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Sample records for admission control decision

  1. SIP Controlled Admission and Preemption

    NARCIS (Netherlands)

    Babiarz, J.; Chan, K.; Karagiannis, Georgios; Eardley, P

    2006-01-01

    This framework defines a method of providing Explicit Congestion Control to real-time inelastic traffic like voice and video through the use of session admission control and preemption mechanisms. This approach uses the Pre-Congestion Notification Marking (PCN) [1] mechanism. PCN marking is deployed

  2. The Economic Burden of Urinary Tract Infection and Pressure Ulceration in Acute Traumatic Spinal Cord Injury Admissions: Evidence for Comparative Economics and Decision Analytics from a Matched Case-Control Study.

    Science.gov (United States)

    White, Barry A B; Dea, Nicolas; Street, John T; Cheng, Christiana L; Rivers, Carly S; Attabib, Najmedden; Kwon, Brian K; Fisher, Charles G; Dvorak, Marcel F

    2017-10-15

    Secondary complications of spinal cord injury (SCI) are a burden to affected individuals and the rest of society. There is limited evidence of the economic burden or cost of complications in SCI populations in Canada, however, which is necessary for comparative economic analyses and decision analytic modeling of possible solutions to these common health problems. Comparative economic analyses can inform resource allocation decisions, but the outputs are only as good as the inputs. In this article, new evidence of the excess or incremental costs of urinary tract infection (UTI) and pressure ulceration (PU) in acute traumatic SCI from an exploratory case series analysis of admissions to a Level I specialized Canadian spine facility (2008-2013) is presented. Participants in a national SCI registry were case-control matched (1:1) on the predicted probability of experiencing UTI or PU during initial acute SCI admission. The excess costs of UTI and PU are estimated as the mean of the differences in total direct acute SCI admission costs (length of stay, accommodation, nursing, pharmacy) from the perspective of the admitting facility between participants matched or paired on demographic and SCI characteristics. Even relatively minor UTI and PU, respectively, added an average of $7,790 (standard deviation [SD] $6,267) and $18,758 (SD $27,574) to the direct cost of acute SCI admission in 2013 Canadian dollars (CAD). This case series analysis established evidence of the excess costs of UTI and PU in acute SCI admissions, which will support decision-informing analyses in SCI.

  3. Admission Control Techniques for UMTS System

    Directory of Open Access Journals (Sweden)

    P. Kejik

    2010-09-01

    Full Text Available Universal mobile telecommunications system (UMTS is one of the 3rd generation (3G cell phone technologies. The capacity of UMTS is interference limited. Radio resources management (RRM functions are therefore used. They are responsible for supplying optimum coverage, ensuring efficient use of physical resources, and providing the maximum planned capacity. This paper deals with admission control techniques for UMTS. An own UMTS simulation program and several versions of proposed admission control algorithms are presented in this paper. These algorithms are based on fuzzy logic and genetic algorithms. The performance of algorithms is verified via simulations.

  4. Multi-Stage Admission Control for Load Balancing in Next Generation Systems

    DEFF Research Database (Denmark)

    Mihovska, Albena D.; Anggorojati, Bayu; Luo, Jijun

    2008-01-01

    This paper describes a load-dependent multi-stage admission control suitable for next generation systems. The concept uses decision polling in entities located at different levels of the architecture hierarchy and based on the load to activate a sequence of actions related to the admission...

  5. 28 CFR 541.47 - Admission to control unit.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Admission to control unit. 541.47 Section... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.47 Admission to control unit. Staff shall provide an inmate admitted to a control unit with: (a) Notice of the projected duration of...

  6. The Use of Criminal History Information in College Admissions Decisions

    Science.gov (United States)

    Pierce, Matthew W.; Runyan, Carol W.; Bangdiwala, Shrikant I.

    2014-01-01

    To understand the potential public health and social justice implications of criminal background screening on college admissions, we examined postsecondary institutions' reasons for collecting or not collecting applicants' criminal justice information. We invited heads of admissions from 300 randomly sampled postsecondary institutions to complete…

  7. Simple measurement-based admission control for DiffServ access networks

    Science.gov (United States)

    Lakkakorpi, Jani

    2002-07-01

    In order to provide good Quality of Service (QoS) in a Differentiated Services (DiffServ) network, a dynamic admission control scheme is definitely needed as an alternative to overprovisioning. In this paper, we present a simple measurement-based admission control (MBAC) mechanism for DiffServ-based access networks. Instead of using active measurements only or doing purely static bookkeeping with parameter-based admission control (PBAC), the admission control decisions are based on bandwidth reservations and periodically measured & exponentially averaged link loads. If any link load on the path between two endpoints is over the applicable threshold, access is denied. Link loads are periodically sent to Bandwidth Broker (BB) of the routing domain, which makes the admission control decisions. The information needed in calculating the link loads is retrieved from the router statistics. The proposed admission control mechanism is verified through simulations. Our results prove that it is possible to achieve very high bottleneck link utilization levels and still maintain good QoS.

  8. Variability of intensive care admission decisions for the very elderly.

    Directory of Open Access Journals (Sweden)

    Ariane Boumendil

    Full Text Available Although increasing numbers of very elderly patients are requiring intensive care, few large sample studies have investigated ICU admission of very elderly patients. Data on pre triage by physicians from other specialities is limited. This observational cohort study aims at examining inter-hospital variability of ICU admission rates and its association with patients' outcomes. All patients over 80 years possibly qualifying for ICU admission who presented to the emergency departments (ED of 15 hospitals in the Paris (France area during a one-year period were prospectively included in the study. Main outcome measures were ICU eligibility, as assessed by the ED and ICU physicians; in-hospital mortality; and vital and functional status 6 months after the ED visit. 2646 patients (median age 86; interquartile range 83-91 were included in the study. 94% of participants completed follow-up (n = 2495. 12.4% (n = 329 of participants were deemed eligible for ICU admission by ED physicians and intensivists. The overall in-hospital and 6-month mortality rates were respectively 27.2% (n = 717 and 50.7% (n = 1264. At six months, 57.5% (n = 1433 of patients had died or had a functional deterioration. Rates of patients deemed eligible for ICU admission ranged from 5.6% to 38.8% across the participating centers, and this variability persisted after adjustment for patients' characteristics. Despite this variability, we found no association between level of ICU eligibility and either in-hospital death or six-month death or functional deterioration. In France, the likelihood that a very elderly person will be admitted to an ICU varies widely from one hospital to another. Influence of intensive care admission on patients' outcome remains unclear.ClinicalTrials.gov NCT00912600.

  9. the admissibility of subregional courts' decisions before the african

    African Journals Online (AJOL)

    AbdiJA

    by framing its decisions in terms of treaty violations. ... The impact of the amendment was negative as it narrowed the jurisdiction of the. Court and provided a ...... Besides, there is no sufficient legal basis for making such references. Member.

