Sample records for ultimate decision makers

  1. 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.

  2. 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.

  3. Adopting Cut Scores: Post-Standard-Setting Panel Considerations for Decision Makers

    ERIC Educational Resources Information Center

    Geisinger, Kurt F.; McCormick, Carina M.

    2010-01-01

    Standard-setting studies utilizing procedures such as the Bookmark or Angoff methods are just one component of the complete standard-setting process. Decision makers ultimately must determine what they believe to be the most appropriate standard or cut score to use, employing the input of the standard-setting panelists as one piece of information…

  4. Teacher as Decision-Maker.

    ERIC Educational Resources Information Center

    Smith, Carl B.

    The teacher as decisionmaker is a fairly new concept, and yet the choices teachers make--among alternative approaches--afffect the attitudes, knowledge, and skills students carry into adult life. This booklet's chapter titles are as follows: (1) New Image for Teachers--Decision-Maker; (2) Decisions Teachers Make; (3) A Rational Model; (4) Planning…

  5. Licensing Surrogate Decision-Makers.

    PubMed

    Rosoff, Philip M

    2017-06-01

    As medical technology continues to improve, more people will live longer lives with multiple chronic illnesses with increasing cumulative debilitation, including cognitive dysfunction. Combined with the aging of society in most developed countries, an ever-growing number of patients will require surrogate decision-makers. While advance care planning by patients still capable of expressing their preferences about medical interventions and end-of-life care can improve the quality and accuracy of surrogate decisions, this is often not the case, not infrequently leading to demands for ineffective, inappropriate and prolonged interventions. In 1980 LaFollette called for the licensing of prospective parents, basing his argument on the harm they can do to vulnerable people (children). In this paper, I apply his arguments to surrogate decision-makers for cognitively incapacitated patients, rhetorically suggesting that we require potential surrogates to qualify for this position by demonstrating their ability to make reasonable and rational decisions for others. I employ this theoretical approach to argue that the loose criteria by which we authorize surrogates' generally unchallenged power should be reconsidered.

  6. Appropriateness for Total Joint Replacement: Perspectives of Decision-Makers

    PubMed Central

    Clavel, Nathalie; De coster, Carolyn; Pomey, Marie-Pascale; Sanmartin, Claudia; Bohm, Éric; Dunbar, Michael J.; Frank, CY; Hawker, Gillian; Noseworthy, Tom

    2016-01-01

    Background: Improving access to total joint replacement (TJR) has been a priority. Without robust mechanisms to ensure appropriateness, these procedures may be overused, incurring substantial costs. In that context, decision-makers are particularly concerned with the appropriateness of TJR. Objective: While our previous research focused on the appropriateness of TJR from clinical and patient perspectives, this study is aimed at understanding decision-makers' perspectives. Methods: Using a semi-structured guide, we interviewed a convenience sample of decision-makers in four Canadian provinces (Alberta, Manitoba, Nova Scotia and Quebec) between February and March 2013. For the purposes of this study, a decision-maker was defined as a manager, institutional leader or policy maker. Results: Fifteen interviews were conducted with decision-makers at ministry (n = 3), regional (n = 6) and institutional levels (n = 8). Decision-makers see themselves as having a key role in the appropriateness discourse, that of optimizing resource allocation and efficient delivery of services for TJR, to improve population outcomes. Conclusion: The decision-makers' view of appropriateness recognizes the importance of the clinical view, but it offers a very different input into the appropriateness discourse, more closely aligned with appropriateness of setting, which refers to cost-effectiveness considerations. PMID:27027795

  7. Information processing by networks of quantum decision makers

    NASA Astrophysics Data System (ADS)

    Yukalov, V. I.; Yukalova, E. P.; Sornette, D.

    2018-02-01

    We suggest a model of a multi-agent society of decision makers taking decisions being based on two criteria, one is the utility of the prospects and the other is the attractiveness of the considered prospects. The model is the generalization of quantum decision theory, developed earlier for single decision makers realizing one-step decisions, in two principal aspects. First, several decision makers are considered simultaneously, who interact with each other through information exchange. Second, a multistep procedure is treated, when the agents exchange information many times. Several decision makers exchanging information and forming their judgment, using quantum rules, form a kind of a quantum information network, where collective decisions develop in time as a result of information exchange. In addition to characterizing collective decisions that arise in human societies, such networks can describe dynamical processes occurring in artificial quantum intelligence composed of several parts or in a cluster of quantum computers. The practical usage of the theory is illustrated on the dynamic disjunction effect for which three quantitative predictions are made: (i) the probabilistic behavior of decision makers at the initial stage of the process is described; (ii) the decrease of the difference between the initial prospect probabilities and the related utility factors is proved; (iii) the existence of a common consensus after multiple exchange of information is predicted. The predicted numerical values are in very good agreement with empirical data.

  8. Trusted Advisors, Decision Models and Other Keys to Communicating Science to Decision Makers

    NASA Astrophysics Data System (ADS)

    Webb, E.

    2006-12-01

    Water resource management decisions often involve multiple parties engaged in contentious negotiations that try to navigate through complex combinations of legal, social, hydrologic, financial, and engineering considerations. The standard approach for resolving these issues is some form of multi-party negotiation, a formal court decision, or a combination of the two. In all these cases, the role of the decision maker(s) is to choose and implement the best option that fits the needs and wants of the community. However, each path to a decision carries the risk of technical and/or financial infeasibility as well as the possibility of unintended consequences. To help reduce this risk, decision makers often rely on some type of predictive analysis from which they can evaluate the projected consequences of their decisions. Typically, decision makers are supported in the analysis process by trusted advisors who engage in the analysis as well as the day to day tasks associated with multi-party negotiations. In the case of water resource management, the analysis is frequently a numerical model or set of models that can simulate various management decisions across multiple systems and output results that illustrate the impact on areas of concern. Thus, in order to communicate scientific knowledge to the decision makers, the quality of the communication between the analysts, the trusted advisor, and the decision maker must be clear and direct. To illustrate this concept, a multi-attribute decision analysis matrix will be used to outline the value of computer model-based collaborative negotiation approaches to guide water resources decision making and communication with decision makers. In addition, the critical role of the trusted advisor and other secondary participants in the decision process will be discussed using examples from recent water negotiations.

  9. 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.

  10. Bridging the Gap: Tailor-made Information Products for Decision Makers

    NASA Astrophysics Data System (ADS)

    Mandler, B. E.; Rose, C. A.; Gonzales, L. M.; Boland, M. A.

    2016-12-01

    The American Geosciences Institute (AGI) is launching a new information platform designed to link decision makers with information generated by geoscientific research. Decision makers, especially those at the state and local level, frequently need scientific information but do not always have easy access to it, while scientists create new knowledge but often lack opportunities to communicate this knowledge more broadly to the people who need it the most. Major differences in communication styles and language can also hinder the use of scientific information by decision makers. AGI is building an online portfolio of case studies and fact sheets that are based on cutting-edge research presented in a format and style that meets the needs and expectations of decision makers. Based on discussions with state and local decision makers around the country, AGI has developed a template for these products. Scientists are invited to write short (500-700-word) summaries of their research and the ways in which it provides useful tools and information to decision makers. We are particularly interested in showcasing actionable information derived from basic or applied research. Researchers are encouraged to contact AGI to discuss topics that may be an appropriate basis for case studies or fact sheets, and AGI may also contact researchers based on scientific needs identified during our discussions with decision makers. All submissions will be edited and reviewed by AGI staff and an external peer review team before being published online and made available to decision makers through AGI's Critical Issues web platform and extensive professional networks. Publicizing the results of scientific research to key legislative, regulatory, advisory, and engaged citizen groups and individuals broadens the impact of scientists' research and highlights the value and importance of the geosciences to society. By presenting the information in a format that is designed with the end-user in mind

  11. On avoiding framing effects in experienced decision makers.

    PubMed

    Garcia-Retamero, Rocio; Dhami, Mandeep K

    2013-01-01

    The present study aimed to (a) demonstrate the effect of positive-negative framing on experienced criminal justice decision makers, (b) examine the debiasing effect of visually structured risk messages, and (c) investigate whether risk perceptions mediate the debiasing effect of visual aids on decision making. In two phases, 60 senior police officers estimated the accuracy of a counterterrorism technique in identifying whether a known terror suspect poses an imminent danger and decided whether they would recommend the technique to policy makers. Officers also rated their confidence in this recommendation. When information about the effectiveness of the counterterrorism technique was presented in a numerical format, officers' perceptions of accuracy and recommendation decisions were susceptible to the framing effect: The technique was perceived to be more accurate and was more likely to be recommended when its effectiveness was presented in a positive than in a negative frame. However, when the information was represented visually using icon arrays, there were no such framing effects. Finally, perceptions of accuracy mediated the debiasing effect of visual aids on recommendation decisions. We offer potential explanations for the debiasing effect of visual aids and implications for communicating risk to experienced, professional decision makers.

  12. Finding common ground to achieve a "good death": family physicians working with substitute decision-makers of dying patients. A qualitative grounded theory study.

    PubMed

    Tan, Amy; Manca, Donna

    2013-01-22

    Substitute decision-makers are integral to the care of dying patients and make many healthcare decisions for patients. Unfortunately, conflict between physicians and surrogate decision-makers is not uncommon in end-of-life care and this could contribute to a "bad death" experience for the patient and family. We aim to describe Canadian family physicians' experiences of conflict with substitute decision-makers of dying patients to identify factors that may facilitate or hinder the end-of-life decision-making process. This insight will help determine how to best manage these complex situations, ultimately improving the overall care of dying patients. Grounded Theory methodology was used with semi-structured interviews of family physicians in Edmonton, Canada, who experienced conflict with substitute decision-makers of dying patients. Purposeful sampling included maximum variation and theoretical sampling strategies. Interviews were audio-taped, and transcribed verbatim. Transcripts, field notes and memos were coded using the constant-comparative method to identify key concepts until saturation was achieved and a theoretical framework emerged. Eleven family physicians with a range of 3 to 40 years in clinical practice participated.The family physicians expressed a desire to achieve a "good death" and described their role in positively influencing the experience of death.Finding Common Ground to Achieve a "Good Death" for the Patient emerged as an important process which includes 1) Building Mutual Trust and Rapport through identifying key players and delivering manageable amounts of information, 2) Understanding One Another through active listening and ultimately, and 3) Making Informed, Shared Decisions. Facilitators and barriers to achieving Common Ground were identified. Barriers were linked to conflict. The inability to resolve an overt conflict may lead to an impasse at any point. A process for Resolving an Impasse is described. A novel framework for developing

  13. Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

    DOE PAGES

    Zhang, Xiaodong; Vesselinov, Velimir Valentinov

    2016-09-03

    Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

  14. Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

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

    Zhang, Xiaodong; Vesselinov, Velimir Valentinov

    Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

  15. Finding common ground to achieve a “good death”: family physicians working with substitute decision-makers of dying patients. A qualitative grounded theory study

    PubMed Central

    2013-01-01

    Background Substitute decision-makers are integral to the care of dying patients and make many healthcare decisions for patients. Unfortunately, conflict between physicians and surrogate decision-makers is not uncommon in end-of-life care and this could contribute to a “bad death” experience for the patient and family. We aim to describe Canadian family physicians’ experiences of conflict with substitute decision-makers of dying patients to identify factors that may facilitate or hinder the end-of-life decision-making process. This insight will help determine how to best manage these complex situations, ultimately improving the overall care of dying patients. Methods Grounded Theory methodology was used with semi-structured interviews of family physicians in Edmonton, Canada, who experienced conflict with substitute decision-makers of dying patients. Purposeful sampling included maximum variation and theoretical sampling strategies. Interviews were audio-taped, and transcribed verbatim. Transcripts, field notes and memos were coded using the constant-comparative method to identify key concepts until saturation was achieved and a theoretical framework emerged. Results Eleven family physicians with a range of 3 to 40 years in clinical practice participated. The family physicians expressed a desire to achieve a “good death” and described their role in positively influencing the experience of death. Finding Common Ground to Achieve a “Good Death” for the Patient emerged as an important process which includes 1) Building Mutual Trust and Rapport through identifying key players and delivering manageable amounts of information, 2) Understanding One Another through active listening and ultimately, and 3) Making Informed, Shared Decisions. Facilitators and barriers to achieving Common Ground were identified. Barriers were linked to conflict. The inability to resolve an overt conflict may lead to an impasse at any point. A process for Resolving an Impasse is

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

    NASA Astrophysics Data System (ADS)

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

    2017-12-01

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

  17. A regret theory approach to decision curve analysis: a novel method for eliciting decision makers' preferences and decision-making.

    PubMed

    Tsalatsanis, Athanasios; Hozo, Iztok; Vickers, Andrew; Djulbegovic, Benjamin

    2010-09-16

    Decision curve analysis (DCA) has been proposed as an alternative method for evaluation of diagnostic tests, prediction models, and molecular markers. However, DCA is based on expected utility theory, which has been routinely violated by decision makers. Decision-making is governed by intuition (system 1), and analytical, deliberative process (system 2), thus, rational decision-making should reflect both formal principles of rationality and intuition about good decisions. We use the cognitive emotion of regret to serve as a link between systems 1 and 2 and to reformulate DCA. First, we analysed a classic decision tree describing three decision alternatives: treat, do not treat, and treat or no treat based on a predictive model. We then computed the expected regret for each of these alternatives as the difference between the utility of the action taken and the utility of the action that, in retrospect, should have been taken. For any pair of strategies, we measure the difference in net expected regret. Finally, we employ the concept of acceptable regret to identify the circumstances under which a potentially wrong strategy is tolerable to a decision-maker. We developed a novel dual visual analog scale to describe the relationship between regret associated with "omissions" (e.g. failure to treat) vs. "commissions" (e.g. treating unnecessary) and decision maker's preferences as expressed in terms of threshold probability. We then proved that the Net Expected Regret Difference, first presented in this paper, is equivalent to net benefits as described in the original DCA. Based on the concept of acceptable regret we identified the circumstances under which a decision maker tolerates a potentially wrong decision and expressed it in terms of probability of disease. We present a novel method for eliciting decision maker's preferences and an alternative derivation of DCA based on regret theory. Our approach may be intuitively more appealing to a decision-maker, particularly

  18. The medical decision model and decision maker tools for management of radiological and nuclear incidents.

    PubMed

    Koerner, John F; Coleman, C Norman; Murrain-Hill, Paula; FitzGerald, Denis J; Sullivan, Julie M

    2014-06-01

    Effective decision making during a rapidly evolving emergency such as a radiological or nuclear incident requires timely interim decisions and communications from onsite decision makers while further data processing, consultation, and review are ongoing by reachback experts. The authors have recently proposed a medical decision model for use during a radiological or nuclear disaster, which is similar in concept to that used in medical care, especially when delay in action can have disastrous effects. For decision makers to function most effectively during a complex response, they require access to onsite subject matter experts who can provide information, recommendations, and participate in public communication efforts. However, in the time before this expertise is available or during the planning phase, just-in-time tools are essential that provide critical overview of the subject matter written specifically for the decision makers. Recognizing the complexity of the science, risk assessment, and multitude of potential response assets that will be required after a nuclear incident, the Office of the Assistant Secretary for Preparedness and Response, in collaboration with other government and non-government experts, has prepared a practical guide for decision makers. This paper illustrates how the medical decision model process could facilitate onsite decision making that includes using the deliberative reachback process from science and policy experts and describes the tools now available to facilitate timely and effective incident management.

  19. Proxy decision making and dementia: Using Construal Level Theory to analyse the thoughts of decision makers.

    PubMed

    Convey, Helen; Holt, Janet; Summers, Barbara

    2018-07-01

    This study explored the feasibility of using Construal Level Theory to analyse proxy decision maker thinking about a hypothetical ethical dilemma, relating to a person who has dementia. Proxy decision makers make decisions on behalf of individuals who are living with dementia when dementia affects that individual's decision making ability. Ethical dilemmas arise because there is a need to balance the individual's past and contemporary values and views. Understanding of how proxy decision makers respond is incomplete. Construal Level Theory contends that individuals imagine reactions and make predications about the future by crossing psychological distance. This involves abstract thinking, giving meaning to decisions. There is no empirical evidence of Construal Level Theory being used to analyse proxy decision maker thinking. Exploring the feasibility of using Construal Level Theory to understand dementia carer thinking regarding proxy decisions may provide insights which inform the support given. Descriptive qualitative research with semi-structured interviews. Seven participants were interviewed using a hypothetical dementia care scenario in February 2016. Interview transcripts were analysed for themes. Construal Level Theory was applied to analyse participant responses within themes using the Linguistic Category Model. Participants travelled across psychological distance, using abstract thinking to clarify goals and provide a basis for decisions. When thinking concretely participants established boundaries regarding the ethical dilemma. Construal Level Theory gives insight into proxy decision maker thinking and the levels of abstraction used. Understanding what dementia carers think about when making proxy decisions may help nurses to understand their perspectives and to provide appropriate support. © 2018 John Wiley & Sons Ltd.

  20. ENVIRONMENTAL PLANNING FOR SMALL COMMUNITIES: A GUIDE FOR LOCAL DECISION-MAKERS

    EPA Science Inventory

    Environmental Planning for Small Communities - A Guide for Local Decision-Makers presents a process for creating and implementing a community environmental plan. With a comprehensive environmental plan, local decision-makers can create an integrated approach to protecting the env...

  1. The Art of Influencing Decision Makers.

    ERIC Educational Resources Information Center

    Diegmueller, Karen

    1992-01-01

    Influencing educational decision makers requires creating ongoing relationships, keeping everyone informed, and developing persuasive skills. Persuasion requires preparation, refinement, hard work, and a sound understanding of the people being lobbied. Lobbying must be factual and relevant to the audience. The article looks at influence from the…

  2. A regret theory approach to decision curve analysis: A novel method for eliciting decision makers' preferences and decision-making

    PubMed Central

    2010-01-01

    Background Decision curve analysis (DCA) has been proposed as an alternative method for evaluation of diagnostic tests, prediction models, and molecular markers. However, DCA is based on expected utility theory, which has been routinely violated by decision makers. Decision-making is governed by intuition (system 1), and analytical, deliberative process (system 2), thus, rational decision-making should reflect both formal principles of rationality and intuition about good decisions. We use the cognitive emotion of regret to serve as a link between systems 1 and 2 and to reformulate DCA. Methods First, we analysed a classic decision tree describing three decision alternatives: treat, do not treat, and treat or no treat based on a predictive model. We then computed the expected regret for each of these alternatives as the difference between the utility of the action taken and the utility of the action that, in retrospect, should have been taken. For any pair of strategies, we measure the difference in net expected regret. Finally, we employ the concept of acceptable regret to identify the circumstances under which a potentially wrong strategy is tolerable to a decision-maker. Results We developed a novel dual visual analog scale to describe the relationship between regret associated with "omissions" (e.g. failure to treat) vs. "commissions" (e.g. treating unnecessary) and decision maker's preferences as expressed in terms of threshold probability. We then proved that the Net Expected Regret Difference, first presented in this paper, is equivalent to net benefits as described in the original DCA. Based on the concept of acceptable regret we identified the circumstances under which a decision maker tolerates a potentially wrong decision and expressed it in terms of probability of disease. Conclusions We present a novel method for eliciting decision maker's preferences and an alternative derivation of DCA based on regret theory. Our approach may be intuitively more

  3. Factors influencing decision regret regarding placement of a PEG among substitute decision-makers of older persons in Japan: a prospective study.

    PubMed

    Kuraoka, Yumiko; Nakayama, Kazuhiro

    2017-06-28

    A tube feeding decision aid designed at the Ottawa Health Research Institute was specifically created for substitute decision-makers who must decide whether to allow placement of a percutaneous endoscopic gastrostomy (PEG) tube in a cognitively impaired older person. We developed a Japanese version and found that the decision aid promoted the decision-making process of substitute decision-makers to decrease decisional conflict and increase knowledge. However, the factors that influence decision regret among substitute decision-makers were not measured after the decision was made. The objective of this study was to explore the factors that influence decision regret among substitute decision-makers 6 months after using a decision aid for PEG placement. In this prospective study, participants comprised substitute decision-makers for 45 inpatients aged 65 years and older who were being considered for placement of a PEG tube in hospitals, nursing homes and patients' homes in Japan. The Decisional Conflict Scale (DCS) was used to evaluate decisional conflict among substitute decision-makers immediately after deciding whether to introduce tube feeding and the Decision Regret Scale (DRS) was used to evaluate decisional regret among substitute decision-makers 6 months after they made their decision. Normalized scores were evaluated and analysis of variance was used to compare groups. The results of the multiple regression analysis suggest that PEG placement (P < .01) and decision conflict (P < .001) are explanatory factors of decision regret regarding placement of a PEG among substitute decision-makers. PEG placement and decision conflict immediately after deciding whether to allow PEG placement have an influence on decision regret among substitute decision-makers after 6 months.

  4. Modelling a Network of Decision Makers

    DTIC Science & Technology

    2004-06-01

    DATES COVERED 00-00-2004 to 00-00-2004 4. TITLE AND SUBTITLE Modelling a Netowrk of Decision Makers (Briefing Charts) 5a. CONTRACT NUMBER 5b...contains color images. 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 31 19a

  5. The Morality of University Decision-Makers

    ERIC Educational Resources Information Center

    Hatier, Cécile

    2014-01-01

    Ethical failures in UK higher education have recently made the news but are not a recent development. University decision-makers can, in order to adopt an ethical way of reasoning, resort to several ethical traditions. This article focuses, through the use of concrete examples, on three which have had a significant impact in recent higher…

  6. Climate modeling with decision makers in mind

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

    Jones, Andrew; Calvin, Katherine; Lamarque, Jean -Francois

    The need for regional- and local-scale climate information is increasing rapidly as decision makers seek to anticipate and manage a variety of context-specific climate risks over the next several decades. Furthermore, global climate models are not developed with these user needs in mind, and they typically operate at resolutions that are too coarse to provide information that could be used to support regional and local decisions.

  7. Climate modeling with decision makers in mind

    DOE PAGES

    Jones, Andrew; Calvin, Katherine; Lamarque, Jean -Francois

    2016-04-27

    The need for regional- and local-scale climate information is increasing rapidly as decision makers seek to anticipate and manage a variety of context-specific climate risks over the next several decades. Furthermore, global climate models are not developed with these user needs in mind, and they typically operate at resolutions that are too coarse to provide information that could be used to support regional and local decisions.

  8. A Reward-Maximizing Spiking Neuron as a Bounded Rational Decision Maker.

    PubMed

    Leibfried, Felix; Braun, Daniel A

    2015-08-01

    Rate distortion theory describes how to communicate relevant information most efficiently over a channel with limited capacity. One of the many applications of rate distortion theory is bounded rational decision making, where decision makers are modeled as information channels that transform sensory input into motor output under the constraint that their channel capacity is limited. Such a bounded rational decision maker can be thought to optimize an objective function that trades off the decision maker's utility or cumulative reward against the information processing cost measured by the mutual information between sensory input and motor output. In this study, we interpret a spiking neuron as a bounded rational decision maker that aims to maximize its expected reward under the computational constraint that the mutual information between the neuron's input and output is upper bounded. This abstract computational constraint translates into a penalization of the deviation between the neuron's instantaneous and average firing behavior. We derive a synaptic weight update rule for such a rate distortion optimizing neuron and show in simulations that the neuron efficiently extracts reward-relevant information from the input by trading off its synaptic strengths against the collected reward.

  9. Coping Strategies and Posttraumatic Stress Symptoms in Post-ICU Family Decision Makers.

    PubMed

    Petrinec, Amy B; Mazanec, Polly M; Burant, Christopher J; Hoffer, Alan; Daly, Barbara J

    2015-06-01

    To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. A single-group descriptive longitudinal correlational study. Medical, surgical, and neurological ICUs in a large tertiary care university hospital. Consecutive family decision makers of adult critical care patients from August 2012 to November 2013. Study inclusion occurred after the patient's fifth day in the ICU. None. Family decision makers of incapacitated adult ICU patients completed the Brief COPE instrument assessing coping strategy use 5 days after ICU admission and 30 days after hospital discharge or death of the patient and completed the Impact of Event Scale-Revised assessing posttraumatic stress symptoms 60 days after hospital discharge. Seventy-seven family decision makers of the eligible 176 completed all data collection time points of this study. The use of problem-focused (p=0.01) and emotion-focused (p<0.01) coping decreased over time while avoidant coping (p=0.20) use remained stable. Coping strategies 30 days after hospitalization (R2=0.50, p<0.001) were better predictors of later posttraumatic stress symptoms than coping strategies 5 days after ICU admission (R2=0.30, p=0.001) controlling for patient and decision-maker characteristics. The role of decision maker for a parent and patient death were the only noncoping predictors of posttraumatic stress symptoms. Avoidant coping use 30 days after hospitalization mediated the relationship between patient death and later posttraumatic stress symptom severity. Coping strategy use is a significant predictor of posttraumatic stress symptom severity 60 days after hospitalization in family decision makers of ICU patients.

  10. Targeting Continuing Medical Education on Decision Makers: Who Decides to Transfuse Blood?

    ERIC Educational Resources Information Center

    Goodnough, Lawrence T.; And Others

    1992-01-01

    Staff communication patterns were observed during 13 open-heart surgeries to identify the transfusion decision makers. It was determined that targeting decision makers for continuing medical education would improve the quality of transfusion practice and increase the efficiency of continuing education. (SK)

  11. Focusing biodiversity research on the needs of decision makers

    NASA Astrophysics Data System (ADS)

    Smythe, Katie D.; Bernabo, J. Christopher; Carter, Thomas B.; Jutro, Peter R.

    1996-11-01

    The project on Biodiversity Uncertainties and Research Needs (BURN) ensures the advancement of usable knowledge on biodiversity by obtaining input from decision makers on their priority information needs about biodiversity and then using this input to engage leading scientists in designing policy-relevant research. Decision makers articulated concerns related to four issues: significance of biodiversity; status and trends of biodiversity; management for biodiversity; and the linkage of social, cultural, economic, legal, and biological objectives. Leading natural and social scientists then identified the research required to address the decision makers' needs and determined the probability of success. The diverse group of experts reached consensus on several fundamental issues, helping to clarify the role of biodiversity in land and resource management. The BURN participants identified several features that should be incorporated into policy-relevant research plans and management strategies for biodiversity. Research and assessment efforts should be: multidisciplinary and integrative, participatory with stakeholder involvement, hierarchical (multiple scales), and problem- and region-specific. The activities should be focused regionally within a global perspective. Meta-analysis of existing data is needed on all fronts to assess the state of the science. More specifically, the scientists recommended six priority research areas that should be pursued to address the information needs articulated by decision makers: (1) characterization of biodiversity, (2) environmental valuation, (3) management for sustainability—for humans and the environment (adaptive management), (4) information management strategies, (5) governance and stewardship issues, and (6) communication and outreach. Broad recommendations were developed for each research area to provide direction for research planning and resource management strategies. The results will directly benefit those groups that

  12. 49 CFR 1503.659 - Petition to reconsider or modify a final decision and order of the TSA decision maker on appeal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and order of the TSA decision maker on appeal. 1503.659 Section 1503.659 Transportation Other... Practice in TSA Civil Penalty Actions § 1503.659 Petition to reconsider or modify a final decision and order of the TSA decision maker on appeal. (a) General. Any party may petition the TSA decision maker to...

  13. [Hospital self-management policy in Chile: perceptions of decision-makers].

    PubMed

    Méndez, Claudio A; Miranda, Christian; Torres, M Cristina; Márquez, Myriam

    2013-01-01

    To learn the perceptions of decision-makers concerning the imple-men-t-ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia and the Hospital San José de Osorno from August 2010 to December 2011. A convenience sample of 26 decision-makers was selected. The 26 interviews were recorded and transcribed verbatim. The information was analyzed using inductive content analysis. The interviewees consider the concept of self-management to be determined by autonomy in decision-making about resource allocation and the financing of health service delivery in the hospitals. They also stated that human resources and financing policies should be included to improve the implementation stage. They related weaknesses with the lack of organizational capabilities and managerial skills in the health teams implementing the changes. Conceptually, the hospital self-management policy is based on financial autonomy, and implementation is affected by persistent capacity gaps in policy design.

  14. [Attitudes and opinions of Palestinian decision-makers about premarital examination law].

    PubMed

    El Sharif, Nuha; Rifai, Ayshea; Assi, Sana'a; Al Hmidat, Amjad

    2006-11-01

    We explored the attitudes and opinions of 90 Palestinian decision-makers about the draft law on premarital examination. The findings revealed that decision-makers were aware of the spread of genetic diseases but not infectious diseases. The majority agreed on the draft law; however, they differed on the mode of its application. Half believed that the law is not ready yet for application due to insufficient financial support to establish the needed infrastructure. The most significant recommendations made by the decision-makers were to: enhance community awareness of the law, ensure proper coordination among the concerned ministries and institutions, and establish a national organization to work on endorsement of the tests and issuance of the appropriate application strategies and regulations.

  15. [The Intentions Affecting the Medical Decision-Making Behavior of Surrogate Decision Makers of Critically Ill Patients and Related Factors].

    PubMed

    Su, Szu-Huei; Wu, Li-Min

    2018-04-01

    The severity of diseases and high mortality rates that typify the intensive care unit often make it difficult for surrogate decision makers to make decisions for critically ill patients regarding whether to continue medical treatments or to accept palliative care. To explore the behavioral intentions that underlie the medical decisions of surrogate decision makers of critically ill patients and the related factors. A cross-sectional, correlation study design was used. A total of 193 surrogate decision makers from six ICUs in a medical center in southern Taiwan were enrolled as participants. Three structured questionnaires were used, including a demographic datasheet, the Family Relationship Scale, and the Behavioral Intention of Medical Decisions Scale. Significantly positive correlations were found between the behavioral intentions underlying medical decisions and the following variables: the relationship of the participant to the patient (Eta = .343, p = .020), the age of the patient (r = .295, p < .01), and whether the patient had signed a currently valid advance healthcare directive (Eta = .223, p = .002). Furthermore, a significantly negative correlation was found between these intentions and length of stay in the ICU (r = -.263, p < .01). Patient age, whether the patient had signed a currently valid advance healthcare directive, and length of stay in the ICU were all predictive factors for the behavioral intentions underlying the medical decisions of the surrogate decision makers, explaining 13.9% of the total variance. In assessing the behavioral intentions underlying the medical decisions of surrogate decision makers, health providers should consider the relationship between critical patients and their surrogate decision makers, patient age, the length of ICU stay, and whether the patient has a pre-signed advance healthcare directive in order to maximize the effectiveness of medical care provided to critically ill patients.

  16. Quantum decision-maker theory and simulation

    NASA Astrophysics Data System (ADS)

    Zak, Michail; Meyers, Ronald E.; Deacon, Keith S.

    2000-07-01

    A quantum device simulating the human decision making process is introduced. It consists of quantum recurrent nets generating stochastic processes which represent the motor dynamics, and of classical neural nets describing the evolution of probabilities of these processes which represent the mental dynamics. The autonomy of the decision making process is achieved by a feedback from the mental to motor dynamics which changes the stochastic matrix based upon the probability distribution. This feedback replaces unavailable external information by an internal knowledge- base stored in the mental model in the form of probability distributions. As a result, the coupled motor-mental dynamics is described by a nonlinear version of Markov chains which can decrease entropy without an external source of information. Applications to common sense based decisions as well as to evolutionary games are discussed. An example exhibiting self-organization is computed using quantum computer simulation. Force on force and mutual aircraft engagements using the quantum decision maker dynamics are considered.

  17. Educational Goods and Values: A Framework for Decision Makers

    ERIC Educational Resources Information Center

    Brighouse, Harry; Ladd, Helen F.; Loeb, Susanna; Swift, Adam

    2016-01-01

    This article articulates a framework suitable for use when making decisions about education policy. Decision makers should establish what the feasible options are and evaluate them in terms of their contribution to the development, and distribution, of educational goods in children, balanced against the negative effect of policies on important…

  18. Constructing Perceptions of Climate Change: a case study of regional political decision makers

    NASA Astrophysics Data System (ADS)

    Bray, D.

    2012-12-01

    This case study of climate change communications assesses the salient means of communication and the message adopted by regional political decision makers on the German Baltic coast. Realizing that cultural factors and local values (and not simply knowledge) are significant influences in explaining attitudes towards climate change, this analysis draws from the records of regional weather, from scientists with a specific focus on the region, from the political decision makers for that region, and the media message reaching the decision makers, ensuring all elements of the analysis are drawn from the same socioeconomic, geophysical, political and cultural context. This is important as the social dynamics surrounding the trust in science is of critical importance and, as such, all elements of the case study are specifically contained within a common context. If the utility of climate change knowledge is to prompt well conceived adaptation/mitigation strategies then the political decision process, or at least the perceptions shaping it, can best be understood by locating it within the world view of the decision makers involved in the production process. Using the results of two survey questionnaires, one of regional climate scientists and one of regional political decision makers, ten years of local weather records, and a summary of the message from mass media circulation, the discord in perceptions of regional climate change are quantitatively explored. The conclusions drawn from the analysis include, compared to the scientific assessment: The decision makers' perceptions of recent past differ from actual observations. The decision makers' perceptions of the future differ from scientific assessments. The decision makers tend to over estimate the magnitude of regional climate change and its impacts. The decision makers tend to over estimate the sense of immediacy for adaptation measures. The conclusions drawn suggest that in the regional political realm, it is often a

  19. Attunement and alignment of people with schizophrenia and their preferred alternative decision-makers: An exploratory pilot study comparing treatment and research decisions.

    PubMed

    Roberts, Laura Weiss; Kim, Jane Paik

    2015-12-01

    Schizophrenia is a serious mental disorder that may affect the decisional capacity, and as a consequence, preferred alternative decision-makers may be engaged to help with clinical care and research-related choices. Ideally, alternative decision-makers will seek to make decisions that fit with the views and preferences of the ill individual. Few data exist, however, comparing the views of alternative decision-makers to those of individuals with schizophrenia. We conducted a written survey with individuals with schizophrenia living in a community setting, and a parallel survey with the person whom the ill individual identified as being a preferred alternative decision-maker. Complete data were obtained on 20 pairs (n = 40, total). Domains queried included (a) burden, happiness, and safety of the ill individual and of his or her family in treatment and research decisions and (b) importance of ethical principles in every day life. Two-sided paired t-tests and graphical summaries were used to compare responses. Individuals with schizophrenia and their linked preferred alternative decision-makers were attuned on four of six aspects of treatment decision-making and on all six aspects of research decision-making that we queried. The preferred alternative decision-makers overall demonstrated attunement to the views of the ill individuals in this small study. Ill individuals and their preferred alternative decision-makers were aligned in their views of ethically-salient aspects of every day life. These novel findings suggest that alternative decision-makers identified by ill individuals may be able to guide choices based on an accurate understanding of the ill individuals' views and values. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Combining communication technology utilization and organizational innovation: evidence from Canadian healthcare decision makers.

    PubMed

    Jbilou, Jalila; Landry, Réjean; Amara, Nabil; El Adlouni, Salaheddine

    2009-08-01

    Information and Communication Technology (ICT) and Organizational Innovation (OI) are seen as the miracle of post-modernity in organizations. In this way, they are supposed to resolve most organizational problems, efficiently and rapidly. OI is highly dependent on the capacity and the investment in knowledge management (internal and external) to support decision making process and to implement significant changes. We know what explains ICT utilization (ICTU) and what determines OI development (OID) in healthcare services. Moreover, the literature tends to link ICTU to OID and vice versa. However, this dependency has never been explored empirically through the lens of roles combination. To identify the existing combined roles profiles of ICTU and OID among healthcare decision makers and determine factors of the shift from a profile to another. We did the following: (1) a structured review of the literature on healthcare management by focusing on ICTU and OID which allowed us to build two indexes and a comprehensive framework; (2) a copula methodology to identify with high precision the thresholds for ICTU and OID; and (3) a cross-sectional study based on a survey done with a sample of 942 decision makers from Canadian healthcare organizations through a multinomial logit model to identify determinants of the shift. ICTU and OID are correlated at 22% (Kendal's Tau). The joint distribution (combination) of ICTU and OID shows that four major profiles exist among decision makers in Canadian healthcare organizations: the traditional decision maker, the innovative decision maker, the technologic decision maker and the contemporary decision maker. We found out that classic factors act as barriers to the shift from one profile to the desired profile (from 1 to 4, from 2 to 4 and from 3 to 4). We have identified that the attitude toward research and relational capital are transversal barriers of shift. We have also found that some factors have a specific impact such as

  1. Using Cognitive Conflict to Promote the Use of Dialectical Learning for Strategic Decision-Makers

    ERIC Educational Resources Information Center

    Woods, Jeffrey G.

    2012-01-01

    Purpose: The purpose of this paper is to develop a conceptual model that uses dialectical inquiry (DI) to create cognitive conflict in strategic decision-makers for the purpose of improving strategic decisions. Activation of the dialectical learning process using DI requires strategic decision-makers to integrate conflicting information causing…

  2. The Roles of Decision Makers in Special Operations

    DTIC Science & Technology

    2016-12-01

    question and hypotheses. 9 II. CASE STUDIES A. OPERATION THUNDERBOLT (THE RAID ON ENTEBBE) The Israeli Special Forces’ hostage rescue operation...Operations Warfare, 338. 28 Herzog, “The War Against Terrorism: Entebbe,” 338. 29 Chaitanya Arun Sathe, “A Case Study on Crisis Management with a...Assessment of the Roles of Decision Makers This assessment is based on this case study , and the decision makers’ roles in the three phases of a

  3. Overcoming Fear: Helping Decision Makers Understand Risk in Outdoor Education

    ERIC Educational Resources Information Center

    Haras, Kathy

    2010-01-01

    The long history of outdoor education does little to alleviate the fears of many parents, teachers, principals and superintendents who believe that outdoor education is too risky. These decision makers often lack both the knowledge to make informed decisions and the time and resources to investigate their assumptions. Pair these circumstances with…

  4. Ethical challenges related to elder care. High level decision-makers' experiences.

    PubMed

    Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke

    2007-04-10

    Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health

  5. Ethical challenges related to elder care. High level decision-makers' experiences

    PubMed Central

    Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke

    2007-01-01

    Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between

  6. Negative Attitudes toward Older Workers and Hiring Decisions: Testing the Moderating Role of Decision Makers' Core Self-Evaluations.

    PubMed

    Fasbender, Ulrike; Wang, Mo

    2016-01-01

    Organizational hiring practices have been charged for unfair treatment on the grounds of age. Drawing on theories of planned behavior and core self-evaluations, this research investigated the impact of negative attitudes toward older workers on hiring decisions and examined the moderating role of decision-makers' core self-evaluations. We tested our hypotheses based on a structured online questionnaire and a vignette study using a sample of 102 participants working in human resource management across different industries. As predicted, negative attitudes toward older workers were positively related to avoidance of hiring older people, which in turn was negatively related to the likelihood to select the oldest candidate. Because hiring decisions are not only about the hiring subject but also about the decision-maker, we tested the moderating role of decision-makers' core self-evaluations. Results showed that core self-evaluations buffered the relationship between negative attitudes toward older workers and avoidance of hiring older people. Theoretical implications of the findings with regard to hiring decisions about older people and practical recommendations to improve diversity management strategies and age-balanced hiring practices in organizations are discussed.

  7. Testing information to improve communication with communities and decision makers.

    DOT National Transportation Integrated Search

    2011-09-01

    This work focuses on important concepts in making information available to decision makers and the : public, specifically focused on the Transportation Industry. The emphasis is on the PowerPoint : presentation and enhancing the message through this ...

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

    PubMed

    Reddy, K Srikanth; Sahay, Seema

    2016-01-01

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

  9. Taking off the white coat: can family members who are physicians be good surrogate decision-makers?

    PubMed

    Issa, Amalia M

    2002-05-01

    The challenges inherent in physicians treating members of their own families are well known. However, the issues related to physicians acting as surrogate decision-makers on behalf of relatives have not been addressed. The growing number of older persons will increase the need not only for healthcare resources, but also for physicians to act on behalf of incapacitated family members as surrogate decision-makers. In this paper, some of the clinical and ethical tensions evoked by physicians serving as surrogate decision-makers for family members are explored. Some recommendations for managing these tensions are suggested.

  10. The current capacity and future development of economic evaluation for policy decision-making: a survey among researchers and decision-makers in Thailand.

    PubMed

    Chaikledkaew, Usa; Lertpitakpong, Chanida; Teerawattananon, Yot; Thavorncharoensap, Montarat; Tangcharoensathien, Viroj

    2009-01-01

    This study aims to explore the knowledge, experience, and attitudes toward economic evaluation (EE) among decision-makers and researchers in Thailand. Researchers were purposively selected from Thai academics and both public and private research organizations related to EE. Decision-makers at the provincial level were purposively selected from the members of the Management Committees of Provincial Health Offices, and those at hospital level were randomly selected from members of the public and private hospital formulary drug committees throughout Thailand. The self-administered postal questionnaires were distributed. Univariate and bivariate analyses were applied. Of the total 2575 questionnaires distributed, 758 (29.4% response rate) were completed and sent back. The majority of researchers and decision-makers were not familiar with technical terms commonly used in health EE, e.g., incremental cost-effectiveness ratio, discounting, and sensitivity analysis. More decision-makers (70.6%) had never had EE training compared to researchers (50.0%). Both roles indicated that value for money was one of the important issues to consider for health technology adoption. An extensive unmet demand for EE training among Thai researchers and decision-makers still exists. Findings from this study contribute to the short- and long-term plans for research capacity building.

  11. Priority setting in the provincial health services authority: survey of key decision makers

    PubMed Central

    Teng, Flora; Mitton, Craig; MacKenzie, Jennifer

    2007-01-01

    Background In recent years, decision makers in Canada and elsewhere have expressed a desire for more explicit, evidence-based approaches to priority setting. To achieve this aim within health care organizations, knowledge of both the organizational context and stakeholder attitudes towards priority setting are required. The current work adds to a limited yet growing body of international literature describing priority setting practices in health organizations. Methods A qualitative study was conducted using in-depth, face-to-face interviews with 25 key decision makers of the Provincial Health Services Authority (PHSA) of British Columbia. Major themes and sub-themes were identified through content analysis. Results Priorities were described by decision makers as being set in an ad hoc manner, with resources generally allocated along historical lines. Participants identified the Strategic Plan and a strong research base as strengths of the organization. The main areas for improvement were a desire to have a more transparent process for priority setting, a need to develop a culture which supports explicit priority setting, and a focus on fairness in decision making. Barriers to an explicit allocation process included the challenge of providing specialized services for disparate patient groups, and a lack of formal training in priority setting amongst decision makers. Conclusion This study identified factors important to understanding organizational context and informed next steps for explicit priority setting for a provincial health authority. While the PHSA is unique in its organizational structure in Canada, lessons about priority setting should be transferable to other contexts. PMID:17565691

  12. Clarity versus complexity: land-use modeling as a practical tool for decision-makers

    USGS Publications Warehouse

    Sohl, Terry L.; Claggett, Peter

    2013-01-01

    The last decade has seen a remarkable increase in the number of modeling tools available to examine future land-use and land-cover (LULC) change. Integrated modeling frameworks, agent-based models, cellular automata approaches, and other modeling techniques have substantially improved the representation of complex LULC systems, with each method using a different strategy to address complexity. However, despite the development of new and better modeling tools, the use of these tools is limited for actual planning, decision-making, or policy-making purposes. LULC modelers have become very adept at creating tools for modeling LULC change, but complicated models and lack of transparency limit their utility for decision-makers. The complicated nature of many LULC models also makes it impractical or even impossible to perform a rigorous analysis of modeling uncertainty. This paper provides a review of land-cover modeling approaches and the issues causes by the complicated nature of models, and provides suggestions to facilitate the increased use of LULC models by decision-makers and other stakeholders. The utility of LULC models themselves can be improved by 1) providing model code and documentation, 2) through the use of scenario frameworks to frame overall uncertainties, 3) improving methods for generalizing key LULC processes most important to stakeholders, and 4) adopting more rigorous standards for validating models and quantifying uncertainty. Communication with decision-makers and other stakeholders can be improved by increasing stakeholder participation in all stages of the modeling process, increasing the transparency of model structure and uncertainties, and developing user-friendly decision-support systems to bridge the link between LULC science and policy. By considering these options, LULC science will be better positioned to support decision-makers and increase real-world application of LULC modeling results.

  13. Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement.

    PubMed

    Garner, Kimberly K; Dubbert, Patricia; Lensing, Shelly; Sullivan, Dennis H

    2017-01-01

    The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. To better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker. Examination of patient responses to self-assessment questions from advance health care planning educational groups conducted in one medical center primary care clinic and seven community-based outpatient primary care clinics. We assessed the concordance between patient reports of identifying and naming a surrogate decision maker and having completed an advance directive (AD) with presence of an AD in the electronic medical record. Of veterans without a documented AD on file, more than half (66%) reported that they had talked with someone they trusted and nearly half (52%) reported that they had named someone to communicate their preferences. Our clinical project data suggest that many more veterans may have initiated communications with surrogate decision makers than is evident in the electronic medical record. System changes are needed to close the gap between veterans' plans for a surrogate decision maker and the documentation available to acute care health care providers. Published by Elsevier Inc.

  14. Attitudes of Educational Decision Makers toward AVTI Governance and the Local Tax Levy. An Independent Paper.

    ERIC Educational Resources Information Center

    LiaBraaten, James Clayton

    A study investigated the attitudes of vocational education decision makers toward the governance of Minnesota's Area Vocational Technical Institutes (AVTIs) and the impact removal of a local tax to support the AVTIs might have on governance. Five categories of individuals, all considered vocational education decision makers, were surveyed: AVTI…

  15. A rough set approach for determining weights of decision makers in group decision making

    PubMed Central

    Yang, Qiang; Du, Ping-an; Wang, Yong; Liang, Bin

    2017-01-01

    This study aims to present a novel approach for determining the weights of decision makers (DMs) based on rough group decision in multiple attribute group decision-making (MAGDM) problems. First, we construct a rough group decision matrix from all DMs’ decision matrixes on the basis of rough set theory. After that, we derive a positive ideal solution (PIS) founded on the average matrix of rough group decision, and negative ideal solutions (NISs) founded on the lower and upper limit matrixes of rough group decision. Then, we obtain the weight of each group member and priority order of alternatives by using relative closeness method, which depends on the distances from each individual group member’ decision to the PIS and NISs. Through comparisons with existing methods and an on-line business manager selection example, the proposed method show that it can provide more insights into the subjectivity and vagueness of DMs’ evaluations and selections. PMID:28234974

  16. A rough set approach for determining weights of decision makers in group decision making.

    PubMed

    Yang, Qiang; Du, Ping-An; Wang, Yong; Liang, Bin

    2017-01-01

    This study aims to present a novel approach for determining the weights of decision makers (DMs) based on rough group decision in multiple attribute group decision-making (MAGDM) problems. First, we construct a rough group decision matrix from all DMs' decision matrixes on the basis of rough set theory. After that, we derive a positive ideal solution (PIS) founded on the average matrix of rough group decision, and negative ideal solutions (NISs) founded on the lower and upper limit matrixes of rough group decision. Then, we obtain the weight of each group member and priority order of alternatives by using relative closeness method, which depends on the distances from each individual group member' decision to the PIS and NISs. Through comparisons with existing methods and an on-line business manager selection example, the proposed method show that it can provide more insights into the subjectivity and vagueness of DMs' evaluations and selections.

  17. Rationality versus reality: the challenges of evidence-based decision making for health policy makers

    PubMed Central

    2010-01-01

    Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the

  18. Rationality versus reality: the challenges of evidence-based decision making for health policy makers.

    PubMed

    McCaughey, Deirdre; Bruning, Nealia S

    2010-05-26

    Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the EBDM/EBPM process can be

  19. Eco-informatics for decision makers advancing a research agenda

    USGS Publications Warehouse

    Cushing, J.B.; Wilson, T.; Brandt, L.; Gregg, V.; Spengler, S.; Borning, A.; Delcambre, L.; Bowker, G.; Frame, M.; Fulop, J.; Hert, C.; Hovy, E.; Jones, J.; Landis, E.; Schnase, J.L.; Schweik, C.; Sonntag, W.; ,

    2005-01-01

    Resource managers often face significant information technology (IT) problems when integrating ecological or environmental information to make decisions. At a workshop sponsored by the NSF and USGS in December 2004, university researchers, natural resource managers, and information managers met to articulate IT problems facing ecology and environmental decision makers. Decision making IT problems were identified in five areas: 1) policy, 2) data presentation, 3) data gaps, 4) tools, and 5) indicators. To alleviate those problems, workshop participants recommended specific informatics research in modeling and simulation, data quality, information integration and ontologies, and social and human aspects. This paper reports the workshop findings, and briefly compares these with research that traditionally falls under the emerging eco-informatics rubric. ?? Springer-Verlag Berlin Heidelberg 2005.

  20. The Ultimate Sampling Dilemma in Experience-Based Decision Making

    ERIC Educational Resources Information Center

    Fiedler, Klaus

    2008-01-01

    Computer simulations and 2 experiments demonstrate the ultimate sampling dilemma, which constitutes a serious obstacle to inductive inferences in a probabilistic world. Participants were asked to take the role of a manager who is to make purchasing decisions based on positive versus negative feedback about 3 providers in 2 different product…

  1. Decision makers' experiences of prioritisation and views about how to finance healthcare costs.

    PubMed

    Werntoft, Elisabet; Edberg, Anna-Karin

    2009-10-01

    Prioritisation in healthcare is an issue of growing importance due to scarcity of resources. The aims of this study were firstly to describe decision makers' experience of prioritisation and their views concerning willingness to pay and how to finance healthcare costs. An additional aim was to compare the views of politicians and physicians. The study was a cross-sectional study based on a questionnaire administered to 700 Swedish politicians and physicians. This was analysed using both quantitative and qualitative methods. A majority of the decision makers (55%) suggested that increasing costs should be financed through higher taxation but more physicians than politicians thought that higher patient fees, private health insurance and a reduction in social expenditure were better alternatives. Prioritisation aroused anxiety; politicians were afraid of displeasing voters while physicians were afraid of making medically incorrect decisions. This study do not answer the question about how to make prioritisation in health care but the result highlights the different ways that the decision makers view the subject and thereby elicit that publicly elected politicians and physicians perhaps not always work with the same goal ahead. There are needs for more research but also more media focus on the subject so the citizens will be aware and take part in the debate.

  2. Issues in Distance Education: A Primer for Higher Education Decision Makers

    ERIC Educational Resources Information Center

    Beaudoin, Michael

    2016-01-01

    This chapter presents an overview of current issues related to distance learning in higher education. It identifies central questions, issues, challenges, and opportunities that must be addressed by decision makers, as well as key attributes of effective leaders.

  3. 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.

  4. Economic assessment of flood forecasts for a risk-averse decision-maker

    NASA Astrophysics Data System (ADS)

    Matte, Simon; Boucher, Marie-Amélie; Boucher, Vincent; Fortier-Filion, Thomas-Charles

    2017-04-01

    A large effort has been made over the past 10 years to promote the operational use of probabilistic or ensemble streamflow forecasts. It has also been suggested in past studies that ensemble forecasts might possess a greater economic value than deterministic forecasts. However, the vast majority of recent hydro-economic literature is based on the cost-loss ratio framework, which might be appealing for its simplicity and intuitiveness. One important drawback of the cost-loss ratio is that it implicitly assumes a risk-neutral decision maker. By definition, a risk-neutral individual is indifferent to forecasts' sharpness: as long as forecasts agree with observations on average, the risk-neutral individual is satisfied. A risk-averse individual, however, is sensitive to the level of precision (sharpness) of forecasts. This person is willing to pay to increase his or her certainty about future events. In fact, this is how insurance companies operate: the probability of seeing one's house burn down is relatively low, so the expected cost related to such event is also low. However, people are willing to buy insurance to avoid the risk, however small, of loosing everything. Similarly, in a context where people's safety and property is at stake, the typical decision maker is more risk-averse than risk-neutral. Consequently, the cost-loss ratio is not the most appropriate tool to assess the economic value of flood forecasts. This presentation describes a more realistic framework for assessing the economic value of such forecasts for flood mitigation purposes. Borrowing from economics, the Constant Absolute Risk Aversion utility function (CARA) is the central tool of this new framework. Utility functions allow explicitly accounting for the level of risk aversion of the decision maker and fully exploiting the information related to ensemble forecasts' uncertainty. Three concurrent ensemble streamflow forecasting systems are compared in terms of quality (comparison with

  5. Effective Decision Maker-Scientist Engagement:Climate Change Vulnerability Analysis of California's Water System to Using Decision Scaling.

    NASA Astrophysics Data System (ADS)

    Schwarz, A. M.; Ray, P.; Brown, C.; Wi, S.

    2016-12-01

    For nearly 2 years the California Department of Water Resources (CDWR) has been working with the University of Massachusetts Amherst (UMass) to evaluate climate change vulnerabilities to the California State Water Project. Working cooperatively, the team has developed tools and methods to employ a decision scaling approach to CDWR's existing water system model (CalSim-II/CalLite 3.0). This presentation will discuss how and why this partnership came to be, the co-production model the team has developed to share expertise, the new understanding of the system that has been gained through the process, and current and future efforts to influence planning and investments based on the findings of the work. This cooperative decision-maker-with-scientist engagement is unique in that CDWR has not outsourced the application of the science to their systems, and instead has worked directly with UMass researchers to develop the process, produce results, and interpret findings. Further, CDWR staff has worked with UMass researchers to present results in ways that are more useable and actionable for decision-makers. As will be shown, many of these graphics allow the team to use the science differently to improve decision making.

  6. Characteristics of community health organizations and decision-makers considering the adoption of motivational interviewing.

    PubMed

    Williams, Jessica Roberts; Dusablon, Tracy; Williams, Weston O; Blais, Marissa Puckett; Hennessy, Kevin D

    2014-07-01

    Research related to the adoption of comparative effectiveness research (CER) in mental health practice is limited. This study explores the factors that influence decisions to adopt motivational interviewing (MI)-an evidence-based practice (EBP) grounded in CER-among decision-makers (n = 311) in community health organizations (n = 92). Descriptive analyses focus on organization and decision-maker characteristics and processes that may influence the decision to adopt an EBP, including demographics, structure and operations, readiness, attitudes, barriers, and facilitators. Within-group agreement is examined to determine the degree to which participants within each organization gave similar responses. Results show characteristics differed according to type of organization (community health versus community behavioral health) and position (directors versus staff). Within-group agreement was also influenced by position. These findings indicate different strategies may be needed to best disseminate CER to the two groups.

