educational Resources Information Center

Crain, Stephen; Coker, Pamela L.

This research examines how semantic information influences syntactic parsing decisions during sentence processing. In the first experiment, subjects were presented lexical strings having syntactically identical surface structures but with two possible underlying structures: "The children taught by the Berlitz method," and "The…

Processes of Similarity Judgment

ERIC Educational Resources Information Center

Larkey, Levi B.; Markman, Arthur B.

2005-01-01

Similarity underlies fundamental cognitive capabilities such as memory, categorization, decision making, problem solving, and reasoning. Although recent approaches to similarity appreciate the structure of mental representations, they differ in the processes posited to operate over these representations. We present an experiment that…

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

PubMed

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

2016-11-04

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

Allocating health care: cost-utility analysis, informed democratic decision making, or the veil of ignorance?

PubMed

Goold, S D

1996-01-01

Assuming that rationing health care is unavoidable, and that it requires moral reasoning, how should we allocate limited health care resources? This question is difficult because our pluralistic, liberal society has no consensus on a conception of distributive justice. In this article I focus on an alternative: Who shall decide how to ration health care, and how shall this be done to respect autonomy, pluralism, liberalism, and fairness? I explore three processes for making rationing decisions: cost-utility analysis, informed democratic decision making, and applications of the veil of ignorance. I evaluate these processes as examples of procedural justice, assuming that there is no outcome considered the most just. I use consent as a criterion to judge competing processes so that rationing decisions are, to some extent, self-imposed. I also examine the processes' feasibility in our current health care system. Cost-utility analysis does not meet criteria for actual or presumed consent, even if costs and health-related utility could be measured perfectly. Existing structures of government cannot creditably assimilate the information required for sound rationing decisions, and grassroots efforts are not representative. Applications of the veil of ignorance are more useful for identifying principles relevant to health care rationing than for making concrete rationing decisions. I outline a process of decision making, specifically for health care, that relies on substantive, selected representation, respects pluralism, liberalism, and deliberative democracy, and could be implemented at the community or organizational level.

End-of-life decisions for people with intellectual disabilities, an interview study with patient representatives.

PubMed

Wagemans, Annemieke M A; Van Schrojenstein Lantman-de Valk, Henny M J; Proot, Ireen M; Metsemakers, Job; Tuffrey-Wijne, Irene; Curfs, Leopold M G

2013-09-01

Not much is known about the process of end-of-life decision-making for people with intellectual disabilities. To clarify the process of end-of-life decision-making for people with intellectual disabilities from the perspective of patient representatives. A qualitative study based on semi-structured interviews, recorded digitally and transcribed verbatim. Data were analysed using Grounded Theory procedures. We interviewed 16 patient representatives after the deaths of 10 people with intellectual disabilities in the Netherlands. The core category 'Deciding for someone else' describes the context in which patient representatives took end-of-life decisions. The patient representatives felt highly responsible for the outcomes. They had not involved the patients in the end-of-life decision-making process, nor any professionals other than the doctor. The categories of 'Motives' and 'Support' were connected to the core category of 'Deciding for someone else'. 'Motives' refers to the patient representatives' ideas about quality of life, prevention from suffering, patients who cannot understand the burden of interventions and emotional reasons reported by patient representatives. 'Support' refers to the support that patient representatives wanted the doctors to give to them in the decision-making process. From the perspective of the patient representatives, the process of end-of-life decision-making can be improved by ensuring clear roles and an explicit description of the tasks and responsibilities of all participants. Regular discussion between everyone involved including people with intellectual disabilities themselves can improve knowledge about each other's motives for end-of-decisions and can clarify expectations towards each other.

Decision Making for Destination Therapy Left Ventricular Assist Devices: “There was no choice” versus “I thought about it an awful lot”

PubMed Central

McIlvennan, Colleen K.; Allen, Larry A.; Nowels, Carolyn; Brieke, Andreas; Cleveland, Joseph C.; Matlock, Daniel D.

2014-01-01

Background Destination therapy left ventricular assist devices (DT LVAD) are one of the most invasive medical interventions for end-stage illness. How patients decide whether or not to proceed with device implantation is unknown. We aimed to understand the decision-making processes of patients who either accept or decline DT LVADs. Methods and Results Between October 2012–September 2013, we conducted semi-structured, in-depth interviews to understand patients’ decision-making experiences. Data were analyzed using a mixed inductive and deductive approach. Twenty-two eligible patients were interviewed, 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being “automatic” and others (3 accepters, 7 decliners) being “reflective” in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: “[LVAD] was the only option I had…that or push up daisies…so I automatically took this”. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: “There are worse things than death.” Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. Conclusion Some patients offered a DT LVAD face the decision by reflecting on a process and reasoning through risks and benefits. For others, the desire to live supersedes such reflective processing. Acknowledging this difference is important when considering how to support patients who are faced with this complex decision. PMID:24823949

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

NASA Astrophysics Data System (ADS)

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

2014-09-01

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

How parents and physicians experience end-of-life decision-making for children with profound intellectual and multiple disabilities.

PubMed

Zaal-Schuller, I H; Willems, D L; Ewals, F V P M; van Goudoever, J B; de Vos, M A

2016-12-01

End-of-life decisions (EoLD) often concern children with profound intellectual and multiple disabilities (PIMD). Yet, little is known about how parents and physicians discuss and make these decisions. The objective of this research was to investigate the experiences of the parents and the involved physician during the end-of-life decision-making (EoLDM) process for children with PIMD. In a retrospective, qualitative study, we conducted semi-structured interviews with the physicians and parents of 14 children with PIMD for whom an EoLD was made within the past two years. A long-lasting relationship appeared to facilitate the EoLDM process, although previous negative healthcare encounters could also lead to distrust. Parents and physicians encountered disagreements during the EoLDM process, but these disagreements could also improve the decision-making process. Most parents, as well as most physicians, considered the parents to be the experts on their child. In making an EoLD, both parents and physicians preferred a shared decision-making approach, although they differed in what they actually meant by this concept. The EoLDM process for children with PIMD can be improved if physicians are more aware of the specific situation and of the roles and expectations of the parents of children with PIMD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Asserting Academic Legitimacy: The Influence of the University of Technology Sectoral Agendas on Curriculum Decision-Making

ERIC Educational Resources Information Center

Coleman, Lynn

2016-01-01

This paper argues that curriculum decision-making in the South African University of Technology (UoT) environment is affected not only by industry and disciplinary demands, but also by socio-structural features and ideologies particular to this educational sector. It supports the view that recontextualisation processes are subject to multiple…

A Comparison of Community and State College Leader Perceptions of Trustee Involvement in Decision-Making

ERIC Educational Resources Information Center

Morris, Adam A.; Miller, Michael T.

2014-01-01

Trustees play an important role in determining the direction, priorities, and future of higher education institutions, and as such, are critical actors in the decision-making and policy formation process. Numerous anecdotal reports have concluded that there are often competing interests in the use and structure of trustees throughout higher…

A Proposed Process for Managing the First Amendment Aspects of Campus Hate Speech.

ERIC Educational Resources Information Center

Kaplan, William A.

1992-01-01

A carefully structured process for campus administrative decision making concerning hate speech is proposed and suggestions for implementation are offered. In addition, criteria for evaluating hate speech processes are outlined, and First Amendment principles circumscribing the institution's discretion to regulate hate speech are discussed.…

A qualitative study of women's decision-making at the end of IVF treatment.

PubMed

Peddie, V L; van Teijlingen, E; Bhattacharya, S

2005-07-01

The decision not to pursue further in vitro fertilization (IVF) after one or more unsuccessful attempts is an important and often difficult one for couples. Relatively little is known about the woman's perception of this decision-making process. The aim of this study was to examine patients' perspectives of decision-making, including circumstances influencing it and satisfaction with the decision-making process. Semi-structured interviews were conducted with a purposive sample of 25 women who had decided to end treatment after unsuccessful IVF treatment. Interviews were tape-recorded and transcribed by means of thematic analysis using the open coding technique. Women experienced difficulty in accepting that their infertility would remain unresolved. Many felt that they had started with unrealistic expectations of treatment success and felt vulnerable to the pressures of both the media and society. Although the decision to end treatment was difficult, it offered many women a way out of the emotional distress caused by IVF; however, the process of decision-making created a sense of 'confrontation' for the women in which they had to address issues they had previously avoided. Adoptive parents perceived less societal pressure than those who remained childless. Efforts to improve the psychological preparation of couples who decide to end IVF treatment should be directed towards examination of the existing system of consultation, which has certain limitations in terms of the quality of communication and the provision of post-treatment support. Further efforts to develop strategies, which facilitate the decision-making process, should be considered.

Conceptualizing Surrogate Decision-Making at End of Life in the Intensive Care Unit using Cognitive Task Analysis

PubMed Central

Dionne-Odom, J. Nicholas; Willis, Danny G.; Bakitas, Marie; Crandall, Beth; Grace, Pamela J.

2014-01-01

Background Surrogate decision-makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. Purpose Identify and describe the underlying psychological processes of surrogate decision-making for adults at EOL in the ICU. Method Qualitative case study design using a cognitive task analysis (CTA) interviewing approach. Participants were recruited from October 2012 to June 2013 from an academic tertiary medical center’s ICU located in the rural Northeastern United States. Nineteen SDMs for patients who had died in the ICU completed in-depth semi-structured CTA interviews. Discussion The conceptual framework formulated from data analysis reveals that three underlying, iterative, psychological dimensions: gist impressions, distressing emotions, and moral intuitions impact a SDM’s judgment about the acceptability of either the patient’s medical treatments or his or her condition. Conclusion The framework offers initial insights about the underlying psychological processes of surrogate decision-making and may facilitate enhanced decision support for SDMs. PMID:25982772

Neuroethology of Decision-making

PubMed Central

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

2012-01-01

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

A qualitative analysis of parental decision making for childhood immunisation.

PubMed

Marshall, S; Swerissen, H

1999-10-01

Achieving high rates of childhood immunisation is an important public health aim. Currently, however, immunisation uptake in Australia is disappointing. This qualitative study investigated the factors that influence parental decision making for childhood immunisation, and whether parents' experiences were better conceptualised in terms of static subjective expected utility models or in terms of a more dynamic process. Semi-structured in-depth interviews were conducted with 20 predominantly middle-class mothers--17 immunizers and three non-immunizers, in Melbourne, Victoria, in 1997. The data were then examined using thematic analysis. The results suggested that for these participants the decision regarding childhood immunization was better conceptualized as a dynamic process. The decision required initial consideration, implementation then maintenance. If a better understanding of immunization decision making is to be achieved, future studies must look beyond static frameworks. Clearer insight into the dynamic nature of immunization decision making should assist in the identification of more effective methods of promoting childhood immunization to groups at risk of non-compliance.

Using social network analysis to examine the decision-making process on new vaccine introduction in Nigeria.

PubMed

Wonodi, C B; Privor-Dumm, L; Aina, M; Pate, A M; Reis, R; Gadhoke, P; Levine, O S

2012-05-01

The decision-making process to introduce new vaccines into national immunization programmes is often complex, involving many stakeholders who provide technical information, mobilize finance, implement programmes and garner political support. Stakeholders may have different levels of interest, knowledge and motivations to introduce new vaccines. Lack of consensus on the priority, public health value or feasibility of adding a new vaccine can delay policy decisions. Efforts to support country-level decision-making have largely focused on establishing global policies and equipping policy makers with the information to support decision-making on new vaccine introduction (NVI). Less attention has been given to understanding the interactions of policy actors and how the distribution of influence affects the policy process and decision-making. Social network analysis (SNA) is a social science technique concerned with explaining social phenomena using the structural and relational features of the network of actors involved. This approach can be used to identify how information is exchanged and who is included or excluded from the process. For this SNA of vaccine decision-making in Nigeria, we interviewed federal and state-level government officials, officers of bilateral and multilateral partner organizations, and other stakeholders such as health providers and the media. Using data culled from those interviews, we performed an SNA in order to map formal and informal relationships and the distribution of influence among vaccine decision-makers, as well as to explore linkages and pathways to stakeholders who can influence critical decisions in the policy process. Our findings indicate a relatively robust engagement of key stakeholders in Nigeria. We hypothesized that economic stakeholders and implementers would be important to ensure sustainable financing and strengthen programme implementation, but some economic and implementation stakeholders did not appear centrally on the map; this may suggest a need to strengthen the decision-making processes by engaging these stakeholders more centrally and earlier.

Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

PubMed

Gillespie, Mary

2010-11-01

Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Structured decision making for conservation of bull trout (Salvelinus confluentus) in Long Creek, Klamath River Basin, south-central Oregon

USGS Publications Warehouse

Benjamin, Joseph R.; McDonnell, Kevin; Dunham, Jason B.; Brignon, William R.; Peterson, James T.

2017-06-21

With the decline of bull trout (Salvelinus confluentus), managers face multiple, and sometimes contradictory, management alternatives for species recovery. Moreover, effective decision-making involves all stakeholders influenced by the decisions (such as Tribal, State, Federal, private, and non-governmental organizations) because they represent diverse objectives, jurisdictions, policy mandates, and opinions of the best management strategy. The process of structured decision making is explicitly designed to address these elements of the decision making process. Here we report on an application of structured decision making to a population of bull trout believed threatened by high densities of nonnative brook trout (S. fontinalis) and habitat fragmentation in Long Creek, a tributary to the Sycan River in the Klamath River Basin, south-central Oregon. This involved engaging stakeholders to identify (1) their fundamental objectives for the conservation of bull trout, (2) feasible management alternatives to achieve their objectives, and (3) biological information and assumptions to incorporate in a decision model. Model simulations suggested an overarching theme among the top decision alternatives, which was a need to simultaneously control brook trout and ensure that the migratory tactic of bull trout can be expressed. More specifically, the optimal management decision, based on the estimated adult abundance at year 10, was to combine the eradication of brook trout from Long Creek with improvement of downstream conditions (for example, connectivity or habitat conditions). Other top decisions included these actions independently, as well as electrofishing removal of brook trout. In contrast, translocating bull trout to a different stream or installing a barrier to prevent upstream spread of brook trout had minimal or negative effects on the bull trout population. Moreover, sensitivity analyses suggested that these actions were consistently identified as optimal across a large range of parameter values. Taken together, these results support the conclusion that management actions focused on controlling brook trout and enhancing migrant bull trout are more likely to yield more adult bull trout within the 10-year time frame specified by stakeholders.

A rapidly changing global medicines environment: How adaptable are funding decision-making systems?

PubMed

Leopold, Christine; Morgan, Steven G; Wagner, Anita K

2017-06-01

With the launch of very highly priced therapies and sudden price increases of generics, pressures on health systems have drastically increased. We aimed to elicit opinions of key decision makers responsible for national assessment and funding decisions on their experiences to adapt to these new realities. Through interviews with decision makers of pharmaceutical assessment and/or funding agencies, we describe the challenges systems are currently facing, systems' responses and systems' characteristics facilitating or hindering responses to changes and overarching topics for the future. Among the most common challenges are increased funding pressures, increased uncertainty and lack of transparency in decision-making. Systems' responses include utilization management, changing of assessment processes, stakeholder engagement and a focus on outcomes and on coordinated negotiations. Integrated delivery systems, fixed health care budgets and geographic and historical characteristics facilitate or sometimes hinder responses to change. Future policy emphasis lays on expanding data structures, managing the exit of drugs funded early, and implementing processes for communications with patients and the public. Going forward emphasis has to be given to structured communications with all stakeholders with a specific emphasis on the broader public and patients about financial limits and priority setting in health care. Copyright © 2017 Elsevier B.V. All rights reserved.

The Role of Lexical Competition and Acoustic-Phonetic Structure in Lexical Processing: Evidence from Normal Subjects and Aphasic Patients

ERIC Educational Resources Information Center

Misiurski, Cara; Blumstein, Sheila E.; Rissman, Jesse; Berman, Daniel

2005-01-01

This study examined the effects that the acoustic-phonetic structure of a stimulus exerts on the processes by which lexical candidates compete for activation. An auditory lexical decision paradigm was used to investigate whether shortening the VOT of an initial voiceless stop consonant in a real word results in the activation of the…

Perspectives from Mechanical Circulatory Support Coordinators on the Pre-Implantation Decision Process for Destination Therapy Left Ventricular Assist Devices

PubMed Central

McIlvennan, Colleen K.; Matlock, Daniel D.; Narayan, Madhav P.; Nowels, Carolyn; Thompson, Jocelyn S.; Cannon, Anne; Bradley, William J.; Allen, Larry A.

2015-01-01

Objective To understand mechanical circulatory support (MCS) coordinators’ perspectives related to destination therapy left ventricular assist devices (DT LVAD) decision making Background MCS coordinators are central to the team that interacts with patients considering DT LVAD, and are well positioned to comment upon the pre-implantation process. Methods From August 2012–January 2013, MCS coordinators were recruited to participate in semi-structured, in-depth interviews. Established qualitative approaches were used to analyze and interpret data. Results Eighteen MCS coordinators from 18 programs were interviewed. We found diversity in coordinators’ roles and high programmatic variability in how DT LVAD decisions are approached. Despite these differences, three themes were consistently recommended: 1) DT LVAD is a major patient-centered decision: “you’re your best advocate…this may not be the best choice for you”; 2) this decision benefits from an iterative, multidisciplinary process: “It is not a one-time conversation”; and 3) this process involves a tension between conveying enough detail about the process yet not overwhelming patients: “It’s sometimes hard to walk that line to not scare them but not paint a rainbow and butterflies picture.” Conclusions MCS coordinators endorsed a shared decision-making process that starts early, uses non-biased educational materials, and involves a multidisciplinary team sensitive to the tension between conveying enough detail about the therapy yet not overwhelming patients. PMID:25724116

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey.

PubMed

Smith, Neale; Mitton, Craig; Bryan, Stirling; Davidson, Alan; Urquhart, Bonnie; Gibson, Jennifer L; Peacock, Stuart; Donaldson, Cam

2013-07-02

Resource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons. Between January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating. About one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as 'good' or 'very good'. This paper explores these findings in greater detail and assesses them in context of the larger literature. Data from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada's health system leadership teams.

Quantum stochastic walks on networks for decision-making

NASA Astrophysics Data System (ADS)

Martínez-Martínez, Ismael; Sánchez-Burillo, Eduardo

2016-03-01

Recent experiments report violations of the classical law of total probability and incompatibility of certain mental representations when humans process and react to information. Evidence shows promise of a more general quantum theory providing a better explanation of the dynamics and structure of real decision-making processes than classical probability theory. Inspired by this, we show how the behavioral choice-probabilities can arise as the unique stationary distribution of quantum stochastic walkers on the classical network defined from Luce’s response probabilities. This work is relevant because (i) we provide a very general framework integrating the positive characteristics of both quantum and classical approaches previously in confrontation, and (ii) we define a cognitive network which can be used to bring other connectivist approaches to decision-making into the quantum stochastic realm. We model the decision-maker as an open system in contact with her surrounding environment, and the time-length of the decision-making process reveals to be also a measure of the process’ degree of interplay between the unitary and irreversible dynamics. Implementing quantum coherence on classical networks may be a door to better integrate human-like reasoning biases in stochastic models for decision-making.

Quantum stochastic walks on networks for decision-making

PubMed Central

Martínez-Martínez, Ismael; Sánchez-Burillo, Eduardo

2016-01-01

Recent experiments report violations of the classical law of total probability and incompatibility of certain mental representations when humans process and react to information. Evidence shows promise of a more general quantum theory providing a better explanation of the dynamics and structure of real decision-making processes than classical probability theory. Inspired by this, we show how the behavioral choice-probabilities can arise as the unique stationary distribution of quantum stochastic walkers on the classical network defined from Luce’s response probabilities. This work is relevant because (i) we provide a very general framework integrating the positive characteristics of both quantum and classical approaches previously in confrontation, and (ii) we define a cognitive network which can be used to bring other connectivist approaches to decision-making into the quantum stochastic realm. We model the decision-maker as an open system in contact with her surrounding environment, and the time-length of the decision-making process reveals to be also a measure of the process’ degree of interplay between the unitary and irreversible dynamics. Implementing quantum coherence on classical networks may be a door to better integrate human-like reasoning biases in stochastic models for decision-making. PMID:27030372

Reimbursement of biosimilars in Poland: is there a link to health technology assessment?

PubMed

Neumann, Dominika; Jabłecka, Anna

2016-12-01

Due to their complex structures, biosimilars are not generics. The differences between them are considered during market authorization processes but remain unclear during reimbursement decision-making. We analyzed the reimbursement of biopharmaceuticals in Poland with an emphasis on biosimilars and compared the health technology assessment (HTA) process with that defined in other countries. Recommendations provided by the Polish HTA organization and those in other countries were included as source documents. The period of interest covered January 2012 to December 2014. The reimbursement process for biosimilars in Poland is the same as that for generics. In contrast to other countries, a HTA is not involved in decision-making in Poland. The short administrative procedure for reimbursement of biosimilars in Poland accelerates the decision-making process; therefore, therapies can be made available to patients more quickly. However, this procedure can potentially lead to underestimation of aspects concerning the effectiveness and safety of biosimilars.

Shared decision-making in home-care from the nurse's perspective: sitting at the kitchen table--a qualitative descriptive study.

PubMed

Truglio-Londrigan, Marie

2013-10-01

To come to know, understand and describe the experience of shared decision-making in home-care from the nurse's perspective. The literature presents the concept of shared decision-making as a complex process characterised by a partnership between the healthcare provider and the patient, which is participatory and action oriented with education and negotiation leading to agreement. Few studies have been carried out to explore and describe the events that make up the experiences of shared decision-making in home-care from the nurse's perspective. A qualitative descriptive study was implemented. Semi structured interviews were performed with 10 home-care nurses who were asked to reflect on a time in their practice when they were involved in a shared decision-making process with their patient. All data were analysed using Colaizzi's method. The following Themes were uncovered: Begin where the patient is; Education for shared decision-making; The village and shared decision-making; and Whose decision is it? Each of the four Themes contained Subthemes. The findings of this study present shared decision-making as a complex, multidimensional and fluid process. A thorough understanding of shared decision-making is essential within the multiple contexts in which care is delivered. Nurses in clinical practice need to know and understand the events of the experience of shared decision-making. A more comprehensive understanding of these facts can assist home-care nurses in their practice with regard to the application of shared decision-making. © 2013 Blackwell Publishing Ltd.

Development of a First-of-a-Kind Deterministic Decision-Making Tool for Supervisory Control System

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

Cetiner, Sacit M; Kisner, Roger A; Muhlheim, Michael David

2015-07-01

Decision-making is the process of identifying and choosing alternatives where each alternative offers a different approach or path to move from a given state or condition to a desired state or condition. The generation of consistent decisions requires that a structured, coherent process be defined, immediately leading to a decision-making framework. The overall objective of the generalized framework is for it to be adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or nomore » human intervention. The overriding goal of automation is to replace or supplement human decision makers with reconfigurable decision- making modules that can perform a given set of tasks reliably. Risk-informed decision making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The implementation of the probabilistic portion of the decision-making engine of the proposed supervisory control system was detailed in previous milestone reports. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic multi-attribute decision-making framework uses variable sensor data (e.g., outlet temperature) and calculates where it is within the challenge state, its trajectory, and margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. Metrics to be evaluated include stability, cost, time to complete (action), power level, etc. The integration of deterministic calculations using multi-physics analyses (i.e., neutronics, thermal, and thermal-hydraulics) and probabilistic safety calculations allows for the examination and quantification of margin recovery strategies. This also provides validation of the control options identified from the probabilistic assessment. Thus, the thermal-hydraulics analyses are used to validate the control options identified from the probabilistic assessment. Future work includes evaluating other possible metrics and computational efficiencies.« less

The emergency patient's participation in medical decision-making.

PubMed

Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh

2016-09-01

The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.

Application of Domain Knowledge to Software Quality Assurance

NASA Technical Reports Server (NTRS)

Wild, Christian W.

1997-01-01

This work focused on capturing, using, and evolving a qualitative decision support structure across the life cycle of a project. The particular application of this study was towards business process reengineering and the representation of the business process in a set of Business Rules (BR). In this work, we defined a decision model which captured the qualitative decision deliberation process. It represented arguments both for and against proposed alternatives to a problem. It was felt that the subjective nature of many critical business policy decisions required a qualitative modeling approach similar to that of Lee and Mylopoulos. While previous work was limited almost exclusively to the decision capture phase, which occurs early in the project life cycle, we investigated the use of such a model during the later stages as well. One of our significant developments was the use of the decision model during the operational phase of a project. By operational phase, we mean the phase in which the system or set of policies which were earlier decided are deployed and put into practice. By making the decision model available to operational decision makers, they would have access to the arguments pro and con for a variety of actions and can thus make a more informed decision which balances the often conflicting criteria by which the value of action is measured. We also developed the concept of a 'monitored decision' in which metrics of performance were identified during the decision making process and used to evaluate the quality of that decision. It is important to monitor those decision which seem at highest risk of not meeting their stated objectives. Operational decisions are also potentially high risk decisions. Finally, we investigated the use of performance metrics for monitored decisions and audit logs of operational decisions in order to feed an evolutionary phase of the the life cycle. During evolution, decisions are revisisted, assumptions verified or refuted, and possible reassessments resulting in new policy are made. In this regard we implemented a machine learning algorithm which automatically defined business rules based on expert assessment of the quality of operational decisions as recorded during deployment.

New care home admission following hospitalisation: How do older people, families and professionals make decisions about discharge destination? A case study narrative analysis.

PubMed

Rhynas, Sarah J; Garrido, Azucena Garcia; Burton, Jennifer K; Logan, Gemma; MacArthur, Juliet

2018-03-24

To gain an in-depth understanding of the decision-making processes involved in the discharge of older people admitted to hospital from home and discharged to a care home, as described in the case records. The decision for an older person to move into a care home is significant and life-changing. The discharge planning literature for older people highlights the integral role of nurses in supporting and facilitating effective discharge. However, little research has been undertaken to explore the experiences of those discharged from hospital to a care home or the processes involved in decision-making. A purposive sample of 10 cases was selected from a cohort of 100 individuals admitted to hospital from home and discharged to a care home. Cases were selected to highlight important personal, relational and structural factors thought to affect the decision-making process. Narrative case studies were created and were thematically analysed to explore the perspectives of each stakeholder group and the conceptualisations of risk which influenced decision-making. Care home discharge decision-making is a complex process involving stakeholders with a range of expertise, experience and perspectives. Decisions take time and considerable involvement of families and the multidisciplinary team. There were significant deficits in documentation which limit the understanding of the process and the patient's voice is often absent from case records. The experiences of older people, families and multidisciplinary team members making care home decisions in the hospital setting require further exploration to identify and define best practice. Nurses have a critical role in the involvement of older people making discharge decisions in hospital, improved documentation of the patient's voice is essential. Health and social care systems must allow older people time to make significant decisions about their living arrangements, adapting to changing medical and social needs. © 2018 John Wiley & Sons Ltd.

Cognitive influences on self-care decision making in persons with heart failure.

PubMed

Dickson, Victoria V; Tkacs, Nancy; Riegel, Barbara

2007-09-01

Despite advances in management, heart failure is associated with high rates of hospitalization, poor quality of life, and early death. Education intended to improve patients' abilities to care for themselves is an integral component of disease management programs. True self-care requires that patients make decisions about symptoms, but the cognitive deficits documented in 30% to 50% of the heart failure population may make daily decision making challenging. After describing heart failure self-care as a naturalistic decision making process, we explore cognitive deficits known to exist in persons with heart failure. Problems in heart failure self-care are analyzed in relation to neural alterations associated with heart failure. As a neural process, decision making has been traced to regions of the prefrontal cortex, the same areas that are affected by ischemia, infarction, and hypoxemia in heart failure. Resulting deficits in memory, attention, and executive function may impair the perception and interpretation of early symptoms and reasoning and, thereby, delay early treatment implementation. There is compelling evidence that the neural processes critical to decision making are located in the same structures that are affected by heart failure. Because self-care requires the cognitive ability to learn, perceive, interpret, and respond, research is needed to discern how neural deficits affects these abilities, decision-making, and self-care behaviors.

An integrated fuzzy approach for strategic alliance partner selection in third-party logistics.

PubMed

Erkayman, Burak; Gundogar, Emin; Yilmaz, Aysegul

2012-01-01

Outsourcing some of the logistic activities is a useful strategy for companies in recent years. This makes it possible for firms to concentrate on their main issues and processes and presents facility to improve logistics performance, to reduce costs, and to improve quality. Therefore provider selection and evaluation in third-party logistics become important activities for companies. Making a strategic decision like this is significantly hard and crucial. In this study we proposed a fuzzy multicriteria decision making (MCDM) approach to effectively select the most appropriate provider. First we identify the provider selection criteria and build the hierarchical structure of decision model. After building the hierarchical structure we determined the selection criteria weights by using fuzzy analytical hierarchy process (AHP) technique. Then we applied fuzzy technique for order preference by similarity to ideal solution (TOPSIS) to obtain final rankings for providers. And finally an illustrative example is also given to demonstrate the effectiveness of the proposed model.

An Integrated Fuzzy Approach for Strategic Alliance Partner Selection in Third-Party Logistics

PubMed Central

Gundogar, Emin; Yılmaz, Aysegul

2012-01-01

Outsourcing some of the logistic activities is a useful strategy for companies in recent years. This makes it possible for firms to concentrate on their main issues and processes and presents facility to improve logistics performance, to reduce costs, and to improve quality. Therefore provider selection and evaluation in third-party logistics become important activities for companies. Making a strategic decision like this is significantly hard and crucial. In this study we proposed a fuzzy multicriteria decision making (MCDM) approach to effectively select the most appropriate provider. First we identify the provider selection criteria and build the hierarchical structure of decision model. After building the hierarchical structure we determined the selection criteria weights by using fuzzy analytical hierarchy process (AHP) technique. Then we applied fuzzy technique for order preference by similarity to ideal solution (TOPSIS) to obtain final rankings for providers. And finally an illustrative example is also given to demonstrate the effectiveness of the proposed model. PMID:23365520

Termination of pregnancy following a prenatal diagnosis of Down syndrome: A qualitative study of the decision-making process of pregnant couples.

PubMed

Lou, Stina; Carstensen, Kathrine; Petersen, Olav Bjørn; Nielsen, Camilla Palmhøj; Hvidman, Lone; Lanther, Maja Retpen; Vogel, Ida

2018-05-23

In Denmark, first trimester screening has a very high uptake (>90%). If Down syndrome is diagnosed, termination rates are high (>95%). The aim of this study was to investigate the timing of the decision to terminate pregnancy following a diagnosis of Down syndrome and the factors influencing this decision. Semi-structured, qualitative interview study with 21 couples who had received a prenatal diagnosis of Down syndrome and decided to terminate the pregnancy. Participants were recruited from obstetric departments between February 2016 and July 2017. Data were analyzed using thematic analysis. Five themes were identified: "initial decision-making", "consolidating the decision", "reasons and concerns shaping the termination of pregnancy decision", "the right decision is also burdensome", and "perceived influences in decision-making". For most couples, the initial decision to terminate pregnancy was made before or during the diagnostic process, but it was re-addressed and consolidated following the actual diagnosis. Imagining a family future with a severely affected Down syndrome child was the main factor influencing the termination of pregnancy decision. The decision was articulated as "right" but also as existentially burdensome for some, due to fear of regret and concern about ending a potential life. The decision to terminate pregnancy was considered a private matter between the couple, but was refined through interactions with clinicians and social networks. All couples made an initial decision prior to receiving the Down syndrome diagnosis. Knowledge of the couple's initial decision may facilitate patient-centered communication during and after the diagnostic process. Couples may benefit from counseling to deal with grief and existential concerns. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

When to trust our learners? Clinical teachers' perceptions of decision variables in the entrustment process.

PubMed

Duijn, Chantal C M A; Welink, Lisanne S; Bok, Harold G J; Ten Cate, Olle T J

2018-06-01

Clinical training programs increasingly use entrustable professional activities (EPAs) as focus of assessment. However, questions remain about which information should ground decisions to trust learners. This qualitative study aimed to identify decision variables in the workplace that clinical teachers find relevant in the elaboration of the entrustment decision processes. The findings can substantiate entrustment decision-making in the clinical workplace. Focus groups were conducted with medical and veterinary clinical teachers, using the structured consensus method of the Nominal Group Technique to generate decision variables. A ranking was made based on a relevance score assigned by the clinical teachers to the different decision variables. Field notes, audio recordings and flip chart lists were analyzed and subsequently translated and, as a form of axial coding, merged into one list, combining the decision variables that were similar in their meaning. A list of 11 and 17 decision variables were acknowledged as relevant by the medical and veterinary teacher groups, respectively. The focus groups yielded 21 unique decision variables that were considered relevant to inform readiness to perform a clinical task on a designated level of supervision. The decision variables consisted of skills, generic qualities, characteristics, previous performance or other information. We were able to group the decision variables into five categories: ability, humility, integrity, reliability and adequate exposure. To entrust a learner to perform a task at a specific level of supervision, a supervisor needs information to support such a judgement. This trust cannot be credited on a single case at a single moment of assessment, but requires different variables and multiple sources of information. This study provides an overview of decision variables giving evidence to justify the multifactorial process of making an entrustment decision.

Best interests decisions: professional practices in health and social care.

PubMed

Williams, Val; Boyle, Geraldine; Jepson, Marcus; Swift, Paul; Williamson, Toby; Heslop, Pauline

2014-01-01

This paper reports on data collected in 2011 from a national study about the operation of the best interests principle, a key feature of the Mental Capacity Act (MCA) 2005 for England and Wales. The objective was to provide a picture of current professional practices in best interests decision-making. Four contrasting sample sites were selected, in which National Health Service trusts, social care and other organisations were recruited to participate. A multimethod design was followed, including an online survey with 385 participants, followed by qualitative research through a telephone survey of 68 participants, and face-to-face semi-structured interviews following up 25 best interests cases, with different perspectives on the process in 12 of those cases. The current paper reports only on the qualitative findings. The findings indicate that the MCA was successful in providing a structure for these practitioners, and that the five principles of the MCA were in general adhered to. A variety of perceived risks led to best interests processes being undertaken, and a typical scenario was for a period of hospitalisation or ill health to trigger a best interests decision process about a social care and or a life decision. The study supported previous research in finding the notion of capacity the most difficult aspect of the MCA, and it provides evidence of some specific capacity assessment practices, including problematic ones relating to 'insight'. Best interests decisions were often made by consensus, with practitioners taking on different roles within the process. Meetings played a key part, but other ways of involving people lacking capacity and significant others were also important. It was recommended that the issues highlighted in this research could be clarified further in the Code of Practice, or within risk guidance. © 2013 John Wiley & Sons Ltd.