  10. Power Admission Control with Predictive Thermal Management in Smart Buildings

    DEFF Research Database (Denmark)

    Yao, Jianguo; Costanzo, Giuseppe Tommaso; Zhu, Guchuan

    2015-01-01

    This paper presents a control scheme for thermal management in smart buildings based on predictive power admission control. This approach combines model predictive control with budget-schedulability analysis in order to reduce peak power consumption as well as ensure thermal comfort. First...

  11. Effect of Emergency Department and ICU Occupancy on Admission Decisions and Outcomes for Critically Ill Patients.

    Science.gov (United States)

    Mathews, Kusum S; Durst, Matthew S; Vargas-Torres, Carmen; Olson, Ashley D; Mazumdar, Madhu; Richardson, Lynne D

    2018-05-01

    ICU admission delays can negatively affect patient outcomes, but emergency department volume and boarding times may also affect these decisions and associated patient outcomes. We sought to investigate the effect of emergency department and ICU capacity strain on ICU admission decisions and to examine the effect of emergency department boarding time of critically ill patients on in-hospital mortality. A retrospective cohort study. Single academic tertiary care hospital. Adult critically ill emergency department patients for whom a consult for medical ICU admission was requested, over a 21-month period. None. Patient data, including severity of illness (Mortality Probability Model III on Admission), outcomes of mortality and persistent organ dysfunction, and hourly census reports for the emergency department, for all ICUs and all adult wards were compiled. A total of 854 emergency department requests for ICU admission were logged, with 455 (53.3%) as "accept" and 399 (46.7%) as "deny" cases, with median emergency department boarding times 4.2 hours (interquartile range, 2.8-6.3 hr) and 11.7 hours (3.2-20.3 hr) and similar rates of persistent organ dysfunction and/or death 41.5% and 44.6%, respectively. Those accepted were younger (mean ± SD, 61 ± 17 vs 65 ± 18 yr) and more severely ill (median Mortality Probability Model III on Admission score, 15.3% [7.0-29.5%] vs 13.4% [6.3-25.2%]) than those denied admission. In the multivariable model, a full medical ICU was the only hospital-level factor significantly associated with a lower probability of ICU acceptance (odds ratio, 0.55 [95% CI, 0.37-0.81]). Using propensity score analysis to account for imbalances in baseline characteristics between those accepted or denied for ICU admission, longer emergency department boarding time after consult was associated with higher odds of mortality and persistent organ dysfunction (odds ratio, 1.77 [1.07-2.95]/log10 hour increase). ICU admission decisions for

  12. Utility of Policy Capturing as an Approach to Graduate Admissions Decision Making.

    Science.gov (United States)

    Schmidt, Frank L.; And Others

    1978-01-01

    The present study examined and evaluated the application of linear policy-capturing models to the real-world decision task of graduate admissions. Utility of the policy-capturing models was great enough to be of practical significance, and least-squares weights showed no predictive advantage over equal weights. (Author/CTM)

  13. Resource management in Diffserv measurement-based admission control PHR

    NARCIS (Netherlands)

    Westberg, L.; Heijenk, Geert; Karagiannis, Georgios; Oosthoek, S.; Partain, D.; Rexhepi, Vlora; Szabo, R.; Wallentin, P.; El Allali, H.

    2002-01-01

    The purpose of this draft is to present the Resource Management in Diffserv (RMD) Measurement-Based Admission Control (RIMA) Per Hop Reservation (PHR) protocol. The RIMA PHR protocol is used on a per-hop basis in a Differentiated Services (Diffserv) domain and extends the Diffserv Per Hop Behavior

  14. Scalable approximate policies for Markov decision process models of hospital elective admissions.

    Science.gov (United States)

    Zhu, George; Lizotte, Dan; Hoey, Jesse

    2014-05-01

    To demonstrate the feasibility of using stochastic simulation methods for the solution of a large-scale Markov decision process model of on-line patient admissions scheduling. The problem of admissions scheduling is modeled as a Markov decision process in which the states represent numbers of patients using each of a number of resources. We investigate current state-of-the-art real time planning methods to compute solutions to this Markov decision process. Due to the complexity of the model, traditional model-based planners are limited in scalability since they require an explicit enumeration of the model dynamics. To overcome this challenge, we apply sample-based planners along with efficient simulation techniques that given an initial start state, generate an action on-demand while avoiding portions of the model that are irrelevant to the start state. We also propose a novel variant of a popular sample-based planner that is particularly well suited to the elective admissions problem. Results show that the stochastic simulation methods allow for the problem size to be scaled by a factor of almost 10 in the action space, and exponentially in the state space. We have demonstrated our approach on a problem with 81 actions, four specialities and four treatment patterns, and shown that we can generate solutions that are near-optimal in about 100s. Sample-based planners are a viable alternative to state-based planners for large Markov decision process models of elective admissions scheduling. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. BARTER: Behavior Profile Exchange for Behavior-Based Admission and Access Control in MANETs

    Science.gov (United States)

    Frias-Martinez, Vanessa; Stolfo, Salvatore J.; Keromytis, Angelos D.

    Mobile Ad-hoc Networks (MANETs) are very dynamic networks with devices continuously entering and leaving the group. The highly dynamic nature of MANETs renders the manual creation and update of policies associated with the initial incorporation of devices to the MANET (admission control) as well as with anomaly detection during communications among members (access control) a very difficult task. In this paper, we present BARTER, a mechanism that automatically creates and updates admission and access control policies for MANETs based on behavior profiles. BARTER is an adaptation for fully distributed environments of our previously introduced BB-NAC mechanism for NAC technologies. Rather than relying on a centralized NAC enforcer, MANET members initially exchange their behavior profiles and compute individual local definitions of normal network behavior. During admission or access control, each member issues an individual decision based on its definition of normalcy. Individual decisions are then aggregated via a threshold cryptographic infrastructure that requires an agreement among a fixed amount of MANET members to change the status of the network. We present experimental results using content and volumetric behavior profiles computed from the ENRON dataset. In particular, we show that the mechanism achieves true rejection rates of 95% with false rejection rates of 9%.

  16. New degradation call admission control for increasing WCDMA system capacity

    Institute of Scientific and Technical Information of China (English)

    Liu Ningqing; Lu Zhi; Gu Xuemai

    2006-01-01

    Propose a new degradation call admission control(DCAC)scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic of variable bit rate, so decreasing its bit rate can reduce the load of the system, consequently the system can admit new call which should be blocked when the system is close to full load, therefore new call's access probability increases. This paper brings forward design project and does system simulation, simulation proves that DCAC can effectively decrease calls' blocking probability and increase the total number of the on-line users.