  7. Increasing the scale and adoption of population health interventions: experiences and perspectives of policy makers, practitioners, and researchers

    PubMed Central

    2014-01-01

    Background Decisions to scale up population health interventions from small projects to wider state or national implementation is fundamental to maximising population-wide health improvements. The objectives of this study were to examine: i) how decisions to scale up interventions are currently made in practice; ii) the role that evidence plays in informing decisions to scale up interventions; and iii) the role policy makers, practitioners, and researchers play in this process. Methods Interviews with an expert panel of senior Australian and international public health policy-makers (n = 7), practitioners (n = 7), and researchers (n = 7) were conducted in May 2013 with a participation rate of 84%. Results Scaling up decisions were generally made through iterative processes and led by policy makers and/or practitioners, but ultimately approved by political leaders and/or senior executives of funding agencies. Research evidence formed a component of the overall set of information used in decision-making, but its contribution was limited by the paucity of relevant intervention effectiveness research, and data on costs and cost effectiveness. Policy makers, practitioners/service managers, and researchers had different, but complementary roles to play in the process of scaling up interventions. Conclusions This analysis articulates the processes of how decisions to scale up interventions are made, the roles of evidence, and contribution of different professional groups. More intervention research that includes data on the effectiveness, reach, and costs of operating at scale and key service delivery issues (including acceptability and fit of interventions and delivery models) should be sought as this has the potential to substantially advance the relevance and ultimately usability of research evidence for scaling up population health action. PMID:24735455

  8. Making Invasion models useful for decision makers; incorporating uncertainty, knowledge gaps, and decision-making preferences

    Treesearch

    Denys Yemshanov; Frank H Koch; Mark Ducey

    2015-01-01

    Uncertainty is inherent in model-based forecasts of ecological invasions. In this chapter, we explore how the perceptions of that uncertainty can be incorporated into the pest risk assessment process. Uncertainty changes a decision maker’s perceptions of risk; therefore, the direct incorporation of uncertainty may provide a more appropriate depiction of risk. Our...

  9. Is economic valuation of ecosystem services useful to decision-makers? Lessons learned from Australian coastal and marine management.

    PubMed

    Marre, Jean-Baptiste; Thébaud, Olivier; Pascoe, Sean; Jennings, Sarah; Boncoeur, Jean; Coglan, Louisa

    2016-08-01

    Economic valuation of ecosystem services is widely advocated as being useful to support ecosystem management decision-making. However, the extent to which it is actually used or considered useful in decision-making is poorly documented. This literature blindspot is explored with an application to coastal and marine ecosystems management in Australia. Based on a nation-wide survey of eighty-eight decision-makers representing a diversity of management organizations, the perceived usefulness and level of use of economic valuation of ecosystem services, in support of coastal and marine management, are examined. A large majority of decision-makers are found to be familiar with economic valuation and consider it useful - even necessary - in decision-making, although this varies across groups of decision-makers. However, most decision-makers never or rarely use economic valuation. The perceived level of importance and trust in estimated dollar values differ across ecosystem services, and are especially high for values that relate to commercial activities. A number of factors are also found to influence respondent's use of economic valuation. Such findings concur with conclusions from other studies on the usefulness and use of ESV in environmental management decision-making. They also demonstrate the strength of the survey-based approach developed in this application to examine this issue in a variety of contexts. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Surrogate End-of-Life Care Decision Makers' Postbereavement Grief and Guilt Responses.

    PubMed

    Lovell, Geoff P; Smith, Trish; Kannis-Dymand, Lee

    2015-01-01

    This article examined differences in familial/friend surrogate decision makers' (N = 93) postbereavement grief and guilt associated with decisions to either prioritize comfort or longevity in determining end-of-life care for decisionally incapacitated adult palliative loved ones. Results demonstrated that participants prioritizing the longevity of loved ones experienced significantly and meaningfully higher levels of grief, complicated grief, and trauma related guilt than those who prioritized comfort.

  11. Students as Rational Decision-Makers: The Question of Beliefs and Attitudes

    ERIC Educational Resources Information Center

    Sullivan, Alice

    2006-01-01

    Rational choice theorists have analysed rates of participation in post-compulsory education, and, in particular, class differentials in these rates. Various claims have been made about the motivations of student decision-makers, but these claims have not been grounded empirically. This paper will assess the question of whether students' attitudes…

  12. Comparative analysis of decision maker preferences for equity/efficiency attributes in reimbursement decisions in three European countries.

    PubMed

    Baji, Petra; García-Goñi, Manuel; Gulácsi, László; Mentzakis, Emmanouil; Paolucci, Francesco

    2016-09-01

    In addition to cost-effectiveness, national guidelines often include other factors in reimbursement decisions. However, weights attached to these are rarely quantified, thus decisions can depend strongly on decision-maker preferences. To explore the preferences of policymakers and healthcare professionals involved in the decision-making process for different efficiency and equity attributes of interventions and to analyse cross-country differences. Discrete choice experiments (DCEs) were carried out in Austria, Hungary, and Norway with policymakers and other professionals working in the health industry (N = 153 respondents). Interventions were described in terms of different efficiency and equity attributes (severity of disease, target age of the population and willingness to subsidise others, potential number of beneficiaries, individual health benefit, and cost-effectiveness). Parameter estimates from the DCE were used to calculate the probability of choosing a healthcare intervention with different characteristics, and to rank different equity and efficiency attributes according to their importance. In all three countries, cost-effectiveness, individual health benefit and severity of the disease were significant and equally important determinants of decisions. All countries show preferences for interventions targeting young and middle aged populations compared to those targeting populations over 60. However, decision-makers in Austria and Hungary show preferences more oriented to efficiency than equity, while those in Norway show equal preferences for equity and efficiency attributes. We find that factors other than cost-effectiveness seem to play an equally important role in decision-making. We also find evidence of cross-country differences in the weight of efficiency and equity attributes.

  13. Risk manager formula for success: Influencing decision making.

    PubMed

    Midgley, Mike

    2017-10-01

    Providing the ultimate decision makers with a quantitative risk analysis based on thoughtful assessment by the organization's experts enables an efficient decision. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  14. Disease management in healthcare organizations: results of in-depth interviews with disease management decision makers.

    PubMed

    Whellan, David J; Cohen, Elizabeth J; Matchar, David B; Califf, Robert M

    2002-07-01

    Despite the widening use of disease management (DM) programs throughout the country, little is understood about the "state of DM" in healthcare systems and managed care organizations. To better characterize the range of users of DM in healthcare and to identify critical issues, both present and future, for DM. Qualitative survey. Forty-seven healthcare systems (n = 22) and managed care organizations (n = 25) were randomly selected. Decision makers were identified and interviewed between January 1, 2000, and March 31, 2000. We limited quantitative analysis to tabulations of suitable responses, without statistical testing. Responses were organized around 3 themes: models for DM, implementation strategies, and measurements of success. Of 47 decision makers surveyed, 42 (89%) reported that their organizations currently have (75%) or are working to develop (14%) DM programs. Although the goals of DM programs were similar, organizations took a variety of approaches to achieving these ends. There were typically 3 steps in implementing a DM program: analysis of patient data, external analysis, and organizational analysis. Decision makers believed that DM programs had only achieved partial success in reaching the 2 main goals of improved quality of care and cost savings. Given the variety of DM programs, there is a need to develop a classification scheme to allow for better comparison between programs. Further quantitative studies of decision makers' opinions would be helpful in developing programs and in designing necessary studies of patient management strategies.

  15. Public health privatization: proponents, registers, and decision-makers.

    PubMed

    Keane, Christopher; Marx, John; Ricci, Edmund

    2002-01-01

    We previously documented the extent and consequences of the privatization of public health, using a nationally representative sample of 347 Local Health Department (LHD) directors. Here we present the directors' descriptions of the actors involved in the privatization of services. LHD top administrators are the most influential privatization decision-makers in about half of LHDs. But other groups significantly influence privatization decisions, particularly state governments, state health departments, and local officials. Nearly two thirds of LHDs experienced pressures to privatize, either from state legislatures, state health departments, funding organizations, or other source of political pressure. Almost half of LHD directors reported resistance to privatization, often from employees. The majority of directors did not believe it was desirable to put employees on a temporary, contractual basis. Many directors believed that retaining permanent, full-time employees was fairer as well as necessary to maintain a cadre of experienced public health professionals.

  16. E-mail as the Appropriate Method of Communication for the Decision-Maker When Soliciting Advice for an Intellective Decision Task.

    PubMed

    Prahl, Andrew; Dexter, Franklin; Swol, Lyn Van; Braun, Michael T; Epstein, Richard H

    2015-09-01

    For many problems in operating room and anesthesia group management, there are tasks with optimal decisions, and yet experienced personnel tend to make decisions that are worse or no better than random chance. Such decisions include staff scheduling, case scheduling, moving cases among operating rooms, and choosing patient arrival times. In such settings, operating room management leadership decision-making should typically be autocratic rather than participative. Autocratic-style decision-making calls for managers to solicit and consider feedback from stakeholders in the decision outcome but to make the decision themselves using their expert knowledge and the facts received. For this to be effective, often the manager will obtain expert advice from outside the organization (e.g., health system). In this narrative review, we evaluate the advantages and disadvantages of using prompt asynchronous written communication (i.e., e-mail) as a communication channel for such interaction between a decision-maker (manager) and advisor. A detailed Appendix (Supplemental Digital Content, http://links.lww.com/AA/B72) lists each observational and experimental result. We find that the current ubiquitous role of e-mail for such communication is appropriate. Its benefits include improved time management via asynchronicity, low cognitive load (e.g., relative to Web conferencing), the ability to hide undesirable and irrelevant cues (e.g., physical appearance), the appropriateness of adding desirable cues (e.g., titles and degrees), the opportunity to provide written expression of confidence, and the ability for the advisor to demonstrate the answer for the decision-maker. Given that the manager is e-mailing an advisor whose competence the manager trusts, it is unnecessary to use a richer communication channel to develop trust. Finally, many of the limitations of e-mail can be rectified through training. We expect that decades from now, e-mail (i.e., asynchronous writing) between an

  17. Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers

    ERIC Educational Resources Information Center

    Macdonald, Marilyn; Lang, Ariella; MacDonald, Jo-Anne

    2011-01-01

    The purpose of this qualitative interpretive design was to explore the perspectives of researchers, health care providers, policy makers, and decision makers on key risks, concerns, and emerging issues related to home care safety that would inform a line of research inquiry. Defining safety specifically in this home care context has yet to be…

  18. An Approach for Web Service Selection Based on Confidence Level of Decision Maker

    PubMed Central

    Khezrian, Mojtaba; Jahan, Ali; Wan Kadir, Wan Mohd Nasir; Ibrahim, Suhaimi

    2014-01-01

    Web services today are among the most widely used groups for Service Oriented Architecture (SOA). Service selection is one of the most significant current discussions in SOA, which evaluates discovered services and chooses the best candidate from them. Although a majority of service selection techniques apply Quality of Service (QoS), the behaviour of QoS-based service selection leads to service selection problems in Multi-Criteria Decision Making (MCDM). In the existing works, the confidence level of decision makers is neglected and does not consider their expertise in assessing Web services. In this paper, we employ the VIKOR (VIšekriterijumskoKOmpromisnoRangiranje) method, which is absent in the literature for service selection, but is well-known in other research. We propose a QoS-based approach that deals with service selection by applying VIKOR with improvement of features. This research determines the weights of criteria based on user preference and accounts for the confidence level of decision makers. The proposed approach is illustrated by an example in order to demonstrate and validate the model. The results of this research may facilitate service consumers to attain a more efficient decision when selecting the appropriate service. PMID:24897426

  19. Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

    PubMed

    Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.

  20. Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review

    PubMed Central

    2011-01-01

    Background The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Results Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. Conclusions A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes

  1. An analytical framework to assist decision makers in the use of forest ecosystem model predictions

    USGS Publications Warehouse

    Larocque, Guy R.; Bhatti, Jagtar S.; Ascough, J.C.; Liu, J.; Luckai, N.; Mailly, D.; Archambault, L.; Gordon, Andrew M.

    2011-01-01

    The predictions from most forest ecosystem models originate from deterministic simulations. However, few evaluation exercises for model outputs are performed by either model developers or users. This issue has important consequences for decision makers using these models to develop natural resource management policies, as they cannot evaluate the extent to which predictions stemming from the simulation of alternative management scenarios may result in significant environmental or economic differences. Various numerical methods, such as sensitivity/uncertainty analyses, or bootstrap methods, may be used to evaluate models and the errors associated with their outputs. However, the application of each of these methods carries unique challenges which decision makers do not necessarily understand; guidance is required when interpreting the output generated from each model. This paper proposes a decision flow chart in the form of an analytical framework to help decision makers apply, in an orderly fashion, different steps involved in examining the model outputs. The analytical framework is discussed with regard to the definition of problems and objectives and includes the following topics: model selection, identification of alternatives, modelling tasks and selecting alternatives for developing policy or implementing management scenarios. Its application is illustrated using an on-going exercise in developing silvicultural guidelines for a forest management enterprise in Ontario, Canada.

  2. Surface transportation weather decision support requirements : user needs and appendices : advanced-integrated decision support using weather information for surface transportation decision makers

    DOT National Transportation Integrated Search

    2000-01-24

    The Federal Highway Administration (FHWA) of the U.S. Department of Transportation (USDOT) : has a responsibility to coordinate and promote projects that will bring the best information on weather to decision makers, in order to improve performance o...

  3. How is the New Public Management applied in the occupational health care system? - decision-makers' and OH personnel's views in Finland

    PubMed Central

    2011-01-01

    Background In many countries occupational health care system is in change. Occupational health studies are mainly focused on occupational health substance and content. This study offers new perspectives on municipal OHS and its operations from management perspective. Aim The aim of this study is to analyse how New Public Management (NPM) doctrines are applied in the Finnish occupational health care system (OHS). The main focus is to describe and compare the views of decision-makers' and OH workers within the framework of NPM. Methods The data were collected by semi-structured interviews from 17 municipal decision-makers' and 26 municipal OH workers. Data was analyzed by examining coded data in a theory-driven way according to Hood's doctrine of NPM. Results The doctrines were not as compatible with the OH personnel view as with the decision-makers' view. Decision-makers and OH personnel highlighted the strict criteria required for operation evaluation. Moreover, decision-makers strongly accentuated professional management in the public sector and the reorganization of public sector units. These were not equally relevant in OH personnel views. In OH personnel views, other doctrines (more attention to performance and accomplishments, emphasizing and augmentation of the competition and better control of public expense and means test) were not similarly in evidence, only weak evidence was observed when their importance viewed as medium by decision-makers. Neither of the respondents group kept the doctrine of management models of the private sector relevant. Conclusions The NPM and Hoods doctrine fitted well with OH research. The doctrine brought out view differences and similarities between decision-makers and OH personnel. For example, policymakers highlighted more strongly the structural change by emphasizing professional management compared to OH personnel. The need for reorganization of municipal OH, regardless of different operational preconditions, was obvious

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

    PubMed

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

    2014-01-01

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

  5. Reported Influence of Evaluation Data on Decision Makers' Actions: An Empirical Examination

    ERIC Educational Resources Information Center

    Christie, Christina A.

    2007-01-01

    Using a set of scenarios derived from actual evaluation studies, this simulation study examines the reported influence of evaluation information on decision makers' potential actions. Each scenario described a context where one of three types of evaluation information (large-scale study data, case study data, or anecdotal accounts) is presented…

  6. Healthy School Meals...Healthy Kids! A Leadership Guide for School Decision-Makers.

    ERIC Educational Resources Information Center

    Food and Consumer Service (USDA), Washington, DC.

    The School Meals Initiative for Healthy Children was launched in June 1994 to improve the health and education of children through better nutrition. This leadership guide provides information to school decision-makers on using materials and resources developed by the U.S. Department of Agriculture and describes Team Nutrition, an implementation…

  7. PUMP-AND-TREAT GROUND-WATER REMEDIATION: A GUIDE FOR DECISION MAKERS AND PRACTITIONERS

    EPA Science Inventory

    This guide presents decision makers with a foundation for evaluating the appropriateness of conventional or innovative approaches. An introduction to pump-and-treat ground-water remediation, the guide addresses the following questions: When is pump-and-treat an appropriate remedi...

  8. Science in Society: Bridging the gap to connect science to decision makers

    NASA Astrophysics Data System (ADS)

    Jones, L.; Bwarie, J.; Pearce, I.

    2016-12-01

    The gap between science and decision making in our society can be large and multi-faceted, involving communication, process, cultural and even subconscious differences. In sweeping generalization, scientists reject anecdotes, focus on uncertainty and details, and expect conflict as part of the scientific process, while non-scientists respond to stories, want certainty and the big picture, and see conflict as a reason to reject the message. Bridging this gap often requires ongoing collaboration to find the intersection of three independent domains: what science can provide, the technical information decision makers need to make the most effective choices and what information decision makers need to motivate action. For ten years, the USGS has experimented with improving the usefulness of its science through the SAFRR (Science Application for Risk Reduction) Project and its predecessor, the Multi Hazards Demonstration Project in Southern California. Through leading and participating in these activities, we have recognized 3 steps that have been essential to successful partnerships between scientists and decision makers. First, determining what makes for a successful product cannot be done in isolation by either scientists or users. The users may want something science cannot produce (e.g., accurate short-term earthquake predictions), while the scientists can fail to see that the product they know how to make may not be relevant to the decisions that need to be made. Real discussions with real exchange and absorption of information on both sides makes for the most useful products. Second, most scientific results need work beyond what belongs in a journal to create a product that can be used. This is not just a different style of communication, but analyses that focus on the community's local questions rather than on scientific advances. Third, probabilities of natural hazards almost never motivate action to mitigate. The probabilities are usually low on human time

  9. Doubt and belief in physicians' ability to prognosticate during critical illness: The perspective of surrogate decision makers

    PubMed Central

    Zier, Lucas S.; Burack, Jeffrey H.; Micco, Guy; Chipman, Anne K.; Frank, James A.; Luce, John M.; White, Douglas B.

    2009-01-01

    Objectives: Although discussing a prognosis is a duty of physicians caring for critically ill patients, little is known about surrogate decision-makers' beliefs about physicians' ability to prognosticate. We sought to determine: 1) surrogates' beliefs about whether physicians can accurately prognosticate for critically ill patients; and 2) how individuals use prognostic information in their role as surrogate decision-makers. Design, Setting, and Patients: Multicenter study in intensive care units of a public hospital, a tertiary care hospital, and a veterans' hospital. We conducted semistructured interviews with 50 surrogate decision-makers of critically ill patients. We analyzed the interview transcripts using grounded theory methods to inductively develop a framework to describe surrogates' beliefs about physicians' ability to prognosticate. Validation methods included triangulation by multidisciplinary analysis and member checking. Measurements and Main Results: Overall, 88% (44 of 50) of surrogates expressed doubt about physicians' ability to prognosticate for critically ill patients. Four distinct themes emerged that explained surrogates' doubts about prognostic accuracy: a belief that God could alter the course of the illness, a belief that predicting the future is inherently uncertain, prior experiences where physicians' prognostications were inaccurate, and experiences with prognostication during the patient's intensive care unit stay. Participants also identified several factors that led to belief in physicians' prognostications, such as receiving similar prognostic estimates from multiple physicians and prior experiences with accurate prognostication. Surrogates' doubts about prognostic accuracy did not prevent them from wanting prognostic information. Instead, most surrogate decision-makers view physicians' prognostications as rough estimates that are valuable in informing decisions, but are not determinative. Surrogates identified the act of prognostic

  10. Climate Modeling and Analysis with Decision Makers in Mind

    NASA Astrophysics Data System (ADS)

    Jones, A. D.; Jagannathan, K.; Calvin, K. V.; Lamarque, J. F.; Ullrich, P. A.

    2016-12-01

    There is a growing need for information about future climate conditions to support adaptation planning across a wide range of sectors and stakeholder communities. However, our principal tools for understanding future climate - global Earth system models - were not developed with these user needs in mind, nor have we developed transparent methods for evaluating and communicating the credibility of various climate information products with respect to the climate characteristics that matter most to decision-makers. Several recent community engagements have identified a need for "co-production" of knowledge among stakeholders and scientists. Here we highlight some of the barriers to communication and collaboration that must be overcome to improve the dialogue among researchers and climate adaptation practitioners in a meaningful way. Solutions to this challenge are two-fold: 1) new institutional arrangements and collaborative mechanisms designed to improve coordination and understanding among communities, and 2) a research agenda that explicitly incorporates stakeholder needs into model evaluation, development, and experimental design. We contrast the information content in global-scale model evaluation exercises with that required for in specific decision contexts, such as long-term agricultural management decisions. Finally, we present a vision for advancing the science of model evaluation in the context of predicting decision-relevant hydroclimate regime shifts in North America.

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

    USGS Publications Warehouse

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

    2015-01-01

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

  12. The Ecological Model Web Concept: A Consultative Infrastructure for Decision Makers and Researchers

    NASA Astrophysics Data System (ADS)

    Geller, G.; Nativi, S.

    2011-12-01

    Rapid climate and socioeconomic changes may be outrunning society's ability to understand, predict, and respond to change effectively. Decision makers want better information about what these changes will be and how various resources will be affected, while researchers want better understanding of the components and processes of ecological systems, how they interact, and how they respond to change. Although there are many excellent models in ecology and related disciplines, there is only limited coordination among them, and accessible, openly shared models or model systems that can be consulted to gain insight on important ecological questions or assist with decision-making are rare. A "consultative infrastructure" that increased access to and sharing of models and model outputs would benefit decision makers, researchers, as well as modelers. Of course, envisioning such an ambitious system is much easier than building it, but several complementary approaches exist that could contribute. The one discussed here is called the Model Web. This is a concept for an open-ended system of interoperable computer models and databases based on making models and their outputs available as services ("model as a service"). Initially, it might consist of a core of several models from which it could grow gradually as new models or databases were added. However, a model web would not be a monolithic, rigidly planned and built system--instead, like the World Wide Web, it would grow largely organically, with limited central control, within a framework of broad goals and data exchange standards. One difference from the WWW is that a model web is much harder to create, and has more pitfalls, and thus is a long term vision. However, technology, science, observations, and models have advanced enough so that parts of an ecological model web can be built and utilized now, forming a framework for gradual growth as well as a broadly accessible infrastructure. Ultimately, the value of a model

  13. Ecological rationality: a framework for understanding and aiding the aging decision maker.

    PubMed

    Mata, Rui; Pachur, Thorsten; von Helversen, Bettina; Hertwig, Ralph; Rieskamp, Jörg; Schooler, Lael

    2012-01-01

    The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people's decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into reduced decision quality. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision environment in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker.

  14. Parents and end-of-life decision-making for their child: roles and responsibilities.

    PubMed

    Sullivan, Jane; Gillam, Lynn; Monagle, Paul

    2015-09-01

    Whether parents want to be and should be the decision-maker for their child in end-of-life matters are contested clinical and ethical questions. Previous research outcomes are equivocal. A qualitative interview method was used to examine the views and experiences of 25 bereaved parents in end-of-life decision-making for their child. Data were analysed thematically. Three types of decision-making roles were identified: self-determined, guided (both involving active decision-making) and acquiescent (passive).The majority of parents had been active in the decision-making process for their child. They perceived themselves as the ultimate end-of-life decision-maker. This was perceived as part of their parental responsibility. A minority of parents did not consider that they had been an active, ultimate decision-maker. Generally, parents in the self-determined and guided groups reported no negative consequences from their decision-making involvement. Importantly, parents in the acquiescent group described their experience as difficult at the time and subsequently, although not all difficulties related directly to decision-making. Parents considered that in principle parents should be the end-of-life decision-maker for their child, but understood personal characteristics and preference could prevent some parents from taking this role. This study unequivocally supports parents' desire to fulfil the end-of-life decision-making role. It provides a nuanced understanding of parents' roles and contributes evidence for the ethical position that parents should be the end-of-life decision-makers for their child, unless not in the child's best interests. On the whole, parents want this role and can manage its consequences. Indeed, not being the end-of-life decision-maker could be detrimental to parents' well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Establishing the connection between crowd-sourced data and decision makers

    NASA Astrophysics Data System (ADS)

    Paxton, L. J.; Swartz, W.; Strong, S. B.; Nix, M. G.; Schaefer, R. K.; Weiss, M.

    2014-12-01

    There are many challenges in using, developing, and ensuring the viability of crowd-sourced data. Establishing and maintaining relevance is one of them but each participant in the challenge has different criteria for relevance. Consider, for example, the collection of data using smart phones. Some participants just like to contribute to something they consider good for the community. How do you engender that commitment? This becomes especially problematic when an additional sensor may need to be added to the smart phone. Certainly the humanitarian-egalitarian may be willing to "buy-in" but what value does it hold for the entrepreneurial-individualist? Another challenge is that of the crowd-sourced data themselves. Most readily available apps collect only one kind of data. The frontier lies in not only aggregating the data from those devices but in fusing the data with other data types (e.g. satellite imagery, installed sensors, radars, etc.). Doing this requires resources and the establishment and negotiation of data rights, how data are valued, how data are used, and the model used for support of the process (e.g. profit-driven, communal, scientific, etc.). In this talk we will discuss a few problems that we have looked at wherein distributed sensor networks provide potential value, data fusion is a "value multiplier" of those crowd-sourced data and how we make that connection to decision makers. We have explored active decision making through our Global Assimilation of Information for Action project (see our old website http://gaia.jhuapl.edu) and the use of "serious games" to establish affinities and illuminate opportunities and issues. We assert that the field of dreams approach ("build it and they will come") is not a sufficiently robust approach; the decision-makers (or paying customers) must be involved in the process of defining the data system products and quantifying the value proposition for their clients.

  16. Communication with U.S. federal decision makers : a primer with notes on the use of computer models as a means of communication.

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

    Webb, Erik Karl; Tidwell, Vincent Carroll

    2009-10-01

    This document outlines ways to more effectively communicate with U.S. Federal decision makers by outlining the structure, authority, and motivations of various Federal groups, how to find the trusted advisors, and how to structure communication. All three branches of Federal governments have decision makers engaged in resolving major policy issues. The Legislative Branch (Congress) negotiates the authority and the resources that can be used by the Executive Branch. The Executive Branch has some latitude in implementation and prioritizing resources. The Judicial Branch resolves disputes. The goal of all decision makers is to choose and implement the option that best fitsmore » the needs and wants of the community. However, understanding the risk of technical, political and/or financial infeasibility and possible unintended consequences is extremely difficult. Primarily, decision makers are supported in their deliberations by trusted advisors who engage in the analysis of options as well as the day-to-day tasks associated with multi-party negotiations. In the best case, the trusted advisors use many sources of information to inform the process including the opinion of experts and if possible predictive analysis from which they can evaluate the projected consequences of their decisions. The paper covers the following: (1) Understanding Executive and Legislative decision makers - What can these decision makers do? (2) Finding the target audience - Who are the internal and external trusted advisors? (3) Packaging the message - How do we parse and integrate information, and how do we use computer simulation or models in policy communication?« less

  17. The threat of funding cuts for graduate medical education: survey of decision makers.

    PubMed

    Kozak, R J; Kazzi, A A; Langdorf, M I; Martinez, C T

    1997-07-01

    To assess the potential actions of medical school deans, graduate medical education (GME) committee chairs, and hospital chief executive officers (CEOs) regarding future funding reductions for residency training. Specifically, institutions with emergency medicine (EM) residencies were surveyed to see whether EM training was disproportionally at risk for reductions. An anonymous 2-page survey was used. Ninety-eight EM residency programs were identified using the American Medical Association Graduate Medical Education Directory 1994-95. Seventy deans, 102 GME chairs, and 97 hospital CEOs were identified. The survey posed a hypothetical 25% forced reduction in residency positions and asked the decision makers for their responses. Options included: 1) proportional reductions of training positions from all residencies, 2) proportional reductions in either primary care or specialty residency positions, or 3) reduction or elimination of specific training programs. The survey asked for a first and second choice of residencies to be reduced or eliminated from an alphabetical list of 17. The survey elicited explanations for each program reduction. 200 (74%) of 269 surveys were returned. Eighty-four responders selected specific residencies to be reduced or eliminated. EM was selected 8 times, making EM the seventh most vulnerable residency to be targeted for reductions. The decision makers who selected proportional reductions chose to reduce across all residencies 32 times, among only the specialty residencies 129 times, and among only the primary care residencies 3 times. In the setting of anticipated residency cuts, favored proportional reductions in specialty residencies would likely affect EM training. However, most GME decision makers with an existing EM residency program do not consider the EM residency a top choice to be reduced or eliminated.

  18. What contributes to a technical purchasing decision maker's reliance on brand name for design decisions involving I&T products

    NASA Astrophysics Data System (ADS)

    Coutoumanos, Vincent

    The following research is intended to develop more formal mechanisms for collection, analysis, retention and dissemination of information relating to brand influence on high-technology products. Specifically, these high-technology products are associated with the engineering applications that likely would involve the loss of human life in the advent of catastrophic failure. The results of the study lead to an extension of theory involving marketing and product selection of "highly engineered" parts within the aerospace industry. The findings were separated into three distinct areas: 1) Information load will play a large role in the final design decision. If the designer is under a high level of information load during the time of a design decision, he or she likely will gravitate to the traditional design choice, regardless of the level of brand strength. 2) Even when strong brand names, like 3M, were offered as the non-traditional design choice, engineers gravitated to the traditional design choice that was presented in a mock Society for Manufacturing Engineers article. 3) Designer self-efficacy by itself will not often contribute to a decision maker's design choice. However, these data collected indicates that a combination of high designer self-efficacy moderated by high brand strength is likely to contribute significantly to a decision maker's decision. The post-hoc finding shows that many designers having high levels of self-efficacy could be developing a sense of comfort with strong brand names (like 3M) when making a design choice.

  19. Ecological Rationality: A Framework for Understanding and Aiding the Aging Decision Maker

    PubMed Central

    Mata, Rui; Pachur, Thorsten; von Helversen, Bettina; Hertwig, Ralph; Rieskamp, Jörg; Schooler, Lael

    2012-01-01

    The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people’s decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into reduced decision quality. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision environment in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker. PMID:22347843

  20. Reciprocal Dialogue between Educational Decision Makers and Students of Color: Opportunities and Obstacles

    ERIC Educational Resources Information Center

    Bertrand, Melanie

    2014-01-01

    Purpose: This article explores the possibilities for reciprocal dialogue between educational decision makers and Students of Color. Such dialogue--defined as interactions in which participants build on each other's words--may provide the means to develop creative ways to address manifestations of systemic racism in education. The article uses…

  1. Monitoring Values and Practices of Oak Woodland Decision Makers on the Urban Fringe

    Treesearch

    William Stewart

    1991-01-01

    Concern over oak woodlands has shifted away from ranch management towards residential areas. This shift has been accompanied by the involvement of decision makers who previously had little involvement with rangeland policies and practices. A survey of three recent Cooperative Extension workshops illustrates a number of important patterns regarding interest and...

  2. Identifying family members who may struggle in the role of surrogate decision maker.

    PubMed

    Majesko, Alyssa; Hong, Seo Yeon; Weissfeld, Lisa; White, Douglas B

    2012-08-01

    Although acting as a surrogate decision maker can be highly distressing for some family members of intensive care unit patients, little is known about whether there are modifiable risk factors for the occurrence of such difficulties. To identify: 1) factors associated with lower levels of confidence among family members to function as surrogates and 2) whether the quality of clinician-family communication is associated with the timing of decisions to forego life support. We conducted a prospective study of 230 surrogate decision makers for incapacitated, mechanically ventilated patients at high risk of death in four intensive care units at University of California San Francisco Medical Center from 2006 to 2007. Surrogates completed a questionnaire addressing their perceived ability to act as a surrogate and the quality of their communication with physicians. We used clustered multivariate logistic regression to identify predictors of low levels of perceived ability to act as a surrogate and a Cox proportional hazard model to determine whether quality of communication was associated with the timing of decisions to withdraw life support. There was substantial variability in family members' confidence to act as surrogate decision makers, with 27% rating their perceived ability as 7 or lower on a 10-point scale. Independent predictors of lower role confidence were the lack of prior experience as a surrogate (odds ratio 2.2, 95% confidence interval [1.04-4.46], p=.04), no prior discussions with the patient about treatment preferences (odds ratio 3.7, 95% confidence interval [1.79-7.76], p<.001), and poor quality of communication with the ICU physician (odds ratio 1.2, 95% confidence interval [1.09-1.35] p<.001). Higher quality physician-family communication was associated with a significantly shorter duration of life-sustaining treatment among patients who died (β=0.11, p=.001). Family members without prior experience as a surrogate and those who had not engaged in

  3. Charting a path forward: building AGU's capacity to help foster scientist-decision maker engagement

    NASA Astrophysics Data System (ADS)

    Vano, J. A.; Behar, D. H.; Mote, P.; Ferguson, D. B.; Pandya, R.

    2016-12-01

    Most research proposals, papers, and presentation abstracts begin with the motivation that the new science presented will benefit society. Behind this, beyond making good on the promises to get funding, is a sincere effort to contribute our knowledge and talent to build a better (safer, sustainable, more resilient) world. For this to happen, however, the science needs to be connected to people in communities who make decisions. While this happens in a variety of ways, often for research to be most useful to society, engagement with decision makers should occur at the beginning and throughout the research process. Increasingly this is being recognized as important, as evidenced by the growing number of boundary organizations (e.g., U.S. Department of the Interior's Climate Science Centers, NOAA's Regional Integrated Sciences and Assessment programs). Even within AGU, in recent years there has been a number of new activities and networks that suggest a growing community of practice for those doing work at the science-society interface (e.g., The Thriving Earth Exchange, the Water and Society Technical Committee in the Hydrology Section). In this presentation, we highlight what these activities are and share insights from those involved. We evaluate trends (e.g., have the number of abstracts on this topic increased?) and present responses from AGU members to questions on where this community of practice should go next (e.g., What is the most important task the AGU community should do to improve decision maker-scientist engagement?). The goal of this presentation is to promote a conversation about how the AGU community can be better prepared to foster engagement with decision makers that will lead to more actionable science. This will help us ensure our science is useful to society, fulfilling our motivations, and arguably responsibilities, both individually and as a community. It will also serve to prepare new scientists for a broader range of careers beyond

  4. The use of control charts by laypeople and hospital decision-makers for guiding decision making.

    PubMed

    Schmidtke, K A; Watson, D G; Vlaev, I

    2017-07-01

    Graphs presenting healthcare data are increasingly available to support laypeople and hospital staff's decision making. When making these decisions, hospital staff should consider the role of chance-that is, random variation. Given random variation, decision-makers must distinguish signals (sometimes called special-cause data) from noise (common-cause data). Unfortunately, many graphs do not facilitate the statistical reasoning necessary to make such distinctions. Control charts are a less commonly used type of graph that support statistical thinking by including reference lines that separate data more likely to be signals from those more likely to be noise. The current work demonstrates for whom (laypeople and hospital staff) and when (treatment and investigative decisions) control charts strengthen data-driven decision making. We present two experiments that compare people's use of control and non-control charts to make decisions between hospitals (funnel charts vs. league tables) and to monitor changes across time (run charts with control lines vs. run charts without control lines). As expected, participants more accurately identified the outlying data using a control chart than using a non-control chart, but their ability to then apply that information to more complicated questions (e.g., where should I go for treatment?, and should I investigate?) was limited. The discussion highlights some common concerns about using control charts in hospital settings.

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

    NASA Astrophysics Data System (ADS)

    Trexler, M.

    2017-12-01

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

  6. Decision-Makers As Messengers Of Climate Change Impacts And Ambassadors For Their Communities.

    NASA Astrophysics Data System (ADS)

    Boudrias, M. A.; DeBenedict, C.; Bruce, L.; Estrada, M.; Hedge, N.; Silva-Send, N. J.

    2016-12-01

    Over the past several years there have been many coordinated efforts to improve climate change literacy of diverse audiences. The challenge has been to balance science content with audience-specific messaging with a goal to reach solutions and build community resilience. In the San Diego Region, Climate Education Partners (CEP) has been working with business leaders, elected officials, tribal leaders, and other community leaders to develop a suite of programs and activities to enhance the channels of communication outside traditional settings. CEP has employed a multidisciplinary approach that integrates climate science, social and learning sciences and effective communication strategies to create innovative resources and new approaches to climate change communication in order to engage audiences more effectively. We have interviewed over 140 key San Diego leaders and invited them to serve as ambassadors to the project by engaging them directly in the creation of a variety of innovative educational resources as well as serving as spokespersons for outreach activities. Our program has evolved from having only scientists, educators and community practitioners serve as presenters to strategically and deliberately engaging a mix of scientists, educators and decision makers as the conveyers of key messages. Our protocol for events includes preparing all speakers in advance, researching our audience, creating a script, immediate debriefs of each activity and a qualitative and quantitative assessment of each event. Two examples of this integrated approach will show how to engage decision-makers more deeply: (1) coastal flooding tour as a place-based activity and (2) impact videos that blend climate science, local personal stories and key messages from decision makers themselves. For climate change communication to be successful in the future, we will need creative and coordinated approaches.

  7. Communicating Glacier Change and Associated Impacts to Communities and Decision-makers

    NASA Astrophysics Data System (ADS)

    Timm, K.; Hood, E. W.; O'Neel, S.; Wolken, G. J.

    2017-12-01

    A critical, but often overlooked, part of making cryosphere science relevant to decision makers is ensuring that the communication and translation of scientific information is deliberate, dialogic, and the product of careful planning. This presentation offers several lessons learned from a team of scientists and a communication professional who have collaboratively produced several award-winning and repeatedly used communication products. Consisting of illustrations (for presentations, publications, and other uses), posters, and fact sheets, the products communicate how Alaska's glaciers are changing, how changing glaciers influence nearby ecosystems, and the natural hazards that emerge as glaciers recede and thin to a range of audiences, including community members, business owners, resource managers, and other decision makers. The success of these communication products can be attributed in part to six broad characteristics of the development process, which are based on the literature from science communication research and reflections from the team: connect, design, respect, iterate, share, and reflect. For example, connecting with other people is important because effective science communication is usually the product of a team of researchers and communication professionals. Connecting with the audience or stakeholders is also important for developing an understanding of their information needs. In addition, respect is essential, as this process relies on the diverse skills, experience, and knowledge that everyone brings to the endeavor. Also for consideration, developing a shared language and executing a scientifically accurate design takes synthesis and iteration, which must be accounted for in the project timeline. Taken together, these factors and others that will be described in the presentation can help improve the communication of cryosphere science and expand its utility for important societal decisions.

  8. Anchor effects in decision making can be reduced by the interaction between goal monitoring and the level of the decision maker's executive functions.

    PubMed

    Schiebener, Johannes; Wegmann, Elisa; Pawlikowski, Mirko; Brand, Matthias

    2012-11-01

    Models of decision making postulate that interactions between contextual conditions and characteristics of the decision maker determine decision-making performance. We tested this assumption by using a possible positive contextual influence (goals) and a possible negative contextual influence (anchor) in a risky decision-making task (Game of Dice Task, GDT). In this task, making advantageous choices is well known to be closely related to a specific decision maker variable: the individual level of executive functions. One hundred subjects played the GDT in one of four conditions: with self-set goal for final balance (n = 25), with presentation of an anchor (a fictitious Top 10 list, showing high gains of other participants; n = 25), with anchor and goal definition (n = 25), and with neither anchor nor goal setting (n = 25). Subjects in the conditions with anchor made more risky decisions irrespective of the negative feedback, but this anchor effect was influenced by goal monitoring and moderated by the level of the subjects' executive functions. The findings imply that impacts of situational influences on decision making as they frequently occur in real life depend upon the individual's cognitive abilities. Anchor effects can be overcome by subjects with good cognitive abilities.

  9. Who to Blame: Irrational Decision-Makers or Stupid Modelers? (Arne Richter Award for Outstanding Young Scientists Lecture)

    NASA Astrophysics Data System (ADS)

    Madani, Kaveh

    2016-04-01

    Water management benefits from a suite of modelling tools and techniques that help simplifying and understanding the complexities involved in managing water resource systems. Early water management models were mainly concerned with optimizing a single objective, related to the design, operations or management of water resource systems (e.g. economic cost, hydroelectricity production, reliability of water deliveries). Significant improvements in methodologies, computational capacity, and data availability over the last decades have resulted in developing more complex water management models that can now incorporate multiple objectives, various uncertainties, and big data. These models provide an improved understanding of complex water resource systems and provide opportunities for making positive impacts. Nevertheless, there remains an alarming mismatch between the optimal solutions developed by these models and the decisions made by managers and stakeholders of water resource systems. Modelers continue to consider decision makers as irrational agents who fail to implement the optimal solutions developed by sophisticated and mathematically rigours water management models. On the other hand, decision makers and stakeholders accuse modelers of being idealist, lacking a perfect understanding of reality, and developing 'smart' solutions that are not practical (stable). In this talk I will have a closer look at the mismatch between the optimality and stability of solutions and argue that conventional water resources management models suffer inherently from a full-cooperation assumption. According to this assumption, water resources management decisions are based on group rationality where in practice decisions are often based on individual rationality, making the group's optimal solution unstable for individually rational decision makers. I discuss how game theory can be used as an appropriate framework for addressing the irrational "rationality assumption" of water

  10. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: methods of a decision-maker-researcher partnership systematic review.

    PubMed

    Haynes, R Brian; Wilczynski, Nancy L

    2010-02-05

    Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Data will be summarized using descriptive summary measures, including proportions

  11. Decision Maker Perception of Information Quality: A Case Study of Military Command and Control

    ERIC Educational Resources Information Center

    Morgan, Grayson B.

    2013-01-01

    Decision maker perception of information quality cues from an "information system" (IS) and the process which creates such meta cueing, or data about cues, is a critical yet un-modeled component of "situation awareness" (SA). Examples of common information quality meta cueing for quality criteria include custom ring-tones for…

  12. Automation: Decision Aid or Decision Maker?

    NASA Technical Reports Server (NTRS)

    Skitka, Linda J.

    1998-01-01

    This study clarified that automation bias is something unique to automated decision making contexts, and is not the result of a general tendency toward complacency. By comparing performance on exactly the same events on the same tasks with and without an automated decision aid, we were able to determine that at least the omission error part of automation bias is due to the unique context created by having an automated decision aid, and is not a phenomena that would occur even if people were not in an automated context. However, this study also revealed that having an automated decision aid did lead to modestly improved performance across all non-error events. Participants in the non- automated condition responded with 83.68% accuracy, whereas participants in the automated condition responded with 88.67% accuracy, across all events. Automated decision aids clearly led to better overall performance when they were accurate. People performed almost exactly at the level of reliability as the automation (which across events was 88% reliable). However, also clear, is that the presence of less than 100% accurate automated decision aids creates a context in which new kinds of errors in decision making can occur. Participants in the non-automated condition responded with 97% accuracy on the six "error" events, whereas participants in the automated condition had only a 65% accuracy rate when confronted with those same six events. In short, the presence of an AMA can lead to vigilance decrements that can lead to errors in decision making.

  13. An analytical framework to assist decision makers in the use of forest ecosystem model predictions

    USDA-ARS?s Scientific Manuscript database

    The predictions of most terrestrial ecosystem models originate from deterministic simulations. Relatively few uncertainty evaluation exercises in model outputs are performed by either model developers or users. This issue has important consequences for decision makers who rely on models to develop n...

  14. Gender inequalities in the workplace: the effects of organizational structures, processes, practices, and decision makers' sexism.

    PubMed

    Stamarski, Cailin S; Son Hing, Leanne S

    2015-01-01

    Gender inequality in organizations is a complex phenomenon that can be seen in organizational structures, processes, and practices. For women, some of the most harmful gender inequalities are enacted within human resources (HRs) practices. This is because HR practices (i.e., policies, decision-making, and their enactment) affect the hiring, training, pay, and promotion of women. We propose a model of gender discrimination in HR that emphasizes the reciprocal nature of gender inequalities within organizations. We suggest that gender discrimination in HR-related decision-making and in the enactment of HR practices stems from gender inequalities in broader organizational structures, processes, and practices. This includes leadership, structure, strategy, culture, organizational climate, as well as HR policies. In addition, organizational decision makers' levels of sexism can affect their likelihood of making gender biased HR-related decisions and/or behaving in a sexist manner while enacting HR practices. Importantly, institutional discrimination in organizational structures, processes, and practices play a pre-eminent role because not only do they affect HR practices, they also provide a socializing context for organizational decision makers' levels of hostile and benevolent sexism. Although we portray gender inequality as a self-reinforcing system that can perpetuate discrimination, important levers for reducing discrimination are identified.

  15. Patient Preferences and Surrogate Decision Making in Neuroscience Intensive Care Units

    PubMed Central

    Cai, Xuemei; Robinson, Jennifer; Muehlschlegel, Susanne; White, Douglas B.; Holloway, Robert G.; Sheth, Kevin N.; Fraenkel, Liana; Hwang, David Y.

    2016-01-01

    In the neuroscience intensive care unit (NICU), most patients lack the capacity to make their own preferences known. This fact leads to situations where surrogate decision makers must fill the role of the patient in terms of making preference-based treatment decisions, oftentimes in challenging situations where prognosis is uncertain. The neurointensivist has a large responsibility and role to play in this shared decision making process. This review covers how NICU patient preferences are determined through existing advance care documentation or surrogate decision makers and how the optimum roles of the physician and surrogate decision maker are addressed. We outline the process of reaching a shared decision between family and care team and describe a practice for conducting optimum family meetings based on studies of ICU families in crisis. We review challenges in the decision making process between surrogate decision makers and medical teams in neurocritical care settings, as well as methods to ameliorate conflicts. Ultimately, the goal of shared decision making is to increase knowledge amongst surrogates and care providers, decrease decisional conflict, promote realistic expectations and preference-centered treatment strategies, and lift the emotional burden on families of neurocritical care patients. PMID:25990137

  16. Creating and synthesizing evidence with decision makers in mind: integrating evidence from clinical trials and other study designs.

    PubMed

    Atkins, David

    2007-10-01

    Randomized controlled trials (RCTs) remain the accepted "gold standard" for determining the efficacy of new drugs or medical procedures. Randomized trials alone, however, cannot provide all the relevant information decision makers need to determine the relative risks and benefits when choosing the best treatment of individual patients or weighing the implications of particular policies affecting medical therapies. To demonstrate the limitations of RCTs in providing the information needed by medical decision makers, and to show how information from observational studies can supplement evidence from RCTs. Qualitative description of the limitations of RCTs in providing the information needed by medical decision makers, and demonstration of how evidence from additional sources can aid in decision making, using the examples of deciding whether a 60-year-old woman with mildly elevated blood pressure should take daily low-dose aspirin, and whether a hospital network should implement carotid artery surgery for asymptomatic patients. Even the most rigorously designed RCTs leave many questions central to medical decision making unanswered. Research using cohort and case-control designs, disease and intervention registries, and outcomes studies based on administrative data can all shed light on who is most likely to benefit from the treatment, and what the important tradeoffs are. This suggests the need to revise the traditional evidence hierarchy, whereby evidence progresses linearly from basic research to rigorous RCTs. This revised hierarchy recognizes that other research designs can provide important evidence to strengthen our understanding of how to apply research findings in practice.

  17. 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.

  18. Corporate financial decision makers' perceptions of their company's safety performance, programs and personnel: Do company size and industry injury risk matter?

    PubMed

    DeArmond, Sarah; Huang, Yueng-Hsiang; Chen, Peter Y; Courtney, Theodore K

    2010-01-01

    Top-level managers make important decisions about safety-related issues, yet little research has been done involving these individuals. The current study explored corporate financial decisions makers' perceptions of their company's safety and their justifications for these perceptions. This study also explored whether their perceptions and justifications varied as a function of company size or industry injury risk. A total of 404 individuals who were the most senior managers responsible for making decisions about property and casualty risk at their companies participated in this study. The participants took part in a telephone survey. The results suggest that corporate financial decision makers have positive views of safety at their companies relative to safety at other companies within their industries. Further, many believe their company's safety is influenced by the attention/emphasis placed on safety and the selection and training of safety personnel. Participants' perceptions varied somewhat based on the size of their company and the level of injury risk in their industry. While definitive conclusions about corporate financial decision makers' perceptions of safety cannot be reached as a result of this single study, this work does lay groundwork for future research aimed at better understanding the perceptions top-level managers.

  19. Automatic mental associations predict future choices of undecided decision-makers.

    PubMed

    Galdi, Silvia; Arcuri, Luciano; Gawronski, Bertram

    2008-08-22

    Common wisdom holds that choice decisions are based on conscious deliberations of the available information about choice options. On the basis of recent insights about unconscious influences on information processing, we tested whether automatic mental associations of undecided individuals bias future choices in a manner such that these choices reflect the evaluations implied by earlier automatic associations. With the use of a computer-based, speeded categorization task to assess automatic mental associations (i.e., associations that are activated unintentionally, difficult to control, and not necessarily endorsed at a conscious level) and self-report measures to assess consciously endorsed beliefs and choice preferences, automatic associations of undecided participants predicted changes in consciously reported beliefs and future choices over a period of 1 week. Conversely, for decided participants, consciously reported beliefs predicted changes in automatic associations and future choices over the same period. These results indicate that decision-makers sometimes have already made up their mind at an unconscious level, even when they consciously indicate that they are still undecided.

  20. Counseling Model Application: A Student Career Development Guidance for Decision Maker and Consultation

    NASA Astrophysics Data System (ADS)

    Irwan; Gustientiedina; Sunarti; Desnelita, Yenny

    2017-12-01

    The purpose of this study is to design a counseling model application for a decision-maker and consultation system. This application as an alternative guidance and individual career development for students, that include career knowledge, planning and alternative options from an expert tool based on knowledge and rule to provide the solutions on student’s career decisions. This research produces a counseling model application to obtain the important information about student career development and facilitating individual student’s development through the service form, to connect their plan with their career according to their talent, interest, ability, knowledge, personality and other supporting factors. This application model can be used as tool to get information faster and flexible for the student’s guidance and counseling. So, it can help students in doing selection and making decision that appropriate with their choice of works.

  1. 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

  2. Single-photon decision maker

    NASA Astrophysics Data System (ADS)

    Naruse, Makoto; Berthel, Martin; Drezet, Aurélien; Huant, Serge; Aono, Masashi; Hori, Hirokazu; Kim, Song-Ju

    2015-08-01

    Decision making is critical in our daily lives and for society in general and is finding evermore practical applications in information and communication technologies. Herein, we demonstrate experimentally that single photons can be used to make decisions in uncertain, dynamically changing environments. Using a nitrogen-vacancy in a nanodiamond as a single-photon source, we demonstrate the decision-making capability by solving the multi-armed bandit problem. This capability is directly and immediately associated with single-photon detection in the proposed architecture, leading to adequate and adaptive autonomous decision making. This study makes it possible to create systems that benefit from the quantum nature of light to perform practical and vital intelligent functions.

  3. Energizing Government Decision-Makers with the Facts on Solar Technology, Policy, and Integration

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

    The Solar Technical Assistance Team (STAT) is a network of solar technology and implementation experts who provide timely, unbiased expertise to assist policymakers and regulators in making informed decisions about solar programs and policies. Government officials can submit requests directly to the STAT for technical assistance. STAT then partners with experts in solar policy, regulation, finance, technology, and other areas to deliver accurate, up-to-date information to state and local decision makers. The STAT responds to requests on a wide range of issues -- including, but not limited to, feed-in tariffs, renewable portfolio standards, rate design, program design, workforce and economicmore » impacts of solar on jurisdictions, and project financing.« less

  4. 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

  5. The effect of prognostic data presentation format on perceived risk among surrogate decision makers of critically ill patients: a randomized comparative trial.

    PubMed

    Chapman, Andy R; Litton, Edward; Chamberlain, Jenny; Ho, Kwok M

    2015-04-01

    The purpose of this study is to determine whether varying the format used to present prognostic data alters the perception of risk among surrogate decision makers in the intensive care unit (ICU). This was a prospective randomized comparative trial conducted in a 23-bed adult tertiary ICU. Enrolled surrogate decision makers were randomized to 1 of 2 questionnaires, which presented hypothetical ICU scenarios, identical other than the format in which prognostic data were presented (eg, frequencies vs percentages). Participants were asked to rate the risk associated with each prognostic statement. We enrolled 141 surrogate decision makers. The perception of risk varied significantly dependent on the presentation format. For "quantitative data," risks were consistently perceived as higher, when presented as frequencies (eg, 1 in 50) compared with equivalent percentages (eg, 2%). Framing "qualitative data" in terms of chance of "death" rather than "survival" led to a statistically significant increase in perceived risks. Framing "quantitative" data in this way did not significantly affect risk perception. Data format had a significant effect on how surrogate decision makers interpreted risk. Qualitative statements are interpreted widely and affected by framing. Where possible, multiple quantitative formats should be used for presenting prognostic information. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  6. Technical note: An approach to derive breeding goals from the preferences of decision makers.

    PubMed

    Alfonso, L

    2016-11-01

    This paper deals with the use of the Choquet integral to identify breeding objectives and construct an aggregate genotype. The Choquet integral can be interpreted as an extension of the aggregate genotype based on profit equations, substituting the vector of economic weights by a monotone function, called capacity, which allows the aggregation of traits based, for instance, on the preferences of decision makers. It allows the aggregation of traits with or without economic value, taking into account not only the importance of the breeding value of each trait but also the interaction among them. Two examples have been worked out for pig and dairy cattle breeding scenarios to illustrate its application. It is shown that the expression of stakeholders' or decision makers' preferences, as a single ranking of animals or groups of animals, could be sufficient to extract information to derive breeding objectives. It is also shown that coalitions among traits can be identified to evaluate whether a linear additive function, equivalent of the Hazel aggregate genotype where economic values are replaced by Shapley values, could be adequate to define the net merit of breeding animals.

  7. Linking Space Weather Science and Decision Making (Invited)

    NASA Astrophysics Data System (ADS)

    Fisher, G. M.

    2009-12-01

    Linking scientific knowledge to decision making is a challenge for both the science and policy communities. In particular, in the field of space weather, there are unique challenges such as decision makers may not know that space has weather that poses risks to our technologically-dependent economy. Additionally, in an era of limited funds for scientific research, hazards posed by other natural disasters such as flooding and earthquakes are by contrast well known to policy makers, further making the importance of space weather research and monitoring a tough sell. Today, with industries and individuals more dependent on the Global Positioning System, wireless technology, and satellites than ever before, any disruption or inaccuracy can result in severe economic impacts. Therefore, it is highly important to understand how space weather science can most benefit society. The key to connecting research to decision making is to ensure that the information is salient, credible, and legitimate. To achieve this, scientists need to understand the decision makers' perspectives, including their language and culture, and recognize that their needs may evolve. This presentation will take a closer look at the steps required to make space weather research, models, and forecasts useful to decision makers and ultimately, benefit society.

  8. Decision Making and Training: A Review of Theoretical and Empirical Studies of Decision Making and Their Implications for the Training of Decision Makers

    DTIC Science & Technology

    1975-08-01

    34 of an outcome for the particular decisi’on maker involved. According to thio formulation the same decision outcome may appeal to dif- ferent...characterizing thes_ sources is in turmu of 1he two properties: degree of passivity and deoqreu of oopcrative,,’s. According to this conceptualizati on...procedure has been, however, is open to question. Data collected during field exercises have indicated that ratinqs often are omitted from spot reports, and

  9. Toward actionable science: Empowering ecologists to engage in the process of translation through decision-maker and stakeholder partnerships

    NASA Astrophysics Data System (ADS)

    Enquist, C.; Jackson, S. T.; Garfin, G. M.

