From Forecasters to the General Public: A Communication Tool to Understand Decision-making Challenges in Weather-related Early Warning Systems

NASA Astrophysics Data System (ADS)

Terti, G.; Ruin, I.; Kalas, M.; Lorini, V.; Sabbatini, T.; i Alonso, A. C.

2017-12-01

New technologies are currently adopted worldwide to improve weather forecasts and communication of the corresponding warnings to the end-users. "EnhANcing emergency management and response to extreme WeatHER and climate Events" (ANYWHERE) project is an innovating action that aims at developing and implementing a European decision-support platform for weather-related risks integrating cutting-edge forecasting technology. The initiative is built in a collaborative manner where researchers, developers, potential users and other stakeholders meet frequently to define needs, capabilities and challenges. In this study, we propose a role-playing game to test the added value of the ANYWHERE platform on i) the decision-making process and the choice of warning levels under uncertainty, ii) the management of the official emergency response and iii) the crisis communication and triggering of protective actions at different levels of the warning system (from hazard detection to citizen response). The designed game serves as an interactive communication tool. Here, flood and flash flood focused simulations seek to enhance participant's understanding of the complexities and challenges embedded in various levels of the decision-making process under the threat of weather disasters (e.g., forecasting/warnings, official emergency actions, self-protection). Also, we facilitate collaboration and coordination between the participants who belong to different national or local agencies/authorities across Europe. The game is first applied and tested in ANYWHERE's workshop in Helsinki (September, 2017) where about 30-50 people, including researchers, forecasters, civil protection and representatives of related companies, are anticipated to play the simulation. The main idea is to provide to the players a virtual case study that well represents realistic uncertainties and dilemmas embedded in the real-time forecasting-warning processes. At the final debriefing step the participants are

Coral Reef Early Warning System (CREWS) RPC Experiment

NASA Technical Reports Server (NTRS)

Estep, Leland; Spruce, Joseph P.; Hall, Callie

2007-01-01

This viewgraph document reviews the background, objectives, methodology, validation, and present status of the Coral Reef Early Warning System (CREWS) Rapid Prototyping Capability (RPC) experiment. The potential NASA contribution to CREWS Decision Support Tool (DST) centers on remotely sensed imagery products.

Three-Month Real-Time Dengue Forecast Models: An Early Warning System for Outbreak Alerts and Policy Decision Support in Singapore.

PubMed

Shi, Yuan; Liu, Xu; Kok, Suet-Yheng; Rajarethinam, Jayanthi; Liang, Shaohong; Yap, Grace; Chong, Chee-Seng; Lee, Kim-Sung; Tan, Sharon S Y; Chin, Christopher Kuan Yew; Lo, Andrew; Kong, Waiming; Ng, Lee Ching; Cook, Alex R

2016-09-01

With its tropical rainforest climate, rapid urbanization, and changing demography and ecology, Singapore experiences endemic dengue; the last large outbreak in 2013 culminated in 22,170 cases. In the absence of a vaccine on the market, vector control is the key approach for prevention. We sought to forecast the evolution of dengue epidemics in Singapore to provide early warning of outbreaks and to facilitate the public health response to moderate an impending outbreak. We developed a set of statistical models using least absolute shrinkage and selection operator (LASSO) methods to forecast the weekly incidence of dengue notifications over a 3-month time horizon. This forecasting tool used a variety of data streams and was updated weekly, including recent case data, meteorological data, vector surveillance data, and population-based national statistics. The forecasting methodology was compared with alternative approaches that have been proposed to model dengue case data (seasonal autoregressive integrated moving average and step-down linear regression) by fielding them on the 2013 dengue epidemic, the largest on record in Singapore. Operationally useful forecasts were obtained at a 3-month lag using the LASSO-derived models. Based on the mean average percentage error, the LASSO approach provided more accurate forecasts than the other methods we assessed. We demonstrate its utility in Singapore's dengue control program by providing a forecast of the 2013 outbreak for advance preparation of outbreak response. Statistical models built using machine learning methods such as LASSO have the potential to markedly improve forecasting techniques for recurrent infectious disease outbreaks such as dengue. Shi Y, Liu X, Kok SY, Rajarethinam J, Liang S, Yap G, Chong CS, Lee KS, Tan SS, Chin CK, Lo A, Kong W, Ng LC, Cook AR. 2016. Three-month real-time dengue forecast models: an early warning system for outbreak alerts and policy decision support in Singapore. Environ Health

Three-Month Real-Time Dengue Forecast Models: An Early Warning System for Outbreak Alerts and Policy Decision Support in Singapore

PubMed Central

Shi, Yuan; Liu, Xu; Kok, Suet-Yheng; Rajarethinam, Jayanthi; Liang, Shaohong; Yap, Grace; Chong, Chee-Seng; Lee, Kim-Sung; Tan, Sharon S.Y.; Chin, Christopher Kuan Yew; Lo, Andrew; Kong, Waiming; Ng, Lee Ching; Cook, Alex R.

2015-01-01

alerts and policy decision support in Singapore. Environ Health Perspect 124:1369–1375; http://dx.doi.org/10.1289/ehp.1509981 PMID:26662617

New Decision Support for Landslide and Other Disaster Events

NASA Astrophysics Data System (ADS)

Nair, U. S.; Keiser, K.; Wu, Y.; Kaulfus, A.; Srinivasan, K.; Anderson, E. R.; McEniry, M.

2013-12-01

An Event-Driven Data delivery (ED3) framework has been created that provides reusable services and configurations to support better data preparedness for decision support of disasters and other events by rapidly providing pre-planned access to data, special processing, modeling and other capabilities, all executed in response to criteria-based events. ED3 facilitates decision makers to plan in advance of disasters and other types of events for the data necessary for decisions and response activities. A layer of services provided in the ED3 framework allows systems to support user definition of subscriptions for data plans that will be triggered when events matching specified criteria occur. Pre-planning for data in response to events lessens the burden on decision makers in the aftermath of an event and allows planners to think through the desired processing for specialized data products. Additionally the ED3 framework provides support for listening for event alerts and support for multiple workflow managers that provide data and processing functionality in response to events. Landslides are often costly and, at times, deadly disaster events. Whereas intense and/or sustained rainfall is often the primary trigger for landslides, soil type and slope are also important factors in determining the location and timing of slope failure. Accounting for the substantial spatial variability of these factors is one of the major difficulties when predicting the timing and location of slope failures. A wireless sensor network (WSN), developed by NASA SERVIR and USRA, with peer-to-peer communication capability and low power consumption, is ideal for high spatial in situ monitoring in remote locations. In collaboration with the University of Huntsville at Alabama, WSN equipped with accelerometer, rainfall and soil moisture sensors is being integrated into an end-to-end landslide warning system. The WSN is being tested to ascertain communication capabilities and the density of

Improvements in agricultural water decision support using remote sensing

NASA Astrophysics Data System (ADS)

Marshall, M. T.

2012-12-01

Population driven water scarcity, aggravated by climate-driven evaporative demand in dry regions of the world, has the potential of transforming ecological and social systems to the point of armed conflict. Water shortages will be most severe in agricultural areas, as the priority shifts to urban and industrial use. In order to design, evaluate, and monitor appropriate mitigation strategies, predictive models must be developed that quantify exposure to water shortage. Remote sensing data has been used for more than three decades now to parametrize these models, because field measurements are costly and difficult in remote regions of the world. In the past decade, decision-makers for the first time can make accurate and near real-time evaluations of field conditions with the advent of hyper- spatial and spectral and coarse resolution continuous remote sensing data. Here, we summarize two projects representing diverse applications of remote sensing to improve agricultural water decision support. The first project employs MODIS (coarse resolution continuous data) to drive an evapotranspiration index, which is combined with the Standardized Precipitation Index driven by meteorological satellite data to improve famine early warning in Africa. The combined index is evaluated using district-level crop yield data from Kenya and Malawi and national-level crop yield data from the United Nations Food and Agriculture Organization. The second project utilizes hyper- spatial (GeoEye 1, Quickbird, IKONOS, and RapidEye) and spectral (Hyperion/ALI), as well as multi-spectral (Landsat ETM+, SPOT, and MODIS) data to develop biomass estimates for key crops (alfalfa, corn, cotton, and rice) in the Central Valley of California. Crop biomass is an important indicator of crop water productivity. The remote sensing data is combined using various data fusion techniques and evaluated with field data collected in the summer of 2012. We conclude with a brief discussion on implementation of

Intersection decision support : evaluation of a violation warning system to mitigate straight crossing path collisions.

DOT National Transportation Integrated Search

2006-01-01

This project entailed the design, development, testing, and evaluation of intersection decision support (IDS) systems to address straight crossing path (SCP) intersection crashes. This type of intersection crash is responsible for more than 100,000 c...

Severe Thunderstorm and Tornado Warnings at Raleigh, North Carolina.

NASA Astrophysics Data System (ADS)

Hoium, Debra K.; Riordan, Allen J.; Monahan, John; Keeter, Kermit K.

1997-11-01

The National Weather Service issues public warnings for severe thunderstorms and tornadoes when these storms appear imminent. A study of the warning process was conducted at the National Weather Service Forecast Office at Raleigh, North Carolina, from 1994 through 1996. The purpose of the study was to examine the decision process by documenting the types of information leading to decisions to warn or not to warn and by describing the sequence and timing of events in the development of warnings. It was found that the evolution of warnings followed a logical sequence beginning with storm monitoring and proceeding with increasingly focused activity. For simplicity, information input to the process was categorized as one of three types: ground truth, radar reflectivity, or radar velocity.Reflectivity, velocity, and ground truth were all equally likely to initiate the investigation process. This investigation took an average of 7 min, after which either a decision was made not to warn or new information triggered the warning. Decisions not to issue warnings were based more on ground truth and reflectivity than radar velocity products. Warnings with investigations of more than 2 min were more likely to be triggered by radar reflectivity, than by velocity or ground truth. Warnings with a shorter investigation time, defined here as "immediate trigger warnings," were less frequently based on velocity products and more on ground truth information. Once the decision was made to warn, it took an average of 2.1 min to prepare the warning text. In 85% of cases when warnings were issued, at least one contact was made to emergency management officials or storm spotters in the warned county. Reports of severe weather were usually received soon after the warning was transmitted-almost half of these within 30 min after issue. A total of 68% were received during the severe weather episode, but some of these storm reports later proved false according to Storm Data.Even though the WSR

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

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

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

1990-08-01

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

Future of Earthquake Early Warning: Quantifying Uncertainty and Making Fast Automated Decisions for Applications

NASA Astrophysics Data System (ADS)

Wu, Stephen

Earthquake early warning (EEW) systems have been rapidly developing over the past decade. Japan Meteorological Agency (JMA) has an EEW system that was operating during the 2011 M9 Tohoku earthquake in Japan, and this increased the awareness of EEW systems around the world. While longer-time earthquake prediction still faces many challenges to be practical, the availability of shorter-time EEW opens up a new door for earthquake loss mitigation. After an earthquake fault begins rupturing, an EEW system utilizes the first few seconds of recorded seismic waveform data to quickly predict the hypocenter location, magnitude, origin time and the expected shaking intensity level around the region. This early warning information is broadcast to different sites before the strong shaking arrives. The warning lead time of such a system is short, typically a few seconds to a minute or so, and the information is uncertain. These factors limit human intervention to activate mitigation actions and this must be addressed for engineering applications of EEW. This study applies a Bayesian probabilistic approach along with machine learning techniques and decision theories from economics to improve different aspects of EEW operation, including extending it to engineering applications. Existing EEW systems are often based on a deterministic approach. Often, they assume that only a single event occurs within a short period of time, which led to many false alarms after the Tohoku earthquake in Japan. This study develops a probability-based EEW algorithm based on an existing deterministic model to extend the EEW system to the case of concurrent events, which are often observed during the aftershock sequence after a large earthquake. To overcome the challenge of uncertain information and short lead time of EEW, this study also develops an earthquake probability-based automated decision-making (ePAD) framework to make robust decision for EEW mitigation applications. A cost-benefit model that

Integrating observation and statistical forecasts over sub-Saharan Africa to support Famine Early Warning

USGS Publications Warehouse

Funk, Chris; Verdin, James P.; Husak, Gregory

2007-01-01

Famine early warning in Africa presents unique challenges and rewards. Hydrologic extremes must be tracked and anticipated over complex and changing climate regimes. The successful anticipation and interpretation of hydrologic shocks can initiate effective government response, saving lives and softening the impacts of droughts and floods. While both monitoring and forecast technologies continue to advance, discontinuities between monitoring and forecast systems inhibit effective decision making. Monitoring systems typically rely on high resolution satellite remote-sensed normalized difference vegetation index (NDVI) and rainfall imagery. Forecast systems provide information on a variety of scales and formats. Non-meteorologists are often unable or unwilling to connect the dots between these disparate sources of information. To mitigate these problem researchers at UCSB's Climate Hazard Group, NASA GIMMS and USGS/EROS are implementing a NASA-funded integrated decision support system that combines the monitoring of precipitation and NDVI with statistical one-to-three month forecasts. We present the monitoring/forecast system, assess its accuracy, and demonstrate its application in food insecure sub-Saharan Africa.

Database of tsunami scenario simulations for Western Iberia: a tool for the TRIDEC Project Decision Support System for tsunami early warning

NASA Astrophysics Data System (ADS)

Armigliato, Alberto; Pagnoni, Gianluca; Zaniboni, Filippo; Tinti, Stefano

2013-04-01

TRIDEC is a EU-FP7 Project whose main goal is, in general terms, to develop suitable strategies for the management of crises possibly arising in the Earth management field. The general paradigms adopted by TRIDEC to develop those strategies include intelligent information management, the capability of managing dynamically increasing volumes and dimensionality of information in complex events, and collaborative decision making in systems that are typically very loosely coupled. The two areas where TRIDEC applies and tests its strategies are tsunami early warning and industrial subsurface development. In the field of tsunami early warning, TRIDEC aims at developing a Decision Support System (DSS) that integrates 1) a set of seismic, geodetic and marine sensors devoted to the detection and characterisation of possible tsunamigenic sources and to monitoring the time and space evolution of the generated tsunami, 2) large-volume databases of pre-computed numerical tsunami scenarios, 3) a proper overall system architecture. Two test areas are dealt with in TRIDEC: the western Iberian margin and the eastern Mediterranean. In this study, we focus on the western Iberian margin with special emphasis on the Portuguese coasts. The strategy adopted in TRIDEC plans to populate two different databases, called "Virtual Scenario Database" (VSDB) and "Matching Scenario Database" (MSDB), both of which deal only with earthquake-generated tsunamis. In the VSDB we simulate numerically few large-magnitude events generated by the major known tectonic structures in the study area. Heterogeneous slip distributions on the earthquake faults are introduced to simulate events as "realistically" as possible. The members of the VSDB represent the unknowns that the TRIDEC platform must be able to recognise and match during the early crisis management phase. On the other hand, the MSDB contains a very large number (order of thousands) of tsunami simulations performed starting from many different

Global Drought Services: Collaborations Toward an Information System for Early Warning

NASA Astrophysics Data System (ADS)

Hayes, M. J.; Pulwarty, R. S.; Svoboda, M.

2014-12-01

Drought is a hazard that lends itself well to diligent, sustained monitoring and early warning. However, unlike most hazards, the fact that droughts typically evolve slowly, can last for months or years and cover vast areas spanning multiple political boundaries/jurisdictions and economic sectors can make it a daunting task to monitor, develop plans for, and identify appropriate, proactive mitigation strategies. The National Drought Mitigation Center (NDMC) and National Integrated Drought Information System (NIDIS) have been working together to reduce societal vulnerability to drought by helping decision makers at all levels to: 1) implement drought early warning/forecasting and decision support systems; 2) support and advocate for better collection of, and understanding of drought impacts; and 3) increase long-term resilience to drought through proactive planning. The NDMC and NIDIS risk management approach has been the basis from which many partners around the world are developing a collaboration and coordination nexus with an ultimate goal of building comprehensive global drought early warning information systems (GDEWIS). The core emphasis of this model is on developing and applying useful and usable information that can be integrated and transferred freely to other regions around the globe. The High-Level Ministerial Declaration on Drought, the Integrated Drought Management Programme (IDMP) co-led by the WMO and the Global Water Partnership (GWP), and the Global Framework for Climate Services are drawing extensively from the integrated NDMC-NIDIS risk management framework. This presentation will describe, in detail, the various drought resources, tools, services, and collaborations already being provided and undertaken at the national and regional scales by the NDMC, NIDIS, and their partners. The presentation will be forward-looking, identifying improvements in existing and proposed mechanisms to help strengthen national and international drought early

Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

PubMed

North, Frederick; Richards, Debra D; Bremseth, Kimberly A; Lee, Mary R; Cox, Debra L; Varkey, Prathibha; Stroebel, Robert J

2014-03-20

Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed

Influence of warning information changes on emergency response

NASA Astrophysics Data System (ADS)

Heisterkamp, Tobias; Ulbrich, Uwe; Glade, Thomas; Tetzlaff, Gerd

2014-05-01

Mitigation and risk reduction of natural hazards is significantly related to the possibility of predicting the actual event. Some hazards can already be forecasted several days in advance. For these hazards, early warning systems have been developed, installed and improved over the years. The formation of winter storms for example can be recognized up to one week before they pass through Central Europe. This relative long early warning time has the advantage that forecasters can concretise the warnings over time. Therefore, warnings can even be adapted to alternating conditions within the process, the observation or changes in its modelling. Emergency managers are one group of warning recipients in the civil protection sector. They have to prepare or initiate prevention or response measures at a specific point of time, depending on the required lead time of the referring actions. At this point of time already, the forecast and its equivalent warning, has to be assumed as a stage of reality, hence the decision-makers have to come to a conclusion. These decisions are based on spatial and temporal knowledge of the forecasted event and the consequential situation of risk. With incoming warning updates, the detailed status of information is permanently being alternated. Consequently, decisions can be influenced by the development of the warning situation and the inherent tendency before a certain point of time. They can also be adapted to updates later on, according to the changing 'decision reality'. The influence of these dynamic hazard situations on operational planning and response by emergency managers is investigated in case studies on winter storms for Berlin, Germany. Therefore, the issued warnings by the weather service and data of operation of Berlin Fire Brigades are analysed and compared. This presentation shows and discusses first results.

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

Decision Support Tool Evaluation Report for Coral Reef Early Warning System (CREWS) Version 7.0

NASA Technical Reports Server (NTRS)

D'Sa, Eurico; Hall, Callie; Zanoni, Vicki; Holland, Donald; Blonski, Slawomir; Pagnutti, Mary; Spruce, Joseph P.

2004-01-01

The Coral Reef Early Warning System (CREWS) is operated by NOAA's Office of Oceanic and Atmospheric Research as part of its Coral Reef Watch program in response to the deteriorating global state of coral reef and related benthic ecosystems. In addition to sea surface temperatures (SSTs), the two most important parameters used by the CREWS network in generating coral reef bleaching alerts are 1) wind speed and direction and 2) photosynthetically available radiation (PAR). NASA remote sensing products that can enhance CREWS in these areas include SST and PAR products from the Moderate Resolution Imaging Spectroradiometer (MODIS) and wind data from the Quick Scatterometer (QuikSCAT). CREWS researchers are also interested in chlorophyll, chromophoric dissolved organic matter (CDOM), and salinity. Chlorophyll and CDOM are directly available as NASA products, while rainfall (an available NASA product) can be used as a proxy for salinity. Other potential NASA inputs include surface reflectance products from MODIS, the Advanced Spaceborne Thermal Emission and Reflection Radiometer, and Landsat. This report also identifies NASA-supported ocean circulation models and products from future satellite missions that might enchance the CREWS DST.

Towards a climate-driven dengue decision support system for Thailand

NASA Astrophysics Data System (ADS)

Lowe, Rachel; Cazelles, Bernard; Paul, Richard; Rodó, Xavier

2014-05-01

Dengue is a peri-urban mosquito-transmitted disease, ubiquitous in the tropics and the subtropics. The geographic distribution of dengue and its more severe form, dengue haemorrhagic fever (DHF), have expanded dramatically in the last decades and dengue is now considered to be the world's most important arboviral disease. Recent demographic changes have greatly contributed to the acceleration and spread of the disease along with uncontrolled urbanization, population growth and increased air travel, which acts as a mechanism for transporting and exchanging dengue viruses between endemic and epidemic populations. The dengue vector and virus are extremely sensitive to environmental conditions such as temperature, humidity and precipitation that influence mosquito biology, abundance and habitat and the virus replication speed. In order to control the spread of dengue and impede epidemics, decision support systems are required that take into account the multi-faceted array of factors that contribute to increased dengue risk. Due to availability of seasonal climate forecasts, that predict the average climate conditions for forthcoming months/seasons in both time and space, there is an opportunity to incorporate precursory climate information in a dengue decision support system to aid epidemic planning months in advance. Furthermore, oceanic indicators from teleconnected areas in the Pacific and Indian Ocean, that can provide some indication of the likely prevailing climate conditions in certain regions, could potentially extend predictive lead time in a dengue early warning system. In this paper we adopt a spatio-temporal Bayesian modelling framework for dengue in Thailand to support public health decision making. Monthly cases of dengue in the 76 provinces of Thailand for the period 1982-2012 are modelled using a multi-layered approach. Environmental explanatory variables at various spatial and temporal resolutions are incorporated into a hierarchical model in order to

Corruption Early Prevention: Decision Support System for President of the Republic of Indonesia

NASA Astrophysics Data System (ADS)

Sasmoko; Widhoyoko, S. A.; Ariyanto, S.; Indrianti, Y.; Noerlina; Muqsith, A. M.; Alamsyah, M.

2017-01-01

Corruption is an extraordinary crime, and then the prevention must also be extraordinary, simultaneously (national) in the form of early warning that involves all elements; government, industry, and society. To realize it the system needs to be built which in this study is called the Corruption Early Prevention (CEP) as a Decision Support System for President of the Republic of Indonesia. This study aims to examine 1) how is the construct of the Corruption Early Prevention as a Decision Support System for President of the Republic of Indonesia?, and 2) how is the design form of the system of Corruption Early Prevention as a Decision Support System for President of Republic of Indonesia? The research method is using Neuro-Research which is the collaboration of qualitative and quantitative research methods and the model development of Information Technology (IT). The research found that: 1) the construct of CEP is theoretically feasible, valid and reliable by content to be developed in the context of the prevention of corruption in Indonesia as an early prevention system that diagnoses Indonesia simultaneously and in real time, and 2) the concept of system design and business process of CEP is predicted to be realized in the IT-based program.

Preparing for floods: flood forecasting and early warning

NASA Astrophysics Data System (ADS)

Cloke, Hannah

2016-04-01

Flood forecasting and early warning has continued to stride ahead in strengthening the preparedness phases of disaster risk management, saving lives and property and reducing the overall impact of severe flood events. For example, continental and global scale flood forecasting systems such as the European Flood Awareness System and the Global Flood Awareness System provide early information about upcoming floods in real time to various decisionmakers. Studies have found that there are monetary benefits to implementing these early flood warning systems, and with the science also in place to provide evidence of benefit and hydrometeorological institutional outlooks warming to the use of probabilistic forecasts, the uptake over the last decade has been rapid and sustained. However, there are many further challenges that lie ahead to improve the science supporting flood early warning and to ensure that appropriate decisions are made to maximise flood preparedness.

30 CFR 75.208 - Warning devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Warning devices. 75.208 Section 75.208 Mineral... SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.208 Warning devices. Except during the installation of roof supports, the end of permanent roof support shall be posted with a readily visible warning...

30 CFR 75.208 - Warning devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Warning devices. 75.208 Section 75.208 Mineral... SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.208 Warning devices. Except during the installation of roof supports, the end of permanent roof support shall be posted with a readily visible warning...

30 CFR 75.208 - Warning devices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Warning devices. 75.208 Section 75.208 Mineral... SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.208 Warning devices. Except during the installation of roof supports, the end of permanent roof support shall be posted with a readily visible warning...

30 CFR 75.208 - Warning devices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Warning devices. 75.208 Section 75.208 Mineral... SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.208 Warning devices. Except during the installation of roof supports, the end of permanent roof support shall be posted with a readily visible warning...

30 CFR 75.208 - Warning devices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Warning devices. 75.208 Section 75.208 Mineral... SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.208 Warning devices. Except during the installation of roof supports, the end of permanent roof support shall be posted with a readily visible warning...

Clinical decision support improves quality of telephone triage documentation - an analysis of triage documentation before and after computerized clinical decision support

PubMed Central

2014-01-01

Background Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. Methods We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Results Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). Conclusions CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS

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

PubMed Central

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

2015-01-01

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

Effectiveness of text versus pictorial health warning labels and predictors of support for plain packaging of tobacco products within the European Union.

PubMed

Agaku, Israel T; Filippidis, Filippos T; Vardavas, Constantine I

2015-01-01

Tobacco product warning labels are a key health communication medium with plain packaging noted as the next step in the evolution of tobacco packaging. We assessed the self-reported impact of text versus pictorial health warnings and the determinants of support for plain packaging of tobacco products in the European Union (EU). The Special Eurobarometer 385 survey was analyzed for 26,566 adults from 27 EU countries in 2012. The self-reported impact of warning labels (text or pictorial) and determinants of EU-wide support for plain packaging were assessed using multivariate logistic regression. Current smokers in countries where cigarette pictorial warnings were implemented had higher odds of reporting that health warning labels had any effect on their smoking behavior (making a quit attempt or reducing number of cigarettes smoked per day) compared to respondents in countries with text-only warning labels (adjusted odds ratio, aOR = 1.31; 95% confidence interval, 95% CI: 1.10-1.56). Population support for plain packaging of tobacco packs was higher in countries where cigarette pictorial warnings already existed (aOR = 1.17; 95% CI: 1.07-1.28). These findings indicate that the implementation of pictorial warnings at an EU level may have a positive behavioral impact among smokers and pave the way for population support for plain packaging in the EU.

A Walk through TRIDEC's intermediate Tsunami Early Warning System

NASA Astrophysics Data System (ADS)

Hammitzsch, M.; Reißland, S.; Lendholt, M.

2012-04-01

The management of natural crises is an important application field of the technology developed in the project Collaborative, Complex, and Critical Decision-Support in Evolving Crises (TRIDEC), co-funded by the European Commission in its Seventh Framework Programme. TRIDEC is based on the development of the German Indonesian Tsunami Early Warning System (GITEWS) and the Distant Early Warning System (DEWS) providing a service platform for both sensor integration and warning dissemination. In TRIDEC new developments in Information and Communication Technology (ICT) are used to extend the existing platform realising a component-based technology framework for building distributed tsunami warning systems for deployment, e.g. in the North-eastern Atlantic, the Mediterranean and Connected Seas (NEAM) region. The TRIDEC system will be implemented in three phases, each with a demonstrator. Successively, the demonstrators are addressing challenges, such as the design and implementation of a robust and scalable service infrastructure supporting the integration and utilisation of existing resources with accelerated generation of large volumes of data. These include sensor systems, geo-information repositories, simulation tools and data fusion tools. In addition to conventional sensors also unconventional sensors and sensor networks play an important role in TRIDEC. The system version presented is based on service-oriented architecture (SOA) concepts and on relevant standards of the Open Geospatial Consortium (OGC), the World Wide Web Consortium (W3C) and the Organization for the Advancement of Structured Information Standards (OASIS). In this way the system continuously gathers, processes and displays events and data coming from open sensor platforms to enable operators to quickly decide whether an early warning is necessary and to send personalized warning messages to the authorities and the population at large through a wide range of communication channels. The system

Progress and challenges with Warn-on-Forecast

NASA Astrophysics Data System (ADS)

Stensrud, David J.; Wicker, Louis J.; Xue, Ming; Dawson, Daniel T.; Yussouf, Nusrat; Wheatley, Dustan M.; Thompson, Therese E.; Snook, Nathan A.; Smith, Travis M.; Schenkman, Alexander D.; Potvin, Corey K.; Mansell, Edward R.; Lei, Ting; Kuhlman, Kristin M.; Jung, Youngsun; Jones, Thomas A.; Gao, Jidong; Coniglio, Michael C.; Brooks, Harold E.; Brewster, Keith A.

2013-04-01

The current status and challenges associated with two aspects of Warn-on-Forecast-a National Oceanic and Atmospheric Administration research project exploring the use of a convective-scale ensemble analysis and forecast system to support hazardous weather warning operations-are outlined. These two project aspects are the production of a rapidly-updating assimilation system to incorporate data from multiple radars into a single analysis, and the ability of short-range ensemble forecasts of hazardous convective weather events to provide guidance that could be used to extend warning lead times for tornadoes, hailstorms, damaging windstorms and flash floods. Results indicate that a three-dimensional variational assimilation system, that blends observations from multiple radars into a single analysis, shows utility when evaluated by forecasters in the Hazardous Weather Testbed and may help increase confidence in a warning decision. The ability of short-range convective-scale ensemble forecasts to provide guidance that could be used in warning operations is explored for five events: two tornadic supercell thunderstorms, a macroburst, a damaging windstorm and a flash flood. Results show that the ensemble forecasts of the three individual severe thunderstorm events are very good, while the forecasts from the damaging windstorm and flash flood events, associated with mesoscale convective systems, are mixed. Important interactions between mesoscale and convective-scale features occur for the mesoscale convective system events that strongly influence the quality of the convective-scale forecasts. The development of a successful Warn-on-Forecast system will take many years and require the collaborative efforts of researchers and operational forecasters to succeed.

ForWarn: A Cross-Cutting Forest Resource Management and Decision Support System Providing the Capacity to Identify and Track Forest Disturbances Nationally

NASA Astrophysics Data System (ADS)

Hargrove, W. W.; Spruce, J.; Norman, S.; Christie, W.; Hoffman, F. M.

2012-12-01

The Eastern Forest Environmental Threat Assessment Center and Western Wildland Environmental Assessment Center of the USDA Forest Service have collaborated with NASA Stennis Space Center to develop ForWarn, a forest monitoring tool that uses MODIS satellite imagery to produce weekly snapshots of vegetation conditions across the lower 48 United States. Forest and natural resource managers can use ForWarn to rapidly detect, identify, and respond to unexpected changes in the nation's forests caused by insects, diseases, wildfires, severe weather, or other natural or human-caused events. ForWarn detects most types of forest disturbances, including insects, disease, wildfires, frost and ice damage, tornadoes, hurricanes, blowdowns, harvest, urbanization, and landslides. It also detects drought, flood, and temperature effects, and shows early and delayed seasonal vegetation development. Operating continuously since January 2010, results show ForWarn to be a robust and highly capable tool for detecting changes in forest conditions. ForWarn is the first national-scale system of its kind based on remote sensing developed specifically for forest disturbances. It has operated as a prototype since January 2010 and has provided useful information about the location and extent of disturbances detected during the 2011 growing season, including tornadoes, wildfires, and extreme drought. The ForWarn system had an official unveiling and rollout in March 2012, initiated by a joint NASA and USDA press release. The ForWarn home page has had 2,632 unique visitors since rollout in March 2012, with 39% returning visits. ForWarn was used to map tornado scars from the historic April 27, 2011 tornado outbreak, and detected timber damage within more than a dozen tornado tracks across northern Mississippi, Alabama, and Georgia. ForWarn is the result of an ongoing, substantive cooperation among four different government agencies: USDA, NASA, USGS, and DOE. Disturbance maps are available on the

Medication-related clinical decision support alert overrides in inpatients.

PubMed

Nanji, Karen C; Seger, Diane L; Slight, Sarah P; Amato, Mary G; Beeler, Patrick E; Her, Qoua L; Dalleur, Olivia; Eguale, Tewodros; Wong, Adrian; Silvers, Elizabeth R; Swerdloff, Michael; Hussain, Salman T; Maniam, Nivethietha; Fiskio, Julie M; Dykes, Patricia C; Bates, David W

2018-05-01

To define the types and numbers of inpatient clinical decision support alerts, measure the frequency with which they are overridden, and describe providers' reasons for overriding them and the appropriateness of those reasons. We conducted a cross-sectional study of medication-related clinical decision support alerts over a 3-year period at a 793-bed tertiary-care teaching institution. We measured the rate of alert overrides, the rate of overrides by alert type, the reasons cited for overrides, and the appropriateness of those reasons. Overall, 73.3% of patient allergy, drug-drug interaction, and duplicate drug alerts were overridden, though the rate of overrides varied by alert type (P < .0001). About 60% of overrides were appropriate, and that proportion also varied by alert type (P < .0001). Few overrides of renal- (2.2%) or age-based (26.4%) medication substitutions were appropriate, while most duplicate drug (98%), patient allergy (96.5%), and formulary substitution (82.5%) alerts were appropriate. Despite warnings of potential significant harm, certain categories of alert overrides were inappropriate >75% of the time. The vast majority of duplicate drug, patient allergy, and formulary substitution alerts were appropriate, suggesting that these categories of alerts might be good targets for refinement to reduce alert fatigue. Almost three-quarters of alerts were overridden, and 40% of the overrides were not appropriate. Future research should optimize alert types and frequencies to increase their clinical relevance, reducing alert fatigue so that important alerts are not inappropriately overridden.

Early Warning Indicator System: Supporting K-12 Educators in the Identification, Support, and Monitoring of At-Risk Students

ERIC Educational Resources Information Center

Massachusetts Department of Elementary and Secondary Education, 2016

2016-01-01

A rise in data availability gives educators the opportunity to tailor instructional practices and interventions to student needs and invest resources in areas where students require the most support. Massachusetts developed the Early Warning Indicator System (EWIS), which synthesizes the wealth of student data available in the state, including…

Potential economic value of drought information to support early warning in Africa

NASA Astrophysics Data System (ADS)

Quiroga, S.; Iglesias, A.; Diz, A.; Garrote, L.

2012-04-01

We present a methodology to estimate the economic value of advanced climate information for food production in Africa under climate change scenarios. The results aim to facilitate better choices in water resources management. The methodology includes 4 sequential steps. First two contrasting management strategies (with and without early warning) are defined. Second, the associated impacts of the management actions are estimated by calculating the effect of drought in crop productivity under climate change scenarios. Third, the optimal management option is calculated as a function of the drought information and risk aversion of potential information users. Finally we use these optimal management simulations to compute the economic value of enhanced water allocation rules to support stable food production in Africa. Our results show how a timely response to climate variations can help reduce loses in food production. The proposed framework is developed within the Dewfora project (Early warning and forecasting systems to predict climate related drought vulnerability and risk in Africa) that aims to improve the knowledge on drought forecasting, warning and mitigation, and advance the understanding of climate related vulnerability to drought and to develop a prototype operational forecasting.

Building strategies for tsunami scenarios databases to be used in a tsunami early warning decision support system: an application to western Iberia

NASA Astrophysics Data System (ADS)

Tinti, S.; Armigliato, A.; Pagnoni, G.; Zaniboni, F.

2012-04-01

One of the most challenging goals that the geo-scientific community is facing after the catastrophic tsunami occurred on December 2004 in the Indian Ocean is to develop the so-called "next generation" Tsunami Early Warning Systems (TEWS). Indeed, the meaning of "next generation" does not refer to the aim of a TEWS, which obviously remains to detect whether a tsunami has been generated or not by a given source and, in the first case, to send proper warnings and/or alerts in a suitable time to all the countries and communities that can be affected by the tsunami. Instead, "next generation" identifies with the development of a Decision Support System (DSS) that, in general terms, relies on 1) an integrated set of seismic, geodetic and marine sensors whose objective is to detect and characterise the possible tsunamigenic sources and to monitor instrumentally the time and space evolution of the generated tsunami, 2) databases of pre-computed numerical tsunami scenarios to be suitably combined based on the information coming from the sensor environment and to be used to forecast the degree of exposition of different coastal places both in the near- and in the far-field, 3) a proper overall (software) system architecture. The EU-FP7 TRIDEC Project aims at developing such a DSS and has selected two test areas in the Euro-Mediterranean region, namely the western Iberian margin and the eastern Mediterranean (Turkish coasts). In this study, we discuss the strategies that are being adopted in TRIDEC to build the databases of pre-computed tsunami scenarios and we show some applications to the western Iberian margin. In particular, two different databases are being populated, called "Virtual Scenario Database" (VSDB) and "Matching Scenario Database" (MSDB). The VSDB contains detailed simulations of few selected earthquake-generated tsunamis. The cases provided by the members of the VSDB are computed "real events"; in other words, they represent the unknowns that the TRIDEC

Decision Support Framework (DSF) (Formerly Decision Support Platform)

EPA Science Inventory

The Science Advisory Board (SAB) provided several comments on the draft Ecosystem Services Research Program's (ESRP's) Multi-Year Plan (MYP). This presentation provides a response to comments related to the decision support framework (DSF) part of Long-Term Goal 1. The comments...

Weighting Statistical Inputs for Data Used to Support Effective Decision Making During Severe Emergency Weather and Environmental Events

NASA Technical Reports Server (NTRS)

Gardner, Adrian

2010-01-01

National Aeronautical and Space Administration (NASA) weather and atmospheric environmental organizations are insatiable consumers of geophysical, hydrometeorological and solar weather statistics. The expanding array of internet-worked sensors producing targeted physical measurements has generated an almost factorial explosion of near real-time inputs to topical statistical datasets. Normalizing and value-based parsing of such statistical datasets in support of time-constrained weather and environmental alerts and warnings is essential, even with dedicated high-performance computational capabilities. What are the optimal indicators for advanced decision making? How do we recognize the line between sufficient statistical sampling and excessive, mission destructive sampling ? How do we assure that the normalization and parsing process, when interpolated through numerical models, yields accurate and actionable alerts and warnings? This presentation will address the integrated means and methods to achieve desired outputs for NASA and consumers of its data.

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

NASA Astrophysics Data System (ADS)

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

2014-05-01

Natural hazard risk management requires decision making in several stages. Decision making on alternatives for risk reduction planning starts with an intelligence phase for recognition of the decision problems and identifying the objectives. Development of the alternatives and assigning the variable by decision makers to each alternative are employed to the design phase. Final phase evaluates the optimal choice by comparing the alternatives, defining indicators, assigning a weight to each and ranking them. This process is referred to as Multi-Criteria Decision Making analysis (MCDM), Multi-Criteria Evaluation (MCE) or Multi-Criteria Analysis (MCA). In the framework of the ongoing 7th Framework Program "CHANGES" (2011-2014, Grant Agreement No. 263953) of the European Commission, a Spatial Decision Support System is under development, that has the aim to analyse changes in hydro-meteorological risk and provide support to selecting the best risk reduction alternative. This paper describes the module for Multi-Criteria Decision Making analysis (MCDM) that incorporates monetary and non-monetary criteria in the analysis of the optimal alternative. The MCDM module consists of several components. The first step is to define criteria (or Indicators) which are subdivided into disadvantages (criteria that indicate the difficulty for implementing the risk reduction strategy, also referred to as Costs) and advantages (criteria that indicate the favorability, also referred to as benefits). In the next step the stakeholders can use the developed web-based tool for prioritizing criteria and decision matrix. Public participation plays a role in decision making and this is also planned through the use of a mobile web-version where the general local public can indicate their agreement on the proposed alternatives. The application is being tested through a case study related to risk reduction of a mountainous valley in the Alps affected by flooding. Four alternatives are evaluated in

Decision support for clinical laboratory capacity planning.

PubMed

van Merode, G G; Hasman, A; Derks, J; Goldschmidt, H M; Schoenmaker, B; Oosten, M

1995-01-01

The design of a decision support system for capacity planning in clinical laboratories is discussed. The DSS supports decisions concerning the following questions: how should the laboratory be divided into job shops (departments/sections), how should staff be assigned to workstations and how should samples be assigned to workstations for testing. The decision support system contains modules for supporting decisions at the overall laboratory level (concerning the division of the laboratory into job shops) and for supporting decisions at the job shop level (assignment of staff to workstations and sample scheduling). Experiments with these modules are described showing both the functionality and the validity.

Bayesian Decision Support

NASA Astrophysics Data System (ADS)

Berliner, M.

2017-12-01

Bayesian statistical decision theory offers a natural framework for decision-policy making in the presence of uncertainty. Key advantages of the approach include efficient incorporation of information and observations. However, in complicated settings it is very difficult, perhaps essentially impossible, to formalize the mathematical inputs needed in the approach. Nevertheless, using the approach as a template is useful for decision support; that is, organizing and communicating our analyses. Bayesian hierarchical modeling is valuable in quantifying and managing uncertainty such cases. I review some aspects of the idea emphasizing statistical model development and use in the context of sea-level rise.

Toward the Modularization of Decision Support Systems

NASA Astrophysics Data System (ADS)

Raskin, R. G.

2009-12-01

Decision support systems are typically developed entirely from scratch without the use of modular components. This “stovepiped” approach is inefficient and costly because it prevents a developer from leveraging the data, models, tools, and services of other developers. Even when a decision support component is made available, it is difficult to know what problem it solves, how it relates to other components, or even that the component exists, The Spatial Decision Support (SDS) Consortium was formed in 2008 to organize the body of knowledge in SDS within a common portal. The portal identifies the canonical steps in the decision process and enables decision support components to be registered, categorized, and searched. This presentation describes how a decision support system can be assembled from modular models, data, tools and services, based on the needs of the Earth science application.

A Decision Support System for Tele-Monitoring COPD-Related Worrisome Events.