  17. TCP-Call Admission Control Interaction in Multiplatform Space Architectures

    Directory of Open Access Journals (Sweden)

    Georgios Theodoridis

    2007-06-01

    Full Text Available The implementation of efficient call admission control (CAC algorithms is useful to prevent congestion and guarantee target quality of service (QoS. When TCP protocol is adopted, some inefficiencies can arise due to the peculiar evolution of the congestion window. The development of cross-layer techniques can greatly help to improve efficiency and flexibility for wireless networks. In this frame, the present paper addresses the introduction of TCP feedback into the CAC procedures in different nonterrestrial wireless architectures. CAC performance improvement is shown for different space-based architectures, including both satellites and high altitude platform (HAP systems.

  18. TCP-Call Admission Control Interaction in Multiplatform Space Architectures

    Directory of Open Access Journals (Sweden)

    Roseti Cesare

    2007-01-01

    Full Text Available The implementation of efficient call admission control (CAC algorithms is useful to prevent congestion and guarantee target quality of service (QoS. When TCP protocol is adopted, some inefficiencies can arise due to the peculiar evolution of the congestion window. The development of cross-layer techniques can greatly help to improve efficiency and flexibility for wireless networks. In this frame, the present paper addresses the introduction of TCP feedback into the CAC procedures in different nonterrestrial wireless architectures. CAC performance improvement is shown for different space-based architectures, including both satellites and high altitude platform (HAP systems.

  19. Cross-Layer Admission Control Policy for CDMA Beamforming Systems

    Directory of Open Access Journals (Sweden)

    Sheng Wei

    2007-01-01

    Full Text Available A novel admission control (AC policy is proposed for the uplink of a cellular CDMA beamforming system. An approximated power control feasibility condition (PCFC, required by a cross-layer AC policy, is derived. This approximation, however, increases outage probability in the physical layer. A truncated automatic retransmission request (ARQ scheme is then employed to mitigate the outage problem. In this paper, we investigate the joint design of an AC policy and an ARQ-based outage mitigation algorithm in a cross-layer context. This paper provides a framework for joint AC design among physical, data-link, and network layers. This enables multiple quality-of-service (QoS requirements to be more flexibly used to optimize system performance. Numerical examples show that by appropriately choosing ARQ parameters, the proposed AC policy can achieve a significant performance gain in terms of reduced outage probability and increased system throughput, while simultaneously guaranteeing all the QoS requirements.

  20. Medication reconciliation at patient admission: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mendes AE

    2016-03-01

    Full Text Available Objective: To measure length of hospital stay (LHS in patients receiving medication reconciliation. Secondary characteristics included analysis of number of preadmission medications, medications prescribed at admission, number of discrepancies, and pharmacists interventions done and accepted by the attending physician. Methods: A 6 month, randomized, controlled trial conducted at a public teaching hospital in southern Brazil. Patients admitted to general wards were randomized to receive usual care or medication reconciliation, performed within the first 72 hours of hospital admission. Results: The randomization process assigned 68 patients to UC and 65 to MR. LHS was 10±15 days in usual care and 9±16 days in medication reconciliation (p=0.620. The total number of discrepancies was 327 in the medication reconciliation group, comprising 52.6% of unintentional discrepancies. Physicians accepted approximately 75.0% of the interventions. Conclusion: These results highlight weakness at patient transition care levels in a public teaching hospital. LHS, the primary outcome, should be further investigated in larger studies. Medication reconciliation was well accepted by physicians and it is a useful tool to find and correct discrepancies, minimizing the risk of adverse drug events and improving patient safety.

  1. Admission Control and Interference Management in Dynamic Spectrum Access Networks

    Directory of Open Access Journals (Sweden)

    Jorge Martinez-Bauset

    2010-01-01

    Full Text Available We study two important aspects to make dynamic spectrum access work in practice: the admission policy of secondary users (SUs to achieve a certain degree of quality of service and the management of the interference caused by SUs to primary users (PUs. In order to limit the forced termination probability of SUs, we evaluate the Fractional Guard Channel reservation scheme to give priority to spectrum handovers over new arrivals. We show that, contrary to what has been proposed, the throughput of SUs cannot be maximized by configuring the reservation parameter. We also study the interference caused by SUs to PUs. We propose and evaluate different mechanisms to reduce the interference, which are based on simple spectrum access algorithms for both PUs and SUs and channel repacking algorithms for SUs. Numerical results show that the reduction can be of one order of magnitude or more with respect to the random access case. Finally, we propose an adaptive admission control scheme that is able to limit simultaneously the forced termination probability of SUs and what we define as the probability of interference. Our scheme does not require any configuration parameters beyond the probability objectives. Besides, it is simple to implement and it can operate with any arrival process and distribution of the session duration.

  2. 'Heads you win, tails I lose': a critical incident study of GPs' decisions about emergency admission referrals.

    Science.gov (United States)

    Dempsey, Owen P; Bekker, Hilary L

    2002-12-01

    Acute hospital Trusts' inability to cope with the numbers of emergency admissions has led to the production of guidelines by the Department of Health aimed at reducing inappropriate admissions by GPs. There is a paucity of research describing GPs' decisions to (not) admit patients and it is unclear how effective these guidelines are in changing these practices. To describe GPs' decision-making about referrals for emergency hospital admissions. Observational design using the critical incident technique to elicit data. Eight GPs in West Yorkshire recorded details of memorable emergency admission decisions, both prospective and retrospective consultations. The transcript data were classified by theme using NUD*IST. Forty prospective and 8 retrospective consultations were analysed. Factors affecting GPs' decisions were:Identification of all consequences for all stakeholders in the decision. Emotional impact on the GP of managing these conflicting needs. 'Peer review' of the GP's professionalism about the decision. Contextual pressures limiting effectiveness of GPs' decision-making. Referral decisions require the evaluation of several conflicting consequences for many stakeholders in time-pressured and peer-reviewed situations. These factors encourage the use of heuristics, i.e. GPs' judgements will be influenced more by the social context of the choice than information about the patient's condition. Emergency referral guidelines provide more information to evaluate from another stakeholder; introducing guidelines is likely to increase GPs' use of heuristics and the making of less optimal decisions.

  3. Impact of Admission Control Methods to the Traffic Management

    Directory of Open Access Journals (Sweden)

    Filip Chamraz

    2015-01-01

    Full Text Available The paper deals with Admission control methods (AC in IMS networks (IP multimedia subsystem as one of the elements that help ensure QoS (Quality of service. In the paper we are trying to choose the best AC method for selected IMS network node to allow access to the greatest number of users. Of the large number of methods that were tested and considered good we chose two. The paper compares Gaussian approximation method and one of the measurement based method, specifically „Measured Sum“. Both methods estimate effective bandwidth to allow access for the greatest number of users/devices and allow them access to prepaid services or multimedia content.

  4. Patient-related factors and circumstances surrounding decisions to forego life-sustaining treatment, including intensive care unit admission refusal.

    Science.gov (United States)

    Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic

    2008-07-01

    To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.