    2017-12-01

    Translational ecology is an approach by which ecologists, stakeholders, and decision-makers work collaboratively to develop and deliver ecological research that, ideally, results in actionable science that leads to improved environmental decision-making. We analyzed a diverse array of real-world case studies and distilled six principles that characterize the practice of translational ecology: communication, commitment, collaboration, engagement, process, and decision-framing. In this talk, we highlight a subset of the case studies that illustrate these principles. Notably, we found that translational ecology is distinct from both basic and applied ecological research. As a practice, the approach deliberately extends research beyond theory or opportunistic applications, motivated by a search for outcomes that directly serve the needs of natural resource managers and decision-makers. Translational ecology is also distinct from knowledge co-production in that it does not require deep engagement between collaborators, although incorporating differing modes of co-production relative to the decision context, associated time frame, and available financial resources can greatly enhance the translational approach. Although there is a need for incentives to pursue in this type of work, we found that the creativity and context-specific knowledge of resource managers, practitioners, and decision-makers informs and enriches the scientific process, helping shape actionable science. Moreover, the process of addressing research questions arising from on-the-ground management issues, rather than from the top-down or expert-oriented perspectives of traditional science, can foster the long-term trust and commitment that is critical for long-term, sustained engagement between partners. Now, perhaps more than ever, the climate and environmental issues facing society are complex, often politicized, and value-laden. We argue that ecological science should play a key role in informing

  10. Teachers as Decision-Makers.

    ERIC Educational Resources Information Center

    Shedd, Joseph B.; And Others

    Scholars working from various perspectives are beginning to define teaching as a decision-making process. Research shows that teachers are reflective and connect knowledge to situations through observation, understanding, analysis, interpretation, and decision-making. This paper provides empirical evidence to show the relationship of…

  11. Knowledge Style Profiling: An Exploration of Cognitive, Temperament, Demographic and Organizational Characteristics among Decision Makers Using Advanced Analytical Technologies

    ERIC Educational Resources Information Center

    Polito, Vincent A., Jr.

    2010-01-01

    The objective of this research was to explore the possibilities of identifying knowledge style factors that could be used as central elements of a professional business analyst's (PBA) performance attributes at work for those decision makers that use advanced analytical technologies on decision making tasks. Indicators of knowledge style were…

  12. Overview of EPA tools for supporting local- and regional-scale decision makers addressing energy and environmental issues

    EPA Science Inventory

    EPA’s Office of Research and Development (ORD) has been developing tools and illustrative case studies for decision makers in local and regional authorities who are facing challenges of establishing resilience to extreme weather events, aging built environment and infrastru...

  13. Moving beyond the cost-loss ratio: economic assessment of streamflow forecasts for a risk-averse decision maker

    NASA Astrophysics Data System (ADS)

    Matte, Simon; Boucher, Marie-Amélie; Boucher, Vincent; Fortier Filion, Thomas-Charles

    2017-06-01

    A large effort has been made over the past 10 years to promote the operational use of probabilistic or ensemble streamflow forecasts. Numerous studies have shown that ensemble forecasts are of higher quality than deterministic ones. Many studies also conclude that decisions based on ensemble rather than deterministic forecasts lead to better decisions in the context of flood mitigation. Hence, it is believed that ensemble forecasts possess a greater economic and social value for both decision makers and the general population. However, the vast majority of, if not all, existing hydro-economic studies rely on a cost-loss ratio framework that assumes a risk-neutral decision maker. To overcome this important flaw, this study borrows from economics and evaluates the economic value of early warning flood systems using the well-known Constant Absolute Risk Aversion (CARA) utility function, which explicitly accounts for the level of risk aversion of the decision maker. This new framework allows for the full exploitation of the information related to a forecasts' uncertainty, making it especially suited for the economic assessment of ensemble or probabilistic forecasts. Rather than comparing deterministic and ensemble forecasts, this study focuses on comparing different types of ensemble forecasts. There are multiple ways of assessing and representing forecast uncertainty. Consequently, there exist many different means of building an ensemble forecasting system for future streamflow. One such possibility is to dress deterministic forecasts using the statistics of past error forecasts. Such dressing methods are popular among operational agencies because of their simplicity and intuitiveness. Another approach is the use of ensemble meteorological forecasts for precipitation and temperature, which are then provided as inputs to one or many hydrological model(s). In this study, three concurrent ensemble streamflow forecasting systems are compared: simple statistically dressed

  14. Science For Decision-Makers: Climate Change Indicators For The North-Central California Coast And Ocean

    NASA Astrophysics Data System (ADS)

    Duncan, B.; Higgason, K.; Suchanek, T.; Stachowicz, J.; Largier, J. L.; Cayan, D. R.

    2013-12-01

    Resource managers and decision-makers in North-central California recognize a need for increased information about the impacts of climate change on the region's coast and ocean to ensure that adaptation and conservation decisions are grounded in sound science. To help meet this need, ocean climate indicators were developed in a project based at NOAA's Gulf of the Farallones National Marine Sanctuary for the North-central California coast and ocean, from Año Nuevo to Point Arena, including the Pacific coastline of the San Francisco Bay Area. These represent the first regional ocean climate indicators in the National Marine Sanctuary System. The indicators were developed in collaboration with over 50 regional research scientists and resource managers representing federal and state agencies, research universities and institutions, and non-governmental organizations. Following the indicator development process, an interdisciplinary working group incorporated the indicators into a regional indicators monitoring inventory and plan that will be used by scientists, natural resource managers, and state and municipal planners to monitor, track, and develop adaptation strategies for the impacts of climate change on the region. The working group collaborated extensively to co-identify key measurements and data sources for the indicators, and to ensure that the monitoring plan was accessible and convenient for decision-makers while still providing a valuable resource for research scientists.

  15. Decision Makers' Allocation of Home-Care Therapy Services: A Process Map

    PubMed Central

    Poss, Jeff; Egan, Mary; Rappolt, Susan; Berg, Katherine

    2013-01-01

    ABSTRACT Purpose: To explore decision-making processes currently used in allocating occupational and physical therapy services in home care for complex long-stay clients in Ontario. Method: An exploratory study using key-informant interviews and client vignettes was conducted with home-care decision makers (case managers and directors) from four home-care regions in Ontario. The interview data were analyzed using the framework analysis method. Results: The decision-making process for allocating therapy services has four stages: intake, assessment, referral to service provider, and reassessment. There are variations in the management processes deployed at each stage. The major variation is in the process of determining the volume of therapy services across home-care regions, primarily as a result of financial constraints affecting the home-care programme. Government funding methods and methods of information sharing also significantly affect home-care therapy allocation. Conclusion: Financial constraints in home care are the primary contextual factor affecting allocation of therapy services across home-care regions. Given the inflation of health care costs, new models of funding and service delivery need to be developed to ensure that the right person receives the right care before deteriorating and requiring more costly long-term care. PMID:24403672

  16. Perspectives of Women Decision-Makers Over the Participation and Recreational Events in Sports: A Turkish Perspective

    ERIC Educational Resources Information Center

    Guzel, Pinar

    2015-01-01

    The purpose of this research is to put forth the role of the leisure and recreation events awareness including women decision-makers effects on their fellow women. Three main themes were recognized: Past; "Process of leisure and recreation events of women in Turkey", Present; "Model of Turkey for women on leisure and…

  17. Assessing the impact of federal and state preemption in public health: a framework for decision makers.

    PubMed

    Pertschuk, Mark; Pomeranz, Jennifer L; Aoki, Julie Ralston; Larkin, Michelle A; Paloma, Marjorie

    2013-01-01

    In the United States, state and local public health policies play a fundamental role in innovation and progress. Preemption, by which Congress or the state legislatures limit the authority of lower jurisdictions, can eliminate the benefits of state and local policy initiatives. Preemption can also have a negative impact on enforcement, civic engagement, and grassroots movement building.In June 2011, the Institute of Medicine published a groundbreaking report on policy and law that considered preemption as a crosscutting issue in public health. The Institute of Medicine recommended that federal and state policy makers "should set minimum standards...allowing states and localities to further protect the health and safety of their inhabitants," and "should avoid language that hinders public health action."The Preemption Framework is a tool to support effective decision making by helping the public health field anticipate, assess, and, if necessary, counter preemptive policy proposals. We review the consequences of preemption, including its potential impact on grassroots public health movements, and propose practical questions and considerations to assist decision makers in responding to preemptive proposals.

  18. Children's Participation in Decision-Making in the Philippines: Understanding the Attitudes of Policy-Makers and Service Providers

    ERIC Educational Resources Information Center

    Bessell, Sharon

    2009-01-01

    This article explores the ideas about children's participation in decision-making held by government officials and non-government representatives engaged in promoting children's participation in the Philippines. It suggests that the ideas that policy-makers and service deliverers hold about children's participation are heterogeneous, diverse and…

  19. Ultimate justification: Wittgenstein and medical ethics.

    PubMed

    Hughes, J

    1995-02-01

    Decisions must be justified. In medical ethics various grounds are given to justify decisions, but ultimate justification seems illusory and little considered. The philosopher Wittgenstein discusses the problem of ultimate justification in the context of general philosophy. His comments, nevertheless, are pertinent to ethics. From a discussion of Wittgensteinian notions, such as 'bedrock', the idea that 'ultimate' justification is grounded in human nature as such is derived. This discussion is relevant to medical ethics in at least five ways: it shows generally what type of certainty there is in practical ethics; it seems to imply some objective foundation to our ethical judgements; it squares with our experience of making ethical decisions; it shows something of the nature of moral arguments; and, finally, it has implications for teaching medicine and ethics.

  20. Ultimate justification: Wittgenstein and medical ethics.

    PubMed Central

    Hughes, J

    1995-01-01

    Decisions must be justified. In medical ethics various grounds are given to justify decisions, but ultimate justification seems illusory and little considered. The philosopher Wittgenstein discusses the problem of ultimate justification in the context of general philosophy. His comments, nevertheless, are pertinent to ethics. From a discussion of Wittgensteinian notions, such as 'bedrock', the idea that 'ultimate' justification is grounded in human nature as such is derived. This discussion is relevant to medical ethics in at least five ways: it shows generally what type of certainty there is in practical ethics; it seems to imply some objective foundation to our ethical judgements; it squares with our experience of making ethical decisions; it shows something of the nature of moral arguments; and, finally, it has implications for teaching medicine and ethics. PMID:7776343

  1. Importance of perspective in economic analyses of cancer screening decisions.

    PubMed

    Mansley, E C; McKenna, M T

    2001-10-06

    As the fifth, and final, report in this Lancet series on health economics, we discuss how economic analyses in public health, with cancer screening as the example, differ depending on the perspective taken. We identify nine different, but related, decision makers at various levels, from the individual patient to society as a whole, and discuss how their different viewpoints affect their ultimate decisions. Central to our discussion is the identification of seven distinct components of perspective, each potentially important in the screening decision. In many fields of healthcare, decisions about the use of resources, such as time, wealth, or energy, are made by weighing up the positive and negative consequences of the alternatives under consideration and are thus based on an economic analysis of the situation (although sometimes this process is subconscious). For simplicity, we restrict our report to the effect of perspective on cancer screening decisions and show how the costs (negative consequences) and benefits (positive consequences) vary depending on the decision maker.

  2. 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.

  3. Residents' perceptions about surrogate decision makers' financial conflicts of interest in ventilator withdrawal.

    PubMed

    Wastila, Lisa J; Farber, Neil J

    2014-05-01

    There have been no studies to date that examine physicians' decisions to withdraw life-sustaining treatment for patients based on their surrogates' financial gain. The authors' objective was to ascertain physician attitudes about withdrawing life-sustaining treatment when financial considerations are involved. A survey was developed and pretested containing eight scenarios in which a terminally ill patient's spouse had a decision to make regarding withdrawal of the ventilator, which was deemed medically futile. Nested variables included agreement or disagreement between the spouse and patient, decision to withdraw or continue the ventilator, and financial gain or no financial gain for the spouse. The authors surveyed all internal medicine residents at the University of California, San Diego in the autumn of 2011 and winter of 2012. The responses on each of the three variables for which respondents were likely to withdraw the ventilator were analyzed via student's t-tests. Residents were more likely to withdraw the ventilator when requested to do so than when it was requested to be continued. They were also more likely to withdraw the ventilator when there was agreement in the decision between the spouse and the patient. Residents were more likely to withdraw the ventilator when the spouse would not benefit financially. Internal medicine residents make some decisions about whether to withdraw life-sustaining treatment based on financial considerations. There needs to be ongoing communication with residents about end-of-life decisions where conflicts may exist between the surrogate decision makers and patients or physicians.

  4. Development of policies for Natura 2000 sites: a multi-criteria approach to support decision makers.

    PubMed

    Cortina, Carla; Boggia, Antonio

    2014-08-01

    The aim of this study is to present a methodology to support decision makers in the choice of Natura 2000 sites needing an appropriate management plan to ensure a sustainable socio-economic development. In order to promote sustainable development in the Natura 2000 sites compatible with nature preservation, conservation measures or management plans are necessary. The main issue is to decide when only conservation measures can be applied and when the sites need an appropriate management plan. We present a case study for the Italian Region of Umbria. The methodology is based on a multi-criteria approach to identify the biodiversity index (BI), and on the development of a human activities index (HAI). By crossing the two indexes for each site on a Cartesian plane, four groups of sites were identified. Each group corresponds to a specific need for an appropriate management plan. Sites in the first group with a high level both of biodiversity and human activities have the most urgent need of an appropriate management plan to ensure sustainable development. The proposed methodology and analysis is replicable in other regions or countries by using the data available for each site in the Natura 2000 standard data form. A multi-criteria analysis is especially suitable for supporting decision makers when they deal with a multidimensional decision process. We found the multi-criteria approach particularly sound in this case, due to the concept of biodiversity itself, which is complex and multidimensional, and to the high number of alternatives (Natura 2000 sites) to be assessed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Leveraging human decision making through the optimal management of centralized resources

    NASA Astrophysics Data System (ADS)

    Hyden, Paul; McGrath, Richard G.

    2016-05-01

    Combining results from mixed integer optimization, stochastic modeling and queuing theory, we will advance the interdisciplinary problem of efficiently and effectively allocating centrally managed resources. Academia currently fails to address this, as the esoteric demands of each of these large research areas limits work across traditional boundaries. The commercial space does not currently address these challenges due to the absence of a profit metric. By constructing algorithms that explicitly use inputs across boundaries, we are able to incorporate the advantages of using human decision makers. Key improvements in the underlying algorithms are made possible by aligning decision maker goals with the feedback loops introduced between the core optimization step and the modeling of the overall stochastic process of supply and demand. A key observation is that human decision-makers must be explicitly included in the analysis for these approaches to be ultimately successful. Transformative access gives warfighters and mission owners greater understanding of global needs and allows for relationships to guide optimal resource allocation decisions. Mastery of demand processes and optimization bottlenecks reveals long term maximum marginal utility gaps in capabilities.

  6. 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

  7. A data mining system for providing analytical information on brain tumors to public health decision makers.

    PubMed

    Santos, R S; Malheiros, S M F; Cavalheiro, S; de Oliveira, J M Parente

    2013-03-01

    Cancer is the leading cause of death in economically developed countries and the second leading cause of death in developing countries. Malignant brain neoplasms are among the most devastating and incurable forms of cancer, and their treatment may be excessively complex and costly. Public health decision makers require significant amounts of analytical information to manage public treatment programs for these patients. Data mining, a technology that is used to produce analytically useful information, has been employed successfully with medical data. However, the large-scale adoption of this technique has been limited thus far because it is difficult to use, especially for non-expert users. One way to facilitate data mining by non-expert users is to automate the process. Our aim is to present an automated data mining system that allows public health decision makers to access analytical information regarding brain tumors. The emphasis in this study is the use of ontology in an automated data mining process. The non-experts who tried the system obtained useful information about the treatment of brain tumors. These results suggest that future work should be conducted in this area. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Development of the England Wildlife Health Strategy--a framework for decision makers.

    PubMed

    Hartley, M; Lysons, R

    2011-02-12

    Diseases in wildlife have been recognised as having the potential to affect human health, livestock health and species conservation. In order to assess and respond to these potential risks in an effective and a proportionate way, the UK Government initiated development of the Wildlife Health Strategy to provide a framework for decision making. The England Wildlife Health Strategy (EWHS) has been developed through extensive consultation. Discussions and negotiations with government departments, agencies, non-governmental public bodies and wildlife organisations were held to obtain advice and input on specific and specialised aspects of wildlife health. A series of workshops to investigate the application of innovative science to wildlife health policy contributed further. A formal public consultation was held that proposed a range of actions to implement the strategy. A summary of responses to this consultation was published in October 2007. The EWHS was published in June 2009 and provides a framework for a generic four-stage approach to wildlife health that can be adopted by decision makers both within and outside government.

  9. Impact of a decision aid on surrogate decision-makers' perceptions of feeding options for patients with dementia.

    PubMed

    Snyder, E Amanda; Caprio, Anthony J; Wessell, Kathryn; Lin, Feng Chang; Hanson, Laura C

    2013-02-01

    In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates' perceptions of feeding options, and to determine whether a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Semistructured interview with prestudy and poststudy design for surrogates in the intervention group. Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Two hundred and fifty-five surrogate decision makers for nursing home residents with advanced dementia and feeding problems, in control (n = 129) and intervention (n = 126) groups. For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options, and the role of surrogates in making these decisions. The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true/false items and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the decisional conflict scale. Before the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical, and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs 16.8; P < .001), decreased expectation of benefits from tube feeding (2.73 vs 2.32; P = .001), and reduced decisional

  10. Designing evaluation studies to optimally inform policy: what factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?

    PubMed

    Wu, Shishi; Legido-Quigley, Helena; Spencer, Julia; Coker, Richard James; Khan, Mishal Sameer

    2018-02-23

    In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. Our qualitative study indicates that training programme evaluations that focus narrowly on direct training

  11. Bridging the Gap Between NASA Earth Observations and Decision Makers Through the NASA Develop National Program

    NASA Astrophysics Data System (ADS)

    Remillard, C. M.; Madden, M.; Favors, J.; Childs-Gleason, L.; Ross, K. W.; Rogers, L.; Ruiz, M. L.

    2016-06-01

    The NASA DEVELOP National Program bridges the gap between NASA Earth Science and society by building capacity in both participants and partner organizations that collaborate to conduct projects. These rapid feasibility projects highlight the capabilities of satellite and aerial Earth observations. Immersion of decision and policy makers in these feasibility projects increases awareness of the capabilities of Earth observations and contributes to the tools and resources available to support enhanced decision making. This paper will present the DEVELOP model, best practices, and two case studies, the Colombia Ecological Forecasting project and the Miami-Dade County Ecological Forecasting project, that showcase the successful adoption of tools and methods for decision making. Through over 90 projects each year, DEVELOP is always striving for the innovative, practical, and beneficial use of NASA Earth science data.

  12. Perspectives of policy and political decision makers on access to formal dementia care: expert interviews in eight European countries.

    PubMed

    Broda, Anja; Bieber, Anja; Meyer, Gabriele; Hopper, Louise; Joyce, Rachael; Irving, Kate; Zanetti, Orazio; Portolani, Elisa; Kerpershoek, Liselot; Verhey, Frans; Vugt, Marjolein de; Wolfs, Claire; Eriksen, Siren; Røsvik, Janne; Marques, Maria J; Gonçalves-Pereira, Manuel; Sjölund, Britt-Marie; Woods, Bob; Jelley, Hannah; Orrell, Martin; Stephan, Astrid

    2017-08-03

    As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers. Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4-7 experts (total N = 38). The interview guide addressed the topics "Complexity and Continuity of Care", "Formal Services", and "Public Awareness". Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries. The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness. Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations.

  13. Neural correlates of effective learning in experienced medical decision-makers.

    PubMed

    Downar, Jonathan; Bhatt, Meghana; Montague, P Read

    2011-01-01

    Accurate associative learning is often hindered by confirmation bias and success-chasing, which together can conspire to produce or solidify false beliefs in the decision-maker. We performed functional magnetic resonance imaging in 35 experienced physicians, while they learned to choose between two treatments in a series of virtual patient encounters. We estimated a learning model for each subject based on their observed behavior and this model divided clearly into high performers and low performers. The high performers showed small, but equal learning rates for both successes (positive outcomes) and failures (no response to the drug). In contrast, low performers showed very large and asymmetric learning rates, learning significantly more from successes than failures; a tendency that led to sub-optimal treatment choices. Consistently with these behavioral findings, high performers showed larger, more sustained BOLD responses to failed vs. successful outcomes in the dorsolateral prefrontal cortex and inferior parietal lobule while low performers displayed the opposite response profile. Furthermore, participants' learning asymmetry correlated with anticipatory activation in the nucleus accumbens at trial onset, well before outcome presentation. Subjects with anticipatory activation in the nucleus accumbens showed more success-chasing during learning. These results suggest that high performers' brains achieve better outcomes by attending to informative failures during training, rather than chasing the reward value of successes. The differential brain activations between high and low performers could potentially be developed into biomarkers to identify efficient learners on novel decision tasks, in medical or other contexts.

  14. Working with Decision Makers to Improve Energy-Water System Resiliency in the Lower Hudson River Basin

    NASA Astrophysics Data System (ADS)

    Fellows, J. D.; Schoonen, M. A.; Pullen, J.; González, J. E.; Saleh, F.; Bhatt, V.

    2017-12-01

    Nearly half of the 180 million people living in the eastern U.S. reside in coastal watershed or shoreline counties. The population density of these areas continues to increase, driving an increase in energy-water (EW) system demand and expansion of critical infrastructure. Along with population, these areas are also being stressed by environmental and technology stresses, including climate change. We have been working with decision makers in the Lower Hudson River Basin (LHRB) to develop the tools and data needed to better understand and improve the resiliency of LHRB EW systems facing these kinds of stresses. The LHRB represents: 1) a coastal environment subject to sea level rise that is among the fastest in the East; 2) one of the steepest gradients in population density in the US, with Manhattan the most densely populated coastal county in the nation; 3) a EWN infrastructure serving the largest metropolitan area in the US and the financial center of the world; 4) a history of environmental impacts, ranging from heatwaves, hurricanes to localized storms, that can be used to hindcast; and 5) a wealth of historic and real-time data, extensive monitoring facilities and existing specific sector models that can be leveraged. This presentation will focus on the lessons learned working with the LHRB decision makers.

  15. A Framework for Bridging Scientists, Knowledge Brokers and Local Decision Makers in State-level Climate Assessments

    NASA Astrophysics Data System (ADS)

    Galford, G. L.; Nash, J. L.

    2016-12-01

    Large-scale analyses like the National Climate Assessment (NCA) contain a wealth of information critical to national and regional responses to climate change but tend to be insufficiently detailed for action at state or local levels. Many states now develop assessments (SCAs) to provide relevant, actionable information to state and local authorities. These assessments generate new or additional primary information, build networks and inform stakeholders. Based on our experience in the Vermont Climate Assessment (VCA), we present a SCA framework to engage local decision makers, using a fluid network of scientific experts and knowledge brokers to conduct subject area prioritization, data analysis, and writing. Knowledge brokers bridged the scientific and stakeholder communities, providing a two-way flow of information by capitalizing on their existing networks. Rich citizen records of climate and climate change impacts associated a human voice, a memorable story, or personal observation with a climate record, improving climate information salience. This engagement process that created salient climate information perceived as credible and legitimate by local and state decision makers. We present this framework as an effective structure for SCAs to foster interaction among scientists, knowledge brokers and stakeholders. We include a qualitative impact evaluation and lessons learned for future SCAs.

  16. Surrogate Decision Makers and Proxy Ownership: Challenges of Privacy Management in Health Care Decision Making

    PubMed Central

    Bute, Jennifer J.; Petronio, Sandra; Torke, Alexia M.

    2016-01-01

    This study explored the communicative experiences of surrogates who served as decision makers for patients who were unable to convey health information and choices about treatment options. Drawing on assumptions from communication privacy management theory (Petronio, 2002), 35 surrogates were interviewed to explore how they navigated the role of guardian of patients’ private health information while the patient was hospitalized. This research determined that surrogates are not only guardians and thereby co-owners of the patients’ private health information, they actually served in a “proxy ownership” role. Surrogates described obstacles to both obtaining and sharing private health information about the patient, suggesting that their rights as legitimate co-owners of the patients’ information were not fully acknowledged by the medical teams. Surrogates also described challenges in performing the proxy ownership role when they were not fully aware of the patient's wishes. Theoretical and practical implications of these challenges are discussed. PMID:25175060

  17. The Current Mind-Set of Federal Information Security Decision-Makers on the Value of Governance: An Informative Study

    ERIC Educational Resources Information Center

    Stroup, Jay Walter

    2014-01-01

    Understanding the mind-set or perceptions of organizational leaders and decision-makers is important to ascertaining the trends and priorities in policy and governance of the organization. This study finds that a significant shift in the mind-set of government IT and information security leaders has started and will likely result in placing a…

  18. Evaluation of an Interactive Workshop Designed to Teach Practical Welfare Techniques to Beef Cattle Caretakers and Decision Makers

    ERIC Educational Resources Information Center

    Dewell, Reneé; Hanthorn, Christy; Danielson, Jared; Burzette, Rebecca; Coetzee, Johann; Griffin, D. Dee; Ramirez, Alejandro; Dewell, Grant

    2015-01-01

    The purpose of the project was to evaluate the use of an interactive workshop designed to teach novel practical welfare techniques to beef cattle caretakers and decision makers. Following training, respondents reported being more likely to use or recommend use of local anesthesia for dehorning and castration and were more inclined to use meloxicam…

  19. Communicating the Needs of Climate Change Policy Makers to Scientists

    NASA Technical Reports Server (NTRS)

    Brown, Molly E.; Escobar, Vanessa M.; Lovell, Heather

    2012-01-01

    This chapter will describe the challenges that earth scientists face in developing science data products relevant to decision maker and policy needs, and will describe strategies that can improve the two-way communication between the scientist and the policy maker. Climate change policy and decision making happens at a variety of scales - from local government implementing solar homes policies to international negotiations through the United Nations Framework Convention on Climate Change. Scientists can work to provide data at these different scales, but if they are not aware of the needs of decision makers or understand what challenges the policy maker is facing, they are likely to be less successful in influencing policy makers as they wished. This is because the science questions they are addressing may be compelling, but not relevant to the challenges that are at the forefront of policy concerns. In this chapter we examine case studies of science-policy partnerships, and the strategies each partnership uses to engage the scientist at a variety of scales. We examine three case studies: the global Carbon Monitoring System pilot project developed by NASA, a forest biomass mapping effort for Silvacarbon project, and a forest canopy cover project being conducted for forest management in Maryland. In each of these case studies, relationships between scientists and policy makers were critical for ensuring the focus of the science as well as the success of the decision-making.

  20. Defining products for a new health technology assessment agency in Madrid, Spain: a survey of decision makers.

    PubMed

    Andradas, Elena; Blasco, Juan-Antonio; Valentín, Beatriz; López-Pedraza, María-José; Gracia, Francisco-Javier

    2008-01-01

    The aim of this study was to explore the needs and requirements of decision makers in our regional healthcare system for health technology assessment (HTA) products to support portfolio development planning for a new HTA agency in Madrid, Spain. A Delphi study was conducted during 2003. Questionnaires were developed based on a review of products and services offered by other agency members of the International Network of Agencies for Health Technology Assessment, and included preference and prioritization questions to evaluate twenty-two different products and services. The initial Delphi panel involved eighty-seven experts from twenty-one public hospitals, eleven primary healthcare centers, six private hospitals, and eight departments of the Regional Ministry of Health of the Community of Madrid. The global participation rate was 83.9 percent. Ten of the twenty-two possible products were rated of high interest by more than 80 percent of respondents. Important differences in preferences and priorities were detected across different settings. Public hospitals and primary healthcare centers shared a more "micro" perspective, preferring classic technology-centered HTA products, whereas private hospitals and Ministry representatives demanded more "macro" products and services such as organizational model and information system assessments. The high participation rate supports the representativeness of the results for our regional context. The strategic development of an HTA portfolio based on decision makers' needs and requirements as identified in this type of exercise should help achieve a better impact on policy development and decision making.

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

    PubMed

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

    2015-03-11

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

  2. What criteria do decision makers in Thailand use to set priorities for vaccine introduction?

    PubMed

    Pooripussarakul, Siriporn; Riewpaiboon, Arthorn; Bishai, David; Muangchana, Charung; Tantivess, Sripen

    2016-08-02

    There is a need to identify rational criteria and set priorities for vaccines. In Thailand, many licensed vaccines are being considering for introduction into the Expanded Program on Immunization; thus, the government has to make decisions about which vaccines should be adopted. This study aimed to set priorities for new vaccines and to facilitate decision analysis. We used a best-worst scaling study for rank-ordering of vaccines. The candidate vaccines were determined by a set of criteria, including burden of disease, target age group, budget impact, side effect, effectiveness, severity of disease, and cost of vaccine. The criteria were identified from a literature review and by in-depth, open-ended interviews with experts. The priority-setting model was conducted among three groups of stakeholders, including policy makers, healthcare professionals and healthcare administrators. The vaccine data were mapped and then calculated for the probability of selection. From the candidate vaccines, the probability of hepatitis B vaccine being selected by all respondents (96.67 %) was ranked first. This was followed, respectively, by pneumococcal conjugate vaccine-13 (95.09 %) and Haemophilus influenzae type b vaccine (90.87 %). The three groups of stakeholders (policy makers, healthcare professionals and healthcare administrators) showed the same ranking trends. Most severe disease, high fever rate and high disease burden showed the highest coefficients for criterion levels being selected by all respondents. This result can be implied that a vaccine which can prevent most severe disease with high disease burden and has low safety has a greater chance of being selected by respondents in this study. The priority setting of vaccines through a multiple-criteria approach could contribute to transparency and accountability in the decision-making process. This is a step forward in the development of an evidence-based approach that meets the need of developing country. The

  3. Gaining Momentum: How Media Influences Public Opinion To Push Civil-Military Decision Makers Into Formulating Foreign Policy

    DTIC Science & Technology

    2016-02-09

    1 AIR WAR COLLEGE AIR UNIVERSITY GAINING MOMENTUM: HOW MEDIA INFLUENCES PUBLIC OPINION TO PUSH CIVIL-MILITARY DECISION MAKERS INTO...engagements from the past, evidence suggest the media or press does have an influence over public opinion, especially during times of war and humanitarian...changes and that leaders must take into consideration that public opinion and the media may provide a large amount of influence over how the nation

  4. Possibilities and hindrances for prevention of intimate partner violence: perceptions among professionals and decision makers in a Swedish medium-sized town.

    PubMed

    Jakobsson, A; von Borgstede, C; Krantz, G; Spak, F; Hensing, G

    2013-09-01

    Intimate partner violence (IPV) is a major public health problem, but few evidence-based prevention programs have yet been implemented. This study explored the perceptions and beliefs of local-level decision makers, social and health-care professionals, and representatives from the police force regarding the possibilities and hindrances for prevention of IPV. An explorative qualitative approach was used, and participants were strategically selected for focus group discussions. The participants, 19 men and 23 women, were professionals or decision makers within health-care services, social welfare, municipal administration, the police force, local industry, and local politicians in a Swedish town of 54,000 inhabitants. The focus group discussions were audio recorded, transcribed verbatim, and thematically analyzed. A manifest content analysis was performed on the text. Preschools, schools, sports associations, workplaces, and the mass media were suggested as possible arenas for prevention measures. The proposed activities included norm building and improved social support structures. Hindrances were conceptualized as societal beliefs and attitudes, shame, silence, gender inequality, the counteracting influence of the media, and lack of resources. The participants demonstrated closeness and distance to IPV, expressed as acceptance or referral of responsibility to others regarding where and by whom prevention measures should be executed. This study gave new insights in the prevailing perceptions of professionals and decision makers of a medium-sized Swedish town, which can be a useful knowledge in future preventive work and contribute to bridge the gap between research and practice.

  5. Marketing Authorization Procedures for Advanced Cancer Drugs: Exploring the Views of Patients, Oncologists, Healthcare Decision Makers, and Citizens in France.

    PubMed

    Protiére, Christel; Baker, Rachel; Genre, Dominique; Goncalves, Anthony; Viens, Patrice

    2017-07-01

    The past decades have seen advances in cancer treatments in terms of toxicity and side effects but progress in the treatment of advanced cancer has been modest. New drugs have emerged improving progression free survival but with little impact on overall survival, raising questions about the criteria on which to base decisions to grant marketing authorizations and about the authorization procedure itself. For decisions to be fair, transparent and accountable, it is necessary to consider the views of those with relevant expertise and experience. We conducted a Q-study to explore the views of a range of stakeholders in France, involving: 54 patients (18 months after diagnosis); 50 members of the general population; 27 oncologists; 19 healthcare decision makers; and 2 individuals from the pharmaceutical industry. Three viewpoints emerged, focussing on different dimensions entitled: 1) 'Quality of life (QoL), opportunity cost and participative democracy'; 2)'QoL and patient-centeredness'; and 3) 'Length of life'. Respondents from all groups were associated with each viewpoint, except for healthcare decision makers, who were only associated with the first one. Our results highlight plurality in the views of stakeholders, emphasize the need for transparency in decision making processes, and illustrate the importance of a re-evaluation of treatments for all 3 viewpoints. In the context of advanced cancer, our results suggest that QoL should be more prominent amongst authorization criteria, as it is a concern for 2 of the 3 viewpoints.

  6. Development of an integrated model for energy systems planning and carbon dioxide mitigation under uncertainty - Tradeoffs between two-level decision makers.

    PubMed

    Jin, S W; Li, Y P; Xu, L P

    2018-07-01

    A bi-level fuzzy programming (BFLP) method was developed for energy systems planning (ESP) and carbon dioxide (CO 2 ) mitigation under uncertainty. BFLP could handle fuzzy information and leader-follower problem in decision-making processes. It could also address the tradeoffs among different decision makers in two decision-making levels through prioritizing the most important goal. Then, a BFLP-ESP model was formulated for planning energy system of Beijing, in which the upper-level objective is to minimize CO 2 emission and the lower-level objective is to minimize the system cost. Results provided a range of decision alternatives that corresponded to a tradeoff between system optimality and reliability under uncertainty. Compared to the single-level model with a target to minimize system cost, the amounts of pollutant/CO 2 emissions from BFLP-ESP were reduced since the study system would prefer more clean energies (i.e. natural gas, LPG and electricity) to replace coal fuel. Decision alternatives from BFLP were more beneficial for supporting Beijing to adjust its energy mix and enact its emission-abatement policy. Results also revealed that the low-carbon policy for power plants (e.g., shutting down all coal-fired power plants) could lead to a potentially increment of imported energy for Beijing, which would increase the risk of energy shortage. The findings could help decision makers analyze the interactions between different stakeholders in ESP and provide useful information for policy design under uncertainty. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. The Ising Decision Maker: a binary stochastic network for choice response time.

    PubMed

    Verdonck, Stijn; Tuerlinckx, Francis

    2014-07-01

    The Ising Decision Maker (IDM) is a new formal model for speeded two-choice decision making derived from the stochastic Hopfield network or dynamic Ising model. On a microscopic level, it consists of 2 pools of binary stochastic neurons with pairwise interactions. Inside each pool, neurons excite each other, whereas between pools, neurons inhibit each other. The perceptual input is represented by an external excitatory field. Using methods from statistical mechanics, the high-dimensional network of neurons (microscopic level) is reduced to a two-dimensional stochastic process, describing the evolution of the mean neural activity per pool (macroscopic level). The IDM can be seen as an abstract, analytically tractable multiple attractor network model of information accumulation. In this article, the properties of the IDM are studied, the relations to existing models are discussed, and it is shown that the most important basic aspects of two-choice response time data can be reproduced. In addition, the IDM is shown to predict a variety of observed psychophysical relations such as Piéron's law, the van der Molen-Keuss effect, and Weber's law. Using Bayesian methods, the model is fitted to both simulated and real data, and its performance is compared to the Ratcliff diffusion model. (c) 2014 APA, all rights reserved.

  8. Resource allocation within the National AIDS Control Program of Pakistan: a qualitative assessment of decision maker's opinions.

    PubMed

    Husain, Sara; Kadir, Masood; Fatmi, Zafar

    2007-01-23

    Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program. A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to allocate resources within the program were conducted. HIV was not considered a priority issue by all study participants and external funding for the program was thought to have been accepted because of poor foreign currency reserves and donor agency influence rather than local need. Political influences from the federal government and donor agencies were thought to manipulate distribution of funds within the program. These influences were thought to occur despite the existence of a well-laid out procedure to determine allocation of public resources. Lack of collaboration among departments involved in decision making, a pervasive lack of technical expertise, paucity of information and an atmosphere of ad hoc decision making were thought to reduce resistance to external pressures. Development of a unified program vision through a consultative process and advocacy is necessary to understand goals to be achieved, to enhance program ownership and develop consensus about how money and effort should be directed. Enhancing public sector expertise in planning and budgeting is essential not just for the program, but also to reduce reliance on external agencies for technical support. Strengthening available databases for effective decision making is required to make financial allocations based on real

  9. Resource allocation within the National AIDS Control Program of Pakistan: a qualitative assessment of decision maker's opinions

    PubMed Central

    Husain, Sara; Kadir, Masood; Fatmi, Zafar

    2007-01-01

    Background Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program. Methods A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to allocate resources within the program were conducted. Results HIV was not considered a priority issue by all study participants and external funding for the program was thought to have been accepted because of poor foreign currency reserves and donor agency influence rather than local need. Political influences from the federal government and donor agencies were thought to manipulate distribution of funds within the program. These influences were thought to occur despite the existence of a well-laid out procedure to determine allocation of public resources. Lack of collaboration among departments involved in decision making, a pervasive lack of technical expertise, paucity of information and an atmosphere of ad hoc decision making were thought to reduce resistance to external pressures. Conclusion Development of a unified program vision through a consultative process and advocacy is necessary to understand goals to be achieved, to enhance program ownership and develop consensus about how money and effort should be directed. Enhancing public sector expertise in planning and budgeting is essential not just for the program, but also to reduce reliance on external agencies for technical support. Strengthening available databases for effective decision making is required to make

  10. Characteristics and use of urban health indicator tools by municipal built environment policy and decision-makers: a systematic review protocol.

    PubMed

    Pineo, Helen; Glonti, Ketevan; Rutter, Harry; Zimmermann, Nicole; Wilkinson, Paul; Davies, Michael

    2017-01-13

    There is wide agreement that there is a lack of attention to health in municipal environmental policy-making, such as urban planning and regeneration. Explanations for this include differing professional norms between health and urban environment professionals, system complexity and limited evidence for causality between attributes of the built environment and health outcomes. Data from urban health indicator (UHI) tools are potentially a valuable form of evidence for local government policy and decision-makers. Although many UHI tools have been specifically developed to inform policy, there is poor understanding of how they are used. This study aims to identify the nature and characteristics of UHI tools and their use by municipal built environment policy and decision-makers. Health and social sciences databases (ASSIA, Campbell Library, EMBASE, MEDLINE, Scopus, Social Policy and Practice and Web of Science Core Collection) will be searched for studies using UHI tools alongside hand-searching of key journals and citation searches of included studies. Advanced searches of practitioner websites and Google will also be used to find grey literature. Search results will be screened for UHI tools, and for studies which report on or evaluate the use of such tools. Data about UHI tools will be extracted to compile a census and taxonomy of existing tools based on their specific characteristics and purpose. In addition, qualitative and quantitative studies about the use of these tools will be appraised using quality appraisal tools produced by the UK National Institute for Health and Care Excellence (NICE) and synthesised in order to gain insight into the perceptions, value and use of UHI tools in the municipal built environment policy and decision-making process. This review is not registered with PROSPERO. This systematic review focuses specifically on UHI tools that assess the physical environment's impact on health (such as transport, housing, air quality and greenspace

  11. Computerized clinical decision support systems for drug prescribing and management: a decision-maker-researcher partnership systematic review.

    PubMed

    Hemens, Brian J; Holbrook, Anne; Tonkin, Marita; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    Computerized clinical decision support systems (CCDSSs) for drug therapy management are designed to promote safe and effective medication use. Evidence documenting the effectiveness of CCDSSs for improving drug therapy is necessary for informed adoption decisions. The objective of this review was to systematically review randomized controlled trials assessing the effects of CCDSSs for drug therapy management on process of care and patient outcomes. We also sought to identify system and study characteristics that predicted benefit. We conducted a decision-maker-researcher partnership systematic review. We updated our earlier reviews (1998, 2005) by searching MEDLINE, EMBASE, EBM Reviews, Inspec, and other databases, and consulting reference lists through January 2010. Authors of 82% of included studies confirmed or supplemented extracted data. We included only randomized controlled trials that evaluated the effect on process of care or patient outcomes of a CCDSS for drug therapy management compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. Sixty-five studies met our inclusion criteria, including 41 new studies since our previous review. Methodological quality was generally high and unchanged with time. CCDSSs improved process of care performance in 37 of the 59 studies assessing this type of outcome (64%, 57% of all studies). Twenty-nine trials assessed patient outcomes, of which six trials (21%, 9% of all trials) reported improvements. CCDSSs inconsistently improved process of care measures and seldomly improved patient outcomes. Lack of clear patient benefit and lack of data on harms and costs preclude a recommendation to adopt CCDSSs for drug therapy management.

  12. The adoption of children from out-of-home care: The understandings of key decision makers in Victoria, Australia.

    PubMed

    Butlinski, Anna; Rowe, Heather; Goddard, Christopher; Freezer, Nicholas

    2017-10-01

    Adoption is one of a range of options that can provide children in out-of-home care with permanency when they are unable to be reunified with their birth parents. This paper reports on how the adoption of children from out-of-home care is understood by professionals involved in making decisions about the permanent placement of children in out-of-home care in Victoria, Australia, where adoption is rarely used. Data were collected through a single, face-to-face semi-structured interview with 21 professionals; eight child welfare specialists, eight adoption and permanent care specialists and five judicial officers. The adoption of children from out-of-home care was primarily understood as a child-centered practice that can afford children stability and a sense of belonging. Adoption was largely viewed as a voluntary process dependent upon the consent of a child's birth parents. Adoption and permanent care specialists were the only group to refer to the dispensation of parental consent as a means of obtaining an adoption order. Most decision makers understood that contact between children and their birth parents is possible following adoption, but this was not understood by all judicial officers or all child welfare specialists. Children's connection to their cultural heritage was viewed as important to the consideration of adoption for children in out-of-home care. This research provides insight into the foundations upon which decision makers may appraise adoption, within a hierarchy of options, as a potential outcome for children in need of permanency. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. A comparison of workplace safety perceptions among financial decision-makers of medium- vs. large-size companies.

    PubMed

    Huang, Yueng-Hsiang; Leamon, Tom B; Courtney, Theodore K; Chen, Peter Y; DeArmond, Sarah

    2011-01-01

    This study, through a random national survey in the U.S., explored how corporate financial decision-makers perceive important workplace safety issues as a function of the size of the company for which they worked (medium- vs. large-size companies). Telephone surveys were conducted with 404 U.S. corporate financial decision-makers: 203 from medium-size companies and 201 from large companies. Results showed that the patterns of responding for participants from medium- and large-size companies were somewhat similar. The top-rated safety priorities in resource allocation reported by participants from both groups were overexertion, repetitive motion, and bodily reaction. They believed that there were direct and indirect costs associated with workplace injuries and for every dollar spent improving workplace safety, more than four dollars would be returned. They perceived the top benefits of an effective safety program to be predominately financial in nature - increased productivity and reduced costs - and the safety modification participants mentioned most often was to have more/better safety-focused training. However, more participants from large- than medium-size companies reported that "falling on the same level" was the major cause of workers' compensation loss, which is in line with industry loss data. Participants from large companies were more likely to see their safety programs as better than those of other companies in their industries, and those of medium-size companies were more likely to mention that there were no improvements needed for their companies. Copyright © 2009 Elsevier Ltd. All rights reserved.

  14. MED SUV TASK 6.3 Capacity building and interaction with decision makers: Improving volcanic risk communication through volcanic hazard tools evaluation, Campi Flegrei Caldera case study (Italy)

    NASA Astrophysics Data System (ADS)

    Nave, Rosella; Isaia, Roberto; Sandri, Laura; Cristiani, Chiara

    2016-04-01

    In the communication chain between scientists and decision makers (end users), scientific outputs, as maps, are a fundamental source of information on hazards zoning and the related at risk areas definition. Anyway the relationship between volcanic phenomena, their probability and potential impact can be complex and the geospatial information not easily decoded or understood by not experts even if decision makers. Focusing on volcanic hazard the goal of MED SUV WP6 Task 3 is to improve the communication efficacy of scientific outputs, to contribute in filling the gap between scientists and decision-makers. Campi Flegrei caldera, in Neapolitan area has been chosen as the pilot research area where to apply an evaluation/validation procedure to provide a robust evaluation of the volcanic maps and its validation resulting from end users response. The selected sample involved are decision makers and officials from Campanian Region Civil Protection and municipalities included in Campi Flegrei RED ZONE, the area exposed to risk from to pyroclastic currents hazard. Semi-structured interviews, with a sample of decision makers and civil protection officials have been conducted to acquire both quantitative and qualitative data. The tested maps have been: the official Campi Flegrei Caldera RED ZONE map, three maps produced by overlapping the Red Zone limit on Orthophoto, DTM and Contour map, as well as other maps included a probabilistic one, showing volcanological data used to border the Red Zone. The outcomes' analysis have assessed level of respondents' understanding of content as displayed, and their needs in representing the complex information embedded in volcanic hazard. The final output has been the development of a leaflet as "guidelines" that can support decision makers and officials in understanding volcanic hazard and risk maps, and also in using them as a communication tool in information program for the population at risk. The same evaluation /validation process

  15. Mutual Distrust: Perspectives From Researchers and Policy Makers on the Research to Policy Gap in 2013 and Recommendations for the Future

    PubMed Central

    Gollust, Sarah E.; Seymour, Jane W.; Pany, Maximilian J.; Goss, Adeline; Meisel, Zachary F.; Grande, David

    2017-01-01

    The production of health policy-relevant research is necessary, but not sufficient, to promote its utilization in policy. Our objective was to understand the perspectives of United States’ state-level policy makers and health researchers on the barriers and facilitators to the translation of health evidence into the policy process, with a particular focus on issues related to relationship building. We conducted interviews with 215 US health services and health policy researchers and 40 state-level staffers and legislators. Researchers and policy makers faced the same major barrier to research translation: lack of dedicated time to do so. Some policy makers questioned the credibility of research, and researchers questioned policy makers’ authentic desire to use evidence in decision making. For some study participants, a mutual mistrust of the other group challenges stronger relationship formation. Interventions are needed to help both groups understand a broader role that research plays in policy making and to increase personal contact, and ultimately trusted relationships, across various actors in the policy process. PMID:28452251

  16. Quality Psychological Advice for Teachers, Parents/Carers and LEA Decision-Makers with Respect to Children and Young People with Special Needs

    ERIC Educational Resources Information Center

    Cameron, R. J. (Sean); Monsen, Jeremy J.

    2005-01-01

    The main aim of this paper is to describe a working protocol which can offer practising educational psychologists a rational framework within which to investigate and understand the complex problems of children and young people in school and to provide appropriate advice to teachers, parents/carers and LEA decision makers on how they can best…

  17. Science communication and vernal pool conservation: a study of local decision maker attitudes in a knowledge-action system.

    PubMed

    McGreavy, Bridie; Webler, Thomas; Calhoun, Aram J K

    2012-03-01

    In this study, we describe local decision maker attitudes towards vernal pools to inform science communication and enhance vernal pool conservation efforts. We conducted interviews with town planning board and conservation commission members (n = 9) from two towns in the State of Maine in the northeastern United States. We then mailed a questionnaire to a stratified random sample of planning board members in August and September 2007 with a response rate of 48.4% (n = 320). The majority of survey respondents favored the protection and conservation of vernal pools in their towns. Decision makers were familiar with the term "vernal pool" and demonstrated positive attitudes to vernal pools in general. General appreciation and willingness to conserve vernal pools predicted support for the 2006 revisions to the Natural Resource Protection Act regulating Significant Vernal Pools. However, 48% of respondents were unaware of this law and neither prior knowledge of the law nor workshop attendance predicted support for the vernal pool law. Further, concerns about private property rights and development restrictions predicted disagreement with the vernal pool law. We conclude that science communication must rely on specific frames of reference, be sensitive to cultural values, and occur in an iterative system to link knowledge and action in support of vernal pool conservation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Cost Accounting for Decision Makers.

    ERIC Educational Resources Information Center

    Kaneklides, Ann L.

    1985-01-01

    Underscores the importance of informed decision making through accurate anticipation of cost incurrence in light of changing economic and environmental conditions. Explains the concepts of cost accounting, full allocation of costs, the selection of an allocation base, the allocation of indirect costs, depreciation, and implications for community…

  19. Providing Climate Policy Makers With a Strong Scientific Base (Invited)

    NASA Astrophysics Data System (ADS)

    Struzik, E.

    2009-12-01

    Scientists can and should inform public policy decisions in the Arctic. But the pace of climate change in the polar world has been occurring far more quickly than most scientists have been able to predict. This creates problems for decision-makers who recognize that difficult management decisions have to be made in matters pertaining to wildlife management, cultural integrity and economic development. With sea ice melting, glaciers receding, permafrost thawing, forest fires intensifying, and disease and invasive species rapidly moving north, the challenge for scientists to provide climate policy makers with a strong scientific base has been daunting. Clashing as this data sometimes does with the “traditional knowledge” of indigenous peoples in the north, it can also become very political. As a result the need to effectively communicate complex data is more imperative now than ever before. Here, the author describes how the work of scientists can often be misinterpreted or exploited in ways that were not intended. Examples include the inappropriate use of scientific data in decision-making on polar bears, caribou and other wildlife populations; the use of scientific data to debunk the fact that greenhouse gases are driving climate change, and the use of scientific data to position one scientist against another when there is no inherent conflict. This work will highlight the need for climate policy makers to increase support for scientists working in the Arctic, as well as illustrate why it is important to find new and more effective ways of communicating scientific data. Strategies that might be considered by granting agencies, scientists and climate policy decision-makers will also be discussed.

  20. State Decision-Makers Guide for Hazardous Waste Management: Defining Hazardous Wastes, Problem Recognition, Land Use, Facility Operations, Conceptual Framework, Policy Issues, Transportation.

    ERIC Educational Resources Information Center

    Corson, Alan; And Others

    Presented are key issues to be addressed by state, regional, and local governments and agencies in creating effective hazardous waste management programs. Eight chapters broadly frame the topics which state-level decision makers should consider. These chapters include: (1) definition of hazardous waste; (2) problem definition and recognition; (3)…

  1. Comparing the sustainability impacts of solar thermal and natural gas combined cycle for electricity production in Mexico: Accounting for decision makers' priorities

    NASA Astrophysics Data System (ADS)

    Rodríguez-Serrano, Irene; Caldés, Natalia; Oltra, Christian; Sala, Roser

    2017-06-01

    The aim of this paper is to conduct a comprehensive sustainability assessment of the electricity generation with two alternative electricity generation technologies by estimating its economic, environmental and social impacts through the "Framework for Integrated Sustainability Assessment" (FISA). Based on a Multiregional Input Output (MRIO) model linked to a social risk database (Social Hotspot Database), the framework accounts for up to fifteen impacts across the three sustainability pillars along the supply chain of the electricity production from Solar Thermal Electricity (STE) and Natural Gas Combined Cycle (NGCC) technologies in Mexico. Except for value creation, results show larger negative impacts for NGCC, particularly in the environmental pillar. Next, these impacts are transformed into "Aggregated Sustainability Endpoints" (ASE points) as a way to support the decision making in selecting the best sustainable project. ASE points obtained are later compared to the resulting points weighted by the reported priorities of Mexican decision makers in the energy sector obtained from a questionnaire survey. The comparison shows that NGCC achieves a 1.94 times worse negative score than STE, but after incorporating decision makerś priorities, the ratio increases to 2.06 due to the relevance given to environmental impacts such as photochemical oxidants formation and climate change potential, as well as social risks like human rights risks.

  2. New challenges for seismology and decision makers after L'Aquila trial

    NASA Astrophysics Data System (ADS)

    Marzocchi, Warner

    2013-04-01

    On 22 October seven experts who attended a Major Risk Committee meeting were sentenced to six years in prison on charges of manslaughter for underestimating the risk before the devastating 6.3-magnitude earthquake that struck the hillside city of L'Aquila on 6 April 2009, which caused more than 300 deaths. The earthquake followed a sequence of seismic events that started at the beginning of the year, with the largest shock - a 4.2-magnitude earthquake - occurring on 30 March. A day later, the seven experts met in L'Aquila; the minutes of the meeting, which were released after the quake, contained three main conclusions: that earthquakes are not predictable in a deterministic sense; that the L'Aquila region has the highest seismic hazard in Italy; and that the occurrence of a large earthquake in the short term was unlikely. There is not doubt that this trial will represent an important turning point for seismologists, and more in general for scientists who serve as advisors for public safety purposes. Here, starting from the analysis of the accusations made by the prosecutor and a detailed scientific appraisal of what happened, we try to figure out how seismology can evolve in order to be more effective in protecting people, and (possibly) avoiding accusations like the ones who characterize the L'Aquila trial. In particular, we discuss (i) the principles of the Operational Earthquake Forecasting that were put forward by an international Commission on Earthquake Forecasting (ICEF) nominated after L'Aquila earthquake, (ii) the ICEF recommendations for Civil Protection, and (iii) the recent developments in this field in Italy. Finally, we also explore the interface between scientists and decision makers, in particular in the framework of making decisions in a low probability environment.

  3. Getting Decision Makers to the Table: Digestible Facts, a Few Good Friends and Sharing Recipes for Solutions to Climate Change Impacts.

    NASA Astrophysics Data System (ADS)

    Boudrias, M. A.; Estrada, M.; Gershunov, A.; Silva-Send, N. J.; Young, E.

    2014-12-01

    Decision makers and community leaders are key audiences to engage in our efforts to improve climate literacy. Climate Education Partners has been working with business leaders, elected officials, tribal leaders, and other Key Influentials in the San Diego Region to enhance the channels of communication outside traditional settings. Over the past year we have interviewed over 90 Key Influential San Diego leaders asking them about their knowledge of climate change and their personal and professional efforts to adapt to and/or mitigate the impacts of climate change. We also engaged them directly in the creation of an innovative educational resource called "San Diego, 2050 is Calling. How will we answer?" Results of the interviews indicate that 90% of these leaders are concerned about climate change, more than 50% are already doing something about the impacts, and the majority of them want more information, greater dialogue and examples of actions taken by other community leaders. We found that repeated engagement of leaders at the San Diego County Water Authority went from basic collaboration in our water tours, to greater participation of their top leaders in a water tour for top decision makers from the City of San Diego, finally culminating with full support of and participation in the 2050 report. The 2050 report represents an integrated approach blending local climate change science, social science education theory and presentation of a suite of solution-driven opportunities for local leaders. The report includes science infographics that illustrate rigorous scientific facts, statements from expert scientists and direct quotes from decision makers, and examples of successful climate change adaptation actions from companies, government groups and others. The video and photography sessions for the 2050 report led to many unexpected discussion among leaders with differing opinions on climate change, greater enthusiasm to participate in outreach activities with other

  4. WeightLifter: Visual Weight Space Exploration for Multi-Criteria Decision Making.

    PubMed

    Pajer, Stephan; Streit, Marc; Torsney-Weir, Thomas; Spechtenhauser, Florian; Muller, Torsten; Piringer, Harald

    2017-01-01

    A common strategy in Multi-Criteria Decision Making (MCDM) is to rank alternative solutions by weighted summary scores. Weights, however, are often abstract to the decision maker and can only be set by vague intuition. While previous work supports a point-wise exploration of weight spaces, we argue that MCDM can benefit from a regional and global visual analysis of weight spaces. Our main contribution is WeightLifter, a novel interactive visualization technique for weight-based MCDM that facilitates the exploration of weight spaces with up to ten criteria. Our technique enables users to better understand the sensitivity of a decision to changes of weights, to efficiently localize weight regions where a given solution ranks high, and to filter out solutions which do not rank high enough for any plausible combination of weights. We provide a comprehensive requirement analysis for weight-based MCDM and describe an interactive workflow that meets these requirements. For evaluation, we describe a usage scenario of WeightLifter in automotive engineering and report qualitative feedback from users of a deployed version as well as preliminary feedback from decision makers in multiple domains. This feedback confirms that WeightLifter increases both the efficiency of weight-based MCDM and the awareness of uncertainty in the ultimate decisions.