PubMed

Merone, Mario; Pedone, Claudio; Capasso, Giuseppe; Incalzi, Raffaele Antonelli; Soda, Paolo

2017-03-01

Chronic Obstructive Pulmonary Disease (COPD) is a preventable, treatable, and slowly progressive disease, whose course is aggravated by a periodic worsening of symptoms and lung function lasting for several days. The development of home telemonitoring systems has made possible to collect symptoms and physiological data in electronic records, boosting the development of decision support systems (DSSs). Current DSSs work with physiological measurements collected by means of several measuring and communication devices as well as with symptoms gathered by questionnaires submitted to COPD subjects. However, this contrasts with the advices provided by the World Health Organization and the Global initiative for chronic Obstructive Lung Disease that recommend to avoid invasive or complex daily measurements. For these reasons this manuscript presents a DSS detecting the onset of worrisome events in COPD subjects. It uses the hearth rate and the oxygen saturation, which can be collected via a pulse oximeter. The DSS consists in a binary finite state machine, whose training stage allows a subject specific personalization of the predictive model, triggering warnings, and alarms as the health status evolves over time. The experiments on data collected from 22 COPD patients tele-monitored at home for six months show that the system recognition performance is better than the one achieved by medical experts. Furthermore, the support offered by the system in the decision-making process allows to increase the agreement between the specialists, largely impacting the recognition of the worrisome events.

A decision-supported outpatient practice system.

PubMed Central

Barrows, R. C.; Allen, B. A.; Smith, K. C.; Arni, V. V.; Sherman, E.

1996-01-01

We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed. PMID:8947774

Decision Support for Ecosystem Management (Chapter 28)

Treesearch

Keith Reynolds; Jennifer Bjork; Rachel Riemann Hershey; Dan Schmoldt; John Payne; Susan King; Lee DeCola; Mark J. Twery; Pat Cunningham

1999-01-01

This chapter presents a management perspective on decision support for ecosystem management.The Introduction provides a brief historical overview of decision support technology as it has been used in natural resource management, discusses the role of decision support in ecosystem management as we see it, and summarizes the current state of the technology.

Merging Air Quality and Public Health Decision Support Systems

NASA Astrophysics Data System (ADS)

Hudspeth, W. B.; Bales, C. L.

2003-12-01

The New Mexico Air Quality Mapper (NMAQM) is a Web-based, open source GIS prototype application that Earth Data Analysis Center is developing under a NASA Cooperative Agreement. NMAQM enhances and extends existing data and imagery delivery systems with an existing Public Health system called the Rapid Syndrome Validation Project (RSVP). RSVP is a decision support system operating in several medical and public health arenas. It is evolving to ingest remote sensing data as input to provide early warning of human health threats, especially those related to anthropogenic atmospheric pollutants and airborne pathogens. The NMAQM project applies measurements of these atmospheric pollutants, derived from both remotely sensed data as well as from in-situ air quality networks, to both forecasting and retrospective analyses that influence human respiratory health. NMAQM provides a user-friendly interface for visualizing and interpreting environmentally-linked epidemiological phenomena. The results, and the systems made to provide the information, will be applicable not only to decision-makers in the public health realm, but also to air quality organizations, demographers, community planners, and other professionals in information technology, and social and engineering sciences. As an accessible and interactive mapping and analysis application, it allows environment and health personnel to study historic data for hypothesis generation and trend analysis, and then, potentially, to predict air quality conditions from daily data acquisitions. Additional spin off benefits to such users include the identification of gaps in the distribution of in-situ monitoring stations, the dissemination of air quality data to the public, and the discrimination of local vs. more regional sources of air pollutants that may bear on decisions relating to public health and public policy.

Preparing for a decision support system.

PubMed

Callan, K

2000-08-01

The increasing pressure to reduce costs and improve outcomes is driving the health care industry to view information as a competitive advantage. Timely information is required to help reduce inefficiencies and improve patient care. Numerous disparate operational or transactional information systems with inconsistent and often conflicting data are no longer adequate to meet the information needs of integrated care delivery systems and networks in competitive managed care environments. This article reviews decision support system characteristics and describes a process to assess the preparedness of an organization to implement and use decision support systems to achieve a more effective, information-based decision process. Decision support tools included in this article range from reports to data mining.

False alarms and missed events: the impact and origins of perceived inaccuracy in tornado warning systems.

PubMed

Ripberger, Joseph T; Silva, Carol L; Jenkins-Smith, Hank C; Carlson, Deven E; James, Mark; Herron, Kerry G

2015-01-01

Theory and conventional wisdom suggest that errors undermine the credibility of tornado warning systems and thus decrease the probability that individuals will comply (i.e., engage in protective action) when future warnings are issued. Unfortunately, empirical research on the influence of warning system accuracy on public responses to tornado warnings is incomplete and inconclusive. This study adds to existing research by analyzing two sets of relationships. First, we assess the relationship between perceptions of accuracy, credibility, and warning response. Using data collected via a large regional survey, we find that trust in the National Weather Service (NWS; the agency responsible for issuing tornado warnings) increases the likelihood that an individual will opt for protective action when responding to a hypothetical warning. More importantly, we find that subjective perceptions of warning system accuracy are, as theory suggests, systematically related to trust in the NWS and (by extension) stated responses to future warnings. The second half of the study matches survey data against NWS warning and event archives to investigate a critical follow-up question--Why do some people perceive that their warning system is accurate, whereas others perceive that their system is error prone? We find that subjective perceptions are--in part-a function of objective experience, knowledge, and demographic characteristics. When considered in tandem, these findings support the proposition that errors influence perceptions about the accuracy of warning systems, which in turn impact the credibility that people assign to information provided by systems and, ultimately, public decisions about how to respond when warnings are issued. © 2014 Society for Risk Analysis.

Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores.

PubMed

Skyttberg, Niclas; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2017-08-30

Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores. The study also provides reference data on triage vital signs in Swedish emergency care. We extracted a dataset including vital signs, demographic and administrative data from emergency care visits (n=335027) at five Swedish emergency hospitals during 2013 using either completely paper-based, completely electronic or mixed documentation practices. Descriptive statistics were used to assess fitness for use in emergency care decision support systems aiming to calculate warning and triage scores, and data quality was described in three categories: currency, completeness and correctness. To estimate correctness, two further categories - plausibility and concordance - were used. The study showed an acceptable correctness of the registered vital signs irrespectively of the type of documentation practice. Completeness was high in sites where registrations were routinely entered into the Electronic Health Record (EHR). The currency was only acceptable in sites with a completely electronic documentation practice. Although vital signs that were recorded in completely electronic documentation practices showed plausible results regarding correctness, completeness and currency, the study concludes that vital signs documented in Swedish emergency care EHRs cannot generally be considered fit for use for calculation of triage and warning scores. Low completeness and currency were found if the documentation was not completely

The Heat Is On: Decision-Maker Perspectives on When and How to Issue a Heat Warning

NASA Astrophysics Data System (ADS)

O'Neill, M.; Sampson, N.; McCormick, S.; Rood, R. B.; Buxton, M.; Ebi, K. L.; Gronlund, C. J.; Zhang, K.; Catalano, L.; White-Newsome, J. L.; Conlon, K. C.; Parker, E. A.

2011-12-01

To better understand how to prevent illness and deaths during hot weather, particularly among at-risk populations, we conducted a study in Detroit, Michigan; Phoenix, Arizona; New York, New York, and Philadelphia, Pennsylvania. Our aims were to characterize and better understand how heatwave and health early warning systems (HHWS) and related prevention and sustainability programs can be more widely and effectively implemented. Specifically, we here report on the scientific evidence, expert judgments and the process used in deciding to trigger a HHWS and activate public health and social services interventions. We conducted interviews with public officials who decide if and when heat advisories/warnings are issued. After transcribing the interviews, we used a qualitative analysis software, QSR NVivo 9.0, to assign codes to portions of text from each transcript and allow analysis of information with common themes across the data. For example, several sentences in a transcript discussing a heat index might be coded as 'definition of heat wave'. A common theme across cities was that deciding what type of weather is dangerous to health is not straightforward. The time in season that heat occurs; the duration of the heat; the level of humidity and other meteorological factors; the extent to which temperatures drop at night, allowing people to cool off; and prevailing weather conditions all play a role. A single 'safe' threshold is unrealistic because people's individual sensitivity, housing, surrounding environments, behaviors, and access to air conditioning can differ greatly. However, choices must be made as to the trigger for the HHWS. Although quantitative analysis with health data (mortality, hospital admissions) can inform the design of the triggers, historical analysis has limitations, and decisions to issue heat warnings are sometimes related to planned activities, such as parades or fairs, that may expose large numbers of people to heat. The HHWS approach

Development of the Supported Decision Making Inventory System.

PubMed

Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan

2017-12-01

Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.

Impacts Assessment of Dynamic Speed Harmonization with Queue Warning : Task 3, Impacts Assessment Report. [supporting datasets

DOT National Transportation Integrated Search

2015-05-31

The datasets in the .pdf and .zip attached to this record are in support of Intelligent Transportation Systems Joint Program Office (ITS JPO) report FHWA-JPO-15-222, "Impacts Assessment of Dynamic Speed Harmonization with Queue Warning : Task 3, Impa...

Warning Alert HITL Experiment Results

NASA Technical Reports Server (NTRS)

Monk, Kevin J.; Ferm, Lisa; Roberts, Zach

2018-01-01

Minimum Operational Performance Standards (MOPS) are being developed to support the integration of Unmanned Aircraft Systems (UAS) in the National Airspace (NAS). Input from subject matter experts and multiple research studies have informed display requirements for Detect-and-Avoid (DAA) systems aimed at supporting timely and appropriate pilot responses to collision hazards. Phase 1 DAA MOPS alerting is designed to inform pilots if an avoidance maneuver is necessary; the two highest alert levels - caution and warning - indicate how soon pilot action is required and whether there is adequate time to coordinate with the air traffic controller (ATC). Additional empirical support is needed to clarify the extent to which warning-level alerting impacts DAA task performance. The present study explores the differential effects of the auditory and visual cues provided by the DAA Warning alert, and performance implications compared to caution-only alerting are discussed.

Developing Drought Outlook Forums in Support of a Regional Drought Early Warning Information System

NASA Astrophysics Data System (ADS)

Mcnutt, C. A.; Pulwarty, R. S.; Darby, L. S.; Verdin, J. P.; Webb, R. S.

2011-12-01

The National Integrated Drought Information System (NIDIS) Act of 2006 (P.L. 109-430) charged NIDIS with developing the leadership and partnerships necessary to implement an integrated national drought monitoring and forecasting system that creates a drought "early warning system". The drought early warning information system should be capable of providing accurate, timely and integrated information on drought conditions at the relevant spatial scale to facilitate proactive decisions aimed at minimizing the economic, social and ecosystem losses associated with drought. As part of this effort, NIDIS has held Regional Drought Outlook Forums in several regions of the U.S. The purpose of the Forums is to inform practices that reduce vulnerability to drought through an interactive and collaborative process that includes the users of the information. The Forums have focused on providing detailed assessments of present conditions and impacts, comparisons with past drought events, and seasonal predictions including discussion of the state and expected evolution of the El Niño Southern Oscillation phenomena. Regional Climate Outlook Forums (RCOFs) that include close interaction between information providers and users are not a new concept, however. RCOFs started in Africa in the 1990s in response to the 1997-98 El Niño and have since expanded to South America, Asia, the Pacific islands, and the Caribbean. As a result of feedback from the RCOFs a large body of research has gone into improving seasonal forecasts and the capacity of the users to apply the information in a way that improves their decision-making. Over time, it has become clear that more is involved than just improving the interaction between the climate forecasters and decision-makers. NIDIS is using the RCOF approach as one component in a larger effort to develop Regional Drought Early Warning Information Systems (RDEWS) around the U.S. Using what has been learned over the past decade in the RCOF process

An early warning system for flash floods in Egypt

NASA Astrophysics Data System (ADS)

Cools, J.; Abdelkhalek, A.; El Sammany, M.; Fahmi, A. H.; Bauwens, W.; Huygens, M.

2009-09-01

This paper describes the development of the Flash Flood Manager, abbreviated as FlaFloM. The Flash Flood Manager is an early warning system for flash floods which is developed under the EU LIFE project FlaFloM. It is applied to Wadi Watier located in the Sinai peninsula (Egypt) and discharges in the Red Sea at the local economic and tourist hub of Nuweiba city. FlaFloM consists of a chain of four modules: 1) Data gathering module, 2) Forecasting module, 3) Decision support module or DSS and 4) Warning module. Each module processes input data and consequently send the output to the following module. In case of a flash flood emergency, the final outcome of FlaFloM is a flood warning which is sent out to decision-makers. The ‘data gathering module’ collects input data from different sources, validates the input, visualise data and exports it to other modules. Input data is provided ideally as water stage (h), discharge (Q) and rainfall (R) through real-time field measurements and external forecasts. This project, however, as occurs in many arid flash flood prone areas, was confronted with a scarcity of data, and insufficient insight in the characteristics that release a flash flood. Hence, discharge and water stage data were not available. Although rainfall measurements are available through classical off line rain gauges, the sparse rain gauges network couldn’t catch the spatial and temporal characteristics of rainfall events. To overcome this bottleneck, we developed rainfall intensity raster maps (mm/hr) with an hourly time step and raster cell of 1*1km. These maps are derived through downscaling from two sources of global instruments: the weather research and forecasting model (WRF) and satellite estimates from the Tropical Rainfall Measuring Mission (TRMM). The ‘forecast module’ comprises three numerical models that, using data from the gathering module performs simulations on command: a rainfall-runoff model, a river flow model, and a flood model. A

The effectiveness of current French health warnings displayed on alcohol advertisements and alcoholic beverages.

PubMed

Dossou, Gloria; Gallopel-Morvan, Karine; Diouf, Jacques-François

2017-08-01

Many countries use health warnings in an attempt to regulate alcohol consumption. However, there is a lack of conclusive evidence in the research on alcohol warnings to support decision-making on effective health policies. This study explores the effectiveness of two mandatory warnings introduced in France in 1991 and 2007: the first (Alcohol abuse is harmful) is displayed on alcohol advertisements; the second (a pictogram) on bottles. Given that advertising content regulations have been implemented in some countries to reduce the attractiveness of alcohol marketing (e.g. the Evin law in France), this research also aims to explore whether such regulations can improve the effectiveness of warnings. In-depth interviews were conducted with 26 French people aged 15-29 years. The effectiveness of health warnings was assessed in terms of recall, noticeability, credibility, comprehension, responsiveness, and ability to encourage moderate drinking and abstinence during pregnancy. Participants were shown alcohol advertisements and bottles that either followed or challenged content regulations. The data were analyzed using double manual coding and NVivo software. While both warnings suffered from a lack of visibility and noticeability due to their size, location, and outdatedness and because of competition from marketing design elements, the warning on the advertisement that followed content regulations was most visible. Both warnings were considered to be informationally vague, lacking in credibility and ineffective in terms of making participants feel concerned and influencing consumption habits. Current French warnings are ineffective and require modification. Improvements are suggested regarding the design and content of warnings to help increase their effectiveness. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

REWSET: A prototype seismic and tsunami early warning system in Rhodes island, Greece

NASA Astrophysics Data System (ADS)

Papadopoulos, Gerasimos; Argyris, Ilias; Aggelou, Savvas; Karastathis, Vasilis

2014-05-01

Tsunami warning in near-field conditions is a critical issue in the Mediterranean Sea since the most important tsunami sources are situated within tsunami wave travel times starting from about five minutes. The project NEARTOWARN (2012-2013) supported by the EU-DG ECHO contributed substantially to the development of new tools for the near-field tsunami early warning in the Mediterranean. One of the main achievements is the development of a local warning system in the test-site of Rhodes island (Rhodes Early Warning System for Earthquakes and Tsunamis - REWSET). The system is composed by three main subsystems: (1) a network of eight seismic early warning devices installed in four different localities of the island, one in the civil protection, another in the Fire Brigade and another two in municipality buildings; (2) two radar-type (ultrasonic) tide-gauges installed in the eastern coastal zine of the island which was selected since research on the historical earthquake and tsunami activity has indicated that the most important, near-field tsunami sources are situated offshore to the east of Rhodes; (3) a crisis Geographic Management System (GMS), which is a web-based and GIS-based application incorporating a variety of thematic maps and other information types. The seismic early warning devices activate by strong (magnitude around 6 or more) earthquakes occurring at distances up to about 100 km from Rhodes, thus providing immediate mobilization of the civil protection. The tide-gauges transmit sea level data, while during the crisis the GMS supports decisions to be made by civil protection. In the near future it is planned the REWSET system to be integrated with national and international systems. REWSET is a prototype which certainly could be developed in other coastal areas of the Mediterranean and beyond.

Visualization Component of Vehicle Health Decision Support System

NASA Technical Reports Server (NTRS)

Jacob, Joseph; Turmon, Michael; Stough, Timothy; Siegel, Herbert; Walter, patrick; Kurt, Cindy

2008-01-01

The visualization front-end of a Decision Support System (DSS) also includes an analysis engine linked to vehicle telemetry, and a database of learned models for known behaviors. Because the display is graphical rather than text-based, the summarization it provides has a greater information density on one screen for evaluation by a flight controller.This tool provides a system-level visualization of the state of a vehicle, and drill-down capability for more details and interfaces to separate analysis algorithms and sensor data streams. The system-level view is a 3D rendering of the vehicle, with sensors represented as icons, tied to appropriate positions within the vehicle body and colored to indicate sensor state (e.g., normal, warning, anomalous state, etc.). The sensor data is received via an Information Sharing Protocol (ISP) client that connects to an external server for real-time telemetry. Users can interactively pan, zoom, and rotate this 3D view, as well as select sensors for a detail plot of the associated time series data. Subsets of the plotted data can be selected and sent to an external analysis engine to either search for a similar time series in an historical database, or to detect anomalous events. The system overview and plotting capabilities are completely general in that they can be applied to any vehicle instrumented with a collection of sensors. This visualization component can interface with the ISP for data streams used by NASA s Mission Control Center at Johnson Space Center. In addition, it can connect to, and display results from, separate analysis engine components that identify anomalies or that search for past instances of similar behavior. This software supports NASA's Software, Intelligent Systems, and Modeling element in the Exploration Systems Research and Technology Program by augmenting the capability of human flight controllers to make correct decisions, thus increasing safety and reliability. It was designed specifically as a

Near the conflagration: the wide duty to warn.

PubMed

Helminski, F

1993-07-01

The "duty to warn" has become fixed in US law since the 1976 case of Tarasoff v Regents of the University of California. In that case, the California Supreme Court decided that psychotherapists whose patients make a specific, serious threat of violence against a specific, clearly identifiable potential victim have a duty to warn the intended victim, directly or indirectly, of the threat. Tarasoff inspired several successful and unsuccessful lawsuits. A recent Vermont case has extended the duty to warn in that state to a threat of damage to property when persons may be physically harmed. The duty to warn is explicitly based on considerations of social utility and, as such, is attractive for courts to expand because an apparently minimal effort by therapists will often prevent substantial harm to victims. Some states have codified the duty to warn in a statute, but other states have refused to adopt the Tarasoff reasoning. In the absence of clear legal decisions to the contrary, psychotherapists may well anticipate that the duty to warn operates in their states.

Decision support systems in health economics.

PubMed

Quaglini, S; Dazzi, L; Stefanelli, M; Barosi, G; Marchetti, M

1999-08-01

This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

Early Warning System Implementation Guide: For Use with the National High School Center's Early Warning System Tool v2.0

ERIC Educational Resources Information Center

Therriault, Susan Bowles; Heppen, Jessica; O'Cummings, Mindee; Fryer, Lindsay; Johnson, Amy

2010-01-01

This Early Warning System (EWS) Implementation Guide is a supporting document for schools and districts that are implementing the National High School Center's Early Warning System (EWS) Tool v2.0. Developed by the National High School Center at the American Institutes for Research (AIR), the guide and tool support the establishment and…

Geospatial decision support systems for societal decision making

USGS Publications Warehouse

Bernknopf, R.L.

2005-01-01

While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the

Nurses' Clinical Decision Making on Adopting a Wound Clinical Decision Support System.

PubMed

Khong, Peck Chui Betty; Hoi, Shu Yin; Holroyd, Eleanor; Wang, Wenru

2015-07-01

Healthcare information technology systems are considered the ideal tool to inculcate evidence-based nursing practices. The wound clinical decision support system was built locally to support nurses to manage pressure ulcer wounds in their daily practice. However, its adoption rate is not optimal. The study's objective was to discover the concepts that informed the RNs' decisions to adopt the wound clinical decision support system as an evidence-based technology in their nursing practice. This was an exploratory, descriptive, and qualitative design using face-to-face interviews, individual interviews, and active participatory observation. A purposive, theoretical sample of 14 RNs was recruited from one of the largest public tertiary hospitals in Singapore after obtaining ethics approval. After consenting, the nurses were interviewed and observed separately. Recruitment stopped when data saturation was reached. All transcribed interview data underwent a concurrent thematic analysis, whereas observational data were content analyzed independently and subsequently triangulated with the interview data. Eight emerging themes were identified, namely, use of the wound clinical decision support system, beliefs in the wound clinical decision support system, influences of the workplace culture, extent of the benefits, professional control over nursing practices, use of knowledge, gut feelings, and emotions (fear, doubt, and frustration). These themes represented the nurses' mental outlook as they made decisions on adopting the wound clinical decision support system in light of the complexities of their roles and workloads. This research has provided insight on the nurses' thoughts regarding their decision to interact with the computer environment in a Singapore context. It captured the nurses' complex thoughts when deciding whether to adopt or reject information technology as they practice in a clinical setting.

Supporting end of life decision making: Case studies of relational closeness in supported decision making for people with severe or profound intellectual disability.

PubMed

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-11-01

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions. Five people with severe or profound intellectual disability's experiences of supported decision making were examined. This article is particularly focused on one participant's experiences at the end of his life. All five case studies identified that supporters were most effective in providing decision-making support for participants when they were relationally close to the person and had knowledge of the person's life story, particularly in relation to events that demonstrated preference. Findings from this study provide new understandings of supported decision making for people with severe or profound intellectual disability and have particular relevance for supporting decision making at the end of life. © 2017 John Wiley & Sons Ltd.

Features of computerized clinical decision support systems supportive of nursing practice: a literature review.

PubMed

Lee, Seonah

2013-10-01

This study aimed to organize the system features of decision support technologies targeted at nursing practice into assessment, problem identification, care plans, implementation, and outcome evaluation. It also aimed to identify the range of the five stage-related sequential decision supports that computerized clinical decision support systems provided. MEDLINE, CINAHL, and EMBASE were searched. A total of 27 studies were reviewed. The system features collected represented the characteristics of each category from patient assessment to outcome evaluation. Several features were common across the reviewed systems. For the sequential decision support, all of the reviewed systems provided decision support in sequence for patient assessment and care plans. Fewer than half of the systems included problem identification. There were only three systems operating in an implementation stage and four systems in outcome evaluation. Consequently, the key steps for sequential decision support functions were initial patient assessment, problem identification, care plan, and outcome evaluation. Providing decision support in such a full scope will effectively help nurses' clinical decision making. By organizing the system features, a comprehensive picture of nursing practice-oriented computerized decision support systems was obtained; however, the development of a guideline for better systems should go beyond the scope of a literature review.

Advanced decision support for winter road maintenance

DOT National Transportation Integrated Search

2008-01-01

This document provides an overview of the Federal Highway Administration's winter Maintenance Decision Support System (MDSS). The MDSS is a decision support tool that has the ability to provide weather predictions focused toward the road surface. The...

Aircraft Cabin Turbulence Warning Experiment

NASA Technical Reports Server (NTRS)

Bogue, Rodney K.; Larcher, Kenneth

2006-01-01

New turbulence prediction technology offers the potential for advance warning of impending turbulence encounters, thereby allowing necessary cabin preparation time prior to the encounter. The amount of time required for passengers and flight attendants to be securely seated (that is, seated with seat belts fastened) currently is not known. To determine secured seating-based warning times, a consortium of aircraft safety organizations have conducted an experiment involving a series of timed secured seating trials. This demonstrative experiment, conducted on October 1, 2, and 3, 2002, used a full-scale B-747 wide-body aircraft simulator, human passenger subjects, and supporting staff from six airlines. Active line-qualified flight attendants from three airlines participated in the trials. Definitive results have been obtained to provide secured seating-based warning times for the developers of turbulence warning technology

Red warning for air pollution in China: Exploring residents' perceptions of the first two red warnings in Beijing.

PubMed

Zhao, Hanping; Wang, Fangping; Niu, Chence; Wang, Han; Zhang, Xiaoxue

2018-02-01

Air pollution early warnings have been issued in China to mitigate the effects of high pollution days. Public perceptions and views about early warning signals can affect individual behaviors and play a major role in the public's response to air pollution risks. This study examined public attitudes and responses to the first two red warnings for air pollution in Beijing in 2015. An online survey was sent out, and 664 respondents (response rate = 90%) provided their perspectives on the red warnings. Descriptive statistics, sign tests and binary logit models were used to analyze the data. More than half of the respondents reported that their life and work were affected by the red warning in December 2015. In contrast to their perceptions about the second red warning period, the public thought that the first red warning should have been issued earlier and that the number of consecutive days of warnings should have been reduced. The respondents also recommended that instead of reducing the number of red warnings, the red warning emergency measures should be adjusted. Specifically, the public preferred the installation of air purifiers in schools rather than closing schools and strengthening road flushing and dust pollution controls over restrictions on driving. Data analyses were conducted to examine the affected groups and different groups' perceptions of the necessity of implementing emergency measures. The results indicated that men and more educated respondents were more likely to be affected by driving limitations, and men were less supportive of these limitations. The age and education of respondents were significantly negatively associated with the opinion that schools should be closed, whereas wealthier respondents were more supportive of school closings. The finding of a negative attitude among the public toward the first two red warnings may be used to help local governments modify protective measures and pollution mitigation initiatives to increase

Scalable software architectures for decision support.

PubMed

Musen, M A

1999-12-01

Interest in decision-support programs for clinical medicine soared in the 1970s. Since that time, workers in medical informatics have been particularly attracted to rule-based systems as a means of providing clinical decision support. Although developers have built many successful applications using production rules, they also have discovered that creation and maintenance of large rule bases is quite problematic. In the 1980s, several groups of investigators began to explore alternative programming abstractions that can be used to build decision-support systems. As a result, the notions of "generic tasks" and of reusable problem-solving methods became extremely influential. By the 1990s, academic centers were experimenting with architectures for intelligent systems based on two classes of reusable components: (1) problem-solving methods--domain-independent algorithms for automating stereotypical tasks--and (2) domain ontologies that captured the essential concepts (and relationships among those concepts) in particular application areas. This paper highlights how developers can construct large, maintainable decision-support systems using these kinds of building blocks. The creation of domain ontologies and problem-solving methods is the fundamental end product of basic research in medical informatics. Consequently, these concepts need more attention by our scientific community.

Decision Support Systems for Research and Management in Advanced Life Support

NASA Technical Reports Server (NTRS)

Rodriquez, Luis F.

2004-01-01

Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

Future of electronic health records: implications for decision support.

PubMed

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

2012-01-01

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

Evaluation of Flood Forecast and Warning in Elbe river basin - Impact of Forecaster's Strategy

NASA Astrophysics Data System (ADS)

Danhelka, Jan; Vlasak, Tomas

2010-05-01

model operation, experience and forecasting strategy differs between responsible forecasting offices. Warning is based on model outputs interpretation by hydrologists-forecaster. Warning hit rate reached 0.60 for threshold set to lowest flood stage of which 0.11 was underestimation of flood degree (miss 0.22, false alarm 0.28). Critical success index of model forecast was 0.34, while the same criteria for warning reached 0.55. We assume that the increase accounts not only to change of scale from single forecasting point to region for warning, but partly also to forecaster's added value. There is no official warning strategy preferred in the Czech Republic (f.e. tolerance towards higher false alarm rate). Therefore forecaster decision and personal strategy is of great importance. Results show quite successful warning for 1st flood level exceedance, over-warning for 2nd flood level, but under-warning for 3rd (highest) flood level. That suggests general forecaster's preference of medium level warning (2nd flood level is legally determined to be the start of the flood and flood protection activities). In conclusion human forecaster's experience and analysis skill increases flood warning performance notably. However society preference should be specifically addressed in the warning strategy definition to support forecaster's decision making.

Design of a reliable and operational landslide early warning system at regional scale

NASA Astrophysics Data System (ADS)

Calvello, Michele; Piciullo, Luca; Gariano, Stefano Luigi; Melillo, Massimo; Brunetti, Maria Teresa; Peruccacci, Silvia; Guzzetti, Fausto

2017-04-01

Landslide early warning systems at regional scale are used to warn authorities, civil protection personnel and the population about the occurrence of rainfall-induced landslides over wide areas, typically through the prediction and measurement of meteorological variables. A warning model for these systems must include a regional correlation law and a decision algorithm. A regional correlation law can be defined as a functional relationship between rainfall and landslides; it is typically based on thresholds of rainfall indicators (e.g., cumulated rainfall, rainfall duration) related to different exceedance probabilities of landslide occurrence. A decision algorithm can be defined as a set of assumptions and procedures linking rainfall thresholds to warning levels. The design and the employment of an operational and reliable early warning system for rainfall-induced landslides at regional scale depend on the identification of a reliable correlation law as well as on the definition of a suitable decision algorithm. Herein, a five-step process chain addressing both issues and based on rainfall thresholds is proposed; the procedure is tested in a landslide-prone area of the Campania region in southern Italy. To this purpose, a database of 96 shallow landslides triggered by rainfall in the period 2003-2010 and rainfall data gathered from 58 rain gauges are used. First, a set of rainfall thresholds are defined applying a frequentist method to reconstructed rainfall conditions triggering landslides in the test area. In the second step, several thresholds at different exceedance probabilities are evaluated, and different percentile combinations are selected for the activation of three warning levels. Subsequently, within steps three and four, the issuing of warning levels is based on the comparison, over time and for each combination, between the measured rainfall and the pre-defined warning level thresholds. Finally, the optimal percentile combination to be employed in

Automating hypertext for decision support

NASA Technical Reports Server (NTRS)

Bieber, Michael

1990-01-01

A decision support system (DSS) shell is being constructed that can support applications in a variety of fields, e.g., engineering, manufacturing, finance. The shell provides a hypertext-style interface for 'navigating' among DSS application models, data, and reports. The traditional notion of hypertext had to be enhanced. Hypertext normally requires manually, pre-defined links. A DSS shell, however, requires that hypertext connections to be built 'on the fly'. The role of hypertext is discussed in augmenting DSS applications and the decision making process. Also discussed is how hypertext nodes, links, and link markers tailored to an arbitrary DSS application were automatically generated.

Shared decision-making and decision support: their role in obstetrics and gynecology.

PubMed

Tucker Edmonds, Brownsyne

2014-12-01

To discuss the role for shared decision-making in obstetrics/gynecology and to review evidence on the impact of decision aids on reproductive health decision-making. Among the 155 studies included in a 2014 Cochrane review of decision aids, 31 (29%) addressed reproductive health decisions. Although the majority did not show evidence of an effect on treatment choice, there was a greater uptake of mammography in selected groups of women exposed to decision aids compared with usual care; and a statistically significant reduction in the uptake of hormone replacement therapy among detailed decision aid users compared with simple decision aid users. Studies also found an effect on patient-centered outcomes of care, such as medication adherence, quality-of-life measures, and anxiety scores. In maternity care, only decision analysis tools affected final treatment choice, and patient-directed aids yielded no difference in planned mode of birth after cesarean. There is untapped potential for obstetricians/gynecologists to optimize decision support for reproductive health decisions. Given the limited evidence-base guiding practice, the preference-sensitive nature of reproductive health decisions, and the increase in policy efforts and financial incentives to optimize patients' satisfaction, it is increasingly important for obstetricians/gynecologists to appreciate the role of shared decision-making and decision support in providing patient-centered reproductive healthcare.

VineSens: An Eco-Smart Decision-Support Viticulture System

PubMed Central

Pérez-Expósito, Josman P.; Fernández-Caramés, Tiago M.; Fraga-Lamas, Paula; Castedo, Luis

2017-01-01

This article presents VineSens, a hardware and software platform for supporting the decision-making of the vine grower. VineSens is based on a wireless sensor network system composed by autonomous and self-powered nodes that are deployed throughout a vineyard. Such nodes include sensors that allow us to obtain detailed knowledge on different viticulture processes. Thanks to the use of epidemiological models, VineSens is able to propose a custom control plan to prevent diseases like one of the most feared by vine growers: downy mildew. VineSens generates alerts that warn farmers about the measures that have to be taken and stores the historical weather data collected from different spots of the vineyard. Such data can then be accessed through a user-friendly web-based interface that can be accessed through the Internet by using desktop or mobile devices. VineSens was deployed at the beginning in 2016 in a vineyard in the Ribeira Sacra area (Galicia, Spain) and, since then, its hardware and software have been tested to prevent the development of downy mildew, showing during its first season that the system can led to substantial savings, to decrease the amount of phytosanitary products applied, and, as a consequence, to obtain a more ecologically sustainable and healthy wine. PMID:28245619

VineSens: An Eco-Smart Decision-Support Viticulture System.

PubMed

Pérez-Expósito, Josman P; Fernández-Caramés, Tiago M; Fraga-Lamas, Paula; Castedo, Luis

2017-02-25

This article presents VineSens, a hardware and software platform for supporting the decision-making of the vine grower. VineSens is based on a wireless sensor network system composed by autonomous and self-powered nodes that are deployed throughout a vineyard. Such nodes include sensors that allow us to obtain detailed knowledge on different viticulture processes. Thanks to the use of epidemiological models, VineSens is able to propose a custom control plan to prevent diseases like one of the most feared by vine growers: downy mildew. VineSens generates alerts that warn farmers about the measures that have to be taken and stores the historical weather data collected from different spots of the vineyard. Such data can then be accessed through a user-friendly web-based interface that can be accessed through the Internet by using desktop or mobile devices. VineSens was deployed at the beginning in 2016 in a vineyard in the Ribeira Sacra area (Galicia, Spain) and, since then, its hardware and software have been tested to prevent the development of downy mildew, showing during its first season that the system can led to substantial savings, to decrease the amount of phytosanitary products applied, and, as a consequence, to obtain a more ecologically sustainable and healthy wine.

A probabilistic approach of the Flash Flood Early Warning System (FF-EWS) in Catalonia based on radar ensemble generation

NASA Astrophysics Data System (ADS)

Velasco, David; Sempere-Torres, Daniel; Corral, Carles; Llort, Xavier; Velasco, Enrique

2010-05-01

Early Warning Systems (EWS) are commonly identified as the most efficient tools in order to improve the preparedness and risk management against heavy rains and Flash Floods (FF) with the objective of reducing economical losses and human casualties. In particular, flash floods affecting torrential Mediterranean catchments are a key element to be incorporated within operational EWSs. The characteristic high spatial and temporal variability of the storms requires high-resolution data and methods to monitor/forecast the evolution of rainfall and its hydrological impact in small and medium torrential basins. A first version of an operational FF-EWS has been implemented in Catalonia (NE Spain) under the name of EHIMI system (Integrated Tool for Hydrometeorological Forecasting) with the support of the Catalan Water Agency (ACA) and the Meteorological Service of Catalonia (SMC). Flash flood warnings are issued based on radar-rainfall estimates. Rainfall estimation is performed on radar observations with high spatial and temporal resolution (1km2 and 10 minutes) in order to adapt the warning scale to the 1-km grid of the EWS. The method is based on comparing observed accumulated rainfall against rainfall thresholds provided by the regional Intensity-Duration-Frequency (IDF) curves. The so-called "aggregated rainfall warning" at every river cell is obtained as the spatially averaged rainfall over its associated upstream draining area. Regarding the time aggregation of rainfall, the critical duration is thought to be an accumulation period similar to the concentration time of each cachtment. The warning is issued once the forecasted rainfall accumulation exceeds the rainfall thresholds mentioned above, which are associated to certain probability of occurrence. Finally, the hazard warning is provided and shown to the decision-maker in terms of exceeded return periods at every river cell covering the whole area of Catalonia. The objective of the present work includes the

Forests and Phenology: Designing the Early Warning System to Understand Forest Change

NASA Astrophysics Data System (ADS)

Pierce, T.; Phillips, M. B.; Hargrove, W. W.; Dobson, G.; Hicks, J.; Hutchins, M.; Lichtenstein, K.

2010-12-01

Vegetative phenology is the study of plant development and changes with the seasons, such as the greening-up and browning-down of forests, and how these events are influenced by variations in climate. A National Phenology Data Set, based on Moderate Resolution Imaging Spectroradiometer satellite images covering 2002 through 2009, is now available from work by NASA, the US Forest Service, and Oak Ridge National Laboratory. This new data set provides an easily interpretable product useful for detecting changes to the landscape due to long-term factors such as climate change, as well as finding areas affected by short-term forest threats such as insects or disease. The Early Warning System (EWS) is a toolset being developed by the US Forest Service and the University of North Carolina-Asheville to support distribution and use of the National Phenology Data Set. The Early Warning System will help research scientists, US Forest Service personnel, forest and natural resources managers, decision makers, and the public in the use of phenology data to better understand unexpected change within our nation’s forests. These changes could have multiple natural sources such as insects, disease, or storm damage, or may be due to human-induced events, like thinning, harvest, forest conversion to agriculture, or residential and commercial use. The primary goal of the Early Warning System is to provide a seamless integration between monitoring, detection, early warning and prediction of these forest disturbances as observed through phenological data. The system consists of PC and web-based components that are structured to support four user stages of increasing knowledge and data sophistication. Building Literacy: This stage of the Early Warning System educates potential users about the system, why the system should be used, and the fundamentals about the data the system uses. The channels for this education include a website, interactive tutorials, pamphlets, and other technology

Research and Application of an Air Quality Early Warning System Based on a Modified Least Squares Support Vector Machine and a Cloud Model.

PubMed

Wang, Jianzhou; Niu, Tong; Wang, Rui

2017-03-02

The worsening atmospheric pollution increases the necessity of air quality early warning systems (EWSs). Despite the fact that a massive amount of investigation about EWS in theory and practicality has been conducted by numerous researchers, studies concerning the quantification of uncertain information and comprehensive evaluation are still lacking, which impedes further development in the area. In this paper, firstly a comprehensive warning system is proposed, which consists of two vital indispensable modules, namely effective forecasting and scientific evaluation, respectively. For the forecasting module, a novel hybrid model combining the theory of data preprocessing and numerical optimization is first developed to implement effective forecasting for air pollutant concentration. Especially, in order to further enhance the accuracy and robustness of the warning system, interval forecasting is implemented to quantify the uncertainties generated by forecasts, which can provide significant risk signals by using point forecasting for decision-makers. For the evaluation module, a cloud model, based on probability and fuzzy set theory, is developed to perform comprehensive evaluations of air quality, which can realize the transformation between qualitative concept and quantitative data. To verify the effectiveness and efficiency of the warning system, extensive simulations based on air pollutants data from Dalian in China were effectively implemented, which illustrate that the warning system is not only remarkably high-performance, but also widely applicable.

Research and Application of an Air Quality Early Warning System Based on a Modified Least Squares Support Vector Machine and a Cloud Model

PubMed Central

Wang, Jianzhou; Niu, Tong; Wang, Rui

2017-01-01

The worsening atmospheric pollution increases the necessity of air quality early warning systems (EWSs). Despite the fact that a massive amount of investigation about EWS in theory and practicality has been conducted by numerous researchers, studies concerning the quantification of uncertain information and comprehensive evaluation are still lacking, which impedes further development in the area. In this paper, firstly a comprehensive warning system is proposed, which consists of two vital indispensable modules, namely effective forecasting and scientific evaluation, respectively. For the forecasting module, a novel hybrid model combining the theory of data preprocessing and numerical optimization is first developed to implement effective forecasting for air pollutant concentration. Especially, in order to further enhance the accuracy and robustness of the warning system, interval forecasting is implemented to quantify the uncertainties generated by forecasts, which can provide significant risk signals by using point forecasting for decision-makers. For the evaluation module, a cloud model, based on probability and fuzzy set theory, is developed to perform comprehensive evaluations of air quality, which can realize the transformation between qualitative concept and quantitative data. To verify the effectiveness and efficiency of the warning system, extensive simulations based on air pollutants data from Dalian in China were effectively implemented, which illustrate that the warning system is not only remarkably high-performance, but also widely applicable. PMID:28257122

People-centred landslide early warning systems in the context of risk management

NASA Astrophysics Data System (ADS)

Haß, S.; Asch, K.; Fernandez-Steeger, T.; Arnhardt, C.