  5. Strategic level proton therapy patient admission planning: a Markov decision process modeling approach.

    Science.gov (United States)

    Gedik, Ridvan; Zhang, Shengfan; Rainwater, Chase

    2017-06-01

    A relatively new consideration in proton therapy planning is the requirement that the mix of patients treated from different categories satisfy desired mix percentages. Deviations from these percentages and their impacts on operational capabilities are of particular interest to healthcare planners. In this study, we investigate intelligent ways of admitting patients to a proton therapy facility that maximize the total expected number of treatment sessions (fractions) delivered to patients in a planning period with stochastic patient arrivals and penalize the deviation from the patient mix restrictions. We propose a Markov Decision Process (MDP) model that provides very useful insights in determining the best patient admission policies in the case of an unexpected opening in the facility (i.e., no-shows, appointment cancellations, etc.). In order to overcome the curse of dimensionality for larger and more realistic instances, we propose an aggregate MDP model that is able to approximate optimal patient admission policies using the worded weight aggregation technique. Our models are applicable to healthcare treatment facilities throughout the United States, but are motivated by collaboration with the University of Florida Proton Therapy Institute (UFPTI).

  6. Burden's on U! the Impact of the "Fisher v. University of Texas at Austin" Decision on K-16 Admissions Policies

    Science.gov (United States)

    Nguyen, David H. K.

    2014-01-01

    Using race as a factor in admissions policies was contested in "Fisher v. University of Texas at Austin." Although the U.S. Supreme Court firmly held in "Grutter v. Bollinger" that race can be considered among many factors in admitting students, the recent decision in "Fisher" has posed many questions and challenges…

  7. Family control and financing decisions

    NARCIS (Netherlands)

    Croci, Ettore; Doukas, John A.; Gonenc, Halit

    2011-01-01

    This study uses a comprehensive European dataset to investigate the role of family control in corporate financing decisions during the period 1998-2008. We find that family firms have a preference for debt financing, a non-control-diluting security, and are more reluctant than non-family firms to

  8. Potential Impact of the Addition of a Writing Assessment on Admissions Decisions.

    Science.gov (United States)

    Bridgeman, Brent; McHale, Frederick

    1998-01-01

    A study investigated the effect of adding a writing measure to the Graduate Management Admission Test on the gender/ethnic composition of an admissions pool. Standardized differences from the white male reference group were computed for men and women in four ethnic/minority groups: Whites, Asian-Americans, African-Americans, and…

  9. Location-based admission control for differentiated services in 3G cellular networks

    NARCIS (Netherlands)

    Núñez-Queija, R.; Tan, H.-P.

    2006-01-01

    Third generation wireless systems can simultaneously accommodate flow transmissions of users with widely heterogeneous applications. As resources are limited (particularly in the air interface), admission control is necessary to ensure that all active users are accommodated with sufficient capacity

  10. Patient-controlled hospital admission for patients with severe mental disorders

    DEFF Research Database (Denmark)

    Thomsen, Christoffer Torgaard; Benros, Michael Eriksen; Hastrup, Lene Halling

    2016-01-01

    INTRODUCTION: Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous...... studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled...... hospital admission on the use of coercion and of healthcare services. DESIGN AND METHODS: We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare...

  11. Distributed Decision Making and Control

    CERN Document Server

    Rantzer, Anders

    2012-01-01

    Distributed Decision Making and Control is a mathematical treatment of relevant problems in distributed control, decision and multiagent systems, The research reported was prompted by the recent rapid development in large-scale networked and embedded systems and communications. One of the main reasons for the growing complexity in such systems is the dynamics introduced by computation and communication delays. Reliability, predictability, and efficient utilization of processing power and network resources are central issues and the new theory and design methods presented here are needed to analyze and optimize the complex interactions that arise between controllers, plants and networks. The text also helps to meet requirements arising from industrial practice for a more systematic approach to the design of distributed control structures and corresponding information interfaces Theory for coordination of many different control units is closely related to economics and game theory network uses being dictated by...

  12. Admission Control Threshold in Cellular Relay Networks with Power Adjustment

    Directory of Open Access Journals (Sweden)

    Lee Ki-Dong

    2009-01-01

    Full Text Available Abstract In the cellular network with relays, the mobile station can benefit from both coverage extension and capacity enhancement. However, the operation complexity increases as the number of relays grows up. Furthermore, in the cellular network with cooperative relays, it is even more complex because of an increased dimension of signal-to-noise ratios (SNRs formed in the cooperative wireless transmission links. In this paper, we propose a new method for admission capacity planning in a cellular network using a cooperative relaying mechanism called decode-and-forward. We mathematically formulate the dropping ratio using the randomness of "channel gain." With this, we formulate an admission threshold planning problem as a simple optimization problem, where we maximize the accommodation capacity (in number of connections subject to two types of constraints. (1 A constraint that the sum of the transmit powers of the source node and relay node is upper-bounded where both nodes can jointly adjust the transmit power. (2 A constraint that the dropping ratio is upper-bounded by a certain threshold value. The simplicity of the problem formulation facilitates its solution in real-time. We believe that the proposed planning method can provide an attractive guideline for dimensioning a cellular relay network with cooperative relays.

  13. Exploring social media and admissions decision-making - friends or foes?

    Science.gov (United States)

    Law, Marcus; Mylopoulos, Maria; Veinot, Paula; Miller, Daniel; Hanson, Mark D

    2016-10-01

    Despite the ever-increasing use of social media (e.g., Facebook, Twitter) little is known about its use in medical school admissions. This qualitative study explores whether and how social media (SM) is used in undergraduate admissions in Canada, and the attitudes of admissions personnel towards such use. Phone interviews were conducted with admissions deans and nominated admissions personnel. A qualitative descriptive analysis was performed using iterative coding and comparing, and grouping data into themes. Personnel from 15 of 17 Canadian medical schools participated. A sizeable proportion had, at some point, examined social media (SM) profiles to acquire information on applicants. Participants did not report using it explicitly to screen all applicants (primary use); however, several did admit to looking at SM to follow up on preliminary indications of misbehaviour (secondary use). Participants articulated concerns, such as validity and equity, about using SM in admissions. Despite no schools having existing policy, participants expressed openness to future use. While some of the 15 schools had used SM to acquire information on applicants, criteria for formulating judgments were obscure, and participants expressed significant apprehension, based on concerns for fairness and validity. Findings suggest participant ambivalence and ongoing risks associated with "hidden" selection practices.

  14. Command and Control : faster decisions

    CSIR Research Space (South Africa)

    Venter, C

    2012-10-01

    Full Text Available Decisions 4th Biennial Conference Presented by Cobus Venter 10 October 2012 ? CSIR 2012 Slide 2 Command and Control Planning TaskingControl Assessment Si tu at io n DPSS Objective Ends Increase the Defence Capability of South Africa Ways... Supported by SAAB THALES Global CommsDPSS DDSI ERGOTECH Cooperation to make it work Example 1: Future SA Army Strategy and Joint Operations Support Campus Experiment Example 1: Future SA Army Strategy and Joint Operations Support Campus Experiment...