  5. AdViSHE: A Validation-Assessment Tool of Health-Economic Models for Decision Makers and Model Users.

    PubMed

    Vemer, P; Corro Ramos, I; van Voorn, G A K; Al, M J; Feenstra, T L

    2016-04-01

    A trade-off exists between building confidence in health-economic (HE) decision models and the use of scarce resources. We aimed to create a practical tool providing model users with a structured view into the validation status of HE decision models, to address this trade-off. A Delphi panel was organized, and was completed by a workshop during an international conference. The proposed tool was constructed iteratively based on comments from, and the discussion amongst, panellists. During the Delphi process, comments were solicited on the importance and feasibility of possible validation techniques for modellers, their relevance for decision makers, and the overall structure and formulation in the tool. The panel consisted of 47 experts in HE modelling and HE decision making from various professional and international backgrounds. In addition, 50 discussants actively engaged in the discussion at the conference workshop and returned 19 questionnaires with additional comments. The final version consists of 13 items covering all relevant aspects of HE decision models: the conceptual model, the input data, the implemented software program, and the model outcomes. Assessment of the Validation Status of Health-Economic decision models (AdViSHE) is a validation-assessment tool in which model developers report in a systematic way both on validation efforts performed and on their outcomes. Subsequently, model users can establish whether confidence in the model is justified or whether additional validation efforts should be undertaken. In this way, AdViSHE enhances transparency of the validation status of HE models and supports efficient model validation.

  6. MAOA-a novel decision maker of apoptosis and autophagy in hormone refractory neuroendocrine prostate cancer cells

    PubMed Central

    Lin, Yi-Cheng; Chang, Yi-Ting; Campbell, Mel; Lin, Tzu-Ping; Pan, Chin-Chen; Lee, Hsin-Chen; Shih, Jean C.; Chang, Pei-Ching

    2017-01-01

    Autophagy and apoptosis are two well-controlled mechanisms regulating cell fate. An understanding of decision-making between these two pathways is in its infancy. Monoamine oxidase A (MAOA) is a mitochondrial enzyme that is well-known in psychiatric research. Emerging reports showed that overexpression MAOA is associated with prostate cancer (PCa). Here, we show that MAOA is involved in mediating neuroendocrine differentiation of PCa cells, a feature associated with hormone-refractory PCa (HRPC), a lethal type of disease. Following recent reports showing that NED of PCa requires down-regulation of repressor element-1 silencing transcription factor (REST) and activation of autophagy; we observe that MAOA is a novel direct target gene of REST. Reactive oxygen species (ROS) produced by overexpressed MAOA plays an essential role in inhibiting apoptosis and activating autophagy in NED PCa cells. MAOA inhibitors significantly reduced NED and autophagy activation of PCa cells. Our results here show MAOA as a new decision-maker for activating autophagy and MAOA inhibitors may be useful as a potential therapy for neuroendocrine tumors. PMID:28402333

  7. MAOA-a novel decision maker of apoptosis and autophagy in hormone refractory neuroendocrine prostate cancer cells.

    PubMed

    Lin, Yi-Cheng; Chang, Yi-Ting; Campbell, Mel; Lin, Tzu-Ping; Pan, Chin-Chen; Lee, Hsin-Chen; Shih, Jean C; Chang, Pei-Ching

    2017-04-12

    Autophagy and apoptosis are two well-controlled mechanisms regulating cell fate. An understanding of decision-making between these two pathways is in its infancy. Monoamine oxidase A (MAOA) is a mitochondrial enzyme that is well-known in psychiatric research. Emerging reports showed that overexpression MAOA is associated with prostate cancer (PCa). Here, we show that MAOA is involved in mediating neuroendocrine differentiation of PCa cells, a feature associated with hormone-refractory PCa (HRPC), a lethal type of disease. Following recent reports showing that NED of PCa requires down-regulation of repressor element-1 silencing transcription factor (REST) and activation of autophagy; we observe that MAOA is a novel direct target gene of REST. Reactive oxygen species (ROS) produced by overexpressed MAOA plays an essential role in inhibiting apoptosis and activating autophagy in NED PCa cells. MAOA inhibitors significantly reduced NED and autophagy activation of PCa cells. Our results here show MAOA as a new decision-maker for activating autophagy and MAOA inhibitors may be useful as a potential therapy for neuroendocrine tumors.

  8. Procuring Stationary Fuel Cells For CHP: A Guide for Federal Facility Decision Makers

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

    Stinton, David P; McGervey, Joseph; Curran, Scott

    2011-11-01

    Federal agency leaders are expressing growing interest in using innovative fuel cell combined heat and power (CHP) technology at their sites, motivated by both executive branch sustainability targets and a desire to lead by example in the transition to a clean energy economy. Fuel cell CHP can deliver reliable electricity and heat with 70% to 85% efficiency. Implementing this technology can be a high efficiency, clean energy solution for agencies striving to meet ambitious sustainability requirements with limited budgets. Fuel cell CHP systems can use natural gas or renewable fuels, such as biogas. Procuring Stationary Fuel Cells for CHP: Amore » Guide for Federal Facility Decision Makers presents an overview of the process for planning and implementing a fuel cell CHP project in a concise, step-by-step format. This guide is designed to help agency leaders turn their interest in fuel cell technology into successful installations. This guide concentrates on larger (100 kW and greater) fuel cell CHP systems and does not consider other fuel cell applications such as cars, forklifts, backup power supplies or small generators (<100 kW). Because fuel cell technologies are rapidly evolving and have high up front costs, their deployment poses unique challenges. The electrical and thermal output of the CHP system must be integrated with the building s energy systems. Innovative financing mechanisms allow agencies to make a make versus buy decision to maximize savings. This guide outlines methods that federal agencies may use to procure fuel cell CHP systems with little or no capital investment. Each agency and division, however, has its own set of procurement procedures. This guide was written as a starting point, and it defers to the reader s set of rules if differences exist. The fuel cell industry is maturing, and project developers are gaining experience in working with federal agencies. Technology improvements, cost reductions, and experienced project developers are

  9. Do evidence summaries increase policy-makers' use of evidence from systematic reviews: A systematic review protocol.

    PubMed

    Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter

    2015-09-28

    Systematic reviews are important for decision-makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision-makers. This systematic review will assess the effectiveness of systematic review summaries on increasing policymakers' use of systematic review evidence and to identify the components or features of these summaries that are most effective. We will include studies of policy-makers at all levels as well as health-system managers. We will include studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that present evidence in a summarized form. The primary outcomes are the following: (1) use of systematic review summaries decision-making (e.g., self-reported use of the evidence in policy-making, decision-making) and (2) policy-maker understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We will conduct a systematic review of randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series (ITS) studies. The results of this review will inform the development of future systematic review summaries to ensure that systematic review evidence is accessible to and used by policy-makers making health-related decisions.

  10. Context before implementation: a qualitative study of decision makers' views of a peer-led healthy lifestyle intervention for people with serious mental illness in supportive housing.

    PubMed

    Cabassa, Leopoldo J; Stefancic, Ana

    2018-04-04

    People with serious mental illness die at an earlier age than people in the general population largely due to cardiovascular disease. Healthy lifestyle interventions can help reduce this health inequity. In this qualitative study, we examined the perceptions that decision makers in supportive housing agencies had toward a peer-led healthy lifestyle intervention and their views of contextual factors that could shape implementation at these agencies. A purposive sample of 12 decision makers from three supportive housing agencies was recruited. We presented participants a vignette describing our peer-led intervention and used semistructured qualitative interviews to examine their views. Interviews were recorded, professionally transcribed, and analyzed using directed content analysis. Participants reported positive views toward the intervention with the most valued intervention attributes being relative advantage over existing services, compatibility to clients' needs, ability to pilot the intervention, and cost. A model emerged from our data depicting multilevel contextual factors believed to shape the implementation of our intervention at these agencies, including system- (funding, marketability, and external regulations), organization- (leadership support, fit with organization, staff buy-in and burden), and client-level (adaptability to clients' needs, and clients' buy-in) factors. Study findings illustrate the importance of understanding the context of practice before implementation. This examination can help identify critical views from decision makers that could undermine or advance the integration of peer-led interventions in supportive housing agencies and help identify structures, policies, and organizational practices that can inform the implementation process.

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

    NASA Astrophysics Data System (ADS)

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

    2017-12-01

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

  12. The influence of science funding agencies in support of effective decision-maker scientist partnerships

    NASA Astrophysics Data System (ADS)

    Arnott, J. C.; Lemos, M. C.

    2017-12-01

    A wealth of evidence supports the idea that collaboration between scientists and decision-makers is an influential factor in generating actionable knowledge. Nevertheless, persistent obstacles across the research-policy-practice interface limit the amount of engagement that may be necessary to satisfy demands for information to support decisions. Funding agencies have been identified as one possible driver of change, but few multi-year studies have been conducted to trace the influence of program designs on research practices or other outcomes. To fill this gap, we examine a body of applied science projects (n=120) funded through NOAA's National Estuarine Research Reserve System from 1998-2014. Periodic innovation in the structure of this funding program, including requirements for end user engagement and the inclusion of collaboration specialists, offers a natural experiment from which to test hypotheses about the how funding program design influences research practice, utilization, and broader impacts. Using content analysis of project reports and interviews of project team members, end users, and program managers (n=40), we produce a data that can be analyzed through both statistical and qualitative methods. We find that funder mandates significantly influence the intensity of interaction between researchers and practitioners as well as affect long-term change in research cultures. When interaction intensifies, corresponding gains appear in the readiness of research to support decision-making and the readiness of user groups to incorporate findings into their work. While collaborative methods transform research practice and positively influence the applied contexts in which partnerships occur, it remains less clear whether this actually increases the direct use of scientific to inform decisions. For example, collaboration may lead to outcomes other than new knowledge or knowledge application, yielding many positive outcomes that are distinct from knowledge use

  13. Advance directives lessen the decisional burden of surrogate decision-making for the chronically critically ill.

    PubMed

    Hickman, Ronald L; Pinto, Melissa D

    2014-03-01

    To identify the relationships between advance directive status, demographic characteristics and decisional burden (role stress and depressive symptoms) of surrogate decision-makers (SDMs) of patients with chronic critical illness. Although the prevalence of advance directives among Americans has increased, SDMs are ultimately responsible for complex medical decisions of the chronically critically ill patient. Decisional burden has lasting psychological effects on SDMs. There is insufficient evidence on the influence of advance directives on the decisional burden of surrogate decision-makers of patients with chronic critical illness. The study was a secondary data analysis of cross-sectional data. Data were obtained from 489 surrogate decision-makers of chronically critically ill patients at two academic medical centres in Northeast Ohio, United States, between September 2005-May 2008. Data were collected using demographic forms and questionnaires. A single-item measure of role stress and the Center for Epidemiological Studies Depression (CESD) scale were used to capture the SDM's decisional burden. Descriptive statistics, t-tests, chi-square and path analyses were performed. Surrogate decision-makers who were nonwhite, with low socioeconomic status and low education level were less likely to have advance directive documentation for their chronically critically ill patient. The presence of an advance directive mitigates the decisional burden by directly reducing the SDM's role stress and indirectly lessening the severity of depressive symptoms. Most SDMs of chronically critically ill patients will not have the benefit of knowing the patient's preferences for life-sustaining therapies and consequently be at risk of increased decisional burden. Study results are clinically useful for patient education on the influence of advance directives. Patients may be informed that SDMs without advance directives are at risk of increased decisional burden and will require

  14. Defining decision making: a qualitative study of international experts' views on surgical trainee decision making.

    PubMed

    Rennie, Sarah C; van Rij, Andre M; Jaye, Chrystal; Hall, Katherine H

    2011-06-01

    Decision making is a key competency of surgeons; however, how best to assess decisions and decision makers is not clearly established. The aim of the present study was to identify criteria that inform judgments about surgical trainees' decision-making skills. A qualitative free text web-based survey was distributed to recognized international experts in Surgery, Medical Education, and Cognitive Research. Half the participants were asked to identify features of good decisions, characteristics of good decision makers, and essential factors for developing good decision-making skills. The other half were asked to consider these areas in relation to poor decision making. Template analysis of free text responses was performed. Twenty-nine (52%) experts responded to the survey, identifying 13 categories for judging a decision and 14 for judging a decision maker. Twelve features/characteristics overlapped (considered, informed, well timed, aware of limitations, communicated, knowledgeable, collaborative, patient-focused, flexible, able to act on the decision, evidence-based, and coherent). Fifteen categories were generated for essential factors leading to development of decision-making skills that fall into three major themes (personal qualities, training, and culture). The categories compiled from the perspectives of good/poor were predominantly the inverse of each other; however, the weighting given to some categories varied. This study provides criteria described by experts when considering surgical decisions, decision makers, and development of decision-making skills. It proposes a working definition of a good decision maker. Understanding these criteria will enable clinical teachers to better recognize and encourage good decision-making skills and identify poor decision-making skills for remediation.

  15. Knowledge and Attitudes of a Number of Iranian Policy-makers towards Abortion

    PubMed Central

    Shamshiri-Milani, Hourieh; Pourreza, Abolghasem; Akbari, Feizollah

    2010-01-01

    Introduction Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. Materials and Methods A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. Results There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. Conclusion It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights

  16. Knowledge and Attitudes of a Number of Iranian Policy-makers towards Abortion.

    PubMed

    Hourieh, Shamshiri-Milani; Abolghasem, Pourreza; Feizollah, Akbari

    2010-10-01

    Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights.

  17. Work-Based Learning: A Practical Approach for Learning to Work and Working to Learn. A Case Study on Decision-Makers' Professional Development in Iran

    ERIC Educational Resources Information Center

    Arani, Mohammad Reza Sarkar; Alagamandan, Jafar; Tourani, Heidar

    2004-01-01

    The work-based learning model of human resource development has captured a great deal of attention and has gained increasing importance in higher education in recent years. Work-based learning is a powerful phenomenon that attempts to help policy-makers, managers and curriculum developers improve the quality of the decision and organizational…

  18. Restoration handbook for sagebrush steppe ecosystems with emphasis on greater sage-grouse habitat—Part 2. Landscape level restoration decisions

    USGS Publications Warehouse

    Pyke, David A.; Knick, Steven T.; Chambers, Jeanne C.; Pellant, Mike; Miller, Richard F.; Beck, Jeffrey L.; Doescher, Paul S.; Schupp, Eugene W.; Roundy, Bruce A.; Brunson, Mark; McIver, James D.

    2015-12-07

    Land managers do not have resources to restore all locations because of the extent of the restoration need and because some land uses are not likely to change, therefore, restoration decisions made at the landscape to regional scale may improve the effectiveness of restoration to achieve landscape and local restoration objectives. We present a landscape restoration decision tool intended to assist decision makers in determining landscape objectives, to identify and prioritize landscape areas where sites for priority restoration projects might be located, and to aid in ultimately selecting restoration sites guided by criteria used to define the landscape objectives. The landscape restoration decision tool is structured in five sections that should be addressed sequentially. Each section has a primary question or statement followed by related questions and statements to assist the user in addressing the primary question or statement. This handbook will guide decision makers through the important process steps of identifying appropriate questions, gathering appropriate data, developing landscape objectives, and prioritizing landscape patches where potential sites for restoration projects may be located. Once potential sites are selected, land managers can move to the site-specific decision tool to guide restoration decisions at the site level.

  19. Health care decision makers' use of comparative effectiveness research: report from a series of focus groups.

    PubMed

    Villa, Lorenzo; Warholak, Terri L; Hines, Lisa E; Taylor, Ann M; Brown, Mary; Hurwitz, Jason; Brixner, Diana; Malone, Daniel C

    2013-01-01

    Comparative effectiveness research (CER) is a helpful approach to improve health outcomes by developing and disseminating evidence-based information to patients, clinicians, and other decision makers about the most effective interventions. To (a) identify the factors necessary to increase the use of the Agency for Healthcare Research and Quality's (AHRQ) CER reviews in hospitals and managed care organizations; (b) assess current awareness and implementation of CER materials in these facilities and organizations; and (c) inform development of content for a workshop on CER. Pharmacy and therapeutics (PT) committee members and supportive personnel were recruited to participate in focus groups conducted at national health professional meetings. Prior to the sessions, each participant completed a prefocus group questionnaire evaluating the organization and process of the respondent's PT committee, as well as the respondent's role in the PT committee and awareness of AHRQ CER reports. Each session consisted of a focused discussion about CER and sources of evidence for PT monographs, and each participant completed a ballot to rank topics of importance for inclusion in a CER workshop for health care professionals involved in the PT process. Overarching themes were later identified using qualitative analysis of the transcripts of the focus group sessions. Thirty-nine (68%) pharmacists and 18 (32%) physicians involved in the PT process participated in 1 of 7 focus groups. Almost half of the participants had 6-15 years experience with the PT process. Participants represented health plans, hospitals, and health care systems. Two-thirds indicated they were aware of AHRQ's Effective Health Care Program's CER reviews, yet only 26% reported using the reviews in their organizations. The overarching themes reflected the need for timely and conclusive CER information; the role of the pharmacist as central to evidence synthesis for the PT process; and the need for educational programs

  20. Ensuring Adequate Health and Safety Information for Decision Makers during Large-Scale Chemical Releases

    NASA Astrophysics Data System (ADS)

    Petropoulos, Z.; Clavin, C.; Zuckerman, B.

    2015-12-01

    The 2014 4-Methylcyclohexanemethanol (MCHM) spill in the Elk River of West Virginia highlighted existing gaps in emergency planning for, and response to, large-scale chemical releases in the United States. The Emergency Planning and Community Right-to-Know Act requires that facilities with hazardous substances provide Material Safety Data Sheets (MSDSs), which contain health and safety information on the hazardous substances. The MSDS produced by Eastman Chemical Company, the manufacturer of MCHM, listed "no data available" for various human toxicity subcategories, such as reproductive toxicity and carcinogenicity. As a result of incomplete toxicity data, the public and media received conflicting messages on the safety of the contaminated water from government officials, industry, and the public health community. Two days after the governor lifted the ban on water use, the health department partially retracted the ban by warning pregnant women to continue avoiding the contaminated water, which the Centers for Disease Control and Prevention deemed safe three weeks later. The response in West Virginia represents a failure in risk communication and calls to question if government officials have sufficient information to support evidence-based decisions during future incidents. Research capabilities, like the National Science Foundation RAPID funding, can provide a solution to some of the data gaps, such as information on environmental fate in the case of the MCHM spill. In order to inform policy discussions on this issue, a methodology for assessing the outcomes of RAPID and similar National Institutes of Health grants in the context of emergency response is employed to examine the efficacy of research-based capabilities in enhancing public health decision making capacity. The results of this assessment highlight potential roles rapid scientific research can fill in ensuring adequate health and safety data is readily available for decision makers during large

  1. Optimal global value of information trials: better aligning manufacturer and decision maker interests and enabling feasible risk sharing.

    PubMed

    Eckermann, Simon; Willan, Andrew R

    2013-05-01

    Risk sharing arrangements relate to adjusting payments for new health technologies given evidence of their performance over time. Such arrangements rely on prospective information regarding the incremental net benefit of the new technology, and its use in practice. However, once the new technology has been adopted in a particular jurisdiction, randomized clinical trials within that jurisdiction are likely to be infeasible and unethical in the cases where they would be most helpful, i.e. with current evidence of positive while uncertain incremental health and net monetary benefit. Informed patients in these cases would likely be reluctant to participate in a trial, preferring instead to receive the new technology with certainty. Consequently, informing risk sharing arrangements within a jurisdiction is problematic given the infeasibility of collecting prospective trial data. To overcome such problems, we demonstrate that global trials facilitate trialling post adoption, leading to more complete and robust risk sharing arrangements that mitigate the impact of costs of reversal on expected value of information in jurisdictions who adopt while a global trial is undertaken. More generally, optimally designed global trials offer distinct advantages over locally optimal solutions for decision makers and manufacturers alike: avoiding opportunity costs of delay in jurisdictions that adopt; overcoming barriers to evidence collection; and improving levels of expected implementation. Further, the greater strength and translatability of evidence across jurisdictions inherent in optimal global trial design reduces barriers to translation across jurisdictions characteristic of local trials. Consequently, efficiently designed global trials better align the interests of decision makers and manufacturers, increasing the feasibility of risk sharing and the expected strength of evidence over local trials, up until the point that current evidence is globally sufficient.

  2. Graduate nurses: critical thinkers or better decision makers?

    PubMed

    Girot, E A

    2000-02-01

    This study evaluates the difference in development of critical thinking across four groups of nurses at different stages of the academic process and their perception of their decision-making ability in practice. With the move of nurse education into institutes of higher education nationally, there are no empirical data in the UK to suggest that graduates practice any differently from their non-graduate colleagues. An opportunistic sample of 82 nurses, was chosen from recent admission on a pre-registration degree programme, to mature graduates, as well as a group of experienced, non-graduate practitioners. A quasi-experimental, between-subjects design was used. A series of one-way ANOVAs was used to analyse the difference in critical thinking across all four groups, employing the Watson-Glaser Critical Thinking Appraisal. Additionally, the Jenkins Clinical Decision-Making in Nursing Scale was used to determine the differences in decision-making ability in practice across three of the groups with clinical experience. Furthermore, a correlation was undertaken to determine what relationship, if any, existed between critical thinking and decision-making in practice. It was found that there was no significant difference in the critical thinking skills across all groups studied, supporting the findings of other studies in the USA, which examined the cognitive skills of students undertaking graduate programmes. However, in their practice, it was found that those exposed to the academic process were significantly better at decision-making than their non-academic colleagues. Finally, no relationship could be found between the development of critical thinking and decision-making in practice, suggesting that more work needs to be done to look carefully at both critical thinking skills and decision-making in practice and the tools used to measure these.

  3. Bridging the gap between science and decision making.

    PubMed

    von Winterfeldt, Detlof

    2013-08-20

    All decisions, whether they are personal, public, or business-related, are based on the decision maker's beliefs and values. Science can and should help decision makers by shaping their beliefs. Unfortunately, science is not easily accessible to decision makers, and scientists often do not understand decision makers' information needs. This article presents a framework for bridging the gap between science and decision making and illustrates it with two examples. The first example is a personal health decision. It shows how a formal representation of the beliefs and values can reflect scientific inputs by a physician to combine with the values held by the decision maker to inform a medical choice. The second example is a public policy decision about managing a potential environmental hazard. It illustrates how controversial beliefs can be reflected as uncertainties and informed by science to make better decisions. Both examples use decision analysis to bridge science and decisions. The conclusions suggest that this can be a helpful process that requires skills in both science and decision making.

  4. Using Decision Analysis to Improve Malaria Control Policy Making

    PubMed Central

    Kramer, Randall; Dickinson, Katherine L.; Anderson, Richard M.; Fowler, Vance G.; Miranda, Marie Lynn; Mutero, Clifford M.; Saterson, Kathryn A.; Wiener, Jonathan B.

    2013-01-01

    Malaria and other vector-borne diseases represent a significant and growing burden in many tropical countries. Successfully addressing these threats will require policies that expand access to and use of existing control methods, such as insecticide-treated bed nets and artemesinin combination therapies for malaria, while weighing the costs and benefits of alternative approaches over time. This paper argues that decision analysis provides a valuable framework for formulating such policies and combating the emergence and re-emergence of malaria and other diseases. We outline five challenges that policy makers and practitioners face in the struggle against malaria, and demonstrate how decision analysis can help to address and overcome these challenges. A prototype decision analysis framework for malaria control in Tanzania is presented, highlighting the key components that a decision support tool should include. Developing and applying such a framework can promote stronger and more effective linkages between research and policy, ultimately helping to reduce the burden of malaria and other vector-borne diseases. PMID:19356821

  5. Development of An Analytic Approach to Determine How Environmental Protection Agency’s Integrated Risk Information System (IRIS) Is Used by Non-EPA Decision Makers (Final Contractor Report)

    EPA Science Inventory

    EPA announced the availability of the final contractor report entitled, Development of an Analytic Approach to Determine How Environmental Protection Agency’s Integrated Risk Information System (IRIS) Is Used By Non EPA Decision Makers. This contractor report analyzed how ...

  6. Decision conflict and regret among surrogate decision makers in the medical intensive care unit.

    PubMed

    Miller, Jesse J; Morris, Peter; Files, D Clark; Gower, Emily; Young, Michael

    2016-04-01

    Family members of critically ill patients in the intensive care unit face significant morbidity. It may be the decision-making process that plays a significant role in the psychological morbidity associated with being a surrogate in the ICU. We hypothesize that family members facing end-of-life decisions will have more decisional conflict and decisional regret than those facing non-end-of-life decisions. We enrolled a sample of adult patients and their surrogates in a tertiary care, academic medical intensive care unit. We queried the surrogates regarding decisions they had made on behalf of the patient and assessed decision conflict. We then contacted the family member again to assess decision regret. Forty (95%) of 42 surrogates were able to identify at least 1 decision they had made on behalf of the patient. End-of-life decisions (defined as do not resuscitate [DNR]/do not intubate [DNI] or continuation of life support) accounted for 19 of 40 decisions (47.5%). Overall, the average Decision Conflict Scale (DCS) score was 21.9 of 100 (range 0-100, with 0 being little decisional conflict and 100 being great decisional conflict). The average DCS score for families facing end-of-life decisions was 25.5 compared with 18.7 for all other decisions. Those facing end-of-life decisions scored higher on the uncertainty subscale (subset of DCS questions that indicates level of certainty regarding decision) with a mean score of 43.4 compared with all other decisions with a mean score of 27.0. Overall, very few surrogates experienced decisional regret with an average DRS score of 13.4 of 100. Nearly all surrogates enrolled were faced with decision-making responsibilities on behalf of his or her critically ill family member. In our small pilot study, we found more decisional conflict in those surrogates facing end-of-life decisions, specifically on the subset of questions dealing with uncertainty. Surrogates report low levels of decisional regret. Copyright © 2015 Elsevier

  7. Surrogate decision makers' perspectives on preventable breakdowns in care among critically ill patients: A qualitative study.

    PubMed

    Fisher, Kimberly A; Ahmad, Sumera; Jackson, Madeline; Mazor, Kathleen M

    2016-10-01

    To describe surrogate decision makers' (SDMs) perspectives on preventable breakdowns in care among critically ill patients. We screened 70 SDMs of critically ill patients for those who identified a preventable breakdown in care, defined as an event where the SDM believes something "went wrong", that could have been prevented, and resulted in harm. In-depth interviews were conducted with SDMs who identified an eligible event. 32 of 70 participants (46%) identified at least one preventable breakdown in care, with a total of 75 discrete events. Types of breakdowns involved medical care (n=52), communication (n=59), and both (n=40). Four additional breakdowns were related to problems with SDM bedside access to the patient. Adverse consequences of breakdowns included physical harm, need for additional medical care, emotional distress, pain, suffering, loss of trust, life disruption, impaired decision making, and financial expense. 28 of 32 SDMs raised their concerns with clinicians, yet only 25% were satisfactorily addressed. SDMs of critically ill patients frequently identify preventable breakdowns in care which result in harm. An in-depth understanding of the types of events SDMs find problematic and the associated harms is an important step towards improving the safety and patient-centeredness of healthcare. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Scenarios use to engage scientists and decision-makers in a changing Arctic

    NASA Astrophysics Data System (ADS)

    Lee, O. A.; Eicken, H.; Payne, J. F.

    2015-12-01

    Scenarios provide a framework to develop more adaptive Arctic policies that allow decision makers to consider the best available science to address complex relationships and key uncertainties in drivers of change. These drivers may encompass biophysical factors such as climate change, socioeconomic drivers, and wild-cards that represent low likelihood but influential events such as major environmental disasters. We outline some of the lessons learned from the North Slope Science Initiative (NSSI) scenarios project that could help in the development of adaptive science-based policies. Three spatially explicit development scenarios were identified corresponding to low, medium and high resource extraction activities on the North Slope and adjacent seas. In the case of the high energy development scenario science needs were focused on new technology, oil spill response, and the effects of offshore activities on marine mammals important for subsistence. Science needs related to community culture, erosion, permafrost degradation and hunting and trapping on land were also identified for all three scenarios. The NSSI science needs will guide recommendations for future observing efforts, and data from these observing activities could subsequently improve policy guidance for emergency response, subsistence management and other issues. Scenarios at pan-Arctic scales may help improve the development of international policies for resilient northern communities and encourage the use of science to reduce uncertainties in plans for adapting to change in the Arctic.

  9. Understanding Mali: Lessons for Policy Makers

    DTIC Science & Technology

    2014-06-01

    and health care . By the same token, the corruption and ethnic inequalities that are rampant in weak and failed states show an obvious lack of social ...one of the means used to take care of the terrorist threat. However, conflicts against terrorists groups such as in Afghanistan have proven long and...instability that led to the present situation in Mali, this study aspires to provide decision makers with concrete factors that should deserve careful

  10. 49 CFR 1503.657 - Appeal from initial decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AND ENFORCEMENT PROCEDURES Rules of Practice in TSA Civil Penalty Actions § 1503.657 Appeal from... order of the TSA decision maker have been entered on the record. (b) Issues on appeal. A party may... appeal with the consent of the TSA decision maker. If the TSA decision maker grants an extension of time...

  11. National policy-makers speak out: are researchers giving them what they need?

    PubMed Central

    Hyder, Adnan A; Corluka, Adrijana; Winch, Peter J; El-Shinnawy, Azza; Ghassany, Harith; Malekafzali, Hossein; Lim, Meng-Kin; Mfutso-Bengo, Joseph; Segura, Elsa; Ghaffar, Abdul

    2011-01-01

    The objective of this empirical study was to understand the perspectives and attitudes of policy-makers towards the use and impact of research in the health sector in low- and middle-income countries. The study used data from 83 semi-structured, in-depth interviews conducted with purposively selected policy-makers at the national level in Argentina, Egypt, Iran, Malawi, Oman and Singapore. The interviews were structured around an interview guide developed based on existing literature and in consultation with all six country investigators. Transcripts were processed using a thematic-analysis approach. Policy-makers interviewed for this study were unequivocal in their support for health research and the high value they attribute to it. However, they stated that there were structural and informal barriers to research contributing to policy processes, to the contribution research makes to knowledge generally, and to the use of research in health decision-making specifically. Major findings regarding barriers to evidence-based policy-making included poor communication and dissemination, lack of technical capacity in policy processes, as well as the influence of the political context. Policy-makers had a variable understanding of economic analysis, equity and burden of disease measures, and were vague in terms of their use in national decisions. Policy-maker recommendations regarding strategies for facilitating the uptake of research into policy included improving the technical capacity of policy-makers, better packaging of research results, use of social networks, and establishment of fora and clearinghouse functions to help assist in evidence-based policy-making. PMID:20547652

  12. Dairy cow culling strategies: making economical culling decisions.

    PubMed

    Lehenbauer, T W; Oltjen, J W

    1998-01-01

    The purpose of this report was to examine important economic elements of culling decisions, to review progress in development of culling decision support systems, and to discern some of the potentially rewarding areas for future research on culling models. Culling decisions have an important influence on the economic performance of the dairy but are often made in a nonprogrammed fashion and based partly on the intuition of the decision maker. The computer technology that is available for dairy herd management has made feasible the use of economic models to support culling decisions. Financial components--including profit, cash flow, and risk--are major economic factors affecting culling decisions. Culling strategies are further influenced by short-term fluctuations in cow numbers as well as by planned herd expansion. Changes in herd size affect the opportunity cost for postponed replacement and may alter the relevance of optimization strategies that assume a fixed herd size. Improvements in model components related to biological factors affecting future cow performance, including milk production, reproductive status, and mastitis, appear to offer the greatest economic potential for enhancing culling decision support systems. The ultimate value of any culling decision support system for developing economic culling strategies will be determined by its results under field conditions.

  13. Engagement Between Decision Makers and the Research Community in Califonria'a Climate Assessments

    NASA Astrophysics Data System (ADS)

    Bedsworth, L. W.; Franco, G.; Wilhelm, S.; DeLaRosa, J.

    2016-12-01

    The State of California has been supporting the development of regional climate change science for more than two decades. The engagement between the scientific community in California and State agencies has been strong, and supported by multiple formalized relationships. For example, research results have informed state climate policy formulation such as the passage of AB32, a law that requires the State to bring GHG emissions to 1990 levels by 2020, and three Bills on climate adaptation that became law late in 2015. Scientific research has also been used for long-term planning of state resources such as the Forestry Plan, the Water Plan, and the Integrated Energy Policy Report. The Climate Action Team Research Working Group meets monthly to coordinate climate-related research activities supported by more than 20 state agencies and is the steering committee for the next California Climate Assessment that will be released in 2018. The State is co-producing the research commissioned for the 2018 Assessment in various ways, including the identification of research projects, the integration of more than 50 research studies, and active participation during execution of the research. The presentation will discuss the State's successes in linking decision-makers and the scientific community as well as challenges and potential ways to enhance these linkages.

  14. Participatory modeling and structured decision making

    USGS Publications Warehouse

    Robinson, Kelly F.; Fuller, Angela K.

    2016-01-01

    Structured decision making (SDM) provides a framework for making sound decisions even when faced with uncertainty, and is a transparent, defensible, and replicable method used to understand complex problems. A hallmark of SDM is the explicit incorporation of values and science, which often includes participation from multiple stakeholders, helping to garner trust and ultimately result in a decision that is more likely to be implemented. The core steps in the SDM process are used to structure thinking about natural resources management choices, and include: (1) properly defining the problem and the decision context, (2) determining the objectives that help describe the aspirations of the decision maker, (3) devising management actions or alternatives that can achieve those objectives, (4) evaluating the outcomes or consequences of each alternative on each of the objectives, (5) evaluating trade-offs, and (6) implementing the decision. Participatory modeling for SDM includes engaging stakeholders in some or all of the steps of the SDM process listed above. In addition, participatory modeling often is crucial for creating qualitative and quantitative models of how the system works, providing data for these models, and eliciting expert opinion when data are unavailable. In these ways, SDM provides a framework for decision making in natural resources management that includes participation from stakeholder groups throughout the process, including the modeling phase.

  15. Creating dialogue: a workshop on "Uncertainty in Decision Making in a Changing Climate"

    NASA Astrophysics Data System (ADS)

    Ewen, Tracy; Addor, Nans; Johnson, Leigh; Coltekin, Arzu; Derungs, Curdin; Muccione, Veruska

    2014-05-01

    Uncertainty is present in all fields of climate research, spanning from projections of future climate change, to assessing regional impacts and vulnerabilities, to adaptation policy and decision-making. In addition to uncertainties, managers and planners in many sectors are often confronted with large amounts of information from climate change research whose complex and interdisciplinary nature make it challenging to incorporate into the decision-making process. An overarching issue in tackling this problem is the lack of institutionalized dialogue between climate researchers, decision-makers and user groups. Forums that facilitate such dialogue would allow climate researchers to actively engage with end-users and researchers in different disciplines to better characterize uncertainties and ultimately understand which ones are critically considered and incorporated into decisions made. We propose that the introduction of students to these challenges at an early stage of their education and career is a first step towards improving future dialogue between climate researchers, decision-makers and user groups. To this end, we organized a workshop at the University of Zurich, Switzerland, entitled "Uncertainty in Decision Making in a Changing Climate". It brought together 50 participants, including Bachelor, Master and PhD students and academic staff, and nine selected speakers from academia, industry, government, and philanthropy. Speakers introduced participants to topics ranging from uncertainties in climate model scenarios to managing uncertainties in development and aid agencies. The workshop consisted of experts' presentations, a panel discussion and student group work on case studies. Pedagogical goals included i) providing participants with an overview of the current research on uncertainty and on how uncertainty is dealt with by decision-makers, ii) fostering exchange between practitioners, students, and scientists from different backgrounds, iii) exposing

  16. The female community health volunteer programme in Nepal: decision makers' perceptions of volunteerism, payment and other incentives.

    PubMed

    Glenton, Claire; Scheel, Inger B; Pradhan, Sabina; Lewin, Simon; Hodgins, Stephen; Shrestha, Vijaya

    2010-06-01

    The Female Community Health Volunteer (FCHV) Programme in Nepal has existed since the late 1980s and includes almost 50,000 volunteers. Although volunteer programmes are widely thought to be characterised by high attrition levels, the FCHV Programme loses fewer than 5% of its volunteers annually. The degree to which decision makers understand community health worker motivations and match these with appropriate incentives is likely to influence programme sustainability. The purpose of this study was to explore the views of stakeholders who have participated in the design and implementation of the Female Community Health Volunteer regarding Volunteer motivation and appropriate incentives, and to compare these views with the views and expectations of Volunteers. Semi-structured interviews were carried out in 2009 with 19 purposively selected non-Volunteer stakeholders, including policy makers and programme managers. Results were compared with data from previous studies of Female Community Health Volunteers and from interviews with four Volunteers and two Volunteer activists. Stakeholders saw Volunteers as motivated primarily by social respect, religious and moral duty. The freedom to deliver services at their leisure was seen as central to the volunteer concept. While stakeholders also saw the need for extrinsic incentives such as micro-credit, regular wages were regarded not only as financially unfeasible, but as a potential threat to the Volunteers' social respect, and thereby to their motivation. These views were reflected in interviews with and previous studies of Female Community Health Volunteers, and appear to be influenced by a tradition of volunteering as moral behaviour, a lack of respect for paid government workers, and the Programme's community embeddedness. Our study suggests that it may not be useful to promote a generic range of incentives, such as wages, to improve community health worker programme sustainability. Instead, programmes should ensure that

  17. A review of the literature: midwifery decision-making and birth.

    PubMed

    Jefford, Elaine; Fahy, Kathleen; Sundin, Deborah

    2010-12-01

    Clinical decision-making was initially studied in medicine where hypothetico-deductive reasoning is the model for decision-making. The nursing perspective on clinical decision-making has largely been shaped by Patricia Benner's ground breaking work. Benner claimed expert nurses use humanistic-intuitive ways of making clinical decisions rather than the 'rational reasoning' as claimed by medicine. Clinical decision-making in midwifery is not the same as either nursing or medical decision-making because of the woman-midwife partnership where the woman is the ultimate decision-maker. CINHAL, Medline and Cochrane databases were systematically searched using key words derived from the guiding question. A review of the decision-making research literature in midwifery was undertaken where studies were published in English. The selection criteria for papers were: only research papers of direct relevance to the guiding research question were included in the review. Decision-making is under-researched in midwifery and more specifically birth, as only 4 research articles met the inclusion criteria in this review. Three of the studies involved qualified midwives, and one involved student midwives. Two studies were undertaken in England, one in Scotland and one in Sweden. The major findings synthesised from this review, are that; (1) midwifery decision-making during birth is socially negotiated involving hierarchies of surveillance and control; (2) the role of the woman in shared decision-making during birth has not been explored by midwifery research; (3) clinical decision-making encompasses clinical reasoning as essential but not sufficient for midwives to actually implement their preferred decision. We argue that existing research does not inform the discipline of the complexity of midwifery clinical decision-making during birth. A well-designed study would involve investigating the clinical reasoning skills of the midwife, her relationship with the woman, the context of the

  18. URBAN DECISION-MAKING, THE UNIVERSITY'S ROLE.

    ERIC Educational Resources Information Center

    BAILEY, STEPHEN K.

    THE AUTHOR EXAMINES THE VARIOUS WAYS IN WHICH THE UNIVERSITY CAN AND SHOULD INFLUENCE URBAN DECISION MAKING. THE CENTRAL UNIVERSITY ROLE IS SENSITIZING THE DECISION MAKERS AND THE CITIZENS TO HUMAN MISERY, SUCH AS BIGOTRY, SQUALOR, DISEASE, UGLINESS, POVERTY, AND IGNORANCE. LONG-RANGE ROLES ARE PINPOINTING THE PROBLEMS URBAN DECISION MAKERS SHOULD…

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  20. How do researchers influence decision-makers? Case studies of Mexican policies.

    PubMed

    Trostle, J; Bronfman, M; Langer, A

    1999-06-01

    Though the problems translating or applying research in policy-making are legion, solutions are rare. As developing countries increase their capacities to develop effective local solutions to their health problems, they confront the research/policy dilemma. Yet few descriptive studies of research-policy links can be found from developing countries, and the relevance of European and North American models and data is questionable. We report the results of a descriptive study from Mexico of the relationship between health research and policy in four vertical programmes (AIDS, cholera, family planning, immunization). We interviewed 67 researchers and policy-makers from different institutions and levels of responsibility. We analyzed interviewee responses looking for factors that promoted or impeded exchanges between researchers and policy-makers. These were, in turn, divided into emphases on content, actors, process, and context. Many of the promoting factors resembled findings from studies in industrialized countries. Some important differences across the four programmes, which also distinguish them from industrialized country programmes, included extent of reliance on formal communication channels, role of the mass media in building social consensus or creating discord, levels of social consensus, role of foreign donors, and extent of support for biomedical versus social research. We recommend various ways to increase the impact of research on health policy-making in Mexico. Some of the largest challenges include the fact that researchers are but one of many interest groups, and research but one input among many equally legitimate elements to be considered by policy-makers. Another important challenge in Mexico is the relatively small role played by the public in policy-making. Further democratic changes in Mexico may be the most important incentive to increase the use of research in policy-making.

  1. 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.

  2. Understanding The Decision Context: DPSIR, Decision Landscape, And Social Network Analysis

    EPA Science Inventory

    Establishing the decision context for a management problem is the critical first step for effective decision analysis. Understanding the decision context allow stakeholders and decision-makers to integrate the societal, environmental, and economic considerations that must be con...

  3. The Computer as Adaptive Instructional Decision Maker.

    ERIC Educational Resources Information Center

    Kopstein, Felix F.; Seidel, Robert J.

    The computer's potential for education, and most particularly for instruction, is contingent on the development of a class of instructional decision models (formal instructional strategies) that interact with the student through appropriate peripheral equipment (man-machine interfaces). Computer hardware and software by themselves should not be…

  4. Decision Theory and the Governance of Technology.

    ERIC Educational Resources Information Center

    Woodhouse, Edward J.

    1987-01-01

    Provides an overview of the decision making process for science and technology. Finds that government agencies and officials are not the major decision makers. Examines obstacles to achieving intelligent decisions when policy makers are scientists, business executives, and consumers. Concludes with five strategies for improving technological…

  5. Breast Cancer Risk Estimation and Personal Insurance: A Qualitative Study Presenting Perspectives from Canadian Patients and Decision Makers

    PubMed Central

    Dalpé, Gratien; Ngueng Feze, Ida; Salman, Shahad; Joly, Yann; Hagan, Julie; Lévesque, Emmanuelle; Dorval, Véronique; Blouin-Bougie, Jolyane; Amara, Nabil; Dorval, Michel; Simard, Jacques

    2017-01-01

    Genetic stratification approaches in personalized medicine may considerably improve our ability to predict breast cancer risk for women at higher risk of developing breast cancer. Notwithstanding these advantages, concerns have been raised about the use of the genetic information derived in these processes, outside of the research and medical health care settings, by third parties such as insurers. Indeed, insurance applicants are asked to consent to insurers accessing their medical information (implicitly including genetic) to verify or determine their insurability level, or eligibility to certain insurance products. This use of genetic information may result in the differential treatment of individuals based on their genetic information, which could lead to higher premium, exclusionary clauses or even the denial of coverage. This phenomenon has been commonly referred to as “Genetic Discrimination” (GD). In the Canadian context, where federal Bill S-201, An Act to prohibit and prevent genetic discrimination, has recently been enacted but may be subject to constitutional challenges, information about potential risks to insurability may raise issues in the clinical context. We conducted a survey with women in Quebec who have never been diagnosed with breast cancer to document their perspectives. We complemented the research with data from 14 semi-structured interviews with decision-makers in Quebec to discuss institutional issues raised by the use of genetic information by insurers. Our results provide findings on five main issues: (1) the reluctance to undergo genetic screening test due to insurability concerns, (2) insurers' interest in genetic information, (3) the duty to disclose genetic information to insurers, (4) the disclosure of potential impacts on insurability before genetic testing, and (5) the status of genetic information compared to other health data. Overall, both groups of participants (the women surveyed and the decision-makers interviewed

  6. Breast Cancer Risk Estimation and Personal Insurance: A Qualitative Study Presenting Perspectives from Canadian Patients and Decision Makers.

    PubMed

    Dalpé, Gratien; Ngueng Feze, Ida; Salman, Shahad; Joly, Yann; Hagan, Julie; Lévesque, Emmanuelle; Dorval, Véronique; Blouin-Bougie, Jolyane; Amara, Nabil; Dorval, Michel; Simard, Jacques

    2017-01-01

    Genetic stratification approaches in personalized medicine may considerably improve our ability to predict breast cancer risk for women at higher risk of developing breast cancer. Notwithstanding these advantages, concerns have been raised about the use of the genetic information derived in these processes, outside of the research and medical health care settings, by third parties such as insurers. Indeed, insurance applicants are asked to consent to insurers accessing their medical information (implicitly including genetic) to verify or determine their insurability level, or eligibility to certain insurance products. This use of genetic information may result in the differential treatment of individuals based on their genetic information, which could lead to higher premium, exclusionary clauses or even the denial of coverage. This phenomenon has been commonly referred to as "Genetic Discrimination" (GD). In the Canadian context, where federal Bill S-201, An Act to prohibit and prevent genetic discrimination , has recently been enacted but may be subject to constitutional challenges, information about potential risks to insurability may raise issues in the clinical context. We conducted a survey with women in Quebec who have never been diagnosed with breast cancer to document their perspectives. We complemented the research with data from 14 semi-structured interviews with decision-makers in Quebec to discuss institutional issues raised by the use of genetic information by insurers. Our results provide findings on five main issues: (1) the reluctance to undergo genetic screening test due to insurability concerns, (2) insurers' interest in genetic information, (3) the duty to disclose genetic information to insurers, (4) the disclosure of potential impacts on insurability before genetic testing, and (5) the status of genetic information compared to other health data. Overall, both groups of participants (the women surveyed and the decision-makers interviewed

  7. "World of Uncertainty" Game for Decision-Makers

    ERIC Educational Resources Information Center

    Kyzy, Jyldyz Tabyldy

    2011-01-01

    Decisions on both personal and public matters benefit significantly if uncertainties and risks are handled with more care and accuracy. It is crucial to refine and express degrees of confidence and subjective probabilities of various outcomes. Experience, intuition, and skills help make the most of uncertain information. This paper proposes a…

  8. Delegating Decisions to Experts

    ERIC Educational Resources Information Center

    Li, Hao; Suen, Wing

    2004-01-01

    We present a model of delegation with self-interested and privately informed experts. A team of experts with extreme but opposite biases is acceptable to a wide range of decision makers with diverse preferences, but the value of expertise from such a team is low. A decision maker wants to appoint experts who are less partisan than he is in order…

  9. Value of Information and Prospect theory as tools to involve decision-makers in water-related design, operation and planning of water systems

    NASA Astrophysics Data System (ADS)

    Alfonso, Leonardo

    2013-04-01

    The role of decision-makers is to take the outputs from hydrological and hydraulic analyses and, in some extent, use them as inputs to make decisions that are related to planning, design and operation of water systems. However, the use of these technical analyses is frequently limited, since there are other non-hydrological issues that must be considered, that may end up in very different solutions than those envisaged by the purely technical ones. A possibility to account for the nature of the human decisions under uncertainty is by exploring the use of concepts from decision theory and behavioural economics, such as Value of Information and Prospect Theory and embed them into the methodologies we use in the hydrology practice. Three examples are presented to illustrate these multidisciplinary interactions. The first one, for monitoring network design, uses Value of Information within a methodology to locate water level stations in a complex canal of networks in the Netherlands. The second example, for operation, shows how the Value of Information concept can be used to formulate alternative methods to evaluate flood risk according to the set of options available for decision-making during a flood event. The third example, for planning, uses Prospect Theory concepts to understand how the "losses hurt more than gains feel good" effect can determine the final decision of urbanise or not a flood-prone area. It is demonstrated that decision theory and behavioural economic principles are promising to evaluate the complex decision-making process in water-related issues.

  10. Transferring Knowledge from Observations and Models to Decision Makers: An Overview and Challenges

    NASA Technical Reports Server (NTRS)

    Habib, Shahid; Nokra, Nada Abu

    2003-01-01

    Over the last 25 years, a tremendous progress has been made in the Earth science space-based remote sensing observations, technologies and algorithms. Such advancements have improved the predictability by providing lead-time and accuracy of forecast in weather, climate, natural hazards, and natural resources. It has further reduced or bounded the overall uncertainties by partially improving our understanding of planet Earth as an integrated system that is governed by non-linear and chaotic behavior. Many countries such US, European Community, Japan, China and others have invested billions of dollars in developing and launching space-based assets in the low earth (LEO) and geostationary (GEO) orbits. However, the wealth of this scientific knowledge that has potential of extracting monumental socio-economic benefits from such large investments have been slow in reaching to public and decision makers. For instance, there are a number of areas such as energy forecasting, aviation safety, agricultural competitiveness, disaster management, security, air quality and public health can directly take advantage. Nevertheless, we all live in a global economy that depends on access to the best available Earth Science information for all inhabitants of this planet. This paper surveys and examines a number such applications in terms of their architecture, maturity and economic applicability as they apply to the societal needs. A detailed analysis is also presented of various challenges and issues that pertain to a number of areas such as: (1) difficulties in making a speedy transition of data and information from observations and models to relevant Decision Support Systems (DSS) or tools, (2) data and models inter-operability issues, (3) limitations of spatial, spectral and temporal resolution, (4) communication limitations as dictated by the availability of image processing and data compression techniques. Additionally, the most critical element amongst all is the organizational

  11. Transferring knowledge from observations and models to decision makers: an overview and challenges

    NASA Astrophysics Data System (ADS)

    Habib, Shahid; Nokra, Nada A.

    2004-02-01

    Over the last 25 years, a tremendous progress has been made in the Earth science space-based remote sensing observations, technologies and algorithms. Such advancements have improved the predictability by providing lead-time and accuracy of forecast in weather, climate, natural hazards, and natural resources. It has further reduced or bounded the overall uncertainties by partially improving our understanding of planet Earth as an integrated system that is governed by non-linear and chaotic behavior. Many countries such US, European Community, Japan, China and others have invested billions of dollars in developing and launching space-based assets in the low earth (LEO) and geostationary (GEO) orbits. However, the wealth of this scientific knowledge that has potential of extracting monumental socio-economic benefits from such large investments have been slow in reaching the public and decision makers. For instance, there are a number of areas such as energy forecasting, aviation safety, agricultural competitiveness, disaster management, homeland security, air quality and public health, which can directly take advantage. Nevertheless, we all live in a global economy that depends on access to the best available Earth Science information for all inhabitants of this planet. This paper surveys and examines a number such applications in terms of their architecture, maturity and economic applicability as they apply to the societal needs. A detailed analysis is also presented of various challenges and issues that pertain to a number of areas such as: (1) difficulties in making a speedy transition of data and information from observations and models to relevant Decision Support Systems (DSS) or tools, (2) data and models inter-operability issues, (3) limitations of spatial, spectral and temporal resolution,(4) communication limitations as dictated by the availability of image processing and data compression techniques. Additionally, the most critical element amongst all is

  12. An Introduction to Solar Decision-Making Tools

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

    Mow, Benjamin

    2017-09-12

    The National Renewable Energy Laboratory (NREL) offers a variety of models and analysis tools to help decision makers evaluate and make informed decisions about solar projects, policies, and programs. This fact sheet aims to help decision makers determine which NREL tool to use for a given solar project or policy question, depending on its scope.

  13. A model of the human observer and decision maker

    NASA Technical Reports Server (NTRS)

    Wewerinke, P. H.

    1981-01-01

    The decision process is described in terms of classical sequential decision theory by considering the hypothesis that an abnormal condition has occurred by means of a generalized likelihood ratio test. For this, a sufficient statistic is provided by the innovation sequence which is the result of the perception an information processing submodel of the human observer. On the basis of only two model parameters, the model predicts the decision speed/accuracy trade-off and various attentional characteristics. A preliminary test of the model for single variable failure detection tasks resulted in a very good fit of the experimental data. In a formal validation program, a variety of multivariable failure detection tasks was investigated and the predictive capability of the model was demonstrated.

  14. Use of economic evaluation in decision making: evidence and recommendations for improvement.

    PubMed

    Simoens, Steven

    2010-10-22

    Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes. Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines. Economic evaluation is used by policy makers and healthcare payers to inform medicine pricing/reimbursement decisions in more and more countries. It is a suitable tool to evaluate medicines and to present information about their value for money to decision makers in a familiar format. In order to fully exploit the use of economic evaluation for decision-making purposes, researchers need to take care to conduct such economic evaluations according to methodologically sound principles. Additionally, researchers need to take into account the decision-making context. They need to identify the various objectives that decision makers pursue and discuss how decision makers can use study findings to attain these objectives. These issues require further attention from researchers, policy makers, healthcare payers, healthcare professionals and pharmaceutical companies with a view to optimizing the use of economic evaluation in decision making.

  15. Barriers and challenges in adopting Saudi telemedicine network: The perceptions of decision makers of healthcare facilities in Saudi Arabia.