2009-04-01

hazard assessment and emergency response. Great importance is attached to the scientific understanding of hazards and protective structures, while analysis of socio-economic impacts and risk assessment are not considered enough. The reduction of vulnerability has to be taken into greater account. Also the information needs of different stakeholders have to be identified at an early stage and should be integrated in the development of early warning systems. The content of the warning message must be simple, understandable and should cover instructions on how to react. Further the timeliness of the messages has to be guarented. In this context the aim of the landslide monitoring and early warning system SLEWS (Sensor Based Landslide Early Warning System) is to integrate the above mentioned aspects of a holistic disaster and risk management. The technology of spatial data infrastructures and web services provides the use of multiple communication channels within an early warning system. Thus people-centred early warning messages and information about slope stability can be sent in nearly real-time. It has to be underlined that the technological information process is just one element of an effective warning system. Moreover the warning system has also to be considered as a social system and has to make allowance to socio-economic and gender aspects : «[...] Develop early warning systems that are people centered, in particular systems whose warnings are timely and understandable to those at risk, which take into account the demographic, gender, cultural and livelihood characteristics of the target audiences, including guidance on how to act upon warnings, and that support effective operations by disaster managers and other decision makers » (Hyogo Framework, 2005) References : UNITED NATIONS INTERNATIONAL STRATEGY FOR DISASTER REDUCTION SECRETARIAT (UNISDR) (2006): Developing early warning systems: a checklist, Third international conference on early warning (EWC III

Systematic Review of Medical Informatics-Supported Medication Decision Making.

PubMed

Melton, Brittany L

2017-01-01

This systematic review sought to assess the applications and implications of current medical informatics-based decision support systems related to medication prescribing and use. Studies published between January 2006 and July 2016 which were indexed in PubMed and written in English were reviewed, and 39 studies were ultimately included. Most of the studies looked at computerized provider order entry or clinical decision support systems. Most studies examined decision support systems as a means of reducing errors or risk, particularly associated with medication prescribing, whereas a few studies evaluated the impact medical informatics-based decision support systems have on workflow or operations efficiency. Most studies identified benefits associated with decision support systems, but some indicate there is room for improvement.

Observations to support adaptation: Principles, scales and decision-making

NASA Astrophysics Data System (ADS)

Pulwarty, R. S.

2012-12-01

As has been long noted, a comprehensive, coordinated observing system is the backbone of any Earth information system. Demands are increasingly placed on earth observation and prediction systems and attendant services to address the needs of economically and environmentally vulnerable sectors and investments, including energy, water, human health, transportation, agriculture, fisheries, tourism, biodiversity, and national security. Climate services include building capacity to interpret information and recognize standards and limitations of data in the promotion of social and economic development in a changing climate. This includes improving the understanding of climate in the context of a variety of temporal and spatial scales (including the influence of decadal scale forcings and land surface feedbacks on seasonal forecast reliability). Climate data and information are central for developing decision options that are sensitive to climate-related uncertainties and the design of flexible adaptation pathways. Ideally monitoring should be action oriented to support climate risk assessment and adaptation including informing robust decision making to multiple risks over the long term. Based on the experience of global observations programs and empirical research we outline- Challenges in developing effective monitoring and climate information systems to support adaptation. The types of observations of critical importance needed for sector planning to enhance food, water and energy security, and to improve early warning for disaster risk reduction Observations needed for ecosystem-based adaptation including the identification of thresholds, maintenance of biological diversity and land degradation The benefits and limits of linking regional model output to local observations including analogs and verification for adaptation planning To support these goals a robust systems of integrated observations are needed to characterize the uncertainty surrounding emergent risks

IBM's Health Analytics and Clinical Decision Support.

PubMed

Kohn, M S; Sun, J; Knoop, S; Shabo, A; Carmeli, B; Sow, D; Syed-Mahmood, T; Rapp, W

2014-08-15

This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation.

On the importance of risk knowledge for an end-to-end tsunami early warning system

NASA Astrophysics Data System (ADS)

Post, Joachim; Strunz, Günter; Riedlinger, Torsten; Mück, Matthias; Wegscheider, Stephanie; Zosseder, Kai; Steinmetz, Tilmann; Gebert, Niklas; Anwar, Herryal

2010-05-01

Warning systems commonly use information provided by networks of sensors able to monitor and detect impending disasters, aggregate and condense these information to provide reliable information to a decision maker whether to warn or not, disseminates the warning message and provide this information to people at risk. Ultimate aim is to enable those in danger to make decisions (e.g. initiate protective actions for buildings) and to take action to safe their lives. This involves very complex issues when considering all four elements of early warning systems (UNISDR-PPEW), namely (1) risk knowledge, (2) monitoring and warning service, (3) dissemination and communication, (4) response capability with the ultimate aim to gain as much time as possible to empower individuals and communities to act in an appropriate manner to reduce injury, loss of life, damage to property and the environment and loss of livelihoods. Commonly most warning systems feature strengths and main attention on the technical/structural dimension (monitoring & warning service, dissemination tools) with weaknesses and less attention on social/cultural dimension (e.g. human response capabilities, defined warning chain to and knowing what to do by the people). Also, the use of risk knowledge in early warning most often is treated in a theoretical manner (knowing that it is somehow important), yet less in an operational, practical sense. Risk assessments and risk maps help to motivate people, prioritise early warning system needs and guide preparations for response and disaster prevention activities. Beyond this risk knowledge can be seen as a tie between national level early warning and community level reaction schemes. This presentation focuses on results, key findings and lessons-learnt related to tsunami risk assessment in the context of early warning within the GITEWS (German-Indonesian Tsunami Early Warning) project. Here a novel methodology reflecting risk information needs in the early warning

Whose decision is it anyway? How clinicians support decision-making participation after acquired brain injury.

PubMed

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2013-01-01

To raise professional awareness of factors that may influence the support offered by clinicians to people with acquired brain injury (ABI), and to consider the potential implications of these factors in terms of post-injury rehabilitation and living. A review of the literature was conducted to identify factors that determine how clinicians provide support and influence opportunities for individuals with ABI to participate in decision making across the rehabilitation continuum. Clinical case studies are used to highlight two specific issues: (1) hidden assumptions on the part of the practitioner, and (2) perceptions of risk operating in clinical practice. There are a range of factors which may influence the decision-making support provided by clinicians and, ultimately, shape lifetime outcomes for individuals with ABI. A multidimensional framework may assist clinicians to identify relevant factors and consider their potential implications including those that influence how clinicians involved in supporting decision making approach this task. Participation in decision making is an undisputed human right and central to the provision of person-centred care. Further research is required to understand how clinical practice can maximise both opportunities and support for increased decision-making participation by individuals with ABI. There is an increasing focus on the rights of all individuals to be supported to participate in decision making about their life. A number of changes associated with ABI mean that individuals with ABI will require support with decision making. Clinicians have a critical role in providing this support over the course of the rehabilitation continuum. Clinicians need to be aware of the range of factors that may influence the decision-making support they provide. A multidimensional framework may be used by clinicians to identify influences on the decision-making support they provide.

Strengthening Agricultural Decisions in Countries at Risk of Food Insecurity: The GEOGLAM Crop Monitor for Early Warning

NASA Astrophysics Data System (ADS)

Becker-Reshef, I.; Barker, B.; McGaughey, K.; Humber, M. L.; Sanchez, A.; Justice, C. O.; Rembold, F.; Verdin, J. P.

2016-12-01

Timely, reliable information on crop conditions, and prospects at the subnational scale, is critical for making informed policy and agricultural decisions for ensuring food security, particularly for the most vulnerable countries. However, such information is often incomplete or lacking. As such, the Crop Monitor for Early Warning (CM for EW) was developed with the goal to reduce uncertainty and strengthen decision support by providing actionable information on a monthly basis to national, regional and global food security agencies through timely consensus assessments of crop conditions. This information is especially critical in recent years, given the extreme weather conditions impacting food supplies including the most recent El Nino event. This initiative brings together the main international food security monitoring agencies and organizations to develop monthly crop assessments based on satellite observations, meteorological information, field observations and ground reports, which reflect an international consensus. This activity grew out of the successful Crop Monitor for the G20 Agricultural Market Information System (AMIS), which provides operational monthly crop assessments of the main producing countries of the world. The CM for EW was launched in February 2016 and has already become a trusted source of information internationally and regionally. Its assessments have been featured in a large number of news articles, reports, and press releases, including a joint statement by the USAID's FEWS NET, UN World Food Program, European Commission Joint Research Center, and the UN Food and Agriculture Organziation, on the devastating impacts of the southern African drought due to El Nino. One of the main priorities for this activity going forward is to expand its partnership with regional and national monitoring agencies, and strengthen capacity for national crop condition assessments.

Developing the U.S. Wildland Fire Decision Support System

Treesearch

Erin Noonan-Wright; Tonja S. Opperman; Mark A. Finney; Tom Zimmerman; Robert C. Seli; Lisa M. Elenz; David E. Calkin; John R. Fiedler

2011-01-01

A new decision support tool, the Wildland Fire Decision Support System (WFDSS) has been developed to support risk-informed decision-making for individual fires in the United States. WFDSS accesses national weather data and forecasts, fire behavior prediction, economic assessment, smoke management assessment, and landscape databases to efficiently formulate and apply...

Food product health warnings promote dietary self-control through reductions in neural signals indexing food cue reactivity.

PubMed

Rosenblatt, Daniel H; Summerell, Patrick; Ng, Alyssa; Dixon, Helen; Murawski, Carsten; Wakefield, Melanie; Bode, Stefan

2018-01-01

Modern societies are replete with palatable food cues. A growing body of evidence suggests that food cue exposure activates conditioned appetitive physiological and psychological responses that may override current metabolic needs and existing eating goals, such as the desire to maintain a healthy diet. This conditioned response results in unhealthy dietary choices and is a contributing factor in the current obesity epidemic. Prime based obesity prevention measures such as health warnings at point-of-sale or on product packaging may have the potential to counteract the influence of the obesogenic environment at the crucial moment when people make food purchasing or consumption decisions. Existing research into the efficacy of these intervention strategies has predominantly employed self-report and population level measures, and little evidence exists to support the contention that these measures counteract food cue reactivity at the time of decision making. Using a dietary self-control priming paradigm, we demonstrated that brief exposure to food product health warnings enhanced dietary self-control. Further, we analysed electroencephalographic correlates of selective attention and food cue evoked craving (N1, P3, LPP) to show that health warning exposure reduced the automatic appetitive response towards palatable food cues. These findings contribute to existing evidence that exogenous information can successfully prime latent goals, and substantiate the notion that food product health warnings may provide a new avenue through which to curb excessive energy intake and reduce rising obesity rates.

Decisions, Decisions....

ERIC Educational Resources Information Center

White, Owen Roberts

1985-01-01

The author reviews systems providing objective guidelines to facilitate ongoing, daily instructional decisions, focusing on those which utilize the sensitive datum and uniform charting procedures of precision teaching. Potential users are warned that the special education teacher must remain a critical and vigilant analyst of the learning process.…

Electrical Distribution System (EDS) and Caution and Warning System (CWS)

NASA Technical Reports Server (NTRS)

Mcclung, T.

1975-01-01

An astronaut caution and warning system is described which monitors various life support system parameters and detects out-of-range parameter conditions. The warning system generates a warning tone and displays the malfunction condition to the astronaut along with the proper corrective procedures required.

Maintenance and operations decision support tool : Clarus regional demonstrations.

DOT National Transportation Integrated Search

2011-01-01

Weather affects almost all maintenance activity decisions. The Federal Highway Administration (FHWA) tested a new decision support system for maintenance in Iowa, Indiana, and Illinois called the Maintenance and Operations Decision Support System (MO...

A medical informatics perspective on clinical decision support systems. Findings from the yearbook 2013 section on decision support.

PubMed

Bouaud, J; Lamy, J-B

2013-01-01

To summarize excellent research and to select best papers published in 2012 in the field of computer-based decision support in healthcare. A bibliographic search focused on clinical decision support systems (CDSSs) and computer provider order entry was performed, followed by a double-blind literature review. The review process yielded six papers, illustrating various aspects of clinical decision support. The first paper is a systematic review of CDSS intervention trials in real settings, and considers different types of possible outcomes. It emphasizes the heterogeneity of studies and confirms that CDSSs can improve process measures but that evidence lacks for other types of outcomes, especially clinical or economic. Four other papers tackle the safety of drug prescribing and show that CDSSs can be efficient in reducing prescription errors. The sixth paper exemplifies the growing role of ontological resources which can be used for several applications including decision support. CDSS research has to be continuously developed and assessed. The wide variety of systems and of interventions limits the understanding of factors of success of CDSS implementations. A standardization in the characterization of CDSSs and of intervention trial reporting will help to overcome this obstacle.

Development, deployment and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard.

PubMed

Lobach, David F; Kawamoto, Kensaku; Anstrom, Kevin J; Russell, Michael L; Woods, Peter; Smith, Dwight

2007-01-01

Clinical decision support is recognized as one potential remedy for the growing crisis in healthcare quality in the United States and other industrialized nations. While decision support systems have been shown to improve care quality and reduce errors, these systems are not widely available. This lack of availability arises in part because most decision support systems are not portable or scalable. The Health Level 7 international standard development organization recently adopted a draft standard known as the Decision Support Service standard to facilitate the implementation of clinical decision support systems using software services. In this paper, we report the first implementation of a clinical decision support system using this new standard. This system provides point-of-care chronic disease management for diabetes and other conditions and is deployed throughout a large regional health system. We also report process measures and usability data concerning the system. Use of the Decision Support Service standard provides a portable and scalable approach to clinical decision support that could facilitate the more extensive use of decision support systems.

Informing climate change adaptation with insights from famine early warning (Invited)

NASA Astrophysics Data System (ADS)

Funk, C. C.; Verdin, J. P.

2010-12-01

Famine early warning systems provide a unique viewpoint for understanding the implications of climate change on food security, identifying the locations and seasons where millions of food insecure people are dependent upon climate-sensitive agricultural systems. The Famine Early Warning Systems Network (FEWS NET) is a decision support system sponsored by the Office of Food for Peace of the U.S. Agency for International Development (USAID), which distributes over two billion dollars of food aid to more than 40 countries each year. FEWS NET identifies the times and places where food aid is required by the most climatically sensitive and consequently food insecure populations of the developing world. As result, FEWS NET has developed its own "climate service", implemented by USGS, NOAA, and NASA, to support its decision making processes. The foundation of this climate service is the monitoring of current growing conditions for early identification of agricultural drought that might impact food security. Since station networks are sparse in the countries monitored, FEWS NET has a tradition (dating back to 1985) of reliance on satellite remote sensing of vegetation and rainfall. In the last ten years, climate forecasts have become an additional tool for food security assessment, extending the early warning perspective to include expected agricultural outcomes for the season ahead. More recently, research has expanded to include detailed analyses of recent observed climate trends, combined with diagnostic ocean-atmosphere studies. These studies are then used to develop interpretations of GCM scenarios and their implications for future patterns of precipitation and temperature, revealing trends towards warmer/drier climate conditions and increases in the relative frequency of drought. In some regions, like Eastern Africa, such changes seem to be already occurring, with an associated increase in food insecurity. Sub-national analyses for Kenya, for example, point to the

Applying the Wildland Fire Decision Support System (WFDSS) to support risk-informed decision making: The Gold Pan Fire, Bitterroot National Forest, Montana, USA

Treesearch

Erin K. Noonan-Wright; Tonja S. Opperman

2015-01-01

In response to federal wildfire policy changes, risk-informed decision-making by way of improved decision support, is increasingly becoming a component of managing wildfires. As fire incidents escalate in size and complexity, the Wildland Fire Decision Support System (WFDSS) provides support with different analytical tools as fire conditions change. We demonstrate the...

The Warning System in Disaster Situations: A Selective Analysis.

DTIC Science & Technology

DISASTERS, *WARNING SYSTEMS), CIVIL DEFENSE, SOCIAL PSYCHOLOGY, REACTION(PSYCHOLOGY), FACTOR ANALYSIS, CLASSIFICATION, STATISTICAL DATA, TIME ... MANAGEMENT PLANNING AND CONTROL, DAMAGE, CONTROL SYSTEMS, THREAT EVALUATION, DECISION MAKING, DATA PROCESSING, COMMUNICATION SYSTEMS, NUCLEAR EXPLOSIONS

Using Visualization in Cockpit Decision Support Systems

NASA Technical Reports Server (NTRS)

Aragon, Cecilia R.

2005-01-01

In order to safely operate their aircraft, pilots must make rapid decisions based on integrating and processing large amounts of heterogeneous information. Visual displays are often the most efficient method of presenting safety-critical data to pilots in real time. However, care must be taken to ensure the pilot is provided with the appropriate amount of information to make effective decisions and not become cognitively overloaded. The results of two usability studies of a prototype airflow hazard visualization cockpit decision support system are summarized. The studies demonstrate that such a system significantly improves the performance of helicopter pilots landing under turbulent conditions. Based on these results, design principles and implications for cockpit decision support systems using visualization are presented.

RISA progress in the development of drought indicators to support decision making

NASA Astrophysics Data System (ADS)

Close, S.; Simpson, C.

2015-12-01

Communities around the country are increasingly recognizing the need to plan for water shortages and long-term drought. To build preparedness and help communities manage risk, researchers funded by NOAA's National Integrated Drought Information System (NIDIS) Coping with Drought initiative through the Regional Integrated Sciences and Assessments (RISA) program are working to better understand these impacts across the country and work with communities and resource managers to develop adaptation strategies that meet their needs. The Coping with Drought initiative supports research involving the use of climate predictions and forecast information in decision-making across a range of sectors including agriculture, natural and water resources management, and public health. As a component of this initiative, the RISA program supported research and engagement to develop indicators of drought designed to be of most use to managers and planners grappling with severe and in some cases ongoing drought in their regions. Indicators are being developed for coastal ecosystems in the Carolinas, water management in California, and native communities in Arizona. For instance, the California Nevada Applications Program (CNAP) RISA developed a percentile-based indicator system for analyzing historic droughts and characterizing the ongoing California drought. And in the Southwest, the Climate Assessment for the Southwest (CLIMAS) RISA has been working with the Hopi community on drought monitoring and planning to develop the first-ever Hopi Quarterly Drought Status Report which integrates scientific and local knowledge about drought. This presentation will discuss RISA's role in developing drought indicators based on engagement with decision makers and how this work fits into the larger role that RISAs are playing in the development of the NIDIS Regional Drought Early Warning Systems across the U.S.

Developing effective warning systems: Ongoing research at Ruapehu volcano, New Zealand

NASA Astrophysics Data System (ADS)

Leonard, Graham S.; Johnston, David M.; Paton, Douglas; Christianson, Amy; Becker, Julia; Keys, Harry

2008-05-01

PurposeThis paper examines the unique challenges to volcanic risk management associated with having a ski area on an active volcano. Using a series of simulated eruption/lahar events at Ruapehu volcano, New Zealand, as a context, a model of risk management that integrates warning system design and technology, risk perceptions and the human response is explored. Principal resultsDespite increases in the observed audibility and comprehension of the warning message, recall of public education content, and people's awareness of volcanic risk, a persistent minority of the public continued to demonstrate only moderate awareness of the correct actions to take during a warning and failed to respond effectively. A relationship between level of staff competence and correct public response allowed the level of public response to be used to identify residual risk and additional staff training needs. The quality of staff awareness, action and decision-making has emerged as a critical factor, from detailed staff and public interviews and from exercise observations. Staff actions are especially important for mobilising correct public response at Ruapehu ski areas due to the transient nature of the visitor population. Introduction of education material and staff training strategies that included the development of emergency decision-making competencies improved knowledge of correct actions, and increased the proportion of people moving out of harm's way during blind tests. Major conclusionsWarning effectiveness is a function of more than good hazard knowledge and the generation and notification of an early warning message. For warning systems to be effective, these factors must be complemented by accurate knowledge of risk and risk management actions. By combining the Ruapehu findings with those of other warning system studies in New Zealand, and internationally, a practical five-step model for effective early warning systems is discussed. These steps must be based upon sound and

Warnings and Human Response in the Oroville Dam Crisis, February 2017

NASA Astrophysics Data System (ADS)

Sorensen, J. H.; Mileti, D. S.; Needham, J. T.

2017-12-01

On February 7, 2017, erosion was detected in the primary spillway for Oroville Dam in northern California, causing an elevated concern for the safety of downstream communities. The situation seemed stable until heavy rains on February 11 resulted in the flow of water over the emergency spillway. On February 12, erosion below the emergency spillway was observed. At 4:21 PM on February 12, the Butte County Sheriff issued an evacuation order for "low levels of Oroville and downstream areas". Counties downstream followed with evacuation warnings. The purpose of this paper is to present preliminary results of research, conducted for the U.S. Army Corp of Engineers, on the Oroville event. This investigation is part of a research program designed to collect and analyze data on: 1) The timing of the decisions to order public evacuation warnings including the flow of information between engineers and geologist monitoring the hazard and local officials. 2) The method and timing of the dissemination of those warnings including the diffusion or warning by various communication channels. 3) The interpretation and response of the public to those warnings, including the timing of protective action decisions. The findings from these studies will be incorporated into risk assessment models used in assessing the impacts of dam and levee failures on a national basis.

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…

Grand Challenges in Clinical Decision Support v10

PubMed Central

Sittig, Dean F.; Wright, Adam; Osheroff, Jerome A.; Middleton, Blackford; Teich, Jonathan M.; Ash, Joan S.; Campbell, Emily; Bates, David W.

2008-01-01

There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical decision support. This list was created to educate and inspire researchers, developers, funders, and policy-makers. The list of challenges in order of importance that they be solved if patients and organizations are to begin realizing the fullest benefits possible of these systems consists of: Improve the human-computer interface; Disseminate best practices in CDS design, development, and implementation; Summarize patient-level information; Prioritize and filter recommendations to the user; Create an architecture for sharing executable CDS modules and services; Combine recommendations for patients with co-morbidities; Prioritize CDS content development and implementation; Create internet-accessible clinical decision support repositories; Use freetext information to drive clinical decision support; Mine large clinical databases to create new CDS. Identification of solutions to these challenges is critical if clinical decision support is to achieve its potential and improve the quality, safety and efficiency of healthcare. PMID:18029232

New approaches for real time decision support systems

NASA Technical Reports Server (NTRS)

Hair, D. Charles; Pickslay, Kent

1994-01-01

NCCOSC RDT&E Division (NRaD) is conducting research into ways of improving decision support systems (DSS) that are used in tactical Navy decision making situations. The research has focused on the incorporation of findings about naturalistic decision-making processes into the design of the DSS. As part of that research, two computer tools were developed that model the two primary naturalistic decision-making strategies used by Navy experts in tactical settings. Current work is exploring how best to incorporate the information produced by those tools into an existing simulation of current Navy decision support systems. This work has implications for any applications involving the need to make decisions under time constraints, based on incomplete or ambiguous data.

Supporting End of Life Decision Making: Case Studies of Relational Closeness in Supported Decision Making for People with Severe or Profound Intellectual Disability

ERIC Educational Resources Information Center

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-01-01

Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…

The Contribution of a Decision Support System to Educational Decision-Making Processes

ERIC Educational Resources Information Center

Klein, Joseph; Ronen, Herman

2003-01-01

In the light of reports of bias, the present study investigated the hypothesis that administrative educational decisions assisted by Decision Support Systems (DSS) are characterized by different pedagogical and organizational orientation than decisions made without computer assistance. One hundred and ten high school teachers were asked to suggest…

How to guide - transit operations decision support systems (TODSS).

DOT National Transportation Integrated Search

2014-12-01

Transit Operations Decision Support Systems (TODSS) are decision support systems designed to support dispatchers in real-time bus operations management in response to incidents, special events, and other changing conditions in order to restore servic...

Decision support frameworks and tools for conservation

USGS Publications Warehouse

Schwartz, Mark W.; Cook, Carly N.; Pressey, Robert L.; Pullin, Andrew S.; Runge, Michael C.; Salafsky, Nick; Sutherland, William J.; Williamson, Matthew A.

2018-01-01

The practice of conservation occurs within complex socioecological systems fraught with challenges that require transparent, defensible, and often socially engaged project planning and management. Planning and decision support frameworks are designed to help conservation practitioners increase planning rigor, project accountability, stakeholder participation, transparency in decisions, and learning. We describe and contrast five common frameworks within the context of six fundamental questions (why, who, what, where, when, how) at each of three planning stages of adaptive management (project scoping, operational planning, learning). We demonstrate that decision support frameworks provide varied and extensive tools for conservation planning and management. However, using any framework in isolation risks diminishing potential benefits since no one framework covers the full spectrum of potential conservation planning and decision challenges. We describe two case studies that have effectively deployed tools from across conservation frameworks to improve conservation actions and outcomes. Attention to the critical questions for conservation project planning should allow practitioners to operate within any framework and adapt tools to suit their specific management context. We call on conservation researchers and practitioners to regularly use decision support tools as standard practice for framing both practice and research.

Exploring the Role of Social Memory of Floods for Designing Flood Early Warning Operations

NASA Astrophysics Data System (ADS)

Girons Lopez, Marc; Di Baldassarre, Giuliano; Grabs, Thomas; Halldin, Sven; Seibert, Jan

2016-04-01

Early warning systems are an important tool for natural disaster mitigation practices, especially for flooding events. Warnings rely on near-future forecasts to provide time to take preventive actions before a flood occurs, thus reducing potential losses. However, on top of the technical capacities, successful warnings require an efficient coordination and communication among a range of different actors and stakeholders. The complexity of integrating the technical and social spheres of warning systems has, however, resulted in system designs neglecting a number of important aspects such as social awareness of floods thus leading to suboptimal results. A better understanding of the interactions and feedbacks among the different elements of early warning systems is therefore needed to improve their efficiency and therefore social resilience. When designing an early warning system two important decisions need to be made regarding (i) the hazard magnitude at and from which a warning should be issued and (ii) the degree of confidence required for issuing a warning. The first decision is usually taken based on the social vulnerability and climatic variability while the second one is related to the performance (i.e. accuracy) of the forecasting tools. Consequently, by estimating the vulnerability and the accuracy of the forecasts, these two variables can be optimized to minimize the costs and losses. Important parameters with a strong influence on the efficiency of warning systems such as social awareness are however not considered in their design. In this study we present a theoretical exploration of the impact of social awareness on the design of early warning systems. For this purpose we use a definition of social memory of flood events as a proxy for flood risk awareness and test its effect on the optimization of the warning system design variables. Understanding the impact of social awareness on warning system design is important to make more robust warnings that can

An early warning and control system for urban, drinking water quality protection: China's experience.

PubMed

Hou, Dibo; Song, Xiaoxuan; Zhang, Guangxin; Zhang, Hongjian; Loaiciga, Hugo

2013-07-01

An event-driven, urban, drinking water quality early warning and control system (DEWS) is proposed to cope with China's urgent need for protecting its urban drinking water. The DEWS has a web service structure and provides users with water quality monitoring functions, water quality early warning functions, and water quality accident decision-making functions. The DEWS functionality is guided by the principles of control theory and risk assessment as applied to the feedback control of urban water supply systems. The DEWS has been deployed in several large Chinese cities and found to perform well insofar as water quality early warning and emergency decision-making is concerned. This paper describes a DEWS for urban water quality protection that has been developed in China.

Experiences integrating autonomous components and legacy systems into tsunami early warning systems

NASA Astrophysics Data System (ADS)

Reißland, S.; Herrnkind, S.; Guenther, M.; Babeyko, A.; Comoglu, M.; Hammitzsch, M.

2012-04-01

Fostered by and embedded in the general development of Information and Communication Technology (ICT) the evolution of Tsunami Early Warning Systems (TEWS) shows a significant development from seismic-centred to multi-sensor system architectures using additional sensors, e.g. sea level stations for the detection of tsunami waves and GPS stations for the detection of ground displacements. Furthermore, the design and implementation of a robust and scalable service infrastructure supporting the integration and utilisation of existing resources serving near real-time data not only includes sensors but also other components and systems offering services such as the delivery of feasible simulations used for forecasting in an imminent tsunami threat. In the context of the development of the German Indonesian Tsunami Early Warning System (GITEWS) and the project Distant Early Warning System (DEWS) a service platform for both sensor integration and warning dissemination has been newly developed and demonstrated. In particular, standards of the Open Geospatial Consortium (OGC) and the Organization for the Advancement of Structured Information Standards (OASIS) have been successfully incorporated. In the project Collaborative, Complex, and Critical Decision-Support in Evolving Crises (TRIDEC) new developments are used to extend the existing platform to realise a component-based technology framework for building distributed TEWS. This talk will describe experiences made in GITEWS, DEWS and TRIDEC while integrating legacy stand-alone systems and newly developed special-purpose software components into TEWS using different software adapters and communication strategies to make the systems work together in a corporate infrastructure. The talk will also cover task management and data conversion between the different systems. Practical approaches and software solutions for the integration of sensors, e.g. providing seismic and sea level data, and utilisation of special

Military Medical Decision Support for Homeland Defense During Emergency

DTIC Science & Technology

2004-12-01

abstraction hierarchy, three levels of information requirement for designing emergency training interface are recognized. These are epistemological ...support human decision making process is considered to be decision-centric. A typical decision-centric interface is supported by at least four design ... Designing Emergency Training Interface ......................................................................................... 5 Epistemological

'My kidneys, my choice, decision aid': supporting shared decision making.

PubMed

Fortnum, Debbie; Smolonogov, Tatiana; Walker, Rachael; Kairaitis, Luke; Pugh, Debbie

2015-06-01

For patients with chronic kidney disease (CKD) who are progressing to end-stage kidney disease (ESKD) a decision of whether to undertake dialysis or conservative care is a critical component of the patient journey. Shared decision making for complex decisions such as this could be enhanced by a decision aid, a practice which is well utilised in other disciplines but limited for nephrology. A multidisciplinary team in Australia and New Zealand (ANZ) utilised current decision-making theory and best practice to develop the 'My Kidneys, My Choice', a decision aid for the treatment of kidney disease. A patient-centred, five-sectioned tool is now complete and freely available to all ANZ units to support the ESKD education and shared decision-making process. Distribution and education have occurred across ANZ and evaluation of the decision aid in practice is in the first phase. Development of a new tool such as an ESKD decision aid requires vision, multidisciplinary input and ongoing implementation resources. This tool is being integrated into ANZ, ESKD education practice and is promoting the philosophy of shared decision making. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Enhancing access and usage of earth observations to support environmental decision making in Eastern and Southern Africa

NASA Astrophysics Data System (ADS)

Shukla, S.; Husak, G. J.; Macharia, D.; Peterson, P.; Landsfeld, M. F.; Funk, C.; Flores, A.

2017-12-01

Remote sensing, reanalysis and model based earth observations (EOs) are crucial for environmental decision making, particularly in a region like Eastern and Southern Africa, where ground-based observations are sparse. NASA and the Famine Early Warning System Network (FEWS NET) provide several EOs relevant for monitoring, providing early warning of agroclimatic conditions. Nonetheless, real-time application of those EOs for decision making in the region is still limited. This presentation reports on an ongoing SERVIR-supported Applied Science Team (AST) project that aims to fill that gap by working in close collaboration with Regional Centre for Mapping of Resources for Development (RCMRD), the NASA SERVIR regional hub. The three main avenues being taken to enhance access and usage of EOs in the region are: (1) Transition and implementation of web-based tools to RCMRD to allow easy processing and visualization of EOs (2) Capacity building of personnel from regional and national agroclimate service agencies in using EOs, through training using targeted case studies, and (3) Development of new datasets to meet the specific needs of RCMRD and regional stakeholders. The presentation will report on the initial success, lessons learned, and feedback thus far in this project regarding the implementation of web-based tool and capacity building efforts. It will also briefly describe three new datasets, currently in development, to improve agroclimate monitoring in the region, which are: (1) Satellite infrared and stations based temperature maximum dataset (CHIRTS) (2) NASA's GEOS5 and NCEP's CFSv2 based seasonal scale reference evapotranspiration forecasts and (3) NCEP's GEFS based medium range weather forecasts which are bias-corrected to USGS and UCSB's rainfall monitoring dataset (CHIRPS).

Actionable knowledge and strategic decision making for bio- and agroterrorism threats: building a collaborative early warning culture.

PubMed

Mårtensson, Per-Åke; Hedström, Lars; Sundelius, Bengt; Skiby, Jeffrey E; Elbers, Armin; Knutsson, Rickard

2013-09-01

Current trends in biosecurity and cybersecurity include (1) the wide availability of technology and specialized knowledge that previously were available only to governments; (2) the global economic recession, which may increase the spread of radical non-state actors; and (3) recent US and EU commission reports that reflect concerns about non-state actors in asymmetric threats. The intersectoral and international nature of bioterrorism and agroterrorism threats requires collaboration across several sectors including intelligence, police, forensics, customs, and other law enforcement organizations who must work together with public and animal health organizations as well as environmental and social science organizations. This requires coordinated decision making among these organizations, based on actionable knowledge and information sharing. The risk of not sharing information among organizations compared to the benefit of sharing information can be considered in an "information sharing risk-benefit analysis" to prevent a terrorism incident from occurring and to build a rapid response capability. In the EU project AniBioThreat, early warning is the main topic in work package 3 (WP 3). A strategy has been generated based on an iterative approach to bring law enforcement agencies and human and animal health institutes together. Workshops and exercises have taken place during the first half of the project, and spin-off activities include new preparedness plans for institutes and the formation of a legal adviser network for decision making. In addition, a seminar on actionable knowledge was held in Stockholm, Sweden, in 2012, which identified the need to bring various agency cultures together to work on developing a resilient capability to identify early signs of bio- and agroterrorism threats. The seminar concluded that there are a number of challenges in building a collaborative culture, including developing an education program that supports collaboration and shared

SafeLand guidelines for landslide monitoring and early warning systems in Europe - Design and required technology

NASA Astrophysics Data System (ADS)

Bazin, S.

2012-04-01

Landslide monitoring means the comparison of landslide characteristics like areal extent, speed of movement, surface topography and soil humidity from different periods in order to assess landslide activity. An ultimate "universal" methodology for this purpose does not exist; every technology has its own advantages and disadvantages. End-users should carefully consider each one to select the methodologies that represent the best compromise between pros and cons, and are best suited for their needs. Besides monitoring technology, there are many factors governing the choice of an Early Warning System (EWS). A people-centred EWS necessarily comprises five key elements: (1) knowledge of the risks; (2) identification, monitoring, analysis and forecasting of the hazards; (3) operational centre; (4) communication or dissemination of alerts and warnings; and (5) local capabilities to respond to the warnings received. The expression "end-to-end warning system" is also used to emphasize that EWSs need to span all steps from hazard detection through to community response. The aim of the present work is to provide guidelines for establishing the different components for landslide EWSs. One of the main deliverables of the EC-FP7 SafeLand project addresses the technical and practical issues related to monitoring and early warning for landslides, and identifies the best technologies available in the context of both hazard assessment and design of EWSs. This deliverable targets the end-users and aims to facilitate the decision process by providing guidelines. For the purpose of sharing the globally accumulated expertise, a screening study was done on 14 EWSs from 8 different countries. On these bases, the report presents a synoptic view of existing monitoring methodologies and early-warning strategies and their applicability for different landslide types, scales and risk management steps. Several comprehensive checklists and toolboxes are also included to support informed

Electronic decision support for diagnostic imaging in a primary care setting

PubMed Central

Reed, Martin H

2011-01-01

Methods Clinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines. Results Of those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software. Conclusions Physicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow. PMID:21486884

Famines in Africa: is early warning early enough?

PubMed Central

Kim, Jeeyon Janet; Guha-Sapir, Debarati

2012-01-01

Following the second Sahelian famine in 1984–1985, major investments were made to establish Early Warning Systems. These systems help to ensure that timely warnings and vulnerability information are available to decision makers to anticipate and avert food crises. In the recent crisis in the Horn of Africa, alarming levels of acute malnutrition were documented from March 2010, and by August 2010, an impending food crisis was forecast. Despite these measures, the situation remained unrecognised, and further deteriorated causing malnutrition levels to grow in severity and scope. By the time the United Nations officially declared famine on 20 July 2011, and the humanitarian community sluggishly went into response mode, levels of malnutrition and mortality exceeded catastrophic levels. At this time, an estimated 11 million people were in desperate and immediate need for food. With warnings of food crises in the Sahel, South Sudan, and forecast of the drought returning to the Horn, there is an immediate need to institutionalize change in the health response during humanitarian emergencies. Early warning systems are only effective if they trigger an early response. PMID:22745628

Famines in Africa: is early warning early enough?

PubMed

Kim, Jeeyon Janet; Guha-Sapir, Debarati

2012-01-01

Following the second Sahelian famine in 1984-1985, major investments were made to establish Early Warning Systems. These systems help to ensure that timely warnings and vulnerability information are available to decision makers to anticipate and avert food crises. In the recent crisis in the Horn of Africa, alarming levels of acute malnutrition were documented from March 2010, and by August 2010, an impending food crisis was forecast. Despite these measures, the situation remained unrecognised, and further deteriorated causing malnutrition levels to grow in severity and scope. By the time the United Nations officially declared famine on 20 July 2011, and the humanitarian community sluggishly went into response mode, levels of malnutrition and mortality exceeded catastrophic levels. At this time, an estimated 11 million people were in desperate and immediate need for food. With warnings of food crises in the Sahel, South Sudan, and forecast of the drought returning to the Horn, there is an immediate need to institutionalize change in the health response during humanitarian emergencies. Early warning systems are only effective if they trigger an early response.

Improving performance with clinical decision support.

PubMed

Brailer, D J; Goldfarb, S; Horgan, M; Katz, F; Paulus, R A; Zakrewski, K

1996-07-01

CADU/CIS (Clinical and Administrative Decision-support Utility and Clinical Information System) is a clinical decision-support workstation that allows large volumes of clinical information systems data to be analyzed in a timely and user-friendly fashion. CARE PROCESS MEASUREMENT: For any given disease, subgroups of patients are identified, and automated, customized "clinical pathways" are generated. For each subgroup, the best practice norms for use of test and therapies are identified. Practice style variations are then compared to outcomes to focus inquiry on decisions that significantly affect outcomes. INTESTINAL OBSTRUCTION: Graduate Health Systems, a multisite integrated provider in the Philadelphia area, has used CADU/CIS to improve quality problems, reduce treatment-intensity variations, and improve clinical participation in care process evaluation and decision making. A task force selected intestinal obstruction without hernia as its first study because of the related high-volume and high-morbidity complications. Use of a ten-step method for clinical performance improvement showed that the intravenous administration of unnecessary fluids to 104 patients with intestinal obstruction induced congestive heart failure (CHF) in 5 patients. Task force members and other practicing physicians are now developing guidelines and other interventions aimed at fluid use. Indeed, the task force used CADU/CIS to identify an additional 250 patients in one year whose conditions were complicated by CHF. A clinical decision support tool can be instrumental in detecting problems with important clinical and economic implications, identifying their important underlying causes, tracking the associated tests and therapies, and monitoring interventions.

Supporting multi-stakeholder environmental decisions.

PubMed

Hajkowicz, Stefan A

2008-09-01

This paper examines how multiple criteria analysis (MCA) can be used to support multi-stakeholder environmental management decisions. It presents a study through which 48 stakeholders from environmental, primary production and community interest groups used MCA to prioritise 30 environmental management problems in the Mackay-Whitsunday region of Queensland, Australia. The MCA model, with procedures for aggregating multi-stakeholder output, was used to inform a final decision on the priority of the region's environmental management problems. The result was used in the region's environmental management plan as required under Australia's Natural Heritage Trust programme. The study shows how relatively simple MCA methods can help stakeholders make group decisions, even when they hold strongly conflicting preferences.

Decision aids that support decisions about prenatal testing for Down syndrome: an environmental scan.

PubMed

Leiva Portocarrero, Maria Esther; Garvelink, Mirjam M; Becerra Perez, Maria Margarita; Giguère, Anik; Robitaille, Hubert; Wilson, Brenda J; Rousseau, François; Légaré, France

2015-09-24

Prenatal screening tests for Down syndrome (DS) are routine in many developed countries and new tests are rapidly becoming available. Decisions about prenatal screening are increasingly complex with each successive test, and pregnant women need information about risks and benefits as well as clarity about their values. Decision aids (DAs) can help healthcare providers support women in this decision. Using an environmental scan, we aimed to identify publicly available DAs focusing on prenatal screening/diagnosis for Down syndrome that provide effective support for decision making. Data sources searched were the Decision Aids Library Inventory (DALI) of the Ottawa Patient Decision Aids Research Group at the Ottawa Health Research Institute; Google searches on the internet; professional organizations, academic institutions and other experts in the field; and references in existing systematic reviews on DAs. Eligible DAs targeted pregnant women, focused on prenatal screening and/or diagnosis, applied to tests for fetal abnormalities or aneuploidies, and were in French, English, Spanish or Portuguese. Pairs of reviewers independently identified eligible DAs and extracted characteristics including the presence of practical decision support tools and features to aid comprehension. They then performed quality assessment using the 16 minimum standards established by the International Patient Decision Aids Standards (IPDASi v4.0). Of 543 potentially eligible DAs (512 in DALI, 27 from experts, and four on the internet), 23 were eligible and 20 were available for data extraction. DAs were developed from 1996 to 2013 in six countries (UK, USA, Canada, Australia, Sweden, and France). Five DAs were for prenatal screening, three for prenatal diagnosis and 12 for both). Eight contained values clarification methods (personal worksheets). The 20 DAs scored a median of 10/16 (range 6-15) on the 16 IPDAS minimum standards. None of the 20 included DAs met all 16 IPDAS minimum standards

System for selecting relevant information for decision support.

PubMed

Kalina, Jan; Seidl, Libor; Zvára, Karel; Grünfeldová, Hana; Slovák, Dalibor; Zvárová, Jana

2013-01-01

We implemented a prototype of a decision support system called SIR which has a form of a web-based classification service for diagnostic decision support. The system has the ability to select the most relevant variables and to learn a classification rule, which is guaranteed to be suitable also for high-dimensional measurements. The classification system can be useful for clinicians in primary care to support their decision-making tasks with relevant information extracted from any available clinical study. The implemented prototype was tested on a sample of patients in a cardiological study and performs an information extraction from a high-dimensional set containing both clinical and gene expression data.