  15. Decision support in supervisory control

    International Nuclear Information System (INIS)

    Rasmussen, J.; Goodstein, L.P.

    1985-08-01

    It is argued that the supervisory control of complex industrial processes having a potential for serious consequences in case of accidents requires careful consideration of the allocation of decision making between the three main agents of control; namely the designer, the operator and the automatic control system. In particular, it is advocated that instead of continuing their efforts to make their preplanning of responses and countermeasures more and more complete and restricting the operator's initiative, designers should take advantage of modern information technology to make available to the operators their conceptual models and their processing resources so as to allow the operators to function as their extended arm in coping with the plant. Such an interactive decision making activity would thus benefit from this simultaneous availability of the design basis, up-to-date knowledge of plant status and accumualted operational experience. (author)

  16. Designing Effective Interactions for Concordance around End-of-Life Care Decisions: Lessons from Hospice Admission Nurses

    Directory of Open Access Journals (Sweden)

    Carey Candrian

    2017-04-01

    Full Text Available Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual’s acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable. One goal of these interactions is ensuring patients and families have accurate and clear information about hospice care to facilitate informed decisions. So inconsistent are practices across hospices in consenting patients that a 2016 report from the Office of Inspector General (OIG entitled “Hospices should improve their election statements and certifications of terminal illness” called for complete and accurate election statements to ensure that hospice patients and their caregivers can make informed decisions and understand the costs and benefits of choosing hospice care. Whether complete and accurate information at initial admission visits improves interactions and outcomes is unknown. Our recent qualitative work investigating interactions between patients, caregivers, and hospice nurses has uncovered diverse and often diverging stakeholder-specific expectations and perceptions which if not addressed can create discordance and inhibit decision-making. This paper focuses on better understanding the communication dynamics and practices involved in hospice admission interactions in order to design more effective interactions and support the mandate from the OIG to provide hospice patients and their caregivers with accurate and complete information. This clarity is particularly important when discussing the non-curative nature of hospice care, and the

  17. Cognitive interference modeling with applications in power and admission control

    KAUST Repository

    Mahmood, Nurul Huda; Yilmaz, Ferkan; Alouini, Mohamed-Slim; Ø ien, Geir Egil

    2012-01-01

    One of the key design challenges in a cognitive radio network is controlling the interference generated at coexisting primary receivers. In order to design efficient cognitive radio systems and to minimize their unwanted consequences

  18. Cognitive interference modeling with applications in power and admission control

    KAUST Repository

    Mahmood, Nurul Huda

    2012-10-01

    One of the key design challenges in a cognitive radio network is controlling the interference generated at coexisting primary receivers. In order to design efficient cognitive radio systems and to minimize their unwanted consequences, it is therefore necessary to effectively control the secondary interference at the primary receivers. In this paper, a generalized framework for the interference analysis of a cognitive radio network where the different secondary transmitters may transmit with different powers and transmission probabilities, is presented and various applications of this interference model are demonstrated. The findings of the analytical performance analyses are confirmed through selected computer-based Monte-Carlo simulations. © 2012 IEEE.

  19. 49 CFR 382.121 - Employee admission of alcohol and controlled substances use.

    Science.gov (United States)

    2010-10-01

    ... and has successfully completed education or treatment requirements in accordance with the self... substances use. 382.121 Section 382.121 Transportation Other Regulations Relating to Transportation... SAFETY REGULATIONS CONTROLLED SUBSTANCES AND ALCOHOL USE AND TESTING General § 382.121 Employee admission...

  20. QoS-Guaranteed Admission Control for OFDMA-based Systems

    DEFF Research Database (Denmark)

    Ramkumar, Venkata; Anggorojati, Bayu; Lucian, Stefan P. Andrei

    2010-01-01

    This paper proposes a novel admission control (AC) algorithm for guaranteed quality of service (QoS) to all users. The proposed solution provides better utilization of system capacity using adaptive modulation (AM). A scheduler based on a per user priority function is also given in this paper. Th...

  1. A new LP formulation of the admission control problem modelled as an MDP under average reward criterion

    Science.gov (United States)

    Pietrabissa, Antonio

    2011-12-01

    The admission control problem can be modelled as a Markov decision process (MDP) under the average cost criterion and formulated as a linear programming (LP) problem. The LP formulation is attractive in the present and future communication networks, which support an increasing number of classes of service, since it can be used to explicitly control class-level requirements, such as class blocking probabilities. On the other hand, the LP formulation suffers from scalability problems as the number C of classes increases. This article proposes a new LP formulation, which, even if it does not introduce any approximation, is much more scalable: the problem size reduction with respect to the standard LP formulation is O((C + 1)2/2 C ). Theoretical and numerical simulation results prove the effectiveness of the proposed approach.

  2. Recent decision of the Constitutional Court concerning the admissibility of the referendum on nuclear power plants

    International Nuclear Information System (INIS)

    Pomodoro, Sergio.

    1981-01-01

    This paper provides a thorough analysis of the decision of the Constitutional Court on 13 February 1981 ruling that a request for a referendum whose purpose was to have adopted a partial annulment of Act no. 393 of 1975 on nuclear power plant siting was inadmissible. The decision is based on the ground that, firstly the Constitution does not allow a referendum for annulment of an Act to be held and secondly, this request ran counter to the objectives fixed by the Euratom Treaty (Community nuclear power development) to which Italy, as a Party, was committed. (NEA) [fr

  3. EUPHIDS, a decision-support system for the admission of pesticides

    NARCIS (Netherlands)

    Beinat E; Berg R van den; Vrije Universiteit van; Fraunhofer Institue for Environmental Chemistry; International Centre of Pesticide Safety, Busto; LBG

    1996-01-01

    EUPHIDS (EUropean Pesticide Hazard Information and Decision-support System) is the result of a research project carried out during 1993-1995 with the support of the Environment Research Programme (1990-1994) of the European Union. The system is meant to become an aid in the process of registering a

  4. Model predictive control using fuzzy decision functions

    NARCIS (Netherlands)

    Kaymak, U.; Costa Sousa, da J.M.

    2001-01-01

    Fuzzy predictive control integrates conventional model predictive control with techniques from fuzzy multicriteria decision making, translating the goals and the constraints to predictive control in a transparent way. The information regarding the (fuzzy) goals and the (fuzzy) constraints of the

  5. Integrating a Patient-Controlled Admission Program Into Mental Health Hospital Service: A Multicenter Grounded Theory Study

    DEFF Research Database (Denmark)

    Ellegaard, Trine; Bliksted, Vibeke Fuglsang; Mehlsen, Mimi Yung

    2018-01-01

    Patient-controlled admissions (PCAs) enable mental health patients by means of a contract to initiate an admission at a mental health hospital unit without using traditional admission procedures. This study was part of a 3-year Danish multicenter project, and we explored how mental health...... the mental health professionals strived to integrate PCA into clinical practice. The process was motivated by the idea of establishing a partnership with patients and involved two interrelated strategies to manage (a) the patient-related duties and (b) the admission contracts. The professionals moved from...