Integrated Nuclear and Conventional Theater Warfare Simulation (INWARS) Level III Specifications. Volume III. Air Combat Modeling.

DTIC Science & Technology

1978-07-24

will include an implicit air function that will perform the air planning and requesting associated with the various headquarters. The decision structure...air headquarters (The ATAF/TAA) will be included in the CIC to perform the implementation of the decisions /goals of the C21 elements, 1-4...realistic fashion. Once the AMPs have been formed, the operational process of launching, mission implementation etc. is no longer keyed to the decision cycle

Living kidney donation: considerations and decision-making.

PubMed

Agerskov, Hanne; Bistrup, Claus; Ludvigsen, Mette Spliid; Pedersen, Birthe D

2014-06-01

When possible, renal transplantation is the treatment of choice for patients with end-stage kidney disease. Technological developments in immunology have made it possible to perform kidney transplants between donors and recipients despite antibodies against the donor organ. This allows for a wider range of relationships between recipient and donor. We investigated experiences of, and reflections on, kidney donation among genetic and non-genetic living donors before first consultation at the transplant centre. The aim was to investigate early experiences in the process of becoming a living kidney donor (LKD). The study was conducted within a phenomenological-hermeneutic theoretical framework. Data were generated through semi-structured interviews with 18 potential donors. Data were interpreted and discussed in accordance with the Ricoeur's text interpretation theory on the three levels of naïve reading, structural analysis and critical interpretation and discussion. Two themes emerged: the decision-making process and dilemmas in decision-making. The study identifies that the decision about donation was made in relation to one's own life, family situation and in relation to the recipient-considerations that demonstrate that a range of dilemmas can occur during the decision-making process. The desire to help was prominent and was of significance in decision-making. The study provides insight and knowledge for the health care professionals to meet and involve donors' narratives in reflections about and modifications to clinical nursing practice. It is essential that health care professionals have an understanding and appreciation of the experiences and concerns among LKDs, and this can help in planning and providing individual nursing care and support to donors. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Organizational Perspectives on Rapid Response Team Structure, Function, and Cost: A Qualitative Study.

PubMed

Smith, Patricia L; McSweeney, Jean

Understanding how an organization determines structure and function of a rapid response team (RRT), as well as cost evaluation and implications, can provide foundational knowledge to guide decisions about RRTs. The objectives were to (1) identify influencing factors in organizational development of RRT structure and function and (2) describe evaluation of RRT costs. Using a qualitative, ethnographic design, nurse executives and experts in 15 moderate-size hospitals were interviewed to explore their decision-making processes in determining RRT structure and function. Face-to-face interviews were audio recorded and transcribed verbatim and verified for accurateness. Using content analysis and constant comparison, interview data were analyzed. Demographic data were analyzed using descriptive statistics. The sample included 27 participants from 15 hospitals in 5 south-central states. They described a variety of RRT responders and functions, with the majority of hospitals having a critical care charge nurse attending all RRT calls for assistance. Others described a designated RRT nurse with primary RRT duties as responder to all RRT calls. Themes of RRT development from the data included influencers, decision processes, and thoughts about cost. It is important to understand how hospitals determine optimal structure and function to enhance support of quality nursing care. Determining the impact of an RRT on costs and benefits is vital in balancing patient safety and limited resources. Future research should focus on clarifying differences between team structure and function in outcomes as well as the most effective means to estimate costs and benefits.

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

PubMed

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

2017-01-01

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

The association of hospital governance with innovation in Taiwan.

PubMed

Yang, Chen-Wei; Yan, Yu-Hua; Fang, Shih-Chieh; Inamdar, Syeda Noorein; Lin, Hsien-Cheng

2018-01-01

Hospitals in Taiwan are facing major changes and innovation is increasingly becoming a critical factor for remaining competitive. One determinant that can have a significant impact on innovation is hospital governance. However, there is limited prior research on the relationship between hospital governance and innovation. The purpose of this study is to propose a conceptual framework to hypothesize the relationship between governance mechanisms and innovation and to empirically test the hypotheses in hospital organizations. We examine the relationship between governance mechanisms and innovation using data on 102 hospitals in Taiwan from the Taiwan Joint Commission on Hospital Accreditation and Quality Improvement. We model governance mechanisms using board structure, information transparency and strategic decision-making processes. For our modeling and data analysis we use measurement and structural models. We find that in hospital governance, information transparency and strategic decision making did impact innovation. However, governance structure did not. To facilitate innovation, hospital boards can increase information transparency and improve the decision-making process when considering strategic investments in innovative initiatives. To remain competitive, hospital boards need to develop and monitor indices that measure hospital innovation to ensure ongoing progress. Copyright © 2017 John Wiley & Sons, Ltd.

The Relationship of Business Intelligence Systems to Organizational Performance Benefits: A Structural Equation Modeling of Management Decision Making

ERIC Educational Resources Information Center

Sparks, Betsy H.

2014-01-01

Business Intelligence is a major expenditure in many organizations and necessary for competitive advantage. These expenditures do not result in maximum benefits for the organization if the information obtained from the Business Intelligence System (BIS) is not used in the management decision-making process. This quantitative research study used an…

Frantic Voters: How Context Affects Voter Information Searches

ERIC Educational Resources Information Center

Seib, Jerod Drew

2012-01-01

Scholars have researched how voters make decisions for well over a half a century, but these studies are limited in what they are able to say about how voters make decisions because they have focused on the choice rather than the process. Most of these studies have focused on the choice that voters reach or the way their memories are structured,…

A Behavioural Approach to Understanding Semi-Subsistence Farmers' Technology Adoption Decisions: The Case of Improved Paddy-Prawn System in Indonesia

ERIC Educational Resources Information Center

Sambodo, Leonardo A. A. T.; Nuthall, Peter L.

2010-01-01

Purpose: This study traced the origins of subsistence Farmers' technology adoption attitudes and extracted the critical elements in their decision making systems. Design/Methodology/Approach: The analysis was structured using a model based on the Theory of Planned Behaviour (TPB). The role of a "bargaining process" was particularly…

Donor Motivations and Decision Making: Understanding the Major Gift Development Process from a Donor's Perspective

ERIC Educational Resources Information Center

Morrison, Anna Lee

2015-01-01

Higher education is faced with a challenge to its traditional funding structure. As a result, academic programs must seek alternative sources of support. Chief among these sources is philanthropy in the form of major gifts. Insight into donor motivations and decision making when approached to consider a major gift may help to maximize the success…

Realigning Shared Governance With Magnet® and the Organization's Operating System to Achieve Clinical Excellence.

PubMed

Moreno, Janette V; Girard, Anita S; Foad, Wendy

2018-03-01

In 2012, an academic medical center successfully overhauled a 15-year-old shared governance to align 6 house-wide and 30 unit-based councils with the new Magnet Recognition Program® and the organization's operating system, using the processes of LEAN methodology. The redesign improved cross-council communication structures, facilitated effective shared decision-making processes, increased staff engagement, and improved clinical outcomes. The innovative structural and process elements of the new model are replicable in other health institutions.

A Logico-Structural, Worldview Analysis of the Interrelationship between Science Interest, Gender, and Concept of Nature.

ERIC Educational Resources Information Center

Cobern, William W.; And Others

The purpose of this research was to provide information about gender-related worldview structures, among college students, that can inform the instructional decision making process. Information was generated in a logico-structural investigation of the interrelationship of gender, interest in science, and concept of nature. The strength of the…

Protocol and practice in the adaptive management of waterfowl harvests

USGS Publications Warehouse

Johnson, F.; Williams, K.

1999-01-01

Waterfowl harvest management in North America, for all its success, historically has had several shortcomings, including a lack of well-defined objectives, a failure to account for uncertain management outcomes, and inefficient use of harvest regulations to understand the effects of management. To address these and other concerns, the U.S. Fish and Wildlife Service began implementation of adaptive harvest management in 1995. Harvest policies are now developed using a Markov decision process in which there is an explicit accounting for uncontrolled environmental variation, partial controllability of harvest, and structural uncertainty in waterfowl population dynamics. Current policies are passively adaptive, in the sense that any reduction in structural uncertainty is an unplanned by-product of the regulatory process. A generalization of the Markov decision process permits the calculation of optimal actively adaptive policies, but it is not yet clear how state-specific harvest actions differ between passive and active approaches. The Markov decision process also provides managers the ability to explore optimal levels of aggregation or "management scale" for regulating harvests in a system that exhibits high temporal, spatial, and organizational variability. Progress in institutionalizing adaptive harvest management has been remarkable, but some managers still perceive the process as a panacea, while failing to appreciate the challenges presented by this more explicit and methodical approach to harvest regulation. Technical hurdles include the need to develop better linkages between population processes and the dynamics of landscapes, and to model the dynamics of structural uncertainty in a more comprehensive fashion. From an institutional perspective, agreement on how to value and allocate harvests continues to be elusive, and there is some evidence that waterfowl managers have overestimated the importance of achievement-oriented factors in setting hunting regulations. Indeed, it is these unresolved value judgements, and the lack of an effective structure for organizing debate, that present the greatest threat to adaptive harvest management as a viable means for coping with management uncertainty. Copyright ?? 1999 by The Resilience Alliance.

Choosing an Advanced Therapy in Parkinson's Disease; is it an Evidence-Based Decision in Current Practice?

PubMed

Nijhuis, Frouke A P; van Heek, Jolien; Bloem, Bastiaan R; Post, Bart; Faber, Marjan J

2016-07-25

In advanced Parkinson's disease (PD), neurologists and patients face a complex decision for an advanced therapy. When choosing a treatment, the best available evidence should be combined with the professional's expertise and the patient's preferences. The objective of this study was to explore current decision-making in advanced PD. We conducted focus group discussions and individual interviews with patients (N = 20) who had received deep brain stimulation, Levodopa-Carbidopa intestinal gel, or subcutaneous apomorphine infusion, and with their caregivers (N = 16). Furthermore, we conducted semi-structured interviews with neurologists (N = 7) and PD nurse specialists (N = 3) to include the perspectives of all key players in this decision-making process. Data were analyzed by two researchers using a qualitative thematic analysis approach. Four themes representing current experiences with the decision-making process were identified: 1) information and information needs, 2) factors influencing treatment choice and individual decision strategies, 3) decision-making roles, and 4) barriers and facilitators to shared decision-making (SDM). Patient preferences were taken into account, however patients were not always provided with adequate information. The professional's expertise influenced the decision-making process in both positive and negative ways. Although professionals and patients considered SDM essential for the decision of an advanced treatment, they mentioned several barriers for the implementation in current practice. In this study we found several factors explaining why in current practice, evidence-based decision-making in advanced PD is not optimal. An important first step would be to develop objective information on all treatment options.

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.

A haptic-inspired audio approach for structural health monitoring decision-making

NASA Astrophysics Data System (ADS)

Mao, Zhu; Todd, Michael; Mascareñas, David

2015-03-01

Haptics is the field at the interface of human touch (tactile sensation) and classification, whereby tactile feedback is used to train and inform a decision-making process. In structural health monitoring (SHM) applications, haptic devices have been introduced and applied in a simplified laboratory scale scenario, in which nonlinearity, representing the presence of damage, was encoded into a vibratory manual interface. In this paper, the "spirit" of haptics is adopted, but here ultrasonic guided wave scattering information is transformed into audio (rather than tactile) range signals. After sufficient training, the structural damage condition, including occurrence and location, can be identified through the encoded audio waveforms. Different algorithms are employed in this paper to generate the transformed audio signals and the performance of each encoding algorithms is compared, and also compared with standard machine learning classifiers. In the long run, the haptic decision-making is aiming to detect and classify structural damages in a more rigorous environment, and approaching a baseline-free fashion with embedded temperature compensation.

Probabilistic confidence for decisions based on uncertain reliability estimates

NASA Astrophysics Data System (ADS)

Reid, Stuart G.

2013-05-01

Reliability assessments are commonly carried out to provide a rational basis for risk-informed decisions concerning the design or maintenance of engineering systems and structures. However, calculated reliabilities and associated probabilities of failure often have significant uncertainties associated with the possible estimation errors relative to the 'true' failure probabilities. For uncertain probabilities of failure, a measure of 'probabilistic confidence' has been proposed to reflect the concern that uncertainty about the true probability of failure could result in a system or structure that is unsafe and could subsequently fail. The paper describes how the concept of probabilistic confidence can be applied to evaluate and appropriately limit the probabilities of failure attributable to particular uncertainties such as design errors that may critically affect the dependability of risk-acceptance decisions. This approach is illustrated with regard to the dependability of structural design processes based on prototype testing with uncertainties attributable to sampling variability.

Quantum cognition based on an ambiguous representation derived from a rough set approximation.

PubMed

Gunji, Yukio-Pegio; Sonoda, Kohei; Basios, Vasileios

2016-03-01

Over the last years, in a series papers by Arecchi and others, a model for the cognitive processes involved in decision making has been proposed and investigated. The key element of this model is the expression of apprehension and judgment, basic cognitive process of decision making, as an inverse Bayes inference classifying the information content of neuron spike trains. It has been shown that for successive plural stimuli this inference, equipped with basic non-algorithmic jumps, is affected by quantum-like characteristics. We show here that such a decision making process is related consistently with an ambiguous representation by an observer within a universe of discourse. In our work the ambiguous representation of an object or a stimuli is defined as a pair of maps from objects of a set to their representations, where these two maps are interrelated in a particular structure. The a priori and a posteriori hypotheses in Bayes inference are replaced by the upper and lower approximations, correspondingly, for the initial data sets that are derived with respect to each map. Upper and lower approximations herein are defined in the context of "rough set" analysis. The inverse Bayes inference is implemented by the lower approximations with respect to the one map and for the upper approximation with respect to the other map for a given data set. We show further that, due to the particular structural relation between the two maps, the logical structure of such combined approximations can only be expressed as an orthomodular lattice and therefore can be represented by a quantum rather than a Boolean logic. To our knowledge, this is the first investigation aiming to reveal the concrete logic structure of inverse Bayes inference in cognitive processes. Copyright © 2016. Published by Elsevier Ireland Ltd.

How do the EMA and FDA decide which anticancer drugs make it to the market? A comparative qualitative study on decision makers' views.

PubMed

Tafuri, G; Stolk, P; Trotta, F; Putzeist, M; Leufkens, H G; Laing, R O; De Allegri, M

2014-01-01

The process leading to a regulatory outcome is guided by factors both related and unrelated to the data package, defined in this analysis as 'formal and informal factors', respectively. The aim of this qualitative study was to analyse which formal and informal factors drive the decision-making process of the European Medicines Agency (EMA) and Food and Drug Administration (FDA) regulators with regard to anticancer drugs, using in-depth semi-structured interviews with regulators of the two agencies. In line with the theory and practice of qualitative research, no set sample size was defined a priori. Respondent enrolment continued until saturation and redundancy were reached. Data were collected through means of in-depth semi-structured interviews conducted either in a face-to-face setting or via Skype(®) with each regulator. The interviews were audio-recorded and verbatim transcribed. The analysis was manually carried out on the transcribed text. Data were independently coded and categorized by two researchers. Interpretation of the findings emerged through a process of triangulation between the two. Seven EMA and six FDA regulators, who had extensive experience with making decisions about anticancer medicines, were interviewed between April and June 2012. There is an open dialogue between the FDA and EMA, with the two moving closer and exchanging information, not opinions. Differences in decision-making between the agencies may be due to a different evaluation of end points. Different interaction modalities with industry and patients represent an additional source of divergence with a potential impact on decision-making. The key message of our respondents was that the agencies manage uncertainty in a different way: unlike the EMA, the FDA has a prevailing attitude to take risks in order to guarantee quicker access to new treatments. Although formal factors are the main drivers for regulatory decisions, the influence of informal factors plays an important role in the drug evaluation process.

[Involving patients, the insured and the general public in healthcare decision making].

PubMed

Mühlbacher, Axel C; Juhnke, Christin

2016-01-01

No doubt, the public should be involved in healthcare decision making, especially when decision makers from politics and self-government agencies are faced with the difficult task of setting priorities. There is a general consensus on the need for a stronger patient centeredness, even in HTA processes, and internationally different ways of public participation are discussed and tested in decision making processes. This paper describes how the public can be involved in different decision situations, and it shows how preference measurement methods are currently being used in an international context to support decision making. It distinguishes between different levels of decision making on health technologies: approval, assessment, pricing, and finally utilization. The range of participation efforts extends from qualitative surveys of patients' needs (Citizen Councils of NICE in the UK) to science-based documentation of quantitative patient preferences, such as in the current pilot projects of the FDA in the US and the EMA at the European level. Possible approaches for the elicitation and documentation of preference structures and trade-offs in relation to alternate health technologies are decision aids, such as multi-criteria decision analysis (MCDA), that provide the necessary information for weighting and prioritizing decision criteria. Copyright © 2015. Published by Elsevier GmbH.

Conceptualizing a model: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force-2.

PubMed

Roberts, Mark; Russell, Louise B; Paltiel, A David; Chambers, Michael; McEwan, Phil; Krahn, Murray

2012-01-01

The appropriate development of a model begins with understanding the problem that is being represented. The aim of this article is to provide a series of consensus-based best practices regarding the process of model conceptualization. For the purpose of this series of papers, the authors consider the development of models whose purpose is to inform medical decisions and health-related resource allocation questions. They specifically divide the conceptualization process into two distinct components: the conceptualization of the problem, which converts knowledge of the health care process or decision into a representation of the problem, followed by the conceptualization of the model itself, which matches the attributes and characteristics of a particular modeling type to the needs of the problem being represented. Recommendations are made regarding the structure of the modeling team, agreement on the statement of the problem, the structure, perspective and target population of the model, and the interventions and outcomes represented. Best practices relating to the specific characteristics of model structure, and which characteristics of the problem might be most easily represented in a specific modeling method, are presented. Each section contains a number of recommendations that were iterated among the authors, as well as the wider modeling taskforce, jointly set up by the International Society for Pharmacoeconomics and Outcomes Research and the Society for Medical Decision Making.

HTA and decision-making processes in Central, Eastern and South Eastern Europe: Results from a survey.

PubMed

García-Mochón, Leticia; Espín Balbino, Jaime; Olry de Labry Lima, Antonio; Caro Martinez, Araceli; Martin Ruiz, Eva; Pérez Velasco, Román

2017-03-31

To gain knowledge and insights on health technology assessment (HTA) and decision-making processes in Central, Eastern and South Eastern Europe (CESEE) countries. A cross-sectional study was performed. Based on the literature, a questionnaire was developed in a multi-stage process. The questionnaire was arranged according to 5 broad domains: (i) introduction/country settings; (ii) use of HTA in the country; (iii) decision-making process; (iv) implementation of decisions; and (v) HTA and decision-making: future challenges. Potential survey respondents were identified through literature review-with a total of 118 contacts from the 24 CESEE countries. From March to July 2014, the survey was administered via e-mail. A total of 22 questionnaires were received generating an 18.6% response rate, including 4 responses indicating that their institutions had no involvement in HTA. Most of the CESEE countries have entities under government mandates with advisory functions and different responsibilities for decision-making, but mainly in charge of the reimbursement and pricing of medicines. Other areas where discrepancies across countries were found include criteria for selecting technologies to be assessed, stakeholder involvement, evidence requirements, use of economic evaluation, and timeliness of HTA. A number of CESEE countries have created formal decision-making processes for which HTA is used. However, there is a high level of heterogeneity related to the degree of development of HTA structures, and the methods and processes followed. Further studies focusing on the countries from which information is scarcer and on the HTA of health technologies other than medicines are warranted. Reviews/comparative analyses. Copyright © 2017 Elsevier B.V. All rights reserved.

How Green Water Flows structure be a decision indicator for ecological water allocation in arid Ejina Delta, China.

NASA Astrophysics Data System (ADS)

Yu, J.; Du, C.; Zhang, Y.; Liu, X.

2014-12-01

Green water flows, a key ecohydrological process, dominates the hydrological cycle in arid region. The structure of green water flows reflects the landscape water consumption characteristics and can be easily obtained by means of remote sensing approach. In arid region, limited fresh water and fragile environment resulted in sharp contradictions between economy and natural ecosystem concerning water demands. To rationally allocate economic and ecological water use, to maximize the regional freshwater use efficiency, is the route one must take for sustainable development in arid area. The pursuit of the most necessary ecological protection function and the maximum ecological water use efficiency is the key to ecological water allocation. However, we are short of simple and quick detectable variables or indexes to assess ecological water allocation decision. This paper introduced the green water flows structure as a decision variable, chose Heihe river flow allocation to downstream Ejina Delta for ecological protection as an example, put forward why and how green water flows structure could be used for ecological water allocation decision. The authors expect to provide reference for integrated fresh water resources management practice in arid region.

Team Attributes, Processes, and Values: A Pedagogical Framework

ERIC Educational Resources Information Center

Keyton, Joann; Beck, Stephenson J.

2008-01-01

This article proposes a pedagogical framework to help students analyze their group and team interactions. Intersecting five fundamental group attributes (group size, group goal, group member interdependence, group structure, and group identity) with three overarching group processes (leadership, decision making, and conflict management) creates an…

The decisions regarding ADHD management (DRAMa) study: uncertainties and complexities in assessment, diagnosis and treatment, from the clinician's point of view.

PubMed

Kovshoff, Hanna; Williams, Sarah; Vrijens, May; Danckaerts, Marina; Thompson, Margaret; Yardley, Lucy; Hodgkins, Paul; Sonuga-Barke, Edmund J S

2012-02-01

Clinical decision making is influenced by a range of factors and constitutes an inherently complex task. Here we present results from the decisions regarding ADHD management (DRAMa) study in which we undertook a thematic analysis of clinicians' experiences and attitudes to assessment, diagnosis and treatment of ADHD. Fifty prescribing child psychiatrists and paediatricians from Belgium and the UK took part in semi-structured interviews about their decisions regarding the assessment, diagnosis and treatment of ADHD. Interviews were transcribed and processed using thematic analysis and the principles of grounded theory. Clinicians described the assessment and diagnostic process as inherently complicated and requiring time and experience to piece together the accounts of children made by multiple sources and through the use of varying information gathering techniques. Treatment decisions were viewed as a shared process between families, children, and the clinician. Published guidelines were viewed as vague, and few clinicians spoke about the use of symptom thresholds or specific impairment criteria. Furthermore, systematic or operationalised criteria to assess treatment outcomes were rarely used. Decision making in ADHD is regarded as a complicated, time consuming process which requires extensive use of clinical impression, and involves a partnership with parents. Clinicians want to separate biological from environmental causal factors to understand the level of impairment and the subsequent need for a diagnosis of ADHD. Clinical guidelines would benefit from revisions to take into account the real-world complexities of clinical decision making for ADHD.

Development of a robust space power system decision model

NASA Astrophysics Data System (ADS)

Chew, Gilbert; Pelaccio, Dennis G.; Jacobs, Mark; Stancati, Michael; Cataldo, Robert

2001-02-01

NASA continues to evaluate power systems to support human exploration of the Moon and Mars. The system(s) would address all power needs of surface bases and on-board power for space transfer vehicles. Prior studies have examined both solar and nuclear-based alternatives with respect to individual issues such as sizing or cost. What has not been addressed is a comprehensive look at the risks and benefits of the options that could serve as the analytical framework to support a system choice that best serves the needs of the exploration program. This paper describes the SAIC developed Space Power System Decision Model, which uses a formal Two-step Analytical Hierarchy Process (TAHP) methodology that is used in the decision-making process to clearly distinguish candidate power systems in terms of benefits, safety, and risk. TAHP is a decision making process based on the Analytical Hierarchy Process, which employs a hierarchic approach of structuring decision factors by weights, and relatively ranks system design options on a consistent basis. This decision process also includes a level of data gathering and organization that produces a consistent, well-documented assessment, from which the capability of each power system option to meet top-level goals can be prioritized. The model defined on this effort focuses on the comparative assessment candidate power system options for Mars surface application(s). This paper describes the principles of this approach, the assessment criteria and weighting procedures, and the tools to capture and assess the expert knowledge associated with space power system evaluation. .

Negotiation and Decision Making with Collaborative Software: How MarineMap 'Changed the Game' in California's Marine Life Protected Act Initiative.

PubMed

Cravens, Amanda E

2016-02-01

Environmental managers and planners have become increasingly enthusiastic about the potential of decision support tools (DSTs) to improve environmental decision-making processes as information technology transforms many aspects of daily life. Discussions about DSTs, however, rarely recognize the range of ways software can influence users' negotiation, problem-solving, or decision-making strategies and incentives, in part because there are few empirical studies of completed processes that used technology. This mixed-methods study-which draws on data from approximately 60 semi-structured interviews and an online survey--examines how one geospatial DST influenced participants' experiences during a multi-year marine planning process in California. Results suggest that DSTs can facilitate communication by creating a common language, help users understand the geography and scientific criteria in play during the process, aid stakeholders in identifying shared or diverging interests, and facilitate joint problem solving. The same design features that enabled the tool to aid in decision making, however, also presented surprising challenges in certain circumstances by, for example, making it difficult for participants to discuss information that was not spatially represented on the map-based interface. The study also highlights the importance of the social context in which software is developed and implemented, suggesting that the relationship between the software development team and other participants may be as important as technical software design in shaping how DSTs add value. The paper concludes with considerations to inform the future use of DSTs in environmental decision-making processes.

Negotiation and Decision Making with Collaborative Software: How MarineMap `Changed the Game' in California's Marine Life Protected Act Initiative

NASA Astrophysics Data System (ADS)

Cravens, Amanda E.

2016-02-01

Environmental managers and planners have become increasingly enthusiastic about the potential of decision support tools (DSTs) to improve environmental decision-making processes as information technology transforms many aspects of daily life. Discussions about DSTs, however, rarely recognize the range of ways software can influence users' negotiation, problem-solving, or decision-making strategies and incentives, in part because there are few empirical studies of completed processes that used technology. This mixed-methods study—which draws on data from approximately 60 semi-structured interviews and an online survey—examines how one geospatial DST influenced participants' experiences during a multi-year marine planning process in California. Results suggest that DSTs can facilitate communication by creating a common language, help users understand the geography and scientific criteria in play during the process, aid stakeholders in identifying shared or diverging interests, and facilitate joint problem solving. The same design features that enabled the tool to aid in decision making, however, also presented surprising challenges in certain circumstances by, for example, making it difficult for participants to discuss information that was not spatially represented on the map-based interface. The study also highlights the importance of the social context in which software is developed and implemented, suggesting that the relationship between the software development team and other participants may be as important as technical software design in shaping how DSTs add value. The paper concludes with considerations to inform the future use of DSTs in environmental decision-making processes.

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

NASA Astrophysics Data System (ADS)

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

2012-04-01

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

The Role of Ethics Committees and Ethics Consultation in Allocation Decisions

PubMed Central

Strech, Daniel; Hurst, Samia; Danis, Marion

2013-01-01

Background Decisions about the allocation and rationing of medical interventions likely occur in all health care systems worldwide. So far very little attention has been given to the question of what role ethics consultation and ethics committees could or should play in questions of allocation at the hospital level. Objectives and Methods This article argues for the need for ethics consultation in rationing decisions using empirical data about the status quo and the inherent nature of bedside rationing. Subsequently, it introduces a 4-stage process for establishing and conducting ethics consultation in rationing questions with systematic reference to core elements of procedural justice. Results Qualitative and quantitative findings show a significant demand for ethics consultation expressed directly by doctors, as well as additional indirect evidence of such a need as indicated by ethically challenging circumstances of inconsistent and structurally disadvantaging rationing decisions. To address this need, we suggest 4 stages for establishing and conducting ethics consultation in rationing questions we recommend: (1) training, (2) identifying actual scarcity-related problems at clinics, (3) supporting decision-making, and (4) evaluation. Conclusion This process of ethics consultation regarding rationing decisions would facilitate the achievement of several practical goals: (i) encouragement of an awareness and understanding of ethical problems in bedside rationing, (ii) encouragement of achieving efficiency along with rationing, (iii) reinforcement of consistency in inter- and intraindvidual decision-making, (iv) encouragement of explicit reflection and justification of the prioritization criteria taken into consideration, (v) improvement in internal (in-house) and external transparency, and (vi) prevention of the misuse of the corresponding consulting structures. PMID:20706163

Wireless structural monitoring for homeland security applications

NASA Astrophysics Data System (ADS)

Kiremidjian, Garo K.; Kiremidjian, Anne S.; Lynch, Jerome P.

2004-07-01

This paper addresses the development of a robust, low-cost, low power, and high performance autonomous wireless monitoring system for civil assets such as large facilities, new construction, bridges, dams, commercial buildings, etc. The role of the system is to identify the onset, development, location and severity of structural vulnerability and damage. The proposed system represents an enabling infrastructure for addressing structural vulnerabilities specifically associated with homeland security. The system concept is based on dense networks of "intelligent" wireless sensing units. The fundamental properties of a wireless sensing unit include: (a) interfaces to multiple sensors for measuring structural and environmental data (such as acceleration, displacements, pressure, strain, material degradation, temperature, gas agents, biological agents, humidity, corrosion, etc.); (b) processing of sensor data with embedded algorithms for assessing damage and environmental conditions; (c) peer-to-peer wireless communications for information exchange among units(thus enabling joint "intelligent" processing coordination) and storage of data and processed information in servers for information fusion; (d) ultra low power operation; (e) cost-effectiveness and compact size through the use of low-cost small-size off-the-shelf components. An integral component of the overall system concept is a decision support environment for interpretation and dissemination of information to various decision makers.

Decision-making deficit of a patient with axonal damage after traumatic brain injury.

PubMed

Yasuno, Fumihiko; Matsuoka, Kiwamu; Kitamura, Soichiro; Kiuchi, Kuniaki; Kosaka, Jun; Okada, Koji; Tanaka, Syohei; Shinkai, Takayuki; Taoka, Toshiaki; Kishimoto, Toshifumi

2014-02-01

Patients with traumatic brain injury (TBI) were reported to have difficulty making advantageous decisions, but the underlying deficits of the network of brain areas involved in this process were not directly examined. We report a patient with TBI who demonstrated problematic behavior in situations of risk and complexity after cerebral injury from a traffic accident. The Iowa gambling task (IGT) was used to reveal his deficits in the decision-making process. To examine underlying deficits of the network of brain areas, we examined T1-weighted structural MRI, diffusion tensor imaging (DTI) and Tc-ECD SPECT in this patient. The patient showed abnormality in IGT. DTI-MRI results showed a significant decrease in fractional anisotropy (FA) in the fasciculus between the brain stem and cortical regions via the thalamus. He showed significant decrease in gray matter volumes in the bilateral insular cortex, hypothalamus, and posterior cingulate cortex, possibly reflecting Wallerian degeneration secondary to the fasciculus abnormalities. SPECT showed significant blood flow decrease in the broad cortical areas including the ventromedial prefrontal cortex (VM). Our study showed that the patient had dysfunctional decision-making process. Microstructural abnormality in the fasciculus, likely from the traffic accident, caused reduced afferent feedback to the brain, resulting in less efficient decision-making. Our findings support the somatic-marker hypothesis (SMH), where somatic feedback to the brain influences the decision-making process. Copyright © 2013 Elsevier Inc. All rights reserved.

Functional Freedom: A Psychological Model of Freedom in Decision-Making.

PubMed

Lau, Stephan; Hiemisch, Anette

2017-07-05

The freedom of a decision is not yet sufficiently described as a psychological variable. We present a model of functional decision freedom that aims to fill that role. The model conceptualizes functional freedom as a capacity of people that varies depending on certain conditions of a decision episode. It denotes an inner capability to consciously shape complex decisions according to one's own values and needs. Functional freedom depends on three compensatory dimensions: it is greatest when the decision-maker is highly rational, when the structure of the decision is highly underdetermined, and when the decision process is strongly based on conscious thought and reflection. We outline possible research questions, argue for psychological benefits of functional decision freedom, and explicate the model's implications on current knowledge and research. In conclusion, we show that functional freedom is a scientific variable, permitting an additional psychological foothold in research on freedom, and that is compatible with a deterministic worldview.

The influence of spatiotemporal structure of noisy stimuli in decision making.

PubMed

Insabato, Andrea; Dempere-Marco, Laura; Pannunzi, Mario; Deco, Gustavo; Romo, Ranulfo

2014-04-01

Decision making is a process of utmost importance in our daily lives, the study of which has been receiving notable attention for decades. Nevertheless, the neural mechanisms underlying decision making are still not fully understood. Computational modeling has revealed itself as a valuable asset to address some of the fundamental questions. Biophysically plausible models, in particular, are useful in bridging the different levels of description that experimental studies provide, from the neural spiking activity recorded at the cellular level to the performance reported at the behavioral level. In this article, we have reviewed some of the recent progress made in the understanding of the neural mechanisms that underlie decision making. We have performed a critical evaluation of the available results and address, from a computational perspective, aspects of both experimentation and modeling that so far have eluded comprehension. To guide the discussion, we have selected a central theme which revolves around the following question: how does the spatiotemporal structure of sensory stimuli affect the perceptual decision-making process? This question is a timely one as several issues that still remain unresolved stem from this central theme. These include: (i) the role of spatiotemporal input fluctuations in perceptual decision making, (ii) how to extend the current results and models derived from two-alternative choice studies to scenarios with multiple competing evidences, and (iii) to establish whether different types of spatiotemporal input fluctuations affect decision-making outcomes in distinctive ways. And although we have restricted our discussion mostly to visual decisions, our main conclusions are arguably generalizable; hence, their possible extension to other sensory modalities is one of the points in our discussion.