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

PubMed

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-04-01

To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

Becoming a Mother: Supported Decision-Making in Context

ERIC Educational Resources Information Center

Jamieson, Rhiann; Theodore, Kate; Raczka, Roman

2016-01-01

Little is known about how women with intellectual disabilities make decisions in relation to pregnancy. Social support is important for mothers with intellectual disabilities in many areas. This study explored how the support network influenced the decision-making of women with intellectual disabilities in relation to pregnancy. The study extended…

How Decision Support Systems Can Benefit from a Theory of Change Approach.

PubMed

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

How Decision Support Systems Can Benefit from a Theory of Change Approach

NASA Astrophysics Data System (ADS)

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

Using SMAP data to improve drought early warning over the US Great Plains

NASA Astrophysics Data System (ADS)

Fu, R.; Fernando, N.; Tang, W.

2015-12-01

A drought prone region such as the Great Plains of the United States (US GP) requires credible and actionable drought early warning. Such information cannot simply be extracted from available climate forecasts because of their large uncertainties at regional scales, and unclear connections to the needs of the decision makers. In particular, current dynamic seasonal predictions and climate projections, such as those produced by the NOAA North American Multi-Model Ensemble experiment (NMME) are much more reliable for winter and spring than for the summer season for the US GP. To mitigate the weaknesses of dynamic prediction/projections, we have identified three key processes behind the spring-to-summer dry memory through observational studies, as the scientific basis for a statistical drought early warning system. This system uses percentile soil moisture anomalies in spring as a key input to provide a probabilistic summer drought early warning. The latter outperforms the dynamic prediction over the US Southern Plains and has been used by the Texas state water agency to support state drought preparedness. A main source of uncertainty for this drought early warning system is the soil moisture input obtained from the NOAA Climate Forecasting System (CFS). We are testing use of the beta version of NASA Soil Moisture Active Passive (SMAP) soil moisture data, along with the Soil Moisture and Ocean Salinity (SMOS), and the long-term Essential Climate Variable Soil Moisture (ECV-SM) soil moisture data, to reduce this uncertainty. Preliminary results based on ECV-SM suggests satellite based soil moisture data could improve early warning of rainfall anomalies over the western US GP with less dense vegetation. The skill degrades over the eastern US GP where denser vegetation is found. We evaluate our SMAP-based drought early warning for 2015 summer against observations.

IBM’s Health Analytics and Clinical Decision Support

PubMed Central

Sun, J.; Knoop, S.; Shabo, A.; Carmeli, B.; Sow, D.; Syed-Mahmood, T.; Rapp, W.

2014-01-01

Summary Objectives This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Methods Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. Results There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Conclusion Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation. PMID:25123736

Aggregation of Environmental Model Data for Decision Support

NASA Astrophysics Data System (ADS)

Alpert, J. C.

2013-12-01

Weather forecasts and warnings must be prepared and then delivered so as to reach their intended audience in good time to enable effective decision-making. An effort to mitigate these difficulties was studied at a Workshop, 'Sustaining National Meteorological Services - Strengthening WMO Regional and Global Centers' convened, June , 2013, by the World Bank, WMO and the US National Weather Service (NWS). The skill and accuracy of atmospheric forecasts from deterministic models have increased and there are now ensembles of such models that improve decisions to protect life, property and commerce. The NWS production of numerical weather prediction products result in model output from global and high resolution regional ensemble forecasts. Ensembles are constructed by changing the initial conditions to make a 'cloud' of forecasts that attempt to span the space of possible atmospheric realizations which can quantify not only the most likely forecast, but also the uncertainty. This has led to an unprecedented increase in data production and information content from higher resolution, multi-model output and secondary calculations. One difficulty is to obtain the needed subset of data required to estimate the probability of events, and report the information. The calibration required to reliably estimate the probability of events, and honing of threshold adjustments to reduce false alarms for decision makers is also needed. To meet the future needs of the ever-broadening user community and address these issues on a national and international basis, the weather service implemented the NOAA Operational Model Archive and Distribution System (NOMADS). NOMADS provides real-time and retrospective format independent access to climate, ocean and weather model data and delivers high availability content services as part of NOAA's official real time data dissemination at its new NCWCP web operations center. An important aspect of the server's abilities is to aggregate the matrix of

Human factors research problems in electronic voice warning system design

NASA Technical Reports Server (NTRS)

Simpson, C. A.; Williams, D. H.

1975-01-01

The speech messages issued by voice warning systems must be carefully designed in accordance with general principles of human decision making processes, human speech comprehension, and the conditions in which the warnings can occur. The operator's effectiveness must not be degraded by messages that are either inappropriate or difficult to comprehend. Important experimental variables include message content, linguistic redundancy, signal/noise ratio, interference with concurrent tasks, and listener expectations generated by the pragmatic or real world context in which the messages are presented.

The Global Drought Information System - A Decision Support Tool with Global Applications

NASA Astrophysics Data System (ADS)

Heim, R. R.; Brewer, M.

2012-12-01

Drought is a natural hazard which can cause famine in developing countries and severe economic hardship in developed countries. Given current concerns with the increasing frequency and magnitude of droughts in many regions of the world, especially in the light of expected climate change, drought monitoring and dissemination of early warning information in a timely fashion on a global scale is a critical concern as an important adaptation and mitigation strategy. While a number of nations, and a few continental-scale activities have developed drought information system activities, a global drought early warning system (GDEWS) remains elusive, despite the benefits highlighted by ministers to the Global Earth Observation System of System in 2008. In an effort to begin a process of drought monitoring with international collaboration, the National Integrated Drought Information System's (NIDIS) U.S. Drought Portal, a web-based information system created to address drought services and early warning in the United States, including drought monitoring, forecasting, impacts, mitigation, research, and education, volunteered to develop a prototype Global Drought Monitoring Portal (GDMP). Through integration of data and information at the global level, and with four continental-level partners, the GDMP has proven successful as a tool to monitor drought around the globe. At a recent meeting between NIDIS, the World Meteorological Organization, and the Global Earth Observation System of Systems, it was recommended that the GDMP form the basis for a Global Drought Information System (GDIS). Currently, GDIS activities are focused around incorporating additional drought monitoring information, especially from those areas without regional or continental-scale input, and incorporating drought-specific climate forecast information from the World Climate Research Programme. Additional GDIS pilot activities are underway with an emphasis on information and decision making, and how to

Graphic warnings and text warning labels on cigarette packages in Riyadh Kingdom of Saudi Arabia: Awareness and perceptions

PubMed Central

Jradi, Hoda; Saddik, Basema

2018-01-01

BACKGROUND: Graphic warning labels have been shown to be effective in smoking initiation and cessation and were implemented in Saudi Arabia in 2012. To date, no study has assessed the effectiveness of these labels and the Saudi population's perceptions on the effectiveness of cigarette health warning labels. METHODS: We used a cross-sectional qualitative study comprising of nine focus groups among 3 different community group members including health-care workers, adult women and adult men. We conducted in-depth interviews among community leaders. Both focus groups and interviews assessed awareness levels and elicited perceptions about health warning labels on cigarette boxes currently used in the Kingdom of Saudi Arabia. RESULTS: While most participants in the study were aware and supported the use of graphic warning labels on cigarette packages, the awareness of the specific details on the labels was low. Participants perceived the effectiveness of current labels somewhat vague in smoking cessation and advocated for stronger and more aggressive graphics. Community leaders, however, preferred text-only labels and did not support aggressive labels which were deemed culturally and religiously inappropriate. CONCLUSIONS: The study suggests that while graphic warning labels are perceived as necessary on cigarette packages the currently used messages are not clear and therefore do not serve their intended purposes. Measures should be undertaken to ensure that pictorial cigarette labels used in Saudi Arabia are culturally and ethnically appropriate and are rotated on a regular basis to ensure salience among smokers and nonsmokers alike. PMID:29387252

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 ...

Evidence-Based Support for the Characteristics of Tsunami Warning Messages for Local, Regional and Distant Sources

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Johnston, D. M.; Sorensen, J. H.; Vogt Sorensen, B.; Whitmore, P.

2014-12-01

Many studies since 2004 have documented the dissemination and receipt of risk information for local to distant tsunamis and factors influencing people's responses. A few earlier tsunami studies and numerous studies of other hazards provide additional support for developing effective tsunami messages. This study explores evidence-based approaches to developing such messages for the Pacific and National Tsunami Warning Centers in the US. It extends a message metric developed for the NWS Tsunami Program. People at risk to tsunamis receive information from multiple sources through multiple channels. Sources are official and informal and environmental and social cues. Traditionally, official tsunami messages followed a linear dissemination path through relatively few channels from warning center to emergency management to public and media. However, the digital age has brought about a fundamental change in the dissemination and receipt of official and informal communications. Information is now disseminated in very non-linear paths and all end-user groups may receive the same message simultaneously. Research has demonstrated a range of factors that influence rapid respond to an initial real or perceived threat. Immediate response is less common than one involving delayed protective actions where people first engage in "milling behavior" to exchange information and confirm the warning before taking protective action. The most important message factors to achieve rapid response focus on the content and style of the message and the frequency of dissemination. Previously we developed a tsunami message metric consisting of 21 factors divided into message content and style and receiver characteristics. Initially, each factor was equally weighted to identify gaps, but here we extend the work by weighting specific factors. This utilizes recent research that identifies the most important determinants of protective action. We then discuss the prioritization of message information

Should We Stay Or Should We Go Now? Hazard Warnings, Risk Perception, and Evacuation Decisions at Pacaya Volcano, Guatemala During the 2010 Eruption.

NASA Astrophysics Data System (ADS)

Lechner, H. N.; Rouleau, M.

2017-12-01

Pacaya volcano, in Guatemala, presents considerable risk to nearby communities and in May 2010, the volcano experienced its largest eruption in more than a decade. The eruption damaged or destroyed hundreds of homes, injured scores of people with one fatality, and prompted the evacuation of approximately 2000 people from several communities. During this eruption crisis, people living within at-risk communities were presented with the choice to evacuate or remain in the hazard zone. Many chose not to leave. Using quantitative methodologies, this research investigates evacuation decisions through causal relationships between hazard warnings, evacuation orders, risk perception, evacuation intention and behavior, and attempts to understand why some people chose to stay in harm's-way. In October 2016, we conducted a door-to-door survey administered to 172 households in eight communities within 5 km of the active vent. Participants were asked to rank factors that influenced their decision to evacuate or not, their level of trust in emergency management agencies, and the intention to evacuate during a future crisis. Initial analysis suggests that many people have confidence in emergency management agencies and information from volcano scientists; however, during the 2010 eruption, warning messages and evacuation orders were based on previous eruption patterns and tephra distribution and therefore disseminated differentially to at-risk communities. This likely delayed evacuation decisions by households in the communities that were most affected by the eruption. The data also suggest that while many households perceive evacuation as the most effective protective action, the perceived risk to one's home and property may play a more important role in the decision making process. We will discuss these results as well as communication strategies between agencies and communities, and how to better facilitate more effective and successful evacuations during future eruption crises

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study

PubMed Central

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-01-01

OBJECTIVE: To explore multiple stakeholders’ perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. METHODS: An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators’, clinicians’, parents’ and youths’ perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. RESULTS: Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders’ knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital’s culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. CONCLUSIONS: Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors’ paediatric hospital. PMID:27398058

The conceptual foundation of environmental decision support.

PubMed

Reichert, Peter; Langhans, Simone D; Lienert, Judit; Schuwirth, Nele

2015-05-01

Environmental decision support intends to use the best available scientific knowledge to help decision makers find and evaluate management alternatives. The goal of this process is to achieve the best fulfillment of societal objectives. This requires a careful analysis of (i) how scientific knowledge can be represented and quantified, (ii) how societal preferences can be described and elicited, and (iii) how these concepts can best be used to support communication with authorities, politicians, and the public in environmental management. The goal of this paper is to discuss key requirements for a conceptual framework to address these issues and to suggest how these can best be met. We argue that a combination of probability theory and scenario planning with multi-attribute utility theory fulfills these requirements, and discuss adaptations and extensions of these theories to improve their application for supporting environmental decision making. With respect to (i) we suggest the use of intersubjective probabilities, if required extended to imprecise probabilities, to describe the current state of scientific knowledge. To address (ii), we emphasize the importance of value functions, in addition to utilities, to support decisions under risk. We discuss the need for testing "non-standard" value aggregation techniques, the usefulness of flexibility of value functions regarding attribute data availability, the elicitation of value functions for sub-objectives from experts, and the consideration of uncertainty in value and utility elicitation. With respect to (iii), we outline a well-structured procedure for transparent environmental decision support that is based on a clear separation of scientific prediction and societal valuation. We illustrate aspects of the suggested methodology by its application to river management in general and with a small, didactical case study on spatial river rehabilitation prioritization. Copyright © 2015 The Authors. Published by

Analytical Support Capabilities of Turkish General Staff Scientific Decision Support Centre (SDSC) to Defence Transformation

DTIC Science & Technology

2005-04-01

RTO-MP-SAS-055 4 - 1 UNCLASSIFIED/UNLIMITED UNCLASSIFIED/UNLIMITED Analytical Support Capabilities of Turkish General Staff Scientific...the end failed to achieve anything commensurate with the effort. The analytical support capabilities of Turkish Scientific Decision Support Center to...percent of the İpekkan, Z.; Özkil, A. (2005) Analytical Support Capabilities of Turkish General Staff Scientific Decision Support Centre (SDSC) to

Interprofessional education about patient decision support in specialty care.

PubMed

Politi, Mary C; Pieterse, Arwen H; Truant, Tracy; Borkhoff, Cornelia; Jha, Vikram; Kuhl, Laura; Nicolai, Jennifer; Goss, Claudia

2011-11-01

Specialty care involves services provided by health professionals who focus on treating diseases affecting one body system. In contrast to primary care - aimed at providing continuous, comprehensive care - specialty care often involves intermittent episodes of care focused around specific medical conditions. In addition, it typically includes multiple providers who have unique areas of expertise that are important in supporting patients' care. Interprofessional care involves multiple professionals from different disciplines collaborating to provide an integrated approach to patient care. For patients to experience continuity of care across interprofessional providers, providers need to communicate and maintain a shared sense of responsibility to their patients. In this article, we describe challenges inherent in providing interprofessional patient decision support in specialty care. We propose ways for providers to engage in interprofessional decision support and discuss promising approaches to teaching an interprofessional decision support to specialty care providers. Additional evaluation and empirical research are required before further recommendations can be made about education for interprofessional decision support in specialty care.

Public attitudes toward larger cigarette pack warnings: Results from a nationally representative U.S. sample

PubMed Central

2017-01-01

A large body of evidence supports the effectiveness of larger health warnings on cigarette packages. However, there is limited research examining attitudes toward such warning labels, which has potential implications for implementation of larger warning labels. The purpose of the current study was to examine attitudes toward larger warning sizes on cigarette packages and examine variables associated with more favorable attitudes. In a nationally representative survey of U.S. adults (N = 5,014), participants were randomized to different warning size conditions, assessing attitude toward “a health warning that covered (25, 50, 75) % of a cigarette pack.” SAS logistic regression survey procedures were used to account for the complex survey design and sampling weights. Across experimental groups, nearly three-quarters (72%) of adults had attitudes supportive of larger warning labels on cigarette packs. Among the full sample and smokers only (N = 1,511), most adults had favorable attitudes toward labels that covered 25% (78.2% and 75.2%, respectively), 50% (70% and 58.4%, respectively), and 75% (67.9% and 61%, respectively) of a cigarette pack. Young adults, females, racial/ethnic minorities, and non-smokers were more likely to have favorable attitudes toward larger warning sizes. Among smokers only, females and those with higher quit intentions held more favorable attitudes toward larger warning sizes. Widespread support exists for larger warning labels on cigarette packages among U.S. adults, including among smokers. Our findings support the implementation of larger health warnings on cigarette packs in the U.S. as required by the 2009 Tobacco Control Act. PMID:28253257

Temporal reasoning for decision support in medicine.

PubMed

Augusto, Juan Carlos

2005-01-01

Handling time-related concepts is essential in medicine. During diagnosis it can make a substantial difference to know the temporal order in which some symptoms occurred or for how long they lasted. During prognosis the potential evolutions of a disease are conceived as a description of events unfolding in time. In therapy planning the different steps of treatment must be applied in a precise order, with a given frequency and for a certain span of time in order to be effective. This article offers a survey on the use of temporal reasoning for decision support-related tasks in medicine. Key publications of the area, mainly circumscribed to the latest two decades, are reviewed and classified according to three important stages of patient treatment requiring decision support: diagnosis, prognosis and therapy planning/management. Other complementary publications, like those on time-centered information storage and retrieval, are also considered as they provide valuable support to the above mentioned three stages. Key areas are highlighted and used to organize the latest contributions. The survey of previous research is followed by an analysis of what can still be improved and what is needed to make the next generation of decision support systems for medicine more effective. It can be observed that although the area has been considerably developed, there are still areas where more research is needed to make time-based systems of widespread use in decision support-related areas of medicine. Several suggestions for further exploration are proposed as a result of the survey.

Autonomous Task Management and Decision Support Tools

NASA Technical Reports Server (NTRS)

Burian, Barbara

2017-01-01

For some time aircraft manufacturers and researchers have been pursuing mechanisms for reducing crew workload and providing better decision support to the pilots, especially during non-normal situations. Some previous attempts to develop task managers or pilot decision support tools have not resulted in robust and fully functional systems. However, the increasing sophistication of sensors and automated reasoners, and the exponential surge in the amount of digital data that is now available create a ripe environment for the development of a robust, dynamic, task manager and decision support tool that is context sensitive and integrates information from a wide array of on-board and off aircraft sourcesa tool that monitors systems and the overall flight situation, anticipates information needs, prioritizes tasks appropriately, keeps pilots well informed, and is nimble and able to adapt to changing circumstances. This presentation will discuss the many significant challenges and issues associated with the development and functionality of such a system for use on the aircraft flight deck.

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.

A Hyperknowledge Framework of Decision Support Systems.

ERIC Educational Resources Information Center

Chang, Ai-Mei; And Others

1994-01-01

Presents a hyperknowledge framework of decision support systems (DSS). This framework formalizes specifics about system functionality, representation of knowledge, navigation of the knowledge system, and user-interface traits as elements of a DSS environment that conforms closely to human cognitive processes in decision making. (Contains 52…

The role of integrating natural and social science concepts for risk governance and the design of people-centred early warning systems. Case study from the German-Indonesian Tsunami Early Warning System Project (GITEWS)

NASA Astrophysics Data System (ADS)

Gebert, Niklas; Post, Joachim

2010-05-01

The development of early warning systems are one of the key domains of adaptation to global environmental change and contribute very much to the development of societal reaction and adaptive capacities to deal with extreme events. Especially, Indonesia is highly exposed to tsunami. In average every three years small and medium size tsunamis occur in the region causing damage and death. In the aftermath of the Indian Ocean Tsunami 2004, the German and Indonesian government agreed on a joint cooperation to develop a People Centered End-to-End Early Warning System (GITEWS). The analysis of risk and vulnerability, as an important step in risk (and early warning) governance, is a precondition for the design of effective early warning structures by delivering the knowledge base for developing institutionalized quick response mechanisms of organizations involved in the issuing of a tsunami warning, and of populations exposed to react to warnings and to manage evacuation before the first tsunami wave hits. Thus, a special challenge for developing countries is the governance of complex cross-sectoral and cross-scale institutional, social and spatial processes and requirements for the conceptualization, implementation and optimization of a people centered tsunami early warning system. In support of this, the risk and vulnerability assessment of the case study aims at identifying those factors that constitute the causal structure of the (dis)functionality between the technological warning and the social response system causing loss of life during an emergency situation: Which social groups are likely to be less able to receive and respond to an early warning alert? And, are people able to evacuate in due time? Here, only an interdisciplinary research approach is capable to analyze the socio-spatial and environmental conditions of vulnerability and risk and to produce valuable results for decision makers and civil society to manage tsunami risk in the early warning context

A conceptual evolutionary aseismic decision support framework for hospitals

NASA Astrophysics Data System (ADS)

Hu, Yufeng; Dargush, Gary F.; Shao, Xiaoyun

2012-12-01

In this paper, aconceptual evolutionary framework for aseismic decision support for hospitalsthat attempts to integrate a range of engineering and sociotechnical models is presented. Genetic algorithms are applied to find the optimal decision sets. A case study is completed to demonstrate how the frameworkmay applytoa specific hospital.The simulations show that the proposed evolutionary decision support framework is able to discover robust policy sets in either uncertain or fixed environments. The framework also qualitatively identifies some of the characteristicbehavior of the critical care organization. Thus, by utilizing the proposedframework, the decision makers are able to make more informed decisions, especially toenhance the seismic safety of the hospitals.

Research on web-based decision support system for sports competitions

NASA Astrophysics Data System (ADS)

Huo, Hanqiang

2010-07-01

This paper describes the system architecture and implementation technology of the decision support system for sports competitions, discusses the design of decision-making modules, management modules and security of the system, and proposes the development idea of building a web-based decision support system for sports competitions.

Towards ethical decision support and knowledge management in neonatal intensive care.

PubMed

Yang, L; Frize, M; Eng, P; Walker, R; Catley, C

2004-01-01

Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.

Decision support systems for robotic surgery and acute care

NASA Astrophysics Data System (ADS)

Kazanzides, Peter

2012-06-01

Doctors must frequently make decisions during medical treatment, whether in an acute care facility, such as an Intensive Care Unit (ICU), or in an operating room. These decisions rely on a various information sources, such as the patient's medical history, preoperative images, and general medical knowledge. Decision support systems can assist by facilitating access to this information when and where it is needed. This paper presents some research eorts that address the integration of information with clinical practice. The example systems include a clinical decision support system (CDSS) for pediatric traumatic brain injury, an augmented reality head- mounted display for neurosurgery, and an augmented reality telerobotic system for minimally-invasive surgery. While these are dierent systems and applications, they share the common theme of providing information to support clinical decisions and actions, whether the actions are performed with the surgeon's own hands or with robotic assistance.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

ScienceCinema

None

2018-01-16

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

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

None

2016-07-27

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

NOAA/West coast and Alaska Tsunami warning center Atlantic Ocean response criteria

USGS Publications Warehouse

Whitmore, P.; Refidaff, C.; Caropolo, M.; Huerfano-Moreno, V.; Knight, W.; Sammler, W.; Sandrik, A.

2009-01-01

West Coast/Alaska Tsunami Warning Center (WCATWC) response criteria for earthquakesoccurring in the Atlantic and Caribbean basins are presented. Initial warning center decisions are based on an earthquake's location, magnitude, depth, distance from coastal locations, and precomputed threat estimates based on tsunami models computed from similar events. The new criteria will help limit the geographical extent of warnings and advisories to threatened regions, and complement the new operational tsunami product suite. Criteria are set for tsunamis generated by earthquakes, which are by far the main cause of tsunami generation (either directly through sea floor displacement or indirectly by triggering of sub-sea landslides).The new criteria require development of a threat data base which sets warning or advisory zones based on location, magnitude, and pre-computed tsunami models. The models determine coastal tsunami amplitudes based on likely tsunami source parameters for a given event. Based on the computed amplitude, warning and advisory zones are pre-set.

Impact of social preparedness on flood early warning systems

NASA Astrophysics Data System (ADS)

Girons Lopez, M.; Di Baldassarre, G.; Seibert, J.

2017-01-01

Flood early warning systems play a major role in the disaster risk reduction paradigm as cost-effective methods to mitigate flood disaster damage. The connections and feedbacks between the hydrological and social spheres of early warning systems are increasingly being considered as key aspects for successful flood mitigation. The behavior of the public and first responders during flood situations, determined by their preparedness, is heavily influenced by many behavioral traits such as perceived benefits, risk awareness, or even denial. In this study, we use the recency of flood experiences as a proxy for social preparedness to assess its impact on the efficiency of flood early warning systems through a simple stylized model and implemented this model using a simple mathematical description. The main findings, which are based on synthetic data, point to the importance of social preparedness for flood loss mitigation, especially in circumstances where the technical forecasting and warning capabilities are limited. Furthermore, we found that efforts to promote and preserve social preparedness may help to reduce disaster-induced losses by almost one half. The findings provide important insights into the role of social preparedness that may help guide decision-making in the field of flood early warning systems.

The Financial Benefit of Early Flood Warnings in Europe

NASA Astrophysics Data System (ADS)

Pappenberger, Florian; Cloke, Hannah L.; Wetterhall, Fredrik; Parker, Dennis J.; Richardson, David; Thielen, Jutta

2015-04-01

Effective disaster risk management relies on science based solutions to close the gap between prevention and preparedness measures. The outcome of consultations on the UNIDSR post-2015 framework for disaster risk reduction highlight the need for cross-border early warning systems to strengthen the preparedness phases of disaster risk management in order to save people's lives and property and reduce the overall impact of severe events. In particular, continental and global scale flood forecasting systems provide vital information to various decision makers with which early warnings of floods can be made. Here the potential monetary benefits of early flood warnings using the example of the European Flood Awareness System (EFAS) are calculated based on pan-European Flood damage data and calculations of potential flood damage reductions. The benefits are of the order of 400 Euro for every 1 Euro invested. Because of the uncertainties which accompany the calculation, a large sensitivity analysis is performed in order to develop an envelope of possible financial benefits. Current EFAS system skill is compared against perfect forecasts to demonstrate the importance of further improving the skill of the forecasts. Improving the response to warnings is also essential in reaping the benefits of flood early warnings.

Big-Data Based Decision-Support Systems to Improve Clinicians' Cognition.

PubMed

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.

Towards a certification process for tsunami early warning systems

NASA Astrophysics Data System (ADS)

Löwe, Peter; Wächter, Jochen; Hammitzsch, Martin

2013-04-01

The natural disaster of the Boxing Day Tsunami of 2004 was followed by an information catastrophe. Crucial early warning information could not be delivered to the communities under imminent threat, resulting in over 240,000 casualties in 14 countries. This tragedy sparked the development of a new generation of integrated modular Tsunami Early Warning Systems (TEWS). While significant advances were accomplished in the past years, recent events, like the Chile 2010 and the Tohoku 2011 tsunami demonstrate that the key technical challenge for Tsunami Early Warning research on the supranational scale still lies in the timely issuing of status information and reliable early warning messages in a proven workflow. A second challenge stems from the main objective of the Intergovernmental Oceanographic Commission of UNESCO (IOC) Tsunami Programme, the integration of national TEWS towards ocean-wide networks: Each of the increasing number of integrated Tsunami Early Warning Centres has to cope with the continuing evolution of sensors, hardware and software while having to maintain reliable inter-center information exchange services. To avoid future information catastrophes, the performance of all components, ranging from individual sensors, to Warning Centers within their particular end-to-end Warning System Environments, and up to federated Systems of Tsunami Warning Systems has to be regularly validated against defined criteria. Since 2004, GFZ German Research Centre for Geosciences (GFZ) has built up expertise in the field of TEWS. Within GFZ, the Centre for GeoInformation Technology (CeGIT) has focused its work on the geoinformatics aspects of TEWS in two projects already, being the German Indonesian Tsunami Early Warning System (GITEWS) and the Distant Early Warning System (DEWS). This activity is continued in the TRIDEC project (Collaborative, Complex, and Critical Decision Processes in Evolving Crises) funded under the European Union's seventh Framework Programme (FP7

Alcohol Warning Label Perceptions: Do Warning Sizes and Plain Packaging Matter?

PubMed

Al-Hamdani, Mohammed; Smith, Steven M

2017-01-01

There is a dearth of research on the effectiveness of stringent alcohol warning labels. Our experiment tested whether increasing the size of an alcohol health warning lowers product-based ratings. We examined whether plain packaging lowers ratings of alcohol products and the consumers who use them, increases ratings of bottle "boringness," and enhances warning recognition compared with branded packaging. A total of 440 adults (51.7% female) viewed one of three warning sizes (50%, 75%, or 90% of label surface) on either a plain or branded bottle of distilled spirits, wine, and beer. Participants also rated alcohol bottles on product-based (assessing the product itself), consumer-based (assessing perceptions of consumers of the product), and bottle boringness ratings, and then attempted to recognize the correct warning out of four choices. As expected, the size of warning labels lowered product-based ratings. Similarly, plain packaging lowered product-based and consumer-based ratings and increased bottle boringness but only for wine bottles. Further, plain packaging increased the odds of warning recognition on bottles of distilled spirits. This study shows that plain packaging and warning size (similar to the graphic warnings on cigarette packages) affect perceptions about alcohol bottles. It also shows that plain packaging increases the likelihood for correct health warning recognition, which builds the case for alcohol warning and packaging research and policy.

Environment Agency England flood warning systems

NASA Astrophysics Data System (ADS)

Strong, Chris; Walters, Mark; Haynes, Elizabeth; Dobson, Peter

2015-04-01

registration via third parties. The 'Future Flood Warning System' Our research shows that people want more choice on how they access and receive warnings. Many want a service tailored to their own risk, rather than that of their community. They also want more information about the forecast and the situation to that they can make decisions personal to their circumstances. Our future flood warning system will build upon the success of our existing service and will aim to: • provide our customers with a more flexible and personalised self-service approach which caters for the diverse range of user needs • alert people wherever they are, not just in properties • be flexible enough to respond to user feedback to make improvements and utilise new technology as it becomes available • provide real-time visualisation of system performance, to assist our flood response • capture greater levels of information from the recipients of our warnings • be efficient for operators of the system and utilise automation where relevant • take a risk based approach to resilience to provide the highest level of reliability when needed at a reduced cost

Believability of Cigarette Warnings About Addiction: National Experiments of Adolescents and Adults.

PubMed

Lazard, Allison J; Kowitt, Sarah D; Huang, Li-Ling; Noar, Seth M; Jarman, Kristen L; Goldstein, Adam O

2018-06-07

We conducted two experiments to examine the believability of three addiction-focused cigarette warnings and the influence of message source on believability among adolescents and adults in the United States. Experimental data were collected using national phone surveys of adolescents (age 13-17; n = 1125; response rate, 66%) and adults (age 18+; n = 5014; response rate, 42%). We assessed the believability of three cigarette warnings about addiction attributed to four message sources (Food and Drug Administration [FDA], Surgeon General, Centers for Disease Control and Prevention [CDC], no source). The majority of adolescents and adults reported the three cigarette warnings were very believable (49%-81% for adolescents; 47%-76% for adults). We found four to five times higher odds of adolescents believing a warning that cigarettes are addictive (warning 1) or that nicotine was an addictive chemical (warning 2) compared to a warning that differentiated the addictive risks of menthol versus traditional cigarettes (warning 3), warning 1 adjusted odds ratio (aOR): 4.53, 95% confidence interval (CI): 3.10, 6.63; warning 2 aOR: 3.87, 95% CI: 2.70, 5.50. Similarly, we found three to five times higher odds of adults (including current smokers) believing the same warnings, warning 1 aOR: 3.74, 95% CI: 2.82, 4.95; warning 2 aOR: 3.24, 95% CI: 2.45, 4.28. Message source had no overall impact on the believability of warnings for either population. Our findings support the implementation of FDA's required warnings that cigarettes are addictive and that nicotine is an addictive chemical. These believable warnings may deter adolescents from initiating smoking and encourage adults to quit smoking. This article describes, for the first time, the believability of different cigarette warnings about addiction. We now know that the majority of adolescents and adults believe cigarette warnings that highlight cigarettes as addictive and that nicotine is an addictive chemical in tobacco

Computerized Clinical Decision Support: Contributions from 2015

PubMed Central

Bouaud, J.

2016-01-01

Summary Objective To summarize recent research and select the best papers published in 2015 in the field of computerized clinical decision support for the Decision Support section of the IMIA yearbook. Method A literature review was performed by searching two bibliographic databases for papers related to clinical decision support systems (CDSSs) and computerized provider order entry (CPOE) systems. The aim was to identify a list of candidate best papers from the retrieved papers that were then peer-reviewed by external reviewers. A consensus meeting between the two section editors and the IMIA editorial team was finally conducted to conclude in the best paper selection. Results Among the 974 retrieved papers, the entire review process resulted in the selection of four best papers. One paper reports on a CDSS routinely applied in pediatrics for more than 10 years, relying on adaptations of the Arden Syntax. Another paper assessed the acceptability and feasibility of an important CPOE evaluation tool in hospitals outside the US where it was developed. The third paper is a systematic, qualitative review, concerning usability flaws of medication-related alerting functions, providing an important evidence-based, methodological contribution in the domain of CDSS design and development in general. Lastly, the fourth paper describes a study quantifying the effect of a complex, continuous-care, guideline-based CDSS on the correctness and completeness of clinicians’ decisions. Conclusions While there are notable examples of routinely used decision support systems, this 2015 review on CDSSs and CPOE systems still shows that, despite methodological contributions, theoretical frameworks, and prototype developments, these technologies are not yet widely spread (at least with their full functionalities) in routine clinical practice. Further research, testing, evaluation, and training are still needed for these tools to be adopted in clinical practice and, ultimately, illustrate

Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise.

PubMed

Militello, Laura G; Saleem, Jason J; Borders, Morgan R; Sushereba, Christen E; Haverkamp, Donald; Wolf, Steven P; Doebbeling, Bradley N

2016-03-01

Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration's EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability.

Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise

PubMed Central

Militello, Laura G.; Saleem, Jason J.; Borders, Morgan R.; Sushereba, Christen E.; Haverkamp, Donald; Wolf, Steven P.; Doebbeling, Bradley N.

2016-01-01

Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration’s EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability. PMID:26973441

Assessing the add value of ensemble forecast in a drought early warning

NASA Astrophysics Data System (ADS)

Calmanti, Sandro; Bosi, Lorenzo; Fernandez, Jesus; De Felice, Matteo

2015-04-01

The EU-FP7 project EUPORIAS is developing a prototype climate service to enhance the existing food security drought early warning system in Ethiopia. The Livelihoods, Early Assessment and Protection (LEAP) system is the Government of Ethiopia's national food security early warning system, established with the support of WFP and the World Bank in 2008. LEAP was designed to increase the predictability and timeliness of response to drought-related food crises in Ethiopia. It combines early warning with contingency planning and contingency funding, to allow the government, WFP and other partners to provide early assistance in anticipation of an impending catastrophes. Currently, LEAP uses satellite based rainfall estimates to monitor drought conditions and to compute needs. The main aim of the prototype is to use seasonal hindcast data to assess the added value of using ensemble climate rainfall forecasts to estimate the cost of assistance of population hit by major droughts. We outline the decision making process that is informed by the prototype climate service, and we discuss the analysis of the expected and skill of the available rainfall forecast data over Ethiopia. One critical outcome of this analysis is the strong dependence of the expected skill on the observational estimate assumed as reference. A preliminary evaluation of the full prototype products (drought indices and needs estimated) using hindcasts data will also be presented.

Bayesian Decision Support for Adaptive Lung Treatments

NASA Astrophysics Data System (ADS)

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

2014-03-01

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

Audio-video decision support for patients: the documentary genré as a basis for decision aids.

PubMed

Volandes, Angelo E; Barry, Michael J; Wood, Fiona; Elwyn, Glyn

2013-09-01

Decision support tools are increasingly using audio-visual materials. However, disagreement exists about the use of audio-visual materials as they may be subjective and biased. This is a literature review of the major texts for documentary film studies to extrapolate issues of objectivity and bias from film to decision support tools. The key features of documentary films are that they attempt to portray real events and that the attempted reality is always filtered through the lens of the filmmaker. The same key features can be said of decision support tools that use audio-visual materials. Three concerns arising from documentary film studies as they apply to the use of audio-visual materials in decision support tools include whose perspective matters (stakeholder bias), how to choose among audio-visual materials (selection bias) and how to ensure objectivity (editorial bias). Decision science needs to start a debate about how audio-visual materials are to be used in decision support tools. Simply because audio-visual materials may be subjective and open to bias does not mean that we should not use them. Methods need to be found to ensure consensus around balance and editorial control, such that audio-visual materials can be used. © 2011 John Wiley & Sons Ltd.

Audio‐video decision support for patients: the documentary genré as a basis for decision aids

PubMed Central

Volandes, Angelo E.; Barry, Michael J.; Wood, Fiona; Elwyn, Glyn

2011-01-01

Abstract Objective  Decision support tools are increasingly using audio‐visual materials. However, disagreement exists about the use of audio‐visual materials as they may be subjective and biased. Methods  This is a literature review of the major texts for documentary film studies to extrapolate issues of objectivity and bias from film to decision support tools. Results  The key features of documentary films are that they attempt to portray real events and that the attempted reality is always filtered through the lens of the filmmaker. The same key features can be said of decision support tools that use audio‐visual materials. Three concerns arising from documentary film studies as they apply to the use of audio‐visual materials in decision support tools include whose perspective matters (stakeholder bias), how to choose among audio‐visual materials (selection bias) and how to ensure objectivity (editorial bias). Discussion  Decision science needs to start a debate about how audio‐visual materials are to be used in decision support tools. Simply because audio‐visual materials may be subjective and open to bias does not mean that we should not use them. Conclusion  Methods need to be found to ensure consensus around balance and editorial control, such that audio‐visual materials can be used. PMID:22032516

The application of reduced-processing decision support systems to facilitate the acquisition of decision-making skills.

PubMed

Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard

2013-06-01

The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.

Investigating the Heart Pump Implant Decision Process: Opportunities for Decision Support Tools to Help

PubMed Central

Yang, Qian; Zimmerman, John; Steinfeld, Aaron; Carey, Lisa; Antaki, James F.

2016-01-01

Clinical decision support tools (DSTs) are computational systems that aid healthcare decision-making. While effective in labs, almost all these systems failed when they moved into clinical practice. Healthcare researchers speculated it is most likely due to a lack of user-centered HCI considerations in the design of these systems. This paper describes a field study investigating how clinicians make a heart pump implant decision with a focus on how to best integrate an intelligent DST into their work process. Our findings reveal a lack of perceived need for and trust of machine intelligence, as well as many barriers to computer use at the point of clinical decision-making. These findings suggest an alternative perspective to the traditional use models, in which clinicians engage with DSTs at the point of making a decision. We identify situations across patients’ healthcare trajectories when decision supports would help, and we discuss new forms it might take in these situations. PMID:27833397

Big-Data Based Decision-Support Systems to Improve Clinicians’ Cognition

PubMed Central

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians’ cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems. PMID:27990498

A knowledge-based decision support system for payload scheduling

NASA Technical Reports Server (NTRS)

Floyd, Stephen; Ford, Donnie

1988-01-01

The role that artificial intelligence/expert systems technologies play in the development and implementation of effective decision support systems is illustrated. A recently developed prototype system for supporting the scheduling of subsystems and payloads/experiments for NASA's Space Station program is presented and serves to highlight various concepts. The potential integration of knowledge based systems and decision support systems which has been proposed in several recent articles and presentations is illustrated.

Development of transportation asset management decision support tools : final report.

DOT National Transportation Integrated Search

2017-08-09

This study developed a web-based prototype decision support platform to demonstrate the benefits of transportation asset management in monitoring asset performance, supporting asset funding decisions, planning budget tradeoffs, and optimizing resourc...

Personal digital assistant with a barcode reader--a medical decision support system for nurses in home care.

PubMed

Johansson, Pauline E; Petersson, Göran I; Nilsson, Gunilla C

2010-04-01

Inappropriate medication among elderly people increases the risk of adverse drug-drug interactions, drug-related falls and hospital admissions. In order to prevent these effects it is necessary to obtain a profile of the patients' medication. A personal digital assistant (PDA) can be used as a medical decision support system (MDSS) to obtain a profile of the patients' medication and to check for inappropriate drugs and drug combinations, and to reduce medication errors. The aim of the present study was to evaluate nurses' experiences of using a MDSS in a PDA with a barcode reader, in order to obtain profiles of the patients' medication, regarding drug-drug interactions, therapeutic duplications, and warnings for drugs unsuitable for elderly in home care. The LIFe-reader is a MDSS in a PDA with a barcode reader. By scanning the drug packages in the patients' home, the LIFe-reader obtained profiles of the patients' medication and checked for drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. The LIFe-reader also contained, e.g. drug information and medical reference works. Nurses (n=15) used the LIFe-reader for five weeks during their nursing home care practice assignment. The nurses answered questionnaires about the content and functions of the LIFe-reader before, during and after the nursing home care practice assignment, and were interviewed in focus groups. Descriptive statistics were used and content analysis was applied for qualitative data. By using the LIFe-reader, the majority of the nurses found it easy to obtain profiles of the patients' medication and check for drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. Most nurses regarded the LIFe-reader to reduce drug-related risks of falling, and some thought it could reduce the drug-related admissions to hospitals. The scanning function was described as easy and time saving, although not always possible to

The Global Drought Information System - A Decision Support Tool with Global Applications

NASA Astrophysics Data System (ADS)

Arndt, D. S.; Brewer, M.; Heim, R. R., Jr.

2014-12-01

underway with an emphasis on information and decision making, and how to effectively provide drought early warning. This talk will provide an update on the status of GDIS and its role in international drought monitoring.