  6. A Reinforcement Learning Approach to Call Admission Control in HAPS Communication System

    Directory of Open Access Journals (Sweden)

    Ni Shu Yan

    2017-01-01

    Full Text Available The large changing of link capacity and number of users caused by the movement of both platform and users in communication system based on high altitude platform station (HAPS will resulting in high dropping rate of handover and reduce resource utilization. In order to solve these problems, this paper proposes an adaptive call admission control strategy based on reinforcement learning approach. The goal of this strategy is to maximize long-term gains of system, with the introduction of cross-layer interaction and the service downgraded. In order to access different traffics adaptively, the access utility of handover traffics and new call traffics is designed in different state of communication system. Numerical simulation result shows that the proposed call admission control strategy can enhance bandwidth resource utilization and the performances of handover traffics.

  7. Admission and Preventive Load Control for Delivery of Multicast and Broadcast Services via S-UMTS

    Science.gov (United States)

    Angelou, E.; Koutsokeras, N.; Andrikopoulos, I.; Mertzanis, I.; Karaliopoulos, M.; Henrio, P.

    2003-07-01

    An Admission Control strategy is proposed for unidirectional satellite systems delivering multicast and broadcast services to mobile users. In such systems, both the radio interface and the targeted services impose particular requirements on the RRM task. We briefly discuss the RRM requirements that stem from the services point of view and from the features of the SATIN access scheme that differentiate it from the conventional T-UMTS radio interface. The main functional entities of RRM and the alternative modes of operation are outlined and the proposed Admission Control algorithm is described in detail. The results from the simulation study that demonstrate its performance for a number of different scenarios are finally presented and conclusions derived.

  8. Effect of air pollution control on mortality and hospital admissions in Ireland.

    Science.gov (United States)

    Dockery, Douglas W; Rich, David Q; Goodman, Patrick G; Clancy, Luke; Ohman-Strickland, Pamela; George, Prethibha; Kotlov, Tania

    2013-07-01

    and 1998 bans, adjusting for influenza epidemics, weekly mean temperature, and local admissions for digestive diagnoses. Mean BS concentrations fell in all affected population centers post-ban compared with the pre-ban period, with decreases ranging from 4 to 35 microg/m3 (corresponding to reductions of 45% to 70%, respectively), but we observed no clear pattern in SO2 measured as total gaseous acidity associated with the bans. In comparisons with the pre-ban periods, no significant reduction was found in total death rates associated with the 1990 (1% reduction), 1995 (4% reduction), or 1998 (0% reduction) bans, nor for cardiovascular mortality (0%, 4%, and 1% reductions for the 1990, 1995, and 1998 bans, respectively). Respiratory mortality was reduced in association with the bans (17%, 9%, and 3%, respectively). We found a 4% decrease in hospital admissions for cardiovascular disease associated with the 1995 ban and a 3% decrease with the 1998 ban. Admissions for respiratory disease were not consistently lower after the bans; admissions for pneumonia, chronic obstructive pulmonary disease (COPD), and asthma were reduced. However, underreporting of hospital admissions data and lack of control and comparison series tempered our confidence in these results. The successive coal bans resulted in immediate and sustained decreases in particulate concentrations in each city or town; with the largest decreases in winter and during the heating season. The bans were associated with reductions in respiratory mortality but no detectable improvement in cardiovascular mortality. The changes in hospital admissions for respiratory and cardiovascular disease were supportive of these findings but cannot be considered confirming. Detecting changes in public health indicators associated even with clear improvements in air quality, as in this case, remains difficult when there are simultaneous secular improvements in the same health indicators.

  9. A time-based admission control mechanism for IEEE 802.11 ad Hoc networks

    OpenAIRE

    Costa, Luís Henrique M. K.; Cerveira, Carlos Rodrigo

    2006-01-01

    This paper presents a time-based admission control mechanism (TAC) for IEEE 802.11 ad hoc networks. The proposed mechanism was adapted to the QoS AODV routing protocol, which takes the quality of service requirements of the data flow into account in the route discovery process. TAC-AODV estimates the idle time of the physical medium based on the frames listened. The incoming traffic is admitted according to the offered load as well as the intra-flow interference, calculated based on the numbe...

  10. Traffic Management by Using Admission Control Methods in Multiple Node IMS Network

    Directory of Open Access Journals (Sweden)

    Filip Chamraz

    2016-01-01

    Full Text Available The paper deals with Admission Control methods (AC as a possible solution for traffic management in IMS networks (IP Multimedia Subsystem - from the point of view of an efficient redistribution of the available network resources and keeping the parameters of Quality of Service (QoS. The paper specifically aims at the selection of the most appropriate method for the specific type of traffic and traffic management concept using AC methods on multiple nodes. The potential benefit and disadvantage of the used solution is evaluated.

  11. SaaS enabled admission control for MCMC simulation in cloud computing infrastructures

    Science.gov (United States)

    Vázquez-Poletti, J. L.; Moreno-Vozmediano, R.; Han, R.; Wang, W.; Llorente, I. M.

    2017-02-01

    Markov Chain Monte Carlo (MCMC) methods are widely used in the field of simulation and modelling of materials, producing applications that require a great amount of computational resources. Cloud computing represents a seamless source for these resources in the form of HPC. However, resource over-consumption can be an important drawback, specially if the cloud provision process is not appropriately optimized. In the present contribution we propose a two-level solution that, on one hand, takes advantage of approximate computing for reducing the resource demand and on the other, uses admission control policies for guaranteeing an optimal provision to running applications.

  12. Strategic Control in Decision Making under Uncertainty

    Science.gov (United States)

    Venkatraman, Vinod; Huettel, Scott

    2012-01-01

    Complex economic decisions – whether investing money for retirement or purchasing some new electronic gadget – often involve uncertainty about the likely consequences of our choices. Critical for resolving that uncertainty are strategic meta-decision processes, which allow people to simplify complex decision problems, to evaluate outcomes against a variety of contexts, and to flexibly match behavior to changes in the environment. In recent years, substantial research implicates the dorsomedial prefrontal cortex (dmPFC) in the flexible control of behavior. However, nearly all such evidence comes from paradigms involving executive function or response selection, not complex decision making. Here, we review evidence that demonstrates that the dmPFC contributes to strategic control in complex decision making. This region contains a functional topography such that the posterior dmPFC supports response-related control while the anterior dmPFC supports strategic control. Activation in the anterior dmPFC signals changes in how a decision problem is represented, which in turn can shape computational processes elsewhere in the brain. Based on these findings, we argue both for generalized contributions of the dmPFC to cognitive control, and for specific computational roles for its subregions depending upon the task demands and context. We also contend that these strategic considerations are also likely to be critical for decision making in other domains, including interpersonal interactions in social settings. PMID:22487037