    PubMed

    Alaboudi, Abdulellah; Atkins, Anthony; Sharp, Bernadette; Balkhair, Ahmed; Alzahrani, Mohammed; Sunbul, Tamara

    Despite emerging evidence about the benefits of telemedicine, there are still many barriers and challenges to its adoption. Its adoption is often cited as a failed project because 75% of them are abandoned or 'failed outright' and this percentage increases to 90% in developing countries. The literature has clarified that there is neither one-size-fit-all framework nor best-practice solution for all ICT innovations or for all countries. Barriers and challenges in adopting and implementing one ICT innovation in a given country/organisation may not be similar - not for the same ICT innovation in another country/organisation nor for another ICT innovation in the same country/organisation. To the best of our knowledge, no comprehensive scientific study has investigated these challenges and barriers in all Healthcare Facilities (HCFs) across the Kingdom of Saudi Arabia (KSA). This research, which is undertaken based on the Saudi Telemedicine Network roadmap and in collaboration with the Saudi Ministry of Health (MOH), is aimed at identifying the principle predictive challenges and barriers in the context of the KSA, and understanding the perspective of the decision makers of each HCF type, sector, and location. Three theories are used to underpin this research: the Unified Theory of Acceptance and Use of Technology (UTAUT), the Technology-Organisation-Environment (TOE) theoretical framework, and the Evaluating Telemedicine Systems Success Model (ETSSM). This study applies a three-sequential-phase approach by using three mixed methods (i.e., literature review, interviews, and questionnaires) in order to utilise the source triangulation and the data comparison analysis technique. The findings of this study show that the top three influential barriers to adopt and implement telemedicine by the HCF decision makers are: (i) the availability of adequate sustainable financial support to implement, operate, and maintain the telemedicine system, (ii) ensuring conformity of

  16. Changing Times, Complex Decisions: Presidential Values and Decision Making

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  17. Making Leaders: Leadership Characteristics of Makers and Engineers in the Maker Community

    ERIC Educational Resources Information Center

    Oplinger, James; Lande, Micah; Jordan, Shawn; Camarena, Leonor

    2016-01-01

    This study examines the emergence of leadership characteristics within a new organizational community of individuals: the Maker community. The Maker community is a group of individuals that classify themselves as "Makers" and have become innovators and entrepreneurs through the creation of technological gadgets, artistic projects, and…

  18. Bridging the gap between science and decision making

    PubMed Central

    von Winterfeldt, Detlof

    2013-01-01

    All decisions, whether they are personal, public, or business-related, are based on the decision maker’s beliefs and values. Science can and should help decision makers by shaping their beliefs. Unfortunately, science is not easily accessible to decision makers, and scientists often do not understand decision makers’ information needs. This article presents a framework for bridging the gap between science and decision making and illustrates it with two examples. The first example is a personal health decision. It shows how a formal representation of the beliefs and values can reflect scientific inputs by a physician to combine with the values held by the decision maker to inform a medical choice. The second example is a public policy decision about managing a potential environmental hazard. It illustrates how controversial beliefs can be reflected as uncertainties and informed by science to make better decisions. Both examples use decision analysis to bridge science and decisions. The conclusions suggest that this can be a helpful process that requires skills in both science and decision making. PMID:23940310

  19. Other People’s Money: The Role of Reciprocity and Social Uncertainty in Decisions for Others

    PubMed Central

    2017-01-01

    Many important decisions are taken not by the person who will ultimately gain or lose from the outcome, but on their behalf, by somebody else. We examined economic decision-making about risk and time in situations in which deciders chose for others who also chose for them. We propose that this unique setting, which has not been studied before, elicits perception of reciprocity that prompts a unique bias in preferences. We found that decision-makers are less patient (more discounting), and more risk averse for losses than gains, with other peoples’ money, especially when their choices for others are more uncertain. Those results were derived by exploiting a computational modeling framework that has been shown to account for the underlying psychological and neural decision processes. We propose a novel theoretical mechanism—precautionary preferences under social uncertainty, which explains the findings. Implications for future research and alternative models are also discussed. PMID:29456782

  20. An Ethical and Legal Framework for Physicians as Surrogate Decision-Makers for Their Patients.

    PubMed

    Rosoff, Philip M; Leong, Kelly M

    2015-01-01

    In Western industrialized countries, it is well established that legally competent individuals may choose a surrogate healthcare decision-maker to represent their interests should they lose the capacity to do so themselves. There are few limitations on who they may select to fulfill this function. However, many jurisdictions place restrictions on or prohibit the patient's attending physician or other provider involved with an individual's care to serve in this role. Several authors have previously suggested that respect for the autonomy of patients requires that there be few (if any) constraints on whomever they may appoint as a proxy. In this essay we revisit this topic by first providing a survey of current state laws governing this activity. We then analyze the clinical and ethical circumstances in which potential difficulties could arise. We take a more nuanced and circumspect view of prior suggestions that patients should have virtually unfettered liberty to choose their healthcare proxies. We suggest a strategy to balance the freedom of patients' right to choose their surrogates with fiduciary duty of the state as regulator of medical practice. We identify six domains of possible concern with such relationships and suggest straightforward methods of mitigating their potential negative effects that could be plausibly be incorporated into physician practice. © 2015 American Society of Law, Medicine & Ethics, Inc.

  1. Good decision-making is associated with an adaptive cardiovascular response to social competitive stress.

    PubMed

    Alacreu-Crespo, Adrián; Costa, Raquel; Abad-Tortosa, Diana; Salvador, Alicia; Serrano, Miguel Ángel

    2018-06-22

    Competition elicits different psychological and cardiovascular responses depending on a person's skills. Decision-making has been considered a distal factor that influences competition, but there are no studies analyzing this relationship. Our objective was to analyze whether decision-making affects the response to competition. Specifically, we aimed to test whether good performers on a decision-making test, the Iowa Gambling Task (IGT), showed an adaptive cardiovascular response to competition. In all, 116 participants (44 women) performed the IGT and were classified into Good or Poor decision-makers. Subsequently, they were exposed to a stress task in two different conditions: a face-to-face competition (winners/losers) or a control condition, while an electrocardiogram was recorded. In the competition group, good decision-makers increased their high-frequency respect to the total heart rate variability (HF/HRV) levels during the task, compared to Poor decision-makers. Again, competition group good decision-makers, showed lower LF and higher HF/HRV reactivity than the control group, which represents lower HRV stress pattern. Moreover, in the group of losers, good decision-makers had a decline in low frequency (LF) during the task and faster recovery than poor decision-makers. In conclusion, good decision-makers have a more adaptive stress response and higher levels of mental effort, based on total HRV interpretation. Decision-making skills could be a factor in a more adaptive cardiovascular response to competition.

  2. GLIMPSE: a rapid decision framework for energy and environmental policy.

    PubMed

    Akhtar, Farhan H; Pinder, Robert W; Loughlin, Daniel H; Henze, Daven K

    2013-01-01

    Over the coming decades, new energy production technologies and the policies that oversee them will affect human health, the vitality of our ecosystems, and the stability of the global climate. The GLIMPSE decision model framework provides insights about the implications of technology and policy decisions on these outcomes. Using GLIMPSE, decision makers can identify alternative techno-policy futures, examining their air quality, health, and short- and long-term climate impacts. Ultimately, GLIMPSE will support the identification of cost-effective strategies for simultaneously achieving performance goals for these metrics. Here, we demonstrate the utility of GLIMPSE by analyzing several future energy scenarios under existing air quality regulations and potential CO2 emission reduction policies. We find opportunities for substantial cobenefits in setting both climate change mitigation and health-benefit based air quality improvement targets. Though current policies which prioritize public health protection increase near-term warming, establishing policies that also reduce greenhouse gas emissions may offset warming in the near-term and lead to significant reductions in long-term warming.

  3. Linking decision-making research and cancer prevention and control: important themes.

    PubMed

    McCaul, Kevin D; Peters, Ellen; Nelson, Wendy; Stefanek, Michael

    2005-07-01

    This article describes 6 themes underlying the multiple presentations from the Basic and Applied Decision Making in Cancer Control meeting, held February 19-20, 2004. The following themes have important implications for research and practice linking basic decision-making research to cancer prevention and control: (a) Traditional decision-making theories fail to capture real-world decision making, (b) decision makers are often unable to predict future preferences, (c) preferences are often constructed on the spot and thus are influenced by situational cues, (d) decision makers often rely on feelings rather than beliefs when making a decision, (e) the perspective of the decision maker is critical in determining preferences, and (f) informed decision making may--or may not--yield the best decisions.

  4. How decisions happen: focal points and blind spots in interdependent decision making.

    PubMed

    Halevy, Nir; Chou, Eileen Y

    2014-03-01

    Decision makers often simplify decision problems by ignoring readily available information. The current multimethod research investigated which types of information about interdependence situations are psychologically prominent to decision makers and which tend to go unnoticed. Study 1 used eye-tracking measures to investigate how decision makers allocate their attention in interdependence situations and revealed that individuals fixated on mutual cooperation earlier and longer as compared with alternative combinations of strategies and outcomes. In addition, participants' behavioral cooperation was consistent with their attention allocation. Study 2 introduced a novel information-search paradigm: Participants exchanged yes/no questions and answers to discover which of 25 different games their counterpart chose. Analyzing the contents of participants' questions showed that, consistent with Study 1, participants focused primarily on desirable outcomes and symmetric behavioral choices. Study 3 revealed that outcome desirability is a robust basis of psychological prominence across different types of social relations; in contrast, the psychological prominence of symmetry was moderated by the nature of social relations. Study 4 revealed that whether different bases of psychological prominence directed individuals' attention to the same aspects of the decision-making task moderated the effect of information availability on decision latency and cooperation rates. Taken together, these findings contribute to the mapping of bounded rationality, demonstrate how people think about their interdependence, and enhance our understanding of how decisions happen. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  5. What do hospital decision-makers in Ontario, Canada, have to say about the fairness of priority setting in their institutions?

    PubMed Central

    Reeleder, David; Martin, Douglas K; Keresztes, Christian; Singer, Peter A

    2005-01-01

    Background Priority setting, also known as rationing or resource allocation, occurs at all levels of every health care system. Daniels and Sabin have proposed a framework for priority setting in health care institutions called 'accountability for reasonableness', which links priority setting to theories of democratic deliberation. Fairness is a key goal of priority setting. According to 'accountability for reasonableness', health care institutions engaged in priority setting have a claim to fairness if they satisfy four conditions of relevance, publicity, appeals/revision, and enforcement. This is the first study which has surveyed the views of hospital decision makers throughout an entire health system about the fairness of priority setting in their institutions. The purpose of this study is to elicit hospital decision-makers' self-report of the fairness of priority setting in their hospitals using an explicit conceptual framework, 'accountability for reasonableness'. Methods 160 Ontario hospital Chief Executive Officers, or their designates, were asked to complete a survey questionnaire concerning priority setting in their publicly funded institutions. Eight-six Ontario hospitals completed this survey, for a response rate of 54%. Six close-ended rating scale questions (e.g. Overall, how fair is priority setting at your hospital?), and 3 open-ended questions (e.g. What do you see as the goal(s) of priority setting in your hospital?) were used. Results Overall, 60.7% of respondents indicated their hospitals' priority setting was fair. With respect to the 'accountability for reasonableness' conditions, respondents indicated their hospitals performed best for the relevance (75.0%) condition, followed by appeals/revision (56.6%), publicity (56.0%), and enforcement (39.5%). Conclusions For the first time hospital Chief Executive Officers within an entire health system were surveyed about the fairness of priority setting practices in their institutions using the

  6. Translating PrEP effectiveness into public health impact: key considerations for decision-makers on cost-effectiveness, price, regulatory issues, distributive justice and advocacy for access.

    PubMed

    Hankins, Catherine; Macklin, Ruth; Warren, Mitchell

    2015-01-01

    The extraordinary feat of proving the effectiveness of oral pre-exposure prophylaxis (PrEP) in clinical trials in different populations in a variety of settings may prove to have been easier than ensuring it is used well. Decision-makers must make difficult choices to realize the promise of antiretroviral prophylaxis for their countries. This paper outlines key economic, regulatory and distributive justice issues that must be addressed for effective and acceptable PrEP implementation. In considering the role that PrEP can play in combination prevention programmes, decision-makers must determine who can benefit most from PrEP, how PrEP can be provided safely and efficiently, and what kind of health system support will ensure successful implementation. To do this, they need contextualized information on disease burden by population, analyses of how PrEP services might best be delivered, and projections of the human resource and infrastructure requirements for each potential delivery model. There are cost considerations, varying cost-effectiveness results and regulatory challenges. The principles of ethics can inform thorny discussions about who should be prioritized for oral PrEP and how best to introduce it fairly. We describe the cost-effectiveness of PrEP in different populations at higher risk of HIV exposure, its price in low- and middle-income countries, and the current regulatory situation. We explore the principles of ethics that can inform resource allocation decision-making about PrEP anchored in distributive justice, at a time when universal access to antiretroviral treatment remains to be assured. We then highlight the role of advocacy in moving the PrEP agenda forward. The time is ripe now for decisions about whether, how and for whom PrEP should be introduced into a country's HIV response. It has the potential to contribute significantly to high impact HIV prevention if it is tailored to those who can most benefit from it and if current regulatory and

  7. Decision Performance Using Spatial Decision Support Systems: A Geospatial Reasoning Ability Perspective

    ERIC Educational Resources Information Center

    Erskine, Michael A.

    2013-01-01

    As many consumer and business decision makers are utilizing Spatial Decision Support Systems (SDSS), a thorough understanding of how such decisions are made is crucial for the information systems domain. This dissertation presents six chapters encompassing a comprehensive analysis of the impact of geospatial reasoning ability on…

  8. Trusting families: Responding to Mary Ann Meeker, "Responsive care management: family decision makers in advanced cancer".

    PubMed

    Nelson, James Lindemann

    2011-01-01

    Mary Ann Meeker's article admirably reminds readers that family members are involved in--or "responsively manage"--the care of relatives with severe illness in ways that run considerably beyond the stereotypes at play in many bioethical discussions of advance directives. Her observations thus make thinking about the role of families in healthcare provision more adequate to the facts, and this is an important contribution. There's reason to be worried, however, that one explicit aim of the article--to ease the standing anxieties that many clinicians and ethicists have about the reliability of family members as proxy decision makers--will be frustrated by its very success. Those already inclined to suspicion may tend to think that the more intricate and pervasive the ways in which families influence the healthcare decision making of their sick, the more chances they have for altering the connection between patients' interests and the actions of professional providers. To determine whether and when such alterations are something to be concerned about, we'll need to supplement a better grasp of the pertinent facts with a deeper sense of how human agency works and why we value it. We may also need some reminders about the defensibility of diverse moral understandings. Although both professionals and family members may profess an ethic that sets patients' interests above those of non-patients--as Meeker's own results suggest--any strict allegiance to such a framework may be more notional than normative--as her findings also hint. The actual working norms (among professionals, as well as within families) will likely be more complex, but not necessarily any the less defensible for that.

  9. Do probabilistic forecasts lead to better decisions?

    NASA Astrophysics Data System (ADS)

    Ramos, M. H.; van Andel, S. J.; Pappenberger, F.

    2012-12-01

    The last decade has seen growing research in producing probabilistic hydro-meteorological forecasts and increasing their reliability. This followed the promise that, supplied with information about uncertainty, people would take better risk-based decisions. In recent years, therefore, research and operational developments have also start putting attention to ways of communicating the probabilistic forecasts to decision makers. Communicating probabilistic forecasts includes preparing tools and products for visualization, but also requires understanding how decision makers perceive and use uncertainty information in real-time. At the EGU General Assembly 2012, we conducted a laboratory-style experiment in which several cases of flood forecasts and a choice of actions to take were presented as part of a game to participants, who acted as decision makers. Answers were collected and analyzed. In this paper, we present the results of this exercise and discuss if indeed we make better decisions on the basis of probabilistic forecasts.

  10. Do probabilistic forecasts lead to better decisions?

    NASA Astrophysics Data System (ADS)

    Ramos, M. H.; van Andel, S. J.; Pappenberger, F.

    2013-06-01

    The last decade has seen growing research in producing probabilistic hydro-meteorological forecasts and increasing their reliability. This followed the promise that, supplied with information about uncertainty, people would take better risk-based decisions. In recent years, therefore, research and operational developments have also started focusing attention on ways of communicating the probabilistic forecasts to decision-makers. Communicating probabilistic forecasts includes preparing tools and products for visualisation, but also requires understanding how decision-makers perceive and use uncertainty information in real time. At the EGU General Assembly 2012, we conducted a laboratory-style experiment in which several cases of flood forecasts and a choice of actions to take were presented as part of a game to participants, who acted as decision-makers. Answers were collected and analysed. In this paper, we present the results of this exercise and discuss if we indeed make better decisions on the basis of probabilistic forecasts.

  11. Patient participation, decision-makers and information flow in surgical treatment.

    PubMed

    Heggland, Liv-Helen; Hausken, Kjell

    2014-05-01

    To clarify patient participation by specifying three kinds of information flows between healthcare professionals and patients in four models such as the paternalistic, shared, informed and nonpaternalistic models. The relationship between healthcare professionals and patients has evolved from a traditional paternalistic model where 'doctors know best' and patients are passive recipients, to a partnership where patients act as active participants. A qualitative study. Qualitative data from interviews with four doctors, seven nurses and seven patients illustrate these relationships. A 3 × 3 matrix is developed where healthcare professionals can make decisions unilaterally, patients can make decisions unilaterally, or these can make decisions jointly. Information can flow from healthcare professionals to patient, from patient to healthcare professionals or both ways. This conceptualisation provides a rich understanding of decision-making and information flow in surgical hospitals. The paper illustrates how practice can be assessed empirically to determine how it fits into the structure. Strategies can be implemented to move practice from one part of the structure to another part. © 2013 John Wiley & Sons Ltd.

  12. Framing bioremediation decision making as negotiation: Rationale & guidelineFraming bioremediation decision making as negotiation: Rationale & guidelines

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

    Bjornstad, David J.; Wolfe, Amy K.

    Framing remediation decision making as negotiation: (1) social choice, not technology choice; (2) prompts decision makers to identify interested and affected parties, anticipate objections, effectively address and ameliorate objections, and avoid unacceptable decisions.

  13. Learned helplessness among families and surrogate decision-makers of patients admitted to medical, surgical, and trauma ICUs.

    PubMed

    Sullivan, Donald R; Liu, Xinggang; Corwin, Douglas S; Verceles, Avelino C; McCurdy, Michael T; Pate, Drew A; Davis, Jennifer M; Netzer, Giora

    2012-12-01

    We sought to determine the prevalence of and clinical variables associated with learned helplessness, a psychologic state characterized by reduced motivation, difficulty in determining causality, and depression, in family members of patients admitted to ICUs. We conducted an observational survey study of a prospectively defined cohort of family members, spouses, and partners of patients admitted to surgical, medical, and trauma ICUs at a large academic medical center. Two validated instruments, the Learned Helplessness Scale and the Perceived Stress Scale, were used, and self-report of patient clinical characteristics and subject demographics were collected. Four hundred ninety-nine family members were assessed. Of these, 238 of 460 (51.7%) had responses consistent with a significant degree of learned helplessness. Among surrogate decision-makers, this proportion was 50% (92 of 184). Characteristics associated with significant learned helplessness included grade or high school education (OR, 3.27; 95% CI, 1.29-8.27; P = .01) and Perceived Stress Scale score > 18 (OR, 4.15; 95% CI, 2.65-6.50; P < .001). The presence of a patient advance directive or do not resuscitate (DNR) order was associated with reduced odds of significant learned helplessness (OR, 0.56; 95% CI, 0.32-0.98; P = .05). The majority of family members of patients in the ICU experience significant learned helplessness. Risk factors for learned helplessness include lower educational levels, absence of an advance directive or DNR order, and higher stress levels among family members. Significant learned helplessness in family members may have negative implications in the collaborative decision-making process.

  14. Learned Helplessness Among Families and Surrogate Decision-Makers of Patients Admitted to Medical, Surgical, and Trauma ICUs

    PubMed Central

    Sullivan, Donald R.; Liu, Xinggang; Corwin, Douglas S.; Verceles, Avelino C.; McCurdy, Michael T.; Pate, Drew A.; Davis, Jennifer M.

    2012-01-01

    Background: We sought to determine the prevalence of and clinical variables associated with learned helplessness, a psychologic state characterized by reduced motivation, difficulty in determining causality, and depression, in family members of patients admitted to ICUs. Methods: We conducted an observational survey study of a prospectively defined cohort of family members, spouses, and partners of patients admitted to surgical, medical, and trauma ICUs at a large academic medical center. Two validated instruments, the Learned Helplessness Scale and the Perceived Stress Scale, were used, and self-report of patient clinical characteristics and subject demographics were collected. Results: Four hundred ninety-nine family members were assessed. Of these, 238 of 460 (51.7%) had responses consistent with a significant degree of learned helplessness. Among surrogate decision-makers, this proportion was 50% (92 of 184). Characteristics associated with significant learned helplessness included grade or high school education (OR, 3.27; 95% CI, 1.29-8.27; P = .01) and Perceived Stress Scale score > 18 (OR, 4.15; 95% CI, 2.65-6.50; P < .001). The presence of a patient advance directive or do not resuscitate (DNR) order was associated with reduced odds of significant learned helplessness (OR, 0.56; 95% CI, 0.32-0.98; P = .05). Conclusions: The majority of family members of patients in the ICU experience significant learned helplessness. Risk factors for learned helplessness include lower educational levels, absence of an advance directive or DNR order, and higher stress levels among family members. Significant learned helplessness in family members may have negative implications in the collaborative decision-making process. PMID:22661454

  15. Computational Complexity and Human Decision-Making.

    PubMed

    Bossaerts, Peter; Murawski, Carsten

    2017-12-01

    The rationality principle postulates that decision-makers always choose the best action available to them. It underlies most modern theories of decision-making. The principle does not take into account the difficulty of finding the best option. Here, we propose that computational complexity theory (CCT) provides a framework for defining and quantifying the difficulty of decisions. We review evidence showing that human decision-making is affected by computational complexity. Building on this evidence, we argue that most models of decision-making, and metacognition, are intractable from a computational perspective. To be plausible, future theories of decision-making will need to take into account both the resources required for implementing the computations implied by the theory, and the resource constraints imposed on the decision-maker by biology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Development and formative evaluation of a visual e-tool to help decision makers navigate the evidence around health financing.

    PubMed

    Skordis-Worrall, Jolene; Pulkki-Brännström, Anni-Maria; Utley, Martin; Kembhavi, Gayatri; Bricki, Nouria; Dutoit, Xavier; Rosato, Mikey; Pagel, Christina

    2012-12-21

    There are calls for low and middle income countries to develop robust health financing policies to increase service coverage. However, existing evidence around financing options is complex and often difficult for policy makers to access. To summarize the evidence on the impact of financing health systems and develop an e-tool to help decision makers navigate the findings. After reviewing the literature, we used thematic analysis to summarize the impact of 7 common health financing mechanisms on 5 common health system goals. Information on the relevance of each study to a user's context was provided by 11 country indicators. A Web-based e-tool was then developed to assist users in navigating the literature review. This tool was evaluated using feedback from early users, collected using an online survey and in-depth interviews with key informants. The e-tool provides graphical summaries that allow a user to assess the following parameters with a single snapshot: the number of relevant studies available in the literature, the heterogeneity of evidence, where key evidence is lacking, and how closely the evidence matches their own context. Users particularly liked the visual display and found navigating the tool intuitive. However there was concern that a lack of evidence on positive impact might be construed as evidence against a financing option and that the tool might over-simplify the available financing options. Complex evidence can be made more easily accessible and potentially more understandable using basic Web-based technology and innovative graphical representations that match findings to the users' goals and context.

  17. Decision making.

    PubMed

    Chambers, David W

    2011-01-01

    A decision is a commitment of resources under conditions of risk in expectation of the best future outcome. The smart decision is always the strategy with the best overall expected value-the best combination of facts and values. Some of the special circumstances involved in decision making are discussed, including decisions where there are multiple goals, those where more than one person is involved in making the decision, using trigger points, framing decisions correctly, commitments to lost causes, and expert decision makers. A complex example of deciding about removal of asymptomatic third molars, with and without an EBD search, is discussed.

  18. The GRADE Evidence to Decision (EtD) framework for health system and public health decisions.

    PubMed

    Moberg, Jenny; Oxman, Andrew D; Rosenbaum, Sarah; Schünemann, Holger J; Guyatt, Gordon; Flottorp, Signe; Glenton, Claire; Lewin, Simon; Morelli, Angela; Rada, Gabriel; Alonso-Coello, Pablo

    2018-05-29

    To describe a framework for people making and using evidence-informed health system and public health recommendations and decisions. We developed the GRADE Evidence to Decision (EtD) framework for health system and public health decisions as part of the DECIDE project, in which we simultaneously developed frameworks for these and other types of healthcare decisions, including clinical recommendations, coverage decisions and decisions about diagnostic tests. Building on GRADE EtD tables, we used an iterative approach, including brainstorming, consultation of the literature and with stakeholders, and an international survey of policy-makers. We applied the framework to diverse examples, conducted workshops and user testing with health system and public health guideline developers and policy-makers, and observed and tested its use in real-life guideline panels. All the GRADE EtD frameworks share the same basic structure, including sections for formulating the question, making an assessment and drawing conclusions. Criteria listed in the assessment section of the health system and public health framework cover the important factors for making these types of decisions; in addition to the effects and economic impact of an option, the priority of the problem, the impact of the option on equity, and its acceptability and feasibility are important considerations that can inform both whether and how to implement an option. Because health system and public health interventions are often complex, detailed implementation considerations should be made when making a decision. The certainty of the evidence is often low or very low, but decision-makers must still act. Monitoring and evaluation are therefore often important considerations for these types of decisions. We illustrate the different components of the EtD framework for health system and public health decisions by presenting their application in a framework adapted from a real-life guideline. This framework provides a

  19. Health decision-making preferences among African American men recruited from urban barbershops.

    PubMed

    Hart, Alton; Smith, Wally R; Tademy, Raymond H; McClish, Donna K; McCreary, Micah

    2009-07-01

    To examine general health decision-making roles among African American men ages 40 to 70 recruited in barbershops in the Richmond, Virginia, metropolitan area. We adapted the 1-item Control Preference scale to study the associations between health decision-making role preferences and demographic variables. Forty African-American men were recruited from barbershops to complete a self-administered survey. After performing descriptive statistics, we dichotomized our outcome into active vs nonactive (collaborative or passive) decision makers. Data were then analyzed using chi2, Wilcoxon-Mann-Whitney rank sum, and multiple logistic regression. Fifteen subjects responded that they engaged in active decision making, 20 in collaborative, and 5 in passive decision making. Almost all (86.7%) active decision makers were home owners, vs 41.7% of nonactive decision makers. Among active decision makers, 46.7% had incomes of more than $70000, vs 12.5% of nonactive decision makers. The active group reported health status that was good to excellent, while 20.8% of those in the nonactive group reported poor/fair health. African American male barbershop clients preferred an active or collaborative health decision-making role with their physician, rather than a passive role. The relationship among home ownership, income, and decision style may best be understood by considering the historical and cultural influences on gender role socialization among African American males. More comprehensive assessment of decision styles is necessary to better understand health decision making among African American male patients.

  20. Better Decisions through Consultation and Collaboration

    EPA Pesticide Factsheets

    This manual discusses the benefits of public involvement to agency decision makers, including expanding shared baseline knowledge, generating support for the decision, and developing ongoing relationships that will help in implementing decisions.

  1. I don't want to be the one saying 'we should just let him die': intrapersonal tensions experienced by surrogate decision makers in the ICU.

    PubMed

    Schenker, Yael; Crowley-Matoka, Megan; Dohan, Daniel; Tiver, Greer A; Arnold, Robert M; White, Douglas B

    2012-12-01

    Although numerous studies have addressed external factors associated with difficulty in surrogate decision making, intrapersonal sources of tension are an important element of decision making that have received little attention. To characterize key intrapersonal tensions experienced by surrogate decision makers in the intensive care unit (ICU), and explore associated coping strategies. Qualitative interview study. Thirty surrogates from five ICUs at two hospitals in Pittsburgh, Pennsylvania, who were actively involved in making life-sustaining treatment decisions for a critically ill loved one. We conducted in-depth, semi-structured interviews with surrogates, focused on intrapersonal tensions, role challenges, and coping strategies. We analyzed transcripts using constant comparative methods. Surrogates experience significant emotional conflict between the desire to act in accordance with their loved one's values and 1) not wanting to feel responsible for a loved one's death, 2) a desire to pursue any chance of recovery, and 3) the need to preserve family well-being. Associated coping strategies included 1) recalling previous discussions with a loved one, 2) sharing decisions with family members, 3) delaying or deferring decision making, 4) spiritual/religious practices, and 5) story-telling. Surrogates' struggle to reconcile personal and family emotional needs with their loved ones' wishes, and utilize common coping strategies to combat intrapersonal tensions. These data suggest reasons surrogates may struggle to follow a strict substituted judgment standard. They also suggest ways clinicians may improve decision making, including attending to surrogates' emotions, facilitating family decision making, and eliciting potential emotional conflicts and spiritual needs.

  2. Decision Making Under Uncertainty

    DTIC Science & Technology

    2010-11-01

    A sound approach to rational decision making requires a decision maker to establish decision objectives, identify alternatives, and evaluate those...often violate the axioms of rationality when making decisions under uncertainty. The systematic description of such observations may lead to the...which leads to “anchoring” on the initial value. The fact that individuals have been shown to deviate from rationality when making decisions

  3. Improving IT Portfolio Management Decision Confidence Using Multi-Criteria Decision Making and Hypervariate Display Techniques

    ERIC Educational Resources Information Center

    Landmesser, John Andrew

    2014-01-01

    Information technology (IT) investment decision makers are required to process large volumes of complex data. An existing body of knowledge relevant to IT portfolio management (PfM), decision analysis, visual comprehension of large volumes of information, and IT investment decision making suggest Multi-Criteria Decision Making (MCDM) and…

  4. Repeated causal decision making.

    PubMed

    Hagmayer, York; Meder, Björn

    2013-01-01

    Many of our decisions refer to actions that have a causal impact on the external environment. Such actions may not only allow for the mere learning of expected values or utilities but also for acquiring knowledge about the causal structure of our world. We used a repeated decision-making paradigm to examine what kind of knowledge people acquire in such situations and how they use their knowledge to adapt to changes in the decision context. Our studies show that decision makers' behavior is strongly contingent on their causal beliefs and that people exploit their causal knowledge to assess the consequences of changes in the decision problem. A high consistency between hypotheses about causal structure, causally expected values, and actual choices was observed. The experiments show that (a) existing causal hypotheses guide the interpretation of decision feedback, (b) consequences of decisions are used to revise existing causal beliefs, and (c) decision makers use the experienced feedback to induce a causal model of the choice situation even when they have no initial causal hypotheses, which (d) enables them to adapt their choices to changes of the decision problem. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  5. Strategies for Teaching Regional Climate Modeling: Online Professional Development for Scientists and Decision Makers

    NASA Astrophysics Data System (ADS)

    Walton, P.; Yarker, M. B.; Mesquita, M. D. S.; Otto, F. E. L.

    2014-12-01

    structures of both courses, evaluating the advantages and disadvantages of each, along with the educational approaches used. We conclude by proposing a framework for the develop of educationally robust online professional development programs that actively supports decision makers in understanding, developing and applying regional climate models.

  6. Decision Support | Solar Research | NREL

    Science.gov Websites

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

  7. Ultimate evidence for the ultimate regime

    NASA Astrophysics Data System (ADS)

    Smits, Alexander J.

    2018-04-01

    The ultimate regime of turbulence has been observed, more than half a century after its first prediction. Inspiration for achieving this technical feat came from the imperfections of an everyday pipe.

  8. Making the Connection between Environmental Science and Decision Making

    NASA Astrophysics Data System (ADS)

    Woodhouse, C. A.; Crimmins, M.; Ferguson, D. B.; Garfin, G. M.; Scott, C. A.

    2011-12-01

    As society is confronted with population growth, limited resources, and the impacts of climate variability and change, it is vital that institutions of higher education promote the development of professionals who can work with decision-makers to incorporate scientific information into environmental planning and management. Skills for the communication of science are essential, but equally important is the ability to understand decision-making contexts and engage with resource managers and policy makers. It is increasingly being recognized that people who understand the linkages between science and decision making are crucial if science is to better support planning and policy. A new graduate-level seminar, "Making the Connection between Environmental Science and Decision Making," is a core course for a new post-baccalaureate certificate program, Connecting Environmental Science and Decision Making at the University of Arizona. The goal of the course is to provide students with a basic understanding of the dynamics between scientists and decision makers that result in scientific information being incorporated into environmental planning, policy, and management decisions. Through readings from the environmental and social sciences, policy, and planning literature, the course explores concepts including scientific information supply and demand, boundary organizations, co-production of knowledge, platforms for engagement, and knowledge networks. Visiting speakers help students understand some of the challenges of incorporating scientific information into planning and decision making within institutional and political contexts. The course also includes practical aspects of two-way communication via written, oral, and graphical presentations as well as through the interview process to facilitate the transfer of scientific information to decision makers as well as to broader audiences. We aspire to help students develop techniques that improve communication and

  9. Bi-Level Decision Making for Supporting Energy and Water Nexus

    NASA Astrophysics Data System (ADS)

    Zhang, X.; Vesselinov, V. V.

    2016-12-01

    The inseparable relationship between energy production and water resources has led to the emerging energy-water nexus concept, which provides a means for integrated management and decision making of these two critical resources. However, the energy-water nexus frequently involves decision makers with different and competing management objectives. Furthermore, there is a challenge that decision makers and stakeholders might be making decisions sequentially from a higher level to a lower level, instead of at the same decision level, whereby the objective of a decision maker at a higher level should be satisfied first. In this study, a bi-level decision model is advanced to handle such decision-making situations for managing the energy-water nexus. The work represents a unique contribution to developing an integrated decision-support framework/tool to quantify and analyze the tradeoffs between the two-level energy-water nexus decision makers. Here, plans for electricity generation, fuel supply, water supply, capacity expansion of the power plants and environmental impacts are optimized to provide effective decision support. The developed decision-support framework is implemented in Julia (a high-level, high-performance dynamic programming language for technical computing) and is a part of the MADS (Model Analyses & Decision Support) framework (http://mads.lanl.gov). To demonstrate the capabilities of the developed methodology, a series of analyses are performed for synthetic problems consistent with actual real-world energy-water nexus management problems.

  10. Taking Legislators to the Field: Communicating with Policy Makers about Natural Resource Issues

    NASA Astrophysics Data System (ADS)

    Sawin, R. S.; Buchanan, R. C.

    2006-12-01

    Policy makers are among the most important audiences for scientific information. In particular, legislators, legislative staff, governmental agency staff, business leaders, environmental leaders, and others need accurate, objective natural-resource information to make policy decisions. This audience is busy and difficult to reach with technical information. As part of its public outreach program, the Kansas Geological Survey (a division of the University of Kansas) communicates directly with policy makers through an annual field conference. Operated since 1995, the conference presents information by combining field experiences, presentations by experts, and participant interaction. The primary objective is to give policy makers first-hand, unbiased information about the state's natural resource issues. The field conference takes policy makers to locations where natural resources are produced or used, or where there are important environmental issues, introducing them to experts and others who carry out (or are affected by) their decisions. The conference consists of three days of site visits, presentations, hands-on activities, and panel discussions. Participation is by invitation. Participants pay a small fee, but most costs are covered by co-sponsors, usually other state or local agencies, that are recruited to help defray expenses. Participants receive a guidebook before the trip. Travel is by chartered bus; lodging and meals are provided. Conferences have focused on topics (such as energy or water) or regions of the state. The most recent conference focused on cross-boundary issues and included stops in Kansas, Oklahoma, and Missouri. Written, post-conference evaluations are extremely positive. Legislators report that they regularly use conference information and contacts during the law-making process; conference information played a direct role in decisions related to underground natural-gas storage rules, water-rights by-back legislation, and sand and gravel

  11. Budget-makers and health care systems.

    PubMed

    White, Joseph

    2013-10-01

    Health programs are shaped by the decisions made in budget processes, so how budget-makers view health programs is an important part of making health policy. Budgeting in any country involves its own policy community, with key players including budgeting professionals and political authorities. This article reviews the typical pressures on and attitudes of these actors when they address health policy choices. The worldview of budget professionals includes attitudes that are congenial to particular policy perspectives, such as the desire to select packages of programs that maximize population health. The pressures on political authorities, however, are very different: most importantly, public demand for health care services is stronger than for virtually any other government activity. The norms and procedures of budgeting also tend to discourage adoption of some of the more enthusiastically promoted health policy reforms. Therefore talk about rationalizing systems is not matched by action; and action is better explained by the need to minimize blame. The budget-maker's perspective provides insight about key controversies in healthcare policy such as decentralization, competition, health service systems as opposed to health insurance systems, and dedicated vs. general revenue finance. It also explains the frequency of various "gaming" behaviors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: PUBLISHED REPORT

    EPA Science Inventory

    NRMRL-CIN-1351A Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. EPA/600/R-01/104 (NTIS PB2002-102119). Decision makers using environmental decision support tools are often ...

  13. Relevance of a Managerial Decision-Model to Educational Administration.

    ERIC Educational Resources Information Center

    Lundin, Edward.; Welty, Gordon

    The rational model of classical economic theory assumes that the decision maker has complete information on alternatives and consequences, and that he chooses the alternative that maximizes expected utility. This model does not allow for constraints placed on the decision maker resulting from lack of information, organizational pressures,…

  14. Critical insights for researchers and decision-makers.

    PubMed

    Tomblin, Seven

    2004-01-01

    Regionalization organizations are essential building blocks of health restructuring and are designed to be agents of change and integration in most provinces in Canada. Yet, despite this, most citizens seem to be unaware of regional health authorities, why they exist, the drivers and constraints involved, or whether these divergent structures and regional governance processes have influenced patterns of restructuring and health outcomes. And even when discussions have taken place, these debates have tended to be more prescriptive than analytical. All of this has complicated the task of conceptualizing and making sense of the determinants that have influenced regionalization forms of health service restructuring in Canada and how these have influenced the way resources have been allocated, decisions reached and accountability exercised.

  15. Health System Decision Makers' Feedback on Summaries and Tools Supporting the Use of Systematic Reviews: A Qualitative Study

    ERIC Educational Resources Information Center

    Ellen, Moriah E.; Lavis, John N.; Wilson, Michael G.; Grimshaw, Jeremy; Haynes, R. Brian; Ouimet, Mathieu; Raina, Parminder; Gruen, Russell

    2014-01-01

    Health system managers and policy makers need timely access to high quality, policy-relevant systematic reviews. Our objectives were to obtain managers' and policy makers' feedback about user-friendly summaries of systematic reviews and about tools related to supporting or assessing their use. Our interviews identified that participants prefer key…

  16. Boundary Organizations: Creating a Unique Model for Sustained Dialog Among Scientists and Decison Makers About Long-term Change

    NASA Astrophysics Data System (ADS)

    Duncan, B.; Carter, H.; Knight, E.; Meyer, R.

    2015-12-01

    California Ocean Science Trust is a boundary organization formed by the state of California. We work across traditional boundaries between government, science, and communities to build trust and understanding in ocean and coastal science. We work closely with decision makers to understand their priority needs and identify opportunities for science to have a meaningful impact, and we engage scientists and other experts to compile and translate information into innovative products that help to meet those needs. This often sparks new collaborations that live well beyond the products themselves. Through this unique model, we are deepening relationships and facilitating an ongoing dialogue between scientists, decision-makers, and communities. The West Coast of the United States is already experiencing climate-driven changes in marine conditions at both large and small spatial scales. Decision makers are increasingly concerned with the potential threats that these changes pose to coastal communities, industries, ecosystems, and species. Detecting and understanding these multi-stressor changes requires consideration across scientific disciplines and management jurisdictions. Research and monitoring programs must reflect this new reality: they should be designed to connect with the decision makers who may use their results. In this presentation, I will share how we are drawing from the West Coast Ocean Acidification and Hypoxia Science Panel - an interdisciplinary team of scientists convened by Ocean Science Trust from California, Oregon, Washington, and British Columbia - to develop actionable guidance for long-term monitoring for long-term change. Building on our experiences working with the Panel, I will discuss the unique model that boundary organizations provide for sustained dialog across traditionally siloed disciplines and management regimes, and share best practices and lessons learned in working across those boundaries.

  17. The effect of statutory limitations on the authority of substitute decision makers on the care of patients in the intensive care unit: case examples and review of state laws affecting withdrawing or withholding life-sustaining treatment.

    PubMed

    Venkat, Arvind; Becker, Julianna

    2014-01-01

    While the ethics and critical care literature is replete with discussion of medical futility and the ethics of end-of-life care decisions in the intensive care unit, little attention is paid to the effect of statutory limitations on the authority of substitute decision makers during the course of treatment of patients in the critical care setting. In many jurisdictions, a clear distinction is made between the authority of a health care power of attorney, who is legally designated by a competent adult to make decisions regarding withholding or withdrawing life-sustaining treatment, and of next-of-kin, who are limited in this regard. However, next-of-kin are often relied upon to consent to necessary procedures to advance a patient's medical care. When conflicts arise between critical care physicians and family members regarding projected patient outcome and functional status, these statutory limitations on decision-making authority by next of kin can cause paralysis in the medical care of severely ill patients, leading to practical and ethical impasses. In this article, we will provide case examples of how statutory limitations on substitute decision making authority for next of kin can impede the care of patients. We will also review the varying jurisdictional limitations on the authority of substitute decision makers and explore their implications for patient care in the critical care setting. Finally, we will review possible ethical and legal solutions to resolve these impasses.

  18. Neural basis of quasi-rational decision making.

    PubMed

    Lee, Daeyeol

    2006-04-01

    Standard economic theories conceive homo economicus as a rational decision maker capable of maximizing utility. In reality, however, people tend to approximate optimal decision-making strategies through a collection of heuristic routines. Some of these routines are driven by emotional processes, and others are adjusted iteratively through experience. In addition, routines specialized for social decision making, such as inference about the mental states of other decision makers, might share their origins and neural mechanisms with the ability to simulate or imagine outcomes expected from alternative actions that an individual can take. A recent surge of collaborations across economics, psychology and neuroscience has provided new insights into how such multiple elements of decision making interact in the brain.

  19. Acquisition of decision making criteria: reward rate ultimately beats accuracy.

    PubMed

    Balci, Fuat; Simen, Patrick; Niyogi, Ritwik; Saxe, Andrew; Hughes, Jessica A; Holmes, Philip; Cohen, Jonathan D

    2011-02-01

    Speed-accuracy trade-offs strongly influence the rate of reward that can be earned in many decision-making tasks. Previous reports suggest that human participants often adopt suboptimal speed-accuracy trade-offs in single session, two-alternative forced-choice tasks. We investigated whether humans acquired optimal speed-accuracy trade-offs when extensively trained with multiple signal qualities. When performance was characterized in terms of decision time and accuracy, our participants eventually performed nearly optimally in the case of higher signal qualities. Rather than adopting decision criteria that were individually optimal for each signal quality, participants adopted a single threshold that was nearly optimal for most signal qualities. However, setting a single threshold for different coherence conditions resulted in only negligible decrements in the maximum possible reward rate. Finally, we tested two hypotheses regarding the possible sources of suboptimal performance: (1) favoring accuracy over reward rate and (2) misestimating the reward rate due to timing uncertainty. Our findings provide support for both hypotheses, but also for the hypothesis that participants can learn to approach optimality. We find specifically that an accuracy bias dominates early performance, but diminishes greatly with practice. The residual discrepancy between optimal and observed performance can be explained by an adaptive response to uncertainty in time estimation.

  20. Evaluating and Using Observational Evidence: The Contrasting Views of Policy Makers and Epidemiologists.

    PubMed

    O'Donoughue Jenkins, Lily; Kelly, Paul M; Cherbuin, Nicolas; Anstey, Kaarin J

    2016-01-01

    essence, the policy-making process relied on other jurisdictions' policies and the opinions of internal staff members as primary evidence sources to inform policy decisions. Findings of this study suggest that efforts should be directed toward making scientific information more systematically available to policy makers.

  1. Sources and Uses of Weather Information for Agricultural Decision Makers.

    NASA Astrophysics Data System (ADS)

    McNew, Kevin P.; Mapp, Harry P.; Duchon, Claude E.; Merritt, Earl S.

    1991-04-01

    Numerous studies have examined the importance of weather information to farmers and ranchers across the U.S. This study is focused on the kinds of weather information received by farmers and ranchers, the sources of that information, and its use in production and marketing decisions. Our results are based on a survey of 292 producers from the principal agricultural areas of Oklahoma. Producers were classified into five categories related to their source of income from crop and livestock sales.Among temperature, precipitation, relative humility, and wind speed, temperature information was most widely received. Forecast lengths of highest interest were 24-h and 5-day forecasts. Precipitation information was used by many respondents for planting and harvesting decisions. Weather data and forecasts seem to be of greater value to diversified crop and livestock operators than specialized crop and livestock, perhaps due to more frequent timing decisions. Relative humility and wind information appear to be important especially during specific times of the growing season, for example, at harvest time and time of pesticide application. Television is the primary source of weather information for more than 60% of the producers.It appears that there may be a role for both public and private entities in transforming weather data and forecasts into recommendations to crop and livestock producers. Further research is needed to determine the potential value of weather information for alternative production, marketing and livestock decisions, different categories of producers, and different geographic regions.

  2. Improving Communication With Surrogate Decision-Makers: A Pilot Initiative.

    PubMed

    Meltzer, Ellen C; Shi, Zhenzhen; Suppes, Alexandra; Hersh, Jennifer E; Orlander, Jay D; Calhoun, Aaron W; Tung, Judy; Logio, Lia; Manna, Ruth; Bialer, Philip A; Acres, Cathleen A; Fins, Joseph J

    2017-08-01

    Difficult conversations in medical care often occur between physicians and patients' surrogates, individuals entrusted with medical decisions for patients who lack the capacity to make them. Poor communication between patients' surrogates and physicians may exacerbate anxiety and guilt for surrogates, and may contribute to physician stress and burnout. This pilot study assesses the effectiveness of an experiential learning workshop that was conducted in a clinical setting, and aimed at improving resident physician communication skills with a focus on surrogate decision-making. From April through June 2016, we assessed internal medicine residents' baseline communication skills through an objective structured clinical examination (OSCE) with actors representing standardized surrogates. After an intensive, 6-hour communication skills workshop, residents were reassessed via an OSCE on the same day. A faculty facilitator and the surrogate evaluated participants' communication skills via the expanded Gap Kalamazoo Consensus Statement Assessment Form. Wilcoxon signed rank tests (α of .05) compared mean pre- and postworkshop scores. Of 44 residents, 33 (75%) participated. Participants' average preworkshop OSCE scores ( M  = 3.3, SD = 0.9) were significantly lower than postworkshop scores ( M  = 4.3; SD = 0.8; Z  = 4.193; P  < .001; effect size r  = 0.52). After the workshop, the majority of participants self-reported feeling "more confident." Residents' communication skills specific to surrogate decision-making benefit from focused interventions. Our pilot assessment of a workshop showed promise, and additionally demonstrated the feasibility of bringing OSCEs and simulated encounters into a busy clinical practice.

  3. Examining Tensions That Affect the Evaluation of Technology in Health Care: Considerations for System Decision Makers From the Perspective of Industry and Evaluators

    PubMed Central

    Shaw, James; Wallace, Ross; Bhattacharyya, Onil; Bhatia, R Sacha; Jamieson, Trevor

    2017-01-01

    Virtual technologies have the potential to mitigate a range of challenges for health care systems. Despite the widespread use of mobile devices in everyday life, they currently have a limited role in health service delivery and clinical care. Efforts to integrate the fast-paced consumer technology market with health care delivery exposes tensions among patients, providers, vendors, evaluators, and system decision makers. This paper explores the key tensions between the high bar for evidence prior to market approval that guides health care regulatory decisions and the “fail fast” reality of the technology industry. We examine three core tensions: balancing user needs versus system needs, rigor versus responsiveness, and the role of pre- versus postmarket evidence generation. We use these to elaborate on the structure and appropriateness of evaluation mechanisms for virtual care solutions. Virtual technologies provide a foundation for personalized, patient-centered medicine on the user side, coupled with a broader understanding of impact on the system side. However, mechanisms for stakeholder discussion are needed to clarify the nature of the health technology marketplace and the drivers of evaluation priorities. PMID:29222075

  4. Communicating Ecological Indicators to Decision Makers and the Public

    Treesearch

    A. Schiller; Carolyn Hunsaker; M.A. Kane; A.K. Wolfe; V.H. Dale; G.W. Suter; C.S. Russell; G. Pion; N.H. Jensen; V.C. Konar

    2001-01-01

    Ecological assessments and monitoring programs often rely on indicators to evaluate environmental conditions. Such indicators are frequently developed by scientists, expressed in technical language, and target aspects of the environment that scientists consider useful. Yet setting environmental policy priorities and making environmental decisions requires both...

  5. The Use of Research Evidence in Public Health Decision Making Processes: Systematic Review

    PubMed Central

    Orton, Lois; Lloyd-Williams, Ffion; Taylor-Robinson, David; O'Flaherty, Martin; Capewell, Simon

    2011-01-01

    Background The use of research evidence to underpin public health policy is strongly promoted. However, its implementation has not been straightforward. The objectives of this systematic review were to synthesise empirical evidence on the use of research evidence by public health decision makers in settings with universal health care systems. Methods To locate eligible studies, 13 bibliographic databases were screened, organisational websites were scanned, key informants were contacted and bibliographies of included studies were scrutinised. Two reviewers independently assessed studies for inclusion, extracted data and assessed methodological quality. Data were synthesised as a narrative review. Findings 18 studies were included: 15 qualitative studies, and three surveys. Their methodological quality was mixed. They were set in a range of country and decision making settings. Study participants included 1063 public health decision makers, 72 researchers, and 174 with overlapping roles. Decision making processes varied widely between settings, and were viewed differently by key players. A range of research evidence was accessed. However, there was no reliable evidence on the extent of its use. Its impact was often indirect, competing with other influences. Barriers to the use of research evidence included: decision makers' perceptions of research evidence; the gulf between researchers and decision makers; the culture of decision making; competing influences on decision making; and practical constraints. Suggested (but largely untested) ways of overcoming these barriers included: research targeted at the needs of decision makers; research clearly highlighting key messages; and capacity building. There was little evidence on the role of research evidence in decision making to reduce inequalities. Conclusions To more effectively implement research informed public health policy, action is required by decision makers and researchers to address the barriers identified in

  6. Improving the Slum Planning Through Geospatial Decision Support System

    NASA Astrophysics Data System (ADS)

    Shekhar, S.

    2014-11-01

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

  7. Quantitative Decision Making.

    ERIC Educational Resources Information Center

    Baldwin, Grover H.

    The use of quantitative decision making tools provides the decision maker with a range of alternatives among which to decide, permits acceptance and use of the optimal solution, and decreases risk. Training line administrators in the use of these tools can help school business officials obtain reliable information upon which to base district…

  8. Research of Simple Multi-Attribute Rating Technique for Decision Support

    NASA Astrophysics Data System (ADS)

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

    2017-12-01

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

  9. Pizza makers' contact dermatitis.

    PubMed

    Lembo, Serena; Lembo, Claudio; Patruno, Cataldo; Balato, Anna; Balato, Nicola; Ayala, Fabio

    2014-01-01

    Contact eczema to foods, spices, and food additives can occur in occupational and nonoccupational settings in those who grow, handle, prepare, or cook food. Pizza is one of the most eaten foods in every continent, and pizza making is a common work in many countries. We aimed to evaluate the occurrence and the causes of contact dermatitis in pizza makers in Naples. We performed an observational study in 45 pizza makers: all the enrolled subjects had to answer a questionnaire designed to detect personal history of respiratory or cutaneous allergy, atopy; work characteristics and timing were also investigated. Every subject attended the dermatology clinic for a complete skin examination, and when needed, patients were patch tested using the Italian baseline series of haptens integrated with an arbitrary pizza makers series. Our results reported that 13.3% of the enrolled pizza makers (6/45) presented hand eczema, and that 8.9% (4/45) were affected by occupational allergic contact dermatitis. Diallyl disulfide and ammonium persulfate were the responsible substances. Performing patch tests in pizza makers and food handlers affected by hand contact dermatitis is useful. We propose a specific series of haptens for this wide working category.

  10. Outsourced Investment Management: An Overview for Institutional Decision-Makers

    ERIC Educational Resources Information Center

    Griswold, John S.; Jarvis, William F.

    2013-01-01

    Outsourcing of investment management is a growing trend among institutional investors. With a broad range of institutions using or exploring the outsourced chief investment officer (OCIO) model, portfolio size is no longer the determining factor driving the outsourcing decision. For all but the largest institutional investors--those with deep…

  11. Decision making in recurrent neuronal circuits.

    PubMed

    Wang, Xiao-Jing

    2008-10-23

    Decision making has recently emerged as a central theme in neurophysiological studies of cognition, and experimental and computational work has led to the proposal of a cortical circuit mechanism of elemental decision computations. This mechanism depends on slow recurrent synaptic excitation balanced by fast feedback inhibition, which not only instantiates attractor states for forming categorical choices but also long transients for gradually accumulating evidence in favor of or against alternative options. Such a circuit endowed with reward-dependent synaptic plasticity is able to produce adaptive choice behavior. While decision threshold is a core concept for reaction time tasks, it can be dissociated from a general decision rule. Moreover, perceptual decisions and value-based economic choices are described within a unified framework in which probabilistic choices result from irregular neuronal activity as well as iterative interactions of a decision maker with an uncertain environment or other unpredictable decision makers in a social group.

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

    PubMed

    Jbilou, Jalila; Amara, Nabil; Landry, Réjean

    2007-06-01

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

  13. Emodnet Med Sea Check-Point - Indicators for decision- maker

    NASA Astrophysics Data System (ADS)

    Besnard, Sophie; Claverie, Vincent; Blanc, Frédérique

    2015-04-01

    The Emodnet Checkpoint projects aim is to assess the cost-effectiveness, reliability and utility of the existing monitoring at the sea basin level. This involves the development of monitoring system indicators and a GIS Platform to perform the assessment and make it available. Assessment or production of Check-Point information is made by developing targeted products based on the monitoring data and determining whether the products are meeting the needs of industry and public authorities. Check-point users are the research community, the 'institutional' policy makers for IMP and MSFD implementation, the 'intermediate users', i.e., users capable to understand basic raw data but that benefit from seeing the Checkpoint targeted products and the assessment of the fitness for purpose. We define assessment criteria aimed to characterize/depict the input datasets in terms of 3 territories capable to show performance and gaps of the present monitoring system, appropriateness, availability and fitness for purpose. • Appropriateness: What is made available to users? What motivate/decide them to select this observation rather than this one. • Availability: How this is made available to the user? Place to understand the readiness and service performance of the EU infrastructure • Fitness for use / fitness for purpose: Ability for non-expert user to appreciate the data exploitability (feedback on efficiency & reliability of marine data) For each territory (appropriateness, Availability and Fitness for purpose / for use), we define several indicators. For example, for Availability we define Visibility, Accessibility and Performance. And Visibility is itself defined by "Easily found" and "EU service". So these indicators can be classified according to their territory and sub-territory as seen above, but also according to the complexity to build them. Indicators are built from raw descriptors in 3 stages:  Stage 1: to give a neutral and basic status directly computed from

  14. Decision-makers' preferences for approving new medicines in Wales: a discrete-choice experiment with assessment of external validity.