The Influence of Spatiotemporal Structure of Noisy Stimuli in Decision Making

PubMed Central

Deco, Gustavo; Romo, Ranulfo

2014-01-01

Decision making is a process of utmost importance in our daily lives, the study of which has been receiving notable attention for decades. Nevertheless, the neural mechanisms underlying decision making are still not fully understood. Computational modeling has revealed itself as a valuable asset to address some of the fundamental questions. Biophysically plausible models, in particular, are useful in bridging the different levels of description that experimental studies provide, from the neural spiking activity recorded at the cellular level to the performance reported at the behavioral level. In this article, we have reviewed some of the recent progress made in the understanding of the neural mechanisms that underlie decision making. We have performed a critical evaluation of the available results and address, from a computational perspective, aspects of both experimentation and modeling that so far have eluded comprehension. To guide the discussion, we have selected a central theme which revolves around the following question: how does the spatiotemporal structure of sensory stimuli affect the perceptual decision-making process? This question is a timely one as several issues that still remain unresolved stem from this central theme. These include: (i) the role of spatiotemporal input fluctuations in perceptual decision making, (ii) how to extend the current results and models derived from two-alternative choice studies to scenarios with multiple competing evidences, and (iii) to establish whether different types of spatiotemporal input fluctuations affect decision-making outcomes in distinctive ways. And although we have restricted our discussion mostly to visual decisions, our main conclusions are arguably generalizable; hence, their possible extension to other sensory modalities is one of the points in our discussion. PMID:24743140

Selecting essential information for biosurveillance--a multi-criteria decision analysis.

PubMed

Generous, Nicholas; Margevicius, Kristen J; Taylor-McCabe, Kirsten J; Brown, Mac; Daniel, W Brent; Castro, Lauren; Hengartner, Andrea; Deshpande, Alina

2014-01-01

The National Strategy for Biosurveillance defines biosurveillance as "the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels." However, the strategy does not specify how "essential information" is to be identified and integrated into the current biosurveillance enterprise, or what the metrics qualify information as being "essential". The question of data stream identification and selection requires a structured methodology that can systematically evaluate the tradeoffs between the many criteria that need to be taken in account. Multi-Attribute Utility Theory, a type of multi-criteria decision analysis, can provide a well-defined, structured approach that can offer solutions to this problem. While the use of Multi-Attribute Utility Theoryas a practical method to apply formal scientific decision theoretical approaches to complex, multi-criteria problems has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance.We have developed a formalized decision support analytic framework that can facilitate identification of "essential information" for use in biosurveillance systems or processes and we offer this framework to the global BSV community as a tool for optimizing the BSV enterprise. To demonstrate utility, we applied the framework to the problem of evaluating data streams for use in an integrated global infectious disease surveillance system.

Use of structured decision making to identify monitoring variables and management priorities for salt marsh ecosystems

USGS Publications Warehouse

Neckles, Hilary A.; Lyons, James E.; Guntenspergen, Glenn R.; Shriver, W. Gregory; Adamowicz, Susan C.

2015-01-01

Most salt marshes in the USA have been degraded by human activities, and coastal managers are faced with complex choices among possible actions to restore or enhance ecosystem integrity. We applied structured decision making (SDM) to guide selection of monitoring variables and management priorities for salt marshes within the National Wildlife Refuge System in the northeastern USA. In general, SDM is a systematic process for decomposing a decision into its essential elements. We first engaged stakeholders in clarifying regional salt marsh decision problems, defining objectives and attributes to evaluate whether objectives are achieved, and developing a pool of alternative management actions for achieving objectives. Through this process, we identified salt marsh attributes that were applicable to monitoring National Wildlife Refuges on a regional scale and that targeted management needs. We then analyzed management decisions within three salt marsh units at Prime Hook National Wildlife Refuge, coastal Delaware, as a case example of prioritizing management alternatives. Values for salt marsh attributes were estimated from 2 years of baseline monitoring data and expert opinion. We used linear value modeling to aggregate multiple attributes into a single performance score for each alternative, constrained optimization to identify alternatives that maximized total management benefits subject to refuge-wide cost constraints, and used graphical analysis to identify the optimal set of alternatives for the refuge. SDM offers an efficient, transparent approach for integrating monitoring into management practice and improving the quality of management decisions.

Optimizing model: insemination, replacement, seasonal production, and cash flow.

PubMed

DeLorenzo, M A; Spreen, T H; Bryan, G R; Beede, D K; Van Arendonk, J A

1992-03-01

Dynamic programming to solve the Markov decision process problem of optimal insemination and replacement decisions was adapted to address large dairy herd management decision problems in the US. Expected net present values of cow states (151,200) were used to determine the optimal policy. States were specified by class of parity (n = 12), production level (n = 15), month of calving (n = 12), month of lactation (n = 16), and days open (n = 7). Methodology optimized decisions based on net present value of an individual cow and all replacements over a 20-yr decision horizon. Length of decision horizon was chosen to ensure that optimal policies were determined for an infinite planning horizon. Optimization took 286 s of central processing unit time. The final probability transition matrix was determined, in part, by the optimal policy. It was estimated iteratively to determine post-optimization steady state herd structure, milk production, replacement, feed inputs and costs, and resulting cash flow on a calendar month and annual basis if optimal policies were implemented. Implementation of the model included seasonal effects on lactation curve shapes, estrus detection rates, pregnancy rates, milk prices, replacement costs, cull prices, and genetic progress. Other inputs included calf values, values of dietary TDN and CP per kilogram, and discount rate. Stochastic elements included conception (and, thus, subsequent freshening), cow milk production level within herd, and survival. Validation of optimized solutions was by separate simulation model, which implemented policies on a simulated herd and also described herd dynamics during transition to optimized structure.

Tracing the decision-making process of physicians with a Decision Process Matrix.

PubMed

Hausmann, Daniel; Zulian, Cristina; Battegay, Edouard; Zimmerli, Lukas

2016-10-18

Decision-making processes in a medical setting are complex, dynamic and under time pressure, often with serious consequences for a patient's condition. The principal aim of the present study was to trace and map the individual diagnostic process of real medical cases using a Decision Process Matrix [DPM]). The naturalistic decision-making process of 11 residents and a total of 55 medical cases were recorded in an emergency department, and a DPM was drawn up according to a semi-structured technique following four steps: 1) observing and recording relevant information throughout the entire diagnostic process, 2) assessing options in terms of suspected diagnoses, 3) drawing up an initial version of the DPM, and 4) verifying the DPM, while adding the confidence ratings. The DPM comprised an average of 3.2 suspected diagnoses and 7.9 information units (cues). The following three-phase pattern could be observed: option generation, option verification, and final diagnosis determination. Residents strove for the highest possible level of confidence before making the final diagnoses (in two-thirds of the medical cases with a rating of practically certain) or excluding suspected diagnoses (with practically impossible in half of the cases). The following challenges have to be addressed in the future: real-time capturing of emerging suspected diagnoses in the memory of the physician, definition of meaningful information units, and a more contemporary measurement of confidence. DPM is a useful tool for tracing real and individual diagnostic processes. The methodological approach with DPM allows further investigations into the underlying cognitive diagnostic processes on a theoretical level and improvement of individual clinical reasoning skills in practice.

The Economics of Structured Continuing Education in Selected Professional Journals.

ERIC Educational Resources Information Center

Sasmor, James C.

A study determined what business administration considerations were elements in the managerial decision making process to include structured continuing education in a professional journal and what the positive or negative results have been in terms of operating benefits and profits. An initial literature review showed the need for exploratory…

Modeling Human-Computer Decision Making with Covariance Structure Analysis.

ERIC Educational Resources Information Center

Coovert, Michael D.; And Others

Arguing that sufficient theory exists about the interplay between human information processing, computer systems, and the demands of various tasks to construct useful theories of human-computer interaction, this study presents a structural model of human-computer interaction and reports the results of various statistical analyses of this model.…

The Employer Perspective: A Survey of Employer Participation in Structured Workplace Learning, 2000.

ERIC Educational Resources Information Center

AMR Interactive (Australia).

In 2000, a quantitative telephone survey of 2,098 businesses in Australia determined employer awareness of and participation in structured workplace learning (SWL) programs. It explored "drivers" of participation and employers' decision-making process. Comparisons with a 1998 survey identified changes in employer awareness, attitudes,…

Using Research To Inform Business and Strategic Decisions.

ERIC Educational Resources Information Center

Young, Graeme

This paper examines and reviews research techniques used to support business and strategic planning at a large metropolitan technical and further education (TAFE) college. Section 1 is an outline of the structure of Chisholm Institute's planning and research processes. It discusses the management structure, strategic plan, and departments within…

Simulating Spatial Growth Patterns in Developing Countries: A Case of Shama in the Western Region of Ghana.

NASA Astrophysics Data System (ADS)

Inkoom, J. N.; Nyarko, B. K.

2014-12-01

The integration of geographic information systems (GIS) and agent-based modelling (ABM) can be an efficient tool to improve spatial planning practices. This paper utilizes GIS and ABM approaches to simulate spatial growth patterns of settlement structures in Shama. A preliminary household survey on residential location decision-making choice served as the behavioural rule for household agents in the model. Physical environment properties of the model were extracted from a 2005 image implemented in NetLogo. The resulting growth pattern model was compared with empirical growth patterns to ascertain the model's accuracy. The paper establishes that the development of unplanned structures and its evolving structural pattern are a function of land price, proximity to economic centres, household economic status and location decision-making patterns. The application of the proposed model underlines its potential for integration into urban planning policies and practices, and for understanding residential decision-making processes in emerging cities in developing countries. Key Words: GIS; Agent-based modelling; Growth patterns; NetLogo; Location decision making; Computational Intelligence.

Behavioral variability of choices versus structural inconsistency of preferences.

PubMed

Regenwetter, Michel; Davis-Stober, Clintin P

2012-04-01

Theories of rational choice often make the structural consistency assumption that every decision maker's binary strict preference among choice alternatives forms a strict weak order. Likewise, the very concept of a utility function over lotteries in normative, prescriptive, and descriptive theory is mathematically equivalent to strict weak order preferences over those lotteries, while intransitive heuristic models violate such weak orders. Using new quantitative interdisciplinary methodologies, we dissociate the variability of choices from the structural inconsistency of preferences. We show that laboratory choice behavior among stimuli of a classical "intransitivity" paradigm is, in fact, consistent with variable strict weak order preferences. We find that decision makers act in accordance with a restrictive mathematical model that, for the behavioral sciences, is extraordinarily parsimonious. Our findings suggest that the best place to invest future behavioral decision research is not in the development of new intransitive decision models but rather in the specification of parsimonious models consistent with strict weak order(s), as well as heuristics and other process models that explain why preferences appear to be weakly ordered.

The time course of saccadic decision making: dynamic field theory.

PubMed

Wilimzig, Claudia; Schneider, Stefan; Schöner, Gregor

2006-10-01

Making a saccadic eye movement involves two decisions, the decision to initiate the saccade and the selection of the visual target of the saccade. Here we provide a theoretical account for the time-courses of these two processes, whose instabilities are the basis of decision making. We show how the cross-over from spatial averaging for fast saccades to selection for slow saccades arises from the balance between excitatory and inhibitory processes. Initiating a saccade involves overcoming fixation, as can be observed in the countermanding paradigm, which we model accounting both for the temporal evolution of the suppression probability and its dependence on fixation activity. The interaction between the two forms of decision making is demonstrated by predicting how the cross-over from averaging to selection depends on the fixation stimulus in gap-step-overlap paradigms. We discuss how the activation dynamics of our model may be mapped onto neuronal structures including the motor map and the fixation cells in superior colliculus.

Indicators of Effective Policy Development & Implementation. Issue Brief #8

ERIC Educational Resources Information Center

Stonemeier, Jenny; Trader, Barb; Kaloi, Laura; Williams, Gabrielle

2016-01-01

Within the SWIFT framework, the Inclusive Policy Structure and Practice domain addresses the need for a supportive, reciprocal partnership between the school and its district or local educational agency. Therefore, intentional and effective policy decision-making processes are integral to SWIFT implementation. Such processes create opportunities…

Morphological Structure in Native and Nonnative Language Processing

ERIC Educational Resources Information Center

Clahsen, Harald; Felser, Claudia; Neubauer, Kathleen; Sato, Mikako; Silva, Renita

2010-01-01

This article presents a selective overview of studies that have investigated how advanced adult second language (L2) learners process morphologically complex words. The studies reported here have used different kinds of experimental tasks (including speeded grammaticality judgments, lexical decision, and priming) to examine three domains of…

Decision making and senior management: the implementation of change projects covering clinical management in SUS hospitals.

PubMed

Pacheco, José Márcio da Cunha; Gomes, Romeu

2016-08-01

This paper analyses the decision making process for senior management in public hospitals that are a part of the National Health Service in Brazil (hereafter SUS) in relation to projects aimed at changing clinical management. The methodological design of this study is qualitative in nature taking a hermeneutics-dialectics perspective in terms of results. Hospital directors noted that clinical management projects changed the state of hospitals through: improving their organizations, mobilizing their staff in order to increase a sense of order and systemizing actions and available resources. Technical rationality was the principal basis used in the decision making process for managers. Due to the reality of many hospitals having fragmented organizations, this fact impeded the use of aspects related to rationality, such as economic and financial factors in the decision making process. The incremental model and general politics also play a role in this area. We concluded that the decision making process embraces a large array of factors including rational aspects such as the use of management techniques and the ability to analyze, interpret and summarize. It also incorporates subjective elements such as how to select values and dealing with people's working experiences. We recognized that management problems are wide in scope, ambiguous, complex and do not come with a lot of structure in practice.

Consideration of reference points for the management of renewable resources under an adaptive management paradigm

USGS Publications Warehouse

Irwin, Brian J.; Conroy, Michael J.

2013-01-01

The success of natural resource management depends on monitoring, assessment and enforcement. In support of these efforts, reference points (RPs) are often viewed as critical values of management-relevant indicators. This paper considers RPs from the standpoint of objective-driven decision making in dynamic resource systems, guided by principles of structured decision making (SDM) and adaptive resource management (AM). During the development of natural resource policy, RPs have been variously treated as either ‘targets’ or ‘triggers’. Under a SDM/AM paradigm, target RPs correspond approximately to value-based objectives, which may in turn be either of fundamental interest to stakeholders or intermediaries to other central objectives. By contrast, trigger RPs correspond to decision rules that are presumed to lead to desirable outcomes (such as the programme targets). Casting RPs as triggers or targets within a SDM framework is helpful towards clarifying why (or whether) a particular metric is appropriate. Further, the benefits of a SDM/AM process include elucidation of underlying untested assumptions that may reveal alternative metrics for use as RPs. Likewise, a structured decision-analytic framework may also reveal that failure to achieve management goals is not because the metrics are wrong, but because the decision-making process in which they are embedded is insufficiently robust to uncertainty, is not efficiently directed at producing a resource objective, or is incapable of adaptation to new knowledge.

Mothers' reading skills and child survival in Nigeria: examining the relevance of mothers' decision-making power.

PubMed

Smith-Greenaway, Emily

2013-11-01

Mothers' literacy skills are emerging as a key determinant of children's health and survival in low-income contexts, with emphasis on the cognitive and psychological agency that literacy skills provide. This work has clearly established a strong association between mothers' reading skills--a key subcomponent of broader literacy and language skills--and child mortality. However, this relatively nascent literature has not yet considered how broader social structures condition the process. In Nigeria and in sub-Saharan Africa more broadly, gender-based social inequality constrains many mothers' decision-making power over children's health matters; this structural feature may condition the association between mothers' reading skills and child mortality. This paper uses data from the 2003 Nigerian Demographic and Health Survey (N = 12,076) to test the conditionality of the relationship between mothers' reading skills and child survival on mothers' decision-making power, highlighting how structural realities should factor more heavily into this individual-action-oriented literature. Among Nigerian children whose mothers have decision-making power, mothers' reading skills convey a 27 percent lower risk of child mortality; however, for children whose mothers lack decision-making power, mothers' reading skills do not yield a significant survival advantage. Overall, these findings support the need for future work to further analyze how broader social structures condition the benefits of mothers' reading skills for children's health. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mothers’ Reading Skills and Child Survival in Nigeria: Examining the Relevance of Mothers’ Decision-Making Power

PubMed Central

Smith-Greenaway, Emily

2013-01-01

Mothers’ literacy skills are emerging as a key determinant of children’s health and survival in low-income contexts, with emphasis on the cognitive and psychological agency that literacy skills provide. This work has clearly established a strong association between mothers’ reading skills—a key subcomponent of broader literacy and language skills—and child mortality. However, this relatively nascent literature has not yet considered how broader social structures condition the process. In Nigeria and in sub-Saharan Africa more broadly, gender-based social inequality constrains many mothers’ decision-making power over children’s health matters; this structural feature may condition the association between mothers’ reading skills and child mortality. This paper uses data from the 2003 Nigerian Demographic and Health Survey (N = 12,076) to test the conditionality of the relationship between mothers’ reading skills and child survival on mothers’ decision-making power, highlighting how structural realities should factor more heavily into this individual-action-oriented literature. Among Nigerian children whose mothers have decision-making power, mothers’ reading skills convey a 27 percent lower risk of child mortality; however, for children whose mothers lack decision-making power, mothers’ reading skills do not yield a significant survival advantage. Overall, these findings support the need for future work to further analyze how broader social structures condition the benefits of mothers’ reading skills for children’s health. PMID:24161100

Planning for Higher Education.

ERIC Educational Resources Information Center

Lindstrom, Caj-Gunnar

1984-01-01

Decision processes for strategic planning for higher education institutions are outlined using these parameters: institutional goals and power structure, organizational climate, leadership attitudes, specific problem type, and problem-solving conditions and alternatives. (MSE)

The Factors Affecting End-of-Life Decision-Making by Physicians of Patients with Intellectual Disabilities in the Netherlands: A Qualitative Study

ERIC Educational Resources Information Center

Wagemans, A.; van Schrojenstein Lantman-de Valk, H.; Proot, I.; Metsemakers, J.; Tuffrey-Wijne, I.; Curfs, L.

2013-01-01

Background: The aim of this study was to investigate the process of end-of-life decision-making regarding people with intellectual disabilities (ID) in the Netherlands, from the perspective of physicians. Methods: This qualitative study involved nine semi-structured interviews with ID physicians in the Netherlands after the deaths of patients with…

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

PubMed Central

2013-01-01

Background Resource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons. Methods Between January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating. Results About one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as ‘good’ or ‘very good’. This paper explores these findings in greater detail and assesses them in context of the larger literature. Conclusion Data from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada’s health system leadership teams. PMID:23819598

Visual anticipation biases conscious decision making but not bottom-up visual processing.

PubMed

Mathews, Zenon; Cetnarski, Ryszard; Verschure, Paul F M J

2014-01-01

Prediction plays a key role in control of attention but it is not clear which aspects of prediction are most prominent in conscious experience. An evolving view on the brain is that it can be seen as a prediction machine that optimizes its ability to predict states of the world and the self through the top-down propagation of predictions and the bottom-up presentation of prediction errors. There are competing views though on whether prediction or prediction errors dominate the formation of conscious experience. Yet, the dynamic effects of prediction on perception, decision making and consciousness have been difficult to assess and to model. We propose a novel mathematical framework and a psychophysical paradigm that allows us to assess both the hierarchical structuring of perceptual consciousness, its content and the impact of predictions and/or errors on conscious experience, attention and decision-making. Using a displacement detection task combined with reverse correlation, we reveal signatures of the usage of prediction at three different levels of perceptual processing: bottom-up fast saccades, top-down driven slow saccades and consciousnes decisions. Our results suggest that the brain employs multiple parallel mechanism at different levels of perceptual processing in order to shape effective sensory consciousness within a predicted perceptual scene. We further observe that bottom-up sensory and top-down predictive processes can be dissociated through cognitive load. We propose a probabilistic data association model from dynamical systems theory to model the predictive multi-scale bias in perceptual processing that we observe and its role in the formation of conscious experience. We propose that these results support the hypothesis that consciousness provides a time-delayed description of a task that is used to prospectively optimize real time control structures, rather than being engaged in the real-time control of behavior itself.

The Demand for Higher Education: A Static Structural Approach Accounting for Individual Heterogeneity and Nesting Patterns

ERIC Educational Resources Information Center

Flannery, Darragh; O'Donoghue, Cathal

2013-01-01

In this paper we estimate a structural model of higher education participation and labour choices in a static setting that accounts for individual heterogeneity and possible nesting structures in the decision process. We assume that young people that complete upper secondary education are faced with three choices, go to higher education, not go to…

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

PubMed

Diamond-Brown, Lauren

2016-06-01

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

Analyzing the School Evaluation Use Process To Make Evaluation Worth the Effort.

ERIC Educational Resources Information Center

Pechman, Ellen M.; King, Jean A.

This paper describes a structure for assessing the school evaluation use process developed from a longitudinal case study of districtwide and school level evaluation procedures in a large urban school district. Two fundamental questions guided the study: (1) Why isn't the evaluation process more useful to decision-makers and practitioners? and (2)…

Benefits and Costs of Lexical Decomposition and Semantic Integration during the Processing of Transparent and Opaque English Compounds

ERIC Educational Resources Information Center

Ji, Hongbo; Gagne, Christina L.; Spalding, Thomas L.

2011-01-01

Six lexical decision experiments were conducted to examine the influence of complex structure on the processing speed of English compounds. All experiments revealed that semantically transparent compounds (e.g., "rosebud") were processed more quickly than matched monomorphemic words (e.g., "giraffe"). Opaque compounds (e.g., "hogwash") were also…

Use of Probabilistic Risk Assessment in Shuttle Decision Making Process

NASA Technical Reports Server (NTRS)

Boyer, Roger L.; Hamlin, Teri, L.

2011-01-01

This slide presentation reviews the use of Probabilistic Risk Assessment (PRA) to assist in the decision making for the shuttle design and operation. Probabilistic Risk Assessment (PRA) is a comprehensive, structured, and disciplined approach to identifying and analyzing risk in complex systems and/or processes that seeks answers to three basic questions: (i.e., what can go wrong? what is the likelihood of these occurring? and what are the consequences that could result if these occur?) The purpose of the Shuttle PRA (SPRA) is to provide a useful risk management tool for the Space Shuttle Program (SSP) to identify strengths and possible weaknesses in the Shuttle design and operation. SPRA was initially developed to support upgrade decisions, but has evolved into a tool that supports Flight Readiness Reviews (FRR) and near real-time flight decisions. Examples of the use of PRA for the shuttle are reviewed.

Ranking of Business Process Simulation Software Tools with DEX/QQ Hierarchical Decision Model.

PubMed

Damij, Nadja; Boškoski, Pavle; Bohanec, Marko; Mileva Boshkoska, Biljana

2016-01-01

The omnipresent need for optimisation requires constant improvements of companies' business processes (BPs). Minimising the risk of inappropriate BP being implemented is usually performed by simulating the newly developed BP under various initial conditions and "what-if" scenarios. An effectual business process simulations software (BPSS) is a prerequisite for accurate analysis of an BP. Characterisation of an BPSS tool is a challenging task due to the complex selection criteria that includes quality of visual aspects, simulation capabilities, statistical facilities, quality reporting etc. Under such circumstances, making an optimal decision is challenging. Therefore, various decision support models are employed aiding the BPSS tool selection. The currently established decision support models are either proprietary or comprise only a limited subset of criteria, which affects their accuracy. Addressing this issue, this paper proposes a new hierarchical decision support model for ranking of BPSS based on their technical characteristics by employing DEX and qualitative to quantitative (QQ) methodology. Consequently, the decision expert feeds the required information in a systematic and user friendly manner. There are three significant contributions of the proposed approach. Firstly, the proposed hierarchical model is easily extendible for adding new criteria in the hierarchical structure. Secondly, a fully operational decision support system (DSS) tool that implements the proposed hierarchical model is presented. Finally, the effectiveness of the proposed hierarchical model is assessed by comparing the resulting rankings of BPSS with respect to currently available results.

Communal Participation in Payment for Environmental Services (PES): Unpacking the Collective Decision to Enroll

NASA Astrophysics Data System (ADS)

Murtinho, Felipe; Hayes, Tanya

2017-06-01

Payment for Environmental Service programs are increasingly applied in communal settings where resource users collectively join the program and agree to limit their shared use of a common-property resource. Who decides to join PES and the degree to which community members agree with the collective decision is critical for the success of said programs. Yet, we have limited understanding of the factors that influence communal participation and the collective decision process. This paper examines communal participation in a national payment for conservation program in Ecuador. We use quantitative and qualitative analysis to (i) identify the attributes of the communities that participate (or not), and factors that facilitate participation ( n = 67), and (ii) assess household preference and alignment with the collective decision to participate ( n = 212). Household participation preferences indicate varying degrees of consensus with the collective decision to participate, with those using the resource less likely to support participation. At the communal level, however, our results indicate that over time, those communities that depend more heavily on their resource systems may ultimately choose to participate. Our findings suggest that communal governance structures and outside organizations may be instrumental in gaining participation in resource-dependent communities and building consensus. Findings also point to the need for further research on communal decision-processes to ensure that the collective decision is based on an informed and democratic process.

A Practical Tutorial on Modified Condition/Decision Coverage

NASA Technical Reports Server (NTRS)

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

2001-01-01

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

Transforming organizational culture through nursing shared governance.

PubMed

Newman, Karen Profitt

2011-03-01

Nursing shared governance (NSG) provides a framework for the professionalization of nursing, provides a broader distribution of decision making across the profession, and allocates decisions based on accountability and role expectations. Shared governance defines staff-based decisions, accountability, roles, and ownership of staff in those activities that directly affect nurses' lives and practice. Although NSG is a somewhat ambiguous concept with a vast application, examining it from the perspective of structure, process, and outcomes can more clearly outline a successful strategy for implementation and growth. Copyright © 2011 Elsevier Inc. All rights reserved.

Artificial intelligence in cardiology.

PubMed

Bonderman, Diana

2017-12-01

Decision-making is complex in modern medicine and should ideally be based on available data, structured knowledge and proper interpretation in the context of an individual patient. Automated algorithms, also termed artificial intelligence that are able to extract meaningful patterns from data collections and build decisions upon identified patterns may be useful assistants in clinical decision-making processes. In this article, artificial intelligence-based studies in clinical cardiology are reviewed. The text also touches on the ethical issues and speculates on the future roles of automated algorithms versus clinicians in cardiology and medicine in general.

An Investigation into the Processing of Lexicalized English Blend Words: Evidence from Lexical Decisions and Eye Movements During Reading.

PubMed

Juhasz, Barbara J; Johnson, Rebecca L; Brewer, Jennifer

2017-04-01

New words enter the language through several word formation processes [see Simonini (Engl J 55:752-757, 1966)]. One such process, blending, occurs when two source words are combined to represent a new concept (e.g., SMOG, BRUNCH, BLOG, and INFOMERCIAL). While there have been examinations of the structure of blends [see Gries (Linguistics 42:639-667, 2004) and Lehrer (Am Speech 73:3-28, 1998)], relatively little attention has been given to how lexicalized blends are recognized and if this process differs from other types of words. In the present study, blend words were matched to non-blend control words on length, familiarity, and frequency. Two tasks were used to examine blend processing: lexical decision and sentence reading. The results demonstrated that blend words were processed differently than non-blend control words. However, the nature of the effect varied as a function of task demands. Blends were recognized slower than control words in the lexical decision task but received shorter fixation durations when embedded in sentences.

Chemotherapy treatment decision-making experiences of older adults with cancer, their family members, oncologists and family physicians: a mixed methods study.

PubMed

Puts, Martine T E; Sattar, Schroder; McWatters, Kara; Lee, Katherine; Kulik, Michael; MacDonald, Mary-Ellen; Jang, Raymond; Amir, Eitan; Krzyzanowska, Monika K; Leighl, Natasha; Fitch, Margaret; Joshua, Anthony M; Warde, Padraig; Tourangeau, Ann E; Alibhai, Shabbir M H

2017-03-01

Although comorbidities, frailty, and functional impairment are common in older adults (OA) with cancer, little is known about how these factors are considered during the treatment decision-making process by OAs, their families, and health care providers. Our aim was to better understand the treatment decision process from all these perspectives. A mixed methods multi-perspective longitudinal study using semi-structured interviews and surveys with 29 OAs aged ≥70 years with advanced prostate, breast, colorectal, or lung cancer, 24 of their family members,13 oncologists, and 15 family physicians was conducted. The sample was stratified on age (70-79 and 80+). All interviews were analyzed using thematic analysis. There was no difference in the treatment decision-making experience based on age. Most OAs felt that they should have the final say in the treatment decision, but strongly valued their oncologists' opinion. "Trust in my oncologist" and "chemotherapy as the last resort to prolong life" were the most important reasons to accept treatment. Families indicated a need to improve communication between them, the patient and the specialist, particularly around goals of treatment. Comorbidity and potential side-effects did not play a major role in the treatment decision-making for patients, families, or oncologists. Family physicians reported no involvement in decisions but desired to be more involved. This first study using multiple perspectives showed neither frailty nor comorbidity played a role in the treatment decision-making process. Efforts to improve communication were identified as an opportunity that may enhance quality of care. In a mixed methods study multiple perspective study with older adults with cancer, their family members, their oncologist and their family physician we explored the treatment decision making process and found that most older adults were satisfied with their decision. Comorbidity, functional status and frailty did not impact the older adult's or their family members' decision.

Weaning from mechanical ventilation: factors that influence intensive care nurses' decision-making.

PubMed

Tingsvik, Catarina; Johansson, Karin; Mårtensson, Jan

2015-01-01

The aim of the study was to describe the factors that influence intensive care nurses' decision-making when weaning patients from mechanical ventilation. Patients with failing vital function may require respiratory support. Weaning from mechanical ventilation is a process in which the intensive care nurse participates in both planning and implementation. A qualitative approach was used. The data were collected by means of semi-structured interviews with 22 intensive care nurses. The interviews were transcribed and analysed using qualitative content analysis. One theme emerged: 'A complex nursing situation where the patient receives attention and which is influenced by the current care culture'. There was consensus that the overall assessment of the patient made by the intensive care nurse was the main factor that influenced the decision-making process. This assessment was a continuous process consisting of three factors: the patient's perspective as well as her/his physical and mental state. On the other hand, there was a lack of consensus about what other factors influenced the decision-making process. These factors included the care culture constituted by the characteristics of the team, the intensive care nurses' professional skills, personalities and ability to be present. The individual overall assessment of the patient enabled nursing care from a holistic perspective. Furthermore, the weaning process can be more effective and potential suffering reduced by creating awareness of the care culture's impact on the decision-making process. © 2014 British Association of Critical Care Nurses.

Cortical and Hippocampal Correlates of Deliberation during Model-Based Decisions for Rewards in Humans

PubMed Central

Bornstein, Aaron M.; Daw, Nathaniel D.

2013-01-01

How do we use our memories of the past to guide decisions we've never had to make before? Although extensive work describes how the brain learns to repeat rewarded actions, decisions can also be influenced by associations between stimuli or events not directly involving reward — such as when planning routes using a cognitive map or chess moves using predicted countermoves — and these sorts of associations are critical when deciding among novel options. This process is known as model-based decision making. While the learning of environmental relations that might support model-based decisions is well studied, and separately this sort of information has been inferred to impact decisions, there is little evidence concerning the full cycle by which such associations are acquired and drive choices. Of particular interest is whether decisions are directly supported by the same mnemonic systems characterized for relational learning more generally, or instead rely on other, specialized representations. Here, building on our previous work, which isolated dual representations underlying sequential predictive learning, we directly demonstrate that one such representation, encoded by the hippocampal memory system and adjacent cortical structures, supports goal-directed decisions. Using interleaved learning and decision tasks, we monitor predictive learning directly and also trace its influence on decisions for reward. We quantitatively compare the learning processes underlying multiple behavioral and fMRI observables using computational model fits. Across both tasks, a quantitatively consistent learning process explains reaction times, choices, and both expectation- and surprise-related neural activity. The same hippocampal and ventral stream regions engaged in anticipating stimuli during learning are also engaged in proportion to the difficulty of decisions. These results support a role for predictive associations learned by the hippocampal memory system to be recalled during choice formation. PMID:24339770

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

PubMed Central

Koren, Hila; Kaminer, Ido

2016-01-01

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

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

PubMed

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

2016-01-01

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

Planning for Success: Integrating Analysis with Decision Making.

ERIC Educational Resources Information Center

Goho, James; Webb, Ken

2003-01-01

Describes a successful strategic planning process at a large community college, which linked the analytic inputs of research with the authority and intuition of leaders. Reports key factors attributed to the process' success, including a collegial and organized structure, detailed project management plans, and confidence in the environmental scan.…

Share (And Not) Share Alike: Improving Virtual Team Climate and Decision Performance

ERIC Educational Resources Information Center

Cordes, Sean

2017-01-01

Virtual teams face unique communication and collaboration challenges that impact climate development and performance. First, virtual teams rely on technology mediated communication which can constrain communication. Second, team members lack skill for adapting process to the virtual setting. A collaboration process structure was designed to…

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

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

Goehle, D.G.

1978-01-01

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

Analyzing the nursing organizational structure and process from a scheduling perspective.

PubMed

Maenhout, Broos; Vanhoucke, Mario

2013-09-01

The efficient and effective management of nursing personnel is of critical importance in a hospital's environment comprising approximately 25 % of the hospital's operational costs. The nurse organizational structure and the organizational processes highly affect the nurses' working conditions and the provided quality of care. In this paper, we investigate the impact of different nurse organization structures and different organizational processes for a real-life situation in a Belgian university hospital. In order to make accurate nurse staffing decisions, the employed solution methodology incorporates shift scheduling characteristics in order to overcome the deficiencies of the many phase-specific methodologies that are proposed in the academic literature.

Midwives׳ clinical reasoning during second stage labour: Report on an interpretive study.