  13. Singular formalism and admissible control of spacecraft with rotating flexible solar array

    Directory of Open Access Journals (Sweden)

    Lu Dongning

    2014-02-01

    Full Text Available This paper is concerned with the attitude control of a three-axis-stabilized spacecraft which consists of a central rigid body and a flexible sun-tracking solar array driven by a solar array drive assembly. Based on the linearization of the dynamics of the spacecraft and the modal identities about the flexible and rigid coupling matrices, the spacecraft attitude dynamics is reduced to a formally singular system with periodically varying parameters, which is quite different from a spacecraft with fixed appendages. In the framework of the singular control theory, the regularity and impulse-freeness of the singular system is analyzed and then admissible attitude controllers are designed by Lyapunov’s method. To improve the robustness against system uncertainties, an H∞ optimal control is designed by optimizing the H∞ norm of the system transfer function matrix. Comparative numerical experiments are performed to verify the theoretical results.

  14. Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Costa, D.W. da; Bouwense, S.A.; Schepers, N.J.; Besselink, M.G.; Santvoort, H.C. van; Brunschot, S. van; Bakker, O.J.; Bollen, T.L.; Dejong, C.H.; Goor, H. van; Boermeester, M.A.; Bruno, M.J.; Eijck, C.H. van; Timmer, R.; Weusten, B.L.; Consten, E.C.; Brink, M.A.; Spanier, B.W.; Bilgen, E.J.; Nieuwenhuijs, V.B.; Hofker, H.S.; Rosman, C.; Voorburg, A.M.; Bosscha, K.; Duijvendijk, P. van; Gerritsen, J.J.; Heisterkamp, J.; Hingh, I.H. de; Witteman, B.J.; Kruyt, P.M.; Scheepers, J.J.; Molenaar, I.Q.; Schaapherder, A.F.; Manusama, E.R.; Waaij, L.A. van der; Unen, J. van; Dijkgraaf, M.G.; Ramshorst, B. van; Gooszen, H.G.; Boerma, D.

    2015-01-01

    BACKGROUND: In patients with mild gallstone pancreatitis, cholecystectomy during the same hospital admission might reduce the risk of recurrent gallstone-related complications, compared with the more commonly used strategy of interval cholecystectomy. However, evidence to support same-admission

  15. Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): a multicentre randomised controlled trial

    NARCIS (Netherlands)

    da Costa, David W.; Bouwense, Stefan A.; Schepers, Nicolien J.; Besselink, Marc G.; van Santvoort, Hjalmar C.; van Brunschot, Sandra; Bakker, Olaf J.; Bollen, Thomas L.; Dejong, Cornelis H.; van Goor, Harry; Boermeester, Marja A.; Bruno, Marco J.; van Eijck, Casper H.; Timmer, Robin; Weusten, Bas L.; Consten, Esther C.; Brink, Menno A.; Spanier, B. W. Marcel; Bilgen, Ernst Jan Spillenaar; Nieuwenhuijs, Vincent B.; Hofker, H. Sijbrand; Rosman, Camiel; Voorburg, Annet M.; Bosscha, Koop; van Duijvendijk, Peter; Gerritsen, Jos J.; Heisterkamp, Joos; de Hingh, Ignace H.; Witteman, Ben J.; Kruyt, Philip M.; Scheepers, Joris J.; Molenaar, I. Quintus; Schaapherder, Alexander F.; Manusama, Eric R.; van der Waaij, Laurens A.; van Unen, Jacco; Dijkgraaf, Marcel G.; van Ramshorst, Bert; Gooszen, Hein G.; Boerma, Djamila

    2015-01-01

    Background In patients with mild gallstone pancreatitis, cholecystectomy during the same hospital admission might reduce the risk of recurrent gallstone-related complications, compared with the more commonly used strategy of interval cholecystectomy. However, evidence to support same-admission

  16. Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO) : A multicentre randomised controlled trial

    NARCIS (Netherlands)

    Da Costa, David W.; Bouwense, Stefan A.; Schepers, Nicolien J.; Besselink, Marc G.; van Santvoort, Hjalmar C.; Van Brunschot, Sandra; Bakker, Olaf J.; Bollen, Thomas L.; Dejong, Cornelis H.; Van Goor, Harry; Boermeester, Marja A.; Bruno, Marco J.; Van Eijck, Casper H.; Timmer, Robin; Weusten, Bas L.; Consten, Esther C.; Brink, Menno A.; Spanier, B. W Marcel; Bilgen, Ernst Jan Spillenaar; Nieuwenhuijs, Vincent B.; Hofker, H. Sijbrand; Rosman, Camiel; Voorburg, Annet M.; Bosscha, Koop; Van Duijvendijk, Peter; Gerritsen, Jos J.; Heisterkamp, Joos; De Hingh, Ignace H.; Witteman, Ben J.; Kruyt, Philip M.; Scheepers, Joris J.; Molenaar, I. Quintus; Schaapherder, Alexander F.; Manusama, Eric R.; Van Der Waaij, Laurens A.; Van Unen, Jacco; Dijkgraaf, Marcel G.; Van Ramshorst, Bert; Gooszen, Hein G.; Boerma, Djamila

    2015-01-01

    Background In patients with mild gallstone pancreatitis, cholecystectomy during the same hospital admission might reduce the risk of recurrent gallstone-related complications, compared with the more commonly used strategy of interval cholecystectomy. However, evidence to support same-admission

  17. Waste Transfer Leaks Control Decision Record

    International Nuclear Information System (INIS)

    RYAN, G.W.

    2000-01-01

    Control decision meetings for Waste Transfer Leaks were held on April 24,25,26, and 27, 2000. The agenda for the control decision meetings is included in Appendix A, and attendee lists are included in Appendix B. The purpose of the control decision meetings was to review and revise previously selected controls for the prevention or mitigation of waste transfer leak accidents. Re-evaluation of the controls is warranted due to revisions in the hazard and accident analysis for these Tank Farm events. In particular, calculated radiological consequences are significantly reduced from those currently reported in the Final Safety Analysis Report (FSAR). Revised hazard and accident analysis and a revised control recommendation will be reflected in an Authorization Basis Amendment to be submitted at the Department of Energy, Office of River Protection's (ORP's) request by June 30, 2000 to satisfy ORP Performance Incentive (PI) 2.1.1, Revision 1, ''Authorization Basis Management Process Efficiency Improvement''. The scope of the control decision meetings was to address all waste transfer leak-related hazardous conditions identified in the Tank Farm hazard analysis database, excluding those associated with the use of the Replacement Cross-Site Transfer System (RCSTS) slurry line and sluicing of Tank 241-C-106, which is addressed in FSAR Addendum 1. The scope of this control decision process does include future waste feed delivery waste transfer operations

  18. Peadiatric social admission

    OpenAIRE

    Carter Anand, Janet

    2009-01-01

    The phenomenon of paediatric social admission describes the hospitalisation of children for medicallynon- urgent and/or social reasons. Much of the research in this field has been in relation to avoidable admissions which have been identified, studied and condoned based on strict medical criteria. Such research has tended to mask the significance of social factors and the commonplace practice of Paediatric Social Admission. This paper examines decision making from the perspective of the healt...