Detroit deicing decision support tool : description, operation, and simulation results

DOT National Transportation Integrated Search

2006-01-01

The John A. Volpe National Transportation Systems Center, sponsored by the National Aeronautics and Space Administration, : developed a deicing decision support tool, for Detroit Metropolitan Wayne County Airport (DTW).1 The deicing decision support ...

Flash floods warning technique based on wireless communication networks data

NASA Astrophysics Data System (ADS)

David, Noam; Alpert, Pinhas; Messer, Hagit

2010-05-01

Flash floods can occur throughout or subsequent to rainfall events, particularly in cases where the precipitation is of high-intensity. Unfortunately, each year these floods cause severe property damage and heavy casualties. At present, there are no sufficient real time flash flood warning facilities found to cope with this phenomenon. Here we show the tremendous potential of flash floods advanced warning based on precipitation measurements of commercial microwave links. As was recently shown, wireless communication networks supply high resolution precipitation measurements at ground level while often being situated in flood prone areas, covering large parts of these hazardous regions. We present the flash flood warning potential of the wireless communication system for two different cases when floods occurred at the Judean desert and at the northern Negev in Israel. In both cases, an advanced warning regarding the hazard could have been announced based on this system. • This research was supported by THE ISRAEL SCIENCE FOUNDATION (grant No. 173/08). This work was also supported by a grant from the Yeshaya Horowitz Association, Jerusalem. Additional support was given by the PROCEMA-BMBF project and by the GLOWA-JR BMBF project.

New and Improved Remotely Sensed Products and Tools for Agricultural Monitoring Applications in Support of Famine Early Warning

NASA Astrophysics Data System (ADS)

Budde, M. E.; Rowland, J.; Senay, G. B.; Funk, C. C.; Pedreros, D.; Husak, G. J.; Bohms, S.

2011-12-01

monitoring and modeling. We also present two new monitoring tools, the Early Warning eXplorer (EWX) and the Decision Support Interface (DSI). The EWX is a data analysis tool which provides the ability to rapidly visualize multiple remote sensing datasets and compare standardized anomaly maps and time series. The DSI uses remote sensing data in an automated fashion to map areas of drought concern and ranks their severity at both crop zone and administrative levels. New and improved data products and more targeted analysis tools are a necessity as food security monitoring requirements expand and resources become limited.

Implementation of workflow engine technology to deliver basic clinical decision support functionality

PubMed Central

2011-01-01

Background Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. Results We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. Conclusions We describe an implementation of

Implementation of workflow engine technology to deliver basic clinical decision support functionality.

PubMed

Huser, Vojtech; Rasmussen, Luke V; Oberg, Ryan; Starren, Justin B

2011-04-10

Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. We describe an implementation of a free workflow technology

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

Decision support tools to support the operations of traffic management centers (TMC)

DOT National Transportation Integrated Search

2011-01-31

The goal of this project is to develop decision support tools to support traffic management operations based on collected intelligent transportation system (ITS) data. The project developments are in accordance with the needs of traffic management ce...

Personalizing Drug Selection Using Advanced Clinical Decision Support

PubMed Central

Pestian, John; Spencer, Malik; Matykiewicz, Pawel; Zhang, Kejian; Vinks, Alexander A.; Glauser, Tracy

2009-01-01

This article describes the process of developing an advanced pharmacogenetics clinical decision support at one of the United States’ leading pediatric academic medical centers. This system, called CHRISTINE, combines clinical and genetic data to identify the optimal drug therapy when treating patients with epilepsy or Attention Deficit Hyperactivity Disorder. In the discussion a description of clinical decision support systems is provided, along with an overview of neurocognitive computing and how it is applied in this setting. PMID:19898682

Overcoming barriers to cancer-helpline professionals providing decision support for callers: an implementation study.

PubMed

Stacey, Dawn; Chambers, Suzanne K; Jacobsen, Mary Jane; Dunn, Jeff

2008-11-01

To evaluate the effect of an intervention on healthcare professionals' perceptions of barriers influencing their provision of decision support for callers facing cancer-related decisions. A pre- and post-test study guided by the Ottawa Model of Research Use. Australian statewide cancer call center that provides public access to information and supportive cancer services. 34 nurses, psychologists, and other allied healthcare professionals at the cancer call center. Participants completed baseline measures and, subsequently, were exposed to an intervention that included a decision support tutorial, coaching protocol, and skill-building workshop. Strategies were implemented to address organizational barriers. Perceived barriers and facilitators influencing provision of decision support, decision support knowledge, quality of decision support provided to standardized callers, and call length. Postintervention participants felt more prepared, confident in providing decision support, and aware of decision support resources. They had a stronger belief that providing decision support was within their role. Participants significantly improved their knowledge and provided higher-quality decision support to standardized callers without changing call length. The implementation intervention overcame several identified barriers that influenced call center professionals when providing decision support. Nurses and other helpline professionals have the potential to provide decision support designed to help callers understand cancer information, clarify their values associated with their options, and reduce decisional conflict. However, they require targeted education and organizational interventions to reduce their perceived barriers to providing decision support.

Decision support for patient care: implementing cybernetics.

PubMed

Ozbolt, Judy; Ozdas, Asli; Waitman, Lemuel R; Smith, Janis B; Brennan, Grace V; Miller, Randolph A

2004-01-01

The application of principles and methods of cybernetics permits clinicians and managers to use feedback about care effectiveness and resource expenditure to improve quality and to control costs. Keys to the process are the specification of therapeutic goals and the creation of an organizational culture that supports the use of feedback to improve care. Daily feedback on the achievement of each patient's therapeutic goals provides tactical decision support, enabling clinicians to adjust care as needed. Monthly or quarterly feedback on aggregated goal achievement for all patients on a clinical pathway provides strategic decision support, enabling clinicians and managers to identify problems with supposed "best practices" and to test hypotheses about solutions. Work is underway at Vanderbilt University Medical Center to implement feedback loops in care and management processes and to evaluate the effects.

Early Warning System for reducing disaster risk: the technological platform DEWETRA for the Republic of Serbia

NASA Astrophysics Data System (ADS)

Massabo, Marco; Molini, Luca; Kostic, Bojan; Campanella, Paolo; Stevanovic, Slavimir

2015-04-01

Disaster risk reduction has long been recognized for its role in mitigating the negative environmental, social and economic impacts of natural hazards. Flood Early Warning System is a disaster risk reduction measure based on the capacities of institutions to observe and predict extreme hydro-meteorological events and to disseminate timely and meaningful warning information; it is furthermore based on the capacities of individuals, communities and organizations to prepare and to act appropriately and in sufficient time to reduce the possibility of harm or loss. An operational definition of an Early Warning System has been suggested by ISDR - UN Office for DRR [15 January 2009]: "EWS is the set of capacities needed to generate and disseminate timely and meaningful warning information to enable individuals, communities and organizations threatened by a hazard to prepare and to act appropriately and in sufficient time to reduce the possibility of harm or loss.". ISDR continues by commenting that a people-centered early warning system necessarily comprises four key elements: 1-knowledge of the risks; 2-monitoring, analysis and forecasting of the hazards; 3-communication or dissemination of alerts and warnings; and 4- local capabilities to respond to the warnings received." The technological platform DEWETRA supports the strengthening of the first three key elements of EWS suggested by ISDR definition, hence to improve the capacities to build real-time risk scenarios and to inform and warn the population in advance The technological platform DEWETRA has been implemented for the Republic of Serbia. DEWETRA is a real time-integrate system that supports decision makers for risk forecasting and monitoring and for distributing warnings to end-user and to the general public. The system is based on the rapid availability of different data that helps to establish up-to-date and reliable risk scenarios. The integration of all relevant data for risk management significantly

Technology Infusion Challenges from a Decision Support Perspective

NASA Technical Reports Server (NTRS)

Adumitroaie, V.; Weisbin, C. R.

2009-01-01

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

E-DECIDER Decision Support Gateway For Earthquake Disaster Response

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Stough, T. M.; Parker, J. W.; Burl, M. C.; Donnellan, A.; Blom, R. G.; Pierce, M. E.; Wang, J.; Ma, Y.; Rundle, J. B.; Yoder, M. R.

2013-12-01

Earthquake Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response (E-DECIDER) is a NASA-funded project developing capabilities for decision-making utilizing remote sensing data and modeling software in order to provide decision support for earthquake disaster management and response. E-DECIDER incorporates earthquake forecasting methodology and geophysical modeling tools developed through NASA's QuakeSim project in order to produce standards-compliant map data products to aid in decision-making following an earthquake. Remote sensing and geodetic data, in conjunction with modeling and forecasting tools, help provide both long-term planning information for disaster management decision makers as well as short-term information following earthquake events (i.e. identifying areas where the greatest deformation and damage has occurred and emergency services may need to be focused). E-DECIDER utilizes a service-based GIS model for its cyber-infrastructure in order to produce standards-compliant products for different user types with multiple service protocols (such as KML, WMS, WFS, and WCS). The goal is to make complex GIS processing and domain-specific analysis tools more accessible to general users through software services as well as provide system sustainability through infrastructure services. The system comprises several components, which include: a GeoServer for thematic mapping and data distribution, a geospatial database for storage and spatial analysis, web service APIs, including simple-to-use REST APIs for complex GIS functionalities, and geoprocessing tools including python scripts to produce standards-compliant data products. These are then served to the E-DECIDER decision support gateway (http://e-decider.org), the E-DECIDER mobile interface, and to the Department of Homeland Security decision support middleware UICDS (Unified Incident Command and Decision Support). The E-DECIDER decision support gateway features a web interface that

Development of an Impact-Oriented Quantitative Coastal Inundation forecasting and early warning system with social and economic assessment

NASA Astrophysics Data System (ADS)

Fakhruddin, S. H. M.; Babel, Mukand S.; Kawasaki, Akiyuki

2014-05-01

Coastal inundations are an increasing threat to the lives and livelihoods of people living in low-lying, highly-populated coastal areas. According to a World Bank Report in 2005, at least 2.6 million people may have drowned due to coastal inundation, particularly caused by storm surges, over the last 200 years. Forecasting and prediction of natural events, such as tropical and extra-tropical cyclones, inland flooding, and severe winter weather, provide critical guidance to emergency managers and decision-makers from the local to the national level, with the goal of minimizing both human and economic losses. This guidance is used to facilitate evacuation route planning, post-disaster response and resource deployment, and critical infrastructure protection and securing, and it must be available within a time window in which decision makers can take appropriate action. Recognizing this extreme vulnerability of coastal areas to inundation/flooding, and with a view to improve safety-related services for the community, research should strongly enhance today's forecasting, prediction and early warning capabilities in order to improve the assessment of coastal vulnerability and risks and develop adequate prevention, mitigation and preparedness measures. This paper tries to develop an impact-oriented quantitative coastal inundation forecasting and early warning system with social and economic assessment to address the challenges faced by coastal communities to enhance their safety and to support sustainable development, through the improvement of coastal inundation forecasting and warning systems.

ADHD medication use following FDA risk warnings.

PubMed

Barry, Colleen L; Martin, Andres; Busch, Susan H

2012-09-01

In 2006, the U.S. Food and Drug Administration (FDA) investigated cardiac and psychiatric risks associated with attention deficit/hyperactivity disorder (ADHD) medication use. To examine how disclosure of safety risks affected pediatric ADHD use, and to assess news media coverage of the issue to better understand trends in treatment patterns. We used the AHRQ's Medical Expenditure Panel Survey (MEPS), a nationally representative household panel survey, to calculate unadjusted rates of pediatric ADHD use from 2002 to 2008 overall and by parents' education. We examined whether children (ages 0 to 20) filled a prescription for any ADHD medication during the calendar year. Next, we used content analysis methods to analyze news coverage of the issue in 10 high-circulation newspapers, the 3 major television networks and a major cable news network in the U.S. We examined 6 measures capturing information conveyed on risk and benefits of ADHD medication use. No declines in medication use following FDA safety warnings overall or by parental education level were observed. News media coverage was relatively balanced in its portrayal of the risks and benefits of ADHD medication use by children. ADHD risk warnings were not associated with large declines in medication use, and balanced news coverage may have contributed to the treatment patterns observed. Self-reported surveys like the MEPS rely on the recall of respondents and may be subject to reporting bias. However, the validity of these data is supported by their consistency with other data on drug use from other sources. These findings are in direct contrast to the substantial declines in use observed after pediatric antidepressant risk warnings in the context of a news media environment that emphasized risks over benefits. Our findings are relevant to the ongoing discussion about improving the FDA's ability to monitor drug safety. Safety warnings occur amid ongoing concern that the agency has insufficient authority and

Early warning, warning or alarm systems for natural hazards? A generic classification.

NASA Astrophysics Data System (ADS)

Sättele, Martina; Bründl, Michael; Straub, Daniel

2013-04-01

Early warning, warning and alarm systems have gained popularity in recent years as cost-efficient measures for dangerous natural hazard processes such as floods, storms, rock and snow avalanches, debris flows, rock and ice falls, landslides, flash floods, glacier lake outburst floods, forest fires and even earthquakes. These systems can generate information before an event causes loss of property and life. In this way, they mainly mitigate the overall risk by reducing the presence probability of endangered objects. These systems are typically prototypes tailored to specific project needs. Despite their importance there is no recognised system classification. This contribution classifies warning and alarm systems into three classes: i) threshold systems, ii) expert systems and iii) model-based expert systems. The result is a generic classification, which takes the characteristics of the natural hazard process itself and the related monitoring possibilities into account. The choice of the monitoring parameters directly determines the system's lead time. The classification of 52 active systems moreover revealed typical system characteristics for each system class. i) Threshold systems monitor dynamic process parameters of ongoing events (e.g. water level of a debris flow) and incorporate minor lead times. They have a local geographical coverage and a predefined threshold determines if an alarm is automatically activated to warn endangered objects, authorities and system operators. ii) Expert systems monitor direct changes in the variable disposition (e.g crack opening before a rock avalanche) or trigger events (e.g. heavy rain) at a local scale before the main event starts and thus offer extended lead times. The final alarm decision incorporates human, model and organisational related factors. iii) Model-based expert systems monitor indirect changes in the variable disposition (e.g. snow temperature, height or solar radiation that influence the occurrence probability

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...

Women and smoking—prices and health warning messages: evidence from Spain.

PubMed

Gil-Lacruz, Ana Isabel; Gil-Lacruz, Marta; Leeder, Stephen

2015-06-01

In Spain, fewer men are smoking every year yet the number of women smokers remains relatively high. This paper examines the impact of two anti-smoking policies (increased prices and obligatory pictorial health warning labels) on womens smoking decisions; generation cohorts are used to elucidate the determinants of those decisions. We have drawn 48,755 observations of women living in Spain from the Spanish National Health Surveys of 2001, 2003, 2006 and 2011. Among the main results, we highlight that belonging to a particular generation modulates the manner in which individual characteristics and tobacco policies determine smoking decisions. For example, women's smoking was not considered as socially acceptable until the 1960s and therefore older women have lower smoking rates. However, for the younger female cohorts (generations X and Y) smoking was seen as an act of rebellion and modernity, so women belonging to these groups, irrespective of educational level, are more likely to smoke. The price of cigarettes and pictorial health warning labels on cigarette packets also influence the smoking behaviour of Spanish women. Copyright © 2015 Elsevier Ltd. All rights reserved.

Web-based Tsunami Early Warning System with instant Tsunami Propagation Calculations in the GPU Cloud

NASA Astrophysics Data System (ADS)

Hammitzsch, M.; Spazier, J.; Reißland, S.

2014-12-01

Usually, tsunami early warning and mitigation systems (TWS or TEWS) are based on several software components deployed in a client-server based infrastructure. The vast majority of systems importantly include desktop-based clients with a graphical user interface (GUI) for the operators in early warning centers. However, in times of cloud computing and ubiquitous computing the use of concepts and paradigms, introduced by continuously evolving approaches in information and communications technology (ICT), have to be considered even for early warning systems (EWS). Based on the experiences and the knowledge gained in three research projects - 'German Indonesian Tsunami Early Warning System' (GITEWS), 'Distant Early Warning System' (DEWS), and 'Collaborative, Complex, and Critical Decision-Support in Evolving Crises' (TRIDEC) - new technologies are exploited to implement a cloud-based and web-based prototype to open up new prospects for EWS. This prototype, named 'TRIDEC Cloud', merges several complementary external and in-house cloud-based services into one platform for automated background computation with graphics processing units (GPU), for web-mapping of hazard specific geospatial data, and for serving relevant functionality to handle, share, and communicate threat specific information in a collaborative and distributed environment. The prototype in its current version addresses tsunami early warning and mitigation. The integration of GPU accelerated tsunami simulation computations have been an integral part of this prototype to foster early warning with on-demand tsunami predictions based on actual source parameters. However, the platform is meant for researchers around the world to make use of the cloud-based GPU computation to analyze other types of geohazards and natural hazards and react upon the computed situation picture with a web-based GUI in a web browser at remote sites. The current website is an early alpha version for demonstration purposes to give the

Application of the Risk-Based Early Warning Method in a Fracture-Karst Water Source, North China.

PubMed

Guo, Yongli; Wu, Qing; Li, Changsuo; Zhao, Zhenhua; Sun, Bin; He, Shiyi; Jiang, Guanghui; Zhai, Yuanzheng; Guo, Fang

2018-03-01

  The paper proposes a risk-based early warning considering characteristics of fracture-karst aquifer in North China and applied it in a super-large fracture-karst water source. Groundwater vulnerability, types of land use, water abundance, transmissivity and spatial temporal variation of groundwater quality were chosen as indexes of the method. Weights of factors were obtained by using AHP method based on relative importance of factors, maps of factors were zoned by GIS, early warning map was conducted based on extension theory with the help of GIS, ENVI+IDL. The early warning map fused five factors very well, serious and tremendous warning areas are mainly located in northwest and east with high or relatively high transmissivity and groundwater pollutant loading, and obviously deteriorated or deteriorated trend of petroleum. The early warning map warns people where more attention should be paid, and the paper guides decision making to take appropriate protection actions in different warning levels areas.

Interactive decision support in hepatic surgery

PubMed Central

Dugas, Martin; Schauer, Rolf; Volk, Andreas; Rau, Horst

2002-01-01

Background Hepatic surgery is characterized by complicated operations with a significant peri- and postoperative risk for the patient. We developed a web-based, high-granular research database for comprehensive documentation of all relevant variables to evaluate new surgical techniques. Methods To integrate this research system into the clinical setting, we designed an interactive decision support component. The objective is to provide relevant information for the surgeon and the patient to assess preoperatively the risk of a specific surgical procedure. Based on five established predictors of patient outcomes, the risk assessment tool searches for similar cases in the database and aggregates the information to estimate the risk for an individual patient. Results The physician can verify the analysis and exclude manually non-matching cases according to his expertise. The analysis is visualized by means of a Kaplan-Meier plot. To evaluate the decision support component we analyzed data on 165 patients diagnosed with hepatocellular carcinoma (period 1996–2000). The similarity search provides a two-peak distribution indicating there are groups of similar patients and singular cases which are quite different to the average. The results of the risk estimation are consistent with the observed survival data, but must be interpreted with caution because of the limited number of matching reference cases. Conclusion Critical issues for the decision support system are clinical integration, a transparent and reliable knowledge base and user feedback. PMID:12003639

Using warnings to reduce categorical false memories in younger and older adults.

PubMed

Carmichael, Anna M; Gutchess, Angela H

2016-07-01

Warnings about memory errors can reduce their incidence, although past work has largely focused on associative memory errors. The current study sought to explore whether warnings could be tailored to specifically reduce false recall of categorical information in both younger and older populations. Before encoding word pairs designed to induce categorical false memories, half of the younger and older participants were warned to avoid committing these types of memory errors. Older adults who received a warning committed fewer categorical memory errors, as well as other types of semantic memory errors, than those who did not receive a warning. In contrast, young adults' memory errors did not differ for the warning versus no-warning groups. Our findings provide evidence for the effectiveness of warnings at reducing categorical memory errors in older adults, perhaps by supporting source monitoring, reduction in reliance on gist traces, or through effective metacognitive strategies.

78 FR 6056 - Smokeless Tobacco Product Warning Statements; Request for Comments and Scientific Evidence

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-29

... by scientific evidence, regarding what changes to the smokeless tobacco product warnings, if any... scientific evidence, regarding what changes, if any, to the smokeless tobacco product warnings would promote... supporting evidence should address how any changes in the warnings would affect both users' and nonusers...

User-centered design to improve clinical decision support in primary care.

PubMed

Brunner, Julian; Chuang, Emmeline; Goldzweig, Caroline; Cain, Cindy L; Sugar, Catherine; Yano, Elizabeth M

2017-08-01

A growing literature has demonstrated the ability of user-centered design to make clinical decision support systems more effective and easier to use. However, studies of user-centered design have rarely examined more than a handful of sites at a time, and have frequently neglected the implementation climate and organizational resources that influence clinical decision support. The inclusion of such factors was identified by a systematic review as "the most important improvement that can be made in health IT evaluations." (1) Identify the prevalence of four user-centered design practices at United States Veterans Affairs (VA) primary care clinics and assess the perceived utility of clinical decision support at those clinics; (2) Evaluate the association between those user-centered design practices and the perceived utility of clinical decision support. We analyzed clinic-level survey data collected in 2006-2007 from 170 VA primary care clinics. We examined four user-centered design practices: 1) pilot testing, 2) provider satisfaction assessment, 3) formal usability assessment, and 4) analysis of impact on performance improvement. We used a regression model to evaluate the association between user-centered design practices and the perceived utility of clinical decision support, while accounting for other important factors at those clinics, including implementation climate, available resources, and structural characteristics. We also examined associations separately at community-based clinics and at hospital-based clinics. User-centered design practices for clinical decision support varied across clinics: 74% conducted pilot testing, 62% conducted provider satisfaction assessment, 36% conducted a formal usability assessment, and 79% conducted an analysis of impact on performance improvement. Overall perceived utility of clinical decision support was high, with a mean rating of 4.17 (±.67) out of 5 on a composite measure. "Analysis of impact on performance

Pictorial cigarette pack warnings: a meta-analysis of experimental studies

PubMed Central

Noar, Seth M; Hall, Marissa G; Francis, Diane B; Ribisl, Kurt M; Pepper, Jessica K; Brewer, Noel T

2016-01-01

Objective To inform international research and policy, we conducted a meta-analysis of the experimental literature on pictorial cigarette pack warnings. Data sources We systematically searched 7 computerised databases in April 2013 using several search terms. We also searched reference lists of relevant articles. Study selection We included studies that used an experimental protocol to test cigarette pack warnings and reported data on both pictorial and text-only conditions. 37 studies with data on 48 independent samples (N=33 613) met criteria. Data extraction and synthesis Two independent coders coded all study characteristics. Effect sizes were computed from data extracted from study reports and were combined using random effects meta-analytic procedures. Results Pictorial warnings were more effective than text-only warnings for 12 of 17 effectiveness outcomes (all p<0.05). Relative to text-only warnings, pictorial warnings (1) attracted and held attention better; (2) garnered stronger cognitive and emotional reactions; (3) elicited more negative pack attitudes and negative smoking attitudes and (4) more effectively increased intentions to not start smoking and to quit smoking. Participants also perceived pictorial warnings as being more effective than text-only warnings across all 8 perceived effectiveness outcomes. Conclusions The evidence from this international body of literature supports pictorial cigarette pack warnings as more effective than text-only warnings. Gaps in the literature include a lack of assessment of smoking behaviour and a dearth of theory-based research on how warnings exert their effects. PMID:25948713

The Telecommunications Emergency Decision Support System as a Crisis Management Decision Support System

DTIC Science & Technology

1991-09-01

NAVAL POSTGRADUATE SCHOOL Monterey, California AD-A246 188 7 R DTIC fl ELECTE FEB2 1992 U THESIS THE TELECOMMUNICATIONS EMERGENCY DECISION SUPPORT...ORGANIZATION REPORT NUMBER(S) a. NAME OF PERFORMING ORGANIZATION 6b. OFFICE SYMBOl 7a. NAME OF MONITORING ORGANIZATION Naval Postgraduate School J ""X...s Naval Postgraduate School c. ADDRESS (City, State and ZIP Code) 7b. ADDRESS (City, State, and ZIP Code) Monterey, CA 93943-5000 Monterey, CA 93943

Towards a Decision Support Tool for 3d Visualisation: Application to Selectivity Purpose of Single Object in a 3d City Scene

NASA Astrophysics Data System (ADS)

Neuville, R.; Pouliot, J.; Poux, F.; Hallot, P.; De Rudder, L.; Billen, R.

2017-10-01

This paper deals with the establishment of a comprehensive methodological framework that defines 3D visualisation rules and its application in a decision support tool. Whilst the use of 3D models grows in many application fields, their visualisation remains challenging from the point of view of mapping and rendering aspects to be applied to suitability support the decision making process. Indeed, there exists a great number of 3D visualisation techniques but as far as we know, a decision support tool that facilitates the production of an efficient 3D visualisation is still missing. This is why a comprehensive methodological framework is proposed in order to build decision tables for specific data, tasks and contexts. Based on the second-order logic formalism, we define a set of functions and propositions among and between two collections of entities: on one hand static retinal variables (hue, size, shape…) and 3D environment parameters (directional lighting, shadow, haze…) and on the other hand their effect(s) regarding specific visual tasks. It enables to define 3D visualisation rules according to four categories: consequence, compatibility, potential incompatibility and incompatibility. In this paper, the application of the methodological framework is demonstrated for an urban visualisation at high density considering a specific set of entities. On the basis of our analysis and the results of many studies conducted in the 3D semiotics, which refers to the study of symbols and how they relay information, the truth values of propositions are determined. 3D visualisation rules are then extracted for the considered context and set of entities and are presented into a decision table with a colour coding. Finally, the decision table is implemented into a plugin developed with three.js, a cross-browser JavaScript library. The plugin consists of a sidebar and warning windows that help the designer in the use of a set of static retinal variables and 3D environment

Maintenance decision support system deployment guide

DOT National Transportation Integrated Search

2008-07-01

This is a guide for transportation professionals on why and how to deploy winter Maintenance Decision Support Systems (MDSS). Adverse winter weather can cause traffic delays and crashes. Treating the effects of winter weather can also have impacts on...

Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support

PubMed Central

Seidling, Hanna M; Phansalkar, Shobha; Seger, Diane L; Paterno, Marilyn D; Shaykevich, Shimon; Haefeli, Walter E

2011-01-01

Background Clinical decision support systems can prevent knowledge-based prescription errors and improve patient outcomes. The clinical effectiveness of these systems, however, is substantially limited by poor user acceptance of presented warnings. To enhance alert acceptance it may be useful to quantify the impact of potential modulators of acceptance. Methods We built a logistic regression model to predict alert acceptance of drug–drug interaction (DDI) alerts in three different settings. Ten variables from the clinical and human factors literature were evaluated as potential modulators of provider alert acceptance. ORs were calculated for the impact of knowledge quality, alert display, textual information, prioritization, setting, patient age, dose-dependent toxicity, alert frequency, alert level, and required acknowledgment on acceptance of the DDI alert. Results 50 788 DDI alerts were analyzed. Providers accepted only 1.4% of non-interruptive alerts. For interruptive alerts, user acceptance positively correlated with frequency of the alert (OR 1.30, 95% CI 1.23 to 1.38), quality of display (4.75, 3.87 to 5.84), and alert level (1.74, 1.63 to 1.86). Alert acceptance was higher in inpatients (2.63, 2.32 to 2.97) and for drugs with dose-dependent toxicity (1.13, 1.07 to 1.21). The textual information influenced the mode of reaction and providers were more likely to modify the prescription if the message contained detailed advice on how to manage the DDI. Conclusion We evaluated potential modulators of alert acceptance by assessing content and human factors issues, and quantified the impact of a number of specific factors which influence alert acceptance. This information may help improve clinical decision support systems design. PMID:21571746

Towards Supporting Patient Decision-making In Online Diabetes Communities

PubMed Central

Zhang, Jing; Marmor, Rebecca; Huh, Jina

2017-01-01

As of 2014, 29.1 million people in the US have diabetes. Patients with diabetes have evolving information needs around complex lifestyle and medical decisions. As their conditions progress, patients need to sporadically make decisions by understanding alternatives and comparing options. These moments along the decision-making process present a valuable opportunity to support their information needs. An increasing number of patients visit online diabetes communities to fulfill their information needs. To understand how patients attempt to fulfill the information needs around decision-making in online communities, we reviewed 801 posts from an online diabetes community and included 79 posts for in-depth content analysis. The findings revealed motivations for posters’ inquiries related to decision-making including the changes in disease state, increased self-awareness, and conflict of information received. Medication and food were the among the most popular topics discussed as part of their decision-making inquiries. Additionally, We present insights for automatically identifying those decision-making inquiries to efficiently support information needs presented in online health communities. PMID:29854261

Decision Support for Resilient Communities: EPA’s Watershed Management Optimization Support Tool

EPA Science Inventory

The U.S. EPA Atlantic Ecology Division is releasing version 3 of the Watershed Management Optimization Support Tool (WMOST v3) in February 2018. WMOST is a decision-support tool that facilitates integrated water resources management (IWRM) by communities and watershed organizati...

The design of aircraft using the decision support problem technique

NASA Technical Reports Server (NTRS)

Mistree, Farrokh; Marinopoulos, Stergios; Jackson, David M.; Shupe, Jon A.

1988-01-01

The Decision Support Problem Technique for unified design, manufacturing and maintenance is being developed at the Systems Design Laboratory at the University of Houston. This involves the development of a domain-independent method (and the associated software) that can be used to process domain-dependent information and thereby provide support for human judgment. In a computer assisted environment, this support is provided in the form of optimal solutions to Decision Support Problems.

Cable Overheating Risk Warning Method Based on Impedance Parameter Estimation in Distribution Network

NASA Astrophysics Data System (ADS)

Yu, Zhang; Xiaohui, Song; Jianfang, Li; Fei, Gao

2017-05-01

Cable overheating will lead to the cable insulation level reducing, speed up the cable insulation aging, even easy to cause short circuit faults. Cable overheating risk identification and warning is nessesary for distribution network operators. Cable overheating risk warning method based on impedance parameter estimation is proposed in the paper to improve the safty and reliability operation of distribution network. Firstly, cable impedance estimation model is established by using least square method based on the data from distribiton SCADA system to improve the impedance parameter estimation accuracy. Secondly, calculate the threshold value of cable impedance based on the historical data and the forecast value of cable impedance based on the forecasting data in future from distribiton SCADA system. Thirdly, establish risks warning rules library of cable overheating, calculate the cable impedance forecast value and analysis the change rate of impedance, and then warn the overheating risk of cable line based on the overheating risk warning rules library according to the variation relationship between impedance and line temperature rise. Overheating risk warning method is simulated in the paper. The simulation results shows that the method can identify the imedance and forecast the temperature rise of cable line in distribution network accurately. The result of overheating risk warning can provide decision basis for operation maintenance and repair.

Promoting Shared Decision Making in Disorders of Sex Development (DSD): Decision Aids and Support Tools.

PubMed

Siminoff, L A; Sandberg, D E

2015-05-01

Specific complaints and grievances from adult patients with disorders of sex development (DSD), and their advocates center around the lack of information or misinformation they were given about their condition and feeling stigmatized and shamed by the secrecy surrounding their condition and its management. Many also attribute poor sexual function to damaging genital surgery and/or repeated, insensitive genital examinations. These reports suggest the need to reconsider the decision-making process for the treatment of children born with DSD. This paper proposes that shared decision making, an important concept in adult health care, be operationalized for the major decisions commonly encountered in DSD care and facilitated through the utilization of decision aids and support tools. This approach may help patients and their families make informed decisions that are better aligned with their personal values and goals. It may also lead to greater confidence in decision making with greater satisfaction and less regret. A brief review of the past and current approach to DSD decision making is provided, along with a review of shared decision making and decision aids and support tools. A case study explores the need and potential utility of this suggested new approach. © Georg Thieme Verlag KG Stuttgart · New York.

Reviewing model application to support animal health decision making.

PubMed

Singer, Alexander; Salman, Mo; Thulke, Hans-Hermann

2011-04-01

Animal health is of societal importance as it affects human welfare, and anthropogenic interests shape decision making to assure animal health. Scientific advice to support decision making is manifold. Modelling, as one piece of the scientific toolbox, is appreciated for its ability to describe and structure data, to give insight in complex processes and to predict future outcome. In this paper we study the application of scientific modelling to support practical animal health decisions. We reviewed the 35 animal health related scientific opinions adopted by the Animal Health and Animal Welfare Panel of the European Food Safety Authority (EFSA). Thirteen of these documents were based on the application of models. The review took two viewpoints, the decision maker's need and the modeller's approach. In the reviewed material three types of modelling questions were addressed by four specific model types. The correspondence between tasks and models underpinned the importance of the modelling question in triggering the modelling approach. End point quantifications were the dominating request from decision makers, implying that prediction of risk is a major need. However, due to knowledge gaps corresponding modelling studies often shed away from providing exact numbers. Instead, comparative scenario analyses were performed, furthering the understanding of the decision problem and effects of alternative management options. In conclusion, the most adequate scientific support for decision making - including available modelling capacity - might be expected if the required advice is clearly stated. Copyright © 2011 Elsevier B.V. All rights reserved.

Civil Protection Practitioners' Response to Introducing Nowcasting in Weather Warnings

NASA Astrophysics Data System (ADS)

Ulbrich, Thorsten

2014-05-01

The HErZ project WEXICOM (Improving the process of weather warnings and extreme weather information in the chain from the meteorological forecasts to their communication for the Berlin conurbation) assesses the communication and use of weather warnings. In cooperation with DWD we conducted two online surveys with German relief forces before and after a nowcasting application was introduced into the weather warning platform FEWIS. The aim is to investigate how relief workers make use of the additional information. DWD supports German civil protection by providing the warning platform FeWIS (Fire brigade Weather Information System) for registered relief workers. The platform provides information on meteorological hazards needed to take precautions and to support rescue actions. In June 2013 DWD added nowcasted estimates of storm attributes including warning cones based on a 1x1 km grid. The tool named "GewitterMonitor" is based on NowcastMIX and uses short-term weather models and observations to derive warnings with high precision on intensity, location and timing of thunder storm cells for the following two hours. A first survey provided prior to the addition of nowcasted information investigates how users benefit from FeWIS and how they perceive its functionality and reliability. Following the introduction users gain experience applying the nowcasting tool in the thunderstorm season 2013. In Winter 2013/2014 we conducted another online survey. The post-survey comprises questions on the use of the GewitterMonitor and on how the tool supports relief forces in responding to meteorological risks. The post survey also repeats questions on the perception of functionality and function of FeWIS and poses questions derived from the previous survey. This second survey collects practitioners feedback on GewitterMonitor and allows to detect changes in how users perceive the performance of FeWIS after the addition by relating responses to the prior survey.

Effect of audio in-vehicle red light-running warning message on driving behavior based on a driving simulator experiment.

PubMed

Yan, Xuedong; Liu, Yang; Xu, Yongcun

2015-01-01

Drivers' incorrect decisions of crossing signalized intersections at the onset of the yellow change may lead to red light running (RLR), and RLR crashes result in substantial numbers of severe injuries and property damage. In recent years, some Intelligent Transport System (ITS) concepts have focused on reducing RLR by alerting drivers that they are about to violate the signal. The objective of this study is to conduct an experimental investigation on the effectiveness of the red light violation warning system using a voice message. In this study, the prototype concept of the RLR audio warning system was modeled and tested in a high-fidelity driving simulator. According to the concept, when a vehicle is approaching an intersection at the onset of yellow and the time to the intersection is longer than the yellow interval, the in-vehicle warning system can activate the following audio message "The red light is impending. Please decelerate!" The intent of the warning design is to encourage drivers who cannot clear an intersection during the yellow change interval to stop at the intersection. The experimental results showed that the warning message could decrease red light running violations by 84.3 percent. Based on the logistic regression analyses, drivers without a warning were about 86 times more likely to make go decisions at the onset of yellow and about 15 times more likely to run red lights than those with a warning. Additionally, it was found that the audio warning message could significantly reduce RLR severity because the RLR drivers' red-entry times without a warning were longer than those with a warning. This driving simulator study showed a promising effect of the audio in-vehicle warning message on reducing RLR violations and crashes. It is worthwhile to further develop the proposed technology in field applications.

Decision support system for health care resources allocation

PubMed Central

Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

2017-01-01

Background A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. Aim The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. Methods To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. Results A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. Conclusion In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff. PMID:28848645

Decision support system for health care resources allocation.

PubMed

Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

2017-06-01

A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.

Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

PubMed

Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

2009-04-01

Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

Ensemble modelling and structured decision-making to support Emergency Disease Management.

PubMed

Webb, Colleen T; Ferrari, Matthew; Lindström, Tom; Carpenter, Tim; Dürr, Salome; Garner, Graeme; Jewell, Chris; Stevenson, Mark; Ward, Michael P; Werkman, Marleen; Backer, Jantien; Tildesley, Michael

2017-03-01

Epidemiological models in animal health are commonly used as decision-support tools to understand the impact of various control actions on infection spread in susceptible populations. Different models contain different assumptions and parameterizations, and policy decisions might be improved by considering outputs from multiple models. However, a transparent decision-support framework to integrate outputs from multiple models is nascent in epidemiology. Ensemble modelling and structured decision-making integrate the outputs of multiple models, compare policy actions and support policy decision-making. We briefly review the epidemiological application of ensemble modelling and structured decision-making and illustrate the potential of these methods using foot and mouth disease (FMD) models. In case study one, we apply structured decision-making to compare five possible control actions across three FMD models and show which control actions and outbreak costs are robustly supported and which are impacted by model uncertainty. In case study two, we develop a methodology for weighting the outputs of different models and show how different weighting schemes may impact the choice of control action. Using these case studies, we broadly illustrate the potential of ensemble modelling and structured decision-making in epidemiology to provide better information for decision-making and outline necessary development of these methods for their further application. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Verification and Validation of NASA-Supported Enhancements to PECAD's Decision Support Tools

NASA Technical Reports Server (NTRS)

McKellipo, Rodney; Ross, Kenton W.

2006-01-01

The NASA Applied Sciences Directorate (ASD), part of the Earth-Sun System Division of NASA's Science Mission Directorate, has partnered with the U.S. Department of Agriculture (USDA) to enhance decision support in the area of agricultural efficiency-an application of national importance. The ASD integrated the results of NASA Earth science research into USDA decision support tools employed by the USDA Foreign Agricultural Service (FAS) Production Estimates and Crop Assessment Division (PECAD), which supports national decision making by gathering, analyzing, and disseminating global crop intelligence. Verification and validation of the following enhancements are summarized: 1) Near-real-time Moderate Resolution Imaging Spectroradiometer (MODIS) products through PECAD's MODIS Image Gallery; 2) MODIS Normalized Difference Vegetation Index (NDVI) time series data through the USDA-FAS MODIS NDVI Database; and 3) Jason-1 and TOPEX/Poseidon lake level estimates through PECAD's Global Reservoir and Lake Monitor. Where possible, each enhanced product was characterized for accuracy, timeliness, and coverage, and the characterized performance was compared to PECAD operational requirements. The MODIS Image Gallery and the GRLM are more mature and have achieved a semi-operational status, whereas the USDA-FAS MODIS NDVI Database is still evolving and should be considered

An Integrated Web-based Decision Support System in Disaster Risk Management

NASA Astrophysics Data System (ADS)

Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

2012-04-01

Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact

Early warning systems for the management of chronic heart failure: a systematic literature review of cost-effectiveness models.

PubMed

Albuquerque De Almeida, Fernando; Al, Maiwenn; Koymans, Ron; Caliskan, Kadir; Kerstens, Ankie; Severens, Johan L

2018-04-01

Describing the general and methodological characteristics of decision-analytical models used in the economic evaluation of early warning systems for the management of chronic heart failure patients and performing a quality assessment of their methodological characteristics is expected to provide concise and useful insight to inform the future development of decision-analytical models in the field of heart failure management. Areas covered: The literature on decision-analytical models for the economic evaluation of early warning systems for the management of chronic heart failure patients was systematically reviewed. Nine electronic databases were searched through the combination of synonyms for heart failure and sensitive filters for cost-effectiveness and early warning systems. Expert commentary: The retrieved models show some variability with regards to their general study characteristics. Overall, they display satisfactory methodological quality, even though some points could be improved, namely on the consideration and discussion of any competing theories regarding model structure and disease progression, identification of key parameters and the use of expert opinion, and uncertainty analyses. A comprehensive definition of early warning systems and further research under this label should be pursued. To improve the transparency of economic evaluation publications, authors should make available detailed technical information regarding the published models.

A Decision Support System for Concrete Bridge Maintenance

NASA Astrophysics Data System (ADS)

Rashidi, Maria; Lemass, Brett; Gibson, Peter

2010-05-01

The maintenance of bridges as a key element in transportation infrastructure has become a major concern for asset managers and society due to increasing traffic volumes, deterioration of existing bridges and well-publicised bridge failures. A pivotal responsibility for asset managers in charge of bridge remediation is to identify the risks and assess the consequences of remediation programs to ensure that the decisions are transparent and lead to the lowest predicted losses in recognized constraint areas. The ranking of bridge remediation treatments can be quantitatively assessed using a weighted constraint approach to structure the otherwise ill-structured phases of problem definition, conceptualization and embodiment [1]. This Decision Support System helps asset managers in making the best decision with regards to financial limitations and other dominant constraints imposed upon the problem at hand. The risk management framework in this paper deals with the development of a quantitative intelligent decision support system for bridge maintenance which has the ability to provide a source for consistent decisions through selecting appropriate remediation treatments based upon cost, service life, product durability/sustainability, client preferences, legal and environmental constraints. Model verification and validation through industry case studies is ongoing.