PubMed

Jefford, Elaine; Fahy, Kathleen

2015-05-01

clinical reasoning was once thought to be the exclusive domain of medicine - setting it apart from 'non-scientific' occupations like midwifery. Poor assessment, clinical reasoning and decision-making skills are well known contributors to adverse outcomes in maternity care. Midwifery decision-making models share a common deficit: they are insufficiently detailed to guide reasoning processes for midwives in practice. For these reasons we wanted to explore if midwives actively engaged in clinical reasoning processes within their clinical practice and if so to what extent. The study was conducted using post structural, feminist methodology. to what extent do midwives engage in clinical reasoning processes when making decisions in the second stage labour? twenty-six practising midwives were interviewed. Feminist interpretive analysis was conducted by two researchers guided by the steps of a model of clinical reasoning process. Six narratives were excluded from analysis because they did not sufficiently address the research question. The midwives narratives were prepared via data reduction. A theoretically informed analysis and interpretation was conducted. using a feminist, interpretive approach we created a model of midwifery clinical reasoning grounded in the literature and consistent with the data. Thirteen of the 20 participant narratives demonstrate analytical clinical reasoning abilities but only nine completed the process and implemented the decision. Seven midwives used non-analytical decision-making without adequately checking against assessment data. over half of the participants demonstrated the ability to use clinical reasoning skills. Less than half of the midwives demonstrated clinical reasoning as their way of making decisions. The new model of Midwifery Clinical Reasoning includes 'intuition' as a valued way of knowing. Using intuition, however, should not replace clinical reasoning which promotes through decision-making can be made transparent and be consensually validated. Copyright © 2015 Elsevier Ltd. All rights reserved.

Creating a nursing strategic planning framework based on evidence.

PubMed

Shoemaker, Lorie K; Fischer, Brenda

2011-03-01

This article describes an evidence-informed strategic planning process and framework used by a Magnet-recognized public health system in California. This article includes (1) an overview of the organization and its strategic planning process, (2) the structure created within nursing for collaborative strategic planning and decision making, (3) the strategic planning framework developed based on the organization's balanced scorecard domains and the new Magnet model, and (4) the process undertaken to develop the nursing strategic priorities. Outcomes associated with the structure, process, and key initiatives are discussed throughout the article. Copyright © 2011 Elsevier Inc. All rights reserved.

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.

Decision making about Pap test use among Korean immigrant women: A qualitative study.

PubMed

Kim, Kyounghae; Kim, Soohyun; Gallo, Joseph J; Nolan, Marie T; Han, Hae-Ra

2017-08-01

Understanding how individuals make decisions about Pap tests concerning their personal values helps health-care providers offer tailored approaches to guide patients' decision making. Yet research has largely ignored decision making about Pap tests among immigrant women who experience increased risk of cervical cancer. To explore decision making about Pap tests among Korean immigrant women. We conducted a qualitative descriptive study using 32 semi-structured, in-depth interviews with Korean immigrant women residing in a north-eastern metropolitan area. Data were audio-recorded, transcribed verbatim and analysed using inductive coding. Although most women with positive decisions made their own decisions, some women deferred to their providers, and others made decisions in collaboration with their providers and significant others. While women making positive decisions tended to consider both barriers to and facilitators of having Pap tests, women making negative decisions predominantly discussed the barriers to having Pap tests, such as modesty and differences between the South Korean and US health-care systems. The women's reflections on their decisions differed regarding their Pap test decisions. Women's desired roles in the decision-making process and reflection on their decision outcome appeared to vary, although most participants with positive decisions made their own decisions and were satisfied with their decisions. Future research should conduct longitudinal, quantitative studies to test our findings regarding decision-making processes and outcomes about Pap tests. The findings should be incorporated into cervical cancer screening practices to fulfil the unmet needs of immigrant women in patient-provider communication and to facilitate women's decision making about Pap tests. © 2016 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Information Security Management (ISM)

NASA Astrophysics Data System (ADS)

Šalgovičová, Jarmila; Prajová, Vanessa

2012-12-01

Currently, all organizations have to tackle the issue of information security. The paper deals with various aspects of Information Security Management (ISM), including procedures, processes, organizational structures, policies and control processes. Introduction of Information Security Management should be a strategic decision. The concept and implementation of Information Security Management in an organization are determined by the corporate needs and objectives, security requirements, the processes deployed as well as the size and structure of the organization. The implementation of ISM should be carried out to the extent consistent with the needs of the organization.

Social and ethical perspectives of landslide risk mitigation measures

NASA Astrophysics Data System (ADS)

Kalsnes, Bjørn; Vangelsten, Bjørn V.

2015-04-01

Landslide risk may be mitigated by use of a wide range of measures. Mitigation and prevention options may include (1) structural measures to reduce the frequency, severity or exposure to the hazard, (2) non-structural measures, such as land-use planning and early warning systems, to reduce the hazard frequency and consequences, and (3) measures to pool and transfer the risks. In a given situation the appropriate system of mitigation measures may be a combination of various types of measures, both structural and non-structural. In the process of choosing mitigation measures for a given landslide risk situation, the role of the geoscientist is normally to propose possible mitigation measures on basis of the risk level and technical feasibility. Social and ethical perspectives are often neglected in this process. However, awareness of the need to consider social as well as ethical issues in the design and management of mitigating landslide risk is rising. There is a growing understanding that technical experts acting alone cannot determine what will be considered the appropriate set of mitigation and prevention measures. Issues such as environment versus development, questions of acceptable risk, who bears the risks and benefits, and who makes the decisions, also need to be addressed. Policymakers and stakeholders engaged in solving environmental risk problems are increasingly recognising that traditional expert-based decision-making processes are insufficient. This paper analyse the process of choosing appropriate mitigation measures to mitigate landslide risk from a social and ethical perspective, considering technical, cultural, economical, environmental and political elements. The paper focus on stakeholder involvement in the decision making process, and shows how making strategies for risk communication is a key for a successful process. The study is supported by case study examples from Norway and Italy. In the Italian case study, three different risk mitigation options was presented to the local community. The options were based on a thorough stakeholder involvement process ending up in three different views on how to deal with the landslide risk situation: i) protect lives and properties (hierarchical) ; ii) careful stewardship of the mountains (egalitarian); and iii) rational individual choice (individualist).

Stop making plans; start making decisions.

PubMed

Mankins, Michael C; Steele, Richard

2006-01-01

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

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

PubMed

Taylor, Paul; Dowding, Dawn; Johnson, Miriam

2017-01-25

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

The ideas about advanced life support and affecting factors at the end-stage of life in a hospital in Turkey.

PubMed

Albayrak, Turgay; Şencan, İrfan; Akça, Ömer; Koç, Esra Meltem; Aksoy, Hilal; Ünsal, Selim; Bülbül, İskender; Bahadır, Adem; Kasım, İsmail; Kahveci, Rabia; Özkara, Adem

2017-01-01

The participation of the people in health decisions may be structured in various levels. One of these is participation in decisions for the treatment. "Advanced directives" is one of the examples for the participation in decisions for the treatment. We wanted to determine the decisions on advanced life support at the end-stage of life in case of a life-threatening illness for the people themselves and their first degree relatives and the factors effecting these decisions. The cross-sectional study was conducted with volunteers among patients and patient relatives who applied to all polyclinics of the Ankara Numune Training and Research Hospital except the emergency, oncology and psychiatry polyclinics between 15.12.2012 and 15.03.2013. A questionnaire, the Hospital Anxiety Depression (HAD) scale, and Templer's Death Anxiety Scale (TDA) were applied to all individuals. SPSS for Win. Ver. 17.0 and MS-Excel 2010 Starter software bundles were used for all statistical analysis and calculations. The participants want both themselves and their first degree relatives included in end-stage decision-making process. Therefore, the patients and their families should be informed adequately during decision making process and quality communication must be provided. Participants who have given their end-stage decisions previously want to be treated according to these decisions. This desire can just be possible by advanced directives.When moral and material loads of end-stage process are taken into consideration, countries, in which advanced directives are practiced, should be examined well and participants' desire should be evaluated in terms of practicability.

A Model of Supervisor Decision-Making in the Accommodation of Workers with Low Back Pain.

PubMed

Williams-Whitt, Kelly; Kristman, Vicki; Shaw, William S; Soklaridis, Sophie; Reguly, Paula

2016-09-01

Purpose To explore supervisors' perspectives and decision-making processes in the accommodation of back injured workers. Methods Twenty-three semi-structured, in-depth interviews were conducted with supervisors from eleven Canadian organizations about their role in providing job accommodations. Supervisors were identified through an on-line survey and interviews were recorded, transcribed and entered into NVivo software. The initial analyses identified common units of meaning, which were used to develop a coding guide. Interviews were coded, and a model of supervisor decision-making was developed based on the themes, categories and connecting ideas identified in the data. Results The decision-making model includes a process element that is described as iterative "trial and error" decision-making. Medical restrictions are compared to job demands, employee abilities and available alternatives. A feasible modification is identified through brainstorming and then implemented by the supervisor. Resources used for brainstorming include information, supervisor experience and autonomy, and organizational supports. The model also incorporates the experience of accommodation as a job demand that causes strain for the supervisor. Accommodation demands affect the supervisor's attitude, brainstorming and monitoring effort, and communication with returning employees. Resources and demands have a combined effect on accommodation decision complexity, which in turn affects the quality of the accommodation option selected. If the employee is unable to complete the tasks or is reinjured during the accommodation, the decision cycle repeats. More frequent iteration through the trial and error process reduces the likelihood of return to work success. Conclusion A series of propositions is developed to illustrate the relationships among categories in the model. The model and propositions show: (a) the iterative, problem solving nature of the RTW process; (b) decision resources necessary for accommodation planning, and (c) the impact accommodation demands may have on supervisors and RTW quality.

Comparisons of guardianship laws and surrogate decision-making practices in China, Japan, Thailand and Australia: a review by the Asia Consortium, International Psychogeriatric Association (IPA) capacity taskforce.

PubMed

Tsoh, Joshua; Peisah, Carmelle; Narumoto, Jin; Wongpakaran, Nahathai; Wongpakaran, Tinakon; O'Neill, Nick; Jiang, Tao; Ogano, Shoichi; Mimura, Masaru; Kato, Yuka; Chiu, Helen

2015-06-01

The International Psychogeriatric Association (IPA) capacity taskforce was established to promote the autonomy, proper access to care, and dignity of persons with decision-making disabilities (DMDs) across nations. The Asia Consortium of the taskforce was established to pursue these goals in the Asia-Pacific region. This paper is part of the Asia Consortium's initiative to promote understanding and advocacy in regard to surrogate decision-making across the region. The current guardianship laws are compared, and jurisdictional variations in the processes for proxy decision-making to support persons with DMDs and other health and social needs in China, Japan, Thailand, and Australia are explored. The different Asia-Pacific countries have various proxy decision-making mechanisms in place for persons with DMDs, which are both formalized according to common law, civil law, and other legislation, and shaped by cultural practices. Various processes for guardianship and mechanisms for medical decision-making and asset management exist across the region. Processes that are still evolving across the region include those that facilitate advanced planning as a result of the paucity of legal structures for enduring powers of attorney (EPA) and guardianship in some regions, and the struggle to achieve consensual positions in regard to end-of-life decision-making. Formal processes for supporting decision-making are yet to be developed. The diverse legal approaches to guardianship and administration must be understood to meet the challenges of the rapidly ageing population in the Asia-Pacific region. Commonalities in the solutions and difficulties faced in encountering these challenges have global significance.

The parietal cortices participate in encoding, short-term memory, and decision-making related to tactile shape.

PubMed

Rojas-Hortelano, Eduardo; Concha, Luis; de Lafuente, Victor

2014-10-15

We routinely identify objects with our hands, and the physical attributes of touched objects are often held in short-term memory to aid future decisions. However, the brain structures that selectively process tactile information to encode object shape are not fully identified. In this article we describe the areas within the human cerebral cortex that specialize in encoding, short-term memory, and decision-making related to the shape of objects explored with the hand. We performed event-related functional magnetic resonance imaging in subjects performing a shape discrimination task in which two sequentially presented objects had to be explored to determine whether they had the same shape or not. To control for low-level and nonspecific brain activations, subjects performed a temperature discrimination task in which they compared the temperature of two spheres. Our results show that although a large network of brain structures is engaged in somatosensory processing, it is the areas lining the intraparietal sulcus that selectively participate in encoding, maintaining, and deciding on tactile information related to the shape of objects. Copyright © 2014 the American Physiological Society.

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.

Towards a conceptual multi-agent-based framework to simulate the spatial group decision-making process

NASA Astrophysics Data System (ADS)

Ghavami, Seyed Morsal; Taleai, Mohammad

2017-04-01

Most spatial problems are multi-actor, multi-issue and multi-phase in nature. In addition to their intrinsic complexity, spatial problems usually involve groups of actors from different organizational and cognitive backgrounds, all of whom participate in a social structure to resolve or reduce the complexity of a given problem. Hence, it is important to study and evaluate what different aspects influence the spatial problem resolution process. Recently, multi-agent systems consisting of groups of separate agent entities all interacting with each other have been put forward as appropriate tools to use to study and resolve such problems. In this study, then in order to generate a better level of understanding regarding the spatial problem group decision-making process, a conceptual multi-agent-based framework is used that represents and specifies all the necessary concepts and entities needed to aid group decision making, based on a simulation of the group decision-making process as well as the relationships that exist among the different concepts involved. The study uses five main influencing entities as concepts in the simulation process: spatial influence, individual-level influence, group-level influence, negotiation influence and group performance measures. Further, it explains the relationship among different concepts in a descriptive rather than explanatory manner. To illustrate the proposed framework, the approval process for an urban land use master plan in Zanjan—a provincial capital in Iran—is simulated using MAS, the results highlighting the effectiveness of applying an MAS-based framework when wishing to study the group decision-making process used to resolve spatial problems.

Involving patients in health technology funding decisions: stakeholder perspectives on processes used in Australia.

PubMed

Lopes, Edilene; Street, Jackie; Carter, Drew; Merlin, Tracy

2016-04-01

Governments use a variety of processes to incorporate public perspectives into policymaking, but few studies have evaluated these processes from participants' point of view. The objective of this study was twofold: to understand the perspectives of selected stakeholders with regard to involvement processes used by Australian Advisory Committees to engage the public and patients; and to identify barriers and facilitators to participation. Twelve semi-structured interviews were conducted with representatives of different stakeholder groups involved in health technology funding decisions in Australia. Data were collected and analysed using a theoretical framework created by Rowe and Frewer, but adapted to more fully acknowledge issues of power and influence. Stakeholder groups disagreed as to what constitutes effective and inclusive patient involvement. Barriers reported by interviewees included poor communication, a lack of transparency, unworkable deadlines, and inadequate representativeness. Also described were problems associated with defining the task for patients and their advocates and with the timing of patient input in the decision-making process. Interviewees suggested that patient participation could be improved by increasing the number of patient organizations engaged in processes and including those organizations at different stages of decision making, especially earlier. The different evaluations made by stakeholder groups appear to be underpinned by contrasting conceptions of public involvement and its value, in line with Graham Martin's work which distinguishes between 'technocratic' and 'democratic' public involvement. Understanding stakeholders' perspectives and the contrasting conceptions of public involvement could foster future agreement on which processes should be used to involve the public in decision making. © 2015 John Wiley & Sons Ltd.

Competition between conceptual relations affects compound recognition: the role of entropy.

PubMed

Schmidtke, Daniel; Kuperman, Victor; Gagné, Christina L; Spalding, Thomas L

2016-04-01

Previous research has suggested that the conceptual representation of a compound is based on a relational structure linking the compound's constituents. Existing accounts of the visual recognition of modifier-head or noun-noun compounds posit that the process involves the selection of a relational structure out of a set of competing relational structures associated with the same compound. In this article, we employ the information-theoretic metric of entropy to gauge relational competition and investigate its effect on the visual identification of established English compounds. The data from two lexical decision megastudies indicates that greater entropy (i.e., increased competition) in a set of conceptual relations associated with a compound is associated with longer lexical decision latencies. This finding indicates that there exists competition between potential meanings associated with the same complex word form. We provide empirical support for conceptual composition during compound word processing in a model that incorporates the effect of the integration of co-activated and competing relational information.

Making reasonable decisions: a qualitative study of medical decision making in the care of patients with a clinically significant haemoglobin disorder.

PubMed

Crowther, Helen J; Kerridge, Ian

2015-10-01

Therapies utilized in patients with clinically significant haemoglobin disorders appear to vary between clinicians and units. This study aimed to investigate the processes of evidence implementation and medical decision making in the care of such patients in NSW, Australia. Using semi-structured interviews, 11 haematologists discussed their medical decision-making processes with particular attention paid to the use of published evidence. Transcripts were thematically analysed by a single investigator on a line-by-line basis. Decision making surrounding the care of patients with significant haemoglobin disorders varied and was deeply contextual. Three main determinants of clinical decision making were identified - factors relating to the patient and to their illness, factors specific to the clinician and the institution in which they were practising and factors related to the notion of evidence and to utility and role of evidence-based medicine in clinical practice. Clinicians pay considerable attention to medical decision making and evidence incorporation and attempt to tailor these to particular patient contexts. However, the patient context is often inferred and when discordant with the clinician's own contexture can lead to discomfort with decision recommendations. Clinicians strive to improve comfort through the use of experience and trustworthy evidence. © 2015 John Wiley & Sons, Ltd.

The hidden island of addiction: the insula

PubMed Central

Naqvi, Nasir H.; Bechara, Antoine

2013-01-01

Most prior research on the neurobiology of addiction has focused on the role of subcortical systems, such as the amygdala, the ventral striatum and mesolimbic dopamine system, in promoting the motivation to seek drugs. Recent evidence indicates that a largely overlooked structure, the insula, plays a crucial part in conscious urges to take drugs. The insula has been highlighted as a region that integrates interoceptive (i.e. bodily) states into conscious feelings and into decision-making processes that involve uncertain risk and reward. Here, we propose a model in which the processing of the interoceptive effects of drug use by the insula contributes to conscious drug urges and to decision-making processes that precipitate relapse. PMID:18986715

Conceptualizing a model: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force--2.

PubMed

Roberts, Mark; Russell, Louise B; Paltiel, A David; Chambers, Michael; McEwan, Phil; Krahn, Murray

2012-01-01

The appropriate development of a model begins with understanding the problem that is being represented. The aim of this article was to provide a series of consensus-based best practices regarding the process of model conceptualization. For the purpose of this series of articles, we consider the development of models whose purpose is to inform medical decisions and health-related resource allocation questions. We specifically divide the conceptualization process into two distinct components: the conceptualization of the problem, which converts knowledge of the health care process or decision into a representation of the problem, followed by the conceptualization of the model itself, which matches the attributes and characteristics of a particular modeling type with the needs of the problem being represented. Recommendations are made regarding the structure of the modeling team, agreement on the statement of the problem, the structure, perspective, and target population of the model, and the interventions and outcomes represented. Best practices relating to the specific characteristics of model structure and which characteristics of the problem might be most easily represented in a specific modeling method are presented. Each section contains a number of recommendations that were iterated among the authors, as well as among the wider modeling taskforce, jointly set up by the International Society for Pharmacoeconomics and Outcomes Research and the Society for Medical Decision Making. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Assessing the Process of Retirement: a Cross-Cultural Review of Available Measures.

PubMed

Rafalski, Julia C; Noone, Jack H; O'Loughlin, Kate; de Andrade, Alexsandro L

2017-06-01

Retirement research is now expanding beyond the post-World War II baby boomers' retirement attitudes and plans to include the nature of their workforce exit and how successfully they adjust to their new life. These elements are collectively known as the process of retirement. However, there is insufficient research in developing countries to inform the management of their ageing populations regarding this process. This review aims to facilitate national and cross-cultural research in developing and non-English speaking countries by reviewing the existing measures of the retirement process published in English and Portuguese. The review identified 28 existing measures assessing retirement attitudes, planning, decision making, adjustment and satisfaction with retirement. Information on each scale's item structure, internal reliability, grammatical structure and evidence of translations to other languages is presented. Of the 28 measures, 20 assessed retirement attitudes, plans and decision-making, 5 assessed adjustment to retirement and only two assessed retirement satisfaction. Only eight of the 28 scales had been translated into languages other than English. There is scope to translate measures of retirement attitudes and planning into other languages. However there is a paucity of translated measures of retirement decision-making and adjustment, and measures of retirement satisfaction in general. Within the limitations of this review, researchers are provided with the background to decide between translating existing measures or developing of more culturally appropriate assessment tools for addressing their research questions.

The neural correlates of risky decision making across short and long runs

PubMed Central

Rao, Li-Lin; Dunn, John C.; Zhou, Yuan; Li, Shu

2015-01-01

People frequently change their preferences for options of gambles which they play once compared to those they play multiple times. In general, preferences for repeated play gambles are more consistent with the expected values of the options. According to the one-process view, the change in preference is due to a change in the structure of the gamble that is relevant to decision making. According to the two-process view, the change is attributable to a shift in the decision making strategy that is used. To adjudicate between these two theories, we asked participants to choose between gambles played once or 100 times, and to choose between them based on their expected value. Consistent with the two-process theory, we found a set of brain regions that were sensitive to the extent of behavioral change between single and aggregated play and also showed significant (de)activation in the expected value choice task. These results support the view that people change their decision making strategies for risky choice considered once or multiple times. PMID:26516095

Selecting Essential Information for Biosurveillance—A Multi-Criteria Decision Analysis

PubMed Central

Generous, Nicholas; Margevicius, Kristen J.; Taylor-McCabe, Kirsten J.; Brown, Mac; Daniel, W. Brent; Castro, Lauren; Hengartner, Andrea; Deshpande, Alina

2014-01-01

The National Strategy for Biosurveillancedefines biosurveillance as “the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels.” However, the strategy does not specify how “essential information” is to be identified and integrated into the current biosurveillance enterprise, or what the metrics qualify information as being “essential”. Thequestion of data stream identification and selection requires a structured methodology that can systematically evaluate the tradeoffs between the many criteria that need to be taken in account. Multi-Attribute Utility Theory, a type of multi-criteria decision analysis, can provide a well-defined, structured approach that can offer solutions to this problem. While the use of Multi-Attribute Utility Theoryas a practical method to apply formal scientific decision theoretical approaches to complex, multi-criteria problems has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance.We have developed a formalized decision support analytic framework that can facilitate identification of “essential information” for use in biosurveillance systems or processes and we offer this framework to the global BSV community as a tool for optimizing the BSV enterprise. To demonstrate utility, we applied the framework to the problem of evaluating data streams for use in an integrated global infectious disease surveillance system. PMID:24489748

Dynamics of career choice among students in undergraduate medical courses. A BEME systematic review: BEME Guide No. 33.

PubMed

Querido, Sophie J; Vergouw, David; Wigersma, Lode; Batenburg, Ronald S; De Rond, Marlies E J; Ten Cate, Olle T J

2016-01-01

Due to the lack of a theoretically embedded overview of the recent literature on medical career decision-making, this study provides an outline of these dynamics. Since differences in educational routes to the medical degree likely affect career choice dynamics, this study focuses on medical career decision-making in educational systems with a Western European curriculum structure. A systematic search of electronic databases (Medline, Embase) was conducted from January 2008 to November 2014. A panel of seven independent reviewers performed the data extraction, quality assessment and data synthesis using the Bland-Meurer model of medical specialty choice as a reference. Fifty-seven studies met the inclusion criteria for the review. Factors associated with specialty preference or career choice can be classified in five main categories: (1) medical school characteristics (e.g., curriculum structure), (2) student characteristics (e.g., age, personality), (3) student values (e.g., personal preference), (4) career needs to be satisfied (e.g., expected income, status, and work-life balance), and (5) perception of specialty characteristics (e.g., extracurricular or curricular experiences). Especially career needs and perceptions of specialty characteristics are often associated with medical career decision-making. Our results support that medical career decisions are formed by a matching of perceptions of specialty characteristics with personal needs. However, the process of medical career decision-making is not yet fully understood. Besides identifying possible predictors, future research should focus on detecting interrelations between hypothesized predictors and identify the determinants and interrelations at the various stages of the medical career decision-making process.

Application of optimal control principles to describe the supervisory control behavior of AAA crew members

NASA Technical Reports Server (NTRS)

Hale, C.; Valentino, G. J.

1982-01-01

Supervisory decision making and control behavior within a C(3) oriented, ground based weapon system is being studied. The program involves empirical investigation of the sequence of control strategies used during engagement of aircraft targets. An engagement is conceptually divided into several stages which include initial information processing activity, tracking, and ongoing adaptive control decisions. Following a brief description of model parameters, two experiments which served as initial investigation into the accuracy of assumptions regarding the importance of situation assessment in procedure selection are outlined. Preliminary analysis of the results upheld the validity of the assumptions regarding strategic information processing and cue-criterion relationship learning. These results indicate that this model structure should be useful in studies of supervisory decision behavior.

Stress-induced changes in human decision-making are reversible.

PubMed

Soares, J M; Sampaio, A; Ferreira, L M; Santos, N C; Marques, F; Palha, J A; Cerqueira, J J; Sousa, N

2012-07-03

Appropriate decision-making relies on the ability to shift between different behavioral strategies according to the context in which decisions are made. A cohort of subjects exposed to prolonged stress, and respective gender- and age-matched controls, performed an instrumental behavioral task to assess their decision-making strategies. The stressed cohort was reevaluated after a 6-week stress-free period. The behavioral analysis was complemented by a functional magnetic resonance imaging (fMRI) study to detect the patterns of activation in corticostriatal networks ruling goal-directed and habitual actions. Using structural MRI, the volumes of the main cortical and subcortical regions implicated in instrumental behavior were determined. Here we show that chronic stress biases decision-making strategies in humans toward habits, as choices of stressed subjects become insensitive to changes in outcome value. Using functional imaging techniques, we demonstrate that prolonged exposure to stress in humans causes an imbalanced activation of the networks that govern decision processes, shifting activation from the associative to the sensorimotor circuits. These functional changes are paralleled by atrophy of the medial prefrontal cortex and the caudate, and by an increase in the volume of the putamina. Importantly, a longitudinal assessment of the stressed individuals showed that both the structural and functional changes triggered by stress are reversible and that decisions become again goal-directed.

Creation of structured documentation templates using Natural Language Processing techniques.

PubMed

Kashyap, Vipul; Turchin, Alexander; Morin, Laura; Chang, Frank; Li, Qi; Hongsermeier, Tonya

2006-01-01

Structured Clinical Documentation is a fundamental component of the healthcare enterprise, linking both clinical (e.g., electronic health record, clinical decision support) and administrative functions (e.g., evaluation and management coding, billing). One of the challenges in creating good quality documentation templates has been the inability to address specialized clinical disciplines and adapt to local clinical practices. A one-size-fits-all approach leads to poor adoption and inefficiencies in the documentation process. On the other hand, the cost associated with manual generation of documentation templates is significant. Consequently there is a need for at least partial automation of the template generation process. We propose an approach and methodology for the creation of structured documentation templates for diabetes using Natural Language Processing (NLP).

Functional Freedom: A Psychological Model of Freedom in Decision-Making

PubMed Central

Lau, Stephan; Hiemisch, Anette

2017-01-01

The freedom of a decision is not yet sufficiently described as a psychological variable. We present a model of functional decision freedom that aims to fill that role. The model conceptualizes functional freedom as a capacity of people that varies depending on certain conditions of a decision episode. It denotes an inner capability to consciously shape complex decisions according to one’s own values and needs. Functional freedom depends on three compensatory dimensions: it is greatest when the decision-maker is highly rational, when the structure of the decision is highly underdetermined, and when the decision process is strongly based on conscious thought and reflection. We outline possible research questions, argue for psychological benefits of functional decision freedom, and explicate the model’s implications on current knowledge and research. In conclusion, we show that functional freedom is a scientific variable, permitting an additional psychological foothold in research on freedom, and that is compatible with a deterministic worldview. PMID:28678165

Selective and nonselective transfer: positive and negative priming in a multiple-task environment.

PubMed

Leboe, Jason P; Whittlesea, Bruce W A; Milliken, Bruce

2005-09-01

Processing of a probe stimulus can be affected either positively or negatively by presenting a related stimulus immediately before it. According to structural accounts, such effects occur because processing of the prime activates or inhibits the mental representation of the probe before it is presented. In contrast, transfer-appropriate processing accounts suggest that success in processing a probe depends on resources made available by earlier experiences of related stimuli. The authors manipulated the similarity between the prime and probe on color, lexical status, and orthographic structure, requiring either lexical decision or color identification on each. The authors observed a complex pattern of positive and negative transfer that cannot easily be explained through activation-inhibition of mental structures. Instead, that pattern provides evidence in favor of transfer-appropriate processing.

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.

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

PubMed

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

2015-06-01

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

Formulary evaluation of third-generation cephalosporins using decision analysis.

PubMed

Cano, S B; Fujita, N K

1988-03-01

A structured, objective approach to formulary review of third-generation cephalosporins using the decision-analysis model is described. The pharmacy and therapeutics (P&T) committee approved the evaluation criteria for this drug class and assigned priority weights (as percentages of 100) to those drug characteristics deemed most important. Clinical data (spectrum of activity, pharmacokinetics, adverse effects, and stability) and financial data (cost of acquisition and cost of therapy per day) were used to determine ranking scores for each drug. Total scores were determined by multiplying ranking scores by the assigned priority weights for the criteria. The two highest-scoring drugs were selected for inclusion in the formulary. By this decision-analysis process, the P&T committee recommended that all current third-generation cephalosporins (cefotaxime, cefoperazone, and moxalactam) be removed from the institutions's formulary and be replaced with ceftazidime and ceftriaxone. P&T committees at other institutions may structure their criteria differently, and different recommendations may result. Using decision analysis for formulary review may promote rational drug therapy and achieve cost savings.

Effect of Integrating Hydrologic Scaling Concepts on Students Learning and Decision Making Experiences

ERIC Educational Resources Information Center

Najm, Majdi R. Abou; Mohtar, Rabi H.; Cherkauer, Keith A.; French, Brian F.

2010-01-01

Proper understanding of scaling and large-scale hydrologic processes is often not explicitly incorporated in the teaching curriculum. This makes it difficult for students to connect the effect of small scale processes and properties (like soil texture and structure, aggregation, shrinkage, and cracking) on large scale hydrologic responses (like…

An Investigation of Distributed Communications Systems and Their Potential Applications to Command and Control Structure of the Marine Corps.

DTIC Science & Technology

1979-12-01

The Marine Corps Tactical Command and Control System (MTACCS) is expected to provide increased decision making speed and power through automated ... processing and display of data which previously was processed manually. The landing Force Organizational Systems Study (LFOSS) has challenged Marines to

Improving Survey Methods with Cognitive Interviews in Small- and Medium-Scale Evaluations

ERIC Educational Resources Information Center

Ryan, Katherine; Gannon-Slater, Nora; Culbertson, Michael J.

2012-01-01

Findings derived from self-reported, structured survey questionnaires are commonly used in evaluation and applied research to inform policy-making and program decisions. Although there are a variety of issues related to the quality of survey evidence (e.g., sampling precision), the validity of response processes--how respondents process thoughts…

Breaking down hierarchies of decision-making in primates

PubMed Central

Hyafil, Alexandre; Moreno-Bote, Rubén

2017-01-01

Possible options in a decision often organize as a hierarchy of subdecisions. A recent study concluded that perceptual processes in primates mimic this hierarchical structure and perform subdecisions in parallel. We argue that a flat model that directly selects between final choices accounts more parsimoniously for the reported behavioral and neural data. Critically, a flat model is characterized by decision signals integrating evidence at different hierarchical levels, in agreement with neural recordings showing this integration in localized neural populations. Our results point to the role of experience for building integrated perceptual categories where sensory evidence is merged prior to decision. DOI: http://dx.doi.org/10.7554/eLife.16650.001 PMID:28648171

Neural correlates of decision making with explicit information about probabilities and incentives in elderly healthy subjects.

PubMed

Labudda, Kirsten; Woermann, Friedrich G; Mertens, Markus; Pohlmann-Eden, Bernd; Markowitsch, Hans J; Brand, Matthias

2008-06-01

Recent functional neuroimaging and lesion studies demonstrate the involvement of the orbitofrontal/ventromedial prefrontal cortex as a key structure in decision making processes. This region seems to be particularly crucial when contingencies between options and consequences are unknown but have to be learned by the use of feedback following previous decisions (decision making under ambiguity). However, little is known about the neural correlates of decision making under risk conditions in which information about probabilities and potential outcomes is given. In the present study, we used functional magnetic resonance imaging to measure blood-oxygenation-level-dependent (BOLD) responses in 12 subjects during a decision making task. This task provided explicit information about probabilities and associated potential incentives. The responses were compared to BOLD signals in a control condition without information about incentives. In contrast to previous decision making studies, we completely removed the outcome phase following a decision to exclude the potential influence of feedback previously received on current decisions. The results indicate that the integration of information about probabilities and incentives leads to activations within the dorsolateral prefrontal cortex, the posterior parietal lobe, the anterior cingulate and the right lingual gyrus. We assume that this pattern of activation is due to the involvement of executive functions, conflict detection mechanisms and arithmetic operations during the deliberation phase of decisional processes that are based on explicit information.

Acceptability and Perceived Benefits and Risks of Public and Patient Involvement in Health Care Policy: A Delphi Survey in Belgian Stakeholders.