    PubMed

    Linley, Warren G; Hughes, Dyfrig A

    2013-04-01

    Few studies to date have explored the stated preferences of national decision makers for health technology adoption criteria, and none of these have compared stated decision-making behaviours against actual behaviours. Assessment of the external validity of stated preference studies, such as discrete-choice experiments (DCEs), remains an under-researched area. The primary aim was to explore the preferences of All Wales Medicines Strategy Group (AWMSG) appraisal committee and appraisal sub-committee (the New Medicines Group) members ('appraisal committees') for specific new medicines adoption criteria. Secondary aims were to explore the external validity of respondents' stated preferences and the impact of question choice options upon preference structures in DCEs. A DCE was conducted to estimate appraisal committees members' preferences for incremental cost effectiveness, quality-adjusted life-years (QALYs) gained, annual number of patients expected to be treated, the impact of the disease on patients before treatment, and the assessment of uncertainty in the economic evidence submitted for new medicines compared with current UK NHS treatment. Respondents evaluated 28 pairs of hypothetical new medicines, making a primary forced choice between each pair and a more flexible secondary choice, which permitted either, neither or both new medicines to be chosen. The performance of the resultant models was compared against previous AWMSG decisions. Forty-one out of a total of 80 past and present members of AWMSG appraisal committees completed the DCE. The incremental cost effectiveness of new medicines, and the QALY gains they provide, significantly (p < 0.0001) influence recommendations. Committee members were willing to accept higher incremental cost-effectiveness ratios and lower QALY gains for medicines that treat disease impacting primarily upon survival rather than quality of life, and where uncertainty in the cost-effectiveness estimates has been thoroughly

  15. 49 CFR 1503.655 - Initial decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Rules of Practice in TSA Civil Penalty Actions § 1503.655 Initial decision. (a) Contents. The ALJ may... copies of that initial decision available to all parties and the TSA decision maker. (b) Written decision... ALJ is persuasive authority in any other civil penalty action, unless appealed and reversed by the TSA...

  16. Different approaches for centralized and decentralized water system management in multiple decision makers' problems

    NASA Astrophysics Data System (ADS)

    Anghileri, D.; Giuliani, M.; Castelletti, A.

    2012-04-01

    There is a general agreement that one of the most challenging issues related to water system management is the presence of many and often conflicting interests as well as the presence of several and independent decision makers. The traditional approach to multi-objective water systems management is a centralized management, in which an ideal central regulator coordinates the operation of the whole system, exploiting all the available information and balancing all the operating objectives. Although this approach allows to obtain Pareto-optimal solutions representing the maximum achievable benefit, it is based on assumptions which strongly limits its application in real world contexts: 1) top-down management, 2) existence of a central regulation institution, 3) complete information exchange within the system, 4) perfect economic efficiency. A bottom-up decentralized approach seems therefore to be more suitable for real case applications since different reservoir operators may maintain their independence. In this work we tested the consequences of a change in the water management approach moving from a centralized toward a decentralized one. In particular we compared three different cases: the centralized management approach, the independent management approach where each reservoir operator takes the daily release decision maximizing (or minimizing) his operating objective independently from each other, and an intermediate approach, leading to the Nash equilibrium of the associated game, where different reservoir operators try to model the behaviours of the other operators. The three approaches are demonstrated using a test case-study composed of two reservoirs regulated for the minimization of flooding in different locations. The operating policies are computed by solving one single multi-objective optimal control problem, in the centralized management approach; multiple single-objective optimization problems, i.e. one for each operator, in the independent case

  17. Climate Change Boot Camps: Targeting Policy Makers and Outreach Trainers in Arizona to Improve Climate Literacy

    NASA Astrophysics Data System (ADS)

    Ferguson, D. B.; Guido, Z. S.; Buizer, J.; Roy, M.

    2010-12-01

    Bringing climate change issues into focus for decision makers is a growing challenge. Decision makers are often confronted with unique informational needs, a lack of useable information, and needs for customized climate change training, among other issues. Despite significant progress in improving climate literacy among certain stakeholders such as water managers, recent reports have highlighted the growing demand for climate-change information in regions and sectors across the US. In recent years many ventures have sprung up to address these gaps and have predominantly focused on K-12 education and resource management agencies such as the National Park Service and National Weather Service. However, two groups that are critical for integrating climate information into actions have received less attention: (1) policy makers and (2) outreach experts, such as Cooperative Extension agents. Climate Change Boot Camps (CCBC) is a joint effort between the Climate Assessment for the Southwest (CLIMAS)—a NOAA Regionally Integrated Sciences and Assessments (RISA) program—and researchers at Arizona State University to diagnose climate literacy and training gaps in Arizona and develop a process that converts these deficiencies into actionable knowledge among the two aforementioned groups. This presentation will highlight the initial phases of the CCBC process, which has as its outcomes the identification of effective strategies for reaching legislators, climate literacy and training needs for both policy makers and trainers, and effective metrics to evaluate the success of these efforts. Specific attention is given to evaluating the process from initial needs assessment to the effectiveness of the workshops. Web curriculum and training models made available on the internet will also be developed, drawing on extensive existing Web resources for other training efforts and converted to meet the needs of these two groups. CCBC will also leverage CLIMAS’ long history of

  18. User Oriented Techniques to Support Interaction and Decision Making with Large Educational Databases

    ERIC Educational Resources Information Center

    Hartley, Roger; Almuhaidib, Saud M. Y.

    2007-01-01

    Information Technology is developing rapidly and providing policy/decision makers with large amounts of information that require processing and analysis. Decision support systems (DSS) aim to provide tools that not only help such analyses, but enable the decision maker to experiment and simulate the effects of different policies and selection…

  19. A randomized comparison between league tables and funnel plots to inform health care decision-making.

    PubMed

    Anell, Anders; Hagberg, Oskar; Liedberg, Fredrik; Ryden, Stefan

    2016-12-01

    Comparison of provider performance is commonly used to inform health care decision-making. Little attention has been paid to how data presentations influence decisions. This study analyzes differences in suggested actions by decision-makers informed by league tables or funnel plots. Decision-makers were invited to a survey and randomized to compare hospital performance using either league tables or funnel plots for four different measures within the area of cancer care. For each measure, decision-makers were asked to suggest actions towards 12-16 hospitals (no action, ask for more information, intervene) and provide feedback related to whether the information provided had been useful. Swedish health care. Two hundred and twenty-one decision-makers at administrative and clinical levels. Data presentations in the form of league tables or funnel plots. Number of actions suggested by participants. Proportion of appropriate actions. For all four measures, decision-makers tended to suggest more actions based on the information provided in league tables compared to funnel plots (44% vs. 21%, P < 0.001). Actions were on average more appropriate for funnel plots. However, when using funnel plots, decision-makers more often missed to react even when appropriate. The form of data presentation had an influence on decision-making. With league tables, decision-makers tended to suggest more actions compared to funnel plots. A difference in sensitivity and specificity conditioned by the form of presentation could also be identified, with different implications depending on the purpose of comparisons. Explanations and visualization aids are needed to support appropriate actions. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. Beyond Prediction: the Many Ways in which Climate Science can Inform Adaptation Decisions

    NASA Astrophysics Data System (ADS)

    Lempert, R. J.

    2017-12-01

    Climate science provides an increasingly rich understanding of current and future climate, but this understanding is often not fully incorporated into climate adaptation decisions. In particular, the provision of climate information is still trapped in a narrow prediction-based framework, which envisions a sequential process that begins with model-based forecasts of future climate and decision makers then acting on those forecasts. Among its challenges, this framework can discourage action when climate predictions are deemed too uncertain, encourage overconfidence when climate scientists and decision makers fail to focus on decision-relevant but poorly understood extreme events, and offers a too-narrow communication path among climate scientists and decision makers. This talk will describe how robust decision approaches, organized around the idea of stress testing proposed adaptation decisions over a wide range of futures, can enable a richer flow information among climate scientists and decision makers. The talk illustrates these themes with two examples: 1) conservation management that explores the tradeoffs among alternative climate information products with different combinations of ensemble size and spatial resolution and 2) water quality implementation planning that focuses on the handling of extremes.

  1. The utilization of research evidence in Health Workforce Policies: the perspectives of Portuguese and Brazilian National Policy-Makers.

    PubMed

    Craveiro, Isabel; Hortale, Virginia; Oliveira, Ana Paula Cavalcante de; Dal Poz, Mario; Portela, Gustavo; Dussault, Gilles

    2018-03-01

    The production of knowledge on Human Resources for Health (HRH) issues has increased exponentially since 2000 but integration of the research in the policy-making process is often lagging. We looked at how research on HRH contributes or not to inform policy decisions and interventions affecting the health workforce in Portugal and Brazil. We designed a comparative case study of semi-structured interviews with present and past national decision-makers, policy advisors and researchers. Issues explored included the existence of a national HRH policy and the use, or non-use, of research evidence by policy makers and reasons to do so. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Policy-makers in Brazil recognize a greater use of evidence in the process of defining HRH policy when compared to Portugal's. But the existence of formal instruments to support policy development is not sufficient to ensure that policies are informed by evidence. In both countries the importance of the use of evidence in the formulation of policies was recognized by policy-makers. However, the influence of other factors, such as political pressures from various lobby groups and from the media and the policy short timeframe which requires rapid responses, is predominant.

  2. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS

    EPA Science Inventory

    Decision makers using environmental decision support tools are often confronted with information that predicts a multitude of different human health effects due to environmental stressors. If these health effects need to be contrasted with costs or compared with alternative scena...

  3. PATIENT-CENTERED DECISION MAKING: LESSONS FROM MULTI-CRITERIA DECISION ANALYSIS FOR QUANTIFYING PATIENT PREFERENCES.

    PubMed

    Marsh, Kevin; Caro, J Jaime; Zaiser, Erica; Heywood, James; Hamed, Alaa

    2018-01-01

    Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered. This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences. The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported. The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.

  4. Participation in treatment decision-making among Chinese-Australian women with breast cancer.

    PubMed

    Kwok, Cannas; Koo, Fung Kuen

    2017-03-01

    Using Confucian philosophy as a conceptual framework, this article examines the extent to which cultural values and language affect the participation preferences and experiences of the breast cancer treatment decision-making (TDM) process among Chinese women with breast cancer in Australia. Three focus groups were conducted with 23 Chinese-Australian women diagnosed with breast cancer in their native language (Mandarin and Cantonese). Each interview was translated and transcribed. Content analysis was used to uncover the major themes. Four typologies emerged: the patient as an active decision maker, the patient as a passive decision maker, the patient as a reluctant decision maker and the patient as a reluctant passive decision maker. Language barriers, cultural expectation of doctor's role and family role in Chinese culture appear as influential factors in TDM process among this group of women. Intervention to improve doctors' cultural sensitivities in order to help them assess women's role preferences in TDM and the ability of doctors to communicate in a culturally appropriate manner, may improve the process of breast cancer TDM among women from Chinese background.

  5. Identifying Decision-Makers’ Science Needs for Adaptation to Climate-Related Impacts on Forest Ecosystem Services

    NASA Astrophysics Data System (ADS)

    Gordon, E.; Lukas, J.

    2009-12-01

    Through the Western Water Assessment RISA program, we are conducting a research project that will produce science synthesis information to help local, state, and federal decision-makers in Colorado and Wyoming develop adaptation strategies to deal with climate-related threats to forest ecosystem services, in particular bark beetle infestations and stand-replacing wildfires. We begin by using the problem orientation framework, a policy sciences methodology, to understand how decision-makers can most effectively address policy problems that threaten the attainment of socially accepted goals. By applying this framework to the challenges facing decision-makers, we more accurately identify specific areas where scientific research can improve decision-making. WWA researchers will next begin to connect decision-makers with relevant scientific literature and identify specific areas of future scientific research that will be most effective at addressing their needs.

  6. From research to evidence-informed decision making: a systematic approach

    PubMed Central

    Poot, Charlotte C; van der Kleij, Rianne M; Brakema, Evelyn A; Vermond, Debbie; Williams, Siân; Cragg, Liza; van den Broek, Jos M; Chavannes, Niels H

    2018-01-01

    Abstract Background Knowledge creation forms an integral part of the knowledge-to-action framework aimed at bridging the gap between research and evidence-informed decision making. Although principles of science communication, data visualisation and user-centred design largely impact the effectiveness of communication, their role in knowledge creation is still limited. Hence, this article aims to provide researchers a systematic approach on how knowledge creation can be put into practice. Methods A systematic two-phased approach towards knowledge creation was formulated and executed. First, during a preparation phase the purpose and audience of the knowledge were defined. Subsequently, a developmental phase facilitated how the content is ‘said’ (language) and communicated (channel). This developmental phase proceeded via two pathways: a translational cycle and design cycle, during which core translational and design components were incorporated. The entire approach was demonstrated by a case study. Results The case study demonstrated how the phases in this systematic approach can be operationalised. It furthermore illustrated how created knowledge can be delivered. Conclusion The proposed approach offers researchers a systematic, practical and easy-to-implement tool to facilitate effective knowledge creation towards decision-makers in healthcare. Through the integration of core components of knowledge creation evidence-informed decision making will ultimately be optimized. PMID:29538728

  7. Information and Decision Superiority: Right Concept, Right Tools, Right Training

    DTIC Science & Technology

    2007-01-01

    individual services, and numerous defense contractors have spoken of " information dominance " and "information superiority." Both, particularly the former...technologies will offer an unimaginable level of information to decision makers and operators. Ideas of information dominance , however, are fundamentally...other futuristic sensors will offer an unimaginable level of information to decision makers and operators. Ideas of information dominance , however

  8. 36 CFR 907.14 - Corporation decision making procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Corporation decision making... CORPORATION ENVIRONMENTAL QUALITY § 907.14 Corporation decision making procedures. To ensure that at major decision making points all relevant environmental concerns are considered by the Decision Maker, the...

  9. Decision making with environmental indices

    USGS Publications Warehouse

    Hoag, Dana L.; Ascough, James C.; Keske-Handley, C.; Koontz, Lynne; Burk, A.R.

    2005-01-01

    Since Ott's seminal book on environmental indices (1978), the use of indices has expanded into several natural resource disciplines, including ecological studies, environmental policymaking, and agricultural economics. However, despite their increasing use in natural resource disciplines, researchers and public decision makers continue to express concern about validity of these instruments to capture and communicate multidimensional, and sometimes disparate, characteristics of research data and stakeholder interests. Our purpose is to demonstrate how useful indices can be for communicating environmental information to decision makers. We discuss how environmental indices have evolved over four stages: 1) simple; 2) compound multicriteria; 3) the impact matrix and 4) disparate stakeholder management. We provide examples of simple and compound indices that were used by policy decision makers. We then build a framework, called an Impact Matrix (IM), that comprehensively accounts for multiple indices but lets the user decide how to integrate them. The IM was shaped from the concept of a financial risk payoff matrix and applied to ecosystem risk. While the IM offers flexibility, it does not address stakeholder preferences about which index to use. Therefore, the last phase in our evolutionary ladder includes stakeholder indices to specifically address disparate stakeholder preferences. Finally, we assert that an environmental index has the potential to increase resource efficiency, since the number of decision making resources may be reduced, and hence improve upon resource productivity

  10. Helping the decision maker effectively promote various experts' views into various optimal solutions to China's institutional problem of health care provider selection through the organization of a pilot health care provider research system.

    PubMed

    Tang, Liyang

    2013-04-04

    The main aim of China's Health Care System Reform was to help the decision maker find the optimal solution to China's institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China's health care system, and it could efficiently collect the data for determining the optimal solution to China's institutional problem of health care provider selection from various experts, then the purpose of this study was to apply the optimal implementation methodology to help the decision maker effectively promote various experts' views into various optimal solutions to this problem under the support of this pilot system. After the general framework of China's institutional problem of health care provider selection was established, this study collaborated with the National Bureau of Statistics of China to commission a large-scale 2009 to 2010 national expert survey (n = 3,914) through the organization of a pilot health care provider research system for the first time in China, and the analytic network process (ANP) implementation methodology was adopted to analyze the dataset from this survey. The market-oriented health care provider approach was the optimal solution to China's institutional problem of health care provider selection from the doctors' point of view; the traditional government's regulation-oriented health care provider approach was the optimal solution to China's institutional problem of health care provider selection from the pharmacists' point of view, the hospital administrators' point of view, and the point of view of health officials in health administration departments; the public private partnership (PPP) approach was the optimal solution to China's institutional problem of health care provider selection from the nurses' point of view, the point of view of officials in medical insurance agencies, and the health care researchers' point of view. The data collected through a pilot health care

  11. The Decision-Making Structure and the Dean.

    ERIC Educational Resources Information Center

    Johnson, Betty M.; George, Shirley A.

    1987-01-01

    Characteristics in the college academic setting and the external environment that affect the decision-making structure and that the dean should consider before reorganization are examined. Concepts and theories about governance, decision-making, organizational structure, and characteristics of effective decision makers are also briefly reviewed. A…

  12. Post-decision consolidation in large group decision-making.

    PubMed

    Bäck, Emma A; Esaiasson, Peter; Gilljam, Mikael; Svenson, Ola; Lindholm, Torun

    2011-08-01

    Decision-makers tend to change the psychological attractiveness of decision alternatives in favor of their own preferred alternative after the decision is made. In two experiments, the present research examined whether such decision consolidation occurs also among individual group members in a large group decision-making situation. High-school students were presented with a decision scenario on an important issue in their school. The final decision was made by in-group authority, out-group authority or by majority after a ballot voting. Results showed that individual members of large groups changed the attractiveness of their preferred alternative from a pre- to a post-decision phase, that these consolidation effects increased when decisions were made by in-group members, and when participants identified strongly with their school. Implications of the findings for understanding of group behavior and subgroup relations are discussed. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

  13. Risk Attitude in Small Timesaving Decisions

    ERIC Educational Resources Information Center

    Munichor, Nira; Erev, Ido; Lotem, Arnon

    2006-01-01

    Four experiments are presented that explore situations in which a decision maker has to rely on personal experience in an attempt to minimize delays. Experiment 1 shows that risk-attitude in these timesaving decisions is similar to risk-attitude in money-related decisions from experience: A risky prospect is more attractive than a safer prospect…

  14. Bridge over troubled waters: A Synthesis Session to connect scientific and decision making sectors

    EPA Science Inventory

    Lack of access to relevant scientific data has limited decision makers from incorporating scientific information into their management and policy schemes. Yet, there is increasing interest among decision makers and scientists to integrate coastal and marine science into the polic...

  15. International Exchange of Emergency Phase Information and Assessment: An Aid to Inter/National Decision Makers

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

    Sullivan, T J; Chino, M; Ehrhardt, J

    2003-09-01

    This paper discusses a collaborative project whose purpose is (1) to demonstrate the technical feasibility and mutual benefit of a system seeking early review or preview, in a ''quasi peer review'' mode, of nuclear accident plume and dose assessment predictions by four major international nuclear accident emergency response systems before release of their calculations to their respective national authorities followed by (2) sharing these results with responsible international authorities. The extreme sensitivity of the general public to any nuclear accident information has been a strong motivation to seek peer review prior to public release. Another intended objective of this workmore » is (3) the development of an affordable/accessible system for distribution of prediction results to countries having no prediction capabilities and (4) utilization of the link for exercises and collaboration studies. The project exploits the Internet as a ubiquitous communications medium, browser technology as a simple, user friendly interface, and low-cost PC level hardware. The participants are developing a web based dedicated node with ID and password access control, where the four systems can deposit a minimal set of XML-based data and graphics files, which are then displayed in a common identical map format. Side-by-side viewing and televideo conferencing will permit rapid evaluation, correction or elaboration of data, recalculation (if necessary) and should produce a strong level of consensus to assist international decision makers. Successful completion of this work could lead to easy utilization by national and international organizations, such as the IAEA and WHO, as well as by non-nuclear states at risk of a trans-boundary incursion on their territory.« less

  16. Modelling decision-making by pilots

    NASA Technical Reports Server (NTRS)

    Patrick, Nicholas J. M.

    1993-01-01

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

  17. [The influence of the relationship between physicians and pharmaceutical companies on the patient from the point of view of policy-makers in Israel].

    PubMed

    Nissanholtz-Gannot, Rachel; Shani, Segev; Shvarts, Shifra

    2010-11-01

    The relationship between doctors and pharmaceutical companies is an integral part of the health system in Israel and the whole world. The mutual need for such a relationship requires us, as a society, to examine its influence on the individual and the system as a whole. This research examines the relationship from the points of view of the relevant parties within the health system and outside the health system (decision-makers). The authors used in-depth interviews and qualitative research methods in order to examine and understand the various positions of decision-makers. The position of the decision-makers, regarding all the aspects of this relationship, expresses their wishes and depends on their point of view. The impact of the relationship between the doctors and the pharmaceutical companies was examined with regard to the prescription behavior of the doctor. All the government representatives, all the physicians' representatives and those of the health funds, believe that the physicians' prescription behavior is impacted by the relationship. There are those who perceive this to be a negative trend and some doctors believe it to be a positive trend. With regard to possible harm to the patient, the parties believe that the relationship does not harm the patient, whereas most of the government representatives identify harm to the patients, both on the economic and health levels. The authors believe that the "influence" which exists or could exist on the part of the pharmaceutical companies is the main stumbling block in this relationship, which is expressed in the decision-makers' perspective.

  18. Decision Theory Research

    DTIC Science & Technology

    1975-04-03

    by particular foreign leaders and elites o A comparative study of selected military publica - tions wl^ch would provide a descriptive and...the overall aim of the second wo? kshop was to solicit the observations and sug- gestions of senior decision-makers and planners with respect to: o...shops do contain a number of worthwhile observations and sug- gestions by distinguished representatives of both the decision- maxing/planning and

  19. Foundations for context-aware information retrieval for proactive decision support

    NASA Astrophysics Data System (ADS)

    Mittu, Ranjeev; Lin, Jessica; Li, Qingzhe; Gao, Yifeng; Rangwala, Huzefa; Shargo, Peter; Robinson, Joshua; Rose, Carolyn; Tunison, Paul; Turek, Matt; Thomas, Stephen; Hanselman, Phil

    2016-05-01

    Intelligence analysts and military decision makers are faced with an onslaught of information. From the now ubiquitous presence of intelligence, surveillance, and reconnaissance (ISR) platforms providing large volumes of sensor data, to vast amounts of open source data in the form of news reports, blog postings, or social media postings, the amount of information available to a modern decision maker is staggering. Whether tasked with leading a military campaign or providing support for a humanitarian mission, being able to make sense of all the information available is a challenge. Due to the volume and velocity of this data, automated tools are required to help support reasoned, human decisions. In this paper we describe several automated techniques that are targeted at supporting decision making. Our approaches include modeling the kinematics of moving targets as motifs; developing normalcy models and detecting anomalies in kinematic data; automatically classifying the roles of users in social media; and modeling geo-spatial regions based on the behavior that takes place in them. These techniques cover a wide-range of potential decision maker needs.

  20. 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

  1. System and method for integrating hazard-based decision making tools and processes

    DOEpatents

    Hodgin, C Reed [Westminster, CO

    2012-03-20

    A system and method for inputting, analyzing, and disseminating information necessary for identified decision-makers to respond to emergency situations. This system and method provides consistency and integration among multiple groups, and may be used for both initial consequence-based decisions and follow-on consequence-based decisions. The system and method in a preferred embodiment also provides tools for accessing and manipulating information that are appropriate for each decision-maker, in order to achieve more reasoned and timely consequence-based decisions. The invention includes processes for designing and implementing a system or method for responding to emergency situations.

  2. Examining Tensions That Affect the Evaluation of Technology in Health Care: Considerations for System Decision Makers From the Perspective of Industry and Evaluators.

    PubMed

    Desveaux, Laura; Shaw, James; Wallace, Ross; Bhattacharyya, Onil; Bhatia, R Sacha; Jamieson, Trevor

    2017-12-08

    Virtual technologies have the potential to mitigate a range of challenges for health care systems. Despite the widespread use of mobile devices in everyday life, they currently have a limited role in health service delivery and clinical care. Efforts to integrate the fast-paced consumer technology market with health care delivery exposes tensions among patients, providers, vendors, evaluators, and system decision makers. This paper explores the key tensions between the high bar for evidence prior to market approval that guides health care regulatory decisions and the "fail fast" reality of the technology industry. We examine three core tensions: balancing user needs versus system needs, rigor versus responsiveness, and the role of pre- versus postmarket evidence generation. We use these to elaborate on the structure and appropriateness of evaluation mechanisms for virtual care solutions. Virtual technologies provide a foundation for personalized, patient-centered medicine on the user side, coupled with a broader understanding of impact on the system side. However, mechanisms for stakeholder discussion are needed to clarify the nature of the health technology marketplace and the drivers of evaluation priorities. ©Laura Desveaux, James Shaw, Ross Wallace, Onil Bhattacharyya, R Sacha Bhatia, Trevor Jamieson. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 08.12.2017.

  3. Sharing NASA Science with Decision Makers: A Perspective from NASA's Applied Remote Sensing Training (ARSET) Program

    NASA Astrophysics Data System (ADS)

    Prados, A. I.; Blevins, B.; Hook, E.

    2015-12-01

    NASA ARSET http://arset.gsfc.nasa.gov has been providing applied remote sensing training since 2008. The goals of the program are to develop the technical and analytical skills necessary to utilize NASA resources for decision-support. The program has reached over 3500 participants, with 1600 stakeholders from 100 countries in 2015 alone. The target audience for the program are professionals engaged in environmental management in the public and private sectors, such as air quality forecasters, public utilities, water managers and non-governmental organizations engaged in conservation. Many program participants have little or no expertise in NASA remote sensing, and it's frequently their very first exposure to NASA's vast resources. One the key challenges for the program has been the evolution and refinement of its approach to communicating NASA data access, research, and ultimately its value to stakeholders. We discuss ARSET's best practices for sharing NASA science, which include 1) training ARSET staff and other NASA scientists on methods for science communication, 2) communicating the proper amount of scientific information at a level that is commensurate with the technical skills of program participants, 3) communicating the benefit of NASA resources to stakeholders, and 4) getting to know the audience and tailoring the message so that science information is conveyed within the context of agencies' unique environmental challenges.

  4. An Introspective Critique of Past, Present, and Future USGS Decision Support

    NASA Astrophysics Data System (ADS)

    Neff, B. P.; Pavlick, M.

    2017-12-01

    In response to increasing scrutiny of publicly funded science, the Water Mission Area of USGS is shifting its approach for informing decisions that affect the country. Historically, USGS has focused on providing sound science on cutting edge, societally relevant issues with the expectation that decision makers will take action on this information. In practice, scientists often do not understand or focus on the needs of decision makers and decision makers often cannot or do not utilize information produced by scientists. The Water Mission Area of USGS has recognized that it can better serve the taxpayer by delivering information more relevant to decision making in a form more conducive to its use. To this end, the Water Mission Area of USGS is seeking greater integration with the decision making process to better inform what information it produces. In addition, recognizing that the transfer of scientific knowledge to decision making is fundamentally a social process, USGS is embracing the use of social science to better inform how it delivers scientific information and facilitates its use. This study utilizes qualitative methods to document the evolution of decision support at USGS and provide a rationale for a shift in direction. Challenges to implementation are identified and collaborative opportunities to improve decision making are discussed.

  5. Impact of Cognitive Load on Family Decision Makers' Recall and Understanding of Donation Requests for the Genotype-Tissue Expression (GTEx) Project.

    PubMed

    Siminoff, Laura A; Wilson-Genderson, Maureen; Mosavel, Maghboeba; Barker, Laura; Trgina, Jennifer; Traino, Heather M; Nathan, Howard M; Hasz, Richard D; Walters, Gary

    2018-01-01

    Genomic research projects that collect tissues from deceased organ and tissue donors must obtain the authorization of family decision makers under difficult circumstances that may affect the authorization process. Using a quasi-experimental design, the Ethical, Legal, and Social Issues (ELSI) substudy of the Genotype-Tissue Expression (GTEx) project compared the recall and understanding of the donation authorization process of two groups: family members who had authorized donation of tissues to the GTEx project (the comparison group) and family members who had authorized organ and tissue donations in years previous, who subsequently participated in two different mock-authorization processes that mimicked the GTEx authorization process (the intervention groups). Participants in the comparison and intervention groups were matched on key demographic characteristics. We found that participants in the intervention groups who experienced a mock-authorization process demonstrated better recall of the tissue donation request than members of the comparison group. Our data indicate that the stress associated with the loss of a loved one limited the ability of family members to recall details about the GTEx project. However, we found a similar lack of knowledge in both the comparison and the intervention group participants, suggesting lack of knowledge may be due to the complexity and unfamiliarity of the information presented to them during the authorization process. We discuss these findings in the context of everyday clinical decision making in cognitively challenging conditions. Copyright 2018 The Journal of Clinical Ethics. All rights reserved.

  6. Adaptive Strategy Selection in Decision Making.

    DTIC Science & Technology

    1986-07-31

    information processing capabilities of a decision maker, given any " reasonable " time limit for making the decision. If use of a more normative rule...DECISION MAKING JOHN W. PAYNE DTIC DUKE UNIVERSITY L.CT E AUG 13 JAMES R. BETTMAN DUKE. UNIVERSITY ERIC J. JOHNSON CARNEGIE-MELLON UNIVERSITY...REPORT & PERIOD COVERED ADAPTIVE STRATEGY SELECTION IN DECISION MAKING Research 6. PERFORMING ORO. REPORT NUMSER 7. AUTNORfe) e. CONTRACT ON GRANT

  7. The database search problem: a question of rational decision making.

    PubMed

    Gittelson, S; Biedermann, A; Bozza, S; Taroni, F

    2012-10-10

    This paper applies probability and decision theory in the graphical interface of an influence diagram to study the formal requirements of rationality which justify the individualization of a person found through a database search. The decision-theoretic part of the analysis studies the parameters that a rational decision maker would use to individualize the selected person. The modeling part (in the form of an influence diagram) clarifies the relationships between this decision and the ingredients that make up the database search problem, i.e., the results of the database search and the different pairs of propositions describing whether an individual is at the source of the crime stain. These analyses evaluate the desirability associated with the decision of 'individualizing' (and 'not individualizing'). They point out that this decision is a function of (i) the probability that the individual in question is, in fact, at the source of the crime stain (i.e., the state of nature), and (ii) the decision maker's preferences among the possible consequences of the decision (i.e., the decision maker's loss function). We discuss the relevance and argumentative implications of these insights with respect to recent comments in specialized literature, which suggest points of view that are opposed to the results of our study. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. The First Flight Decision for New Human Spacecraft Vehicles - A General Approach

    NASA Technical Reports Server (NTRS)

    Schaible, Dawn M.; Sumrall, John Phillip

    2011-01-01

    Determining when it is safe to fly a crew on a launch vehicle/spacecraft for the first time, especially when the test flight is a part of the overall system certification process, has long been a challenge for program decision makers. The decision on first flight is ultimately the judgment of the program and agency management in conjunction with the design and operations team. To aid in this decision process, a NASA team undertook the task to develop a generic framework for evaluating whether any given program or commercial provider has sufficiently complete and balanced plans in place to allow crewmembers to safely fly on human spaceflight systems for the first time. It was the team s goal to establish a generic framework that could easily be applied to any new system, although the system design and intended mission would require specific assessment. Historical data shows that there are multiple approaches that have been successful in first flight with crew. These approaches have always been tailored to the specific system design, mission objectives, and launch environment. Because specific approaches may vary significantly between different system designs and situations, prescriptive instructions or thorough checklists cannot be provided ahead of time. There are, however, certain general approaches that should be applied in thinking through the decision for first flight. This paper addresses some of the most important factors to consider when developing a new system or evaluating an existing system for whether or not it is safe to fly humans to/from space. In the simplest terms, it is time to fly crew for the first time when it is safe to do so and the benefit of the crewed flight is greater than the residual risk. This is rarely a straight-forward decision. The paper describes the need for experience, sound judgment, close involvement of the technical and management teams, and established decision processes. In addition, the underlying level of confidence the

  9. Crisis management: an extended reference framework for decision makers.

    PubMed

    Carone, Alessandro; Iorio, Luigi Di

    2013-01-01

    The paper discusses a reference framework for capabilities supporting effective crisis management. This framework has been developed by joining experiences in the field and knowledge of organisational models for crisis management, and executives' empowerment, coaching and behavioural analysis. The paper is aimed at offering further insight to executives on critical success factors and means for managing crisis situations by extending the scope of analysis to human behaviour, to emotions and fears and their correlation with decision making. It is further intended to help familiarise them and to facilitate approaching a path towards emotional awareness.

  10. Game theory and neural basis of social decision making

    PubMed Central

    Lee, Daeyeol

    2008-01-01

    Decision making in a social group displays two unique features. First, humans and other animals routinely alter their behaviors in response to changes in their physical and social environment. As a result, the outcomes of decisions that depend on the behaviors of multiple decision makers are difficult to predict, and this requires highly adaptive decision-making strategies. Second, decision makers may have other-regarding preferences and therefore choose their actions to improve or reduce the well-beings of others. Recently, many neurobiological studies have exploited game theory to probe the neural basis of decision making, and found that these unique features of social decision making might be reflected in the functions of brain areas involved in reward evaluation and reinforcement learning. Molecular genetic studies have also begun to identify genetic mechanisms for personal traits related to reinforcement learning and complex social decision making, further illuminating the biological basis of social behavior. PMID:18368047

  11. A new web-based framework development for fuzzy multi-criteria group decision-making.

    PubMed

    Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

    2016-01-01

    Fuzzy multi-criteria group decision making (FMCGDM) process is usually used when a group of decision-makers faces imprecise data or linguistic variables to solve the problems. However, this process contains many methods that require many time-consuming calculations depending on the number of criteria, alternatives and decision-makers in order to reach the optimal solution. In this study, a web-based FMCGDM framework that offers decision-makers a fast and reliable response service is proposed. The proposed framework includes commonly used tools for multi-criteria decision-making problems such as fuzzy Delphi, fuzzy AHP and fuzzy TOPSIS methods. The integration of these methods enables taking advantages of the strengths and complements each method's weakness. Finally, a case study of location selection for landfill waste in Morocco is performed to demonstrate how this framework can facilitate decision-making process. The results demonstrate that the proposed framework can successfully accomplish the goal of this study.

  12. SEA - Enhancing communication for better environmental decisions

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

    Vicente, Gustavo; Partidario, Maria R.

    Over the years SEA has been subjected to several interpretations, often resulting from different views on democratic processes and social considerations in decision-making. More than strictly a technical tool, as in its original form, SEA has the potential to act as a mediating instrument, bridging problem perceptions with technical solutions, steering the assessment to facilitate the integration of environmental values into decision-making processes, influencing decision-makers' capacity of acceptance. This paper explores the potential of SEA to enhance communication between different stakeholders, enabling discussion and agreement independently of different beliefs, convictions, social roles, values, accumulated experiences, individual needs, or any othermore » factors, that express different world visions and determine the context within which decisions are taken. To face up to this challenge the authors suggest the establishment of communication strategies that enhance the role of SEA in the construction of social expectations and platforms of discussion, in the multiple negotiation processes that take place between stakeholders and decision-makers.« less

  13. Do violations of the axioms of expected utility theory threaten decision analysis?

    PubMed

    Nease, R F

    1996-01-01

    Research demonstrates that people violate the independence principle of expected utility theory, raising the question of whether expected utility theory is normative for medical decision making. The author provides three arguments that violations of the independence principle are less problematic than they might first appear. First, the independence principle follows from other more fundamental axioms whose appeal may be more readily apparent than that of the independence principle. Second, the axioms need not be descriptive to be normative, and they need not be attractive to all decision makers for expected utility theory to be useful for some. Finally, by providing a metaphor of decision analysis as a conversation between the actual decision maker and a model decision maker, the author argues that expected utility theory need not be purely normative for decision analysis to be useful. In short, violations of the independence principle do not necessarily represent direct violations of the axioms of expected utility theory; behavioral violations of the axioms of expected utility theory do not necessarily imply that decision analysis is not normative; and full normativeness is not necessary for decision analysis to generate valuable insights.

  14. Accounting for reasonableness: Exploring the personal internal framework affecting decisions about cancer drug funding.

    PubMed

    Sinclair, Shane; Hagen, Neil A; Chambers, Carole; Manns, Braden; Simon, Anita; Browman, George P

    2008-05-01

    Drug decision-makers are involved in developing and implementing policy, procedure and processes to support health resource allocation regarding drug treatment formularies. A variety of approaches to decision-making, including formal decision-making frameworks, have been developed to support transparent and fair priority setting. Recently, a decision tool, 'The 6-STEPPPs Tool', was developed to assist in making decisions about new cancer drugs within the public health care system. We conducted a qualitative study, utilizing focus groups and participant observation, in order to investigate the internal frameworks that supported and challenged individual participants as they applied this decision tool within a multi-stakeholder decision process. We discovered that health care resource allocation engaged not only the minds of decision-makers but profoundly called on the often conflicting values of the heart. Objective decision-making frameworks for new drug therapies need to consider the subjective internal frameworks of decision-makers that affect decisions. Understanding the very human, internal turmoil experienced by individuals involved in health care resource allocation, sheds additional insight into how to account for reasonableness and how to better support difficult decisions through transparent, values-based resource allocation policy, procedures and processes.

  15. Decision models for capital investment and financing decisions in hospitals.

    PubMed Central

    Vraciu, R A

    1980-01-01

    The literature on capital investment and financing decisions for hospitals has suggested several approaches to analyzing sets of options. In this paper, I present a taxonomy of the different approaches; analyze and compare the different elements of the taxonomy; and illustrate and discuss the information that can be gained by using each approach. I view these different analytic methods as complementary rather than competing methods of providing information to decision makers, and argue that the complex nature of hospital objectives demands the use of more than one approach. Failure to do this may lead to biased evaluations and poor decision making. PMID:6768699

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

    PubMed

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

    2015-01-01

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

  17. Study protocol: DEcisions in health Care to Introduce or Diffuse innovations using Evidence (DECIDE).

    PubMed

    Turner, Simon; Morris, Stephen; Sheringham, Jessica; Hudson, Emma; Fulop, Naomi J

    2016-04-05

    A range of evidence informs healthcare decision-making, from formal research findings to 'soft intelligence' or local data, as well as practical experience or tacit knowledge. However, cultural and organisational factors often prevent the translation of such evidence into practice. Using a multi-level framework, this project will analyse how interactions between the evidence available and processes at the micro (individual/group) and meso (organisational/system) levels influence decisions to introduce or diffuse innovations in acute and primary care within the National Health Service in the UK. This study will use a mixed methods design, combining qualitative and quantitative methods, and involves four interdependent work streams: (1) rapid evidence synthesis of relevant literature with stakeholder feedback; (2) in-depth case studies of 'real-world' decision-making in acute and primary care; (3) a national survey and discrete choice experiment; and (4) development of guidance for decision-makers and evaluators to support the use of evidence in decision-making. This study will enhance the understanding of decision-makers' use of diverse forms of evidence. The findings will provide insights into how and why some evidence does inform decisions to introduce healthcare innovations, and why barriers persist in other cases. It will also quantify decision-makers' preferences, including the 'tipping point' of evidence needed to shift stakeholders' views. Practical guidance will be shared with healthcare decision-makers and evaluators on uses of evidence to enable the introduction and diffusion of innovation.

  18. Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes.

    PubMed

    Souza, Nathan M; Sebaldt, Rolf J; Mackay, Jean A; Prorok, Jeanette C; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    Computerized clinical decision support systems (CCDSSs) are claimed to improve processes and outcomes of primary preventive care (PPC), but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs) assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63%) RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34%) trials assessed patient outcomes, and four (29%) reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15%) and two (5%) trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Evidence supports the effectiveness of CCDSSs for screening and

  19. 10 CFR 429.45 - Automatic commercial ice makers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Automatic commercial ice makers. 429.45 Section 429.45... PRODUCTS AND COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.45 Automatic commercial ice makers. (a... automatic commercial ice makers; and (2) For each basic model of automatic commercial ice maker selected for...

  20. 10 CFR 429.45 - Automatic commercial ice makers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Automatic commercial ice makers. 429.45 Section 429.45... PRODUCTS AND COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.45 Automatic commercial ice makers. (a... automatic commercial ice makers; and (2) For each basic model of automatic commercial ice maker selected for...

  1. 10 CFR 429.45 - Automatic commercial ice makers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Automatic commercial ice makers. 429.45 Section 429.45... PRODUCTS AND COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.45 Automatic commercial ice makers. (a... automatic commercial ice makers; and (2) For each basic model of automatic commercial ice maker selected for...

  2. Human Judgment and Decision Making: Models and Applications.

    ERIC Educational Resources Information Center

    Loke, Wing Hong

    This document notes that researchers study the processes involved in judgment and decision making and prescribe theories and models that reflect the behavior of the decision makers. It addresses the various models that are used to represent judgment and decision making, with particular interest in models that more accurately represent human…

  3. Using Collaborative Simulation Modeling to Develop a Web-Based Tool to Support Policy-Level Decision Making About Breast Cancer Screening Initiation Age

    PubMed Central

    Burnside, Elizabeth S.; Lee, Sandra J.; Bennette, Carrie; Near, Aimee M.; Alagoz, Oguzhan; Huang, Hui; van den Broek, Jeroen J.; Kim, Joo Yeon; Ergun, Mehmet A.; van Ravesteyn, Nicolien T.; Stout, Natasha K.; de Koning, Harry J.; Mandelblatt, Jeanne S.

    2017-01-01

    Background There are no publicly available tools designed specifically to assist policy makers to make informed decisions about the optimal ages of breast cancer screening initiation for different populations of US women. Objective To use three established simulation models to develop a web-based tool called Mammo OUTPuT. Methods The simulation models use the 1970 US birth cohort and common parameters for incidence, digital screening performance, and treatment effects. Outcomes include breast cancers diagnosed, breast cancer deaths averted, breast cancer mortality reduction, false-positive mammograms, benign biopsies, and overdiagnosis. The Mammo OUTPuT tool displays these outcomes for combinations of age at screening initiation (every year from 40 to 49), annual versus biennial interval, lifetime versus 10-year horizon, and breast density, compared to waiting to start biennial screening at age 50 and continuing to 74. The tool was piloted by decision makers (n = 16) who completed surveys. Results The tool demonstrates that benefits in the 40s increase linearly with earlier initiation age, without a specific threshold age. Likewise, the harms of screening increase monotonically with earlier ages of initiation in the 40s. The tool also shows users how the balance of benefits and harms varies with breast density. Surveys revealed that 100% of users (16/16) liked the appearance of the site; 94% (15/16) found the tool helpful; and 94% (15/16) would recommend the tool to a colleague. Conclusions This tool synthesizes a representative subset of the most current CISNET (Cancer Intervention and Surveillance Modeling Network) simulation model outcomes to provide policy makers with quantitative data on the benefits and harms of screening women in the 40s. Ultimate decisions will depend on program goals, the population served, and informed judgments about the weight of benefits and harms. PMID:29376135

  4. A decision framework for coordinating bioterrorism planning: lessons from the BioNet program.

    PubMed

    Manley, Dawn K; Bravata, Dena M

    2009-01-01

    Effective disaster preparedness requires coordination across multiple organizations. This article describes a detailed framework developed through the BioNet program to facilitate coordination of bioterrorism preparedness planning among military and civilian decision makers. The authors and colleagues conducted a series of semistructured interviews with civilian and military decision makers from public health, emergency management, hazardous material response, law enforcement, and military health in the San Diego area. Decision makers used a software tool that simulated a hypothetical anthrax attack, which allowed them to assess the effects of a variety of response actions (eg, issuing warnings to the public, establishing prophylaxis distribution centers) on performance metrics. From these interviews, the authors characterized the information sources, technologies, plans, and communication channels that would be used for bioterrorism planning and responses. The authors used influence diagram notation to describe the key bioterrorism response decisions, the probabilistic factors affecting these decisions, and the response outcomes. The authors present an overview of the response framework and provide a detailed assessment of two key phases of the decision-making process: (1) pre-event planning and investment and (2) incident characterization and initial responsive measures. The framework enables planners to articulate current conditions; identify gaps in existing policies, technologies, information resources, and relationships with other response organizations; and explore the implications of potential system enhancements. Use of this framework could help decision makers execute a locally coordinated response by identifying the critical cues of a potential bioterrorism event, the information needed to make effective response decisions, and the potential effects of various decision alternatives.

  5. Structured decision making as a framework for linking quantitative decision support to community values

    EPA Science Inventory

    Community-level decisions can have large impacts on production and delivery of ecosystem services, which ultimately affects community well-being. But engaging stakeholders in a process to explore these impacts is a significant challenge. The principles of Structured Decision Ma...

  6. Against all odds -- Probabilistic forecasts and decision making

    NASA Astrophysics Data System (ADS)

    Liechti, Katharina; Zappa, Massimiliano

    2015-04-01

    In the city of Zurich (Switzerland) the setting is such that the damage potential due to flooding of the river Sihl is estimated to about 5 billion US dollars. The flood forecasting system that is used by the administration for decision making runs continuously since 2007. It has a time horizon of max. five days and operates at hourly time steps. The flood forecasting system includes three different model chains. Two of those are run by the deterministic NWP models COSMO-2 and COSMO-7 and one is driven by the probabilistic NWP COSMO-Leps. The model chains are consistent since February 2010, so five full years are available for the evaluation for the system. The system was evaluated continuously and is a very nice example to present the added value that lies in probabilistic forecasts. The forecasts are available on an online-platform to the decision makers. Several graphical representations of the forecasts and forecast-history are available to support decision making and to rate the current situation. The communication between forecasters and decision-makers is quite close. To put it short, an ideal situation. However, an event or better put a non-event in summer 2014 showed that the knowledge about the general superiority of probabilistic forecasts doesn't necessarily mean that the decisions taken in a specific situation will be based on that probabilistic forecast. Some years of experience allow gaining confidence in the system, both for the forecasters and for the decision-makers. Even if from the theoretical point of view the handling during crisis situation is well designed, a first event demonstrated that the dialog with the decision-makers still lacks of exercise during such situations. We argue, that a false alarm is a needed experience to consolidate real-time emergency procedures relying on ensemble predictions. A missed event would probably also fit, but, in our case, we are very happy not to report about this option.

  7. A Method for Decision Making using Sustainability Indicators

    EPA Science Inventory

    Calculations aimed at representing the thought process of decision makers are common within multi-objective decision support tools. These calculations that mathematically describe preferences most often combine various utility scores (i.e., abilities to satisfy desires) with weig...

  8. Bringing science to the table: Case studies in science-informed decision making on climate change and beyond

    NASA Astrophysics Data System (ADS)

    Goldman, G. T.; Phartiyal, P.; Mulvey, K.

    2016-12-01

    Federal government officials often rely on the research and advice of scientists to inform their decision making around climate change and other complex topics. Decision makers, however, are constrained by the time and accessibility needed to obtain and incorporate scientific information. At the same time, scientists have limited capacity and incentive to devote significant time to communicating their science to decision makers. The Union of Concerned Scientists has employed several strategies to produce policy-relevant scientific work and to facilitate engagement between scientists and decision makers across research areas. This talk will feature lessons learned and key strategies for science-informed decision making around climate change and other areas of the geosciences. Case studies will include conducting targeted sea level rise studies to inform rulemaking at federal agencies, bringing science to policy discussions on hydraulic fracturing, and leveraging the voice of the scientific community on specific policy proposals around climate change disclosure of companies. Recommendations and lessons learned for producing policy-relevant science and effectively communicating it with decision makers will be offered.

  9. Return-to-play after concussion: state of knowledge, frequency of use and application barriers of guidelines among decision-makers in rugby.

    PubMed

    Niederer, Daniel; Engeroff, Tobias; Lange, Kevin; Vogt, Lutz; Banzer, Winfried

    2018-06-05

    Validated strategies and guidelines for a safe and individualized diagnosis and return-to-play (RTP) after concussion in rugby are needed. Little is known about the state of knowledge, frequency of use and application barriers of state-of-the-art guidelines among decision-makers in professional or semi-professional rugby teams. Participants (n = 195) from the coaching team (head coach, assistance coach, athletic coach), the medical team (physiotherapist, physician, rehabilitation therapist, neuropsychologist), or from the officials of a professional or semi-professional rugby team (top three major leagues in Germany), filled in a questionnaire on their knowledge, frequency of use and application barriers of evidence-based guidelines (Graduated RTP protocol and The 5R). Depending on their function in the team and on the league of play, the state of knowledge and application of the diagnostic tools and the RTP guidelines differ. A considerable number are aware of one or both guidelines, but do not apply these guidelines (up to 27% of respondants). The main reasons for the non-usage were not my decision (59%), use of concurrent guidelines (54%), each player must decide by his own (36%), never experienced a concussion in my players (30%), other (19%), the guideline is useless (18%) and a player may play despite a concussion (14%). Raising awareness of the state-of-the-art guidelines is important to educate further the coaching, medical and official team members in identifying symptoms and executing the RTP-process in accordance with evidence-based strategies.

  10. Bridge over troubled waters: A Synthesis Session to connect ...

    EPA Pesticide Factsheets

    Lack of access to relevant scientific data has limited decision makers from incorporating scientific information into their management and policy schemes. Yet, there is increasing interest among decision makers and scientists to integrate coastal and marine science into the policy and management process. Strategies designed to build communication between decision makers and scientists can be an effective means to disseminate and/or generate policy relevant scientific information. Here researchers develop, test, and present a workshop model designed to bridge the gap between coastal and marine decision makers and scientists. Researchers identify successful components of such a workshop as well as areas for improvement and recommendations to design and conduct similar workshops in the future. This novel workshop format can be used in other fora to effectively connect decision makers and scientists, and to initiate an iterative process to generate and transfer policy relevant scientific information into evidence-based decisions, an important element in protecting coastal and marine resources. In this paper we develop and present a model for increasing collaboration between scientists and decision makers to promote evidence based decisions. Successes and areas for improvement in the tested model are discussed. This novel workshop model is intended to build and sustain connections, with the ultimate goal of creating better policy and management practices. In a recent

  11. NASA E-DECIDER Rapid Disaster Decision Support Products

    NASA Image and Video Library

    2014-09-03

    A NASA-funded disaster decision support system, provided a number of rapid response map data products to decision makers at the California Earthquake Clearinghouse following its activation for the Aug. 24, 2014 magnitude 6.0 earthquake in Napa, California

  12. Judgment and decision making.

    PubMed

    Fischhoff, Baruch

    2010-09-01

    The study of judgment and decision making entails three interrelated forms of research: (1) normative analysis, identifying the best courses of action, given decision makers' values; (2) descriptive studies, examining actual behavior in terms comparable to the normative analyses; and (3) prescriptive interventions, helping individuals to make better choices, bridging the gap between the normative ideal and the descriptive reality. The research is grounded in analytical foundations shared by economics, psychology, philosophy, and management science. Those foundations provide a framework for accommodating affective and social factors that shape and complement the cognitive processes of decision making. The decision sciences have grown through applications requiring collaboration with subject matter experts, familiar with the substance of the choices and the opportunities for interventions. Over the past half century, the field has shifted its emphasis from predicting choices, which can be successful without theoretical insight, to understanding the processes shaping them. Those processes are often revealed through biases that suggest non-normative processes. The practical importance of these biases depends on the sensitivity of specific decisions and the support that individuals have in making them. As a result, the field offers no simple summary of individuals' competence as decision makers, but a suite of theories and methods suited to capturing these sensitivities. Copyright © 2010 John Wiley & Sons, Ltd. For further resources related to this article, please visit the WIREs website. Copyright © 2010 John Wiley & Sons, Ltd.

  13. People learn other people's preferences through inverse decision-making.

    PubMed

    Jern, Alan; Lucas, Christopher G; Kemp, Charles

    2017-11-01

    People are capable of learning other people's preferences by observing the choices they make. We propose that this learning relies on inverse decision-making-inverting a decision-making model to infer the preferences that led to an observed choice. In Experiment 1, participants observed 47 choices made by others and ranked them by how strongly each choice suggested that the decision maker had a preference for a specific item. An inverse decision-making model generated predictions that were in accordance with participants' inferences. Experiment 2 replicated and extended a previous study by Newtson (1974) in which participants observed pairs of choices and made judgments about which choice provided stronger evidence for a preference. Inverse decision-making again predicted the results, including a result that previous accounts could not explain. Experiment 3 used the same method as Experiment 2 and found that participants did not expect decision makers to be perfect utility-maximizers. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Social motives and strategic misrepresentation in social decision making.

    PubMed

    Steinel, Wolfgang; De Dreu, Carsten K W

    2004-03-01

    In 4 experiments, the authors studied the influence of social motives on deception and strategic misrepresentation. In a newly developed information provision game, individuals faced a decision maker whose decision would affect both own and other's outcomes. By withholding information or by giving (in)accurate information about payoffs, participants could try to influence other's decision making. Less accurate and more inaccurate information was given when the decision maker was competitive rather than cooperative (Experiment 1), especially when participants had a prosocial rather than selfish value orientation (Experiments 3 and 4). Accurate information was withheld because of fear of exploitation and greed, and inaccurate information was given because of greed (Experiment 2). Finally, participants engaged in strategic misrepresentation that may trick competitive others into damaging their own and increasing the participant's outcomes.

  15. Decision Analysis for a Sustainable Environment, Economy & Society

    EPA Science Inventory

    Environmental decisions are often made without consideration of the roles that ecosystem services play. Most decision-makers do not currently have access to useful or usable methods and approaches when they are presented with choices that will have significant ecosystem impacts. ...

  16. Decision Analysis For A Sustainable Environment, Economy, & Society

    EPA Science Inventory

    Environmental decisions are often made without consideration of the roles that ecosystem services play. Most decision-makers do not currently have access to useful or usable methods and approaches when they are presented with choices that will have significant ecosystem impacts....

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  18. Quantum Decision Theory in Simple Risky Choices.

    PubMed

    Favre, Maroussia; Wittwer, Amrei; Heinimann, Hans Rudolf; Yukalov, Vyacheslav I; Sornette, Didier

    2016-01-01

    Quantum decision theory (QDT) is a recently developed theory of decision making based on the mathematics of Hilbert spaces, a framework known in physics for its application to quantum mechanics. This framework formalizes the concept of uncertainty and other effects that are particularly manifest in cognitive processes, which makes it well suited for the study of decision making. QDT describes a decision maker's choice as a stochastic event occurring with a probability that is the sum of an objective utility factor and a subjective attraction factor. QDT offers a prediction for the average effect of subjectivity on decision makers, the quarter law. We examine individual and aggregated (group) data, and find that the results are in good agreement with the quarter law at the level of groups. At the individual level, it appears that the quarter law could be refined in order to reflect individual characteristics. This article revisits the formalism of QDT along a concrete example and offers a practical guide to researchers who are interested in applying QDT to a dataset of binary lotteries in the domain of gains.

  19. Entropy Methods For Univariate Distributions in Decision Analysis

    NASA Astrophysics Data System (ADS)

    Abbas, Ali E.

    2003-03-01

    One of the most important steps in decision analysis practice is the elicitation of the decision-maker's belief about an uncertainty of interest in the form of a representative probability distribution. However, the probability elicitation process is a task that involves many cognitive and motivational biases. Alternatively, the decision-maker may provide other information about the distribution of interest, such as its moments, and the maximum entropy method can be used to obtain a full distribution subject to the given moment constraints. In practice however, decision makers cannot readily provide moments for the distribution, and are much more comfortable providing information about the fractiles of the distribution of interest or bounds on its cumulative probabilities. In this paper we present a graphical method to determine the maximum entropy distribution between upper and lower probability bounds and provide an interpretation for the shape of the maximum entropy distribution subject to fractile constraints, (FMED). We also discuss the problems with the FMED in that it is discontinuous and flat over each fractile interval. We present a heuristic approximation to a distribution if in addition to its fractiles, we also know it is continuous and work through full examples to illustrate the approach.