The Global Emergency Observation and Warning System

NASA Technical Reports Server (NTRS)

Bukley, Angelia P.; Mulqueen, John A.

1994-01-01

Based on an extensive characterization of natural hazards, and an evaluation of their impacts on humanity, a set of functional technical requirements for a global warning and relief system was developed. Since no technological breakthroughs are required to implement a global system capable of performing the functions required to provide sufficient information for prevention, preparedness, warning, and relief from natural disaster effects, a system is proposed which would combine the elements of remote sensing, data processing, information distribution, and communications support on a global scale for disaster mitigation.

Pictorial cigarette pack warnings: a meta-analysis of experimental studies.

PubMed

Noar, Seth M; Hall, Marissa G; Francis, Diane B; Ribisl, Kurt M; Pepper, Jessica K; Brewer, Noel T

2016-05-01

To inform international research and policy, we conducted a meta-analysis of the experimental literature on pictorial cigarette pack warnings. We systematically searched 7 computerised databases in April 2013 using several search terms. We also searched reference lists of relevant articles. We included studies that used an experimental protocol to test cigarette pack warnings and reported data on both pictorial and text-only conditions. 37 studies with data on 48 independent samples (N=33,613) met criteria. Two independent coders coded all study characteristics. Effect sizes were computed from data extracted from study reports and were combined using random effects meta-analytic procedures. Pictorial warnings were more effective than text-only warnings for 12 of 17 effectiveness outcomes (all p<0.05). Relative to text-only warnings, pictorial warnings (1) attracted and held attention better; (2) garnered stronger cognitive and emotional reactions; (3) elicited more negative pack attitudes and negative smoking attitudes and (4) more effectively increased intentions to not start smoking and to quit smoking. Participants also perceived pictorial warnings as being more effective than text-only warnings across all 8 perceived effectiveness outcomes. The evidence from this international body of literature supports pictorial cigarette pack warnings as more effective than text-only warnings. Gaps in the literature include a lack of assessment of smoking behaviour and a dearth of theory-based research on how warnings exert their effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Are mobile health applications useful for supporting shared decision making in diagnostic and treatment decisions?

PubMed Central

Abbasgholizadeh Rahimi, Samira; Menear, Matthew; Robitaille, Hubert; Légaré, France

2017-01-01

ABSTRACT Mobile health (mHealth) applications intended to support shared decision making in diagnostic and treatment decisions are increasingly available. In this paper, we discuss some recent studies on mHealth applications with relevance to shared decision making. We discuss the potential advantages and disadvantages of using mHealth in shared decision making in various contexts, and suggest some directions for future research in this quickly expanding field. PMID:28838306

A Multi-criterial Decision Support System for Forest Management

Treesearch

Donald Nute; Geneho Kim; Walter D. Potter; Mark J. Twery; H. Michael Rauscher; Scott Thomasma; Deborah Bennett; Peter Kollasch

1999-01-01

We describe a research project that has as its goal development of a full-featured decision support system for managing forested land to satisfy multiple criteria represented as timber, wildlife, water, ecological, and wildlife objectives. The decision process proposed for what was originally conceived of as a Northeast Decision Model (NED) includes data acquisition,...

Primary Care Physicians' Support of Shared Decision Making for Different Cancer Screening Decisions.

PubMed

Elston Lafata, Jennifer; Brown, Richard F; Pignone, Michael P; Ratliff, Scott; Shay, L Aubree

2017-01-01

Despite its widespread advocacy, shared decision making (SDM) is not routinely used for cancer screening. To better understand the implementation barriers, we describe primary care physicians' (PCPs') support for SDM across diverse cancer screening contexts. Surveys were mailed to a random sample of USA-based PCPs. Using multivariable logistic regression analyses, we tested for associations of PCPs' support of SDM with the US Preventive Service Task Force (USPSTF) assigned recommendation grade, assessed whether the decision pertained to not screening older patients, and the PCPs' autonomous v. controlled motivation-orientation for using SDM. PCPs (n = 278) were, on average, aged 52 years, 38% female, and 69% white. Of these, 79% endorsed discussing screening benefits as very important to SDM; 64% for discussing risks; and 31% for agreeing with patient's opinion. PCPs were most likely to rate SDM as very important for colorectal cancer screening in adults aged 50-75 years (69%), and least likely for colorectal cancer screening in adults aged >85 years (34%). Regression results indicated the importance of PCPs' having autonomous or self-determined reasons for engaging in SDM (e.g., believing in the benefits of SDM) (OR = 2.29, 95% CI, 1.87 to 2.79). PCPs' support for SDM varied by USPSTF recommendation grade (overall contrast, X 2 = 14.7; P = 0.0054), with support greatest for A-Grade recommendations. Support for SDM was lower in contexts where decisions pertained to not screening older patients (OR = 0.45, 95% CI, 0.35 to 0.56). It is unknown whether PCPs' perceptions of the importance of SDM behaviors differs with specific screening decisions or the potential limited ability to generalize findings. Our results highlight the need to document SDM benefits and consider the specific contextual challenges, such as the level of uncertainty or whether evidence supports recommending/not recommending screening, when implementing SDM across an array of cancer screening

Decision support systems for ecosystem management: An evaluation of existing systems

Treesearch

H. Todd Mowrer; Klaus Barber; Joe Campbell; Nick Crookston; Cathy Dahms; John Day; Jim Laacke; Jim Merzenich; Steve Mighton; Mike Rauscher; Rick Sojda; Joyce Thompson; Peter Trenchi; Mark Twery

1997-01-01

This report evaluated 24 computer-aided decision support systems (DSS) that can support management decision-making in forest ecosystems. It compares the scope of each system, spatial capabilities, computational methods, development status, input and output requirements, user support availability, and system performance. Questionnaire responses from the DSS developers (...

Computational Support for Technology- Investment Decisions

NASA Technical Reports Server (NTRS)

Adumitroaie, Virgil; Hua, Hook; Lincoln, William; Block, Gary; Mrozinski, Joseph; Shelton, Kacie; Weisbin, Charles; Elfes, Alberto; Smith, Jeffrey

2007-01-01

Strategic Assessment of Risk and Technology (START) is a user-friendly computer program that assists human managers in making decisions regarding research-and-development investment portfolios in the presence of uncertainties and of non-technological constraints that include budgetary and time limits, restrictions related to infrastructure, and programmatic and institutional priorities. START facilitates quantitative analysis of technologies, capabilities, missions, scenarios and programs, and thereby enables the selection and scheduling of value-optimal development efforts. START incorporates features that, variously, perform or support a unique combination of functions, most of which are not systematically performed or supported by prior decision- support software. These functions include the following: Optimal portfolio selection using an expected-utility-based assessment of capabilities and technologies; Temporal investment recommendations; Distinctions between enhancing and enabling capabilities; Analysis of partial funding for enhancing capabilities; and Sensitivity and uncertainty analysis. START can run on almost any computing hardware, within Linux and related operating systems that include Mac OS X versions 10.3 and later, and can run in Windows under the Cygwin environment. START can be distributed in binary code form. START calls, as external libraries, several open-source software packages. Output is in Excel (.xls) file format.

An Intelligent Decision System for Intraoperative Somatosensory Evoked Potential Monitoring.

PubMed

Fan, Bi; Li, Han-Xiong; Hu, Yong

2016-02-01

Somatosensory evoked potential (SEP) is a useful, noninvasive technique widely used for spinal cord monitoring during surgery. One of the main indicators of a spinal cord injury is the drop in amplitude of the SEP signal in comparison to the nominal baseline that is assumed to be constant during the surgery. However, in practice, the real-time baseline is not constant and may vary during the operation due to nonsurgical factors, such as blood pressure, anaesthesia, etc. Thus, a false warning is often generated if the nominal baseline is used for SEP monitoring. In current practice, human experts must be used to prevent this false warning. However, these well-trained human experts are expensive and may not be reliable and consistent due to various reasons like fatigue and emotion. In this paper, an intelligent decision system is proposed to improve SEP monitoring. First, the least squares support vector regression and multi-support vector regression models are trained to construct the dynamic baseline from historical data. Then a control chart is applied to detect abnormalities during surgery. The effectiveness of the intelligent decision system is evaluated by comparing its performance against the nominal baseline model by using the real experimental datasets derived from clinical conditions.

To Fake or Not to Fake: Antecedents to Interview Faking, Warning Instructions, and Its Impact on Applicant Reactions

PubMed Central

Law, Stephanie J.; Bourdage, Joshua; O’Neill, Thomas A.

2016-01-01

In the present study, we examined the antecedents and processes that impact job interviewees’ decisions to engage in deceptive impression management (i.e., interview faking). Willingness and capacity to engage in faking were found to be the processes underlying the decision to use deceptive impression management in the interview. We also examined a personality antecedent to this behavior, Honesty-Humility, which was negatively related to the use of deceptive impression management through increased willingness to engage in these behaviors. We also tested a possible intervention to reduce IM. In particular, we found that warnings against faking – specifically, an identification warning - reduced both the perceived capacity to engage in interview faking, and subsequent use of several faking behaviors. Moreover, this warning reduced faking without adversely impacting applicant reactions. PMID:27895609

Do consumers 'Get the facts'? A survey of alcohol warning label recognition in Australia.

PubMed

Coomber, Kerri; Martino, Florentine; Barbour, I Robert; Mayshak, Richelle; Miller, Peter G

2015-08-22

There is limited research on awareness of alcohol warning labels and their effects. The current study examined the awareness of the Australian voluntary warning labels, the 'Get the facts' logo (a component of current warning labels) that directs consumers to an industry-designed informational website, and whether alcohol consumers visited this website. Participants aged 18-45 (unweighted n = 561; mean age = 33.6 years) completed an online survey assessing alcohol consumption patterns, awareness of the 'Get the facts' logo and warning labels, and use of the website. No participants recalled the 'Get the facts' logo, and the recall rate of warning labels was 16% at best. A quarter of participants recognised the 'Get the facts' logo, and awareness of the warning labels ranged from 13.1-37.9%. Overall, only 7.3% of respondents had visited the website. Multivariable logistic regression models indicated that younger drinkers, increased frequency of binge drinking, consuming alcohol directly from the bottle or can, and support for warning labels were significantly, positively associated with awareness of the logo and warning labels. While an increased frequency of binge drinking, consuming alcohol directly from the container, support for warning labels, and recognition of the 'Get the facts' logo increased the odds of visiting the website. Within this sample, recall of the current, voluntary warning labels on Australian alcohol products was non-existent, overall awareness was low, and few people reported visiting the DrinkWise website. It appears that current warning labels fail to effectively transmit health messages to the general public.

Design Principles for resilient cyber-physical Early Warning Systems - Challenges, Experiences, Design Patterns, and Best Practices

NASA Astrophysics Data System (ADS)

Gensch, S.; Wächter, J.; Schnor, B.

2014-12-01

Early warning systems (EWS) are safety-critical IT-infrastructures that serve the purpose of potentially saving lives or assets by observing real-world phenomena and issuing timely warning products to authorities and communities. An EWS consists of sensors, communication networks, data centers, simulation platforms, and dissemination channels. The components of this cyber-physical system may all be affected by both natural hazards and malfunctions of components alike. Resilience engineering so far has mostly been applied to safety-critical systems and processes in transportation (aviation, automobile), construction and medicine. Early warning systems need equivalent techniques to compensate for failures, and furthermore means to adapt to changing threats, emerging technology and research findings. We present threats and pitfalls from our experiences with the German and Indonesian tsunami early warning system, as well as architectural, technological and organizational concepts employed that can enhance an EWS' resilience. The current EWS is comprised of a multi-type sensor data upstream part, different processing and analysis engines, a decision support system, and various warning dissemination channels. Each subsystem requires a set of approaches towards ensuring stable functionality across system layer boundaries, including also institutional borders. Not only must services be available, but also produce correct results. Most sensors are distributed components with restricted resources, communication channels and power supply. An example for successful resilience engineering is the power capacity based functional management for buoy and tide gauge stations. We discuss various fault-models like cause and effect models on linear pathways, interaction of multiple events, complex and non-linear interaction of assumedly reliable subsystems and fault tolerance means implemented to tackle these threats.

Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling.

PubMed

Dehlendorf, Christine; Fitzpatrick, Judith; Steinauer, Jody; Swiader, Lawrence; Grumbach, Kevin; Hall, Cara; Kuppermann, Miriam

2017-07-01

We developed and formatively evaluated a tablet-based decision support tool for use by women prior to a contraceptive counseling visit to help them engage in shared decision making regarding method selection. Drawing upon formative work around women's preferences for contraceptive counseling and conceptual understanding of health care decision making, we iteratively developed a storyboard and then digital prototypes, based on best practices for decision support tool development. Pilot testing using both quantitative and qualitative data and cognitive testing was conducted. We obtained feedback from patient and provider advisory groups throughout the development process. Ninety-six percent of women who used the tool in pilot testing reported that it helped them choose a method, and qualitative interviews indicated acceptability of the tool's content and presentation. Compared to the control group, women who used the tool demonstrated trends toward increased likelihood of complete satisfaction with their method. Participant responses to cognitive testing were used in tool refinement. Our decision support tool appears acceptable to women in the family planning setting. Formative evaluation of the tool supports its utility among patients making contraceptive decisions, which can be further evaluated in a randomized controlled trial. Copyright © 2017 Elsevier B.V. All rights reserved.

SANDS: an architecture for clinical decision support in a National Health Information Network.

PubMed

Wright, Adam; Sittig, Dean F

2007-10-11

A new architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support) is introduced and its performance evaluated. The architecture provides a method for performing clinical decision support across a network, as in a health information exchange. Using the prototype we demonstrated that, first, a number of useful types of decision support can be carried out using our architecture; and, second, that the architecture exhibits desirable reliability and performance characteristics.

Operational Tsunami Modelling with TsunAWI for the German-Indonesian Tsunami Early Warning System: Recent Developments

NASA Astrophysics Data System (ADS)

Rakowsky, N.; Harig, S.; Androsov, A.; Fuchs, A.; Immerz, A.; Schröter, J.; Hiller, W.

2012-04-01

Starting in 2005, the GITEWS project (German-Indonesian Tsunami Early Warning System) established from scratch a fully operational tsunami warning system at BMKG in Jakarta. Numerical simulations of prototypic tsunami scenarios play a decisive role in a priori risk assessment for coastal regions and in the early warning process itself. Repositories with currently 3470 regional tsunami scenarios for GITEWS and 1780 Indian Ocean wide scenarios in support of Indonesia as a Regional Tsunami Service Provider (RTSP) were computed with the non-linear shallow water modell TsunAWI. It is based on a finite element discretisation, employs unstructured grids with high resolution along the coast and includes inundation. This contribution gives an overview on the model itself, the enhancement of the model physics, and the experiences gained during the process of establishing an operational code suited for thousands of model runs. Technical aspects like computation time, disk space needed for each scenario in the repository, or post processing techniques have a much larger impact than they had in the beginning when TsunAWI started as a research code. Of course, careful testing on artificial benchmarks and real events remains essential, but furthermore, quality control for the large number of scenarios becomes an important issue.

The design of patient decision support interventions: addressing the theory-practice gap.

PubMed

Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

2011-08-01

Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards

Cigarette pack warning labels in Russia: how graphic should they be?

PubMed

Wade, Benjamin; Merrill, Ray M; Lindsay, Gordon B

2011-06-01

Tobacco warning labels on cigarette packs have been shown to reduce cigarette consumption. The current study measures the Russian population's acceptance and preference of graphic (picture + text) tobacco warning labels. Nationally representative data were collected from 1778 participants in the Russian Federation in October 2009. A cross-sectional survey was conducted through person-to-person household interviews with respondents aged ≥ 14 years. Survey questions included standard demographic queries and three study-specific questions. Participants rated the strength of 13 cigarette warning labels according to their effectiveness to deter from smoking. Smoking status and the population's acceptance of similar warning labels was also measured. A dose-response pattern is apparent between the degree of graphic content of cigarette warning labels and the public's perception regarding the warning label's ability to discourage smoking. Approximately 87% of all respondents thought Russian authorities should require tobacco manufacturers to place graphic warning labels on cigarette packs, while 80% of current smokers wanted their government to enact such enforcement. The Russian population would strongly support government policy that would require graphic warning labels to be placed on cigarette packs in their country. In order to best deter from smoking, future cigarette warning labels in Russia should be as graphic as possible.

Web-based health services and clinical decision support.

PubMed

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

2004-01-01

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

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

PubMed

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

2017-07-01

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

Decision Support Methods and Tools

NASA Technical Reports Server (NTRS)

Green, Lawrence L.; Alexandrov, Natalia M.; Brown, Sherilyn A.; Cerro, Jeffrey A.; Gumbert, Clyde r.; Sorokach, Michael R.; Burg, Cecile M.

2006-01-01

This paper is one of a set of papers, developed simultaneously and presented within a single conference session, that are intended to highlight systems analysis and design capabilities within the Systems Analysis and Concepts Directorate (SACD) of the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC). This paper focuses on the specific capabilities of uncertainty/risk analysis, quantification, propagation, decomposition, and management, robust/reliability design methods, and extensions of these capabilities into decision analysis methods within SACD. These disciplines are discussed together herein under the name of Decision Support Methods and Tools. Several examples are discussed which highlight the application of these methods within current or recent aerospace research at the NASA LaRC. Where applicable, commercially available, or government developed software tools are also discussed

CorRECTreatment: A Web-based Decision Support Tool for Rectal Cancer Treatment that Uses the Analytic Hierarchy Process and Decision Tree

PubMed Central

Karakülah, G.; Dicle, O.; Sökmen, S.; Çelikoğlu, C.C.

2015-01-01

Summary Background The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians’ decision making. Objective The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. Methods The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. Results In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. Conclusions The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options

CorRECTreatment: a web-based decision support tool for rectal cancer treatment that uses the analytic hierarchy process and decision tree.

PubMed

Suner, A; Karakülah, G; Dicle, O; Sökmen, S; Çelikoğlu, C C

2015-01-01

The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians' decision making. The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options.

Knowledge-Based Information Management in Decision Support for Ecosystem Management

Treesearch

Keith Reynolds; Micahel Saunders; Richard Olson; Daniel Schmoldt; Michael Foster; Donald Latham; Bruce Miller; John Steffenson; Lawrence Bednar; Patrick Cunningham

1995-01-01

The Pacific Northwest Research Station (USDA Forest Service) is developing a knowledge-based information management system to provide decision support for watershed analysis in the Pacific Northwest region of the U.S. The decision support system includes: (1) a GIS interface that allows users to graphically navigate to specific provinces and watersheds and display a...

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.

From guideline modeling to guideline execution: defining guideline-based decision-support services.

PubMed Central

Tu, S. W.; Musen, M. A.

2000-01-01

We describe our task-based approach to defining the guideline-based decision-support services that the EON system provides. We categorize uses of guidelines in patient-specific decision support into a set of generic tasks--making of decisions, specification of work to be performed, interpretation of data, setting of goals, and issuance of alert and reminders--that can be solved using various techniques. Our model includes constructs required for representing the knowledge used by these techniques. These constructs form a toolkit from which developers can select modeling solutions for guideline task. Based on the tasks and the guideline model, we define a guideline-execution architecture and a model of interactions between a decision-support server and clients that invoke services provided by the server. These services use generic interfaces derived from guideline tasks and their associated modeling constructs. We describe two implementations of these decision-support services and discuss how this work can be generalized. We argue that a well-defined specification of guideline-based decision-support services will facilitate sharing of tools that implement computable clinical guidelines. PMID:11080007

37 CFR 11.21 - Warnings.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Warnings. 11.21 Section 11.21... Proceedings; Jurisdiction, Sanctions, Investigations, and Proceedings § 11.21 Warnings. A warning is neither... warning. The warning shall contain a brief statement of facts and USPTO Rules of Professional Conduct...

37 CFR 11.21 - Warnings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Warnings. 11.21 Section 11.21... Proceedings; Jurisdiction, Sanctions, Investigations, and Proceedings § 11.21 Warnings. A warning is neither... warning. The warning shall contain a brief statement of facts and Mandatory Disciplinary Rules identified...

37 CFR 11.21 - Warnings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Warnings. 11.21 Section 11.21... Proceedings; Jurisdiction, Sanctions, Investigations, and Proceedings § 11.21 Warnings. A warning is neither... warning. The warning shall contain a brief statement of facts and Mandatory Disciplinary Rules identified...

37 CFR 11.21 - Warnings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Warnings. 11.21 Section 11.21... Proceedings; Jurisdiction, Sanctions, Investigations, and Proceedings § 11.21 Warnings. A warning is neither... warning. The warning shall contain a brief statement of facts and USPTO Rules of Professional Conduct...

37 CFR 11.21 - Warnings.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Warnings. 11.21 Section 11.21... Proceedings; Jurisdiction, Sanctions, Investigations, and Proceedings § 11.21 Warnings. A warning is neither... warning. The warning shall contain a brief statement of facts and Mandatory Disciplinary Rules identified...

Decision-Making Amplification under Uncertainty: An Exploratory Study of Behavioral Similarity and Intelligent Decision Support Systems

ERIC Educational Resources Information Center

Campbell, Merle Wayne

2013-01-01

Intelligent decision systems have the potential to support and greatly amplify human decision-making across a number of industries and domains. However, despite the rapid improvement in the underlying capabilities of these "intelligent" systems, increasing their acceptance as decision aids in industry has remained a formidable challenge.…

Development of Asset Management Decision Support Tools for Power Equipment

NASA Astrophysics Data System (ADS)

Okamoto, Tatsuki; Takahashi, Tsuguhiro

Development of asset management decision support tools become very intensive in order to reduce maintenance cost of power equipment due to the liberalization of power business. This article reviews some aspects of present status of asset management decision support tools development for power equipment based on the papers published in international conferences, domestic conventions, and several journals.

ADHD Medication Use Following FDA Risk Warnings

PubMed Central

Barry, Colleen L.; Martin, Andres; Busch, Susan H.

2013-01-01

Background In 2006, the U.S. Food and Drug Administration (FDA) investigated cardiac and psychiatric risks associated with attention deficit/hyperactivity disorder (ADHD) medication use. Aims of the Study To examine how disclosure of safety risks affected pediatric ADHD use, and to assess news media coverage of the issue to better understand trends in treatment patterns. Methods We used the AHRQ’s Medical Expenditure Panel Survey (MEPS), a nationally representative household panel survey, to calculate unadjusted rates of pediatric ADHD use from 2002 to 2008 overall and by parents’ education. We examined whether children (ages 0 to 20) filled a prescription for any ADHD medication during the calendar year. Next, we used content analysis methods to analyze news coverage of the issue in 10 high-circulation newspapers, the 3 major television networks and a major cable news network in the U.S. We examined 6 measures capturing information conveyed on risk and benefits of ADHD medication use. Results No declines in medication use following FDA safety warnings overall or by parental education level were observed. News media coverage was relatively balanced in its portrayal of the risks and benefits of ADHD medication use by children. Discussion ADHD risk warnings were not associated with large declines in medication use, and balanced news coverage may have contributed to the treatment patterns observed. Self-reported surveys like the MEPS rely on the recall of respondents and may be subject to reporting bias. However, the validity of these data is supported by their consistency with other data on drug use from other sources. Implications for Health Care Provision and Use These findings are in direct contrast to the substantial declines in use observed after pediatric antidepressant risk warnings in the context of a news media environment that emphasized risks over benefits. Implications for Health Policies Our findings are relevant to the ongoing discussion about

Lights and siren: a review of emergency vehicle warning systems.

PubMed

De Lorenzo, R A; Eilers, M A

1991-12-01

Emergency medical services providers routinely respond to emergencies using lights and siren. This practice is not without risk of collision. Audible and visual warning devices and vehicle markings are integral to efficient negotiation of traffic and reduction of collision risk. An understanding of warning system characteristics is necessary to implement appropriate guidelines for prehospital transportation systems. The pertinent literature on emergency vehicle warning systems is reviewed, with emphasis on potential health hazards associated with these techniques. Important findings inferred from the literature are 1) red flashing lights alone may not be as effective as other color combinations, 2) there are no data to support a seizure risk with strobe lights, 3) lime-yellow is probably superior to traditional emergency vehicle colors, 4) the siren is an extremely limited warning device, and 5) exposure to siren noise can cause hearing loss. Emergency physicians must ensure that emergency medical services transportation systems consider the pertinent literature on emergency vehicle warning systems.

Designing Computerized Decision Support That Works for Clinicians and Families

PubMed Central

Fiks, Alexander G.

2011-01-01

Evidence-based decision-making is central to the practice of pediatrics. Clinical trials and other biomedical research provide a foundation for this process, and practice guidelines, drawing from their results, inform the optimal management of an increasing number of childhood health problems. However, many clinicians fail to adhere to guidelines. Clinical decision support delivered using health information technology, often in the form of electronic health records, provides a tool to deliver evidence-based information to the point of care and has the potential to overcome barriers to evidence-based practice. An increasing literature now informs how these systems should be designed and implemented to most effectively improve outcomes in pediatrics. Through the examples of computerized physician order entry, as well as the impact of alerts at the point of care on immunization rates, the delivery of evidence-based asthma care, and the follow-up of children with attention deficit hyperactivity disorder, the following review addresses strategies for success in using these tools. The following review argues that, as decision support evolves, the clinician should no longer be the sole target of information and alerts. Through the Internet and other technologies, families are increasingly seeking health information and gathering input to guide health decisions. By enlisting clinical decision support systems to deliver evidence-based information to both clinicians and families, help families express their preferences and goals, and connect families to the medical home, clinical decision support may ultimately be most effective in improving outcomes. PMID:21315295

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...

Performance evaluation of the national early warning system for shallow landslides in Norway

NASA Astrophysics Data System (ADS)

Dahl, Mads-Peter; Piciullo, Luca; Devoli, Graziella; Colleuille, Hervé; Calvello, Michele

2017-04-01

As a consequence of the increased number of rainfall-and snowmelt-induced landslides (debris flows, debris slides, debris avalanches and slush flows) occurring in Norway, a national landslide early warning system (EWS) has been developed for monitoring and forecasting the hydro-meteorological conditions potentially necessary of triggering slope failures. The system, operational since 2013, is managed by the Norwegian Water Resources and Energy Directorate (NVE) and has been designed in cooperation with the Norwegian Public Road Administration (SVV), the Norwegian National Rail Administration (JBV) and the Norwegian Meteorological Institute (MET). Decision-making in the EWS is based upon hazard threshold levels, hydro-meteorological and real-time landslide observations as well as landslide inventory and susceptibility maps. Hazard threshold levels have been obtained through statistical analyses of historical landslides and modelled hydro-meteorological parameters. Daily hydro-meteorological conditions such as rainfall, snowmelt, runoff, soil saturation, groundwater level and frost depth have been derived from a distributed version of the hydrological HBV-model. Two different landslide susceptibility maps are used as supportive data in deciding daily warning levels. Daily alerts are issued throughout the country considering variable warning zones. Warnings are issued once per day for the following 3 days with an update possibility later during the day according to the information gathered by the monitoring variables. The performance of the EWS has been evaluated applying the EDuMaP method. In particular, the performance of warnings issued in Western Norway, in the period 2013-2014 has been evaluated using two different landslide datasets. The best performance is obtained for the smallest and more accurate dataset. Different performance results may be observed as a function of changing the landslide density criterion, Lden(k), (i.e., thresholds considered to

Web-services-based spatial decision support system to facilitate nuclear waste siting

NASA Astrophysics Data System (ADS)

Huang, L. Xinglai; Sheng, Grant

2006-10-01

The availability of spatial web services enables data sharing among managers, decision and policy makers and other stakeholders in much simpler ways than before and subsequently has created completely new opportunities in the process of spatial decision making. Though generally designed for a certain problem domain, web-services-based spatial decision support systems (WSDSS) can provide a flexible problem-solving environment to explore the decision problem, understand and refine problem definition, and generate and evaluate multiple alternatives for decision. This paper presents a new framework for the development of a web-services-based spatial decision support system. The WSDSS is comprised of distributed web services that either have their own functions or provide different geospatial data and may reside in different computers and locations. WSDSS includes six key components, namely: database management system, catalog, analysis functions and models, GIS viewers and editors, report generators, and graphical user interfaces. In this study, the architecture of a web-services-based spatial decision support system to facilitate nuclear waste siting is described as an example. The theoretical, conceptual and methodological challenges and issues associated with developing web services-based spatial decision support system are described.

Decision support models for solid waste management: Review and game-theoretic approaches

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

Karmperis, Athanasios C., E-mail: athkarmp@mail.ntua.gr; Army Corps of Engineers, Hellenic Army General Staff, Ministry of Defence; Aravossis, Konstantinos

Highlights: ► The mainly used decision support frameworks for solid waste management are reviewed. ► The LCA, CBA and MCDM models are presented and their strengths, weaknesses, similarities and possible combinations are analyzed. ► The game-theoretic approach in a solid waste management context is presented. ► The waste management bargaining game is introduced as a specific decision support framework. ► Cooperative and non-cooperative game-theoretic approaches to decision support for solid waste management are discussed. - Abstract: This paper surveys decision support models that are commonly used in the solid waste management area. Most models are mainly developed within three decisionmore » support frameworks, which are the life-cycle assessment, the cost–benefit analysis and the multi-criteria decision-making. These frameworks are reviewed and their strengths and weaknesses as well as their critical issues are analyzed, while their possible combinations and extensions are also discussed. Furthermore, the paper presents how cooperative and non-cooperative game-theoretic approaches can be used for the purpose of modeling and analyzing decision-making in situations with multiple stakeholders. Specifically, since a waste management model is sustainable when considering not only environmental and economic but also social aspects, the waste management bargaining game is introduced as a specific decision support framework in which future models can be developed.« less

Earthquake Early Warning and Public Policy: Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Goltz, J. D.; Bourque, L.; Tierney, K.; Riopelle, D.; Shoaf, K.; Seligson, H.; Flores, P.

2003-12-01

Development of an earthquake early warning capability and pilot project were objectives of TriNet, a 5-year (1997-2001) FEMA-funded project to develop a state-of-the-art digital seismic network in southern California. In parallel with research to assemble a protocol for rapid analysis of earthquake data and transmission of a signal by TriNet scientists and engineers, the public policy, communication and educational issues inherent in implementation of an earthquake early warning system were addressed by TriNet's outreach component. These studies included: 1) a survey that identified potential users of an earthquake early warning system and how an earthquake early warning might be used in responding to an event, 2) a review of warning systems and communication issues associated with other natural hazards and how lessons learned might be applied to an alerting system for earthquakes, 3) an analysis of organization, management and public policy issues that must be addressed if a broad-based warning system is to be developed and 4) a plan to provide earthquake early warnings to a small number of organizations in southern California as an experimental prototype. These studies provided needed insights into the social and cultural environment in which this new technology will be introduced, an environment with opportunities to enhance our response capabilities but also an environment with significant barriers to overcome to achieve a system that can be sustained and supported. In this presentation we will address the main public policy issues that were subjects of analysis in these studies. They include a discussion of the possible division of functions among organizations likely to be the principle partners in the management of an earthquake early warning system. Drawing on lessons learned from warning systems for other hazards, we will review the potential impacts of false alarms and missed events on warning system credibility, the acceptability of fully automated

Medication-related clinical decision support in computerized provider order entry systems: a review.

PubMed

Kuperman, Gilad J; Bobb, Anne; Payne, Thomas H; Avery, Anthony J; Gandhi, Tejal K; Burns, Gerard; Classen, David C; Bates, David W

2007-01-01

While medications can improve patients' health, the process of prescribing them is complex and error prone, and medication errors cause many preventable injuries. Computer provider order entry (CPOE) with clinical decision support (CDS), can improve patient safety and lower medication-related costs. To realize the medication-related benefits of CDS within CPOE, one must overcome significant challenges. Healthcare organizations implementing CPOE must understand what classes of CDS their CPOE systems can support, assure that clinical knowledge underlying their CDS systems is reasonable, and appropriately represent electronic patient data. These issues often influence to what extent an institution will succeed with its CPOE implementation and achieve its desired goals. Medication-related decision support is probably best introduced into healthcare organizations in two stages, basic and advanced. Basic decision support includes drug-allergy checking, basic dosing guidance, formulary decision support, duplicate therapy checking, and drug-drug interaction checking. Advanced decision support includes dosing support for renal insufficiency and geriatric patients, guidance for medication-related laboratory testing, drug-pregnancy checking, and drug-disease contraindication checking. In this paper, the authors outline some of the challenges associated with both basic and advanced decision support and discuss how those challenges might be addressed. The authors conclude with summary recommendations for delivering effective medication-related clinical decision support addressed to healthcare organizations, application and knowledge base vendors, policy makers, and researchers.

Warning Signs After Birth

MedlinePlus

... Home > Pregnancy > Postpartum care > Warning signs after birth Warning signs after birth E-mail to a friend ... breast infection Postpartum bleeding Postpartum depression (PPD) What warning signs should you look for? Call your provider ...

Windshear warning aerospatiale approach

NASA Technical Reports Server (NTRS)

Bonafe, J. L.

1988-01-01

Vugraphs and transcribed remarks of a presentation on Aerospatiale's approach to windshear warning systems are given. Information is given on low altitude wind shear probability, wind shear warning models and warning system false alarms.

Decision-support systems for natural-hazards and land-management issues

USGS Publications Warehouse

Dinitz, Laura; Forney, William; Byrd, Kristin

2012-01-01

Scientists at the USGS Western Geographic Science Center are developing decision-support systems (DSSs) for natural-hazards and land-management issues. DSSs are interactive computer-based tools that use data and models to help identify and solve problems. These systems can provide crucial support to policymakers, planners, and communities for making better decisions about long-term natural hazards mitigation and land-use planning.

Automated Decision-Support Technologies for Prehospital Care of Trauma Casualties

DTIC Science & Technology

2010-04-01

insensitive to prehospital major traumatic pathology . Second, there are numerous potential sources of decision-support failure, and it is not possible...been speculated to be insensitive to prehospital major traumatic pathology . Second, there are numerous potential sources of decision-support failure...the soldiers, and the diagnostic value of prehospital vital signs for major traumatic pathologies has often been questioned [4-8]. Indeed, our

Gathering Real World Evidence with Cluster Analysis for Clinical Decision Support.

PubMed

Xia, Eryu; Liu, Haifeng; Li, Jing; Mei, Jing; Li, Xuejun; Xu, Enliang; Li, Xiang; Hu, Gang; Xie, Guotong; Xu, Meilin

2017-01-01

Clinical decision support systems are information technology systems that assist clinical decision-making tasks, which have been shown to enhance clinical performance. Cluster analysis, which groups similar patients together, aims to separate patient cases into phenotypically heterogenous groups and defining therapeutically homogeneous patient subclasses. Useful as it is, the application of cluster analysis in clinical decision support systems is less reported. Here, we describe the usage of cluster analysis in clinical decision support systems, by first dividing patient cases into similar groups and then providing diagnosis or treatment suggestions based on the group profiles. This integration provides data for clinical decisions and compiles a wide range of clinical practices to inform the performance of individual clinicians. We also include an example usage of the system under the scenario of blood lipid management in type 2 diabetes. These efforts represent a step toward promoting patient-centered care and enabling precision medicine.

Modular Architecture for Integrated Model-Based Decision Support.

PubMed

Gaebel, Jan; Schreiber, Erik; Oeser, Alexander; Oeltze-Jafra, Steffen

2018-01-01

Model-based decision support systems promise to be a valuable addition to oncological treatments and the implementation of personalized therapies. For the integration and sharing of decision models, the involved systems must be able to communicate with each other. In this paper, we propose a modularized architecture of dedicated systems for the integration of probabilistic decision models into existing hospital environments. These systems interconnect via web services and provide model sharing and processing capabilities for clinical information systems. Along the lines of IHE integration profiles from other disciplines and the meaningful reuse of routinely recorded patient data, our approach aims for the seamless integration of decision models into hospital infrastructure and the physicians' daily work.

Extending BPM Environments of Your Choice with Performance Related Decision Support

NASA Astrophysics Data System (ADS)

Fritzsche, Mathias; Picht, Michael; Gilani, Wasif; Spence, Ivor; Brown, John; Kilpatrick, Peter

What-if Simulations have been identified as one solution for business performance related decision support. Such support is especially useful in cases where it can be automatically generated out of Business Process Management (BPM) Environments from the existing business process models and performance parameters monitored from the executed business process instances. Currently, some of the available BPM Environments offer basic-level performance prediction capabilities. However, these functionalities are normally too limited to be generally useful for performance related decision support at business process level. In this paper, an approach is presented which allows the non-intrusive integration of sophisticated tooling for what-if simulations, analytic performance prediction tools, process optimizations or a combination of such solutions into already existing BPM environments. The approach abstracts from process modelling techniques which enable automatic decision support spanning processes across numerous BPM Environments. For instance, this enables end-to-end decision support for composite processes modelled with the Business Process Modelling Notation (BPMN) on top of existing Enterprise Resource Planning (ERP) processes modelled with proprietary languages.

Developing a Software for Fuzzy Group Decision Support System: A Case Study

ERIC Educational Resources Information Center

Baba, A. Fevzi; Kuscu, Dincer; Han, Kerem

2009-01-01

The complex nature and uncertain information in social problems required the emergence of fuzzy decision support systems in social areas. In this paper, we developed user-friendly Fuzzy Group Decision Support Systems (FGDSS) software. The software can be used for multi-purpose decision making processes. It helps the users determine the main and…

Looming auditory collision warnings for driving.

PubMed

Gray, Rob

2011-02-01

A driving simulator was used to compare the effectiveness of increasing intensity (looming) auditory warning signals with other types of auditory warnings. Auditory warnings have been shown to speed driver reaction time in rear-end collision situations; however, it is not clear which type of signal is the most effective. Although verbal and symbolic (e.g., a car horn) warnings have faster response times than abstract warnings, they often lead to more response errors. Participants (N=20) experienced four nonlooming auditory warnings (constant intensity, pulsed, ramped, and car horn), three looming auditory warnings ("veridical," "early," and "late"), and a no-warning condition. In 80% of the trials, warnings were activated when a critical response was required, and in 20% of the trials, the warnings were false alarms. For the early (late) looming warnings, the rate of change of intensity signaled a time to collision (TTC) that was shorter (longer) than the actual TTC. Veridical looming and car horn warnings had significantly faster brake reaction times (BRT) compared with the other nonlooming warnings (by 80 to 160 ms). However, the number of braking responses in false alarm conditions was significantly greater for the car horn. BRT increased significantly and systematically as the TTC signaled by the looming warning was changed from early to veridical to late. Looming auditory warnings produce the best combination of response speed and accuracy. The results indicate that looming auditory warnings can be used to effectively warn a driver about an impending collision.

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

NASA Astrophysics Data System (ADS)

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

2003-09-01

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

Distributed decision support for the 21st century mission space

NASA Astrophysics Data System (ADS)

McQuay, William K.

2002-07-01

The past decade has produced significant changes in the conduct of military operations: increased humanitarian missions, asymmetric warfare, the reliance on coalitions and allies, stringent rules of engagement, concern about casualties, and the need for sustained air operations. Future mission commanders will need to assimilate a tremendous amount of information, make quick-response decisions, and quantify the effects of those decisions in the face of uncertainty. Integral to this process is creating situational assessment-understanding the mission space, simulation to analyze alternative futures, current capabilities, planning assessments, course-of-action assessments, and a common operational picture-keeping everyone on the same sheet of paper. Decision support tools in a distributed collaborative environment offer the capability of decomposing these complex multitask processes and distributing them over a dynamic set of execution assets. Decision support technologies can semi-automate activities, such as planning an operation, that have a reasonably well-defined process and provide machine-level interfaces to refine the myriad of information that is not currently fused. The marriage of information and simulation technologies provides the mission commander with a collaborative virtual environment for planning and decision support.

Seismic Activity: Public Alert and Warning: Legal Implications

NASA Astrophysics Data System (ADS)

Zocchetti, D.

2007-12-01

governmental actions during emergency situations. At a minimum, the courts have shown a high degree of deference and provided immunity protection for discretionary governmental actions. For example, government organizations are often protected from legal redress for making basic policy decisions such as whether or not to implement an early warning system for emergency actions. Some national and state governments, however, have gone further to provide a legal shield of immunity through specific statutory enactments. Statutory protections generally extend to both the governmental organizations and the decision makers therein. In contrast, these protections are not always extended to third parties such as private businesses, which are often part of the chain of people and organizations that are critical for providing emergency notifications to the public. These businesses include the warning devices manufacturers, the communications systems installers, the software developers, and many other non-governmental parties essential to notifying the public. It can be argued that the legal risk in providing these private sector products or services serves to ensure their quality. But these businesses' real or perceived risk of liability could dissuade their participation in the notification system, or at least chill their innovation. Those involved in designing, developing, implementing, and operating emergency notification systems must consider how their unique situation will be impacted and potentially altered by the legal environment, or in some cases how they should affect change to that legal environment in order to have successful warning systems.

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.

Fuzzy logic inference-based Pavement Friction Management and real-time slippery warning systems: A proof of concept study.