PubMed

Cleemput, Irina; Christiaens, Wendy; Kohn, Laurence; Léonard, Christian; Daue, François; Denis, Alain

2015-06-01

In systems with public health insurance, coverage decisions should reflect social values. Deliberation among stakeholders could achieve this goal, but rarely involves patients and citizens directly. This study aimed at evaluating the acceptability, and the perceived benefits and risks, of public and patient involvement (PPI) in coverage decision making to Belgian stakeholders. A two-round Delphi survey was conducted among all stakeholder groups. The survey was constructed on the basis of interviews with 10 key stakeholders and a review of the literature on participation models. Consensus was defined as 65% or more of the respondents agreeing with a statement and less than 15% disagreeing. Eighty stakeholders participated in both rounds. They were defined as the Delphi panel. Belgian stakeholders are open toward PPI in coverage decision processes. Benefits are expected to exceed risks. The preferred model for involvement is to consult citizens or patients, within the existing decision-making structures and at specific milestones in the process. Consulting citizens and patients is a higher level of involvement than merely informing them and a lower level than letting them participate actively. Consultation involves asking nonbinding advice on (parts of) the decision problem. According to the Delphi panel, the benefits of PPI could be increasing awareness among members of the general public and patients about the challenges and costs of health care, and enriched decision processes with expertise by experience from patients. Potential risks include subjectivity, insufficient resources to participate and weigh on the process, difficulties in finding effective ways to express a collective opinion, the risk of manipulation, and lobbying or power games of other stakeholders. PPI in coverage decision-making processes is acceptable to Belgian stakeholders, be it in different ways for different types of decisions. Benefits are expected to outweigh risks. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Accounting for uncertainty in health economic decision models by using model averaging.

PubMed

Jackson, Christopher H; Thompson, Simon G; Sharples, Linda D

2009-04-01

Health economic decision models are subject to considerable uncertainty, much of which arises from choices between several plausible model structures, e.g. choices of covariates in a regression model. Such structural uncertainty is rarely accounted for formally in decision models but can be addressed by model averaging. We discuss the most common methods of averaging models and the principles underlying them. We apply them to a comparison of two surgical techniques for repairing abdominal aortic aneurysms. In model averaging, competing models are usually either weighted by using an asymptotically consistent model assessment criterion, such as the Bayesian information criterion, or a measure of predictive ability, such as Akaike's information criterion. We argue that the predictive approach is more suitable when modelling the complex underlying processes of interest in health economics, such as individual disease progression and response to treatment.

Benefits and entitlements in the Hungarian health care system.

PubMed

Gaal, Peter

2005-12-01

This contribution considers entitlements and benefits in the Hungarian health care system. After a brief introduction to the organizational structure of the system the decision-making processes are discussed in detail, including the most important actors, types and pieces of legislation, formal structures, decision-making criteria, and outputs in terms of benefit catalogues. Within the two main public financing systems (social insurance and tax-funded services) there are four types of regulatory regimes: (a) traditional political decision making, (b) price negotiations, (c) updating of classification systems for payment purposes, and (d) the procedure for the inclusion of registered medicines in the scope of the social health insurance system. As an example we discuss the benefit regulations and benefit catalogues in the category of services of curative care (HC.1) of the OECD classification of health services.

Benefits and entitlements in the Hungarian health care system

PubMed Central

2005-01-01

This contribution considers entitlements and benefits in the Hungarian health care system. After a brief introduction to the organizational structure of the system the decision-making processes are discussed in detail, including the most important actors, types and pieces of legislation, formal structures, decision-making criteria, and outputs in terms of benefit catalogues. Within the two main public financing systems (social insurance and tax-funded services) there are four types of regulatory regimes: (a) traditional political decision making, (b) price negotiations, (c) updating of classification systems for payment purposes, and (d) the procedure for the inclusion of registered medicines in the scope of the social health insurance system. As an example we discuss the benefit regulations and benefit catalogues in the category of services of curative care (HC.1) of the OECD classification of health services. PMID:16267656

Consensus Recommendations for Systematic Evaluation of Drug-Drug Interaction Evidence for Clinical Decision Support

PubMed Central

Scheife, Richard T.; Hines, Lisa E.; Boyce, Richard D.; Chung, Sophie P.; Momper, Jeremiah; Sommer, Christine D.; Abernethy, Darrell R.; Horn, John; Sklar, Stephen J.; Wong, Samantha K.; Jones, Gretchen; Brown, Mary; Grizzle, Amy J.; Comes, Susan; Wilkins, Tricia Lee; Borst, Clarissa; Wittie, Michael A.; Rich, Alissa; Malone, Daniel C.

2015-01-01

Background Healthcare organizations, compendia, and drug knowledgebase vendors use varying methods to evaluate and synthesize evidence on drug-drug interactions (DDIs). This situation has a negative effect on electronic prescribing and medication information systems that warn clinicians of potentially harmful medication combinations. Objective To provide recommendations for systematic evaluation of evidence from the scientific literature, drug product labeling, and regulatory documents with respect to DDIs for clinical decision support. Methods A conference series was conducted to develop a structured process to improve the quality of DDI alerting systems. Three expert workgroups were assembled to address the goals of the conference. The Evidence Workgroup consisted of 15 individuals with expertise in pharmacology, drug information, biomedical informatics, and clinical decision support. Workgroup members met via webinar from January 2013 to February 2014. Two in-person meetings were conducted in May and September 2013 to reach consensus on recommendations. Results We developed expert-consensus answers to three key questions: 1) What is the best approach to evaluate DDI evidence?; 2) What evidence is required for a DDI to be applicable to an entire class of drugs?; and 3) How should a structured evaluation process be vetted and validated? Conclusion Evidence-based decision support for DDIs requires consistent application of transparent and systematic methods to evaluate the evidence. Drug information systems that implement these recommendations should be able to provide higher quality information about DDIs in drug compendia and clinical decision support tools. PMID:25556085

Web-based health services and clinical decision support.

PubMed

Jegelevicius, Darius; Marozas, Vaidotas; Lukosevicius, Arunas; Patasius, Martynas

2004-01-01

The purpose of this study was the development of a Web-based e-health service for comprehensive assistance and clinical decision support. The service structure consists of a Web server, a PHP-based Web interface linked to a clinical SQL database, Java applets for interactive manipulation and visualization of signals and a Matlab server linked with signal and data processing algorithms implemented by Matlab programs. The service ensures diagnostic signal- and image analysis-sbased clinical decision support. By using the discussed methodology, a pilot service for pathology specialists for automatic calculation of the proliferation index has been developed. Physicians use a simple Web interface for uploading the pictures under investigation to the server; subsequently a Java applet interface is used for outlining the region of interest and, after processing on the server, the requested proliferation index value is calculated. There is also an "expert corner", where experts can submit their index estimates and comments on particular images, which is especially important for system developers. These expert evaluations are used for optimization and verification of automatic analysis algorithms. Decision support trials have been conducted for ECG and ophthalmology ultrasonic investigations of intraocular tumor differentiation. Data mining algorithms have been applied and decision support trees constructed. These services are under implementation by a Web-based system too. The study has shown that the Web-based structure ensures more effective, flexible and accessible services compared with standalone programs and is very convenient for biomedical engineers and physicians, especially in the development phase.

On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis.

PubMed

Pieterse, Arwen H; de Vries, Marieke

2013-09-01

Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic-based VCMs. To critically analyse the suitability of the 'take the best' (TTB) and 'tallying' fast and frugal heuristics in the context of patient decision making. Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. The specific nature of patient preference-sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. © 2011 John Wiley & Sons Ltd.

On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis

PubMed Central

Pieterse, Arwen H.; de Vries, Marieke

2011-01-01

Abstract Background  Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference‐sensitive health‐care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic‐based VCMs. Objective  To critically analyse the suitability of the ‘take the best’ (TTB) and ‘tallying’ fast and frugal heuristics in the context of patient decision making. Strategy  Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. Conclusion  The specific nature of patient preference‐sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. PMID:21902770

Ranking of Business Process Simulation Software Tools with DEX/QQ Hierarchical Decision Model

PubMed Central

2016-01-01

The omnipresent need for optimisation requires constant improvements of companies’ business processes (BPs). Minimising the risk of inappropriate BP being implemented is usually performed by simulating the newly developed BP under various initial conditions and “what-if” scenarios. An effectual business process simulations software (BPSS) is a prerequisite for accurate analysis of an BP. Characterisation of an BPSS tool is a challenging task due to the complex selection criteria that includes quality of visual aspects, simulation capabilities, statistical facilities, quality reporting etc. Under such circumstances, making an optimal decision is challenging. Therefore, various decision support models are employed aiding the BPSS tool selection. The currently established decision support models are either proprietary or comprise only a limited subset of criteria, which affects their accuracy. Addressing this issue, this paper proposes a new hierarchical decision support model for ranking of BPSS based on their technical characteristics by employing DEX and qualitative to quantitative (QQ) methodology. Consequently, the decision expert feeds the required information in a systematic and user friendly manner. There are three significant contributions of the proposed approach. Firstly, the proposed hierarchical model is easily extendible for adding new criteria in the hierarchical structure. Secondly, a fully operational decision support system (DSS) tool that implements the proposed hierarchical model is presented. Finally, the effectiveness of the proposed hierarchical model is assessed by comparing the resulting rankings of BPSS with respect to currently available results. PMID:26871694

Data mining for multiagent rules, strategies, and fuzzy decision tree structure

NASA Astrophysics Data System (ADS)

Smith, James F., III; Rhyne, Robert D., II; Fisher, Kristin

2002-03-01

A fuzzy logic based resource manager (RM) has been developed that automatically allocates electronic attack resources in real-time over many dissimilar platforms. Two different data mining algorithms have been developed to determine rules, strategies, and fuzzy decision tree structure. The first data mining algorithm uses a genetic algorithm as a data mining function and is called from an electronic game. The game allows a human expert to play against the resource manager in a simulated battlespace with each of the defending platforms being exclusively directed by the fuzzy resource manager and the attacking platforms being controlled by the human expert or operating autonomously under their own logic. This approach automates the data mining problem. The game automatically creates a database reflecting the domain expert's knowledge. It calls a data mining function, a genetic algorithm, for data mining of the database as required and allows easy evaluation of the information mined in the second step. The criterion for re- optimization is discussed as well as experimental results. Then a second data mining algorithm that uses a genetic program as a data mining function is introduced to automatically discover fuzzy decision tree structures. Finally, a fuzzy decision tree generated through this process is discussed.

Value choices and considerations when limiting intensive care treatment: a qualitative study.

PubMed

Halvorsen, K; Førde, R; Nortvedt, P

2009-01-01

To shed light on the values and considerations that affect the decision-making processes and the decisions to limit intensive care treatment. Qualitative methodology with participant observation and in-depth interviews, with an emphasis on eliciting the underlying rationale of the clinicians' actions and choices when limiting treatment. Informants perceived over-treatment in intensive care medicine as a dilemma. One explanation was that the decision-making base was somewhat uncertain, complex and difficult. The informants claimed that those responsible for taking decisions from the admitting ward prolonged futile treatment because they may bear guilt or responsibility for something that had gone wrong during the course of treatment. The assessments of the patient's situation made by physicians from the admitting ward were often more organ-oriented and the expectations were less realistic than those of clinicians in the intensive care unit who frequently had a more balanced and overall perspective. Aspects such as the personality and the speciality of those involved, the culture of the unit and the degree of interdisciplinary cooperation were important issues in the decision-making processes. Under-communicated considerations jeopardise the principle of equal treatment. If intensive care patients are to be ensured equal treatment, strategies for interdisciplinary, transparent and appropriate decision-making processes must be developed in which open and hidden values are rendered visible, power structures disclosed, employees respected and the various perspectives of the treatment given their legitimate place.

A new computational account of cognitive control over reinforcement-based decision-making: Modeling of a probabilistic learning task.

PubMed

Zendehrouh, Sareh

2015-11-01

Recent work on decision-making field offers an account of dual-system theory for decision-making process. This theory holds that this process is conducted by two main controllers: a goal-directed system and a habitual system. In the reinforcement learning (RL) domain, the habitual behaviors are connected with model-free methods, in which appropriate actions are learned through trial-and-error experiences. However, goal-directed behaviors are associated with model-based methods of RL, in which actions are selected using a model of the environment. Studies on cognitive control also suggest that during processes like decision-making, some cortical and subcortical structures work in concert to monitor the consequences of decisions and to adjust control according to current task demands. Here a computational model is presented based on dual system theory and cognitive control perspective of decision-making. The proposed model is used to simulate human performance on a variant of probabilistic learning task. The basic proposal is that the brain implements a dual controller, while an accompanying monitoring system detects some kinds of conflict including a hypothetical cost-conflict one. The simulation results address existing theories about two event-related potentials, namely error related negativity (ERN) and feedback related negativity (FRN), and explore the best account of them. Based on the results, some testable predictions are also presented. Copyright © 2015 Elsevier Ltd. All rights reserved.

Process-Based Governance in Public Administrations Using Activity-Based Costing

NASA Astrophysics Data System (ADS)

Becker, Jörg; Bergener, Philipp; Räckers, Michael

Decision- and policy-makers in public administrations currently lack on missing relevant information for sufficient governance. In Germany the introduction of New Public Management and double-entry accounting enable public administrations to get the opportunity to use cost-centered accounting mechanisms to establish new governance mechanisms. Process modelling in this case can be a useful instrument to help the public administrations decision- and policy-makers to structure their activities and capture relevant information. In combination with approaches like Activity-Based Costing, higher management level can be supported with a reasonable data base for fruitful and reasonable governance approaches. Therefore, the aim of this article is combining the public sector domain specific process modelling method PICTURE and concept of activity-based costing for supporting Public Administrations in process-based Governance.

ED Triage Decision-Making With Mental Health Presentations: A "Think Aloud" Study.

PubMed

Clarke, Diana E; Boyce-Gaudreau, Krystal; Sanderson, Ana; Baker, John A

2015-11-01

Triage is the process whereby persons presenting to the emergency department are quickly assessed by a nurse and their need for care and service is prioritized. Research examining the care of persons presenting to emergency departments with psychiatric and mental health problems has shown that triage has often been cited as the most problematic aspect of the encounter. Three questions guided this investigation: Where do the decisions that triage nurses make fall on the intuitive versus analytic dimensions of decision making for mental health presentations in the emergency department, and does this differ according to comfort or familiarity with the type of mental health/illness presentation? How do "decision aids" (i.e., structured triage scales) help in the decision-making process? To what extent do other factors, such as attitudes, influence triage nurses' decision making? Eleven triage nurses participating in this study were asked to talk out loud about the reasoning process they would engage in while triaging patients in 5 scenarios based on mental health presentations to the emergency department. Themes emerging from the data were tweaking the results (including the use of intuition and early judgments) to arrive at the desired triage score; consideration of the current ED environment; managing uncertainty and risk (including the consideration of physical reasons for presentation); and confidence in communicating with patients in distress and managing their own emotive reactions to the scenario. Findings support the preference for using the intuitive mode of decision making with only tacit reliance on the decision aid. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

AgRISTARS: Foreign commodity production forecasting. Corn/soybean decision logic development and testing

NASA Technical Reports Server (NTRS)

Dailey, C. L.; Abotteen, K. M. (Principal Investigator)

1980-01-01

The development and testing of an analysis procedure which was developed to improve the consistency and objectively of crop identification using Landsat data is described. The procedure was developed to identify corn and soybean crops in the U.S. corn belt region. The procedure consists of a series of decision points arranged in a tree-like structure, the branches of which lead an analyst to crop labels. The specific decision logic is designed to maximize the objectively of the identification process and to promote the possibility of future automation. Significant results are summarized.

Behavioral and Organizational Considerations in the Design of Information Systems and Processes for Planning and Decision Support,

DTIC Science & Technology

1981-06-01

analysis and display capability provided by management information systems to include interpretation and aggregation of information and values such as...accomplishment of these) 2. analysis of the issue d) systems analysis and modeling (determination of the structure of the decision situation, the...existingltrtie2) Surveying lsata i situation’ alternatives I altraivDsad Is this alternative -" altrnav acceptable? ANALYSIS o NOYES SHave a sufficient

The Dynamics of Coalition Formation on Complex Networks

NASA Astrophysics Data System (ADS)

Auer, S.; Heitzig, J.; Kornek, U.; Schöll, E.; Kurths, J.

2015-08-01

Complex networks describe the structure of many socio-economic systems. However, in studies of decision-making processes the evolution of the underlying social relations are disregarded. In this report, we aim to understand the formation of self-organizing domains of cooperation (“coalitions”) on an acquaintance network. We include both the network’s influence on the formation of coalitions and vice versa how the network adapts to the current coalition structure, thus forming a social feedback loop. We increase complexity from simple opinion adaptation processes studied in earlier research to more complex decision-making determined by costs and benefits, and from bilateral to multilateral cooperation. We show how phase transitions emerge from such coevolutionary dynamics, which can be interpreted as processes of great transformations. If the network adaptation rate is high, the social dynamics prevent the formation of a grand coalition and therefore full cooperation. We find some empirical support for our main results: Our model develops a bimodal coalition size distribution over time similar to those found in social structures. Our detection and distinguishing of phase transitions may be exemplary for other models of socio-economic systems with low agent numbers and therefore strong finite-size effects.

Decision analysis applied to the purchase of frozen premixed intravenous admixtures.

PubMed

Witte, K W; Eck, T A; Vogel, D P

1985-04-01

A structured decision-analysis model was used to evaluate frozen premixed cefazolin admixtures. Decision analysis is a process of stating the desired outcome, establishing and weighting evaluation criteria, identifying options for reaching the outcome, evaluating and numerically ranking each option for each criterion, multiplying the ranking by the weight for each criterion, and calculating total points for each option. It was used to compare objectively frozen premixed cefazolin admixtures with batch reconstitution from vials and reconstitution of lyophilized, ready-to-mix containers. In this institution the model numerically demonstrated a distinct preference for the premixed frozen admixture over these other alternatives. A comparison of these results with the total cost impact of each option resulted in a decision to purchase the frozen premixed solution. The advantages of the frozen premixed solution that contributed most to this decision were decreased waste and personnel time. The latter was especially important since it allowed for the reallocation of personnel resources to other potentially cost-reducing clinical functions. Decision analysis proved to be an effective tool for formalizing the process of selecting among various alternatives to reach a desired outcome in this hospital pharmacy.

Combining ecosystem services assessment with structured decision making to support ecological restoration planning.

PubMed

Martin, David M; Mazzotta, Marisa; Bousquin, Justin

2018-04-10

Accounting for ecosystem services in environmental decision making is an emerging research topic. Modern frameworks for ecosystem services assessment emphasize evaluating the social benefits of ecosystems, in terms of who benefits and by how much, to aid in comparing multiple courses of action. Structured methods that use decision analytic-approaches are emerging for the practice of ecological restoration. In this article, we combine ecosystem services assessment with structured decision making to estimate and evaluate measures of the potential benefits of ecological restoration with a case study in the Woonasquatucket River watershed, Rhode Island, USA. We partnered with a local watershed management organization to analyze dozens of candidate wetland restoration sites for their abilities to supply five ecosystem services-flood water retention, scenic landscapes, learning opportunities, recreational opportunities, and birds. We developed 22 benefit indicators related to the ecosystem services as well as indicators for social equity and reliability that benefits will sustain in the future. We applied conceptual modeling and spatial analysis to estimate indicator values for each candidate restoration site. Lastly, we developed a decision support tool to score and aggregate the values for the organization to screen the restoration sites. Results show that restoration sites in urban areas can provide greater social benefits than sites in less urban areas. Our research approach is general and can be used to investigate other restoration planning studies that perform ecosystem services assessment and fit into a decision-making process.

An Investigation into the Processing of Lexicalized English Blend Words: Evidence from Lexical Decisions and Eye Movements during Reading

ERIC Educational Resources Information Center

Juhasz, Barbara J.; Johnson, Rebecca L.; Brewer, Jennifer

2017-01-01

New words enter the language through several word formation processes [see Simonini ("Engl J" 55:752-757, 1966)]. One such process, blending, occurs when two source words are combined to represent a new concept (e.g., SMOG, BRUNCH, BLOG, and INFOMERCIAL). While there have been examinations of the structure of blends [see Gries…

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

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

PubMed

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

2014-10-01

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

The ideas about advanced life support and affecting factors at the end-stage of life in a hospital in Turkey

PubMed Central

Albayrak, Turgay; Şencan, İrfan; Akça, Ömer; Aksoy, Hilal; Ünsal, Selim; Bülbül, İskender; Bahadır, Adem; Kasım, İsmail; Kahveci, Rabia; Özkara, Adem

2017-01-01

Background The participation of the people in health decisions may be structured in various levels. One of these is participation in decisions for the treatment. “Advanced directives” is one of the examples for the participation in decisions for the treatment. Aim We wanted to determine the decisions on advanced life support at the end-stage of life in case of a life-threatening illness for the people themselves and their first degree relatives and the factors effecting these decisions. Design and setting The cross-sectional study was conducted with volunteers among patients and patient relatives who applied to all polyclinics of the Ankara Numune Training and Research Hospital except the emergency, oncology and psychiatry polyclinics between 15.12.2012 and 15.03.2013. Method A questionnaire, the Hospital Anxiety Depression (HAD) scale, and Templer’s Death Anxiety Scale (TDA) were applied to all individuals. SPSS for Win. Ver. 17.0 and MS-Excel 2010 Starter software bundles were used for all statistical analysis and calculations. Results The participants want both themselves and their first degree relatives included in end-stage decision-making process. Therefore, the patients and their families should be informed adequately during decision making process and quality communication must be provided. Conclusion Participants who have given their end-stage decisions previously want to be treated according to these decisions. This desire can just be possible by advanced directives.When moral and material loads of end-stage process are taken into consideration, countries, in which advanced directives are practiced, should be examined well and participants’ desire should be evaluated in terms of practicability. PMID:28732071

Collaborative Manufacturing for Small-Medium Enterprises

NASA Astrophysics Data System (ADS)

Irianto, D.

2016-02-01

Manufacturing systems involve decisions concerning production processes, capacity, planning, and control. In a MTO manufacturing systems, strategic decisions concerning fulfilment of customer requirement, manufacturing cost, and due date of delivery are the most important. In order to accelerate the decision making process, research on decision making structure when receiving order and sequencing activities under limited capacity is required. An effective decision making process is typically required by small-medium components and tools maker as supporting industries to large industries. On one side, metal small-medium enterprises are expected to produce parts, components or tools (i.e. jigs, fixture, mold, and dies) with high precision, low cost, and exact delivery time. On the other side, a metal small- medium enterprise may have weak bargaining position due to aspects such as low production capacity, limited budget for material procurement, and limited high precision machine and equipment. Instead of receiving order exclusively, a small-medium enterprise can collaborate with other small-medium enterprise in order to fulfill requirements high quality, low manufacturing cost, and just in time delivery. Small-medium enterprises can share their best capabilities to form effective supporting industries. Independent body such as community service at university can take a role as a collaboration manager. The Laboratory of Production Systems at Bandung Institute of Technology has implemented shared manufacturing systems for small-medium enterprise collaboration.

Patchy 'coherence': using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC).

PubMed

Lloyd, Amy; Joseph-Williams, Natalie; Edwards, Adrian; Rix, Andrew; Elwyn, Glyn

2013-09-05

Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals' perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign ('Ask 3 Questions'); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: 'coherence,' 'cognitive participation,' 'collective action,' and 'reflexive monitoring.' Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose ('coherence'). Shared decision making was facilitated when teams engaged in developing and delivering interventions ('cognitive participation'), and when those interventions fit with existing skill sets and organizational priorities ('collective action') resulting in demonstrable improvements to practice ('reflexive monitoring'). The implementation process uncovered diverse and conflicting attitudes toward shared decision making; 'coherence' was often missing. The study showed that implementation of shared decision making is more complex than the delivery of patient decision support interventions to patients, a portrayal that often goes unquestioned. Normalizing shared decision making requires intensive work to ensure teams have a shared understanding of the purpose of involving patients in decisions, and undergo the attitudinal shifts that many health professionals feel are required when comprehension goes beyond initial interpretations. Divergent views on the value of engaging patients in decisions remain a significant barrier to implementation.

Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC)

PubMed Central

2013-01-01

Background Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals’ perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. Methods The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign (‘Ask 3 Questions’); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. Results A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: ‘coherence,’ ‘cognitive participation,’ ‘collective action,’ and ‘reflexive monitoring.’ Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose (‘coherence’). Shared decision making was facilitated when teams engaged in developing and delivering interventions (‘cognitive participation’), and when those interventions fit with existing skill sets and organizational priorities (‘collective action’) resulting in demonstrable improvements to practice (‘reflexive monitoring’). The implementation process uncovered diverse and conflicting attitudes toward shared decision making; ‘coherence’ was often missing. Conclusions The study showed that implementation of shared decision making is more complex than the delivery of patient decision support interventions to patients, a portrayal that often goes unquestioned. Normalizing shared decision making requires intensive work to ensure teams have a shared understanding of the purpose of involving patients in decisions, and undergo the attitudinal shifts that many health professionals feel are required when comprehension goes beyond initial interpretations. Divergent views on the value of engaging patients in decisions remain a significant barrier to implementation. PMID:24006959

Application of the principles of evidence-based practice in decision making among senior management in Nova Scotia's addiction services agencies.

PubMed

Murphy, Matthew; MacCarthy, M Jayne; McAllister, Lynda; Gilbert, Robert

2014-12-05

Competency profiles for occupational clusters within Canada's substance abuse workforce (SAW) define the need for skill and knowledge in evidence-based practice (EBP) across all its members. Members of the Senior Management occupational cluster hold ultimate responsibility for decisions made within addiction services agencies and therefore must possess the highest level of proficiency in EBP. The objective of this study was to assess the knowledge of the principles of EBP, and use of the components of the evidence-based decision making (EBDM) process in members of this occupational cluster from selected addiction services agencies in Nova Scotia. A convenience sampling method was used to recruit participants from addiction services agencies. Semi-structured qualitative interviews were conducted with eighteen Senior Management. The interviews were audio-recorded, transcribed verbatim and checked by the participants. Interview transcripts were coded and analyzed for themes using content analysis and assisted by qualitative data analysis software (NVivo 9.0). Data analysis revealed four main themes: 1) Senior Management believe that addictions services agencies are evidence-based; 2) Consensus-based decision making is the norm; 3) Senior Management understand the principles of EBP and; 4) Senior Management do not themselves use all components of the EBDM process when making decisions, oftentimes delegating components of this process to decision support staff. Senior Management possess an understanding of the principles of EBP, however, when making decisions they often delegate components of the EBDM process to decision support staff. Decision support staff are not defined as an occupational cluster in Canada's SAW and have not been ascribed a competency profile. As such, there is no guarantee that this group possesses competency in EBDM. There is a need to advocate for the development of a defined occupational cluster and associated competency profile for this critical group.

Working in partnership: the application of shared decision-making to health visitor practice.

PubMed

Astbury, Ruth; Shepherd, Ashley; Cheyne, Helen

2017-01-01

To explore the processes that support shared decision-making when health visitors and parents are creating plans to improve the well-being of babies and children. Worldwide, there is a focus on promoting children's well-being to enhance the population health. Within the United Kingdom, health visitors have a key responsibility for working in partnership with parents to support this agenda. Despite evidence that the application of 'shared decision-making' frameworks can increase patient participation, improve patient satisfaction and improve health outcomes, there is limited research linking shared decision-making with health visitor practice. A qualitative, descriptive study. The study was undertaken in two phases: in Phase 1, data were collected by audio recording two health visitor-parent decision-making conversations, in the absence of the researcher, where decisions around planning for a baby or child were being made as part of usual care, and then the participants' experiences were sought through individual questionnaires. In Phase 2, semistructured interviews were conducted with nine health visitors and nine parents in relation to their recent experiences of planning care. Evidence of supportive processes included having a shared understanding around the issue needing to be addressed; being able to identify interventions that were accessible for the family; engaging in decision-making through deep, meaningful conversations using sensitive and responsive approaches; and establishing positive relationships between health visitors and parents, significant others within the family and other professionals. Despite evidence of strong, trusting relationships between parents and health visitors, there were times when shared decision-making was unable to take place due to the absence of supportive processes. Health visitors are aware that planning interventions with parents can be complex. These findings indicate the value of using a shared decision-making framework to structure planning, as application of a framework identified the processes that support a collaborative approach in practice. © 2016 John Wiley & Sons Ltd.

Bayesian techniques for analyzing group differences in the Iowa Gambling Task: A case study of intuitive and deliberate decision-makers.

PubMed

Steingroever, Helen; Pachur, Thorsten; Šmíra, Martin; Lee, Michael D

2018-06-01

The Iowa Gambling Task (IGT) is one of the most popular experimental paradigms for comparing complex decision-making across groups. Most commonly, IGT behavior is analyzed using frequentist tests to compare performance across groups, and to compare inferred parameters of cognitive models developed for the IGT. Here, we present a Bayesian alternative based on Bayesian repeated-measures ANOVA for comparing performance, and a suite of three complementary model-based methods for assessing the cognitive processes underlying IGT performance. The three model-based methods involve Bayesian hierarchical parameter estimation, Bayes factor model comparison, and Bayesian latent-mixture modeling. We illustrate these Bayesian methods by applying them to test the extent to which differences in intuitive versus deliberate decision style are associated with differences in IGT performance. The results show that intuitive and deliberate decision-makers behave similarly on the IGT, and the modeling analyses consistently suggest that both groups of decision-makers rely on similar cognitive processes. Our results challenge the notion that individual differences in intuitive and deliberate decision styles have a broad impact on decision-making. They also highlight the advantages of Bayesian methods, especially their ability to quantify evidence in favor of the null hypothesis, and that they allow model-based analyses to incorporate hierarchical and latent-mixture structures.

Caregivers' experience of the decision-making process for placing a person with dementia into a nursing home: comparing caregivers from Chinese ethnic minority with those from English-speaking backgrounds.

PubMed

Caldwell, Lauren; Low, Lee-Fay; Brodaty, Henry

2014-03-01

The experience of care transitions for people with dementia from ethnic minority groups has been poorly researched. Few studies have examined the decision to put someone on a waiting list for a nursing home and then actually accept a place. Many nursing homes have long waiting lists, but sometimes offers of a place are declined. Our aims were to investigate the decision-making process for placing a person with dementia on a waiting list for a nursing home, why offers of a place are accepted or declined, and the influence of cultural factors, comparing caregivers from Chinese and English-speaking backgrounds. Semi-structured interviews with 27 caregivers of people with dementia on waiting lists or living in nursing homes (20 Chinese background and seven English-speaking background) were conducted, with thematic analysis of factors affecting caregivers' decision-making. Caregivers were at different stages of decision-making when they applied for a waiting list - some were ready for placement, others applied "just in case," and for some there was no waiting time because of an urgent need for placement. Caregivers' decisions were influenced by their emotions and expectations of nursing homes. The decision-making process was similar for both cultural groups, but Chinese caregivers spoke more about their sense of duty, the need for a Chinese specific facility, and declining a place because of family disagreement. Understanding cultural issues, including stereotypes and concerns about nursing homes, and providing better information about admission processes may help caregivers by allaying their anxiety about nursing home placement.

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

NASA Astrophysics Data System (ADS)

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

2012-12-01

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

The value of artefacts in stimulated-recall interviews.

PubMed

Burden, Sarah; Topping, Annie; O'Halloran, Catherine

2015-09-01

To assess the use of artefacts in semi-structured, stimulated-recall interviews in a study exploring mentors' decisions regarding students' competence in practice. Few empirical studies have examined how mentors reach a decision when assessing students' performance in practice. Concerns have repeatedly been voiced that students may lack essential skills at the point of registration or that mentors may have failed or been reticent to judge students' performance as unsatisfactory. Student practice assessment documents (PADs) were used in stimulated-recall (SR) interviews with mentors to explore decision making. A review of the literature identified that artefacts can play a role in triggering a more comprehensive retrospective examination of decision making, thus helping to capture the essence of a mentor's decision over time and in context. Use of an artefact to stimulate recall can elicit evidence of thought processes, which may be difficult to obtain in a normal, semi-structured interview. PADs proved to be a valuable way to generate naturalistic decision making. In addition, discussion of artefacts created by participants can promote participant-driven enquiry, thereby reducing researcher bias. Identifying an approach that captures post hoc decision making based on sustained engagement and interaction between students and their mentors was a challenge. Artefacts can be used to address the difficulties associated with retrospective introspection about a unique decision. There is the potential to increase the use of artefacts in healthcare research. SR can also help novice mentors develop their skills in making decisions regarding assessments of students.

Case Study of a Merger in Higher Education.

ERIC Educational Resources Information Center

Keohane, Kevin

1984-01-01

The merging of four British teacher training institutions and the accompanying severe reduction in teaching staff is described, focusing on the teachers' role in the process, developing an administrative structure, and making decisions about program redundancy. (MSE)

Modeling the Covariance Structure of Complex Datasets Using Cognitive Models: An Application to Individual Differences and the Heritability of Cognitive Ability.

PubMed

Evans, Nathan J; Steyvers, Mark; Brown, Scott D

2018-06-05

Understanding individual differences in cognitive performance is an important part of understanding how variations in underlying cognitive processes can result in variations in task performance. However, the exploration of individual differences in the components of the decision process-such as cognitive processing speed, response caution, and motor execution speed-in previous research has been limited. Here, we assess the heritability of the components of the decision process, with heritability having been a common aspect of individual differences research within other areas of cognition. Importantly, a limitation of previous work on cognitive heritability is the underlying assumption that variability in response times solely reflects variability in the speed of cognitive processing. This assumption has been problematic in other domains, due to the confounding effects of caution and motor execution speed on observed response times. We extend a cognitive model of decision-making to account for relatedness structure in a twin study paradigm. This approach can separately quantify different contributions to the heritability of response time. Using data from the Human Connectome Project, we find strong evidence for the heritability of response caution, and more ambiguous evidence for the heritability of cognitive processing speed and motor execution speed. Our study suggests that the assumption made in previous studies-that the heritability of cognitive ability is based on cognitive processing speed-may be incorrect. More generally, our methodology provides a useful avenue for future research in complex data that aims to analyze cognitive traits across different sources of related data, whether the relation is between people, tasks, experimental phases, or methods of measurement. © 2018 Cognitive Science Society, Inc.