  20. Beyond Relativism to Ethical Decision-Making

    ERIC Educational Resources Information Center

    Walker, Keith D.; Donlevy, J. Kent

    2006-01-01

    This article examines the ethical conundrum of educational decision makers when faced with a plethora of conflicting value-based decisions. It offers an analysis of a well-known fable as the foil to demonstrate the problematic nature of ethical relativism and postmodern ethics in resolving that conundrum, while advocating the use of five core…

  1. Economic Decisions for Others: An Exception to Loss Aversion Law

    PubMed Central

    Mengarelli, Flavia; Moretti, Laura; Faralla, Valeria; Vindras, Philippe; Sirigu, Angela

    2014-01-01

    In everyday life, people often make decisions on behalf of others. The current study investigates whether risk preferences of decision-makers differ when the reference point is no longer their own money but somebody else money. Thirty four healthy participants performed three different monetary risky choices tasks by making decisions for oneself and for another unknown person. Results showed that loss aversion bias was significantly reduced when participants were choosing on behalf of another person compared to when choosing for themselves. The influence of emotions like regret on decision-making may explain these results. We discuss the importance of the sense of responsibility embodied in the emotion of regret in modulating economic decisions for self but not for others. Moreover, our findings are consistent with the Risk-as-feelings hypothesis, suggesting that self-other asymmetrical behavior is due to the extent the decision-maker is affected by the real and emotional consequences of his/her decision. PMID:24454788

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

    NASA Astrophysics Data System (ADS)

    Gupta, Mahima; Mohanty, B. K.

    2017-04-01

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

  3. From science to decision-making: taking the risk to communicate on risks

    NASA Astrophysics Data System (ADS)

    Leroi, Eric

    2015-04-01

    Geoscientists and decision-makers have the same responsibility toward the society: reducing the damaging consequences induced by natural phenomena. They have to work together, geoscientists to improve the knowledge and decision-makers to take the "best" decision, both to design and implement balanced solutions, both to communicate. Feedback shows that if the collaboration between them has already improved, a lot has still to be done, especially in terms of communication; endless litany, geoscientists don't communicate in the right way! In a hyperspecialized technological and segmented society with sophisticated methods of communication, geoscientists don't use appropriate tools and terminology. It's true, and a lot of examples can be shown that highlight this! Risks is based on complex concepts, on notions that are poorly understood, even by scientists themselves, especially the concepts of probability and occurrence of phenomena. But the problem rest as well on the role and on the responsibility of the geoscientists. Risk management experts address geosciences and technology to identify problems and define protection, including prohibitive measures (such as not allowing building in hazardous areas). Policy makers and local planners want to know where to develop territories. On one hand the identification of problems, on the other hand the needs of solutions. Dialectic is not the same. When responsibility, money and image are the three main pillars of decision-making, long-term modeling and uncertainty, are the basic ones for geosciences. In our participative democracies people want to be actor of the development of their own territories; they want more freedom, more protection and less tax. Face to unrealistic political answers geoscientists have to explain and convince. It's not possible to gain on everything and some are going to loose. Shall geoscientists let decision-makers communicate on topics they hardly understand? No. Shall geoscientists communicate on

  4. Decisions reduce sensitivity to subsequent information.

    PubMed

    Bronfman, Zohar Z; Brezis, Noam; Moran, Rani; Tsetsos, Konstantinos; Donner, Tobias; Usher, Marius

    2015-07-07

    Behavioural studies over half a century indicate that making categorical choices alters beliefs about the state of the world. People seem biased to confirm previous choices, and to suppress contradicting information. These choice-dependent biases imply a fundamental bound of human rationality. However, it remains unclear whether these effects extend to lower level decisions, and only little is known about the computational mechanisms underlying them. Building on the framework of sequential-sampling models of decision-making, we developed novel psychophysical protocols that enable us to dissect quantitatively how choices affect the way decision-makers accumulate additional noisy evidence. We find robust choice-induced biases in the accumulation of abstract numerical (experiment 1) and low-level perceptual (experiment 2) evidence. These biases deteriorate estimations of the mean value of the numerical sequence (experiment 1) and reduce the likelihood to revise decisions (experiment 2). Computational modelling reveals that choices trigger a reduction of sensitivity to subsequent evidence via multiplicative gain modulation, rather than shifting the decision variable towards the chosen alternative in an additive fashion. Our results thus show that categorical choices alter the evidence accumulation mechanism itself, rather than just its outcome, rendering the decision-maker less sensitive to new information. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  5. Helping the decision maker effectively promote various experts’ views into various optimal solutions to China’s institutional problem of health care provider selection through the organization of a pilot health care provider research system

    PubMed Central

    2013-01-01

    Background The main aim of China’s Health Care System Reform was to help the decision maker find the optimal solution to China’s institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China’s health care system, and it could efficiently collect the data for determining the optimal solution to China’s institutional problem of health care provider selection from various experts, then the purpose of this study was to apply the optimal implementation methodology to help the decision maker effectively promote various experts’ views into various optimal solutions to this problem under the support of this pilot system. Methods After the general framework of China’s institutional problem of health care provider selection was established, this study collaborated with the National Bureau of Statistics of China to commission a large-scale 2009 to 2010 national expert survey (n = 3,914) through the organization of a pilot health care provider research system for the first time in China, and the analytic network process (ANP) implementation methodology was adopted to analyze the dataset from this survey. Results The market-oriented health care provider approach was the optimal solution to China’s institutional problem of health care provider selection from the doctors’ point of view; the traditional government’s regulation-oriented health care provider approach was the optimal solution to China’s institutional problem of health care provider selection from the pharmacists’ point of view, the hospital administrators’ point of view, and the point of view of health officials in health administration departments; the public private partnership (PPP) approach was the optimal solution to China’s institutional problem of health care provider selection from the nurses’ point of view, the point of view of officials in medical insurance agencies, and the health care researchers’ point

  6. Learning through Making and Maker Education

    ERIC Educational Resources Information Center

    Hsu, Yu-Chang; Baldwin, Sally; Ching, Yu-Hui

    2017-01-01

    In this paper, we provide an overview of the current efforts in maker education, supported by a review of empirical studies. Our synthesis will inform the community about learning outcomes, potential and common issues, challenges, resources, and future research direction regarding maker education.

  7. Adolescent pediatric decision-making: a critical reconsideration in the light of the data.

    PubMed

    Partridge, Brian

    2014-12-01

    Adolescents present a puzzle. There are foundational unclarities about how they should be regarded as decision-makers. Although superficially adolescents may appear to have mature decisional capacity, their decision-making is in many ways unlike that of adults. Despite this seemingly obvious fact, a concern for the claims of autonomy has led to the development of the legal doctrine of the mature minor. This legal construct considers adolescents, as far as possible, as equivalent to adults for the purpose of medical decision-making. The movement to support independent decision-making by adolescents through providing information to them and securing their consent apart from their parents is encouraged by those legal understandings that hold that unemancipated minors should generally be considered as possessing effective decisional capacity. Such legal structures, however, do not adequately take account of the wide variations in adolescent capacities, the immaturity of most adolescent decision-makers, or the important contributions made by parents to the development of their adolescents through parental partnering in the adolescent's decision-making. The data available indicate that in general adolescents should be regarded as apprentice decision-makers who should make decisions in collaboration with their parents until at least the age of 18. Steps should not be taken pre-emptively to isolate adolescents from the guidance of their parents. As a general rule, what Piker has referred to as "collaborative paternalism" appears most likely both to protect adolescents from their own untoward choices, while also very importantly helping them with parental guidance to develop into mature decision-makers with the capacity to make medical choices on their own.

  8. Decision Support Framework (DSF) Team Research Implementation Plan

    EPA Science Inventory

    The mission of ORD's Ecosystem Services Research Program (ESRP) is to provide the information and methods needed by decision-makers to assess the benefits of ecosystem goods and services to human well-being for inclusion in management alternatives. The Decision Support Framework...

  9. Swift and Smart Decision Making: Heuristics that Work

    ERIC Educational Resources Information Center

    Hoy, Wayne K.; Tarter, C. J.

    2010-01-01

    Purpose: The aim of this paper is to examine the research literature on decision making and identify and develop a set of heuristics that work for school decision makers. Design/methodology/approach: This analysis is a synthesis of the research on decision-making heuristics that work. Findings: A set of nine rules for swift and smart decision…

  10. A Conceptual Framework for Defense Acquisition Decision Makers: Giving the Schedule its Due

    DTIC Science & Technology

    2014-01-01

    Principles from microeconomic theory and operations research can provide insight into acquisition decisions to produce military capabili- ties in an...models based on economic and operations research principles can yield valuable insight into defense acquisition decisions. This article focuses on models...Department Edmund Conrow (1995) developed an excellent microeconomic framework to investigate the incentives of buyers and sellers in the defense

  11. Management of carbon across sectors and scales: Insights from land use decision making

    NASA Astrophysics Data System (ADS)

    Dilling, L.; Failey, E. L.

    2008-12-01

    Carbon management is increasingly becoming a topic of interest among policy circles and business entrepreneurs alike. In the United States, while no binding regulatory framework exists, carbon management is nonetheless being pursued both by voluntary actions at a variety of levels, from the individual to the national level, and through mandatory policies at state and local levels. Controlling the amount of carbon dioxide in the atmosphere for climate purposes will ultimately require a form of governance that will ensure that the actions taken and being rewarded financially are indeed effective with respect to the global atmosphere on long time scales. Moreover, this new system of governance will need to interface with existing governance structures and decision criteria that have been established to arbitrate among various societal values and priorities. These existing institutions and expressed values will need to be examined against those proposed for effective carbon governance, such as the permanence of carbon storage, the additionality of credited activities, and the prevention of leakage, or displacement of prohibited activities to another region outside the governance boundary. The latter issue suggests that interactions among scales of decision making and governance will be extremely important in determining the ultimate success of any future system of carbon governance. The goal of our study is to understand the current context of land use decision making in different sectors and examine the potential for future carbon policy to be effective given this context. This study examined land use decision making in the U.S. state of Colorado from a variety of ownership perspectives, including US Federal land managers, individual private owners, and policy makers involved in land use at a number of different scales. This paper will report on the results of interviews with land managers and provide insight into the policy context for carbon management through land

  12. The Insertion of Human Factors Concerns into NextGen Programmatic Decisions

    NASA Technical Reports Server (NTRS)

    Beard, Bettina L.; Holbrook, Jon Brian; Seely, Rachel

    2013-01-01

    Since the costs of proposed improvements in air traffic management exceed available funding, FAA decision makers must select and prioritize what actually gets implemented. We discuss a set of methods to help forecast operational and human performance issues and benefits before new automation is introduced. This strategy could minimize the impact of politics, assist decision makers in selecting and prioritizing potential improvements, make the process more transparent and strengthen the link between the engineering and human factors domains.

  13. Decision making, procedural compliance, and outcomes definition in U.S. forest service planning processes

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

    Stern, Marc J., E-mail: mjstern@vt.ed; Predmore, S. Andrew, E-mail: sapredmo@vt.ed

    2011-04-15

    The National Environmental Policy Act (NEPA) dictates a process of analyzing and disclosing the likely impacts of proposed agency actions on the human environment. This study addresses two key questions related to NEPA implementation in the U.S. Forest Service: 1) how do Interdisciplinary (ID) team leaders and decision makers conceptualize the outcomes of NEPA processes? And 2), how does NEPA relate to agency decision making? We address these questions through two separate online surveys that posed questions about recently completed NEPA processes - the first with the ID team leaders tasked with carrying out the processes, and the second withmore » the line officers responsible for making the processes' final decisions. Outcomes of NEPA processes include impacts on public relations, on employee morale and team functioning, on the achievement of agency goals, and on the achievement of NEPA's procedural requirements (disclosure) and substantive intent (minimizing negative environmental impacts). Although both tended to view public relations outcomes as important, decision makers' perceptions of favorable outcomes were more closely linked to the achievement of agency goals and process efficiency than was the case for ID team leaders. While ID team leaders' responses suggest that they see decision making closely integrated with the NEPA process, decision makers more commonly decoupled decision making from the NEPA process. These findings suggest a philosophical difference between ID team leaders and decision makers that may pose challenges for both the implementation and the evaluation of agency NEPA. We discuss the pros and cons of integrating NEPA with decision making or separating the two. We conclude that detaching NEPA from decision making poses greater risks than integrating them.« less

  14. Haitian and international responders' and decision-makers' perspectives regarding disability and the response to the 2010 Haiti earthquake.

    PubMed

    Hunt, Matthew R; Chung, Ryoa; Durocher, Evelyne; Henrys, Jean Hugues

    2015-01-01

    Following disasters, persons with disabilities (PWD) are especially vulnerable to harm, yet they have commonly been excluded from disaster planning, and their needs have been poorly addressed during disaster relief. Following the 2010 Haiti earthquake, thousands of individuals experienced acute injuries. Many more individuals with preexisting disabilities experienced heightened vulnerability related to considerations including safety, access to services, and meeting basic needs. The objective of this research was to better understand the perceptions of responders and decision-makers regarding disability and efforts to address the needs of PWD following the 2010 earthquake. We conducted a qualitative study using interpretive description methodology and semistructured interviews with 14 Haitian and 10 international participants who were involved in the earthquake response. Participants identified PWD as being among the most vulnerable individuals following the earthquake. Though some forms of disability received considerable attention in aid efforts, the needs of other PWD did not. Several factors were identified as challenges for efforts to address the needs of PWD including lack of coordination and information sharing, the involvement of multiple aid sectors, perceptions that this should be the responsibility of specialized organizations, and the need to prioritize limited resources. Participants also reported shifts in local social views related to disability following the earthquake. Addressing the needs of PWD following a disaster is a crucial population health challenge and raises questions related to equity and responsibility for non-governmental organizations, governments, and local communities.

  15. Economic evaluations of health technologies in Dutch healthcare decision-making: a qualitative study of the current and potential use, barriers, and facilitators.

    PubMed

    Roseboom, Kitty J; van Dongen, Johanna M; Tompa, Emile; van Tulder, Maurits W; Bosmans, Judith E

    2017-01-26

    The use of economic evaluations in healthcare decision-making can potentially help decision-makers in allocating scarce resources as efficiently as possible. Over a decade ago, the use of such studies was found to be limited in Dutch healthcare decision-making, but their current use is unknown. Therefore, this study aimed to provide insight into the current and potential use of economic evaluations in Dutch healthcare decision-making and to identify barriers and facilitators to the use of such studies. Interviews containing semi-structured and structured questions were conducted among Dutch healthcare decision-makers. Participants were purposefully selected and special efforts were made to include decision-makers working at the macro- (national), meso- (local/regional), and micro-level (patient setting). During the interviews, a topic list was used that was based on the research questions and a literature search, and was developed in consultation with the Dutch National Healthcare Institute. Responses to the semi-structured questions were analyzed using a constant comparative approach. As for the structured questions, participants' definitions of various economic evaluation concepts were scored as either being "correct" or "incorrect" by two researchers, and summary statistics were prepared. Sixteen healthcare decision-makers were interviewed and two health economists. Decision-makers' knowledge of economic evaluations was only modest, and their current use appeared to be limited. Nonetheless, decision-makers recognized the importance of economic evaluations and saw several opportunities for extending their use at the macro- and meso-level, but not at the micro-level. The disparity between the limited use and recognition of the importance of economic evaluations is likely due to the many barriers decision-makers experience preventing their use (e.g. lack of resources, lack of formal willingness-to-pay threshold). Possible facilitators for extending the use of

  16. Carbon Cycle Science in Support of Decision-Making

    NASA Astrophysics Data System (ADS)

    Brown, M. E.; West, T. O.; McGlynn, E.; Gurwick, N. P.; Duren, R. M.; Ocko, I.; Paustian, K.

    2016-12-01

    There has been an extensive amount of basic and applied research conducted on biogeochemical cycles, land cover change, watershed to earth system modeling, climate change, and energy efficiency. Concurrently, there continues to be interest in how to best reduce net carbon emissions, including maintaining or augmenting global carbon stocks and decreasing fossil fuel emissions. Decisions surrounding reductions in net emissions should be grounded in, and informed by, existing scientific knowledge and analyses in order to be most effective. The translation of scientific research to decision-making is rarely direct, and often requires coordination of objectives or intermediate research steps. For example, complex model output may need to be simplified to provide mean estimates for given activities; biogeochemical models used for climate change prediction may need to be altered to estimate net carbon flux associated with particular activities; or scientific analyses may need to aggregate and analyze data in a different manner to address specific questions. In the aforementioned cases, expertise and capabilities of researchers and decision-makers are both needed, and early coordination and communication is most effective. Initial analysis of existing science and current decision-making needs indicate that (a) knowledge that is co-produced by scientists and decision-makers has a higher probability of being usable for decision making, (b) scientific work in the past decade to integrate activity data into models has resulted in more usable information for decision makers, (c) attribution and accounting of carbon cycle fluxes is key to using carbon cycle science for decision-making, and (d) stronger, long-term links among research on climate and management of carbon-related sectors (e.g., energy, land use, industry, and buildings) are needed to adequately address current issues.

  17. White House Maker Faire

    NASA Image and Video Library

    2014-06-18

    The Maker Faire trailer is seen outside the rose garden during the first ever White House Maker Faire, which brings together students, entrepreneurs, and everyday citizens who are using new tools and techniques to launch new businesses, learn vital skills in science, technology, engineering, and math (STEM), and fuel the renaissance in American manufacturing, at the White House, Wednesday, June 18, 2014 in Washington. The President announced new steps the Administration and its partners are taking to support the ability of more Americans, young and old, to have to access to these tools and techniques and brings their ideas to life. Photo Credit: (NASA/Bill Ingalls)

  18. Alaska Center for Climate Assessment and Policy: Partnering with Decision-Makers in Climate Change Adaptation

    NASA Astrophysics Data System (ADS)

    White, D.; Trainor, S.; Walsh, J.; Gerlach, C.

    2008-12-01

    The Alaska Center for Climate Assessment and Policy (ACCAP; www.uaf.edu/accap) is one of several, NOAA funded, Regional Integrated Science and Policy (RISA) programs nation-wide (http://www.climate.noaa.gov/cpo_pa/risa/). Our mission is to assess the socio-economic and biophysical impacts of climate variability in Alaska, make this information available to local and regional decision-makers, and improve the ability of Alaskans to adapt to a changing climate. We partner with the University of Alaska?s Scenario Network for Alaska Planning (SNAP; http://www.snap.uaf.edu/), state and local government, state and federal agencies, industry, and non-profit organizations to communicate accurate and up-to-date climate science and assist in formulating adaptation and mitigation plans. ACCAP and SNAP scientists are members of the Governor?s Climate Change Sub-Cabinet Adaptation and Mitigation Advisory and Technical Working Groups (http://www.climatechange.alaska.gov/), and apply their scientific expertise to provide down-scaled, state-wide maps of temperature and precipitation projections for these groups. An ACCAP scientist also serves as co-chair for the Fairbanks North Star Borough Climate Change Task Force, assisting this group as they work through the five-step model for climate change planning put forward by the International Council for Local Environmental Initiatives (http://www.investfairbanks.com/Taskforces/climate.php). ACCAP scientists work closely with federal resource managers in on a range of projects including: partnering with the U.S. Fish and Wildlife Service to analyze hydrologic changes associated with climate change and related ecological impacts and wildlife management and development issues on Alaska?s North Slope; partnering with members of the Alaska Interagency Wildland Fire Coordinating Group in statistical modeling to predict seasonal wildfire activity and coordinate fire suppression resources state-wide; and working with Alaska Native Elders and

  19. [Requirements for and expectations of health technology assessment in Galicia (Spain). A qualitative study from the perspective of decision-makers and clinicians].

    PubMed

    Varela-Lema, Leonor; Merino, Gerardo Atienza; García, Marisa López; Martínez, María Vidal; Triana, Elena Gervas; Mota, Teresa Cerdá

    2011-01-01

    To explore perceptions of the use of health technology assessment (HTA) in the Galician public health system, identify opinions on the usefulness of the products and services developed by the Galician Health Technology Assessment Agency (avalia-t), and determine the barriers and facilitators to the transfer of results to clinical practice. We performed a qualitative study based on in-depth semi-structured interviews of 20 intentionally selected experts (10 health care professionals and 10 hospital decision makers). The interviews were tape recorded and transcribed for inductive thematic analysis. Interest in HTA activities was high, but most informants considered these activities to be underused as a tool to aid decision making in clinical practice. A series of key factors was identified to guarantee HTA use: greater dissemination of HTA activities and availability of the results, increased involvement and communication among health care professionals in the selection and prioritization of relevant research, contextualization and adaptation of results to the local context, increased organizational support and greater financial resources. The present study allows end-userś opinions on the utility of the various products/services offered by HTA agencies to be contrasted in order to adapt HTA activity to their needs and requirements. The involvement of health care professionals in all HTA fields is perceived as one of the main lines of action for HTA agencies. Such involvement could be achieved by reinforcing personal contact and increasing feedback to collaborators. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Canadian policy makers' views on pharmaceutical reimbursement contracts involving confidential discounts from drug manufacturers.

    PubMed

    Morgan, Steven G; Thomson, Paige A; Daw, Jamie R; Friesen, Melissa K

    2013-10-01

    Pharmaceutical policy makers are increasingly negotiating reimbursement contracts that include confidential price terms that may be affected by drug utilization volumes, patterns, or outcomes. Though such contracts may offer a variety of benefits, including the ability to tie payment to the actual performance of a product, they may also create potential policy challenges. Through telephone interviews about this type of contract, we studied the views of officials in nine of ten Canadian provinces. Use of reimbursement contracts involving confidential discounts is new in Canada and ideas about power and equity emerged as cross-cutting themes in our interviews. Though confidential rebates can lower prices and thereby increase coverage of new medicines, several policy makers felt they had little power in the decision to negotiate rebates. Study participants explained that the recent rise in the use of rebates had been driven by manufacturers' pricing tactics and precedent set by other jurisdictions. Several policy makers expressed concerns that confidential rebates could result in inter-jurisdictional inequities in drug pricing and coverage. Policy makers also noted un-insured and under-insured patients must pay inflated "list prices" even if rebates are negotiated by drug plans. The establishment of policies for disciplined negotiations, inter-jurisdictional cooperation, and provision of drug coverage for all citizens are potential solutions to the challenges created by this new pharmaceutical pricing paradigm. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  1. Dying cancer patients talk about physician and patient roles in DNR decision making.

    PubMed

    Eliott, Jaklin A; Olver, Ian

    2011-06-01

    Within medical and bioethical discourse, there are many models depicting the relationships between, and roles of, physician and patient in medical decision making. Contestation similarly exists over the roles of physician and patient with regard to the decision not to provide cardiopulmonary resuscitation (CPR) following cardiac arrest [the do-not-resuscitate or do-not-resuscitate (DNR) decision], but there is little analysis of patient perspectives. Analyse what patients with cancer within weeks before dying say about the decision to forego CPR and the roles of patient and physician in this decision. Discursive analysis of qualitative data gathered during semi-structured interviews with 28 adult cancer patients close to death and attending palliative or oncology clinics of an Australian teaching hospital. Participants' descriptions of appropriate patient or physician roles in decisions about CPR appeared related to how they conceptualized the decision: as a personal or a medical issue, with patient and doctor respectively identified as appropriate decision makers; or alternatively, both medical and personal, with various roles assigned embodying different versions of a shared decision-making process. Participants' endorsement of physicians as decision makers rested upon physicians' enactment of the rational, knowledgeable and compassionate expert, which legitimized entrusting them to make the DNR decision. Where this was called into question, physicians were positioned as inappropriate decision makers. When patients' and physicians' understandings of the best decision, or of the preferred role of either party, diverge, conflict may ensue. In order to elicit and negotiate with patient preferences, flexibility is required during clinical interactions about decision making. © 2010 Blackwell Publishing Ltd.

  2. From drought indicators to impacts: developing improved tools for monitoring and early warning with decision-makers in mind

    NASA Astrophysics Data System (ADS)

    Hannaford, Jamie; Barker, Lucy; Svensson, Cecilia; Tanguy, Maliko; Laize, Cedric; Bachmair, Sophie; Tijdeman, Erik; Stahl, Kerstin; Collins, Kevin

    2016-04-01

    of M&EW and future aspirations. Different stakeholders clearly have different goals for M&EW, but there are a number of common themes, including a desire to better understand the links between the outputs of large-scale M&EW systems (rainfall, river flow, etc), localised triggers used by decision-makers during drought episodes, and actual impacts of drought. Secondly, we present analyses designed to test the utility of a wide range of drought indicators for their use in UK applications. We demonstrate the suitability of standardised indicators (like the SPI) for use in the UK, addressing the suitability of statistical distributions and using these indicators for drought severity quantification and for understanding propagation from meteorological to hydrological drought; all of which are currently poorly understood aspects that are vital for future monitoring. We then address the extent to which these indicators can be used to predict drought impacts, focusing on several sectors (water supply, agriculture and ecosystems). These analyses test which indicators perform best at predicting drought impacts, and seek to identify indicator thresholds that trigger impact occurrence. Unsurprisingly, we found that no single indicator best predicts impacts, and results are domain, sector and season specific. However, we reveal important linkages between indicators and impacts that could enhance the design and delivery of monitoring and forecasting information and its uptake by decision-makers concerned with drought.

  3. Decision Aids for Naval Air ASW

    DTIC Science & Technology

    1980-03-15

    Algorithm for Zone Optimization Investigation) NADC Developing Sonobuoy Pattern for Air ASW Search DAISY (Decision Aiding Information System) Wharton...sion making behavior. 0 Artificial intelligence sequential pattern recognition algorithm for reconstructing the decision maker’s utility functions. 0...display presenting the uncertainty area of the target. 3.1.5 Algorithm for Zone Optimization Investigation (AZOI) -- Naval Air Development Center 0 A

  4. Choices, choices: the application of multi-criteria decision analysis to a food safety decision-making problem.

    PubMed

    Fazil, A; Rajic, A; Sanchez, J; McEwen, S

    2008-11-01

    In the food safety arena, the decision-making process can be especially difficult. Decision makers are often faced with social and fiscal pressures when attempting to identify an appropriate balance among several choices. Concurrently, policy and decision makers in microbial food safety are under increasing pressure to demonstrate that their policies and decisions are made using transparent and accountable processes. In this article, we present a multi-criteria decision analysis approach that can be used to address the problem of trying to select a food safety intervention while balancing various criteria. Criteria that are important when selecting an intervention were determined, as a result of an expert consultation, to include effectiveness, cost, weight of evidence, and practicality associated with the interventions. The multi-criteria decision analysis approach we present is able to consider these criteria and arrive at a ranking of interventions. It can also provide a clear justification for the ranking as well as demonstrate to stakeholders, through a scenario analysis approach, how to potentially converge toward common ground. While this article focuses on the problem of selecting food safety interventions, the range of applications in the food safety arena is truly diverse and can be a significant tool in assisting decisions that need to be coherent, transparent, and justifiable. Most importantly, it is a significant contributor when there is a need to strike a fine balance between various potentially competing alternatives and/or stakeholder groups.

  5. Learning to Program with Game Maker

    ERIC Educational Resources Information Center

    Johnson, Claire

    2017-01-01

    "Game Maker" is widely used in UK secondary schools, yet under-researched in that context. This paper presents the findings of a qualitative case study that explores how authoring computer games using "Game Maker" can support the learning of basic programming concepts in a mainstream UK secondary setting. The research draws on…

  6. MANAGING UNCERTAINTY IN ENVIRONMENTAL DECISIONS

    EPA Science Inventory

    Many environmental decision makers and practitioners worldwide assume that the quality of data pertaining to a contaminated site is primarily determined by the nature of thhe analytical chemistry methods used to collect information. This assumption, which diminishes the importan...

  7. Decision-making in crisis: Applying a healthcare triage methodology to business continuity management.

    PubMed

    Moore, Bethany; Bone, Eric A

    2017-01-01

    The concept of triage in healthcare has been around for centuries and continues to be applied today so that scarce resources are allocated according to need. A business impact analysis (BIA) is a form of triage in that it identifies which processes are most critical, which to address first and how to allocate limited resources. On its own, however, the BIA provides only a roadmap of the impacts and interdependencies of an event. When disaster strikes, organisational decision-makers often face difficult decisions with regard to allocating limited resources between multiple 'mission-critical' functions. Applying the concept of triage to business continuity provides those decision-makers navigating a rapidly evolving and unpredictable event with a path that protects the fundamental priorities of the organisation. A business triage methodology aids decision-makers in times of crisis by providing a simplified framework for decision-making based on objective, evidence-based criteria, which is universally accepted and understood. When disaster strikes, the survival of the organisation depends on critical decision-making and quick actions to stabilise the incident. This paper argues that organisations need to supplement BIA processes with a decision-making triage methodology that can be quickly applied during the chaos of an actual event.

  8. Linking science, public values, and decision-making: Case study development for public deliberations about climate change resilience

    NASA Astrophysics Data System (ADS)

    Weller, N.; Bennett, I.; Bernstein, M.; Farooque, M.; Lloyd, J.; Lowenthal, C.; Sittenfeld, D.

    2016-12-01

    Actionable science seeks to align scientific inquiry with decision-making priorities to overcome rifts between scientific knowledge and the needs of decision makers. Combining actionable science with explorations of public values and priorities creates useful support for decision makers facing uncertainty, tradeoffs, and limited resources. As part of a broader project to create public forums about climate change resilience, we convened workshops with decision makers, resilience experts, and community stakeholders to discuss climate change resilience. Our goals were 1) to create case studies of resilience strategies for use in public deliberations at science museums across 8 U.S. cities; and 2) to build relationships with decision makers and stakeholders interested in these public deliberations. Prior to workshops, we created summaries of resilience strategies using academic literature, government assessments, municipal resilience plans, and conversations with workshop participants. Workshops began with example deliberation activities followed by semi-structured discussions of resilience strategies centered on 4 questions: 1) What are the key decisions to be made regarding each strategy? 2) What stakeholders and perspectives are relevant to each strategy? 3) What available data are relevant to each strategy? 4) What visualizations or other resources are useful for communicating things about each strategy? Workshops yielded actionable dialogue regarding issues of justice, feasibility, and the socio-ecological-technical systems impacted by climate change hazards and resilience strategies. For example, discussions of drought revealed systemic and individual-level challenges and opportunities; discussions of sea level rise included ways to account for the cultural significance of many coastal communities. The workshops provide a model for identifying decision-making priorities and tradeoffs and building partnerships among stakeholders, scientists, and decision makers.

  9. Multi-criteria decision making--an approach to setting priorities in health care.

    PubMed

    Nobre, F F; Trotta, L T; Gomes, L F

    1999-12-15

    The objective of this paper is to present a multi-criteria decision making (MCDM) approach to support public health decision making that takes into consideration the fuzziness of the decision goals and the behavioural aspect of the decision maker. The approach is used to analyse the process of health technology procurement in a University Hospital in Rio de Janeiro, Brazil. The method, known as TODIM, relies on evaluating alternatives with a set of decision criteria assessed using an ordinal scale. Fuzziness in generating criteria scores and weights or conflicts caused by dealing with different viewpoints of a group of decision makers (DMs) are solved using fuzzy set aggregation rules. The results suggested that MCDM models, incorporating fuzzy set approaches, should form a set of tools for public health decision making analysis, particularly when there are polarized opinions and conflicting objectives from the DM group. Copyright 1999 John Wiley & Sons, Ltd.

  10. A meta-analysis of gender stereotypes and bias in experimental simulations of employment decision making.

    PubMed

    Koch, Amanda J; D'Mello, Susan D; Sackett, Paul R

    2015-01-01

    Gender bias continues to be a concern in many work settings, leading researchers to identify factors that influence workplace decisions. In this study we examine several of these factors, using an organizing framework of sex distribution within jobs (including male- and female-dominated jobs as well as sex-balanced, or integrated, jobs). We conducted random effects meta-analyses including 136 independent effect sizes from experimental studies (N = 22,348) and examined the effects of decision-maker gender, amount and content of information available to the decision maker, type of evaluation, and motivation to make careful decisions on gender bias in organizational decisions. We also examined study characteristics such as type of participant, publication year, and study design. Our findings revealed that men were preferred for male-dominated jobs (i.e., gender-role congruity bias), whereas no strong preference for either gender was found for female-dominated or integrated jobs. Second, male raters exhibited greater gender-role congruity bias than did female raters for male-dominated jobs. Third, gender-role congruity bias did not consistently decrease when decision makers were provided with additional information about those they were rating, but gender-role congruity bias was reduced when information clearly indicated high competence of those being evaluated. Fourth, gender-role congruity bias did not differ between decisions that required comparisons among ratees and decisions made about individual ratees. Fifth, decision makers who were motivated to make careful decisions tended to exhibit less gender-role congruity bias for male-dominated jobs. Finally, for male-dominated jobs, experienced professionals showed smaller gender-role congruity bias than did undergraduates or working adults. (c) 2015 APA, all rights reserved.

  11. The Myth of the Rational Decision Maker: A Framework for Applying and Enhancing Heuristic and Intuitive Decision Making by School Leaders

    ERIC Educational Resources Information Center

    Davis, Stephen H.

    2004-01-01

    This article takes a critical look at administrative decision making in schools and the extent to which complex decisions conform to normative models and common expectations of rationality. An alternative framework for administrative decision making is presented that is informed, but not driven, by theories of rationality. The framework assumes…

  12. The Risky Shift in Policy Decision Making: A Comparative Analysis

    ERIC Educational Resources Information Center

    Wilpert, B.; And Others

    1976-01-01

    Based on analysis of data on 432 decision-makers from around the world, this study examines the decision-making phenomenon that individuals tend to move toward riskier decisions after group discussion. Findings of the analysis contradicted earlier studies, showing a consistent shift toward greater risk avoidance. Available from Elsevier Scientific…

  13. Vocational Career Decision-Making of Finnish Upper Secondary School Students

    ERIC Educational Resources Information Center

    Meriläinen, Matti; Puhakka, Helena; Sinkkonen, Hanna-Maija

    2014-01-01

    The aim of this research was to clarify the characteristics of Finnish upper secondary school students as vocational decision-makers. The focus was especially on what skills and competences were related to decision-making at different phases of the decision-making process. Altogether, 216 upper secondary school students filled in the…

  14. Developing decision-relevant data and information systems for California water through listening and collaboration

    NASA Astrophysics Data System (ADS)

    Bales, R. C.; Bernacchi, L.; Conklin, M. H.; Viers, J. H.; Fogg, G. E.; Fisher, A. T.; Kiparsky, M.

    2017-12-01

    California's historic drought of 2011-2015 provided excellent conditions for researchers to listen to water-management challenges from decision makers, particularly with regard to data and information needs for improved decision making. Through the UC Water Security and Sustainability Research Initiative (http://ucwater.org/) we began a multi-year dialog with water-resources decision makers and state agencies that provide data and technical support for water management. Near-term products of that collaboration will be both a vision for a 21st-century water data and information system, and near-term steps to meet immediate legislative deadlines in a way that is consistent with the longer-term vision. While many university-based water researchers engage with state and local agencies on both science and policy challenges, UC Water's focus was on: i) integrated system management, from headwaters through groundwater and agriculture, and on ii) improved decision making through better water information systems. This focus aligned with the recognition by water leaders that fundamental changes in the way the state manages water were overdue. UC Water is focused on three "I"s: improved water information, empowering Institutions to use and to create new information, and enabling decision makers to make smart investments in both green and grey Infrastructure. Effective communication with water decision makers has led to engagement on high-priority programs where large knowledge gaps remain, including more-widespread groundwater recharge of storm flows, restoration of mountain forests in important source-water areas, governance structures for groundwater sustainability, and filling information gaps by bringing new technology to bear on measurement and data programs. Continuing engagement of UC Water researchers in public dialog around water resources, through opinion pieces, feature articles, blogs, white papers, social media, video clips and a feature documentary film have

  15. Concussion Prevalence in Competitive Ultimate Frisbee Players

    PubMed Central

    Lazar, Damien J.; Lichtenstein, Jonathan D.; Tybor, David J.

    2018-01-01

    Background: Ultimate Frisbee (ultimate) is a fast-growing, popular sport played nationally by over 4 million athletes. While several studies have examined injury rates in ultimate, no work has investigated the prevalence of concussions specifically or players’ knowledge and management of those injuries. Purpose: To estimate the lifetime prevalence of concussions in ultimate and to assess players’ knowledge of concussions as well as their concussion management behaviors. Study Design: Descriptive epidemiology study. Methods: From June to November 2015, we collected ultimate-related concussion data via an anonymous web-based survey, the Concussion in Ultimate Frisbee Survey, from a convenience sample of 787 male and female ultimate players across the United States. Results: There were 553 male and 234 female respondents included in the analysis; 26.58% of men and 24.79% of women reported that they had sustained at least 1 concussion while playing ultimate, with 45.58% and 43.10% of those men and women, respectively, reporting multiple concussions. A total of 67.81% of men and 78.21% of women stated that they would remove themselves from play after sustaining a given concussion, although 45.99% of men and 37.62% of women indicated that they had returned to play in the same game or practice. Conclusion: Our preliminary data suggest that concussions do commonly occur in competitive ultimate and that better education and management of concussions in ultimate athletes are needed. This study is an important first step in deepening our understanding of these issues. PMID:29552572

  16. Evolutionary Perspective on Collective Decision Making

    NASA Astrophysics Data System (ADS)

    Farrell, Dene; Sayama, Hiroki; Dionne, Shelley D.; Yammarino, Francis J.; Wilson, David Sloan

    Team decision making dynamics are investigated from a novel perspective by shifting agency from decision makers to representations of potential solutions. We provide a new way to navigate social dynamics of collective decision making by interpreting decision makers as constituents of an evolutionary environment of an ecology of evolving solutions. We demonstrate distinct patterns of evolution with respect to three forms of variation: (1) Results with random variations in utility functions of individuals indicate that groups demonstrating minimal internal variation produce higher true utility values of group solutions and display better convergence; (2) analysis of variations in behavioral patterns within a group shows that a proper balance between selective and creative evolutionary forces is crucial to producing adaptive solutions; and (3) biased variations of the utility functions diminish the range of variation for potential solution utility, leaving only the differential of convergence performance static. We generally find that group cohesion (low random variation within a group) and composition (appropriate variation of behavioral patterns within a group) are necessary for a successful navigation of the solution space, but performance in both cases is susceptible to group level biases.

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

    PubMed

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

    2008-09-27

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

  18. Understanding the decision-making environment for people in minimally conscious state.

    PubMed

    Yelden, Kudret; Sargent, Sarah; Samanta, Jo

    2017-04-11

    Patients in minimally conscious state (MCS) show minimal, fluctuating but definitive signs of awareness of themselves and their environments. They may exhibit behaviours ranging from the ability to track objects or people with their eyes, to the making of simple choices which requires the ability to recognise objects and follow simple commands. While patients with MCS have higher chances of further recovery than people in vegetative states, this is not guaranteed and their prognosis is fundamentally uncertain. Therefore, patients with MCS need regular input from healthcare professionals to monitor their progress (or non-progress) and to address their needs for rehabilitation, for the provision of an appropriate environment and equipment. These requirements form a backdrop to the potentially huge variety of ethical-legal dilemmas that may be faced by their families, caregivers and ultimately, the courts. This paper analyses the decision-making environment for people with MCS using data obtained through four focus groups which included the input of 29 senior decision makers in the area. The results of the focus group study are presented and further explored with attention on recurrent and strong themes such as lack of expertise, resource issues, and the influence of families and friends of people with MCS.

  19. Moogle, Google, and Garbage Cans: The Impact of Technology on Decision Making

    ERIC Educational Resources Information Center

    Sellers, Martin P.

    2005-01-01

    Decision makers are faced daily with making important and pervasive decisions. This is especially significant in higher education, where decisions about academics will have considerable impact on the next generation of leaders. In place of rational decisions about the substance of learning and instruction, academic administrators make incremental…

  20. Analytic Procedures For Designing and Evaluating Decision Aids.

    DTIC Science & Technology

    1980-04-01

    the taxonomy of decision charateristics . Chapter 5 applies the taxonomies to the information processing functions needed for AAW decisions, and...rationality emphasizes the extent to which organizations and other social institutions consist of individuals who pursue individual objectives by means of...adaptive rationality is always wrong or naive; most of us know persons that seem to be naturally good decision-makers. There is no logic that guarantees

  1. Ultimate Realities: Deterministic and Evolutionary

    ERIC Educational Resources Information Center

    Moxley, Roy A.

    2007-01-01

    References to ultimate reality commonly turn up in the behavioral literature as references to determinism. However, this determinism is often difficult to interpret. There are different kinds of determinisms as well as different kinds of ultimate realities for a behaviorist to consider. To clarify some of the issues involved, the views of ultimate…

  2. Attributions of responsibility and affective reactions to decision outcomes.

    PubMed

    Zeelenberg, M; van der Pligt, J; de Vries, N K

    2000-06-01

    Immediate affective reactions to outcomes are more intense following decisions to act than following decisions not to act. This finding holds for both positive and negative outcomes. We relate this "actor-effect" to attribution theory and argue that decision makers are seen as more responsible for outcomes when these are the result of a decision to act as compared to a decision not to act. Experiment 1 (N = 80) tests the main assumption underlying our reasoning and shows that affective reactions to decision outcomes are indeed more intense when the decision maker is seen as more responsible. Experiment 2 (N = 40) tests whether the actor effect can be predicted on the basis of differential attributions following action and inaction. Participants read vignettes in which active and passive actors obtained a positive or negative outcome. Action resulted in more intense affect than inaction, and positive outcomes resulted in more intense affect than negative outcomes. Experiment 2 further shows that responsibility attributions and affective reactions to outcomes are highly correlated; that is, more extreme affective reactions are associated with more internal attributions. We discuss the implications for research on post-decisional reactions.

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

    NASA Astrophysics Data System (ADS)

    Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

    2013-03-01

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

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

    PubMed

    Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

    2013-03-01

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

  5. School Maker Faires

    ERIC Educational Resources Information Center

    Harlow, Danielle; Hansen, Alexandria

    2018-01-01

    The Maker Movement (Dougherty 2012) highlights innovation and creativity through "activities focused on designing, building, modifying, and/or repurposing material objects, for playful or useful ends, oriented toward making a 'product' of some sort that can be used, interacted with, or demonstrated" (Martin 2015, p. 31). When engaged in…

  6. Decision-Making Phenomena Described by Expert Nurses Working in Urban Community Health Settings.

    ERIC Educational Resources Information Center

    Watkins, Mary P.

    1998-01-01

    Expert community health nurses (n=28) described crucial clinical situations. Content analysis revealed that decision making was both rational and intuitive. Eight themes were identified: decision-making focus, type, purpose, decision-maker characteristics, sequencing of events, data collection methods, facilitators/barriers, and decision-making…

  7. The Reddy maker

    NASA Astrophysics Data System (ADS)

    Nof, Doron; Paldor, Nathan; Gorder, Stephen Van

    2002-09-01

    the (sometimes significantly greater) equilibrium depth corresponding to the point where the outflow's density equals the environmental density.] Most of the time, the outflow descent is accompanied by a reduction in the bottom slope S, and an entrainment which causes both a reduction in g' and an increase in H. All of these alterations bring the outflow closer and closer to the critical condition and it is, therefore, argued that all outflows ultimately reach the critical point (unless diffusion and mixing destroy them prior to that stage). It is suggested that Reddies (i.e., isolated lenses containing Red Sea water) are formed by the above processes. Namely, we propose that the "Reddy maker" is a combination of three processes, the natural reduction in the bottom slope which the outflow senses as it approaches the bottom of the ocean, the entrainment-induced increase in the outflow's thickness, and the entrainment-induced decrease in the outflow's density. An animation of the eddy generation process can be viewed at http://doronnof.net/features.html#video (click on "Reddy maker video").

  8. Empowering Local Organizations and Decision-makers in a Changing Climate: EO-guided Environmental Surveillance of Cholera and Rotavirus for South Asia

    NASA Astrophysics Data System (ADS)

    Akanda, A. S.; Hasan, M. A.; Jutla, A.; Aziz, S.; Alam, M.; Ahsan, G. U.; Huq, A.; Colwell, R. R.

    2017-12-01

    Despite significant advancements in scientific research, diarrheal diseases remain a leading cause of mortality and morbidity in the developing world. Although under-5 child mortality due to such diseases is dropping, prevalence of most diarrheal diseases has increased over past decades, exerting a terrible toll on global public health. Providing safe water and sanitation access, and a safe and clean environment in a sustainable manner remains a critical challenge in the face of rapid population growth, urbanization and increasing threats of natural hazards in a changing climate. We focus on the Bengal Delta region of South Asia, where Cholera and Rotavirus diarrhea continue to have a devastating impact on the public health burden. Climatic change and anthropogenic forcings have greatly affected available water quantity and quality, while the lack of effective institutions and capacity have greatly affected the water-sanitation and public health sectors. The region suffers from recurring dry season freshwater scarcity and temperature extremes, salinity intrusion in coastal areas, inland flooding during monsoons, and resulting water contamination across the delta region. We use earth observation (EO) datasets and techniques to develop a series of tools for surveillance, analysis and decision support to empower government, academic, and non-government stakeholder organizations in South Asia to monitor changes in environmental conditions related to the two most devastating diarrheal diseases, cholera and rotavirus. The developed tools will enable decision makers and stakeholders to significantly increase their understanding of the threats to public health and environmental and climatic conditions related to these diseases, ways to monitor future projections of disease risk, and help identify required policy interventions and strategies to strengthen prevention efforts and limit disease burden in near- (tactical) and long- (strategic) terms.

  9. Decision Making In A High-Tech World: Automation Bias and Countermeasures

    NASA Technical Reports Server (NTRS)

    Mosier, Kathleen L.; Skitka, Linda J.; Burdick, Mark R.; Heers, Susan T.; Rosekind, Mark R. (Technical Monitor)

    1996-01-01

    Automated decision aids and decision support systems have become essential tools in many high-tech environments. In aviation, for example, flight management systems computers not only fly the aircraft, but also calculate fuel efficient paths, detect and diagnose system malfunctions and abnormalities, and recommend or carry out decisions. Air Traffic Controllers will soon be utilizing decision support tools to help them predict and detect potential conflicts and to generate clearances. Other fields as disparate as nuclear power plants and medical diagnostics are similarly becoming more and more automated. Ideally, the combination of human decision maker and automated decision aid should result in a high-performing team, maximizing the advantages of additional cognitive and observational power in the decision-making process. In reality, however, the presence of these aids often short-circuits the way that even very experienced decision makers have traditionally handled tasks and made decisions, and introduces opportunities for new decision heuristics and biases. Results of recent research investigating the use of automated aids have indicated the presence of automation bias, that is, errors made when decision makers rely on automated cues as a heuristic replacement for vigilant information seeking and processing. Automation commission errors, i.e., errors made when decision makers inappropriately follow an automated directive, or automation omission errors, i.e., errors made when humans fail to take action or notice a problem because an automated aid fails to inform them, can result from this tendency. Evidence of the tendency to make automation-related omission and commission errors has been found in pilot self reports, in studies using pilots in flight simulations, and in non-flight decision making contexts with student samples. Considerable research has found that increasing social accountability can successfully ameliorate a broad array of cognitive biases and

  10. Accelerated bridge construction (ABC) decision making and economic modeling tool.

    DOT National Transportation Integrated Search

    2011-12-01

    In this FHWA-sponsored pool funded study, a set of decision making tools, based on the Analytic Hierarchy Process (AHP) was developed. This tool set is prepared for transportation specialists and decision-makers to determine if ABC is more effective ...

  11. The game of making decisions under uncertainty: How sure must one be?

    NASA Astrophysics Data System (ADS)

    Werner, Micha; Verkade, Jan; Wetterhall, Fredrik; van Andel, Schalk-Jan; Ramos, Maria-Helena

    2016-04-01

    Probabilistic hydrometeorological forecasting is now widely accepted to be more skillful than deterministic forecasts, and is increasingly being integrated into operational practice. Provided they are reliable and unbiased, probabilistic forecasts have the advantage that they give decision maker not only the forecast value, but also the uncertainty associated to that prediction. Though that information provides more insight, it does now leave the forecaster/decision maker with the challenge of deciding at what level of probability of a threshold being exceeded the decision to act should be taken. According to the cost-loss theory, that probability should be related to the impact of the threshold being exceeded. However, it is not entirely clear how easy it is for decision makers to follow that rule, even when the impact of a threshold being exceeded, and the actions to choose from are known. To continue the tradition in the "Ensemble Hydrometeorological Forecast" session, we will address the challenge of making decisions based on probabilistic forecasts through a game to be played with the audience. We will explore how decisions made differ depending on the known impacts of the forecasted events. Participants will be divided into a number of groups with differing levels of impact, and will be faced with a number of forecast situations. They will be asked to make decisions and record the consequence of those decisions. A discussion of the differences in the decisions made will be presented at the end of the game, with a fuller analysis later posted on the HEPEX web site blog (www.hepex.org).

  12. Development of an interactive interface to raise awareness of public, policy makers, and practitioners about natural hazards.

    NASA Astrophysics Data System (ADS)

    Gordova, Yulia; Gordov, Evgeny; Okladnikov, Igor; Titov, Alexander

    2017-04-01

    Due to a global climate change the following consequences are predicted: rise in sea level due to melting glaciers and polar ice, changes in precipitation, changes in the hydrological regime, impact on ecosystems, agriculture and forestry. In Russia's vast territory these effects will be most dramatic. According to Hydrometeorological Center of Russian Federation report there is an increase in the magnitude and frequency of extreme weather events, as well as in their damage to ecosystems and infrastructure. In the framework of adaptation to climate change and mitigation of its consequences it is necessary to promote and support activities aimed at reducing possible risks. Adaptation methods include among others improving seasonal weather forecasts, systems of early warning and systems of management of risks. But there is a problem of insufficient awareness among decision-makers, as well a lack of scientific background. Those responsible for making decisions, stakeholders and the public do not have the skills and knowledge to work with the accumulated climate data to development an adaptation and sustainable development strategy. The goal is to provide these groups with tools, skills, thematic information for understanding climate processes occurring in the region. We believe that the preparation of both the persons responsible for decision-making, and the future specialist in environmental sciences shouldn't be realized artificial learning environment, but on the basis of actual operating computational and information systems used in climate research. Such kind of a system was developed by a team of the Institute of Monitoring of Climatic and Ecological Systems SB RAS. The information-computational Web GIS "Climate" (http://climate.climate.scert.ru) provides opportunities to study regional climate change and its consequences providing access to climate and weather models, a large set of geophysical data and means of processing and visualization. Also, the system is

  13. Dying cancer patients talk about physician and patient roles in DNR decision making

    PubMed Central

    Eliott, Jaklin A.; Olver, Ian

    2011-01-01

    Abstract Background  Within medical and bioethical discourse, there are many models depicting the relationships between, and roles of, physician and patient in medical decision making. Contestation similarly exists over the roles of physician and patient with regard to the decision not to provide cardiopulmonary resuscitation (CPR) following cardiac arrest [the do‐not‐resuscitate or do‐not‐resuscitate (DNR) decision], but there is little analysis of patient perspectives. Objective  Analyse what patients with cancer within weeks before dying say about the decision to forego CPR and the roles of patient and physician in this decision. Design and participants  Discursive analysis of qualitative data gathered during semi‐structured interviews with 28 adult cancer patients close to death and attending palliative or oncology clinics of an Australian teaching hospital. Results  Participants’ descriptions of appropriate patient or physician roles in decisions about CPR appeared related to how they conceptualized the decision: as a personal or a medical issue, with patient and doctor respectively identified as appropriate decision makers; or alternatively, both medical and personal, with various roles assigned embodying different versions of a shared decision‐making process. Participants’ endorsement of physicians as decision makers rested upon physicians’ enactment of the rational, knowledgeable and compassionate expert, which legitimized entrusting them to make the DNR decision. Where this was called into question, physicians were positioned as inappropriate decision makers. Conclusion  When patients’ and physicians’ understandings of the best decision, or of the preferred role of either party, diverge, conflict may ensue. In order to elicit and negotiate with patient preferences, flexibility is required during clinical interactions about decision making. PMID:20860782

  14. DECISION-MAKING USING EXISTING DATA

    EPA Science Inventory

    Decision-makers need information on cumulative and aggregate stressors as well as clear information on where problems are likely to occur in the future in order to prioritize risk management actions. The most prevasive and difficult to assess changes are the result of regional-s...

  15. Adaptive Flexibility and Maladaptive Routines in Selecting Fast and Frugal Decision Strategies

    ERIC Educational Resources Information Center

    Broder, Arndt; Schiffer, Stefanie

    2006-01-01

    Decision routines unburden the cognitive capacity of the decision maker. In changing environments, however, routines may become maladaptive. In 2 experiments with a hypothetical stock market game (n = 241), the authors tested whether decision routines tend to persist at the level of decision strategies rather than at the level of options in…

  16. Ultimate Realities: Deterministic and Evolutionary

    PubMed Central

    Moxley, Roy A

    2007-01-01

    References to ultimate reality commonly turn up in the behavioral literature as references to determinism. However, this determinism is often difficult to interpret. There are different kinds of determinisms as well as different kinds of ultimate realities for a behaviorist to consider. To clarify some of the issues involved, the views of ultimate realities are treated as falling along a continuum, with extreme views of complete indeterminism and complete determinism at either end and various mixes in between. Doing so brings into play evolutionary realities and the movement from indeterminism to determinism, as in Peirce's evolutionary cosmology. In addition, this framework helps to show how the views of determinism by B. F. Skinner and other behaviorists have shifted over time. PMID:22478489

  17. 10 CFR 431.132 - Definitions concerning automatic commercial ice makers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Definitions concerning automatic commercial ice makers... CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Automatic Commercial Ice Makers § 431.132 Definitions concerning automatic commercial ice makers. Automatic commercial ice maker means a factory-made assembly (not...

  18. 10 CFR 431.132 - Definitions concerning automatic commercial ice makers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Definitions concerning automatic commercial ice makers... CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Automatic Commercial Ice Makers § 431.132 Definitions concerning automatic commercial ice makers. Automatic commercial ice maker means a factory-made assembly (not...

  19. 10 CFR 431.132 - Definitions concerning automatic commercial ice makers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Definitions concerning automatic commercial ice makers... CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Automatic Commercial Ice Makers § 431.132 Definitions concerning automatic commercial ice makers. Automatic commercial ice maker means a factory-made assembly (not...

  20. 10 CFR 431.132 - Definitions concerning automatic commercial ice makers.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Definitions concerning automatic commercial ice makers... CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Automatic Commercial Ice Makers § 431.132 Definitions concerning automatic commercial ice makers. Automatic commercial ice maker means a factory-made assembly (not...

  1. 10 CFR 431.132 - Definitions concerning automatic commercial ice makers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Definitions concerning automatic commercial ice makers... CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Automatic Commercial Ice Makers § 431.132 Definitions concerning automatic commercial ice makers. Automatic commercial ice maker means a factory-made assembly (not...