PubMed

Najafi, Shahriar; Flintsch, Gerardo W; Khaleghian, Seyedmeysam

2016-05-01

Minimizing roadway crashes and fatalities is one of the primary objectives of highway engineers, and can be achieved in part through appropriate maintenance practices. Maintaining an appropriate level of friction is a crucial maintenance practice, due to the effect it has on roadway safety. This paper presents a fuzzy logic inference system that predicts the rate of vehicle crashes based on traffic level, speed limit, and surface friction. Mamdani and Sugeno fuzzy controllers were used to develop the model. The application of the proposed fuzzy control system in a real-time slippery road warning system is demonstrated as a proof of concept. The results of this study provide a decision support model for highway agencies to monitor their network's friction and make appropriate judgments to correct deficiencies based on crash risk. Furthermore, this model can be implemented in the connected vehicle environment to warn drivers of potentially slippery locations. Published by Elsevier Ltd.

Geospatial Data Fusion and Multigroup Decision Support for Surface Water Quality Management

NASA Astrophysics Data System (ADS)

Sun, A. Y.; Osidele, O.; Green, R. T.; Xie, H.

2010-12-01

Social networking and social media have gained significant popularity and brought fundamental changes to many facets of our everyday life. With the ever-increasing adoption of GPS-enabled gadgets and technology, location-based content is likely to play a central role in social networking sites. While location-based content is not new to the geoscience community, where geographic information systems (GIS) are extensively used, the delivery of useful geospatial data to targeted user groups for decision support is new. Decision makers and modelers ought to make more effective use of the new web-based tools to expand the scope of environmental awareness education, public outreach, and stakeholder interaction. Environmental decision processes are often rife with uncertainty and controversy, requiring integration of multiple sources of information and compromises between diverse interests. Fusing of multisource, multiscale environmental data for multigroup decision support is a challenging task. Toward this goal, a multigroup decision support platform should strive to achieve transparency, impartiality, and timely synthesis of information. The latter criterion often constitutes a major technical bottleneck to traditional GIS-based media, featuring large file or image sizes and requiring special processing before web deployment. Many tools and design patterns have appeared in recent years to ease the situation somewhat. In this project, we explore the use of Web 2.0 technologies for “pushing” location-based content to multigroups involved in surface water quality management and decision making. In particular, our granular bottom-up approach facilitates effective delivery of information to most relevant user groups. Our location-based content includes in-situ and remotely sensed data disseminated by NASA and other national and local agencies. Our project is demonstrated for managing the total maximum daily load (TMDL) program in the Arroyo Colorado coastal river basin

Harnessing Vehicle-to-Pedestrian (V2P) Communication Technology: Sending Traffic Warnings to Texting Pedestrians.

PubMed

Rahimian, Pooya; O'Neal, Elizabeth E; Zhou, Shiwen; Plumert, Jodie M; Kearney, Joseph K

2018-06-01

We examined how sending mobile-device warnings to texting pedestrians when they initiate an unsafe road crossing influences their decisions and actions. Pedestrian texting has been identified as a key risk factor in pedestrian-vehicle collisions. Advances in sensing and communications technology offer the possibility of providing pedestrians with information about traffic conditions to assist them in safely crossing traffic-filled roadways. However, it is unclear how this information can be most effectively communicated to pedestrians. We examined how texting and nontexting pedestrians crossed roads with continuous traffic in a large-screen, immersive pedestrian simulator using a between-subjects design with three conditions: texting, warning, and control. Texting participants in the warning condition received an alarm on their cell phone when they began to cross a dangerously small gap. The results demonstrate the detrimental influence of texting on pedestrians' gap selection, movement timing, and gaze behavior, and show the potential of warnings to improve decision making and safety. However, the results also reveal the limits of warning texting participants once they initiate a crossing and possible overreliance on technology that may lead to reduced situation awareness. Mobile devices and short-range communication technologies offer enormous potential to assist pedestrians, but further study is needed to better understand how to provide useful information in a timely manner. The technology for communicating traffic information to pedestrians via mobile devices is on the horizon. Research on how such information influences all aspects of pedestrian behavior is critical to developing effective solutions.

Application of a Tsunami Warning Message Metric to refine NOAA NWS Tsunami Warning Messages

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Johnston, D.; Sorensen, J.; Whitmore, P.

2013-12-01

In 2010, the U.S. National Weather Service (NWS) funded a three year project to integrate social science into their Tsunami Program. One of three primary requirements of the grant was to make improvements to tsunami warning messages of the NWS' two Tsunami Warning Centers- the West Coast/Alaska Tsunami Warning Center (WCATWC) in Palmer, Alaska and the Pacific Tsunami Warning Center (PTWC) in Ewa Beach, Hawaii. We conducted focus group meetings with a purposive sample of local, state and Federal stakeholders and emergency managers in six states (AK, WA, OR, CA, HI and NC) and two US Territories (US Virgin Islands and American Samoa) to qualitatively asses information needs in tsunami warning messages using WCATWC tsunami messages for the March 2011 Tohoku earthquake and tsunami event. We also reviewed research literature on behavioral response to warnings to develop a tsunami warning message metric that could be used to guide revisions to tsunami warning messages of both warning centers. The message metric is divided into categories of Message Content, Style, Order and Formatting and Receiver Characteristics. A message is evaluated by cross-referencing the message with the operational definitions of metric factors. Findings are then used to guide revisions of the message until the characteristics of each factor are met. Using findings from this project and findings from a parallel NWS Warning Tiger Team study led by T. Nicolini, the WCATWC implemented the first of two phases of revisions to their warning messages in November 2012. A second phase of additional changes, which will fully implement the redesign of messages based on the metric, is in progress. The resulting messages will reflect current state-of-the-art knowledge on warning message effectiveness. Here we present the message metric; evidence-based rational for message factors; and examples of previous, existing and proposed messages.

Designing Tools for Supporting User Decision-Making in e-Commerce

NASA Astrophysics Data System (ADS)

Sutcliffe, Alistair; Al-Qaed, Faisal

The paper describes a set of tools designed to support a variety of user decision-making strategies. The tools are complemented by an online advisor so they can be adapted to different domains and users can be guided to adopt appropriate tools for different choices in e-commerce, e.g. purchasing high-value products, exploring product fit to users’ needs, or selecting products which satisfy requirements. The tools range from simple recommenders to decision support by interactive querying and comparison matrices. They were evaluated in a scenario-based experiment which varied the users’ task and motivation, with and without an advisor agent. The results show the tools and advisor were effective in supporting users and agreed with the predictions of ADM (adaptive decision making) theory, on which the design of the tools was based.

Software to Facilitate Remote Sensing Data Access for Disease Early Warning Systems

PubMed Central

Liu, Yi; Hu, Jiameng; Snell-Feikema, Isaiah; VanBemmel, Michael S.; Lamsal, Aashis; Wimberly, Michael C.

2015-01-01

Satellite remote sensing produces an abundance of environmental data that can be used in the study of human health. To support the development of early warning systems for mosquito-borne diseases, we developed an open-source, client based software application to enable the Epidemiological Applications of Spatial Technologies (EASTWeb). Two major design decisions were full automation of the discovery, retrieval and processing of remote sensing data from multiple sources, and making the system easily modifiable in response to changes in data availability and user needs. Key innovations that helped to achieve these goals were the implementation of a software framework for data downloading and the design of a scheduler that tracks the complex dependencies among multiple data processing tasks and makes the system resilient to external errors. EASTWeb has been successfully applied to support forecasting of West Nile virus outbreaks in the United States and malaria epidemics in the Ethiopian highlands. PMID:26644779

Surface transportation weather decision support requirements : operational concept description : advanced-integrated decision support using weather information for surface transportation decisions makers : draft version 2.0

DOT National Transportation Integrated Search

2000-07-14

This is a draft document for the Surface Transportation Weather Decision Support Requirements (STWDSR) project. The STWDSR project is being conducted for the FHWAs Office of Transportation Operations (HOTO) Road Weather Management Program by Mitre...

Cyborg practices: call-handlers and computerised decision support systems in urgent and emergency care.

PubMed

Pope, Catherine; Halford, Susan; Turnbull, Joanne; Prichard, Jane

2014-06-01

This article draws on data collected during a 2-year project examining the deployment of a computerised decision support system. This computerised decision support system was designed to be used by non-clinical staff for dealing with calls to emergency (999) and urgent care (out-of-hours) services. One of the promises of computerised decisions support technologies is that they can 'hold' vast amounts of sophisticated clinical knowledge and combine it with decision algorithms to enable standardised decision-making by non-clinical (clerical) staff. This article draws on our ethnographic study of this computerised decision support system in use, and we use our analysis to question the 'automated' vision of decision-making in healthcare call-handling. We show that embodied and experiential (human) expertise remains central and highly salient in this work, and we propose that the deployment of the computerised decision support system creates something new, that this conjunction of computer and human creates a cyborg practice.

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).

Verification and Validation of NASA-Supported Enhancements to Decision Support Tools of PECAD

NASA Technical Reports Server (NTRS)

Ross, Kenton W.; McKellip, Rodney; Moore, Roxzana F.; Fendley, Debbie

2005-01-01

This section of the evaluation report summarizes the verification and validation (V&V) of recently implemented, NASA-supported enhancements to the decision support tools of the Production Estimates and Crop Assessment Division (PECAD). The implemented enhancements include operationally tailored Moderate Resolution Imaging Spectroradiometer (MODIS) products and products of the Global Reservoir and Lake Monitor (GRLM). The MODIS products are currently made available through two separate decision support tools: the MODIS Image Gallery and the U.S. Department of Agriculture (USDA) Foreign Agricultural Service (FAS) MODIS Normalized Difference Vegetation Index (NDVI) Database. Both the Global Reservoir and Lake Monitor and MODIS Image Gallery provide near-real-time products through PECAD's CropExplorer. This discussion addresses two areas: 1. Assessments of the standard NASA products on which these enhancements are based. 2. Characterizations of the performance of the new operational products.

Lessons from New Zealand's introduction of pictorial health warnings on tobacco packaging.

PubMed

Hoek, Janet; Wilson, Nick; Allen, Matthew; Edwards, Richard; Thomson, George; Li, Judy

2010-11-01

While international evidence suggests that featuring pictorial health warnings on tobacco packaging is an effective tobacco control intervention, the process used to introduce these new warnings has not been well documented. We examined relevant documents and interviewed officials responsible for this process in New Zealand. We found that, despite tobacco companies' opposition to pictorial health warnings and the resource constraints facing health authorities, the implementation process was generally robust and successful. Potential lessons for other countries planning to introduce or refresh existing pictorial health warnings include: (i) strengthening the link between image research and policy; (ii) requiring frequent image development and refreshment; (iii) using larger pictures (e.g. 80% of the front of the packet); (iv) developing themes that recognize concerns held by different smoker sub-groups; and (v) running integrated mass media campaigns when the warnings are introduced. All countries could also support moves by the World Health Organization Framework Convention on Tobacco Control's Secretariat to develop an international bank of copyright-free warnings.

A prototype knowledge-based decision support system for industrial waste management. Part 1: The decision support system

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

Boyle, C.A.; Baetz, B.W.

1998-12-31

Although there are a number of expert systems available which are designed to assist in resolving environmental problems, there is still a need for a system which would assist managers in determining waste management options for all types of wastes from one or more industrial plants, giving priority to sustainable use of resources, reuse and recycling. A prototype model was developed to determine the potentials for reuse and recycling of waste materials, to select the treatments needed to recycle waste materials or for treatment before disposal, and to determine potentials for co-treatment of wastes. A knowledge-based decision support system wasmore » then designed using this model. This paper describes the prototype model, the developed knowledge-based decision support system, the input and storage of data within the system and the inference engine developed for the system to determine the treatment options for the wastes. Options for sorting and selecting treatment trains are described, along with a discussion of the limitations of the approach and future developments needed for the system.« less

Interprofessional practice and decision support: an organizational framework applied to a mental health setting.

PubMed

Campbell, Susan; Stowe, Karen; Ozanne, Elissa M

2011-11-01

Decision support as a means to assist people in making healthcare decisions has been discussed extensively in the medical literature. However, the potential for use of decision support and decision aids with people with psychiatric disabilities in order to promote recovery has only begun to be researched and discussed in the mental health literature. Organizational factors that foster interprofessional practice within a decision support environment focused on mental health issues are examined in this paper.

Enhanced early warning system impact on nursing practice: A phenomenological study.

PubMed

Burns, Kathleen A; Reber, Tracey; Theodore, Karen; Welch, Brenda; Roy, Debra; Siedlecki, Sandra L

2018-05-01

To determine how an enhanced early warning system has an impact on nursing practice. Early warning systems score physiologic measures and alert nurses to subtle changes in patient condition. Critics of early warning systems have expressed concern that nurses would rely on a score rather than assessment skills and critical thinking to determine the need for intervention. Enhancing early warning systems with innovative technology is still in its infancy, so the impact of an enhanced early warning system on nursing behaviours or practice has not yet been studied. Phenomenological design. Scripted, semistructured interviews were conducted in September 2015 with 25 medical/surgical nurses who used the enhanced early warning system. Data were analysed using thematic analysis techniques (coding and bracketing). Emerging themes were examined for relationships and a model describing the enhanced early warning system experience was developed. Nurses identified awareness leading to investigation and ease of prioritization as the enhanced early warning system's most important impact on their nursing practice. There was also an impact on organizational culture, with nurses reporting improved communication, increased collaboration, increased accountability and proactive responses to early changes in patient condition. Rather than hinder critical thinking, as many early warning systems' critics claim, nurses in this study found that the enhanced early warning system increased their awareness of changes in a patient's condition, resulting in earlier response and reassessment times. It also had an impact on the organization by improving communication and collaboration and supporting a culture of proactive rather than reactive response to early signs of deterioration. © 2017 John Wiley & Sons Ltd.

Decision Support Model for Introduction of Gamification Solution Using AHP

PubMed Central

2014-01-01

Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform. PMID:24892075

Decision support model for introduction of gamification solution using AHP.

PubMed

Kim, Sangkyun

2014-01-01

Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform.

Relational Algebra in Spatial Decision Support Systems Ontologies.

PubMed

Diomidous, Marianna; Chardalias, Kostis; Koutonias, Panagiotis; Magnita, Adrianna; Andrianopoulos, Charalampos; Zimeras, Stelios; Mechili, Enkeleint Aggelos

2017-01-01

Decision Support Systems (DSS) is a powerful tool, for facilitates researchers to choose the correct decision based on their final results. Especially in medical cases where doctors could use these systems, to overcome the problem with the clinical misunderstanding. Based on these systems, queries must be constructed based on the particular questions that doctors must answer. In this work, combination between questions and queries would be presented via relational algebra.

Supporting decision-making processes for evidence-based mental health promotion.

PubMed

Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian

2011-12-01

The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.

NOAA/West Coast and Alaska Tsunami Warning Center Pacific Ocean response criteria

USGS Publications Warehouse

Whitmore, P.; Benz, H.; Bolton, M.; Crawford, G.; Dengler, L.; Fryer, G.; Goltz, J.; Hansen, R.; Kryzanowski, K.; Malone, S.; Oppenheimer, D.; Petty, E.; Rogers, G.; Wilson, Jim

2008-01-01

New West Coast/Alaska Tsunami Warning Center (WCATWC) response criteria for earthquakes occurring in the Pacific basin are presented. Initial warning decisions are based on earthquake location, magnitude, depth, and - dependent on magnitude - either distance from source or precomputed threat estimates generated from tsunami models. The new criteria will help limit the geographical extent of warnings and advisories to threatened regions, and complement the new operational tsunami product suite. Changes to the previous criteria include: adding hypocentral depth dependence, reducing geographical warning extent for the lower magnitude ranges, setting special criteria for areas not well-connected to the open ocean, basing warning extent on pre-computed threat levels versus tsunami travel time for very large events, including the new advisory product, using the advisory product for far-offshore events in the lower magnitude ranges, and specifying distances from the coast for on-shore events which may be tsunamigenic. This report sets a baseline for response criteria used by the WCATWC considering its processing and observational data capabilities as well as its organizational requirements. Criteria are set for tsunamis generated by earthquakes, which are by far the main cause of tsunami generation (either directly through sea floor displacement or indirectly by triggering of slumps). As further research and development provides better tsunami source definition, observational data streams, and improved analysis tools, the criteria will continue to adjust. Future lines of research and development capable of providing operational tsunami warning centers with better tools are discussed.

Warning Signs.

ERIC Educational Resources Information Center

Our Children, 1999

1999-01-01

Presents various signs that may indicate emotional problems in children or teens, noting that if children exhibit any of the warning signs, it is important to talk to a doctor, counselor, or mental-health professional. The warning signs are categorized as things that trouble the child, things that limit the child, behavior problems, and sudden…

Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform.

PubMed

Hoffman, Aubri S; Llewellyn-Thomas, Hilary A; Tosteson, Anna N A; O'Connor, Annette M; Volk, Robert J; Tomek, Ivan M; Andrews, Steven B; Bartels, Stephen J

2014-12-12

Over 100 trials show that patient decision aids effectively improve patients' information comprehension and values-based decision making. However, gaps remain in our understanding of several fundamental and applied questions, particularly related to the design of interactive, personalized decision aids. This paper describes an interdisciplinary development process for, and early field testing of, a web-based patient decision support research platform, or virtual decision lab, to address these questions. An interdisciplinary stakeholder panel designed the web-based research platform with three components: a) an introduction to shared decision making, b) a web-based patient decision aid, and c) interactive data collection items. Iterative focus groups provided feedback on paper drafts and online prototypes. A field test assessed a) feasibility for using the research platform, in terms of recruitment, usage, and acceptability; and b) feasibility of using the web-based decision aid component, compared to performance of a videobooklet decision aid in clinical care. This interdisciplinary, theory-based, patient-centered design approach produced a prototype for field-testing in six months. Participants (n = 126) reported that: the decision aid component was easy to use (98%), information was clear (90%), the length was appropriate (100%), it was appropriately detailed (90%), and it held their interest (97%). They spent a mean of 36 minutes using the decision aid and 100% preferred using their home/library computer. Participants scored a mean of 75% correct on the Decision Quality, Knowledge Subscale, and 74 out of 100 on the Preparation for Decision Making Scale. Completing the web-based decision aid reduced mean Decisional Conflict scores from 31.1 to 19.5 (p < 0.01). Combining decision science and health informatics approaches facilitated rapid development of a web-based patient decision support research platform that was feasible for use in research studies in

Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions.

PubMed

Elwyn, Glyn; Frosch, Dominick; Volandes, Angelo E; Edwards, Adrian; Montori, Victor M

2010-01-01

This article provides an analysis of 'decision aids', interventions to support patients facing tough decisions. Interest has increased since the concept of shared decision making has become widely considered to be a means of achieving desirable clinical outcomes. We consider the aims of these interventions and examine assumptions about their use. We propose three categories, interventions that are used in face-to-face encounters, those designed for use outside clinical encounters and those which are mediated, using telephone or other communication media. We propose the following definition: decision support interventions help people think about choices they face; they describe where and why choice exists; they provide information about options, including, where reasonable, the option of taking no action. These interventions help people to deliberate, independently or in collaboration with others, about options, by considering relevantattributes; they support people to forecast how they might feel about short, intermediate and long-term outcomes which have relevant consequences, in ways which help the process of constructing preferences and eventual decision making, appropriate to their individual situation. Although quality standards have been published for these interventions, we are also cautious about premature closure and consider that the need for short versions for use inside clinical encounters and long versions for external use requires further research. More work is also needed on the use of narrative formats and the translation of theory into practical designs. The interest in decision support interventions for patients heralds a transformation in clinical practice although many important areas remain unresolved.

An integrated decision support system for diagnosing and managing patients with community-acquired pneumonia.

PubMed Central

Aronsky, D.; Haug, P. J.

1999-01-01

Decision support systems that integrate guidelines have become popular applications to reduce variation and deliver cost-effective care. However, adverse characteristics of decision support systems, such as additional and time-consuming data entry or manually identifying eligible patients, result in a "behavioral bottleneck" that prevents decision support systems to become part of the clinical routine. This paper describes the design and the implementation of an integrated decision support system that explores a novel approach for bypassing the behavioral bottleneck. The real-time decision support system does not require health care providers to enter additional data and consists of a diagnostic and a management component. Images Fig. 1 Fig. 2 Fig. 3 PMID:10566348

Design and realization of tourism spatial decision support system based on GIS

NASA Astrophysics Data System (ADS)

Ma, Zhangbao; Qi, Qingwen; Xu, Li

2008-10-01

In this paper, the existing problems of current tourism management information system are analyzed. GIS, tourism as well as spatial decision support system are introduced, and the application of geographic information system technology and spatial decision support system to tourism management and the establishment of tourism spatial decision support system based on GIS are proposed. System total structure, system hardware and software environment, database design and structure module design of this system are introduced. Finally, realization methods of this systemic core functions are elaborated.

Adaptation of a Knowledge-Based Decision-Support System in the Tactical Environment.

DTIC Science & Technology

1981-12-01

002-04-6411S1CURITY CL All PICATION OF 1,416 PAGE (00HIR Onto ea0aOW .L10 *GU9WVC 4bGSI.CAYON S. Voss 10466lVka t... OftesoE ’ making decisons . The...noe..aaw Ad tdlalttt’ IV 680011 MMib) Artificial Intelligence; Decision-Support Systems; Tactical Decision- making ; Knowledge-based Decision-support...tactical information to assist tactical commanders in making decisions. The system, TAC*, for "Tactical Adaptable Consultant," incorporates a database

The impact of false warnings on partial and full lane departure warnings effectiveness and acceptance in car driving.

PubMed

Navarro, Jordan; Yousfi, Elsa; Deniel, Jonathan; Jallais, Christophe; Bueno, Mercedes; Fort, Alexandra

2016-12-01

In the past, lane departure warnings (LDWs) were demonstrated to improve driving behaviours during lane departures but little is known about the effects of unreliable warnings. This experiment focused on the influence of false warnings alone or in combination with missed warnings and warning onset on assistance effectiveness and acceptance. Two assistance unreliability levels (33 and 17%) and two warning onsets (partial and full lane departure) were manipulated in order to investigate interaction. Results showed that assistance, regardless unreliability levels and warning onsets, improved driving behaviours during lane departure episodes and outside of these episodes by favouring better lane-keeping performances. Full lane departure and highly unreliable warnings, however, reduced assistance efficiency. Drivers' assistance acceptance was better for the most reliable warnings and for the subsequent warnings. The data indicate that imperfect LDWs (false warnings or false and missed warnings) further improve driving behaviours compared to no assistance. Practitioner Summary: This study revealed that imperfect lane departure warnings are able to significantly improve driving performances and that warning onset is a key element for assistance effectiveness and acceptance. The conclusion may be of particular interest for lane departure warning designers.

Implications of Modern Decision Science for Military Decision-Support Systems

DTIC Science & Technology

2005-01-01

B. Another major challenge is learning how to exploit the technology of modern recreational games , including massively parallel online activities... online .7 In preparing this monograph, we also concluded that the most valuable aspects of game theory for high-level decision support are the basic...Philosophy, online at http://plato.stanford.edu/ entries/ game -theory. 8 In one example that still rankles, some Cold War game theorists (and military

Hydrologic ensembles based on convection-permitting precipitation nowcasts for flash flood warnings

NASA Astrophysics Data System (ADS)

Demargne, Julie; Javelle, Pierre; Organde, Didier; de Saint Aubin, Céline; Ramos, Maria-Helena

2017-04-01

In order to better anticipate flash flood events and provide timely warnings to communities at risk, the French national service in charge of flood forecasting (SCHAPI) is implementing a national flash flood warning system for small-to-medium ungauged basins. Based on a discharge-threshold flood warning method called AIGA (Javelle et al. 2014), the current version of the system runs a simplified hourly distributed hydrologic model with operational radar-gauge QPE grids from Météo-France at a 1-km2 resolution every 15 minutes. This produces real-time peak discharge estimates along the river network, which are subsequently compared to regionalized flood frequency estimates to provide warnings according to the AIGA-estimated return period of the ongoing event. To further extend the effective warning lead time while accounting for hydrometeorological uncertainties, the flash flood warning system is being enhanced to include Météo-France's AROME-NWC high-resolution precipitation nowcasts as time-lagged ensembles and multiple sets of hydrological regionalized parameters. The operational deterministic precipitation forecasts, from the nowcasting version of the AROME convection-permitting model (Auger et al. 2015), were provided at a 2.5-km resolution for a 6-hr forecast horizon for 9 significant rain events from September 2014 to June 2016. The time-lagged approach is a practical choice of accounting for the atmospheric forecast uncertainty when no extensive forecast archive is available for statistical modelling. The evaluation on 781 French basins showed significant improvements in terms of flash flood event detection and effective warning lead-time, compared to warnings from the current AIGA setup (without any future precipitation). We also discuss how to effectively communicate verification information to help determine decision-relevant warning thresholds for flood magnitude and probability. Javelle, P., Demargne, J., Defrance, D., Arnaud, P., 2014. Evaluating

Using basic geographic information systems functionality to support sustainable forest management decision making and post-decision assessments

Treesearch

Ronald E. McRoberts; R. James Barbour; Krista M. Gebert; Greg C. Liknes; Mark D. Nelson; Dacia M. Meneguzzo; et al.

2006-01-01

Sustainable management of natural resources requires informed decision making and post-decision assessments of the results of those decisions. Increasingly, both activities rely on analyses of spatial data in the forms of maps and digital data layers. Fortunately, a variety of supporting maps and data layers rapidly are becoming available. Unfortunately, however, user-...

Towards Operational Meteotsunami Early Warning System: the Adriatic Project MESSI

NASA Astrophysics Data System (ADS)

Vilibic, I.; Sepic, J.; Denamiel, C. L.; Mihanovic, H.; Muslim, S.; Tudor, M.; Ivankovic, D.; Jelavic, D.; Kovacevic, V.; Masce, T.; Dadic, V.; Gacic, M.; Horvath, K.; Monserrat, S.; Rabinovich, A.; Telisman-Prtenjak, M.

2017-12-01

A number of destructive meteotsunamis - atmospherically-driven long ocean waves in a tsunami frequency band - occurred during the last decade through the world oceans. Owing to significant damage caused by these meteotsunamis, several scientific groups (occasionally in collaboration with public offices) have started developing meteotsunami warning systems. Creation of one such system has been initialized in the late 2015 within the MESSI (Meteotsunamis, destructive long ocean waves in the tsunami frequency band: from observations and simulations towards a warning system) project. Main goal of this project is to build a prototype of a meteotsunami warning system for the eastern Adriatic coast. The system will be based on real-time measurements, operational atmosphere and ocean modeling and real time decision-making process. Envisioned MESSI meteotsunami warning system consists of three modules: (1) synoptic warning module, which will use established correlation between forecasted synoptic fields and high-frequency sea level oscillations to provide qualitative meteotsunami forecasts for up to a week in advance, (2) probabilistic premodeling prediction module, which will use operational WRF-ROMS-ADCIRC modeling system and compare the forecast with an atlas of presimulations to get the probabilistic meteotsunami forecast for up to three days in advance, and (3) real-time module, which is based on real time tracking of properties of air pressure disturbance (amplitude, speed, direction, period, ...) and their real-time comparison with the atlas of meteotsunami simulations. System will be tested on recent meteotsunami events which were recorded in the MESSI area shortly after the operational meteotsunami network installation. Albeit complex, such a multilevel warning system has a potential to be adapted to most meteotsunami hot spots, simply by tuning the system parameters to the available atmospheric and ocean data.

Young Adult Smokers' Neural Response to Graphic Cigarette Warning Labels.

PubMed

Green, Adam E; Mays, Darren; Falk, Emily B; Vallone, Donna; Gallagher, Natalie; Richardson, Amanda; Tercyak, Kenneth P; Abrams, David B; Niaura, Raymond S

2016-06-01

The study examined young adult smokers' neural response to graphic warning labels (GWLs) on cigarette packs using functional magnetic resonance imaging (fMRI). Nineteen young adult smokers ( M age 22.9, 52.6% male, 68.4% non-white, M 4.3 cigarettes/day) completed pre-scan, self-report measures of demographics, cigarette smoking behavior, and nicotine dependence, and an fMRI scanning session. During the scanning session participants viewed cigarette pack images (total 64 stimuli, viewed 4 seconds each) that varied based on the warning label (graphic or visually occluded control) and pack branding (branded or plain packaging) in an event-related experimental design. Participants reported motivation to quit (MTQ) in response to each image using a push-button control. Whole-brain blood oxygenation level-dependent (BOLD) functional images were acquired during the task. GWLs produced significantly greater self-reported MTQ than control warnings ( p < .001). Imaging data indicate stronger neural activation in response to GWLs than the control warnings at a cluster-corrected threshold p <.001 in medial prefrontal cortex, amygdala, medial temporal lobe, and occipital cortex. There were no significant differences in response to warnings on branded versus plain cigarette packages. In this sample of young adult smokers, GWLs promoted neural activation in brain regions involved in cognitive and affective decision-making and memory formation and the effects of GWLs did not differ on branded or plain cigarette packaging. These findings complement other recent neuroimaging GWL studies conducted with older adult smokers and with adolescents by demonstrating similar patterns of neural activation in response to GWLs among young adult smokers.

An Updated Decision Support Interface: A Tool for Remote Monitoring of Crop Growing Conditions

NASA Astrophysics Data System (ADS)

Husak, G. J.; Budde, M. E.; Rowland, J.; Verdin, J. P.; Funk, C. C.; Landsfeld, M. F.

2014-12-01

Remote sensing of agroclimatological variables to monitor food production conditions is a critical component of the Famine Early Warning Systems Network portfolio of tools for assessing food security in the developing world. The Decision Support Interface (DSI) seeks to integrate a number of remotely sensed and modeled variables to create a single, simplified portal for analysis of crop growing conditions. The DSI has been reformulated to incorporate more variables and give the user more freedom in exploring the available data. This refinement seeks to transition the DSI from a "first glance" agroclimatic indicator to one better suited for the differentiation of drought events. The DSI performs analysis of variables over primary agricultural zones at the first sub-national administrative level. It uses the spatially averaged rainfall, normalized difference vegetation index (NDVI), water requirement satisfaction index (WRSI), and actual evapotranspiration (ETa) to identify potential hazards to food security. Presenting this information in a web-based client gives food security analysts and decision makers a lightweight portal for information on crop growing conditions in the region. The crop zones used for the aggregation contain timing information which is critical to the DSI presentation. Rainfall and ETa are accumulated from different points in the crop phenology to identify season-long deficits in rainfall or transpiration that adversely affect the crop-growing conditions. Furthermore, the NDVI and WRSI serve as their own seasonal accumulated measures of growing conditions by capturing vegetation vigor or actual evapotranspiration deficits. The DSI is currently active for major growing regions of sub-Saharan Africa, with intention of expanding to other areas over the coming years.

Air quality early-warning system for cities in China

NASA Astrophysics Data System (ADS)

Xu, Yunzhen; Yang, Wendong; Wang, Jianzhou

2017-01-01

Air pollution has become a serious issue in many developing countries, especially in China, and could generate adverse effects on human beings. Air quality early-warning systems play an increasingly significant role in regulatory plans that reduce and control emissions of air pollutants and inform the public in advance when harmful air pollution is foreseen. However, building a robust early-warning system that will improve the ability of early-warning is not only a challenge but also a critical issue for the entire society. Relevant research is still poor in China and cannot always satisfy the growing requirements of regulatory planning, despite the issue's significance. Therefore, in this paper, a hybrid air quality early-warning system was successfully developed, composed of forecasting and evaluation. First, a hybrid forecasting model was proposed as an important part of this system based on the theory of "decomposition and ensemble" and combined with the advanced data processing technique, support vector machine, the latest bio-inspired optimization algorithm and the leave-one-out strategy for deciding weights. Afterwards, to intensify the research, fuzzy evaluation was performed, which also plays an indispensable role in the early-warning system. The forecasting model and fuzzy evaluation approaches are complementary. Case studies using daily air pollution concentrations of six air pollutants from three cities in China (i.e., Taiyuan, Harbin and Chongqing) are used as examples to evaluate the efficiency and effectiveness of the developed air quality early-warning system. Experimental results demonstrate that both the accuracy and the effectiveness of the developed system are greatly superior for air quality early warning. Furthermore, the application of forecasting and evaluation enables the informative and effective quantification of future air quality, offering a significant advantage, and can be employed to develop rapid air quality early-warning systems.

How do people perceive, understand, and anticipate responding to flash flood risks and warnings? Results from a public survey in Boulder, Colorado, USA

NASA Astrophysics Data System (ADS)

Morss, Rebecca E.; Mulder, Kelsey J.; Lazo, Jeffrey K.; Demuth, Julie L.

2016-10-01

This study investigates flash flood forecast and warning communication, interpretation, and decision making, using data from a survey of 418 members of the public in Boulder, Colorado, USA. Respondents to the public survey varied in their perceptions and understandings of flash flood risks in Boulder, and some had misconceptions about flash flood risks, such as the safety of crossing fast-flowing water. About 6% of respondents indicated consistent reversals of US watch-warning alert terminology. However, more in-depth analysis illustrates the multi-dimensional, situationally dependent meanings of flash flood alerts, as well as the importance of evaluating interpretation and use of warning information along with alert terminology. Some public respondents estimated low likelihoods of flash flooding given a flash flood warning; these were associated with lower anticipated likelihood of taking protective action given a warning. Protective action intentions were also lower among respondents who had less trust in flash flood warnings, those who had not made prior preparations for flash flooding, and those who believed themselves to be safer from flash flooding. Additional analysis, using open-ended survey questions about responses to warnings, elucidates the complex, contextual nature of protective decision making during flash flood threats. These findings suggest that warnings can play an important role not only by notifying people that there is a threat and helping motivate people to take protective action, but also by helping people evaluate what actions to take given their situation.

Introduction to Decision Support Systems for Risk Based Management of Contaminated Sites

EPA Science Inventory

A book on Decision Support Systems for Risk-based Management of contaminated sites is appealing for two reasons. First, it addresses the problem of contaminated sites, which has worldwide importance. Second, it presents Decision Support Systems (DSSs), which are powerful comput...

Decision support system for drinking water management

NASA Astrophysics Data System (ADS)

Janža, M.

2012-04-01

The problems in drinking water management are complex and often solutions must be reached under strict time constrains. This is especially distinct in case of environmental accidents in the catchment areas of the wells that are used for drinking water supply. The beneficial tools that can help decision makers and make program of activities more efficient are decision support systems (DSS). In general they are defined as computer-based support systems that help decision makers utilize data and models to solve unstructured problems. The presented DSS was developed in the frame of INCOME project which is focused on the long-term stable and safe drinking water supply in Ljubljana. The two main water resources Ljubljana polje and Barje alluvial aquifers are characterized by a strong interconnection of surface and groundwater, high vulnerability, high velocities of groundwater flow and pollutant transport. In case of sudden pollution, reactions should be very fast to avoid serious impact to the water supply. In the area high pressures arising from urbanization, industry, traffic, agriculture and old environmental burdens. The aim of the developed DSS is to optimize the activities in cases of emergency water management and to optimize the administrative work regarding the activities that can improve groundwater quality status. The DSS is an interactive computer system that utilizes data base, hydrological modelling, and experts' and stakeholders' knowledge. It consists of three components, tackling the different abovementioned issues in water management. The first one utilizes the work on identification, cleaning up and restoration of illegal dumpsites that are a serious threat to the qualitative status of groundwater. The other two components utilize the predictive capability of the hydrological model and scenario analysis. The user interacts with the system by a graphical interface that guides the user step-by-step to the recommended remedial measures. Consequently, the

Coordinating complex decision support activities across distributed applications

NASA Technical Reports Server (NTRS)

Adler, Richard M.

1994-01-01

Knowledge-based technologies have been applied successfully to automate planning and scheduling in many problem domains. Automation of decision support can be increased further by integrating task-specific applications with supporting database systems, and by coordinating interactions between such tools to facilitate collaborative activities. Unfortunately, the technical obstacles that must be overcome to achieve this vision of transparent, cooperative problem-solving are daunting. Intelligent decision support tools are typically developed for standalone use, rely on incompatible, task-specific representational models and application programming interfaces (API's), and run on heterogeneous computing platforms. Getting such applications to interact freely calls for platform independent capabilities for distributed communication, as well as tools for mapping information across disparate representations. Symbiotics is developing a layered set of software tools (called NetWorks! for integrating and coordinating heterogeneous distributed applications. he top layer of tools consists of an extensible set of generic, programmable coordination services. Developers access these services via high-level API's to implement the desired interactions between distributed applications.

Anatomy of Historical Tsunamis: Lessons Learned for Tsunami Warning

NASA Astrophysics Data System (ADS)

Igarashi, Y.; Kong, L.; Yamamoto, M.; McCreery, C. S.

2011-11-01

Tsunamis are high-impact disasters that can cause death and destruction locally within a few minutes of their occurrence and across oceans hours, even up to a day, afterward. Efforts to establish tsunami warning systems to protect life and property began in the Pacific after the 1946 Aleutian Islands tsunami caused casualties in Hawaii. Seismic and sea level data were used by a central control center to evaluate tsunamigenic potential and then issue alerts and warnings. The ensuing events of 1952, 1957, and 1960 tested the new system, which continued to expand and evolve from a United States system to an international system in 1965. The Tsunami Warning System in the Pacific (ITSU) steadily improved through the decades as more stations became available in real and near-real time through better communications technology and greater bandwidth. New analysis techniques, coupled with more data of higher quality, resulted in better detection, greater solution accuracy, and more reliable warnings, but limitations still exist in constraining the source and in accurately predicting propagation of the wave from source to shore. Tsunami event data collected over the last two decades through international tsunami science surveys have led to more realistic models for source generation and inundation, and within the warning centers, real-time tsunami wave forecasting will become a reality in the near future. The tsunami warning system is an international cooperative effort amongst countries supported by global and national monitoring networks and dedicated tsunami warning centers; the research community has contributed to the system by advancing and improving its analysis tools. Lessons learned from the earliest tsunamis provided the backbone for the present system, but despite 45 years of experience, the 2004 Indian Ocean tsunami reminded us that tsunamis strike and kill everywhere, not just in the Pacific. Today, a global intergovernmental tsunami warning system is coordinated

Decision Support Systems and the Conflict Model of Decision Making: A Stimulus for New Computer-Assisted Careers Guidance Systems.

ERIC Educational Resources Information Center

Ballantine, R. Malcolm

Decision Support Systems (DSSs) are computer-based decision aids to use when making decisions which are partially amenable to rational decision-making procedures but contain elements where intuitive judgment is an essential component. In such situations, DSSs are used to improve the quality of decision-making. The DSS approach is based on Simon's…

Computerised decision support in physical activity interventions: A systematic literature review.

PubMed

Triantafyllidis, Andreas; Filos, Dimitris; Claes, Jomme; Buys, Roselien; Cornelissen, Véronique; Kouidi, Evangelia; Chouvarda, Ioanna; Maglaveras, Nicos

2018-03-01

The benefits of regular physical activity for health and quality of life are unarguable. New information, sensing and communication technologies have the potential to play a critical role in computerised decision support and coaching for physical activity. We provide a literature review of recent research in the development of physical activity interventions employing computerised decision support, their feasibility and effectiveness in healthy and diseased individuals, and map out challenges and future research directions. We searched the bibliographic databases of PubMed and Scopus to identify physical activity interventions with computerised decision support utilised in a real-life context. Studies were synthesized according to the target user group, the technological format (e.g., web-based or mobile-based) and decision-support features of the intervention, the theoretical model for decision support in health behaviour change, the study design, the primary outcome, the number of participants and their engagement with the intervention, as well as the total follow-up duration. From the 24 studies included in the review, the highest percentage (n = 7, 29%) targeted sedentary healthy individuals followed by patients with prediabetes/diabetes (n = 4, 17%) or overweight individuals (n = 4, 17%). Most randomized controlled trials reported significantly positive effects of the interventions, i.e., increase in physical activity (n = 7, 100%) for 7 studies assessing physical activity measures, weight loss (n = 3, 75%) for 4 studies assessing diet, and reductions in glycosylated hemoglobin (n = 2, 66%) for 3 studies assessing glycose concentration. Accelerometers/pedometers were used in almost half of the studies (n = 11, 46%). Most adopted decision support features included personalised goal-setting (n = 16, 67%) and motivational feedback sent to the users (n = 15, 63%). Fewer adopted features were integration with electronic health

Multiple Attribute Evaluation of Auditory Warning Signals for In-Vehicle Crash Avoidance Warning Systems

DOT National Transportation Integrated Search

1995-11-01

This research was directed at optimizing the auditory warnings that may be used in future crash avoidance warning applications. There is a need to standardize such warnings, so that they retain immediacy of meaning across various vehicles, situations...

The lower effectiveness of text-only health warnings in China compared to pictorial health warnings in Malaysia.