Climate Risk Informed Decision Analysis: A Hypothetical Application to the Waas Region

NASA Astrophysics Data System (ADS)

Gilroy, Kristin; Mens, Marjolein; Haasnoot, Marjolijn; Jeuken, Ad

2016-04-01

More frequent and intense hydrologic events under climate change are expected to enhance water security and flood risk management challenges worldwide. Traditional planning approaches must be adapted to address climate change and develop solutions with an appropriate level of robustness and flexibility. The Climate Risk Informed Decision Analysis (CRIDA) method is a novel planning approach embodying a suite of complementary methods, including decision scaling and adaptation pathways. Decision scaling offers a bottom-up approach to assess risk and tailors the complexity of the analysis to the problem at hand and the available capacity. Through adaptation pathway,s an array of future strategies towards climate robustness are developed, ranging in flexibility and immediacy of investments. Flexible pathways include transfer points to other strategies to ensure that the system can be adapted if future conditions vary from those expected. CRIDA combines these two approaches in a stakeholder driven process which guides decision makers through the planning and decision process, taking into account how the confidence in the available science, the consequences in the system, and the capacity of institutions should influence strategy selection. In this presentation, we will explain the CRIDA method and compare it to existing planning processes, such as the US Army Corps of Engineers Principles and Guidelines as well as Integrated Water Resources Management Planning. Then, we will apply the approach to a hypothetical case study for the Waas Region, a large downstream river basin facing rapid development threatened by increased flood risks. Through the case study, we will demonstrate how a stakeholder driven process can be used to evaluate system robustness to climate change; develop adaptation pathways for multiple objectives and criteria; and illustrate how varying levels of confidence, consequences, and capacity would play a role in the decision making process, specifically in regards to the level of robustness and flexibility in the selected strategy. This work will equip practitioners and decision makers with an example of a structured process for decision making under climate uncertainty that can be scaled as needed to the problem at hand. This presentation builds further on another submitted abstract "Climate Risk Informed Decision Analysis (CRIDA): A novel practical guidance for Climate Resilient Investments and Planning" by Jeuken et al.

[An expert system of aiding decision making in breast pathology connected to a clinical data base].

PubMed

Brunet, M; Durrleman, S; Ferber, J; Ganascia, J G; Hacene, K; Hirt, F; Jouniaux, F; Meeus, L

1987-01-01

The René Huguenin Cancer Center holds a medical file for each patient which is intended to store and process medical data. Since 1970, we introduced computerization: a development plan was elaborated and simultaneously a statistical software (Clotilde--GSI/CFRO) was selected. Thus, we now have access to a large database, structured according to medical rationale, and utilizable with methods of artificial intelligence towards three objectives: improved data acquisition, decision making and exploitation. The first application was to breast pathology, which represents one of the Center's primary activities. The structure of the data concerning patients is by all criteria part of the medical knowledge. This information needs to be presented as well as processed with a suitable language. To this end, we chose a language-oriented object, Mering II, usable with Apple and IBM 4 micro-computers. This project has already allowed to work out an operational model.

Spatial planning using probabilistic flood maps

NASA Astrophysics Data System (ADS)

Alfonso, Leonardo; Mukolwe, Micah; Di Baldassarre, Giuliano

2015-04-01

Probabilistic flood maps account for uncertainty in flood inundation modelling and convey a degree of certainty in the outputs. Major sources of uncertainty include input data, topographic data, model structure, observation data and parametric uncertainty. Decision makers prefer less ambiguous information from modellers; this implies that uncertainty is suppressed to yield binary flood maps. Though, suppressing information may potentially lead to either surprise or misleading decisions. Inclusion of uncertain information in the decision making process is therefore desirable and transparent. To this end, we utilise the Prospect theory and information from a probabilistic flood map to evaluate potential decisions. Consequences related to the decisions were evaluated using flood risk analysis. Prospect theory explains how choices are made given options for which probabilities of occurrence are known and accounts for decision makers' characteristics such as loss aversion and risk seeking. Our results show that decision making is pronounced when there are high gains and loss, implying higher payoffs and penalties, therefore a higher gamble. Thus the methodology may be appropriately considered when making decisions based on uncertain information.

What is adaptive about adaptive decision making? A parallel constraint satisfaction account.

PubMed

Glöckner, Andreas; Hilbig, Benjamin E; Jekel, Marc

2014-12-01

There is broad consensus that human cognition is adaptive. However, the vital question of how exactly this adaptivity is achieved has remained largely open. Herein, we contrast two frameworks which account for adaptive decision making, namely broad and general single-mechanism accounts vs. multi-strategy accounts. We propose and fully specify a single-mechanism model for decision making based on parallel constraint satisfaction processes (PCS-DM) and contrast it theoretically and empirically against a multi-strategy account. To achieve sufficiently sensitive tests, we rely on a multiple-measure methodology including choice, reaction time, and confidence data as well as eye-tracking. Results show that manipulating the environmental structure produces clear adaptive shifts in choice patterns - as both frameworks would predict. However, results on the process level (reaction time, confidence), in information acquisition (eye-tracking), and from cross-predicting choice consistently corroborate single-mechanisms accounts in general, and the proposed parallel constraint satisfaction model for decision making in particular. Copyright © 2014 Elsevier B.V. All rights reserved.

Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework.

PubMed

Angelis, Aris; Kanavos, Panos

2017-09-01

Escalating drug prices have catalysed the generation of numerous "value frameworks" with the aim of informing payers, clinicians and patients on the assessment and appraisal process of new medicines for the purpose of coverage and treatment selection decisions. Although this is an important step towards a more inclusive Value Based Assessment (VBA) approach, aspects of these frameworks are based on weak methodologies and could potentially result in misleading recommendations or decisions. In this paper, a Multiple Criteria Decision Analysis (MCDA) methodological process, based on Multi Attribute Value Theory (MAVT), is adopted for building a multi-criteria evaluation model. A five-stage model-building process is followed, using a top-down "value-focused thinking" approach, involving literature reviews and expert consultations. A generic value tree is structured capturing decision-makers' concerns for assessing the value of new medicines in the context of Health Technology Assessment (HTA) and in alignment with decision theory. The resulting value tree (Advance Value Tree) consists of three levels of criteria (top level criteria clusters, mid-level criteria, bottom level sub-criteria or attributes) relating to five key domains that can be explicitly measured and assessed: (a) burden of disease, (b) therapeutic impact, (c) safety profile (d) innovation level and (e) socioeconomic impact. A number of MAVT modelling techniques are introduced for operationalising (i.e. estimating) the model, for scoring the alternative treatment options, assigning relative weights of importance to the criteria, and combining scores and weights. Overall, the combination of these MCDA modelling techniques for the elicitation and construction of value preferences across the generic value tree provides a new value framework (Advance Value Framework) enabling the comprehensive measurement of value in a structured and transparent way. Given its flexibility to meet diverse requirements and become readily adaptable across different settings, the Advance Value Framework could be offered as a decision-support tool for evaluators and payers to aid coverage and reimbursement of new medicines. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

When the user is not the chooser: learning from stakeholder involvement in technology adoption decisions in infection control.

PubMed

Ahmad, R; Kyratsis, Y; Holmes, A

2012-07-01

Health systems need efficient and effective innovation decisions to provide maximum benefit to patients, particularly in a climate of financial constraints. Although evidence-based innovations exist for helping to address healthcare-associated infections, the uptake and implementation of these is highly variable and in some cases very slow. To investigate innovation adoption decisions and implementation processes from an organizational perspective, focusing on the implications of stakeholder involvement during the innovation process. Thirty-eight technology adoption decisions and implementation processes were examined through 121 qualitative interviews in 12 National Health Service healthcare organizations across England. Stakeholder involvement varied across organizations with decisions highly exclusive to the infection prevention and control (IPC) team, to highly inclusive of wider organizational members. The context, including organizational culture, previous experience, and logistical factors influenced the level of stakeholder engagement. The timing of stakeholder involvement in the process impacted on: (i) the range of innovations considered; (ii) the technologies selected, and (iii) the success of technology implementation. Cases of non-adoption, discontinued adoption, and of successful implementation are presented to share learning. The potential benefits of stakeholder involvement for 'successful' innovation adoption are presented including a goal-oriented framework for involvement. Key stakeholder involvement can lead to innovation adoption and implementation compatible with structural and cultural contexts, particularly when involvement crosses the phases of initiation, decision-making and implementation. Involving members of the wider healthcare organization can raise the profile of IPC and reinforce efforts to make IPC everybody's business. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making.

PubMed

Waldron, Nicholas; Johnson, Claire E; Saul, Peter; Waldron, Heidi; Chong, Jeffrey C; Hill, Anne-Marie; Hayes, Barbara

2016-10-06

Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions. Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature. A subsequent iterative consensus process developed two intervention elements: (i) an updated 'Goals of Patient Care' (GOPC) form and process; (ii) an education video and resources for teaching advance CPR decision-making and communication. A multidisciplinary group of health professionals and policy-makers with experience in systems development, education and research provided critical feedback. Three key themes emerged from the focus groups and the literature, which identified a structure for the intervention: (i) knowing what to say; (ii) knowing how to say it; (iii) wanting to say it. The themes informed the development of a video to provide education about advance CPR decision-making framework, improving communication and contextualising relevant clinical issues. Critical feedback assisted in refining the video and further guided development and evolution of a medical GOPC approach to discussing and recording medical treatment and advance care plans. Through an iterative process of consultation and review, video-based education and an expanded GOPC form and approach were developed to address physician and systemic barriers to advance CPR decision-making and documentation. Implementation and evaluation across hospital settings is required to examine utility and determine effect on quality of care.

Confronting dynamics and uncertainty in optimal decision making for conservation

USGS Publications Warehouse

Williams, Byron K.; Johnson, Fred A.

2013-01-01

The effectiveness of conservation efforts ultimately depends on the recognition that decision making, and the systems that it is designed to affect, are inherently dynamic and characterized by multiple sources of uncertainty. To cope with these challenges, conservation planners are increasingly turning to the tools of decision analysis, especially dynamic optimization methods. Here we provide a general framework for optimal, dynamic conservation and then explore its capacity for coping with various sources and degrees of uncertainty. In broadest terms, the dynamic optimization problem in conservation is choosing among a set of decision options at periodic intervals so as to maximize some conservation objective over the planning horizon. Planners must account for immediate objective returns, as well as the effect of current decisions on future resource conditions and, thus, on future decisions. Undermining the effectiveness of such a planning process are uncertainties concerning extant resource conditions (partial observability), the immediate consequences of decision choices (partial controllability), the outcomes of uncontrolled, environmental drivers (environmental variation), and the processes structuring resource dynamics (structural uncertainty). Where outcomes from these sources of uncertainty can be described in terms of probability distributions, a focus on maximizing the expected objective return, while taking state-specific actions, is an effective mechanism for coping with uncertainty. When such probability distributions are unavailable or deemed unreliable, a focus on maximizing robustness is likely to be the preferred approach. Here the idea is to choose an action (or state-dependent policy) that achieves at least some minimum level of performance regardless of the (uncertain) outcomes. We provide some examples of how the dynamic optimization problem can be framed for problems involving management of habitat for an imperiled species, conservation of a critically endangered population through captive breeding, control of invasive species, construction of biodiversity reserves, design of landscapes to increase habitat connectivity, and resource exploitation. Although these decision making problems and their solutions present significant challenges, we suggest that a systematic and effective approach to dynamic decision making in conservation need not be an onerous undertaking. The requirements are shared with any systematic approach to decision making--a careful consideration of values, actions, and outcomes.

Confronting dynamics and uncertainty in optimal decision making for conservation

NASA Astrophysics Data System (ADS)

Williams, Byron K.; Johnson, Fred A.

2013-06-01

The effectiveness of conservation efforts ultimately depends on the recognition that decision making, and the systems that it is designed to affect, are inherently dynamic and characterized by multiple sources of uncertainty. To cope with these challenges, conservation planners are increasingly turning to the tools of decision analysis, especially dynamic optimization methods. Here we provide a general framework for optimal, dynamic conservation and then explore its capacity for coping with various sources and degrees of uncertainty. In broadest terms, the dynamic optimization problem in conservation is choosing among a set of decision options at periodic intervals so as to maximize some conservation objective over the planning horizon. Planners must account for immediate objective returns, as well as the effect of current decisions on future resource conditions and, thus, on future decisions. Undermining the effectiveness of such a planning process are uncertainties concerning extant resource conditions (partial observability), the immediate consequences of decision choices (partial controllability), the outcomes of uncontrolled, environmental drivers (environmental variation), and the processes structuring resource dynamics (structural uncertainty). Where outcomes from these sources of uncertainty can be described in terms of probability distributions, a focus on maximizing the expected objective return, while taking state-specific actions, is an effective mechanism for coping with uncertainty. When such probability distributions are unavailable or deemed unreliable, a focus on maximizing robustness is likely to be the preferred approach. Here the idea is to choose an action (or state-dependent policy) that achieves at least some minimum level of performance regardless of the (uncertain) outcomes. We provide some examples of how the dynamic optimization problem can be framed for problems involving management of habitat for an imperiled species, conservation of a critically endangered population through captive breeding, control of invasive species, construction of biodiversity reserves, design of landscapes to increase habitat connectivity, and resource exploitation. Although these decision making problems and their solutions present significant challenges, we suggest that a systematic and effective approach to dynamic decision making in conservation need not be an onerous undertaking. The requirements are shared with any systematic approach to decision making—a careful consideration of values, actions, and outcomes.

Harmonised framework for ecological risk assessment of sediments from ports and estuarine zones of North and South Atlantic.

PubMed

Choueri, R B; Cesar, A; Abessa, D M S; Torres, R J; Riba, I; Pereira, C D S; Nascimento, M R L; Morais, R D; Mozeto, A A; DelValls, T A

2010-04-01

This paper presents a harmonised framework of sediment quality assessment and dredging material characterisation for estuaries and port zones of North and South Atlantic. This framework, based on the weight-of-evidence approach, provides a structure and a process for conducting sediment/dredging material assessment that leads to a decision. The main structure consists of "step 1" (examination of available data); "step 2" (chemical characterisation and toxicity assessment); "decision 1" (any chemical level higher than reference values? are sediments toxic?); "step 3" (assessment of benthic community structure); "step 4" (integration of the results); "decision 2" (are sediments toxic or benthic community impaired?); "step 5" (construction of the decision matrix) and "decision 3" (is there environmental risk?). The sequence of assessments may be interrupted when the information obtained is judged to be sufficient for a correct characterisation of the risk posed by the sediments/dredging material. This framework brought novel features compared to other sediment/dredging material risk assessment frameworks: data integration through multivariate analysis allows the identification of which samples are toxic and/or related to impaired benthic communities; it also discriminates the chemicals responsible for negative biological effects; and the framework dispenses the use of a reference area. We demonstrated the successful application of this framework in different port and estuarine zones of the North (Gulf of Cádiz) and South Atlantic (Santos and Paranaguá Estuarine Systems).

Decision-making in the adolescent brain.

PubMed

Blakemore, Sarah-Jayne; Robbins, Trevor W

2012-09-01

Adolescence is characterized by making risky decisions. Early lesion and neuroimaging studies in adults pointed to the ventromedial prefrontal cortex and related structures as having a key role in decision-making. More recent studies have fractionated decision-making processes into its various components, including the representation of value, response selection (including inter-temporal choice and cognitive control), associative learning, and affective and social aspects. These different aspects of decision-making have been the focus of investigation in recent studies of the adolescent brain. Evidence points to a dissociation between the relatively slow, linear development of impulse control and response inhibition during adolescence versus the nonlinear development of the reward system, which is often hyper-responsive to rewards in adolescence. This suggests that decision-making in adolescence may be particularly modulated by emotion and social factors, for example, when adolescents are with peers or in other affective ('hot') contexts.

Voice, perceived fairness, agency trust, and acceptance of management decisions among Minnesota anglers

USGS Publications Warehouse

Schroeder, Susan A.; Fulton, David C.

2017-01-01

Although researchers agree that public participation in natural resource decision making is critical to institutional acceptance by stakeholders and the general public, the processes to gain public perceptions of fairness, agency trust, and acceptance of management decisions are not clear. Using results from a mail survey of Minnesota resident anglers, we used structural equation modeling to examine how instrumental versus symbolic motives related to anglers’ perceptions of agency fairness, trustworthiness, and ultimately acceptance of fisheries management decisions. We applied laboratory research on relationships among procedural fairness, trust, and management acceptance, and then tested models incorporating anglers’ perceptions of voice for anglers and nonanglers in management decisions. Results suggested that trust fully mediated the relationship between procedural fairness and management acceptance. Angler perceptions of angler and nonangler voice both related to views of procedural fairness, but angler voice was more strongly related and was also significantly related to acceptance of management decisions.

User-centered design and the development of patient decision aids: protocol for a systematic review.

PubMed

Witteman, Holly O; Dansokho, Selma Chipenda; Colquhoun, Heather; Coulter, Angela; Dugas, Michèle; Fagerlin, Angela; Giguere, Anik Mc; Glouberman, Sholom; Haslett, Lynne; Hoffman, Aubri; Ivers, Noah; Légaré, France; Légaré, Jean; Levin, Carrie; Lopez, Karli; Montori, Victor M; Provencher, Thierry; Renaud, Jean-Sébastien; Sparling, Kerri; Stacey, Dawn; Vaisson, Gratianne; Volk, Robert J; Witteman, William

2015-01-26

Providing patient-centered care requires that patients partner in their personal health-care decisions to the full extent desired. Patient decision aids facilitate processes of shared decision-making between patients and their clinicians by presenting relevant scientific information in balanced, understandable ways, helping clarify patients' goals, and guiding decision-making processes. Although international standards stipulate that patients and clinicians should be involved in decision aid development, little is known about how such involvement currently occurs, let alone best practices. This systematic review consisting of three interlinked subreviews seeks to describe current practices of user involvement in the development of patient decision aids, compare these to practices of user-centered design, and identify promising strategies. A research team that includes patient and clinician representatives, decision aid developers, and systematic review method experts will guide this review according to the Cochrane Handbook and PRISMA reporting guidelines. A medical librarian will hand search key references and use a peer-reviewed search strategy to search MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, the ACM library, IEEE Xplore, and Google Scholar. We will identify articles across all languages and years describing the development or evaluation of a patient decision aid, or the application of user-centered design or human-centered design to tools intended for patient use. Two independent reviewers will assess article eligibility and extract data into a matrix using a structured pilot-tested form based on a conceptual framework of user-centered design. We will synthesize evidence to describe how research teams have included users in their development process and compare these practices to user-centered design methods. If data permit, we will develop a measure of the user-centeredness of development processes and identify practices that are likely to be optimal. This systematic review will provide evidence of current practices to inform approaches for involving patients and other stakeholders in the development of patient decision aids. We anticipate that the results will help move towards the establishment of best practices for the development of patient-centered tools and, in turn, help improve the experiences of people who face difficult health decisions. PROSPERO CRD42014013241.

Decision analysis framing study; in-valley drainage management strategies for the western San Joaquin Valley, California

USGS Publications Warehouse

Presser, Theresa S.; Jenni, Karen E.; Nieman, Timothy; Coleman, James

2010-01-01

Constraints on drainage management in the western San Joaquin Valley and implications of proposed approaches to management were recently evaluated by the U.S. Geological Survey (USGS). The USGS found that a significant amount of data for relevant technical issues was available and that a structured, analytical decision support tool could help optimize combinations of specific in-valley drainage management strategies, address uncertainties, and document underlying data analysis for future use. To follow-up on USGS's technical analysis and to help define a scientific basis for decisionmaking in implementing in-valley drainage management strategies, this report describes the first step (that is, a framing study) in a Decision Analysis process. In general, a Decision Analysis process includes four steps: (1) problem framing to establish the scope of the decision problem(s) and a set of fundamental objectives to evaluate potential solutions, (2) generation of strategies to address identified decision problem(s), (3) identification of uncertainties and their relationships, and (4) construction of a decision support model. Participation in such a systematic approach can help to promote consensus and to build a record of qualified supporting data for planning and implementation. In December 2008, a Decision Analysis framing study was initiated with a series of meetings designed to obtain preliminary input from key stakeholder groups on the scope of decisions relevant to drainage management that were of interest to them, and on the fundamental objectives each group considered relevant to those decisions. Two key findings of this framing study are: (1) participating stakeholders have many drainage management objectives in common; and (2) understanding the links between drainage management and water management is necessary both for sound science-based decisionmaking and for resolving stakeholder differences about the value of proposed drainage management solutions. Citing ongoing legal processes associated with drainage management in the western San Joaquin Valley, the U.S. Bureau of Reclamation (USBR) withdrew from the Decision Analysis process early in the proceedings. Without the involvement of the USBR, the USGS discontinued further development of this study.

The influence of emotion regulation on decision-making under risk.

PubMed

Martin, Laura N; Delgado, Mauricio R

2011-09-01

Cognitive strategies typically involved in regulating negative emotions have recently been shown to also be effective with positive emotions associated with monetary rewards. However, it is less clear how these strategies influence behavior, such as preferences expressed during decision-making under risk, and the underlying neural circuitry. That is, can the effective use of emotion regulation strategies during presentation of a reward-conditioned stimulus influence decision-making under risk and neural structures involved in reward processing such as the striatum? To investigate this question, we asked participants to engage in imagery-focused regulation strategies during the presentation of a cue that preceded a financial decision-making phase. During the decision phase, participants then made a choice between a risky and a safe monetary lottery. Participants who successfully used cognitive regulation, as assessed by subjective ratings about perceived success and facility in implementation of strategies, made fewer risky choices in comparison with trials where decisions were made in the absence of cognitive regulation. Additionally, BOLD responses in the striatum were attenuated during decision-making as a function of successful emotion regulation. These findings suggest that exerting cognitive control over emotional responses can modulate neural responses associated with reward processing (e.g., striatum) and promote more goal-directed decision-making (e.g., less risky choices), illustrating the potential importance of cognitive strategies in curbing risk-seeking behaviors before they become maladaptive (e.g., substance abuse).

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

PubMed

Parker, Lisa

2017-07-01

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

How Do Trainees Choose Their First Psychotherapy Training? The Case of Training in Psychotherapy Integration

ERIC Educational Resources Information Center

Plchová, Romana; Hytych, Roman; Rihácek, Tomáš; Roubal, Jan; Vybíral, Zbynek

2016-01-01

Future trainees go through difficult decision-making processes when starting their first psychotherapy training. The choice of training in psychotherapy integration is a specific type of this process. In this study, qualitative data were obtained from the motivational letters, in-depth semi-structured interviews and e-mail questionnaires of 26…

The Need for Structure and Guidance When ICT Is Used in Project Work

ERIC Educational Resources Information Center

Postholm, May Britt; Pettersson, Tove; Gudmundsdottir, Sigrun; Flem, Annlaug

2004-01-01

Information and Communication Technology (ICT) can be integrated in the classroom processes in different ways. This study reveals ICT, as a mediating artefact in project work can contribute to the learning processes in the classroom. When ICT is used as an artefact to make a film, planning and decision making becomes natural and necessary…

An Analysis and Allocation System for Library Collections Budgets: The Comprehensive Allocation Process (CAP)

ERIC Educational Resources Information Center

Lyons, Lucy Eleonore; Blosser, John

2012-01-01

The "Comprehensive Allocation Process" (CAP) is a reproducible decision-making structure for the allocation of new collections funds, for the reallocation of funds within stagnant budgets, and for budget cuts in the face of reduced funding levels. This system was designed to overcome common shortcomings of current methods. Its philosophical…

Involving women in personalised decision-making on mode of delivery after caesarean section: the development and pilot testing of a patient decision aid.

PubMed

Schoorel, E N C; Vankan, E; Scheepers, H C J; Augustijn, B C C; Dirksen, C D; de Koning, M; van Kuijk, S M J; Kwee, A; Melman, S; Nijhuis, J G; Aardenburg, R; de Boer, K; Hasaart, T H M; Mol, B W J; Nieuwenhuijze, M; van Pampus, M G; van Roosmalen, J; Roumen, F J M E; de Vries, R; Wouters, M G A J; van der Weijden, T; Hermens, R P M G

2014-01-01

To develop a patient decision aid (PtDA) for mode of delivery after caesarean section that integrates personalised prediction of vaginal birth after caesarean (VBAC) with the elicitation of patient preferences and evidence-based information. A PtDA was developed and pilot tested using the International Patients Decision Aid Standards (IPDAS) criteria. Obstetric health care in the Netherlands. A multidisciplinary steering group, an expert panel, and 25 future users of the PtDA, i.e. women with a previous caesarean section. The development consisted of a construction phase (definition of scope and purpose, and selection of content, framework, and format) and a pilot testing phase by interview. The process was supervised by a multidisciplinary steering group. Usability, clarity, and relevance. The construction phase resulted in a booklet including unbiased balanced information on mode of birth after caesarean section, a preference elicitation exercise, and tailored risk information, including a prediction model for successful VBAC. During pilot testing, visualisation of risks and clarity formed the main basis for revisions. Pilot testing showed the availability of tailored structured information to be the main factor involving women in decision-making. The PtDA meets 39 out of 50 IPDAS criteria (78%): 23 out of 23 criteria for content (100%) and 16 out of 20 criteria for the development process (80%). Criteria for effectiveness (n = 7) were not evaluated. An evidence-based PtDA was developed, with the probability of successful VBAC and the availability of structured information as key items. It is likely that the PtDA enhances the quality of decision-making on mode of birth after caesarean section. © 2013 Royal College of Obstetricians and Gynaecologists.

Effects of task structure on category priming in patients with Parkinson's disease and in healthy individuals.

PubMed

Brown, Gregory G; Brown, Sandra J; Christenson, Gina; Williams, Rebecca E; Kindermann, Sandra S; Loftis, Christopher; Olsen, Ryan; Siple, Patricia; Shults, Clifford; Gorell, Jay M

2002-05-01

Lexical decision tasks have been used to study both shifts of attention and semantic processing in Parkinson's Disease (PD). Whereas other laboratories have reported normal levels of semantic priming among PD patients, our laboratory has reported abnormally large levels. In this study, two experiments were performed to determine the influence of task structure on the extent of semantic priming during lexical decision-making and pronunciation tasks among PD patients and neurologically healthy controls. In Experiment 1, the effect of Prime Dominance (the ratio of category to neutral trials) on lexical decision-making was studied. Although equal numbers of word and nonword trials were presented, half of the PD patients and controls were studied under Category Prime Dominance (category : neutral prime ratio of 2:1) and half were studied under Neutral Prime Dominance (category : neutral prime ratio of 1:2). In Experiment 2, PD and control participants were studied on lexical decision-making and pronunciation tasks where twice as many words as nonword trials were presented, consistent with other studies from our laboratory. In Experiment 1, we found no group differences in the magnitude of priming and no effect of Prime Dominance. Moreover, the findings were similar in pattern and magnitude to results published by Neely (1977). In Experiment 2, we observed larger priming effects among PD patients than among controls, but only on the lexical decision (LD) task. These results support the hypothesis that abnormally large category-priming effects appear in LD studies of PD patients when the number of word trials exceeds the number of nonword trials. Furthermore, increased lexical priming in PD appears to be due to processes operating during the decision-making period that follows presentation of the lexical target.

Demographics of reintroduced populations: estimation, modeling, and decision analysis

USGS Publications Warehouse

Converse, Sarah J.; Moore, Clinton T.; Armstrong, Doug P.

2013-01-01

Reintroduction can be necessary for recovering populations of threatened species. However, the success of reintroduction efforts has been poorer than many biologists and managers would hope. To increase the benefits gained from reintroduction, management decision making should be couched within formal decision-analytic frameworks. Decision analysis is a structured process for informing decision making that recognizes that all decisions have a set of components—objectives, alternative management actions, predictive models, and optimization methods—that can be decomposed, analyzed, and recomposed to facilitate optimal, transparent decisions. Because the outcome of interest in reintroduction efforts is typically population viability or related metrics, models used in decision analysis efforts for reintroductions will need to include population models. In this special section of the Journal of Wildlife Management, we highlight examples of the construction and use of models for informing management decisions in reintroduced populations. In this introductory contribution, we review concepts in decision analysis, population modeling for analysis of decisions in reintroduction settings, and future directions. Increased use of formal decision analysis, including adaptive management, has great potential to inform reintroduction efforts. Adopting these practices will require close collaboration among managers, decision analysts, population modelers, and field biologists.

Impact of the rate of the additive process of forming a heavy structure deforming in creep on the development of its technological stresses

NASA Astrophysics Data System (ADS)

Parshin, Dmitry A.

2018-05-01

The additive process of forming a semicircular arched structure by means of layer-by-layer addition of material to its inner surface is simulated. The impact of this process running mode on the development of the technological stresses fields in the structure being formed under the action of gravity under properties of the material creep and aging is examined. In the framework of the linear mechanics of accreted solids a mathematical model of the process under study is offered and numerical experiments are conducted. It is shown that the stress-strain state of the additively formed heavy objects decisively depends on their formation mode. Various practically important trends and features of this dependence are studied.

Distributed digital signal processors for multi-body flexible structures

NASA Technical Reports Server (NTRS)

Lee, Gordon K. F.

1992-01-01

Multi-body flexible structures, such as those currently under investigation in spacecraft design, are large scale (high-order) dimensional systems. Controlling and filtering such structures is a computationally complex problem. This is particularly important when many sensors and actuators are located along the structure and need to be processed in real time. This report summarizes research activity focused on solving the signal processing (that is, information processing) issues of multi-body structures. A distributed architecture is developed in which single loop processors are employed for local filtering and control. By implementing such a philosophy with an embedded controller configuration, a supervising controller may be used to process global data and make global decisions as the local devices are processing local information. A hardware testbed, a position controller system for a servo motor, is employed to illustrate the capabilities of the embedded controller structure. Several filtering and control structures which can be modeled as rational functions can be implemented on the system developed in this research effort. Thus the results of the study provide a support tool for many Control/Structure Interaction (CSI) NASA testbeds such as the Evolutionary model and the nine-bay truss structure.

Programmatic Environmental Assessment for Army 2020 Force Structure Realignment

DTIC Science & Technology

2013-01-01

41 Realignment ( GDPR ) that evaluates U.S. force levels and requirements outside of the U.S. 42 Each of these initiatives is discussed in greater...configuration for the BCT. 9 1.3.3 Global Defense Posture Realignment 10 GDPR is another transformation process that will continue as the Army reduces its...while reducing funding requirements. The 19 decisions of GDPR will affect some of the future basing decisions made as part of Army 2020 20

Systematic assessment of benefits and risks: study protocol for a multi-criteria decision analysis using the Analytic Hierarchy Process for comparative effectiveness research

PubMed Central

Singh, Sonal

2013-01-01

Background: Regulatory decision-making involves assessment of risks and benefits of medications at the time of approval or when relevant safety concerns arise with a medication. The Analytic Hierarchy Process (AHP) facilitates decision-making in complex situations involving tradeoffs by considering risks and benefits of alternatives. The AHP allows a more structured method of synthesizing and understanding evidence in the context of importance assigned to outcomes. Our objective is to evaluate the use of an AHP in a simulated committee setting selecting oral medications for type 2 diabetes.  Methods: This study protocol describes the AHP in five sequential steps using a small group of diabetes experts representing various clinical disciplines. The first step will involve defining the goal of the decision and developing the AHP model. In the next step, we will collect information about how well alternatives are expected to fulfill the decision criteria. In the third step, we will compare the ability of the alternatives to fulfill the criteria and judge the importance of eight criteria relative to the decision goal of the optimal medication choice for type 2 diabetes. We will use pairwise comparisons to sequentially compare the pairs of alternative options regarding their ability to fulfill the criteria. In the fourth step, the scales created in the third step will be combined to create a summary score indicating how well the alternatives met the decision goal. The resulting scores will be expressed as percentages and will indicate the alternative medications' relative abilities to fulfill the decision goal. The fifth step will consist of sensitivity analyses to explore the effects of changing the estimates. We will also conduct a cognitive interview and process evaluation.  Discussion: Multi-criteria decision analysis using the AHP will aid, support and enhance the ability of decision makers to make evidence-based informed decisions consistent with their values and preferences. PMID:24555077

Systematic assessment of benefits and risks: study protocol for a multi-criteria decision analysis using the Analytic Hierarchy Process for comparative effectiveness research.

PubMed

Maruthur, Nisa M; Joy, Susan; Dolan, James; Segal, Jodi B; Shihab, Hasan M; Singh, Sonal

2013-01-01

Regulatory decision-making involves assessment of risks and benefits of medications at the time of approval or when relevant safety concerns arise with a medication. The Analytic Hierarchy Process (AHP) facilitates decision-making in complex situations involving tradeoffs by considering risks and benefits of alternatives. The AHP allows a more structured method of synthesizing and understanding evidence in the context of importance assigned to outcomes. Our objective is to evaluate the use of an AHP in a simulated committee setting selecting oral medications for type 2 diabetes.  This study protocol describes the AHP in five sequential steps using a small group of diabetes experts representing various clinical disciplines. The first step will involve defining the goal of the decision and developing the AHP model. In the next step, we will collect information about how well alternatives are expected to fulfill the decision criteria. In the third step, we will compare the ability of the alternatives to fulfill the criteria and judge the importance of eight criteria relative to the decision goal of the optimal medication choice for type 2 diabetes. We will use pairwise comparisons to sequentially compare the pairs of alternative options regarding their ability to fulfill the criteria. In the fourth step, the scales created in the third step will be combined to create a summary score indicating how well the alternatives met the decision goal. The resulting scores will be expressed as percentages and will indicate the alternative medications' relative abilities to fulfill the decision goal. The fifth step will consist of sensitivity analyses to explore the effects of changing the estimates. We will also conduct a cognitive interview and process evaluation.  Multi-criteria decision analysis using the AHP will aid, support and enhance the ability of decision makers to make evidence-based informed decisions consistent with their values and preferences.

Strength of figure-ground activity in monkey primary visual cortex predicts saccadic reaction time in a delayed detection task.

PubMed

Supèr, Hans; Lamme, Victor A F

2007-06-01

When and where are decisions made? In the visual system a saccade, which is a fast shift of gaze toward a target in the visual scene, is the behavioral outcome of a decision. Current neurophysiological data and reaction time models show that saccadic reaction times are determined by a build-up of activity in motor-related structures, such as the frontal eye fields. These structures depend on the sensory evidence of the stimulus. Here we use a delayed figure-ground detection task to show that late modulated activity in the visual cortex (V1) predicts saccadic reaction time. This predictive activity is part of the process of figure-ground segregation and is specific for the saccade target location. These observations indicate that sensory signals are directly involved in the decision of when and where to look.