  2. The neural basis of belief updating and rational decision making

    PubMed Central

    Achtziger, Anja; Hügelschäfer, Sabine; Steinhauser, Marco

    2014-01-01

    Rational decision making under uncertainty requires forming beliefs that integrate prior and new information through Bayes’ rule. Human decision makers typically deviate from Bayesian updating by either overweighting the prior (conservatism) or overweighting new information (e.g. the representativeness heuristic). We investigated these deviations through measurements of electrocortical activity in the human brain during incentivized probability-updating tasks and found evidence of extremely early commitment to boundedly rational heuristics. Participants who overweight new information display a lower sensibility to conflict detection, captured by an event-related potential (the N2) observed around 260 ms after the presentation of new information. Conservative decision makers (who overweight prior probabilities) make up their mind before new information is presented, as indicated by the lateralized readiness potential in the brain. That is, they do not inhibit the processing of new information but rather immediately rely on the prior for making a decision. PMID:22956673

  3. The neural basis of belief updating and rational decision making.

    PubMed

    Achtziger, Anja; Alós-Ferrer, Carlos; Hügelschäfer, Sabine; Steinhauser, Marco

    2014-01-01

    Rational decision making under uncertainty requires forming beliefs that integrate prior and new information through Bayes' rule. Human decision makers typically deviate from Bayesian updating by either overweighting the prior (conservatism) or overweighting new information (e.g. the representativeness heuristic). We investigated these deviations through measurements of electrocortical activity in the human brain during incentivized probability-updating tasks and found evidence of extremely early commitment to boundedly rational heuristics. Participants who overweight new information display a lower sensibility to conflict detection, captured by an event-related potential (the N2) observed around 260 ms after the presentation of new information. Conservative decision makers (who overweight prior probabilities) make up their mind before new information is presented, as indicated by the lateralized readiness potential in the brain. That is, they do not inhibit the processing of new information but rather immediately rely on the prior for making a decision.

  4. Multiple-attribute group decision making with different formats of preference information on attributes.

    PubMed

    Xu, Zeshui

    2007-12-01

    Interval utility values, interval fuzzy preference relations, and interval multiplicative preference relations are three common uncertain-preference formats used by decision-makers to provide their preference information in the process of decision making under fuzziness. This paper is devoted in investigating multiple-attribute group-decision-making problems where the attribute values are not precisely known but the value ranges can be obtained, and the decision-makers provide their preference information over attributes by three different uncertain-preference formats i.e., 1) interval utility values; 2) interval fuzzy preference relations; and 3) interval multiplicative preference relations. We first utilize some functions to normalize the uncertain decision matrix and then transform it into an expected decision matrix. We establish a goal-programming model to integrate the expected decision matrix and all three different uncertain-preference formats from which the attribute weights and the overall attribute values of alternatives can be obtained. Then, we use the derived overall attribute values to get the ranking of the given alternatives and to select the best one(s). The model not only can reflect both the subjective considerations of all decision-makers and the objective information but also can avoid losing and distorting the given objective and subjective decision information in the process of information integration. Furthermore, we establish some models to solve the multiple-attribute group-decision-making problems with three different preference formats: 1) utility values; 2) fuzzy preference relations; and 3) multiplicative preference relations. Finally, we illustrate the applicability and effectiveness of the developed models with two practical examples.

  5. Thermal power systems small power systems applications project. Decision analysis for evaluating and ranking small solar thermal power system technologies. Volume 1: A brief introduction to multiattribute decision analysis. [explanation of multiattribute decision analysis methods used in evaluating alternatives for small powered systems

    NASA Technical Reports Server (NTRS)

    Feinberg, A.; Miles, R. F., Jr.

    1978-01-01

    The principal concepts of the Keeney and Raiffa approach to multiattribute decision analysis are described. Topics discussed include the concepts of decision alternatives, outcomes, objectives, attributes and their states, attribute utility functions, and the necessary independence properties for the attribute states to be aggregated into a numerical representation of the preferences of the decision maker for the outcomes and decision alternatives.

  6. Decision Support Framework (DSF) For Evaluating Planned Land And Resource Use Decisions: Hypothetical Application Of The DSF To Address Nutrient Loads In The Florida Keys

    EPA Science Inventory

    The mission of ORD's Ecosystme Services Research Program (ESRP) is to provide the information and methods needed by decision-makers to assess the benefits of ecosystem goods and services to human well-being for inclusion in management alternatives. The Decision Support Framework...

  7. Shared decision-making in epilepsy management.

    PubMed

    Pickrell, W O; Elwyn, G; Smith, P E M

    2015-06-01

    Policy makers, clinicians, and patients increasingly recognize the need for greater patient involvement in clinical decision-making. Shared decision-making helps address these concerns by providing a framework for clinicians and patients to make decisions together using the best evidence. Shared decision-making is applicable to situations where several acceptable options exist (clinical equipoise). Such situations occur commonly in epilepsy, for example, in decisions regarding the choice of medication, treatment in pregnancy, and medication withdrawal. A talk model is a way of implementing shared decision-making during consultations, and decision aids are useful tools to assist in the process. Although there is limited evidence available for shared decision-making in epilepsy, there are several benefits of shared decision-making in general including improved decision quality, more informed choices, and better treatment concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Interface Evaluation for Open System Architectures

    DTIC Science & Technology

    2014-03-01

    maker (SDM) is responsible for balancing all of the influences of the IPT when making decisions. Coalescing the IPT perspectives for a single IIM...factors are considered in IIM decisions and that decisions are consistent with the preferences of the SDM, ultimately leading to a balance of schedule... board to perform ranking and weighting determinations. Rank sum, rank exponent, rank reciprocal and ROC leverage a subjective assessment of the

  9. Decision-making tool for applying adaptive traffic control systems : final report.

    DOT National Transportation Integrated Search

    2016-03-01

    Adaptive traffic signal control technologies have been increasingly deployed in real world situations. The objective of this project was to develop a decision-making tool to guide traffic engineers and decision-makers who must decide whether or not a...

  10. What can the rangeland decision-making survey do for you?

    USDA-ARS?s Scientific Manuscript database

    Every day, rangeland managers make complicated decisions to balance multiple outcomes. The complex nature of ranch decision-making is not well understood by scientists, policy makers or the general public. To fill this gap, the Wyoming Stock Growers Association has partnered with the Agricultural Re...

  11. Embedding health policy and systems research into decision-making processes in low- and middle-income countries

    PubMed Central

    2013-01-01

    Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization’s Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems. PMID:23924162

  12. Embedding health policy and systems research into decision-making processes in low- and middle-income countries.

    PubMed

    Koon, Adam D; Rao, Krishna D; Tran, Nhan T; Ghaffar, Abdul

    2013-08-08

    Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization's Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  14. The Assisted Decision-Making (Capacity) Act 2015: what it is and why it matters.

    PubMed

    Kelly, B D

    2017-05-01

    Ireland's Assisted Decision-Making (Capacity) Act 2015 was signed by President Higgins in December 2015 and scheduled for commencement in 2016. To explore the content and implications of the 2015 Act. Review of the 2015 Act and related literature. The 2015 Act places the "will and preferences" of persons with impaired mental capacity at the heart of decision-making relating to "personal welfare" (including healthcare) and "property and affairs". Capacity is to be "construed functionally" and interventions must be "for the benefit of the relevant person". The Act outlines three levels of decision-making assistance: "decision-making assistant", "co-decision-maker" (joint decision-maker) and "decision-making representative" (substitute decision-maker). There are procedures relating to "enduring power of attorney" and "advance healthcare directives"; in the case of the latter, a "refusal of treatment" can be legally binding, while a "request for a specific treatment" must "be taken into consideration". The 2015 Act is considerably more workable than the 2013 Bill that preceded it. Key challenges include the subtle decision-making required by patients, healthcare staff, Circuit Court judges and the director of the Decision Support Service; implementation of "advance healthcare directives", especially if they do not form part of a broader model of advance care planning (incorporating the flexibility required for unpredictable future circumstances); and the over-arching issue of logistics, as very many healthcare decisions are currently made in situations where the patient's capacity is impaired. A key challenge will lie in balancing the emphasis on autonomy with principles of beneficence, mutuality and care.

  15. Climate Information Needs for Financial Decision Making

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

    Higgins, Paul

    Climate Information Needs for Financial Decision Making (Final Report) This Department of Energy workshop award (grant #DE-SC0008480) provided primary support for the American Meteorological Society’s study on climate information needs for financial decision making. The goal of this study was to help advance societal decision making by examining the implications of climate variability and change on near-term financial investments. We explored four key topics: 1) the conditions and criteria that influence returns on investment of major financial decisions, 2) the climate sensitivity of financial decisions, 3) climate information needs of financial decision makers, and 4) potential new mechanisms to promotemore » collaboration between scientists and financial decision makers. Better understanding of these four topics will help scientists provide the most useful information and enable financial decision makers to use scientific information most effectively. As a result, this study will enable leaders in business and government to make well-informed choices that help maximize long-term economic success and social wellbeing in the United States The outcomes of the study include a workshop, which brought together leaders from the scientific and financial decision making communities, a publication of the study report, and a public briefing of the results to the policy community. In addition, we will present the results to the scientific community at the AMS Annual Meeting in February, 2014. The study results were covered well by the media including Bloomberg News and E&E News. Upon request, we also briefed the Office of Science Technology Policy (OSTP) and the Council on Environmental Quality (CEQ) on the outcomes. We presented the results to the policy community through a public briefing in December on Capitol Hill. The full report is publicly available at www.ametsoc.org/cin. Summary of Key Findings The United States invests roughly $1.5 trillion U.S. dollars (USD

  16. Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting.

    PubMed

    Carpenter, Stephanie M; Yates, J Frank; Preston, Stephanie D; Chen, Lydia

    2016-01-01

    Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional "coherence shifting," the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed.

  17. Economic Evaluation of Environmental Health Interventions to Support Decision Making

    PubMed Central

    Hutton, Guy

    2008-01-01

    Environmental burden of disease represents one quarter of overall disease burden, hence necessitating greater attention from decision makers both inside and outside the health sector. Economic evaluation techniques such as cost-effectiveness analysis and cost-benefit analysis provide key information to health decision makers on the efficiency of environmental health interventions, assisting them in choosing interventions which give the greatest social return on limited public budgets and private resources. The aim of this article is to review economic evaluation studies in three environmental health areas—water, sanitation, hygiene (WSH), vector control, and air pollution—and to critically examine the policy relevance and scientific quality of the studies for selecting and funding public programmers. A keyword search of Medline from 1990–2008 revealed 32 studies, and gathering of articles from other sources revealed a further 18 studies, giving a total of 50 economic evaluation studies (13 WSH interventions, 16 vector control and 21 air pollution). Overall, the economic evidence base on environmental health interventions remains relatively weak—too few studies per intervention, of variable scientific quality and from diverse locations which limits generalisability of findings. Importantly, there still exists a disconnect between economic research, decision making and programmer implementation. This can be explained by the lack of translation of research findings into accessible documentation for policy makers and limited relevance of research findings, and the often low importance of economic evidence in budgeting decisions. These findings underline the importance of involving policy makers in the defining of research agendas and commissioning of research, and improving the awareness of researchers of the policy environment into which their research feeds. PMID:21572840

  18. Health care priority setting in Norway a multicriteria decision analysis

    PubMed Central

    2012-01-01

    Background Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and treatment. This study compares the values of the country's health policy makers with these three official principles. Methods In total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas. Results The group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health. Conclusions Norwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions. PMID:22335815

  19. Health care priority setting in Norway a multicriteria decision analysis.

    PubMed

    Defechereux, Thierry; Paolucci, Francesco; Mirelman, Andrew; Youngkong, Sitaporn; Botten, Grete; Hagen, Terje P; Niessen, Louis W

    2012-02-15

    Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and treatment. This study compares the values of the country's health policy makers with these three official principles. In total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas. The group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health. Norwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions.

  20. Documentation of Decision-Aiding Software: Introductory Guide

    DTIC Science & Technology

    1980-02-01

    for the Manager ( New York: Holt, ’ 6 ( Simply put, the discipline assists planners and deci- sion makers in choosing between alternative courses of...con- ducting international negotiations on tanker safety; g. use by Headquarters, U.S. Marine Corps as an orga- nizing vehicle for the preparation of...literature on decision analysis. For an introductory treatment the reader should refer to Howard Raiffa, Decision Analysis (Reading, Massachusetts

  1. Argumentation for Decision Making

    NASA Astrophysics Data System (ADS)

    Amgoud, Leila

    Decision making, often viewed as a form of reasoning toward action, has raised the interest of many scholars including economists, psychologists, and computer scientists for a long time. Any decision problem amounts to selecting the “best” or sufficiently “good” action(s) that are feasible among different alternatives, given some available information about the current state of the world and the consequences of potential actions. Available information may be incomplete or pervaded with uncertainty. Besides, the goodness of an action is judged by estimating how much its possible consequences fit the preferences of the decision maker. This agent is assumed to behave in a rational way [29] amgoud-woold, at least in the sense that his decisions should be as much as possible consistent with his preferences.

  2. The effects of critical thinking instruction on training complex decision making.

    PubMed

    Helsdingen, Anne S; van den Bosch, Karel; van Gog, Tamara; van Merriënboer, Jeroen J G

    2010-08-01

    Two field studies assessed the effects of critical thinking instruction on training and transfer of a complex decision-making skill. Critical thinking instruction is based on studies of how experienced decision makers approach complex problems. Participants conducted scenario-based exercises in both simplified (Study I) and high-fidelity (Study 2) training environments. In both studies, half of the participants received instruction in critical thinking. The other half conducted the same exercises but without critical thinking instruction. After the training, test scenarios were administered to both groups. The first study showed that critical thinking instruction enhanced decision outcomes during both training and the test. In the second study, critical thinking instruction benefited both decision outcomes and processes, specifically on the transfer to untrained problems. The results suggest that critical thinking instruction improves decision strategy and enhances understanding of the general principles of the domain. The results of this study warrant the implementation of critical thinking instruction in training programs for professional decision makers that have to operate in complex and highly interactive, dynamic environments.

  3. Maker Cultures and the Prospects for Technological Action.

    PubMed

    Nascimento, Susana; Pólvora, Alexandre

    2018-06-01

    Supported by easier and cheaper access to tools and expanding communities, maker cultures are pointing towards the ideas of (almost) everyone designing, creating, producing and distributing renewed, new and improved products, machines, things or artefacts. A careful analysis of the assumptions and challenges of maker cultures emphasizes the relevance of what may be called technological action, that is, active and critical interventions regarding the purposes and applications of technologies within ordinary lives, thus countering the deterministic trends of current directions of technology. In such transformative potential, we will explore a set of elements what is and could be technological action through snapshots of maker cultures based on the empirical research conducted in three particular contexts: the Fab Lab Network, Maker Media core outputs and initiatives such as Maker Faires, and the Open Source Hardware Association (OSHWA). Elements such as control and empowerment through material engagement, openness and sharing, and social, cultural, political and ethical values of the common good in topics such as diversity, sustainability and transparency, are critically analysed.

  4. 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.

  5. Spatial and Temporal Flood Risk Assessment for Decision Making Approach

    NASA Astrophysics Data System (ADS)

    Azizat, Nazirah; Omar, Wan-Mohd-Sabki Wan

    2018-03-01

    Heavy rainfall, adversely impacting inundation areas, depends on the magnitude of the flood. Significantly, location of settlements, infrastructure and facilities in floodplains result in many regions facing flooding risks. A problem faced by the decision maker in an assessment of flood vulnerability and evaluation of adaptation measures is recurrent flooding in the same areas. Identification of recurrent flooding areas and frequency of floods should be priorities for flood risk management. However, spatial and temporal variability become major factors of uncertainty in flood risk management. Therefore, dynamic and spatial characteristics of these changes in flood impact assessment are important in making decisions about the future of infrastructure development and community life. System dynamics (SD) simulation and hydrodynamic modelling are presented as tools for modelling the dynamic characteristics of flood risk and spatial variability. This paper discusses the integration between spatial and temporal information that is required by the decision maker for the identification of multi-criteria decision problems involving multiple stakeholders.

  6. Conceptual Frameworks for Child Care Decision-Making. White Paper

    ERIC Educational Resources Information Center

    Chaudry, Ajay; Henly, Julia; Meyers, Marcia

    2010-01-01

    This working paper is one in a series of projects initiated by the Administration for Children and Families (ACF) to improve knowledge for child care researchers and policy makers about parental child care decision making. In this paper, the authors identify three distinct conceptual frameworks for understanding child care decisions--a rational…

  7. Multi-criteria decision analysis of breast cancer control in low- and middle- income countries: development of a rating tool for policy makers.

    PubMed

    Venhorst, Kristie; Zelle, Sten G; Tromp, Noor; Lauer, Jeremy A

    2014-01-01

    The objective of this study was to develop a rating tool for policy makers to prioritize breast cancer interventions in low- and middle- income countries (LMICs), based on a simple multi-criteria decision analysis (MCDA) approach. The definition and identification of criteria play a key role in MCDA, and our rating tool could be used as part of a broader priority setting exercise in a local setting. This tool may contribute to a more transparent priority-setting process and fairer decision-making in future breast cancer policy development. First, an expert panel (n = 5) discussed key considerations for tool development. A literature review followed to inventory all relevant criteria and construct an initial set of criteria. A Delphi study was then performed and questionnaires used to discuss a final list of criteria with clear definitions and potential scoring scales. For this Delphi study, multiple breast cancer policy and priority-setting experts from different LMICs were selected and invited by the World Health Organization. Fifteen international experts participated in all three Delphi rounds to assess and evaluate each criterion. This study resulted in a preliminary rating tool for assessing breast cancer interventions in LMICs. The tool consists of 10 carefully crafted criteria (effectiveness, quality of the evidence, magnitude of individual health impact, acceptability, cost-effectiveness, technical complexity, affordability, safety, geographical coverage, and accessibility), with clear definitions and potential scoring scales. This study describes the development of a rating tool to assess breast cancer interventions in LMICs. Our tool can offer supporting knowledge for the use or development of rating tools as part of a broader (MCDA based) priority setting exercise in local settings. Further steps for improving the tool are proposed and should lead to its useful adoption in LMICs.

  8. Factors Influencing the Adoption of Cloud Storage by Information Technology Decision Makers

    ERIC Educational Resources Information Center

    Wheelock, Michael D.

    2013-01-01

    This dissertation uses a survey methodology to determine the factors behind the decision to adopt cloud storage. The dependent variable in the study is the intent to adopt cloud storage. Four independent variables are utilized including need, security, cost-effectiveness and reliability. The survey includes a pilot test, field test and statistical…

  9. Decision Makers Calibrate Behavioral Persistence on the Basis of Time-Interval Experience

    ERIC Educational Resources Information Center

    McGuire, Joseph T.; Kable, Joseph W.

    2012-01-01

    A central question in intertemporal decision making is why people reverse their own past choices. Someone who initially prefers a long-run outcome might fail to maintain that preference for long enough to see the outcome realized. Such behavior is usually understood as reflecting preference instability or self-control failure. However, if a…

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

    PubMed

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

    2010-02-01

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

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

    PubMed Central

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

    2010-01-01

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

  12. Functional specialization of the primate frontal cortex during decision making.

    PubMed

    Lee, Daeyeol; Rushworth, Matthew F S; Walton, Mark E; Watanabe, Masataka; Sakagami, Masamichi

    2007-08-01

    Economic theories of decision making are based on the principle of utility maximization, and reinforcement-learning theory provides computational algorithms that can be used to estimate the overall reward expected from alternative choices. These formal models not only account for a large range of behavioral observations in human and animal decision makers, but also provide useful tools for investigating the neural basis of decision making. Nevertheless, in reality, decision makers must combine different types of information about the costs and benefits associated with each available option, such as the quality and quantity of expected reward and required work. In this article, we put forward the hypothesis that different subdivisions of the primate frontal cortex may be specialized to focus on different aspects of dynamic decision-making processes. In this hypothesis, the lateral prefrontal cortex is primarily involved in maintaining the state representation necessary to identify optimal actions in a given environment. In contrast, the orbitofrontal cortex and the anterior cingulate cortex might be primarily involved in encoding and updating the utilities associated with different sensory stimuli and alternative actions, respectively. These cortical areas are also likely to contribute to decision making in a social context.

  13. Beyond expected utility: rethinking behavioral decision research.

    PubMed

    Frisch, D; Clemen, R T

    1994-07-01

    Much research in psychology has evaluated the quality of people's decisions by comparisons with subjective expected utility (SEU) theory. This article suggests that typical arguments made for the status of utility theory as normative do not justify its use by psychologists as a standard by which to evaluate decision quality. It is argued that to evaluate decision quality, researchers need to identify those decision processes that tend to lead to desirable outcomes. It is contended that a good decision-making process must be concerned with how (and whether) decision makers evaluate potential consequences of decisions, the extent to which they accurately identify all relevant consequences, and the way in which they make final choices. Research that bears on these issues is reviewed.

  14. Voice in Political Decision-Making: The Effect of Group Voice on Perceived Trustworthiness of Decision Makers and Subsequent Acceptance of Decisions

    ERIC Educational Resources Information Center

    Terwel, Bart W.; Harinck, Fieke; Ellemers, Naomi; Daamen, Dancker D. L.

    2010-01-01

    The implementation of carbon dioxide capture and storage technology (CCS) is considered an important climate change mitigation strategy, but the viability of this technology will depend on public acceptance of CCS policy decisions. The results of three experiments with students as participants show that whether or not interest groups receive an…

  15. Administrative decision making: a stepwise method.

    PubMed

    Oetjen, Reid M; Oetjen, Dawn M; Rotarius, Timothy

    2008-01-01

    Today's health care organizations face tremendous challenges and fierce competition. These pressures impact the decisions that managers must execute on any given day, not to mention the ever-present constraints of time, personnel, competencies, and finances. The importance of making quality and informed decisions cannot be underestimated. Traditional decision making methods are inadequate for today's larger, more complex health care organizations and the rapidly changing health care environment. As a result, today's health care managers and their teams need new approaches to making decisions for their organizations. This article examines the managerial decision making process and offers a model that can be used as a decision making template to help managers successfully navigate the choppy health care seas. The administrative decision making model will enable health care managers and other key decision makers to avoid the common pitfalls of poor decision making and guide their organizations to success.

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

    ERIC Educational Resources Information Center

    Elshami, Ahmed M.

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

  17. Rise and Fall of Decentralized School Governance--Decision-Making Practices in Georgia

    ERIC Educational Resources Information Center

    Gorgodze, Sophia

    2016-01-01

    The current study investigates educational decision-making in the former Soviet Republic of Georgia. The focus is on decisions concerning issues of school governance decentralization/recentralization in the period of 2003-2012. The research draws on in-depth interviews with over 20 top decision-makers, and an extensive review of legal documents,…

  18. GODDESS: A Goal-Directed Decision Structuring System.

    DTIC Science & Technology

    1980-06-01

    differ- ent support techniques. From a practical viewpoint, though, the major drawback of manual interviews is their length and cost. Since real - time ...conducting his future inquiries. A direct man-machine interface could provide three distinct advantages. First, it offers the capability of real - time ...knowledge in tree form. In many real -world applications, the decision maker may not perceive a problem in the form of a time sequence of decision

  19. Default options and neonatal resuscitation decisions.

    PubMed

    Haward, Marlyse Frieda; Murphy, Ryan O; Lorenz, John M

    2012-12-01

    To determine whether presenting delivery room management options as defaults influences decisions to resuscitate extremely premature infants. Adult volunteers recruited from the world wide web were randomised to receive either resuscitation or comfort care as the delivery room management default option for a hypothetical delivery of a 23-week gestation infant. Participants were required to check a box to opt out of the default. The primary outcome measure was the proportion of respondents electing resuscitation. Data were analysed using χ(2) tests and multivariate logistic regression. Participants who were told the delivery room management default option was resuscitation were more likely to opt for resuscitation (OR 6.54 95% CI 3.85 to 11.11, p<0.001). This effect persisted on multivariate regression analysis (OR 7.00, 95% CI 3.97 to 12.36, p<0.001). Female gender, being married or in a committed relationship, being highly religious, experiences with prematurity, and favouring sanctity of life were significantly associated with decisions to resuscitate. Presenting delivery room options for extremely premature infants as defaults exert a significant effect on decision makers. The information structure of the choice task may act as a subtle form of manipulation. Further, this effect may operate in ways that a decision maker is not aware of and this raises questions of patient autonomy. Presenting delivery room options for extremely premature infants as defaults may compromise autonomous decision-making.

  20. Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

    PubMed

    Dolan, James G

    2010-01-01

    Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

  1. Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare

    PubMed Central

    Dolan, James G.

    2010-01-01

    Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers. Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine “hard data” with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings. The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP) PMID:21394218

  2. The Morality of Socioscientific Issues: Construal and Resolution of Genetic Engineering Dilemmas

    ERIC Educational Resources Information Center

    Sadler, Troy D.; Zeidler, Dana L.

    2004-01-01

    The ability to negotiate and resolve socioscientific issues has been posited as integral components of scientific literacy. Although philosophers and science educators have argued that socioscientific issues inherently involve moral and ethical considerations, the ultimate arbiters of morality are individual decision-makers. This study explored…

  3. Weighing in on Genetic Engineering and Morality: Students Reveal Their Ideas, Expectations, and Reservations.

    ERIC Educational Resources Information Center

    Sadler, Troy D.; Zeidler, Dana L.

    The ability to negotiate and resolve socioscientific issues has been posited as integral components of scientific literacy. Although philosophers and science educators have argued that socioscientific issues inherently involve moral and ethical considerations, the ultimate arbiters of morality are individual decision-makers. This study explored…

  4. A mixed integer program to model spatial wildfire behavior and suppression placement decisions

    Treesearch

    Erin J. Belval; Yu Wei; Michael Bevers

    2015-01-01

    Wildfire suppression combines multiple objectives and dynamic fire behavior to form a complex problem for decision makers. This paper presents a mixed integer program designed to explore integrating spatial fire behavior and suppression placement decisions into a mathematical programming framework. Fire behavior and suppression placement decisions are modeled using...

  5. Prediction of alcohol and gambling problems in young adults by using a measure of decision making.

    PubMed

    Harvanko, Arit M; Schreiber, Liana R N; Grant, Jon E

    2013-01-01

    Individuals who regularly gamble, regularly consume alcohol, or meet criteria for an alcohol-use disorder or pathological gambling may make riskier decisions on cognitive tasks. What remains unclear in the literature is whether these decision-making deficits precede or result from these addictive behaviors. This study aimed to determine whether risky decision making on a cognitive task is predictive of increasing gambling behaviors and alcohol use. Fifty-eight young adults (aged 18-29 years) free from Axis I disorders and reporting no symptoms of at-risk gambling behavior or alcohol consumption, who were participating in a longitudinal study of impulsivity, were grouped as either high-risk decision makers (n = 29) or low-risk decision makers (n = 29) by using the Cambridge Gamble Task. Subjects were assessed at 1-year follow-up to examine gambling frequency, alcohol consumption, at-risk alcohol-use criteria, alcohol-use disorder criteria, at-risk gambling criteria, and pathological gambling criteria. High-risk decision makers were found to be more likely to meet at-risk criteria for alcohol use after 1 year. Decision-making group membership was not significantly correlated with frequency of gambling or development of pathological gambling or alcohol-use disorder over 1 year. A variable measuring risky decision making on the Cambridge Gambling Task may be able to predict who is more likely to increase alcohol use per session later in life.

  6. Busy yet Passive: (Non-)Decision-Making in School Governing Bodies

    ERIC Educational Resources Information Center

    Young, Helen

    2017-01-01

    School governing bodies in England have considerable powers and duties, and their formal role positions them as decision-makers. This article draws on qualitative research in the governing bodies of four maintained schools. Using deliberative democracy as a sensitising concept, the article considers some processes by which decisions are made (or…

  7. Critical care physicians’ approaches to negotiating with surrogate decision makers: a qualitative study

    PubMed Central

    Brush, David R.; Brown, Crystal E.; Alexander, G. Caleb

    2013-01-01

    Objective To describe how critical care physicians manage conflicts with surrogates about withdrawing or withholding patients’ life support. Design Qualitative analysis of key informant interviews with critical care physicians during 2010. We transcribed interviews verbatim and used grounded theory to code and revise a taxonomy of themes and to identify illustrative quotes. Setting 3 academic medical centers, 1 academic-affiliated medical center and 4 private practice groups or private hospitals in a large Midwestern city Subjects 14 critical care physicians Measurements and main results Physicians reported tailoring their approach to address specific reasons for disagreement with surrogates. Five common approaches were identified: (1) building trust, (2) educating and informing, (3) providing surrogates more time, (4) adjusting surrogate and physician roles, and (5) highlighting specific values. When mistrust was an issue, physicians endeavored to build a more trusting relationship with the surrogate before re-addressing decision making. Physicians also reported correcting misunderstandings by providing targeted education, and some reported highlighting specific patient, surrogate, or physician values that they hoped would guide surrogates to agree with them. When surrogates struggled with decision making roles, physicians attempted to reinforce the concept of substituted judgment. Physicians noted that some surrogates needed time to “come to terms” with the patent’s illness before agreeing with physicians. Many physicians had witnessed colleagues negotiate in ways they found objectionable, such as providing misleading information, injecting their own values into the negotiation, or behaving unprofessionally towards surrogates. While some physicians viewed their efforts to encourage surrogates’ agreement as persuasive, others strongly denied persuading surrogates and described their actions as “guiding” or “negotiating.” Conclusions Physicians

  8. Why, When, and How to Take into Account the Uncertainty Involved in Career Decisions.

    ERIC Educational Resources Information Center

    Gati, Itamar

    1990-01-01

    Theoretically analyzes career decisions under uncertainty, when career decision maker ranks options rather than choosing best one. Found that how decisions were framed affected ranking of options and quality of decisions. Analysis showed that the rank order of options in optimal ranking always coincided with the rank order of the options by their…

  9. Advisory: Definitions, Descriptions, Decisions, Directions.

    ERIC Educational Resources Information Center

    Galassi, John P.; Gulledge, Suzanne A.; Cox, Nancy D.

    Advisory groups have played an essential role in improving the school climate and conditions for young adolescents in schools. How middle school decision makers go about the process of designing or re-designing an advisory program needs to be considered. A discussion is presented of the background information that helps define advisories. It…

  10. Recreation, resources, and right decisions

    Treesearch

    Elwood L. Shafer; George Moeller; Douglas A. Morrison; Russell Getty

    1974-01-01

    In the midst of national concern for preserving ecosystems, stimulating the economy, and providing outdoor recreation opportunities for the American public, the modern recreation-resource decision-maker faces a monumental task. The authors present a series of relevance trees that pinpoint, in terms of interacting social and physical site variables, the important...

  11. Interval-valued distributed preference relation and its application to group decision making

    PubMed Central

    Liu, Yin; Xue, Min; Chang, Wenjun; Yang, Shanlin

    2018-01-01

    As an important way to help express the preference relation between alternatives, distributed preference relation (DPR) can represent the preferred, non-preferred, indifferent, and uncertain degrees of one alternative over another simultaneously. DPR, however, is unavailable in some situations where a decision maker cannot provide the precise degrees of one alternative over another due to lack of knowledge, experience, and data. In this paper, to address this issue, we propose interval-valued DPR (IDPR) and present its properties of validity and normalization. Through constructing two optimization models, an IDPR matrix is transformed into a score matrix to facilitate the comparison between any two alternatives. The properties of the score matrix are analyzed. To guarantee the rationality of the comparisons between alternatives derived from the score matrix, the additive consistency of the score matrix is developed. In terms of these, IDPR is applied to model and solve multiple criteria group decision making (MCGDM) problem. Particularly, the relationship between the parameters for the consistency of the score matrix associated with each decision maker and those for the consistency of the score matrix associated with the group of decision makers is analyzed. A manager selection problem is investigated to demonstrate the application of IDPRs to MCGDM problems. PMID:29889871

  12. Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority

    PubMed Central

    2011-01-01

    Objectives The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement. PMID:21756357

  13. Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting

    PubMed Central

    Carpenter, Stephanie M.; Yates, J. Frank; Preston, Stephanie D.; Chen, Lydia

    2016-01-01

    Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional “coherence shifting,” the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed. PMID:26986752

  14. Modelling risk aversion to support decision-making for controlling zoonotic livestock diseases.

    PubMed

    van Asseldonk, M A P M; Bergevoet, R H M; Ge, L

    2013-12-01

    Zoonotic infectious livestock diseases are becoming a significant burden for both animal and human health and are rapidly gaining the attention of decision-makers who manage public health programmes. If control decisions have only monetary components, governments are generally regarded as being risk-neutral and the intervention strategy with the highest expected benefit (lowest expected net costs) should be preferred. However, preferences will differ and alternative intervention plans will prevail if (human) life and death outcomes are involved. A rational decision framework must therefore consider risk aversion in the decision-maker and controversial values related to public health. In the present study, risk aversion and its impact on both the utility for the monetary component and the utility for the non-monetary component is shown to be an important element when dealing with emerging zoonotic infectious livestock diseases and should not be ignored in the understanding and support of decision-making. The decision framework was applied to several control strategies for the reduction of human cases of brucellosis (Brucella melitensis) originating from sheep in Turkey.

  15. [A study on participation in clinical decision making by home healthcare nurses].

    PubMed

    Kim, Se Young

    2010-12-01

    This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making. A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used. Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses. In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses' participation in clinical decision making in cases where they can identify and solve the patient health problems.

  16. Surrogate decision making and intellectual virtue.

    PubMed

    Bock, Gregory L

    2014-01-01

    Patients can be harmed by a religiously motivated surrogate decision maker whose decisions are contrary to the standard of care; therefore, surrogate decision making should be held to a high standard. Stewart Eskew and Christopher Meyers proposed a two-part rule for deciding which religiously based decisions to honor: (1) a secular reason condition and (2) a rationality condition. The second condition is based on a coherence theory of rationality, which they claim is accessible, generous, and culturally sensitive. In this article, I will propose strengthening the rationality condition by grounding it in a theory of intellectual virtue, which is both rigorous and culturally sensitive. Copyright 2014 The Journal of Clinical Ethics. All rights reserved.

  17. Age Targeting of Voluntary Medical Male Circumcision Programs Using the Decision Makers' Program Planning Toolkit (DMPPT) 2.0.

    PubMed

    Kripke, Katharine; Opuni, Marjorie; Schnure, Melissa; Sgaier, Sema; Castor, Delivette; Reed, Jason; Njeuhmeli, Emmanuel; Stover, John

    2016-01-01

    Despite considerable efforts to scale up voluntary medical male circumcision (VMMC) for HIV prevention in priority countries over the last five years, implementation has faced important challenges. Seeking to enhance the effect of VMMC programs for greatest and most immediate impact, the U. S. President's Plan for AIDS Relief (PEPFAR) supported the development and application of a model to inform national planning in five countries from 2013-2014. The Decision Makers' Program Planning Toolkit (DMPPT) 2.0 is a simple compartmental model designed to analyze the effects of client age and geography on program impact and cost. The DMPPT 2.0 model was applied in Malawi, South Africa, Swaziland, Tanzania, and Uganda to assess the impact and cost of scaling up age-targeted VMMC coverage. The lowest number of VMMCs per HIV infection averted would be produced by circumcising males ages 20-34 in Malawi, South Africa, Tanzania, and Uganda and males ages 15-34 in Swaziland. The most immediate impact on HIV incidence would be generated by circumcising males ages 20-34 in Malawi, South Africa, Tanzania, and Uganda and males ages 20-29 in Swaziland. The greatest reductions in HIV incidence over a 15-year period would be achieved by strategies focused on males ages 10-19 in Uganda, 15-24 in Malawi and South Africa, 10-24 in Tanzania, and 15-29 in Swaziland. In all countries, the lowest cost per HIV infection averted would be achieved by circumcising males ages 15-34, although in Uganda this cost is the same as that attained by circumcising 15- to 49-year-olds. The efficiency, immediacy of impact, magnitude of impact, and cost-effectiveness of VMMC scale-up are not uniform; there is important variation by age group of the males circumcised and countries should plan accordingly.

  18. 'Holding the line': a qualitative study of the role of evidence in early phase decision-making in the reconfiguration of stroke services in London.

    PubMed

    Fraser, Alec; Baeza, Juan I; Boaz, Annette

    2017-06-09

    Health service reconfigurations are of international interest but remain poorly understood. This article focuses on the use of evidence by senior managerial decision-makers involved in the reconfiguration of stroke services in London 2008-2012. Recent work comparing stroke service reconfiguration in London and Manchester emphasises the ability of senior managerial decision-makers in London to 'hold the line' in the crucial early phases of the stroke reconfiguration programme. In this article, we explore in detail how these decision-makers 'held the line' and ask what the broader power implications of doing so are for the interaction between evidence, health policy and system redesign. The research combined semi-structured interviews (n = 20) and documentary analysis of historically relevant policy papers and contemporary stroke reconfiguration documentation published by NHS London and other interested parties (n = 125). We applied a critical interpretive and reflexive approach to the analysis of the data. We identified two forms of power which senior managerial decision-makers drew upon in order to 'hold the line'. Firstly, discursive power, which through an emphasis on evidence, better patient outcomes, professional support and clinical credibility alongside a tightly managed consultation process, helped to set an agenda that was broadly receptive to the overall decision to change stroke services in the capital in a radical way. Secondly, once the essential parameters of the decision to change services had been agreed, senior managerial decision-makers 'held the line' through hierarchical New Public Management style power to minimise the traditional pressures to de-radicalise the reconfiguration through 'top down' decision-making. We problematise the concept of 'holding the line' and explore the power implications of such managerial approaches in the early phases of health service reconfiguration. We highlight the importance of evidence for senior managerial

  19. Risk Analysis: Its Application to Argumentation and Decision-Making.

    ERIC Educational Resources Information Center

    Follert, Vincent

    1981-01-01

    Notes that utility theory has enjoyed renewed interest among debate critics and other decision makers. Some of the problems with its application are identified and guidelines for debaters are suggested. (PD)

  20. Choosing and using climate change scenarios for ecological-impact assessments and conservation decisions

    USGS Publications Warehouse

    Amy K. Snover,; Nathan J. Mantua,; Littell, Jeremy; Michael A. Alexander,; Michelle M. McClure,; Janet Nye,

    2013-01-01

    Increased concern over climate change is demonstrated by the many efforts to assess climate effects and develop adaptation strategies. Scientists, resource managers, and decision makers are increasingly expected to use climate information, but they struggle with its uncertainty. With the current proliferation of climate simulations and downscaling methods, scientifically credible strategies for selecting a subset for analysis and decision making are needed. Drawing on a rich literature in climate science and impact assessment and on experience working with natural resource scientists and decision makers, we devised guidelines for choosing climate-change scenarios for ecological impact assessment that recognize irreducible uncertainty in climate projections and address common misconceptions about this uncertainty. This approach involves identifying primary local climate drivers by climate sensitivity of the biological system of interest; determining appropriate sources of information for future changes in those drivers; considering how well processes controlling local climate are spatially resolved; and selecting scenarios based on considering observed emission trends, relative importance of natural climate variability, and risk tolerance and time horizon of the associated decision. The most appropriate scenarios for a particular analysis will not necessarily be the most appropriate for another due to differences in local climate drivers, biophysical linkages to climate, decision characteristics, and how well a model simulates the climate parameters and processes of interest. Given these complexities, we recommend interaction among climate scientists, natural and physical scientists, and decision makers throughout the process of choosing and using climate-change scenarios for ecological impact assessment.

  1. The Assisted Decision-Making (Capacity) Bill 2013: content, commentary, controversy.

    PubMed

    Kelly, B D

    2015-03-01

    Ireland's Assisted Decision-Making (Capacity) Bill (2013) aims to reform the law relating to persons who require assistance exercising their decision-making capacity. When finalised, the Bill will replace Ireland's outdated Ward of Court system which has an all-or-nothing approach to capacity; does not adequately define capacity; is poorly responsive to change; makes unwieldy provision for appointing decision-makers; and has insufficient provision for review. To explore the content and implications of the Assisted Decision-Making (Capacity) Bill. Review of the content of the Assisted Decision-Making (Capacity) Bill and related literature. The new Bill includes a presumption of capacity and defines lack of capacity. All interventions must minimise restriction of rights and freedom, and have due regard for "dignity, bodily integrity, privacy and autonomy". The Bill proposes legal frameworks for "assisted decision-making" (where an individual voluntarily appoints someone to assist with specific decisions relating to personal welfare or property and affairs, by, among other measures, assisting the individual to communicate his or her "will and preferences"); "co-decision-making" (where the Circuit Court declares the individual's capacity is reduced but he or she can make specific decisions with a co-decision-maker to share authority); "decision-making representatives" (substitute decision-making); "enduring power of attorney"; and "informal decision-making on personal welfare matters" (without apparent oversight). These measures, if implemented, will shift Ireland's capacity laws away from an approach based on "best interests" to one based on "will and preferences", and increase compliance with the United Nations' Convention on the Rights of Persons with Disabilities.

  2. Structured decision making: Chapter 5

    USGS Publications Warehouse

    Runge, Michael C.; Grand, James B.; Mitchell, Michael S.; Krausman, Paul R.; Cain, James W. III

    2013-01-01

    Wildlife management is a decision-focused discipline. It needs to integrate traditional wildlife science and social science to identify actions that are most likely to achieve the array of desires society has surrounding wildlife populations. Decision science, a vast field with roots in economics, operations research, and psychology, offers a rich set of tools to help wildlife managers frame, decompose, analyze, and synthesize their decisions. The nature of wildlife management as a decision science has been recognized since the inception of the field, but formal methods of decision analysis have been underused. There is tremendous potential for wildlife management to grow further through the use of formal decision analysis. First, the wildlife science and human dimensions of wildlife disciplines can be readily integrated. Second, decisions can become more efficient. Third, decisions makers can communicate more clearly with stakeholders and the public. Fourth, good, intuitive wildlife managers, by explicitly examining how they make decisions, can translate their art into a science that is readily used by the next generation.

  3. Does the market maker stabilize the market?

    NASA Astrophysics Data System (ADS)

    Zhu, Mei; Chiarella, Carl; He, Xue-Zhong; Wang, Duo

    2009-08-01

    The market maker plays an important role in price formation, but his/her behavior and stabilizing impact on the market are relatively unclear, in particular in speculative markets. This paper develops a financial market model that examines the impact on market stability of the market maker, who acts as both a liquidity provider and an active investor in a market consisting of two types of boundedly rational speculative investors-the fundamentalists and trend followers. We show that the market maker does not necessarily stabilize the market when he/she actively manages the inventory to maximize profits, and that rather the market maker’s impact depends on the behavior of the speculators. Numerical simulations show that the model is able to generate outcomes for asset returns and market inventories that are consistent with empirical findings.

  4. The Use of Social Ecological Hotspots Mapping: Co-Developing Adaptation Strategies for Resource Management by Communities and Policy Makers

    NASA Astrophysics Data System (ADS)

    Alessa, L.

    2014-12-01

    Ultimately, adaptation is based on a set of trade-offs rather than optimal conditions, something that is rarely seen in messy social ecological systems (SES). In this talk, we discuss the role of spatial hot-spot mapping using social and biophysical data to understand the feedbacks in SES. We review the types of data needed, their means of acquisition and the analytic methods involved. In addition, we outline the challenges faced in co-developing this type of inquiry based on lessons learned from several long-term programs. Finally, we present the utility of SES hotspots in developing adaptation strategies on the ground by communities and policy makers.

  5. The Ultimate Fizz

    ERIC Educational Resources Information Center

    Heckscher, Mary

    2008-01-01

    Many recipes for elementary science activities suggest making carbon dioxide from baking soda and vinegar; however, they often do not give exact measurements of the ingredients. The author was able to turn this "drawback" into a plus by challenging her fifth-grade students to find the "ultimate fizz"--i.,e., "What amount of baking soda added to a…

  6. Evidence summaries tailored to health policy-makers in low- and middle-income countries

    PubMed Central

    Glenton, Claire; Wiysonge, Charles Shey; Abalos, Edgardo; Mignini, Luciano; Young, Taryn; Althabe, Fernando; Ciapponi, Agustín; Marti, Sebastian Garcia; Meng, Qingyue; Wang, Jian; la Hoz Bradford, Ana Maria De; Kiwanuka, Suzanne N; Rutebemberwa, Elizeus; Pariyo, George W; Flottorp, Signe; Oxman, Andrew D

    2011-01-01

    Abstract Objective To describe how the SUPPORT collaboration developed a short summary format for presenting the results of systematic reviews to policy-makers in low- and middle-income countries (LMICs). Methods We carried out 21 user tests in six countries to explore users’ experiences with the summary format. We modified the summaries based on the results and checked our conclusions through 13 follow-up interviews. To solve the problems uncovered by the user testing, we also obtained advisory group feedback and conducted working group workshops. Findings Policy-makers liked a graded entry format (i.e. short summary with key messages up front). They particularly valued the section on the relevance of the summaries for LMICs, which compensated for the lack of locally-relevant detail in the original review. Some struggled to understand the text and numbers. Three issues made redesigning the summaries particularly challenging: (i) participants had a poor understanding of what a systematic review was; (ii) they expected information not found in the systematic reviews and (iii) they wanted shorter, clearer summaries. Solutions included adding information to help understand the nature of a systematic review, adding more references and making the content clearer and the document quicker to scan. Conclusion Presenting evidence from systematic reviews to policy-makers in LMICs in the form of short summaries can render the information easier to assimilate and more useful, but summaries must be clear and easy to read or scan quickly. They should also explain the nature of the information provided by systematic reviews and its relevance for policy decisions. PMID:21346891

  7. A tool for corporate decision making about cognitive pharmaceutical services.

    PubMed

    Tipton, D J

    2001-01-01

    To present and discuss the models, theories, ideas, and frameworks that corporate decision makers would apply to the implementation of cognitive pharmaceutical services. Large chains and integrated delivery networks dominate the pharmacy marketplace. As a result, in many instances implementing cognitive pharmaceutical services, or expanding their delivery, first requires approval of a corporate decision maker, often not a pharmacist, who is schooled in marketing, management, and finance, and who necessarily views proposals for cognitive pharmaceutical services from those frames of reference. This article focuses on the following six marketing and management questions that corporate decision makers likely want answered before approving and funding the implementation of cognitive pharmaceutical services: (1) What is our product? (2) Who will pay, and what is the price? (3) Is there a market, and can it be reached? (4) What procedures must be put in place? (5) Who will deliver the service? (6) Where are the services to be delivered, and how is the facility to be presented? For a pharmacy manager charged with bringing cognitive pharmaceutical services to the marketplace, consideration of the issues detailed here meets a reasonable test of due diligence in committing human, financial, and organizational resources. It is natural for a pharmacist to look at cognitive pharmaceutical services through a professional lens. It is just as natural for a corporate decision marker to look at cognitive pharmaceutical services through a marketing and management lens. Unless both lenses are put together, one gets only half the picture.

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

    NASA Astrophysics Data System (ADS)

    Roy, Jean; Breton, Richard; Paradis, Stephane

    2001-08-01

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

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

    PubMed

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

    2017-11-01

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

  10. The Critical Importance of Costs for Education Decisions. REL 2017-274

    ERIC Educational Resources Information Center

    Hollands, Fiona M.; Levin, Henry M.

    2017-01-01

    This brief provides guidance to decision makers in schools, districts, state education departments, and intermediary organizations about ways that cost analyses can help inform their decisions about program choices, budgets, and strategies. It addresses questions about: (1) why cost information matters in education; (2) what cost metrics are…

  11. Myopic Regret Avoidance: Feedback Avoidance and Learning in Repeated Decision Making

    ERIC Educational Resources Information Center

    Reb, Jochen; Connolly, Terry

    2009-01-01

    Decision makers can become trapped by "myopic regret avoidance" in which rejecting feedback to avoid short-term "outcome regret" (regret associated with counterfactual outcome comparisons) leads to reduced learning and greater long-term regret over continuing poor decisions. In a series of laboratory experiments involving repeated choices among…

  12. Relation between belief and performance in perceptual decision making.

    PubMed

    Drugowitsch, Jan; Moreno-Bote, Rubén; Pouget, Alexandre

    2014-01-01

    In an uncertain and ambiguous world, effective decision making requires that subjects form and maintain a belief about the correctness of their choices, a process called meta-cognition. Prediction of future outcomes and self-monitoring are only effective if belief closely matches behavioral performance. Equality between belief and performance is also critical for experimentalists to gain insight into the subjects' belief by simply measuring their performance. Assuming that the decision maker holds the correct model of the world, one might indeed expect that belief and performance should go hand in hand. Unfortunately, we show here that this is rarely the case when performance is defined as the percentage of correct responses for a fixed stimulus, a standard definition in psychophysics. In this case, belief equals performance only for a very narrow family of tasks, whereas in others they will only be very weakly correlated. As we will see it is possible to restore this equality in specific circumstances but this remedy is only effective for a decision-maker, not for an experimenter. We furthermore show that belief and performance do not match when conditioned on task difficulty--as is common practice when plotting the psychometric curve--highlighting common pitfalls in previous neuroscience work. Finally, we demonstrate that miscalibration and the hard-easy effect observed in humans' and other animals' certainty judgments could be explained by a mismatch between the experimenter's and decision maker's expected distribution of task difficulties. These results have important implications for experimental design and are of relevance for theories that aim to unravel the nature of meta-cognition.

  13. TREATMENT SWITCHING: STATISTICAL AND DECISION-MAKING CHALLENGES AND APPROACHES.

    PubMed

    Latimer, Nicholas R; Henshall, Chris; Siebert, Uwe; Bell, Helen

    2016-01-01

    Treatment switching refers to the situation in a randomized controlled trial where patients switch from their randomly assigned treatment onto an alternative. Often, switching is from the control group onto the experimental treatment. In this instance, a standard intention-to-treat analysis does not identify the true comparative effectiveness of the treatments under investigation. We aim to describe statistical methods for adjusting for treatment switching in a comprehensible way for nonstatisticians, and to summarize views on these methods expressed by stakeholders at the 2014 Adelaide International Workshop on Treatment Switching in Clinical Trials. We describe three statistical methods used to adjust for treatment switching: marginal structural models, two-stage adjustment, and rank preserving structural failure time models. We draw upon discussion heard at the Adelaide International Workshop to explore the views of stakeholders on the acceptability of these methods. Stakeholders noted that adjustment methods are based on assumptions, the validity of which may often be questionable. There was disagreement on the acceptability of adjustment methods, but consensus that when these are used, they should be justified rigorously. The utility of adjustment methods depends upon the decision being made and the processes used by the decision-maker. Treatment switching makes estimating the true comparative effect of a new treatment challenging. However, many decision-makers have reservations with adjustment methods. These, and how they affect the utility of adjustment methods, require further exploration. Further technical work is required to develop adjustment methods to meet real world needs, to enhance their acceptability to decision-makers.

  14. A decision science approach for integrating social science in climate and energy solutions

    NASA Astrophysics Data System (ADS)

    Wong-Parodi, Gabrielle; Krishnamurti, Tamar; Davis, Alex; Schwartz, Daniel; Fischhoff, Baruch

    2016-06-01

    The social and behavioural sciences are critical for informing climate- and energy-related policies. We describe a decision science approach to applying those sciences. It has three stages: formal analysis of decisions, characterizing how well-informed actors should view them; descriptive research, examining how people actually behave in such circumstances; and interventions, informed by formal analysis and descriptive research, designed to create attractive options and help decision-makers choose among them. Each stage requires collaboration with technical experts (for example, climate scientists, geologists, power systems engineers and regulatory analysts), as well as continuing engagement with decision-makers. We illustrate the approach with examples from our own research in three domains related to mitigating climate change or adapting to its effects: preparing for sea-level rise, adopting smart grid technologies in homes, and investing in energy efficiency for office buildings. The decision science approach can facilitate creating climate- and energy-related policies that are behaviourally informed, realistic and respectful of the people whom they seek to aid.

  15. Decision making in acquiring medical technologies in Israeli medical centers: a preliminary study.

    PubMed

    Greenberg, Dan; Pliskin, Joseph S; Peterburg, Yitzhak

    2003-01-01

    This preliminary study had two objectives: a) charting the considerations relevant to decisions about acquisition of new medical technology at the hospital level; and b) creating a basis for the development of a research tool that will examine the function of the Israeli health system in assessment of new medical technologies. A comprehensive literature review and in-depth interviews with decision makers at different levels allowed formulation of criteria considered by decision makers when they decide to purchase and use (or disallow the use) of new medical technology. The resulting questionnaire was sent to medical center directors, along with a letter explaining the goals of the study. The questionnaire included 31 possible considerations for decision making concerning the acquisition of new medical technology by medical centers. The interviewees were asked to indicate the relevance of each consideration in the decision-making process. The most relevant criteria for the adoption of new technologies related to the need for a large capital investment, clinical efficacy of the technology as well as its influence on side effects and complication rates, and a formal approval by the Ministry of Health. Most interviewees stated that pressures exerted by the industry, by patients, or by senior physicians in the hospital are less relevant to decision making. Very small and usually not statistically significant differences in the ranking of hospital directors were found according to the hospitals' ownership, size, or location. The present study is a basis for a future study that will map and describe the function of hospital decision makers within the area of new technology assessment and the decision-making process in the adoption of new healthcare technologies.

  16. Connecting Systems Model Design to Decision-Maker and Stakeholder Needs: Lessons from Louisiana's Coastal Master Plan

    NASA Astrophysics Data System (ADS)

    Fischbach, J. R.; Johnson, D.

    2017-12-01

    of policy makers and CPRA managers. While changes will be illustrated through examples from Louisiana's 2017 Coastal Master Plan, we endeavor to provide generalizable and actionable insights about how modeling choices should be guided by the decision support process being used by planners.

  17. Ecosystem Decision Support: A Living Database of Existing Tools, Approaches and Techniques for Supporting Decisions Related to Ecosystem Services

    EPA Science Inventory

    Planners and decision makers are challenged to consider not only direct market costs, but also ecological externalities. There is an increasing emphasis on ecosystem services in the context of human well-being, and therefore the valuation and accounting of ecosystem services is b...

  18. Toolbox or Adjustable Spanner? A Critical Comparison of Two Metaphors for Adaptive Decision Making

    ERIC Educational Resources Information Center

    Söllner, Anke; Bröder, Arndt

    2016-01-01

    For multiattribute decision tasks, different metaphors exist that describe the process of decision making and its adaptation to diverse problems and situations. Multiple strategy models (MSMs) assume that decision makers choose adaptively from a set of different strategies (toolbox metaphor), whereas evidence accumulation models (EAMs) hold that a…

  19. Using M and S to Improve Human Decision Making and Achieve Effective Problem Solving in an International Environment

    NASA Technical Reports Server (NTRS)

    Christie, Vanessa L.; Landess, David J.

    2012-01-01

    In the international arena, decision makers are often swayed away from fact-based analysis by their own individual cultural and political bias. Modeling and Simulation-based training can raise awareness of individual predisposition and improve the quality of decision making by focusing solely on fact vice perception. This improved decision making methodology will support the multinational collaborative efforts of military and civilian leaders to solve challenges more effectively. The intent of this experimental research is to create a framework that allows decision makers to "come to the table" with the latest and most significant facts necessary to determine an appropriate solution for any given contingency.

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

    PubMed

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

    2016-12-01

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