PubMed

Elton-Marshall, Tara; Xu, Steve Shaowei; Meng, Gang; Quah, Anne C K; Sansone, Genevieve C; Feng, Guoze; Jiang, Yuan; Driezen, Pete; Omar, Maizurah; Awang, Rahmat; Fong, Geoffrey T

2015-11-01

In 2009, China changed its health warnings on cigarette packs from side-only text warnings to two text-only warnings on 30% of the bottom of the front and back of the pack. Also in 2009, Malaysia changed from similar text warnings to pictorial health warnings consistent with Framework Convention on Tobacco Control (FCTC) Article 11 Guidelines. To measure the impact of the change in health warnings in China and to compare the text-only health warnings to the impact of the pictorial health warnings introduced in Malaysia. We measured changes in key indicators of warning effectiveness among a longitudinal cohort sample of smokers from Waves 1 to 3 (2006-2009) of the International Tobacco Control (ITC) China Survey and from Waves 3 to 4 (2008-2009) of the ITC Malaysia Survey. Each cohort consisted of representative samples of adult (≥18 years) smokers from six cities in China (n=6575) and from a national sample in Malaysia (n=2883). Generalised Estimating Equations (GEE) were used to examine the impact of the health warnings on subsequent changes in salience of warnings, cognitive and behavioural outcomes. Compared to Malaysia, the weak text-only warning labels in China led to a significant change in only two of six key indicators of health warning effectiveness: forgoing cigarettes and reading the warning labels. The change to pictorial health warnings in Malaysia led to significant and substantial increases in five of six indicators (noticing, reading, forgoing, avoiding, thinking about quitting). The delay in implementing pictorial health warnings in China constitutes a lost opportunity for increasing knowledge and awareness of the harms of cigarettes, and for motivating smokers to quit. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Age-related Positivity Effect and Tobacco Warning Labels

PubMed Central

Roberts, Megan E.; Peters, Ellen; Ferketich, Amy K.; Klein, Elizabeth G.

2016-01-01

Objectives This study tested whether age is a factor in viewing time for tobacco warning labels. The approach drew from previous work demonstrating an age-related positivity effect, whereby older adults show preferences toward positive and away from negative stimuli. Methods Participants were 295 daily smokers from Appalachian Ohio (age range: 21–68). All participants took part in an eye-tracking paradigm that captured the attention paid to elements of health warning labels in the context of magazine advertisements. Participants also reported on their past cessation attempts and their beliefs about the dangers of smoking. Results Consistent with theory on age-related positivity, older age predicted weaker beliefs about smoking risks, but only among those with no past-year quit attempts. In support of our primary hypothesis, older age was also related to a lower percentage of time spent viewing tobacco warning labels, both overall (text + image) and for the graphic image alone. These associations remained after controlling for cigarettes smoked per day. Conclusions Overall, findings suggest that age is an important consideration for the design of future graphic warning labels and other tobacco risk communications. For older adults, warning labels may need to be tailored to overcome the age-related positivity effect. PMID:27617273

Community College Faculty Involvement in Decision-Making.

ERIC Educational Resources Information Center

Thaxter, Lynn P.; Graham, Steven W.

1999-01-01

Explores community college faculty's perception of their involvement in decision making. Reports the responses of 70 Midwest community college instructors in five areas: finance, instruction, personnel, goals, and students. Finds that respondents feel little sense of decision-making involvement. Warns that presidents may alienate the faculty if…

Distributed collaborative decision support environments for predictive awareness

NASA Astrophysics Data System (ADS)

McQuay, William K.; Stilman, Boris; Yakhnis, Vlad

2005-05-01

The past decade has produced significant changes in the conduct of military operations: asymmetric warfare, the reliance on dynamic coalitions, stringent rules of engagement, increased concern about collateral damage, and the need for sustained air operations. Mission commanders need to assimilate a tremendous amount of information, rapidly assess the enemy"s course of action (eCOA) or possible actions and promulgate their own course of action (COA) - a need for predictive awareness. Decision support tools in a distributed collaborative environment offer the capability of decomposing complex multitask processes and distributing them over a dynamic set of execution assets that include modeling, simulations, and analysis tools. Revolutionary new approaches to strategy generation and assessment such as Linguistic Geometry (LG) permit the rapid development of COA vs. enemy COA (eCOA). LG tools automatically generate and permit the operators to take advantage of winning strategies and tactics for mission planning and execution in near real-time. LG is predictive and employs deep "look-ahead" from the current state and provides a realistic, reactive model of adversary reasoning and behavior. Collaborative environments provide the framework and integrate models, simulations, and domain specific decision support tools for the sharing and exchanging of data, information, knowledge, and actions. This paper describes ongoing research efforts in applying distributed collaborative environments to decision support for predictive mission awareness.

Clinical Decision Support Alert Appropriateness: A Review and Proposal for Improvement

PubMed Central

McCoy, Allison B.; Thomas, Eric J.; Krousel-Wood, Marie; Sittig, Dean F.

2014-01-01

Background Many healthcare providers are adopting clinical decision support (CDS) systems to improve patient safety and meet meaningful use requirements. Computerized alerts that prompt clinicians about drug-allergy, drug-drug, and drug-disease warnings or provide dosing guidance are most commonly implemented. Alert overrides, which occur when clinicians do not follow the guidance presented by the alert, can hinder improved patient outcomes. Methods We present a review of CDS alerts and describe a proposal to develop novel methods for evaluating and improving CDS alerts that builds upon traditional informatics approaches. Our proposal incorporates previously described models for predicting alert overrides that utilize retrospective chart review to determine which alerts are clinically relevant and which overrides are justifiable. Results Despite increasing implementations of CDS alerts, detailed evaluations rarely occur because of the extensive labor involved in manual chart reviews to determine alert and response appropriateness. Further, most studies have solely evaluated alert overrides that are appropriate or justifiable. Our proposal expands the use of web-based monitoring tools with an interactive dashboard for evaluating CDS alert and response appropriateness that incorporates the predictive models. The dashboard provides 2 views, an alert detail view and a patient detail view, to provide a full history of alerts and help put the patient's events in context. Conclusion The proposed research introduces several innovations to address the challenges and gaps in alert evaluations. This research can transform alert evaluation processes across healthcare settings, leading to improved CDS, reduced alert fatigue, and increased patient safety. PMID:24940129

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

PubMed

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

2017-04-01

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

Knowledge management in healthcare: towards 'knowledge-driven' decision-support services.

PubMed

Abidi, S S

2001-09-01

In this paper, we highlight the involvement of Knowledge Management in a healthcare enterprise. We argue that the 'knowledge quotient' of a healthcare enterprise can be enhanced by procuring diverse facets of knowledge from the seemingly placid healthcare data repositories, and subsequently operationalising the procured knowledge to derive a suite of Strategic Healthcare Decision-Support Services that can impact strategic decision-making, planning and management of the healthcare enterprise. In this paper, we firstly present a reference Knowledge Management environment-a Healthcare Enterprise Memory-with the functionality to acquire, share and operationalise the various modalities of healthcare knowledge. Next, we present the functional and architectural specification of a Strategic Healthcare Decision-Support Services Info-structure, which effectuates a synergy between knowledge procurement (vis-à-vis Data Mining) and knowledge operationalisation (vis-à-vis Knowledge Management) techniques to generate a suite of strategic knowledge-driven decision-support services. In conclusion, we argue that the proposed Healthcare Enterprise Memory is an attempt to rethink the possible sources of leverage to improve healthcare delivery, hereby providing a valuable strategic planning and management resource to healthcare policy makers.

Evaluation of prescriber responses to pharmacogenomics clinical decision support for thiopurine S-methyltransferase testing.

PubMed

Ubanyionwu, Samuel; Formea, Christine M; Anderson, Benjamin; Wix, Kelly; Dierkhising, Ross; Caraballo, Pedro J

2018-02-15

Results of a study of prescribers' responses to a pharmacogenomics-based clinical decision support (CDS) alert designed to prompt thiopurine S -methyltransferase (TPMT) status testing are reported. A single-center, retrospective, chart review-based study was conducted to evaluate prescriber compliance with a pretest CDS alert that warned of potential thiopurine drug toxicity resulting from deficient TPMT activity due to TPMT gene polymorphism. The CDS alert was triggered when prescribers ordered thiopurine drugs for patients whose records did not indicate TPMT status or when historical thiopurine use was documented in the electronic health record. The alert pop-up also provided a link to online educational resources to guide thiopurine dosing calculations. During the 9-month study period, 500 CDS alerts were generated: in 101 cases (20%), TPMT phenotyping or TPMT genotyping was ordered; in 399 cases (80%), testing was not ordered. Multivariable regression analysis indicated that documentation of historical thiopurine use was the only independent predictor of test ordering. Among the 99 patients tested subsequent to CDS alerts, 70 (71%) had normal TPMT activity, 29 (29%) had intermediate activity, and none had deficient activity. The online resources provided thiopurine dosing recommendations applicable to 24 patients, but only 3 were prescribed guideline-supported doses after CDS alerts. The pretest CDS rule resulted in a large proportion of neglected alerts due to poor alerting accuracy and consequent alert fatigue. Prescriber usage of online thiopurine dosing resources was low. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Emotion in the Law and the Lab: The Case of Graphic Cigarette Warnings

PubMed Central

Peters, Ellen; Evans, Abigail T.; Hemmerich, Natalie; Berman, Micah

2017-01-01

The decision in RJ Reynolds vs. FDA (2012) to invalidate FDA’s proposed graphic health warnings was based in part on the reasoning that the proposed graphic warnings cued emotional responses and therefore could not be considered “factual.” However, this reasoning demonstrated the courts’ fundamental misunderstanding of current behavioral-science research. In contrast to the courts’ artificial separation of emotions from fact, we synthesize and interpret relevant research in basic decision sciences and describe an evidence-based characterization of how emotions influence consumer decision making through multiple mechanisms. We then explore how behavioral research gets “lost in translation” in the legal process and recommend ways that behavioral scientists can work with attorneys to remedy this problem. In order for science-based tobacco regulation to survive legal challenges from the tobacco industry, courts must have access to and be able to understand and apply the relevant research. Accordingly, behavioral laboratory researchers must consider the courts as an additional audience when designing research and reporting results. Researchers wishing to influence policy should also work closely with public health lawyers to have the greatest impact on the legal system. PMID:29057296

Rock bolt overload warning device

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

Unrug, K.F.

1983-10-18

A washer is described which is used in the construction of the support for the roof of a mine. The washer is fabricated such that finger like projections rupture in stages as the tension on bolts and pressure in the strata of the roof of the mine increases beyond structurely safe limits. The rupturing of the washer emits audible warning signals and also provides a visual indication of an unsafe condition.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients.

PubMed

Velickovski, Filip; Ceccaroni, Luigi; Roca, Josep; Burgos, Felip; Galdiz, Juan B; Marina, Nuria; Lluch-Ariet, Magí

2014-11-28

The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network.

PubMed

Wright, Adam; Sittig, Dean F

2008-12-01

In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

The GNSS-based component for the new Indonesian tsunami early warning centre provided by GITEWS

NASA Astrophysics Data System (ADS)

Falck, C.; Ramatschi, M.; Bartsch, M.; Merx, A.; Hoeberechts, J.; Rothacher, M.

2009-04-01

sensors on land the processing system delivers deviations from their normal, mean coordinates. The deviations or so called displacements are indicators for land mass movements which can occur, e.g., due to strong earthquakes. The ground motion information is a valuable source for a fast understanding of an earthquake's mechanism with possible relevance for a potentially following tsunami. By this means the GNSS system supports the decision finding process whether most probably a tsunami has been generated or not. For buoy based GNSS data the processing (differential, with GNSS reference station on land) delivers coordinates as well. Only the vertical component is of interest as it corresponds to the instant sea level height. Deviations to the mean sea level height are an indicator for a possibly passing tsunami wave. The graphical user interface (GUI) of the GNSS system supports both, a quick view for all staff members at the warning centre (24h/7d shifts) and deeper analysis by GNSS experts. The GNSS GUI system is implemented as a web-based application and allows all views to be displayed on different screens at the same time, even at remote locations. This is part of the concept, as it can support the dialogue between warning centre staff on duty or on standby and sensor station maintenance staff. Acknowledgements The GITEWS project (German Indonesian Tsunami Early Warning System) is carried out by a large group of scientists and engineers from (GFZ) German Research Centre for Geosciences and its partners from the German Aerospace Centre (DLR), the Alfred Wegener Institute for Polar and Marine Research (AWI), the GKSS Research Centre, the Konsortium Deutsche Meeresforschung (KDM), the Leibniz Institute for Marine Sciences (IFM-GEOMAR), the United Nations University (UNU), the Federal Institute for Geosciences and Natural Resources (BGR), the German Agency for Technical Cooperation (GTZ) and other international partners. Most relevant partners in Indonesia with respect

Warning Signs of Childhood Emergencies

MedlinePlus

... Health & Safety Tips » Warning Signs of Childhood Emergencies Warning Signs of Childhood Emergencies Because their bodies are ... if your child exhibits any of the following warning signs of a medical emergency: Any significant change ...

A Decision Support System for Evaluating Systems of Undersea Sensors and Weapons

DTIC Science & Technology

2015-12-01

distribution is unlimited A DECISION SUPPORT SYSTEM FOR EVALUATING SYSTEMS OF UNDERSEA SENSORS AND WEAPONS by Team Mental Focus Cohort 142O...A DECISION SUPPORT SYSTEM FOR EVALUATING SYSTEMS OF UNDERSEA SENSORS AND WEAPONS 5. FUNDING NUMBERS 6. AUTHOR(S) Systems Engineering Cohort...undersea weapons, it requires the supporting tools to evaluate and predict the effectiveness of these system concepts. While current naval minefield

Watershed forest management using decision support technology

Treesearch

Mark Twery; Robert Northrop

2004-01-01

Using innovative partnerships and a variety of decision support tools, we identified the needs and goals of Baltimore, Maryland, for their reservoir properties containing over 17000 forested acres; developed a management plan; determined the information necessary to evaluate conditions, processes, and context; chose tools to use; collected, organized, and analyzed data...

Crash Warning Interface Metrics: Final Report

DOT National Transportation Integrated Search

2011-08-01

The Crash Warning Interface Metrics (CWIM) project addressed issues of the driver-vehicle interface (DVI) for Advanced Crash Warning Systems (ACWS). The focus was on identifying the effects of certain warning system features (e.g., warning modality) ...

Emergency Warning Systems. Part 2. Warning Systems - Evaluation Guidelines.

DTIC Science & Technology

1983-07-01

ELEMENT. PROJECT. TASK AREA A WORK UNIT NUMBERS PRC Voorhees Work Unit 2234G 1500 Planning Research Drive McLean, Virginia 22102 ___ 11. CONTROLLING ...different from Controlling Office) IS. SECURITY CLASS. (of this report) Unclassified 15a. DECLASSIFICATION/DOWNGRADING SCHEDULE 16. DISTRIBUTION...systems that control these warning systems are discussed. Test results of several warning systems are included along with a discussion of sound

Decision Support for Integrated Energy-Water Planning

NASA Astrophysics Data System (ADS)

Tidwell, V. C.; William, H.; Klise, G.; Kobos, P. H.; Malczynski, L. A.

2008-12-01

Currently, electrical power generation uses about 140 billion gallons of water per day accounting for over 40% of all freshwater withdrawals thus competing with irrigated agriculture as the leading user of water. To meet their demand for water, proposed power plants must often target waterways and aquifers prone to overdraft or which may be home to environmentally sensitive species. Acquisition of water rights, permits and public support may therefore be a formidable hurdle when licensing new power plants. Given these current difficulties, what does the future hold when projected growth in population and the economy may require a 30% increase in power generation capacity by 2025? Technology solutions can only take us so far, as noted by the National Energy-Water Roadmap Exercise. This roadmap identified the need for long-term and integrated resource planning supported with scientifically credible models as a leading issue. To address this need a decision support framework is being developed that targets the shared needs of energy and water producers, resource managers, regulators, and decision makers at the federal, state and local levels. The framework integrates analysis and optimization capabilities to help identify potential trade-offs, and "best" alternatives among an overwhelming number of energy/water options and objectives. The decision support tool is comprised of three basic elements: a system dynamics model coupling the physical and economic systems important to integrated energy-water planning and management; an optimization toolbox; and a software wrapper that integrates the aforementioned elements along with additional external energy/water models, databases, and visualization products. An interactive interface allows direct interaction with the model and access to real-time results organized according to a variety of reference systems, e.g., from a political, watershed, or electric power grid perspective. With this unique synthesis of various

Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence

PubMed Central

2014-01-01

Background Medication non-adherence is prevalent. We assessed the effect of electronic prescribing (e-prescribing) with formulary decision support on preferred formulary tier usage, copayment, and concomitant adherence. Methods We retrospectively analyzed 14,682 initial pharmaceutical claims for angiotensin receptor blocker and inhaled steroid medications among 14,410 patients of 2189 primary care physicians (PCPs) who were offered e-prescribing with formulary decision support, including 297 PCPs who adopted it. Formulary decision support was initially non-interruptive, such that formulary tier symbols were displayed adjacent to medication names. Subsequently, interruptive formulary decision support alerts also interrupted e-prescribing when preferred-tier alternatives were available. A difference in differences design was used to compare the pre-post differences in medication tier for each new prescription attributed to non-adopters, low user (<30% usage rate), and high user PCPs (>30% usage rate). Second, we modeled the effect of formulary tier on prescription copayment. Last, we modeled the effect of copayment on adherence (proportion of days covered) to each new medication. Results Compared with non-adopters, high users of e-prescribing were more likely to prescribe preferred-tier medications (vs. non-preferred tier) when both non-interruptive and interruptive formulary decision support were in place (OR 1.9 [95% CI 1.0-3.4], p = 0.04), but no more likely to prescribe preferred-tier when only non-interruptive formulary decision support was in place (p = 0.90). Preferred-tier claims had only slightly lower mean monthly copayments than non-preferred tier claims (angiotensin receptor blocker: $10.60 versus $11.81, inhaled steroid: $14.86 versus $16.42, p < 0.0001). Medication possession ratio was 8% lower for each $1.00 increase in monthly copayment to the one quarter power (p < 0.0001). However, we detected no significant direct association

Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.

PubMed

Pevnick, Joshua M; Li, Ning; Asch, Steven M; Jackevicius, Cynthia A; Bell, Douglas S

2014-08-28

Medication non-adherence is prevalent. We assessed the effect of electronic prescribing (e-prescribing) with formulary decision support on preferred formulary tier usage, copayment, and concomitant adherence. We retrospectively analyzed 14,682 initial pharmaceutical claims for angiotensin receptor blocker and inhaled steroid medications among 14,410 patients of 2189 primary care physicians (PCPs) who were offered e-prescribing with formulary decision support, including 297 PCPs who adopted it. Formulary decision support was initially non-interruptive, such that formulary tier symbols were displayed adjacent to medication names. Subsequently, interruptive formulary decision support alerts also interrupted e-prescribing when preferred-tier alternatives were available. A difference in differences design was used to compare the pre-post differences in medication tier for each new prescription attributed to non-adopters, low user (<30% usage rate), and high user PCPs (>30% usage rate). Second, we modeled the effect of formulary tier on prescription copayment. Last, we modeled the effect of copayment on adherence (proportion of days covered) to each new medication. Compared with non-adopters, high users of e-prescribing were more likely to prescribe preferred-tier medications (vs. non-preferred tier) when both non-interruptive and interruptive formulary decision support were in place (OR 1.9 [95% CI 1.0-3.4], p = 0.04), but no more likely to prescribe preferred-tier when only non-interruptive formulary decision support was in place (p = 0.90). Preferred-tier claims had only slightly lower mean monthly copayments than non-preferred tier claims (angiotensin receptor blocker: $10.60 versus $11.81, inhaled steroid: $14.86 versus $16.42, p < 0.0001). Medication possession ratio was 8% lower for each $1.00 increase in monthly copayment to the one quarter power (p < 0.0001). However, we detected no significant direct association between formulary decision

Academic Support Services and Career Decision-Making Self-Efficacy in Student Athletes

ERIC Educational Resources Information Center

Burns, Gary N.; Jasinski, Dale; Dunn, Steve; Fletcher, Duncan

2013-01-01

This study examined the relationship between evaluations of academic support services and student athletes' career decision-making self-efficacy. One hundred and fifty-eight NCAA athletes (68% male) from 11 Division I teams completed measures of satisfaction with their academic support services, career decision-making self-efficacy, general…

Reducing Diagnostic Error with Computer-Based Clinical Decision Support

ERIC Educational Resources Information Center

Greenes, Robert A.

2009-01-01

Information technology approaches to delivering diagnostic clinical decision support (CDS) are the subject of the papers to follow in the proceedings. These will address the history of CDS and present day approaches (Miller), evaluation of diagnostic CDS methods (Friedman), and the role of clinical documentation in supporting diagnostic decision…

Developmental differences in false-event rejection: Effects of memorability-based warnings.

PubMed

Ghetti, Simona; Castelli, Paola

2006-08-01

The present study investigated the development of the memorability-based strategy, a metacognitive process through which individuals reject the occurrence of false events if they do not remember the events and they expect them to be highly memorable. Previous research found that only older children spontaneously use this strategy. In the present study, we examined whether providing children with relevant information about expected event-memorability and inferences derived from it induced strategy use. Children aged 5, 7, and 9 (n = 144) were asked about true and false (high- and low-memorability) autobiographical events. Participants were either interviewed according to the standard "lost-in-the-mall" procedure, or were additionally provided with warnings. Warnings were either congruent or incongruent with assessments and decision processes involved in the strategy use. Results showed that receiving memorability-congruent warnings increased false-event rejection rates in 7- and 9-year-olds, but not in 5-year-olds. However, only older children were more likely to reject high-memorability compared with low-memorability false events. Developmental trajectories and factors affecting reliance on the memorability-based strategy are discussed.

Decision support system for nursing management control

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

Ernst, C.J.

A knowledge representation approach for expert systems supporting decision processes in business is proposed. A description of a knowledge representation schema using a logic programming metalanguage is described, then the role of such a schema in a management expert system is demonstrated through the problem of nursing management control in hospitals. 18 references.

Performance evaluation of the machine learning algorithms used in inference mechanism of a medical decision support system.

PubMed

Bal, Mert; Amasyali, M Fatih; Sever, Hayri; Kose, Guven; Demirhan, Ayse

2014-01-01

The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.

Airlock caution and warning system

NASA Technical Reports Server (NTRS)

Mayfield, W. J.; Cork, L. Z.; Malchow, R. G.; Hornback, G. L.

1972-01-01

Caution and warning system, used to monitor performance and warn of hazards or out-of-limit conditions on space vehicles, may have application to aircraft and railway transit systems. System consists of caution and warning subsystem and emergency subsystem.

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

PubMed

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

2016-11-01

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

ENABLING SMART MANUFACTURING TECHNOLOGIES FOR DECISION-MAKING SUPPORT

PubMed Central

Helu, Moneer; Libes, Don; Lubell, Joshua; Lyons, Kevin; Morris, KC

2017-01-01

Smart manufacturing combines advanced manufacturing capabilities and digital technologies throughout the product lifecycle. These technologies can provide decision-making support to manufacturers through improved monitoring, analysis, modeling, and simulation that generate more and better intelligence about manufacturing systems. However, challenges and barriers have impeded the adoption of smart manufacturing technologies. To begin to address this need, this paper defines requirements for data-driven decision making in manufacturing based on a generalized description of decision making. Using these requirements, we then focus on identifying key barriers that prevent the development and use of data-driven decision making in industry as well as examples of technologies and standards that have the potential to overcome these barriers. The goal of this research is to promote a common understanding among the manufacturing community that can enable standardization efforts and innovation needed to continue adoption and use of smart manufacturing technologies. PMID:28649678

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients

PubMed Central

2014-01-01

Background The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. Objectives The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. Methods The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. Results A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Conclusions Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health

Tools to support GHG emissions reduction : a regional effort, part 1 - carbon footprint estimation and decision support.

DOT National Transportation Integrated Search

2010-09-01

Tools are proposed for carbon footprint estimation of transportation construction projects and decision support : for construction firms that must make equipment choice and usage decisions that affect profits, project duration : and greenhouse gas em...

Human Decision Processes: Implications for SSA Support Tools

NASA Astrophysics Data System (ADS)

Picciano, P.

2013-09-01

paper), one opinion shared is that the rational, economic, deliberate listing/evaluation of all options is NOT representative of how many decision are made. A framework gaining interest lately describes two systems predominantly at work: intuition and reasoning (Kahneman, 2003). Intuition is fast, automatic, and parallel contrasted with the more effortful, deliberative, and sequential reasoning. One of the issues of contention is that considerable research is stacked supporting both sides claiming that intuition is: • A hallmark of expertise responsible for rapid, optimal decisions in the face of adversity • A vulnerability where biases serve as decision traps leading to wrong choices Using seminal studies from a range of domains and tasking, potential solutions for SSA decision support will be offered. Important issues such as managing uncertainty, framing inquiries, and information architecture, and contextual cues will be discussed. The purpose is to provide awareness of the human limitations and capabilities in complex decision making so engineers and designers can consider such factors in their development of SSA tools.

Tools to support evidence-informed public health decision making

PubMed Central

2014-01-01

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

Tools to support evidence-informed public health decision making.

PubMed

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

2014-07-18

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

Translational Cognition for Decision Support in Critical Care Environments: A Review

PubMed Central

Patel, Vimla L.; Zhang, Jiajie; Yoskowitz, Nicole A.; Green, Robert; Sayan, Osman R.

2008-01-01

The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers. PMID:18343731

Translational cognition for decision support in critical care environments: a review.

PubMed

Patel, Vimla L; Zhang, Jiajie; Yoskowitz, Nicole A; Green, Robert; Sayan, Osman R

2008-06-01

The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real-world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers.

The impacts of fear and disgust on the perceived effectiveness of smoking warning labels: a study on Turkish university students.

PubMed

Tugrul, Tugba Orten

2015-03-01

This study investigated the perceived effectiveness of pictorial warning labels on cigarette packages on Turkish university students. In particular, the impacts of fear and disgust elicited by these labels were examined using the smoking decision process model. A survey was conducted with 344 undergraduate students at a private university in Izmir, the third largest city of Turkey. The findings showed differences in levels of fear and disgust evoked by pictorial warning labels for each stage in the smoking decision process, which in turn led to differences in the perceived effectiveness of the labels. Thus, this study underlines the importance of tailoring antismoking messages according to specific target groups and also suggests considering the smoking-decision-process model as segments and targeting groups in creating effective messages. © 2013 APJPH.

Alcohol Warnings and Moderate Drinking Patterns among Italian University Students: An Exploratory Study

PubMed Central

Annunziata, Azzurra; Vecchio, Riccardo; Mariani, Angela

2017-01-01

The introduction of health warnings on labels to correct externalities associated with alcohol consumption is heavily debated and has been explored from different perspectives. The current paper aims to analyse the interest and attitudes of Italian university students regarding health warnings on alcoholic beverages and to verify the existence of segments that differ in terms of attitudes towards such warnings. Our results show that young consumers consider health warnings quite important, although the degree of perceived utility differs in relation to the type of warning. Cluster analysis shows the existence of three groups of young consumers with different degrees of attention and perceived utility of warnings on alcoholic beverages, but also in relation to drinking behaviour and awareness of social and health risks related to alcohol consumption. In brief, Italian young adults with moderate consumption behaviour view label warnings positively, while this attitude is weaker among younger adults and those with riskier consumption behaviours. Our findings, albeit limited and based on stated and not revealed data, support the need for appropriate tools to improve the availability of information among young adults on the risks of excessive alcohol consumption and increased awareness of the importance of moderate drinking. PMID:28629138

Middle Mississippi River decision support system: user's manual

USGS Publications Warehouse

Rohweder, Jason J.; Zigler, Steven J.; Fox, Timothy J.; Hulse, Steven N.

2005-01-01

This user's manual describes the Middle Mississippi River Decision Support System (MMRDSS) and gives detailed examples on its use. The MMRDSS provides a framework to assist decision makers regarding natural resource issues in the Middle Mississippi River floodplain. The MMRDSS is designed to provide users with a spatially explicit tool for tasks, such as inventorying existing knowledge, developing models to investigate the potential effects of management decisions, generating hypotheses to advance scientific understanding, and developing scientifically defensible studies and monitoring. The MMRDSS also includes advanced tools to assist users in evaluating differences in complexity, connectivity, and structure of aquatic habitats among river reaches. The Environmental Systems Research Institute ArcView 3.x platform was used to create and package the data and tools of the MMRDSS.

Disaster Response and Decision Support in Partnership with the California Earthquake Clearinghouse

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Rosinski, A.; Vaughan, D.; Morentz, J.

2014-12-01

Getting the right information to the right people at the right time is critical during a natural disaster. E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) is a NASA decision support system designed to produce remote sensing and geophysical modeling data products that are relevant to the emergency preparedness and response communities and serve as a gateway to enable the delivery of NASA decision support products to these communities. The E-DECIDER decision support system has several tools, services, and products that have been used to support end-user exercises in partnership with the California Earthquake Clearinghouse since 2012, including near real-time deformation modeling results and on-demand maps of critical infrastructure that may have been potentially exposed to damage by a disaster. E-DECIDER's underlying service architecture allows the system to facilitate delivery of NASA decision support products to the Clearinghouse through XchangeCore Web Service Data Orchestration that allows trusted information exchange among partner agencies. This in turn allows Clearinghouse partners to visualize data products produced by E-DECIDER and other NASA projects through incident command software such as SpotOnResponse or ArcGIS Online.

Visual attention to health warnings on plain tobacco packaging in adolescent smokers and non-smokers.

PubMed

Maynard, Olivia M; Munafò, Marcus R; Leonards, Ute

2013-02-01

Previous research with adults indicates that plain packaging increases visual attention to health warnings in adult non-smokers and weekly smokers, but not daily smokers. The present research extends this study to adolescents aged 14-19 years. Mixed-model experimental design, with smoking status as a between-subjects factor and pack type (branded or plain pack) and eye gaze location (health warning or branding) as within-subjects factors. Three secondary schools in Bristol, UK. A convenience sample of adolescents comprising never-smokers (n = 26), experimenters (n = 34), weekly smokers (n = 13) and daily smokers (n = 14). Number of eye movements to health warnings and branding on plain and branded packs. Analysis of variance, irrespective of smoking status revealed more eye movements to health warnings than branding on plain packs, but an equal number of eye movements to both regions on branded packs (P = 0.033). This was observed among experimenters (P < 0.001) and weekly smokers (P = 0.047), but not among never-smokers or daily smokers. Among experimenters and weekly smokers, plain packaging increases visual attention to health warnings and away from branding. Daily smokers, even relatively early in their smoking careers, seem to avoid the health warnings on cigarette packs. Adolescent never-smokers attend the health warnings preferentially on both types of packs, a finding which may reflect their decision not to smoke. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Alcohol warnings in TV beer advertisements.

PubMed

Slater, M D; Domenech, M M

1995-05-01

Mandated warnings are among the few steps Congress has taken to influence the use of legal substances such as alcohol. The usefulness of such warnings in discouraging abuse of alcohol is, however, controversial. This study examines the impact of televised warnings on probable antecedents of belief change not examined in previous research: confidence in beliefs about beer risks or benefits, and cognitive responses to the advertisements. The present study (N = 75 male and female college students) tests four of the warnings recommended in Senate Bill 674 (1993--the "Thurmond bill") edited into randomly sampled television beer advertisements, using a between-subjects treatment-and-control experimental design. The four advertisements or advertisement/warning pairs were counterbalanced and analyzed as a repeated measures factor. The study indicated, as hypothesized, that subjects exposed to warnings tended to have less confidence in their generally skeptical assessments of beer risks--a likely precursor to belief change in resistant populations. Repeated exposure to the advertisements alone also appeared to lead to increased confidence in generally positive assessments of beer benefits, whereas repeated exposure to warnings led to decreased confidence in such assessments. Repeated exposure to warnings also may have primed negative reactions to subsequent beer advertisements. These results suggest mechanisms by which alcohol warnings may over time influence beliefs. Measures used here may serve as useful criterion variables in future studies on warnings. Further attention to optimizing warning content and presentation is recommended.

Evaluating the Use of Remote Sensing Data in the USAID Famine Early Warning Systems Network

NASA Technical Reports Server (NTRS)

Brown, Molly E.; Brickley, Elizabeth B.

2011-01-01

The US Agency for International Development (USAID) s Famine Early Warning System Network (FEWS NET) provides monitoring and early warning support to decision makers responsible for responding to food insecurity emergencies on three continents. FEWS NET uses satellite remote sensing and ground observations of rainfall and vegetation in order to provide information on drought, floods and other extreme weather events to decision makers. Previous research has presented results from a professional review questionnaire with FEWS NET expert end-users whose focus was to elicit Earth observation requirements. The review provided FEWS NET operational requirements and assessed the usefulness of additional remote sensing data. Here we analyzed 1342 food security update reports from FEWS NET. The reports consider the biophysical, socioeconomic, and contextual influences on the food security in 17 countries in Africa from 2000-2009. The objective was to evaluate the use of remote sensing information in comparison with other important factors in the evaluation of food security crises. The results show that all 17 countries use rainfall information, agricultural production statistics, food prices and food access parameters in their analysis of food security problems. The reports display large scale patterns that are strongly related to history of the FEWS NET program in each country. We found that rainfall data was used 84% of the time, remote sensing of vegetation 28% of the time, and gridded crop models 10%, reflecting the length of use of each product in the regions. More investment is needed in training personnel on remote sensing products to improve use of data products throughout the FEWS NET system.

49 CFR 234.259 - Warning time.

Code of Federal Regulations, 2011 CFR

2011-10-01

... modified because of a change in train speeds. Electronic devices that accurately determine actual warning... 49 Transportation 4 2011-10-01 2011-10-01 false Warning time. 234.259 Section 234.259..., Inspection, and Testing Inspections and Tests § 234.259 Warning time. Each crossing warning system shall be...

49 CFR 234.259 - Warning time.

Code of Federal Regulations, 2010 CFR

2010-10-01

... modified because of a change in train speeds. Electronic devices that accurately determine actual warning... 49 Transportation 4 2010-10-01 2010-10-01 false Warning time. 234.259 Section 234.259..., Inspection, and Testing Inspections and Tests § 234.259 Warning time. Each crossing warning system shall be...

NOAA-USGS Debris-Flow Warning System - Final Report

USGS Publications Warehouse

,

2005-01-01

Landslides and debris flows cause loss of life and millions of dollars in property damage annually in the United States (National Research Council, 2004). In an effort to reduce loss of life by debris flows, the National Oceanic and Atmospheric Administration's (NOAA) National Weather Service (NWS) and the U.S. Geological Survey (USGS) operated an experimental debris-flow prediction and warning system in the San Francisco Bay area from 1986 to 1995 that relied on forecasts and measurements of precipitation linked to empirical precipitation thresholds to predict the onset of rainfall-triggered debris flows. Since 1995, there have been substantial improvements in quantifying precipitation estimates and forecasts, development of better models for delineating landslide hazards, and advancements in geographic information technology that allow stronger spatial and temporal linkage between precipitation forecasts and hazard models. Unfortunately, there have also been several debris flows that have caused loss of life and property across the United States. Establishment of debris-flow warning systems in areas where linkages between rainfall amounts and debris-flow occurrence have been identified can help mitigate the hazards posed by these types of landslides. Development of a national warning system can help support the NOAA-USGS goal of issuing timely Warnings of potential debris flows to the affected populace and civil authorities on a broader scale. This document presents the findings and recommendations of a joint NOAA-USGS Task Force that assessed the current state-of-the-art in precipitation forecasting and debris-flow hazard-assessment techniques. This report includes an assessment of the science and resources needed to establish a demonstration debris-flow warning project in recently burned areas of southern California and the necessary scientific advancements and resources associated with expanding such a warning system to unburned areas and, possibly, to a

Streamlining Tsunami Messages (e.g., Warnings) of the US National Tsunami Warning Center, Palmer, Alaska

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Sorensen, J. H.; Vogt Sorensen, B.; Whitmore, P.; Johnston, D. M.

2016-12-01

Spurred in part by world-wide interest in improving warning messaging for and response to tsunamis in the wake of several catastrophic tsunamis since 2004 and growing interest at the US National Weather Service (NWS) to integrate social science into their Tsunami Program, the NWS Tsunami Warning Centers in Alaska and Hawaii have made great progress toward enhancing tsunami messages. These include numerous products, among them being Tsunami Warnings, Tsunami Advisories and Tsunami Watches. Beginning in 2010 we have worked with US National Tsunami Hazard Mitigation Program (NTHMP) Warning Coordination and Mitigation and Education Subcommittee members; Tsunami Program administrators; and NWS Weather Forecast Officers to conduct a series of focus group meetings with stakeholders in coastal areas of Alaska, American Samoa, California, Hawaii, North Carolina, Oregon, US Virgin Islands and Washington to understand end-user perceptions of existing messages and their existing needs in message products. We also reviewed research literature on behavioral response to warnings to develop a Tsunami Warning Message Metric that could be used to guide revisions to tsunami warning messages of both warning centers. The message metric is divided into categories of Message Content, Style, Order, Formatting, and Receiver Characteristics. A sample message is evaluated by cross-referencing the message with the operational definitions of metric factors. Findings are then used to guide revisions of the message until the characteristics of each factor are met, whether the message is a full length or short message. Incrementally, this work contributed to revisions in the format, content and style of message products issued by the National Tsunami Warning Center (NTWC). Since that time, interest in short warning messages has continued to increase and in May 2016 the NTWC began efforts to revise message products to take advantage of recent NWS policy changes allowing use of mixed-case text

Impact of Graphic and Text Warnings on Cigarette Packs: Findings from Four Countries over Five Years

PubMed Central

Borland, Ron; Wilson, Nick; Fong, Geoffrey T.; Hammond, David; Cummings, K. Michael; Yong, Hua-Hie; Hosking, Warwick; Hastings, Gerard; Thrasher, James; McNeill, Ann

2015-01-01

Objectives To examine the impact of health warnings on smokers by comparing the short-term impact of new graphic (2006) Australian warnings with: (i) earlier (2003) United Kingdom (UK) larger text-based warnings; (ii) and Canadian graphic warnings (late 2000); and secondarily, to extend our understanding of warning wear-out. Methods The International Tobacco Control Policy Evaluation Survey (ITC Project) follows prospective cohorts (with replenishment) of adult smokers annually (5 waves: 2002–2006), in Canada, United States, UK, and Australia (around 2000 per country per wave; total n=17,773). Measures were of pack warning salience (reading and noticing); cognitive responses (thoughts of harm and quitting); and two behavioural responses: forgoing cigarettes and avoiding the warnings. Results All four indicators of impact increased markedly among Australian smokers following the introduction of graphic warnings. Controlling for date of introduction, they stimulated more cognitive responses than the UK (text-only) changes, and were avoided more, did not significantly increase forgoing cigarettes, but were read and noticed less. The findings also extend previous work showing partial wear-out of both graphic and text-only warnings, but the Canadian warnings have more sustained effects than UK ones. Conclusions Australia’s new health warnings increased reactions that are prospectively predictive of cessation activity. Warning size increases warning effectiveness and graphic warnings may be superior to text-based warnings. While there is partial wear-out in the initial impact associated with all warnings, stronger warnings tend to sustain their effects for longer. These findings support arguments for governments to exceed minimum FCTC requirements on warnings. PMID:19561362

Optimal data systems: the future of clinical predictions and decision support.

PubMed

Celi, Leo A; Csete, Marie; Stone, David

2014-10-01

The purpose of the review is to describe the evolving concept and role of data as it relates to clinical predictions and decision-making. Critical care medicine is, as an especially data-rich specialty, becoming acutely cognizant not only of its historic deficits in data utilization but also of its enormous potential for capturing, mining, and leveraging such data into well-designed decision support modalities as well as the formulation of robust best practices. Modern electronic medical records create an opportunity to design complete and functional data systems that can support clinical care to a degree never seen before. Such systems are often referred to as 'data-driven,' but a better term is 'optimal data systems' (ODS). Here we discuss basic features of an ODS and its benefits, including the potential to transform clinical prediction and decision support.

Decision support systems in water and wastewater treatment process selection and design: a review.

PubMed

Hamouda, M A; Anderson, W B; Huck, P M

2009-01-01

The continuously changing drivers of the water treatment industry, embodied by rigorous environmental and health regulations and the challenge of emerging contaminants, necessitates the development of decision support systems for the selection of appropriate treatment trains. This paper explores a systematic approach to developing decision support systems, which includes the analysis of the treatment problem(s), knowledge acquisition and representation, and the identification and evaluation of criteria controlling the selection of optimal treatment systems. The objective of this article is to review approaches and methods used in decision support systems developed to aid in the selection, sequencing of unit processes and design of drinking water, domestic wastewater, and industrial wastewater treatment systems. Not surprisingly, technical considerations were found to dominate the logic of the developed systems. Most of the existing decision-support tools employ heuristic knowledge. It has been determined that there is a need to develop integrated decision support systems that are generic, usable and consider a system analysis approach.

14 CFR 25.207 - Stall warning.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Stall warning. 25.207 Section 25.207... STANDARDS: TRANSPORT CATEGORY AIRPLANES Flight Stalls § 25.207 Stall warning. (a) Stall warning with... be clear and distinctive to the pilot in straight and turning flight. (b) The warning must be...

21 CFR 1141.10 - Required warnings.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Required warnings. 1141.10 Section 1141.10 Food... PRODUCTS CIGARETTE PACKAGE AND ADVERTISING WARNINGS Cigarette Package and Advertising Warnings § 1141.10 Required warnings. (a) Packages. (1) It shall be unlawful for any person to manufacture, package, sell...

14 CFR 25.207 - Stall warning.

Code of Federal Regulations, 2010 CFR