Comparison of fusion methods from the abstract level and the rank level in a dispersed decision-making system

NASA Astrophysics Data System (ADS)

Przybyła-Kasperek, M.; Wakulicz-Deja, A.

2017-05-01

Issues related to decision making based on dispersed knowledge are discussed in the paper. A dispersed decision-making system, which was proposed by the authors in previous articles, is used in this paper. In the system, a process of combining classifiers into coalitions with a negotiation stage is realized. The novelty that is proposed in this article involves the use of six different methods of conflict analysis that are known from the literature.The main purpose of the tests, which were performed, was to compare the methods from the two groups - the abstract level and the rank level. An additional aim was to investigate the efficiency of the fusion methods used in a dispersed system with a dynamic structure with the efficiency that is obtained when no structure is used. Conclusions were drawn that, in most cases, the use of a dispersed system improves the efficiency of inference.

Accounting for uncertainty in health economic decision models by using model averaging

PubMed Central

Jackson, Christopher H; Thompson, Simon G; Sharples, Linda D

2009-01-01

Health economic decision models are subject to considerable uncertainty, much of which arises from choices between several plausible model structures, e.g. choices of covariates in a regression model. Such structural uncertainty is rarely accounted for formally in decision models but can be addressed by model averaging. We discuss the most common methods of averaging models and the principles underlying them. We apply them to a comparison of two surgical techniques for repairing abdominal aortic aneurysms. In model averaging, competing models are usually either weighted by using an asymptotically consistent model assessment criterion, such as the Bayesian information criterion, or a measure of predictive ability, such as Akaike's information criterion. We argue that the predictive approach is more suitable when modelling the complex underlying processes of interest in health economics, such as individual disease progression and response to treatment. PMID:19381329

Making a Splash.

ERIC Educational Resources Information Center

Maland, Jim

1998-01-01

Presents a 10-step process that allows swimming-pool owners to objectively scrutinize their existing facility's needs, construction, and operation and maintenance budgets before renovating a structurally deficient or costly pool. Four examples of problems involving pool-renovation decision making are highlighted. (GR)

Depression and Anxiety During Pregnancy: Evaluating the Literature in Support of Clinical Risk-Benefit Decision-Making.

PubMed

Dalke, Katharine Baratz; Wenzel, Amy; Kim, Deborah R

2016-06-01

Depression and anxiety during pregnancy are common, and patients and providers are faced with complex decisions regarding various treatment modalities. A structured discussion of the risks and benefits of options with the patient and her support team is recommended to facilitate the decision-making process. This clinically focused review, with emphasis on the last 3 years of published study data, evaluates the major risk categories of medication treatments, namely pregnancy loss, physical malformations, growth impairment, behavioral teratogenicity, and neonatal toxicity. Nonpharmacological treatment options, including neuromodulation and psychotherapy, are also briefly reviewed. Specific recommendations, drawn from the literature and the authors' clinical experience, are also offered to help guide the clinician in decision-making.

The Effects of Using the Transition Planning Inventory and a Structured IEP Process as a Transition Planning Intervention on IEP Meeting Outcomes

ERIC Educational Resources Information Center

Rehfeldt, Jason D.; Clark, Gary M.; Lee, Steven W.

2012-01-01

This study examined two areas. First, the authors looked at whether secondary individualized education program (IEP) teams who used the "Transition Planning Inventory" (TPI) in conjunction with a structured IEP meeting that based discussions and decisions on TPI data as a planning intervention generated significantly more…

Object-oriented classification of forest structure from light detection and ranging data for stand mapping

Treesearch

Alicia A. Sullivan; Robert J. McGaughey; Hans-Erik Andersen; Peter Schiess

2009-01-01

Stand delineation is an important step in the process of establishing a forest inventory and provides the spatial framework for many forest management decisions. Many methods for extracting forest structure characteristics for stand delineation and other purposes have been researched in the past, primarily focusing on high-resolution imagery and satellite data. High-...

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

PubMed

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

2017-10-06

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

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.

Visual anticipation biases conscious decision making but not bottom-up visual processing

PubMed Central

Mathews, Zenon; Cetnarski, Ryszard; Verschure, Paul F. M. J.

2015-01-01

Prediction plays a key role in control of attention but it is not clear which aspects of prediction are most prominent in conscious experience. An evolving view on the brain is that it can be seen as a prediction machine that optimizes its ability to predict states of the world and the self through the top-down propagation of predictions and the bottom-up presentation of prediction errors. There are competing views though on whether prediction or prediction errors dominate the formation of conscious experience. Yet, the dynamic effects of prediction on perception, decision making and consciousness have been difficult to assess and to model. We propose a novel mathematical framework and a psychophysical paradigm that allows us to assess both the hierarchical structuring of perceptual consciousness, its content and the impact of predictions and/or errors on conscious experience, attention and decision-making. Using a displacement detection task combined with reverse correlation, we reveal signatures of the usage of prediction at three different levels of perceptual processing: bottom-up fast saccades, top-down driven slow saccades and consciousnes decisions. Our results suggest that the brain employs multiple parallel mechanism at different levels of perceptual processing in order to shape effective sensory consciousness within a predicted perceptual scene. We further observe that bottom-up sensory and top-down predictive processes can be dissociated through cognitive load. We propose a probabilistic data association model from dynamical systems theory to model the predictive multi-scale bias in perceptual processing that we observe and its role in the formation of conscious experience. We propose that these results support the hypothesis that consciousness provides a time-delayed description of a task that is used to prospectively optimize real time control structures, rather than being engaged in the real-time control of behavior itself. PMID:25741290

On Developing a Taxonomy for Multidisciplinary Design Optimization: A Decision-Based Perspective

NASA Technical Reports Server (NTRS)

Lewis, Kemper; Mistree, Farrokh

1995-01-01

In this paper, we approach MDO from a Decision-Based Design (DBD) perspective and explore classification schemes for designing complex systems and processes. Specifically, we focus on decisions, which are only a small portion of the Decision Support Problem (DSP) Technique, our implementation of DBD. We map coupled nonhierarchical and hierarchical representations from the DSP Technique into the Balling-Sobieski (B-S) framework (Balling and Sobieszczanski-Sobieski, 1994), and integrate domain-independent linguistic terms to complete our taxonomy. Application of DSPs to the design of complex, multidisciplinary systems include passenger aircraft, ships, damage tolerant structural and mechanical systems, and thermal energy systems. In this paper we show that Balling-Sobieski framework is consistent with that of the Decision Support Problem Technique through the use of linguistic entities to describe the same type of formulations. We show that the underlying linguistics of the solution approaches are the same and can be coalesced into a homogeneous framework with which to base the research, application, and technology MDO upon. We introduce, in the Balling-Sobieski framework, examples of multidisciplinary design, namely, aircraft, damage tolerant structural and mechanical systems, and thermal energy systems.

Performance Assessment for Pump-and-Treat Closure or Transition

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

Truex, Michael J.; Johnson, Christian D.; Becker, Dave J.

2015-09-29

A structured performance assessment approach is useful to evaluate pump-and-treat (P&T) groundwater remediation, which has been applied at numerous sites. Consistent with the U.S. Environmental Protection Agency’s Groundwater Road Map, performance assessment during remedy implementation may be needed, and should consider remedy optimization, transition to alternative remedies, or remedy closure. In addition, a recent National Research Council study examined groundwater remediation at complex contaminated sites and concluded that it may be beneficial to evaluate remedy performance and the potential need for transition to alternative approaches at these sites. The intent of this document is to provide a structured approach formore » assessing P&T performance to support a decision to optimize, transition, or close a P&T remedy. The process presented in this document for gathering information and performing evaluations to support P&T remedy decisions includes use of decision elements to distinguish between potential outcomes of a remedy decision. Case studies are used to augment descriptions of decision elements and to illustrate each type of outcome identified in the performance assessment approach. The document provides references to resources for tools and other guidance relevant to conducting the P&T assessment.« less

Evaluating a multispecies adaptive management framework: Must uncertainty impede effective decision-making?

USGS Publications Warehouse

Smith, David R.; McGowan, Conor P.; Daily, Jonathan P.; Nichols, James D.; Sweka, John A.; Lyons, James E.

2013-01-01

Application of adaptive management to complex natural resource systems requires careful evaluation to ensure that the process leads to improved decision-making. As part of that evaluation, adaptive policies can be compared with alternative nonadaptive management scenarios. Also, the value of reducing structural (ecological) uncertainty to achieving management objectives can be quantified.A multispecies adaptive management framework was recently adopted by the Atlantic States Marine Fisheries Commission for sustainable harvest of Delaware Bay horseshoe crabs Limulus polyphemus, while maintaining adequate stopover habitat for migrating red knots Calidris canutus rufa, the focal shorebird species. The predictive model set encompassed the structural uncertainty in the relationships between horseshoe crab spawning, red knot weight gain and red knot vital rates. Stochastic dynamic programming was used to generate a state-dependent strategy for harvest decisions given that uncertainty. In this paper, we employed a management strategy evaluation approach to evaluate the performance of this adaptive management framework. Active adaptive management was used by including model weights as state variables in the optimization and reducing structural uncertainty by model weight updating.We found that the value of information for reducing structural uncertainty is expected to be low, because the uncertainty does not appear to impede effective management. Harvest policy responded to abundance levels of both species regardless of uncertainty in the specific relationship that generated those abundances. Thus, the expected horseshoe crab harvest and red knot abundance were similar when the population generating model was uncertain or known, and harvest policy was robust to structural uncertainty as specified.Synthesis and applications. The combination of management strategy evaluation with state-dependent strategies from stochastic dynamic programming was an informative approach to evaluate adaptive management performance and value of learning. Although natural resource decisions are characterized by uncertainty, not all uncertainty will cause decisions to be altered substantially, as we found in this case. It is important to incorporate uncertainty into the decision framing and evaluate the effect of reducing that uncertainty on achieving the desired outcomes

Deciding treatment for miscarriage--experiences of women and healthcare professionals.

PubMed

Olesen, Mette Linnet; Graungaard, Anette H; Husted, Gitte R

2015-06-01

Women experiencing miscarriage are offered a choice of different treatments to terminate their wanted pregnancy at a time when they are often shocked and distressed. Women's and healthcare professionals' experiences of the decision-making process are not well described. We aimed to gain insight into this process and the circumstances that may affect it. A qualitative study using a grounded theory approach. Data were obtained through semi-structured interviews with six women who had chosen and completed either surgical, medical or expectant treatment for miscarriage and five healthcare professionals involved in the decision-making at an emergency gynaecological department in Denmark. An inductive explorative method was chosen due to limited knowledge about the decision-making process, and a theoretical perspective was not applied until the final analysis. Despite information and pretreatment counselling, choice of treatment was often determined by unspoken emotional considerations, including fear of seeing the foetus or fear of anaesthesia. These considerations were not discussed during the decision-making process, which was a time when the women were under time pressure and experienced emotional distress. Healthcare professionals did not explore women's considerations for choosing a particular treatment and prioritised information differently. We found theory about coping and decision-making in stressful situations useful in increasing our understanding of the women's reactions. In relation to theory about informed consent, our findings suggest that women need more understanding of the treatments before making a decision. This study is limited due to a small sample size, but it generates important findings that need to be examined in a larger sample. Frequently, women did not use information provided about treatment pros and cons in their decision-making process. Because of unspoken thoughts, and women's needs being unexplored by healthcare professionals, information did not target women's needs and their reasoning remained unapparent. © 2014 Nordic College of Caring Science.

Distinct and Overlapping Brain Areas Engaged during Value-Based, Mathematical, and Emotional Decision Processing

PubMed Central

Hsu, Chun-Wei; Goh, Joshua O. S.

2016-01-01

When comparing between the values of different choices, human beings can rely on either more cognitive processes, such as using mathematical computation, or more affective processes, such as using emotion. However, the neural correlates of how these two types of processes operate during value-based decision-making remain unclear. In this study, we investigated the extent to which neural regions engaged during value-based decision-making overlap with those engaged during mathematical and emotional processing in a within-subject manner. In a functional magnetic resonance imaging experiment, participants viewed stimuli that always consisted of numbers and emotional faces that depicted two choices. Across tasks, participants decided between the two choices based on the expected value of the numbers, a mathematical result of the numbers, or the emotional face stimuli. We found that all three tasks commonly involved various cortical areas including frontal, parietal, motor, somatosensory, and visual regions. Critically, the mathematical task shared common areas with the value but not emotion task in bilateral striatum. Although the emotion task overlapped with the value task in parietal, motor, and sensory areas, the mathematical task also evoked responses in other areas within these same cortical structures. Minimal areas were uniquely engaged for the value task apart from the other two tasks. The emotion task elicited a more expansive area of neural activity whereas value and mathematical task responses were in more focal regions. Whole-brain spatial correlation analysis showed that valuative processing engaged functional brain responses more similarly to mathematical processing than emotional processing. While decisions on expected value entail both mathematical and emotional processing regions, mathematical processes have a more prominent contribution particularly in subcortical processes. PMID:27375466

Distinct and Overlapping Brain Areas Engaged during Value-Based, Mathematical, and Emotional Decision Processing.

PubMed

Hsu, Chun-Wei; Goh, Joshua O S

2016-01-01

When comparing between the values of different choices, human beings can rely on either more cognitive processes, such as using mathematical computation, or more affective processes, such as using emotion. However, the neural correlates of how these two types of processes operate during value-based decision-making remain unclear. In this study, we investigated the extent to which neural regions engaged during value-based decision-making overlap with those engaged during mathematical and emotional processing in a within-subject manner. In a functional magnetic resonance imaging experiment, participants viewed stimuli that always consisted of numbers and emotional faces that depicted two choices. Across tasks, participants decided between the two choices based on the expected value of the numbers, a mathematical result of the numbers, or the emotional face stimuli. We found that all three tasks commonly involved various cortical areas including frontal, parietal, motor, somatosensory, and visual regions. Critically, the mathematical task shared common areas with the value but not emotion task in bilateral striatum. Although the emotion task overlapped with the value task in parietal, motor, and sensory areas, the mathematical task also evoked responses in other areas within these same cortical structures. Minimal areas were uniquely engaged for the value task apart from the other two tasks. The emotion task elicited a more expansive area of neural activity whereas value and mathematical task responses were in more focal regions. Whole-brain spatial correlation analysis showed that valuative processing engaged functional brain responses more similarly to mathematical processing than emotional processing. While decisions on expected value entail both mathematical and emotional processing regions, mathematical processes have a more prominent contribution particularly in subcortical processes.

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.

The Drug Reimbursement Decision-Making System in Iran.

PubMed

Ansaripour, Amir; Uyl-de Groot, Carin A; Steenhoek, Adri; Redekop, William K

2014-05-01

Previous studies of health policies in Iran have not focused exclusively on the drug reimbursement process. The aim of this study was to describe the entire drug reimbursement process and the stakeholders, and discuss issues faced by policymakers. Review of documents describing the administrative rules and directives of stakeholders, supplemented by published statistics and interviews with experts and policymakers. Iran has a systematic process for the assessment, appraisal, and judgment of drug reimbursements. The two most important organizations in this process are the Food and Drug Organization, which considers clinical effectiveness, safety, and economic issues, and the Supreme Council of Health Insurance, which considers various criteria, including budget impact and cost-effectiveness. Ultimately, the Iranian Cabinet approves a drug and recommends its use to all health insurance organizations. Reimbursed drugs account for about 53.5% of all available drugs and 77.3% of drug expenditures. Despite its strengths, the system faces various issues, including conflicting stakeholder aims, lengthy decision-making duration, limited access to decision-making details, and rigidity in the assessment process. The Iranian drug reimbursement system uses decision-making criteria and a structured approach similar to those in other countries. Important shortcomings in the system include out-of-pocket contributions due to lengthy decision making, lack of transparency, and conflicting interests among stakeholders. Iranian policymakers should consider a number of ways to remedy these problems, such as case studies of individual drugs and closer examination of experiences in other countries. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

[Shared medical decision making in gynaecology].

PubMed

This, P; Panel, P

2010-02-01

When two options or more can be chosen in medical care, the final decision implies two steps: facts analysis, and patient evaluation of preferences. Shared Medical Decision-Making is a rational conceptual frame that can be used in such cases. In this paper, we describe the concept, its practical modalities, and the questions raised by its use. In gynaecology, many medical situations involve "sensitive preferences choice": for example, contraceptive choice, menorrhagia treatment, and approach of menopause. Some tools from the "Shared Medical Decision Making" concept are useful to structure medical consultations, to convey information, and to reveal patients preferences. Decision aid are used in clinical research settings, but some of them may also be easily used in usual practice, and help physicians to improve both quality and traceability of the decisional process. Copyright 2009 Elsevier Masson SAS. All rights reserved.

How we became the Schmams: conceptualizations of fairness in the decision-making process for Latina/o children.

PubMed

Langhout, Regina Day; Kohfeldt, Danielle M; Ellison, Erin Rose

2011-12-01

The current study examines 16 Latina/o fifth grade children's desires for a decision-making structure within a youth participatory action research (yPAR) program. When given the choices of consensus, majority rule, authoritarian rule, delegation, and random choice models, children chose random choice. Procedural, distributive and emotional justice were heavily weighted in their reasoning around fairness and decision making. Many thought random choice offered the best alternative because it flattened power hierarchies so that each child would, at some point, have the power to make a decision. Additionally, children argued that the neutrality of random choice allowed them to sidestep interpersonal tensions. Implications include how social identities inform definitions of fairness and how yPAR programs should work with youth around how they will make decisions.

Evaluating Quality of Decision-Making Processes in Medicines' Development, Regulatory Review, and Health Technology Assessment: A Systematic Review of the Literature.

PubMed

Bujar, Magdalena; McAuslane, Neil; Walker, Stuart R; Salek, Sam

2017-01-01

Introduction: Although pharmaceutical companies, regulatory authorities, and health technology assessment (HTA) agencies have been increasingly using decision-making frameworks, it is not certain whether these enable better quality decision making. This could be addressed by formally evaluating the quality of decision-making process within those organizations. The aim of this literature review was to identify current techniques (tools, questionnaires, surveys, and studies) for measuring the quality of the decision-making process across the three stakeholders. Methods: Using MEDLINE, Web of Knowledge, and other Internet-based search engines, a literature review was performed to systematically identify techniques for assessing quality of decision making in medicines development, regulatory review, and HTA. A structured search was applied using key words and a secondary review was carried out. In addition, the measurement properties of each technique were assessed and compared. Ten Quality Decision-Making Practices (QDMPs) developed previously were then used as a framework for the evaluation of techniques identified in the review. Due to the variation in studies identified, meta-analysis was inappropriate. Results: This review identified 13 techniques, where 7 were developed specifically to assess decision making in medicines' development, regulatory review, or HTA; 2 examined corporate decision making, and 4 general decision making. Regarding how closely each technique conformed to the 10 QDMPs, the 13 techniques assessed a median of 6 QDMPs, with a mode of 3 QDMPs. Only 2 techniques evaluated all 10 QDMPs, namely the Organizational IQ and the Quality of Decision Making Orientation Scheme (QoDoS), of which only one technique, QoDoS could be applied to assess decision making of both individuals and organizations, and it possessed generalizability to capture issues relevant to companies as well as regulatory authorities. Conclusion: This review confirmed a general paucity of research in this area, particularly regarding the development and systematic application of techniques for evaluating quality decision making, with no consensus around a gold standard. This review has identified QoDoS as the most promising available technique for assessing decision making in the lifecycle of medicines and the next steps would be to further test its validity, sensitivity, and reliability.

Uncertainty in Driftless Area Cold-Water Fishery Decision Making and a Framework for Stakeholder-Based Science

NASA Astrophysics Data System (ADS)

Schuster, Z.

2015-12-01

The paradigm of stakeholder-based science is becoming more popular as organizations such as the U.S. Department of the Interior Climate Science Centers adopt it as a way of providing practicable climate change information to practitioners. One of the key issues stakeholders face in adopting climate change information into their decision processes is how uncertainty is addressed and communicated. In this study, we conducted a series of semi-structured interviews with managers and scientists working on stream habitat restoration of cold-water fisheries in the Driftless Area of Wisconsin that were focused on how they interpret and manage uncertainty and what types of information they need to make better decisions. One of the important lessons we learned from the interviews is that if researchers are going to provide useful climate change information to stakeholders, they need to understand where and how decisions are made and what adaptation measures are actually available in a given decision arena. This method of incorporating social science methods into climate science production can provide a framework for researchers from the Climate Science Centers and others who are interested in pursuing stakeholder-based science. By indentifying a specific ecological system and conducting interviews with actors who work on that system, researchers will be able to gain a better understanding of how their climate change science can fit into existing or shape new decision processes. We also interpreted lessons learned from our interviews via existing literature in areas such as stakeholder-based modeling and the decision sciences to provide guidance specific to the stakeholder-based science process.

Re-engineering the Federal planning process: A total Federal planning strategy, integrating NEPA with modern management tools

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

Eccleston, C.H.

1997-09-05

The National Environmental Policy Act (NEPA) of 1969 was established by Congress more than a quarter of a century ago, yet there is a surprising lack of specific tools, techniques, and methodologies for effectively implementing these regulatory requirements. Lack of professionally accepted techniques is a principal factor responsible for many inefficiencies. Often, decision makers do not fully appreciate or capitalize on the true potential which NEPA provides as a platform for planning future actions. New approaches and modem management tools must be adopted to fully achieve NEPA`s mandate. A new strategy, referred to as Total Federal Planning, is proposed formore » unifying large-scale federal planning efforts under a single, systematic, structured, and holistic process. Under this approach, the NEPA planning process provides a unifying framework for integrating all early environmental and nonenvironmental decision-making factors into a single comprehensive planning process. To promote effectiveness and efficiency, modem tools and principles from the disciplines of Value Engineering, Systems Engineering, and Total Quality Management are incorporated. Properly integrated and implemented, these planning tools provide the rigorous, structured, and disciplined framework essential in achieving effective planning. Ultimately, the goal of a Total Federal Planning strategy is to construct a unified and interdisciplinary framework that substantially improves decision-making, while reducing the time, cost, redundancy, and effort necessary to comply with environmental and other planning requirements. At a time when Congress is striving to re-engineer the governmental framework, apparatus, and process, a Total Federal Planning philosophy offers a systematic approach for uniting the disjointed and often convoluted planning process currently used by most federal agencies. Potentially this approach has widespread implications in the way federal planning is approached.« less

Adolescents' Neural Processing of Risky Decisions: Effects of Sex and Behavioral Disinhibition.

PubMed

Crowley, Thomas J; Dalwani, Manish S; Mikulich-Gilbertson, Susan K; Young, Susan E; Sakai, Joseph T; Raymond, Kristen M; McWilliams, Shannon K; Roark, Melissa J; Banich, Marie T

2015-01-01

Accidental injury and homicide, relatively common among adolescents, often follow risky behaviors; those are done more by boys and by adolescents with greater behavioral disinhibition (BD). Neural processing during adolescents' risky decision-making will differ in youths with greater BD severity, and in males vs. females, both before cautious behaviors and before risky behaviors. 81 adolescents (PATIENTS with substance and conduct problems, and comparison youths (Comparisons)), assessed in a 2 x 2 design ( Comparisons x Male:Female) repeatedly decided between doing a cautious behavior that earned 1 cent, or a risky one that either won 5 or lost 10 cents. Odds of winning after risky responses gradually decreased. Functional magnetic resonance imaging captured brain activity during 4-sec deliberation periods preceding responses. Most neural activation appeared in known decision-making structures. PATIENTS, who had more severe BD scores and clinical problems than Comparisons, also had extensive neural hypoactivity. Comparisons' greater activation before cautious responses included frontal pole, medial prefrontal cortex, striatum, and other regions; and before risky responses, insula, temporal, and parietal regions. Males made more risky and fewer cautious responses than females, but before cautious responses males activated numerous regions more than females. Before risky behaviors female-greater activation was more posterior, and male-greater more anterior. Neural processing differences during risky-cautious decision-making may underlie group differences in adolescents' substance-related and antisocial risk-taking. Patients reported harmful real-life decisions and showed extensive neural hypoactivity during risky-or-cautious decision-making. Males made more risky responses than females; apparently biased toward risky decisions, males (compared with females) utilized many more neural resources to make and maintain cautious decisions, indicating an important risk-related brain sexual dimorphism. The results suggest new possibilities for prevention and management of excessive, dangerous adolescent risk-taking.

Country planning for health interventions under development: lessons from the malaria vaccine decision-making framework and implications for other new interventions

PubMed Central

Brooks, Alan; Ba-Nguz, Antoinette

2012-01-01

Traditionally it has taken years or decades for new public health interventions targeting diseases found in developing countries to be accessible to those most in need. One reason for the delay has been insufficient anticipation of the eventual processes and evidence required for decision making by countries. This paper describes research into the anticipated processes and data needed to inform decision making on malaria vaccines, the most advanced of which is still in phase 3 trials. From 2006 to 2008, a series of country consultations in Africa led to the development of a guide to assist countries in preparing their malaria vaccine decision-making frameworks. The guide builds upon the World Health Organization’s Vaccine Introduction Guidelines. It identifies the processes and data for decisions, when they would be needed relative to the development timelines of the intervention, and where they will come from. Policy development will be supported by data (e.g. malaria disease burden; roles of other malaria interventions; malaria vaccine impact; economic and financial issues; malaria vaccine efficacy, quality and safety) as will implementation decisions (e.g. programmatic issues and socio-cultural environment). This generic guide can now be applied to any future malaria vaccine. The paper discusses the opportunities and challenges to early planning for country decision-making—from the potential for timely, evidence-informed decisions to the risks of over-promising around an intervention still under development. Careful and well-structured planning by countries is an important way to ensure that new interventions do not remain unused for years or decades after they become available. PMID:22513733

Review of retrofit strategies decision system in historic perspective

NASA Astrophysics Data System (ADS)

Bostenaru Dan, M. D.

2004-06-01

Urban development is a process. In structuring and developing its phases different actors are implied, who act under different, sometimes opposite, dynamic conditions and within different reference systems. This paper aims to explore the contribution of participatism to disaster mitigation, when this concerns earthquake impact on urban settlements, through the support provided to multi-criteria decision in matters of retrofit. The research broadness in field of decision making on one side and the lack of a specific model for the retrofit of existing buildings on another side led to an extensive review of the state of the art in related models to address the issue. Core idea in the selection of existing models has been the preoccupation for collaborative issues, in other words, the consideration for the different actors implied in the planning process. The historic perspective on participative planning models is made from the view of two generations of citizen implication. The first approaches focus on the participation of the building owner/inhabitant in the planning process of building construction. As current strategies building rehabilitation and selection from alternative retrofit strategies are presented. New developments include innovative models using the internet or spatial databases. The investigated participation approaches show, that participation and communication as a more comprehensive term are an old topic in the field politics-democratisation-urbanism. In all cases it can be talked of "successful learning processes", of the improvement of the level of the professional debate. More than 30 years history of participation marked a transition in understanding the concept: from participation, based on a central decision process leading to a solution controlled and steered by the political-administrative system, to communication, characterised by simultaneous decision processes taking place outside politics and administration in co-operative procedures.

The Role of Integrated Modelling and Assessment for Decision-Making: Lessons from Water Allocation Issues in Australia

NASA Astrophysics Data System (ADS)

Jakeman, A. J.; Guillaume, J. H. A.; El Sawah, S.; Hamilton, S.

2014-12-01

Integrated modelling and assessment (IMA) is best regarded as a process that can support environmental decision-making when issues are strongly contested and uncertainties pervasive. To be most useful, the process must be multi-dimensional and phased. Principally, it must be tailored to the problem context to encompass diverse issues of concern, management settings and stakeholders. This in turn requires the integration of multiple processes and components of natural and human systems and their corresponding spatial and temporal scales. Modellers therefore need to be able to integrate multiple disciplines, methods, models, tools and data, and many sources and types of uncertainty. These dimensions are incorporated into iteration between the various phases of the IMA process, including scoping, problem framing and formulation, assessing options and communicating findings. Two case studies in Australia are employed to share the lessons of how integration can be achieved in these IMA phases using a mix of stakeholder participation processes and modelling tools. One case study aims to improve the relevance of modelling by incorporating stakeholder's views of irrigated viticulture and water management decision making. It used a novel methodology with the acronym ICTAM, consisting of Interviews to elicit mental models, Cognitive maps to represent and analyse individual and group mental models, Time-sequence diagrams to chronologically structure the decision making process, an All-encompassing conceptual model, and computational Models of stakeholder decision making. The second case uses a hydro-economic river network model to examine basin-wide impacts of water allocation cuts and adoption of farm innovations. The knowledge exchange approach used in each case was designed to integrate data and knowledge bearing in mind the contextual dimensions of the problem at hand, and the specific contributions that environmental modelling was thought to be able to make.

Health Information System in Primary Health Care: The Challenges and Barriers from Local Providers’ Perspective of an Area in Iran

PubMed Central

Yazdi-Feyzabadi, Vahid; Emami, Mozhgan; Mehrolhassani, Mohammad Hossein

2015-01-01

Background: Health information system (HIS) has been utilized for collecting, processing, storing, and transferring the required information for planning and decision-making at different levels of health sector to provide quality services. In this study, in order to provide high-quality HIS, primary health care (PHC) providers’ perspective on current challenges and barriers were investigated. Methods: This study was carried out with a qualitative approach using semi-structured audiotaped focus group discussions (FGDs). One FGD was conducted with 13 Behvarz and health technicians as front-line workers and the other with 16 personnel including physicians, statisticians, and health professionals working in health centers of the PHC network in KUMS. The discussions were transcribed and then analyzed using the framework analysis method. Results: The identified organizational challenges were categorized into two groups: HIS structure and the current model of PHC in urban areas. Furthermore, the structural challenges were classified into HIS management structure (information systems resources, including human, supplies, and organizational rules) and information process. Conclusions: The HIS works effectively and efficiently when there are a consistency and integrity between the human, supplies, and process aspects. Hence, multifaceted interventions including strengthening the organizational culture to use the information in decisions, eliminating infrastructural obstacles, appointing qualified staff and more investment for service delivery at urban areas are the most fundamental requirements of high-quality HIS in PHC. PMID:26236444

The mind as a process.

PubMed

Bruhn, John G; Wolf, Stewart

2003-01-01

Essentially all behavior is regulated by the brain in response to information received from within the body or from the environment. The tangible structures of the brain serve as devices for processing thoughts and emotions as well as information. Stored among the interacting neural structures are memories of past experiences and responses to them. These intangibles participate in determining the decisions made and the actions performed by the brain's structures. There are valuable studies of the clinical and neurological effects of environmental stimuli, but we need to learn more about the processes that lead to these effects. More definitive correlations could be made between environmental stimuli and the neurological pathways they create by studying individual's real life experiences rather than laboratory simulations alone.

Assessing clinical reasoning (ASCLIRE): Instrument development and validation.

PubMed

Kunina-Habenicht, Olga; Hautz, Wolf E; Knigge, Michel; Spies, Claudia; Ahlers, Olaf

2015-12-01

Clinical reasoning is an essential competency in medical education. This study aimed at developing and validating a test to assess diagnostic accuracy, collected information, and diagnostic decision time in clinical reasoning. A norm-referenced computer-based test for the assessment of clinical reasoning (ASCLIRE) was developed, integrating the entire clinical decision process. In a cross-sectional study participants were asked to choose as many diagnostic measures as they deemed necessary to diagnose the underlying disease of six different cases with acute or sub-acute dyspnea and provide a diagnosis. 283 students and 20 content experts participated. In addition to diagnostic accuracy, respective decision time and number of used relevant diagnostic measures were documented as distinct performance indicators. The empirical structure of the test was investigated using a structural equation modeling approach. Experts showed higher accuracy rates and lower decision times than students. In a cross-sectional comparison, the diagnostic accuracy of students improved with the year of study. Wrong diagnoses provided by our sample were comparable to wrong diagnoses in practice. We found an excellent fit for a model with three latent factors-diagnostic accuracy, decision time, and choice of relevant diagnostic information-with diagnostic accuracy showing no significant correlation with decision time. ASCLIRE considers decision time as an important performance indicator beneath diagnostic accuracy and provides evidence that clinical reasoning is a complex ability comprising diagnostic accuracy, decision time, and choice of relevant diagnostic information as three partly correlated but still distinct aspects.

The time-course of lexical activation in Japanese morphographic word recognition: evidence for a character-driven processing model.

PubMed

Miwa, Koji; Libben, Gary; Dijkstra, Ton; Baayen, Harald

2014-01-01

This lexical decision study with eye tracking of Japanese two-kanji-character words investigated the order in which a whole two-character word and its morphographic constituents are activated in the course of lexical access, the relative contributions of the left and the right characters in lexical decision, the depth to which semantic radicals are processed, and how nonlinguistic factors affect lexical processes. Mixed-effects regression analyses of response times and subgaze durations (i.e., first-pass fixation time spent on each of the two characters) revealed joint contributions of morphographic units at all levels of the linguistic structure with the magnitude and the direction of the lexical effects modulated by readers' locus of attention in a left-to-right preferred processing path. During the early time frame, character effects were larger in magnitude and more robust than radical and whole-word effects, regardless of the font size and the type of nonwords. Extending previous radical-based and character-based models, we propose a task/decision-sensitive character-driven processing model with a level-skipping assumption: Connections from the feature level bypass the lower radical level and link up directly to the higher character level.

From market access to patient access: overview of evidence-based approaches for the reimbursement and pricing of pharmaceuticals in 36 European countries.

PubMed

Panteli, Dimitra; Eckhardt, Helene; Nolting, Alexandra; Busse, Reinhard; Kulig, Michael

2015-09-25

Coverage decisions determining the benefit baskets of health systems have been increasingly relying on evidence regarding patient benefit and costs. Relevant structures, methodologies, and processes have especially been established for pharmaceuticals but approaches differ. The objective of this work was thus to identify institutions in a broad range of European countries (n = 36) in charge of determining the value of pharmaceuticals for pricing and reimbursement purposes and to map their decision-making process; to examine the different approaches and consider national and supranational possibilities for best practice. Institutions were identified through websites of international networks, ministries, and published literature. Details on institutional practices were supplemented with information from institution websites and linked online sources. The type and extent of information available varied considerably across countries. Different types of public regulatory bodies are involved in pharmaceutical coverage decisions, assuming a range of responsibilities. As a rule, the assessment of scientific evidence is kept structurally separate from its appraisal. Recommendations on value are uniformly issued by specific committees within or commissioned by responsible institutions; these institutions often also act as decision-makers on reimbursement status and level or market price. While effectiveness and costs are important criteria in all countries, the latter are often considered on a case-by-case basis. In all countries, manufacturer applications, including relevant evidence, are used as one of the main sources of information for the assessment. Transparency of evidence-based coverage decisions should be enhanced. International collaboration can facilitate knowledge exchange, improve efficiency of information production, and strengthen new or developing systems.

Decision-Oriented Health Technology Assessment: One Step Forward in Supporting the Decision-Making Process in Hospitals.

PubMed

Ritrovato, Matteo; Faggiano, Francesco C; Tedesco, Giorgia; Derrico, Pietro

2015-06-01

This article outlines the Decision-Oriented Health Technology Assessment: a new implementation of the European network for Health Technology Assessment Core Model, integrating the multicriteria decision-making analysis by using the analytic hierarchy process to introduce a standardized methodological approach as a valued and shared tool to support health care decision making within a hospital. Following the Core Model as guidance (European network for Health Technology Assessment. HTA core model for medical and surgical interventions. Available from: http://www.eunethta.eu/outputs/hta-core-model-medical-and-surgical-interventions-10r. [Accessed May 27, 2014]), it is possible to apply the analytic hierarchy process to break down a problem into its constituent parts and identify priorities (i.e., assigning a weight to each part) in a hierarchical structure. Thus, it quantitatively compares the importance of multiple criteria in assessing health technologies and how the alternative technologies perform in satisfying these criteria. The verbal ratings are translated into a quantitative form by using the Saaty scale (Saaty TL. Decision making with the analytic hierarchy process. Int J Serv Sci 2008;1:83-98). An eigenvectors analysis is used for deriving the weights' systems (i.e., local and global weights' system) that reflect the importance assigned to the criteria and the priorities related to the performance of the alternative technologies. Compared with the Core Model, this methodological approach supplies a more timely as well as contextualized evidence for a specific technology, making it possible to obtain data that are more relevant and easier to interpret, and therefore more useful for decision makers to make investment choices with greater awareness. We reached the conclusion that although there may be scope for improvement, this implementation is a step forward toward the goal of building a "solid bridge" between the scientific evidence and the final decision maker's choice. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A model of supervisor decision-making in the accommodation of workers with low back pain

PubMed Central

Williams-Whitt, Kelly; Kristman, Vicki; Shaw, William S.; Soklaridis, Sophie; Reguly, Paula

2016-01-01

PURPOSE To explore supervisors’ perspectives and decision-making processes in the accommodation of back injured workers. METHODS Twenty-three semi-structured, in-depth interviews were conducted with supervisors from eleven Canadian organizations about their role in providing job accommodations. Supervisors were identified through an on-line survey and interviews were recorded, transcribed and entered into NVivo software. The initial analyses identified common units of meaning, which were used to develop a coding guide. Interviews were coded, and a model of supervisor decision-making was developed based on the themes, categories and connecting ideas identified in the data. RESULTS The decision-making model includes a process element that is described as iterative “trial and error” decision-making. Medical restrictions are compared to job demands, employee abilities and available alternatives. A feasible modification is identified through brainstorming and then implemented by the supervisor. Resources used for brainstorming include information, supervisor experience and autonomy, and organizational supports. The model also incorporates the experience of accommodation as a job demand that causes strain for the supervisor. Accommodation demands affect the supervisor’s attitude, brainstorming and monitoring effort and communication with returning employees. Resources and demands have a combined effect on accommodation decision complexity, which in turn affects the quality of the accommodation option selected. If the employee is unable to complete the tasks or is reinjured during the accommodation, the decision cycle repeats. More frequent iteration through the trial and error process reduces the likelihood of return to work success. CONCLUSIONS A series of propositions is developed to illustrate the relationships among categories in the model. The model and propositions show: a) the iterative, problem solving nature of the RTW process; b) decision resources necessary for accommodation planning, and c) the impact accommodation demands may have on supervisors and RTW quality. PMID:26811170

An optimal brain can be composed of conflicting agents

PubMed Central

Livnat, Adi; Pippenger, Nicholas

2006-01-01

Many behaviors have been attributed to internal conflict within the animal and human mind. However, internal conflict has not been reconciled with evolutionary principles, in that it appears maladaptive relative to a seamless decision-making process. We study this problem through a mathematical analysis of decision-making structures. We find that, under natural physiological limitations, an optimal decision-making system can involve “selfish” agents that are in conflict with one another, even though the system is designed for a single purpose. It follows that conflict can emerge within a collective even when natural selection acts on the level of the collective only. PMID:16492775

The research on construction and application of machining process knowledge base

NASA Astrophysics Data System (ADS)

Zhao, Tan; Qiao, Lihong; Qie, Yifan; Guo, Kai

2018-03-01

In order to realize the application of knowledge in machining process design, from the perspective of knowledge in the application of computer aided process planning(CAPP), a hierarchical structure of knowledge classification is established according to the characteristics of mechanical engineering field. The expression of machining process knowledge is structured by means of production rules and the object-oriented methods. Three kinds of knowledge base models are constructed according to the representation of machining process knowledge. In this paper, the definition and classification of machining process knowledge, knowledge model, and the application flow of the process design based on the knowledge base are given, and the main steps of the design decision of the machine tool are carried out as an application by using the knowledge base.

Integrating Evidence Within and Across Evidence Streams Using Qualitative Methods

EPA Science Inventory

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this deman...

Integrated Modeling for Watershed Ecosystem Services Assessment and Forecasting

EPA Science Inventory

Regional scale watershed management decisions must be informed by the science-based relationship between anthropogenic activities on the landscape and the change in ecosystem structure, function, and services that occur as a result. We applied process-based models that represent...

The decision of out-of-home placement in residential care after parental neglect: Empirically testing a psychosocial model.

PubMed

Rodrigues, Leonor; Calheiros, Manuela; Pereira, Cícero

2015-11-01

Out-of-home placement decisions in residential care are complex, ambiguous and full of uncertainty, especially in cases of parental neglect. Literature on this topic is so far unable to understand and demonstrate the source of errors involved in those decisions and still fails to focus on professional's decision making process. Therefore, this work intends to test a socio-psychological model of decision-making that is a more integrated, dualistic and ecological version of the Theory of Planned Behavior's model. It describes the process through which the decision maker takes into account personal, contextual and social factors of the Decision-Making Ecology in the definition of his/her decision threshold. One hundred and ninety-five professionals from different Children and Youth Protection Units, throughout the Portuguese territory, participated in this online study. After reading a vignette of a (psychological and physical) neglect case toward a one-year-old child, participants were presented with a group of questions that measured worker's assessment of risk, intention, attitude, subjective norm, behavior control and beliefs toward residential care placement decision, as well as worker's behavior experience, emotions and family/child-related-values involved in that decision. A set of structural equation modeling analyses have proven the good fit of the proposed model. The intention to propose a residential care placement decision was determined by cognitive, social, affective, value-laden and experience variables and the perceived risk. Altogether our model explained 61% of professional's decision toward a parental neglect case. The theoretical and practical implications of these results are discussed, namely the importance of raising awareness about the existence of these biased psychosocial determinants. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dynamic array processing for computationally intensive expert systems in CLIPS

NASA Technical Reports Server (NTRS)

Athavale, N. N.; Ragade, R. K.; Fenske, T. E.; Cassaro, M. A.

1990-01-01

This paper puts forth an architecture for implementing a loop for advanced data structure of arrays in CLIPS. An attempt is made to use multi-field variables in such an architecture to process a set of data during the decision making cycle. Also, current limitations on the expert system shells are discussed in brief in this paper. The resulting architecture is designed to circumvent the current limitations set by the expert system shell and also by the operating environment. Such advanced data structures are needed for tightly coupling symbolic and numeric computation modules.

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

PubMed

Gurtner, Sebastian

2014-01-01

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

Using the Analytic Hierarchy Process for Decision-Making in Ecosystem Management

Treesearch

Daniel L. Schmoldt; David L. Peterson

1997-01-01

Land management activities on public lands combine multiple objectives in order to create a plan of action over a finite time horizon. Because management activities are constrained by time and money, it is critical to make the best use of available agency resources. The Analytic Hierarchy Process (AHP) offers a structure for multi-objective decisionmaking so that...

Proceedings of the international conference on cybernetics and societ

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

Not Available

1985-01-01

This book presents the papers given at a conference on artificial intelligence, expert systems and knowledge bases. Topics considered at the conference included automating expert system development, modeling expert systems, causal maps, data covariances, robot vision, image processing, multiprocessors, parallel processing, VLSI structures, man-machine systems, human factors engineering, cognitive decision analysis, natural language, computerized control systems, and cybernetics.

Superintendents' Perceptions about Social Distance, Succession, and "Sunset" Provisions for Asian, Latino, and Native American Candidates Seeking Building-Level Administrator Positions

ERIC Educational Resources Information Center

Young, I. Phillip; De La Torre, Guadalupe Xavier

2006-01-01

Research addressing the attraction and selection of individuals for administrator positions is encapsulated in a structural model that depicts different phases of the employee procurement process. Within the present study, attention is devoted to the prescreening stage of the selection process, and screening decisions of superintendents are…

A strategy for monitoring and managing declines in an amphibian community.

PubMed

Grant, Evan H Campbell; Zipkin, Elise F; Nichols, James D; Campbell, J Patrick

2013-12-01

Although many taxa have declined globally, conservation actions are inherently local. Ecosystems degrade even in protected areas, and maintaining natural systems in a desired condition may require active management. Implementing management decisions under uncertainty requires a logical and transparent process to identify objectives, develop management actions, formulate system models to link actions with objectives, monitor to reduce uncertainty and identify system state (i.e., resource condition), and determine an optimal management strategy. We applied one such structured decision-making approach that incorporates these critical elements to inform management of amphibian populations in a protected area managed by the U.S. National Park Service. Climate change is expected to affect amphibian occupancy of wetlands and to increase uncertainty in management decision making. We used the tools of structured decision making to identify short-term management solutions that incorporate our current understanding of the effect of climate change on amphibians, emphasizing how management can be undertaken even with incomplete information. Estrategia para Monitorear y Manejar Disminuciones en una Comunidad de Anfibios. © 2013 Society for Conservation Biology.

Using CART to Identify Thresholds and Hierarchies in the Determinants of Funding Decisions.

PubMed

Schilling, Chris; Mortimer, Duncan; Dalziel, Kim

2017-02-01

There is much interest in understanding decision-making processes that determine funding outcomes for health interventions. We use classification and regression trees (CART) to identify cost-effectiveness thresholds and hierarchies in the determinants of funding decisions. The hierarchical structure of CART is suited to analyzing complex conditional and nonlinear relationships. Our analysis uncovered hierarchies where interventions were grouped according to their type and objective. Cost-effectiveness thresholds varied markedly depending on which group the intervention belonged to: lifestyle-type interventions with a prevention objective had an incremental cost-effectiveness threshold of $2356, suggesting that such interventions need to be close to cost saving or dominant to be funded. For lifestyle-type interventions with a treatment objective, the threshold was much higher at $37,024. Lower down the tree, intervention attributes such as the level of patient contribution and the eligibility for government reimbursement influenced the likelihood of funding within groups of similar interventions. Comparison between our CART models and previously published results demonstrated concurrence with standard regression techniques while providing additional insights regarding the role of the funding environment and the structure of decision-maker preferences.

Backcountry snowmobilers' risk perceptions, avalanche related information seeking behaviours, preparedness and decision-making processes

NASA Astrophysics Data System (ADS)

Baker, Jennifer

Although there has been substantial research on the avoidance of risk, much less has been completed on voluntary risk. This study examined backcountry snowmobilers' risk perceptions, avalanche related information seeking behaviours, and decision-making processes when dealing with avalanches and backcountry risk in Canada. To accomplish this, in-depth, semi-structured interviews were conducted with 17 participants who were involved in backcountry snowmobiling. Interviews were done both in person and by telephone. The results of this study show that, unlike previous research on snowmobilers, the participants of this study were well prepared and knowledgeable about backcountry risks. All 17 participants stated that they carried a shovel, probe, and transceiver with them on each backcountry trip, and 10 participants had taken an avalanche safety course. Group dynamics and positive peer pressure were influential in promoting safe backcountry behaviour. KEYWORDS: Backcountry snowmobiling, Avalanches, Voluntary Risk, Preparedness, Decision-Making.

External validity and anchoring heuristics: application of DUNDRUM-1 to secure service gatekeeping in South Wales.

PubMed

Lawrence, Daniel; Davies, Tracey-Lee; Bagshaw, Ruth; Hewlett, Paul; Taylor, Pamela; Watt, Andrew

2018-02-01

Aims and method Structured clinical judgement tools provide scope for the standardisation of forensic service gatekeeping and also allow identification of heuristics in this decision process. The DUNDRUM-1 triage tool was completed retrospectively for 121 first-time referrals to forensic services in South Wales. Fifty were admitted to medium security, 49 to low security and 22 remained in open conditions. DUNDRUM-1 total scores differed appropriately between different levels of security. However, regression revealed heuristic anchoring on the 'legal process' and 'immediacy of risk due to mental disorder' items. Clinical implications Patient placement was broadly aligned with DUNDRUM-1 recommendations. However, not all triage items informed gatekeeping decisions. It remains to be seen whether decisions anchored in this way are effective. Declaration of interest Dr Mark Freestone gave permission for AUC values from Freestone et al. (2015) to be presented here for comparison.

Evidence integration in model-based tree search

PubMed Central

Solway, Alec; Botvinick, Matthew M.

2015-01-01

Research on the dynamics of reward-based, goal-directed decision making has largely focused on simple choice, where participants decide among a set of unitary, mutually exclusive options. Recent work suggests that the deliberation process underlying simple choice can be understood in terms of evidence integration: Noisy evidence in favor of each option accrues over time, until the evidence in favor of one option is significantly greater than the rest. However, real-life decisions often involve not one, but several steps of action, requiring a consideration of cumulative rewards and a sensitivity to recursive decision structure. We present results from two experiments that leveraged techniques previously applied to simple choice to shed light on the deliberation process underlying multistep choice. We interpret the results from these experiments in terms of a new computational model, which extends the evidence accumulation perspective to multiple steps of action. PMID:26324932

Bereaved relatives' decision about deceased organ donation: An integrated psycho-social study conducted in Spain.

PubMed

López, Jorge S; Martínez, José M; Soria-Oliver, María; Aramayona, Begoña; García-Sánchez, Rubén; Martín, María J; Almendros, Carmen

2018-05-01

Family refusal to organ donation of a deceased relative represents one of the most important barriers to organ transplantation. Although a large literature about family decisions has amassed, the existing evidence needs further integration and structuring. This study seeks to analyse relationships between bereaved relatives' decisions and a wide range of factors that converge in the family decision process, including interactions and complex relationship patterns, and taking psychosocial theoretical frameworks as reference to conceptualize empirical findings. This observational study examined 16 Spanish hospitals during a 36-month period. Transplant coordination teams collected data of 421 cases of family decision processes about donation (338 donations/83 refusals) through a previously validated instrument. Indicators of the following factors were collected: deceased's characteristics; circumstances of death; bereaved relatives' characteristics, beliefs, and expressions; behaviour of health and coordination staff; and family's emotional responses. Three global hypotheses related to bivariate and multivariate relations of factors with family decisions and relationships/interactions among factors were tested. Relatives' beliefs about the deceased's wishes concerning donation are the strongest predictor of family decisions. However, family decisions are also related to the deceased's characteristics, relatives' characteristics, satisfaction with medical attention, satisfaction with personal treatment and relatives' emotional responses, and other factors. Relatives' emotional reactions are related to satisfaction with health-staff interventions and condition family decision, even if deceased's will concerning donation is known and positive. Relatives' beliefs about deceased's wishes concerning donation vary as a function of deceased's characteristics and according to relatives' characteristics. Understanding of family decisions underlying organ donation may greatly benefit from a more complex, integrated, and theoretically based approach. Educational efforts should stress the need to register or simply communicate own willingness to donate organs. However, an adequate training and performance of the health-staff involved in the organ donation process may generate substantive differences in consent rates. Copyright © 2018 Elsevier Ltd. All rights reserved.

Acquisition Management for Systems-of-Systems: Exploratory Model Development and Experimentation

DTIC Science & Technology

2009-04-22

outputs of the Requirements Development and Logical Analysis processes into alternative design solutions and selects a final design solution. Decision...Analysis Provides the basis for evaluating and selecting alternatives when decisions need to be made. Implementation Yields the lowest-level system... Dependenc y Matrix 1 ⎥ ⎥ ⎥ ⎦ ⎤ ⎢ ⎢ ⎢ ⎣ ⎡ 011 100 110 2 ⎥ ⎥ ⎥ ⎦ ⎤ ⎢ ⎢ ⎢ ⎣ ⎡ 000 100 100 a) Example of SoS b) Model Structure for Example SoS

Parental Decision-Making and Acceptance of Newborn Bloodspot Screening: An Exploratory Study

PubMed Central

Nicholls, Stuart G.; Southern, Kevin W.

2013-01-01

Objective Newborn bloodspot screening is an internationally established public health measure. Despite this, there is a paucity of information relating to the decision-making process that parents go through when accepting newborn screening. This is important as screening panels are expanding; potentially leading to an increasing amount of complex information. This study sought to understand the factors that influence parental decisions and roles they play in the decision-making process. Patients and Methods Qualitative thematic evaluation of semi structured interviews with parents whose children had recently undergone newborn screening in the Merseyside and Cheshire region of England, UK. Results Eighteen interviews with first time parents (n = 12) and those with previous children (n = 6). Seven factors were identified as being either explicitly or implicitly related to parental decision-making: Experience, Attitudes to medicine, Information-seeking behaviour, Perceived knowledge, Attitudes to screening, and Perceived choice, all of which ultimately impact on Perceived decisional quality. Conclusions These results indicate that while content is important, other contextual factors such as personal experience, perceived choice, and general attitudes toward medicine, are also highly influential. In particular, relationships with key healthcare professionals are central to information collection, attitudes toward screening, and the level of deliberation that is invested in decisions to accept newborn bloodspot screening. PMID:24265771

A methodology for eliciting, representing, and analysing stakeholder knowledge for decision making on complex socio-ecological systems: from cognitive maps to agent-based models.

PubMed

Elsawah, Sondoss; Guillaume, Joseph H A; Filatova, Tatiana; Rook, Josefine; Jakeman, Anthony J

2015-03-15

This paper aims to contribute to developing better ways for incorporating essential human elements in decision making processes for modelling of complex socio-ecological systems. It presents a step-wise methodology for integrating perceptions of stakeholders (qualitative) into formal simulation models (quantitative) with the ultimate goal of improving understanding and communication about decision making in complex socio-ecological systems. The methodology integrates cognitive mapping and agent based modelling. It cascades through a sequence of qualitative/soft and numerical methods comprising: (1) Interviews to elicit mental models; (2) Cognitive maps to represent and analyse individual and group mental models; (3) Time-sequence diagrams to chronologically structure the decision making process; (4) All-encompassing conceptual model of decision making, and (5) computational (in this case agent-based) Model. We apply the proposed methodology (labelled ICTAM) in a case study of viticulture irrigation in South Australia. Finally, we use strengths-weakness-opportunities-threats (SWOT) analysis to reflect on the methodology. Results show that the methodology leverages the use of cognitive mapping to capture the richness of decision making and mental models, and provides a combination of divergent and convergent analysis methods leading to the construction of an Agent Based Model. Copyright © 2014 Elsevier Ltd. All rights reserved.

From axiomatics of quantum probability to modelling geological uncertainty and management of intelligent hydrocarbon reservoirs with the theory of open quantum systems.

PubMed

Lozada Aguilar, Miguel Ángel; Khrennikov, Andrei; Oleschko, Klaudia

2018-04-28

As was recently shown by the authors, quantum probability theory can be used for the modelling of the process of decision-making (e.g. probabilistic risk analysis) for macroscopic geophysical structures such as hydrocarbon reservoirs. This approach can be considered as a geophysical realization of Hilbert's programme on axiomatization of statistical models in physics (the famous sixth Hilbert problem). In this conceptual paper , we continue development of this approach to decision-making under uncertainty which is generated by complexity, variability, heterogeneity, anisotropy, as well as the restrictions to accessibility of subsurface structures. The belief state of a geological expert about the potential of exploring a hydrocarbon reservoir is continuously updated by outputs of measurements, and selection of mathematical models and scales of numerical simulation. These outputs can be treated as signals from the information environment E The dynamics of the belief state can be modelled with the aid of the theory of open quantum systems: a quantum state (representing uncertainty in beliefs) is dynamically modified through coupling with E ; stabilization to a steady state determines a decision strategy. In this paper, the process of decision-making about hydrocarbon reservoirs (e.g. 'explore or not?'; 'open new well or not?'; 'contaminated by water or not?'; 'double or triple porosity medium?') is modelled by using the Gorini-Kossakowski-Sudarshan-Lindblad equation. In our model, this equation describes the evolution of experts' predictions about a geophysical structure. We proceed with the information approach to quantum theory and the subjective interpretation of quantum probabilities (due to quantum Bayesianism).This article is part of the theme issue 'Hilbert's sixth problem'. © 2018 The Author(s).

From axiomatics of quantum probability to modelling geological uncertainty and management of intelligent hydrocarbon reservoirs with the theory of open quantum systems

NASA Astrophysics Data System (ADS)

Lozada Aguilar, Miguel Ángel; Khrennikov, Andrei; Oleschko, Klaudia

2018-04-01

As was recently shown by the authors, quantum probability theory can be used for the modelling of the process of decision-making (e.g. probabilistic risk analysis) for macroscopic geophysical structures such as hydrocarbon reservoirs. This approach can be considered as a geophysical realization of Hilbert's programme on axiomatization of statistical models in physics (the famous sixth Hilbert problem). In this conceptual paper, we continue development of this approach to decision-making under uncertainty which is generated by complexity, variability, heterogeneity, anisotropy, as well as the restrictions to accessibility of subsurface structures. The belief state of a geological expert about the potential of exploring a hydrocarbon reservoir is continuously updated by outputs of measurements, and selection of mathematical models and scales of numerical simulation. These outputs can be treated as signals from the information environment E. The dynamics of the belief state can be modelled with the aid of the theory of open quantum systems: a quantum state (representing uncertainty in beliefs) is dynamically modified through coupling with E; stabilization to a steady state determines a decision strategy. In this paper, the process of decision-making about hydrocarbon reservoirs (e.g. `explore or not?'; `open new well or not?'; `contaminated by water or not?'; `double or triple porosity medium?') is modelled by using the Gorini-Kossakowski-Sudarshan-Lindblad equation. In our model, this equation describes the evolution of experts' predictions about a geophysical structure. We proceed with the information approach to quantum theory and the subjective interpretation of quantum probabilities (due to quantum Bayesianism). This article is part of the theme issue `Hilbert's sixth problem'.

Adoption of trastuzumab for breast cancer in four emerging countries in the use of health technology assessment: a case study.

PubMed

Martín-Ruiz, Eva; Espín Balbino, Jaime; Lemgruber, Alexandre; Caro-Martínez, Araceli; Lessa, Fernanda; Olry-de-Labry-Lima, Antonio; Pérez-Velasco, Roman; García-Mochón, Leticia

2016-07-01

To describe processes for the adoption of trastuzumab in four countries in the use of health technology assessment (HTA): Poland, Albania, Brazil and Colombia. Mixed methods were used for collection and triangulation of data. Data were examined following a conceptual framework connecting HTA process steps and key principles. Trastuzumab was generally assessed following well-structured HTA processes. Nonetheless, areas of improvement were detected in terms of transparency and inclusiveness, as well as in methods used. The extent to which different criteria influenced decisions was unclear. This study covers an area in which information may not always be available, and sets the example for emerging countries interested in HTA. Further studies to gain a better understanding on decision-making across settings are warranted.

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.

SHARD - a SeisComP3 module for Structural Health Monitoring

NASA Astrophysics Data System (ADS)

Weber, B.; Becker, J.; Ellguth, E.; Henneberger, R.; Herrnkind, S.; Roessler, D.

2016-12-01

Monitoring building and structure response to strong earthquake ground shaking or human-induced vibrations in real-time forms the backbone of modern structural health monitoring (SHM). The continuous data transmission, processing and analysis reduces drastically the time decision makers need to plan for appropriate response to possible damages of high-priority buildings and structures. SHARD is a web browser based module using the SeisComp3 framework to monitor the structural health of buildings and other structures by calculating standard engineering seismology parameters and checking their exceedance in real-time. Thresholds can be defined, e.g. compliant with national building codes (IBC2000, DIN4149 or EC8), for PGA/PGV/PGD, response spectra and drift ratios. In case thresholds are exceeded automatic or operator driven reports are generated and send to the decision makers. SHARD also determines waveform quality in terms of data delay and variance to report sensor status. SHARD is the perfect tool for civil protection to monitor simultaneously multiple city-wide critical infrastructure as hospitals, schools, governmental buildings and structures as bridges, dams and power substations.

Searching Choices: Quantifying Decision-Making Processes Using Search Engine Data.

PubMed

Moat, Helen Susannah; Olivola, Christopher Y; Chater, Nick; Preis, Tobias

2016-07-01

When making a decision, humans consider two types of information: information they have acquired through their prior experience of the world, and further information they gather to support the decision in question. Here, we present evidence that data from search engines such as Google can help us model both sources of information. We show that statistics from search engines on the frequency of content on the Internet can help us estimate the statistical structure of prior experience; and, specifically, we outline how such statistics can inform psychological theories concerning the valuation of human lives, or choices involving delayed outcomes. Turning to information gathering, we show that search query data might help measure human information gathering, and it may predict subsequent decisions. Such data enable us to compare information gathered across nations, where analyses suggest, for example, a greater focus on the future in countries with a higher per capita GDP. We conclude that search engine data constitute a valuable new resource for cognitive scientists, offering a fascinating new tool for understanding the human decision-making process. Copyright © 2016 The Authors. Topics in Cognitive Science published by Wiley Periodicals, Inc. on behalf of Cognitive Science Society.

Analyzing stakeholder preferences for managing elk and bison at the National Elk Refuge and Grand Teton National Park: An example of the disparate stakeholder management approach

USGS Publications Warehouse

Koontz, Lynne; Hoag, Dana L.

2005-01-01

Many programs and tools have been developed by different disciplines to facilitate group negotiation and decision making. Three examples are relevant here. First, decision analysis models such as the Analytical Hierarchy Process (AHP) are commonly used to prioritize the goals and objectives of stakeholders’ preferences for resource planning by formally structuring conflicts and assisting decision makers in developing a compromised solution (Forman, 1998). Second, institutional models such as the Legal Institutional Analysis Model (LIAM) have been used to describe the organizational rules of behavior and the institutional boundaries constraining management decisions (Lamb and others, 1998). Finally, public choice models have been used to predict the potential success of rent-seeking activity (spending additional time and money to exert political pressure) to change the political rules (Becker, 1983). While these tools have been successful at addressing various pieces of the natural resource decision making process, their use in isolation is not enough to fully depict the complexities of the physical and biological systems with the rules and constraints of the underlying economic and political systems. An approach is needed that combines natural sciences, economics, and politics.

Amyotrophic lateral sclerosis and assisted ventilation: how patients decide.

PubMed

Lemoignan, Josée; Ells, Carolyn

2010-06-01

Throughout the course of their illness, people with amyotrophic lateral sclerosis (ALS) must make many treatment decisions; however, none has such a significant impact on quality of life and survival as decisions about assisted ventilation. The purpose of this study was to better understand the experience of decision-making about assisted ventilation for ALS patients. Using qualitative phenomenology methodology, 10 semi-structured interviews were conducted with persons with ALS and their caregivers to elicit factors that are pertinent to their decision-making process about assisted ventilation. Six main themes emerged from the interviews. (1) the meaning of the intervention - participants made a sharp distinction between non-invasive ventilation, which they viewed as a means to relieve symptoms of respiratory failure, and invasive ventilation, which they viewed as taking over their breathing and thereby saving their life when they otherwise would die, (2) the importance of context - including functional status, available supports, and financial implications, (3) the importance of values - with respect to communication, relationships, autonomy, life, and quality of life, (4) the effect of fears - particularly respiratory distress, chocking, running out of air, and the process of death itself, (5) the need for information - how use of assisted ventilation would impact daily life, how death from respiratory failure would occur, how caregivers and persons with ALS differ in their information needs and common misconceptions, and (6) adaptation to or acceptance of the intervention - a lengthy process that involved gradual familiarization with the equipment and its benefits. People with ALS and caregivers value autonomy in decision-making about assisted ventilation. Their decision-making process is neither wholly rational nor self-interested, and includes factors that health professionals should anticipate and address. Discussions about assisted ventilation and timing should be tailored to each individual and undertaken periodically.

The Organization of Collective Group Movements in Wild Barbary Macaques (Macaca sylvanus): Social Structure Drives Processes of Group Coordination in Macaques

PubMed Central

Seltmann, Anne; Majolo, Bonaventura

2013-01-01

Social animals have to coordinate activities and collective movements to benefit from the advantages of group living. Animals in large groups maintain cohesion by self-organization processes whereas in smaller groups consensus decisions can be reached. Where consensus decisions are relevant leadership may emerge. Variation in the organization of collective movements has been linked to variation in female social tolerance among macaque species ranging from despotic to egalitarian. Here we investigated the processes underlying group movements in a wild macaque species characterized by a degree of social tolerance intermediate to previously studied congeneric species. We focused on processes before, during and after the departure of the first individual. To this end, we observed one group of wild Barbary macaques (Macaca sylvanus) in the Middle Atlas, Morocco using all-occurrence behaviour sampling of 199 collective movements. We found that initiators of a collective movement usually chose the direction in which more individuals displayed pre-departure behavior. Dominant individuals contributed to group movements more than subordinates, especially juveniles, measured as frequencies of successful initiations and pre-departure behaviour. Joining was determined by affiliative relationships and the number of individuals that already joined the movement (mimetism). Thus, in our study group partially shared consensus decisions mediated by selective mimetism seemed to be prevalent, overall supporting the suggestion that a species’ social style affects the organization of group movements. As only the most tolerant species show equally shared consensus decisions whereas in others the decision is partially shared with a bias to dominant individuals the type of consensus decisions seems to follow a stepwise relation. Joining order may also follow a stepwise, however opposite, relationship, because dominance only determined joining in highly despotic, but not in intermediate and tolerant species. PMID:23805305

Boundaries of Belonging and Postsecondary Access: African-American Students and College Choice Decisionmaking in Social Context. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Horvat, Erin McNamara

Our schools are environments of race and class and these school environments structure opportunity based on race and class. This paper explores how students' lives and their access to postsecondary education are framed and structured by the influences of race and class. The college choice decision process of three female Black students from a…

Measuring societal effects of transdisciplinary research projects: design and application of an evaluation method.

PubMed

Walter, Alexander I; Helgenberger, Sebastian; Wiek, Arnim; Scholz, Roland W

2007-11-01

Most Transdisciplinary Research (TdR) projects combine scientific research with the building of decision making capacity for the involved stakeholders. These projects usually deal with complex, societally relevant, real-world problems. This paper focuses on TdR projects, which integrate the knowledge of researchers and stakeholders in a collaborative transdisciplinary process through structured methods of mutual learning. Previous research on the evaluation of TdR has insufficiently explored the intended effects of transdisciplinary processes on the real world (societal effects). We developed an evaluation framework for assessing the societal effects of transdisciplinary processes. Outputs (measured as procedural and product-related involvement of the stakeholders), impacts (intermediate effects connecting outputs and outcomes) and outcomes (enhanced decision making capacity) are distinguished as three types of societal effects. Our model links outputs and outcomes of transdisciplinary processes via the impacts using a mediating variables approach. We applied this model in an ex post evaluation of a transdisciplinary process. 84 out of 188 agents participated in a survey. The results show significant mediation effects of the two impacts "network building" and "transformation knowledge". These results indicate an influence of a transdisciplinary process on the decision making capacity of stakeholders, especially through social network building and the generation of knowledge relevant for action.

The Influence of Emotion Regulation on Decision-making under Risk

PubMed Central

Martin, Laura N.; Delgado, Mauricio R.

2011-01-01

Cognitive strategies typically involved in regulating negative emotions have recently been shown to also be effective with positive emotions associated with monetary rewards. However, it is less clear how these strategies influence behavior, such as preferences expressed during decision-making under risk, and the underlying neural circuitry. That is, can the effective use of emotion regulation strategies during presentation of a reward-conditioned stimulus influence decision-making under risk and neural structures involved in reward processing such as the striatum? To investigate this question, we asked participants to engage in imagery-focused regulation strategies during the presentation of a cue that preceded a financial decision-making phase. During the decision phase, participants then made a choice between a risky and a safe monetary lottery. Participants who successfully used cognitive regulation, as assessed by subjective ratings about perceived success and facility in implementation of strategies, made fewer risky choices in comparison to trials where decisions were made in the absence of cognitive regulation. Additionally, blood-oxygen-level-dependent (BOLD) responses in the striatum were attenuated during decision-making as a function of successful emotion regulation. These findings suggest that exerting cognitive control over emotional responses can modulate neural responses associated with reward processing (e.g., striatum), and promote more goal-directed decision-making (e.g., less risky choices), illustrating the potential importance of cognitive strategies in curbing risk-seeking behaviors before they become maladaptive (e.g., substance abuse). PMID:21254801

Measuring the pulse of urban green infrastructure: vegetation dynamics across residential landscapes

EPA Science Inventory

Vegetation can be an important component of urban green infrastructure. Its structure is a complex result of the socio-ecological milieu and management decisions, and it can influence numerous ecohydrological processes such as stormwater interception and evapotranspiration. Despi...