  19. Performance of a Two-Level Call Admission Control Scheme for DS-CDMA Wireless Networks

    Directory of Open Access Journals (Sweden)

    Fapojuwo Abraham O

    2007-01-01

    Full Text Available We propose a two-level call admission control (CAC scheme for direct sequence code division multiple access (DS-CDMA wireless networks supporting multimedia traffic and evaluate its performance. The first-level admission control assigns higher priority to real-time calls (also referred to as class 0 calls in gaining access to the system resources. The second level admits nonreal-time calls (or class 1 calls based on the resources remaining after meeting the resource needs for real-time calls. However, to ensure some minimum level of performance for nonreal-time calls, the scheme reserves some resources for such calls. The proposed two-level CAC scheme utilizes the delay-tolerant characteristic of non-real-time calls by incorporating a queue to temporarily store those that cannot be assigned resources at the time of initial access. We analyze and evaluate the call blocking, outage probability, throughput, and average queuing delay performance of the proposed two-level CAC scheme using Markov chain theory. The analytic results are validated by simulation results. The numerical results show that the proposed two-level CAC scheme provides better performance than the single-level CAC scheme. Based on these results, it is concluded that the proposed two-level CAC scheme serves as a good solution for supporting multimedia applications in DS-CDMA wireless communication systems.

  20. Performance of a Two-Level Call Admission Control Scheme for DS-CDMA Wireless Networks

    Directory of Open Access Journals (Sweden)

    Abraham O. Fapojuwo

    2007-11-01

    Full Text Available We propose a two-level call admission control (CAC scheme for direct sequence code division multiple access (DS-CDMA wireless networks supporting multimedia traffic and evaluate its performance. The first-level admission control assigns higher priority to real-time calls (also referred to as class 0 calls in gaining access to the system resources. The second level admits nonreal-time calls (or class 1 calls based on the resources remaining after meeting the resource needs for real-time calls. However, to ensure some minimum level of performance for nonreal-time calls, the scheme reserves some resources for such calls. The proposed two-level CAC scheme utilizes the delay-tolerant characteristic of non-real-time calls by incorporating a queue to temporarily store those that cannot be assigned resources at the time of initial access. We analyze and evaluate the call blocking, outage probability, throughput, and average queuing delay performance of the proposed two-level CAC scheme using Markov chain theory. The analytic results are validated by simulation results. The numerical results show that the proposed two-level CAC scheme provides better performance than the single-level CAC scheme. Based on these results, it is concluded that the proposed two-level CAC scheme serves as a good solution for supporting multimedia applications in DS-CDMA wireless communication systems.

  1. Admission Control for Multiservices Traffic in Hierarchical Mobile IPv6 Networks by Using Fuzzy Inference System

    Directory of Open Access Journals (Sweden)

    Jung-Shyr Wu

    2012-01-01

    Full Text Available CAC (Call Admission Control plays a significant role in providing QoS (Quality of Service in mobile wireless networks. In addition to much research that focuses on modified Mobile IP to get better efficient handover performance, CAC should be introduced to Mobile IP-based network to guarantee the QoS for users. In this paper, we propose a CAC scheme which incorporates multiple traffic types and adjusts the admission threshold dynamically using fuzzy control logic to achieve better usage of resources. The method can provide QoS in Mobile IPv6 networks with few modifications on MAP (Mobility Anchor Point functionality and slight change in BU (Binding Update message formats. According to the simulation results, the proposed scheme presents good performance of voice and video traffic at the expenses of poor performance on data traffic. It is evident that these CAC schemes can reduce the probability of the handoff dropping and the cell overload and limit the probability of the new call blocking.

  2. Optimising decision making in mastitis control

    OpenAIRE

    Down, P.M.

    2016-01-01

    Mastitis remains one of the most common diseases of dairy cows and represents a large economic loss to the industry as well as a considerable welfare issue to the cows affected. Decisions are routinely made about the treatment and control of mastitis despite evidence being sparse regarding the likely consequences in terms of clinical efficacy and return on investment. The aim of this thesis was to enhance decision making around the treatment and prevention of mastitis using probabilistic meth...

  3. Deciding as Intentional Action: Control over Decisions

    Science.gov (United States)

    Shepherd, Joshua

    2015-01-01

    Common-sense folk psychology and mainstream philosophy of action agree about decisions: these are under an agent's direct control, and are thus intentional actions for which agents can be held responsible. I begin this paper by presenting a problem for this view. In short, since the content of the motivational attitudes that drive deliberation and decision remains open-ended until the moment of decision, it is unclear how agents can be thought to exercise control over what they decide at the moment of deciding. I note that this problem might motivate a non-actional view of deciding—a view that decisions are not actions, but are instead passive events of intention acquisition. For without an understanding of how an agent might exercise control over what is decided at the moment of deciding, we lack a good reason for maintaining commitment to an actional view of deciding. However, I then offer the required account of how agents exercise control over decisions at the moment of deciding. Crucial to this account is an understanding of the relation of practical deliberation to deciding, an understanding of skilled deliberative activity, and the role of attention in the mental action of deciding. PMID:26321765

  4. An Interference-Aware Admission Control Design for Wireless Mesh Networks

    Directory of Open Access Journals (Sweden)

    Manikantan Shila Devu

    2010-01-01

    Full Text Available In this paper, we present IAC, an interference aware admission control algorithm for use in wireless mesh networks. The core concept of IAC is to use a low overhead dual threshold based approach to share the bandwidth information with its neighbors in the interfering range. As a result, IAC guarantees that the shared wireless bandwidth is not overutilized and the quality of all existing flows are preserved. Moreover, IAC takes into account the intraflow interference effect to estimate the bandwidth consumption of the flow in a multihop path. We have further proposed two approaches of bandwidth allocation, FCFS and MCU, and demonstrated that proper tuning of thresholds can lead to high performance of both schemes. Simulation results illustrate that IAC effectively limits the overutilization of channel resources which in turn results in high throughput, low delay and low packet loss rate for all admitted flows.

  5. Voice Communications over 802.11 Ad Hoc Networks: Modeling, Optimization and Call Admission Control

    Science.gov (United States)

    Xu, Changchun; Xu, Yanyi; Liu, Gan; Liu, Kezhong

    Supporting quality-of-service (QoS) of multimedia communications over IEEE 802.11 based ad hoc networks is a challenging task. This paper develops a simple 3-D Markov chain model for queuing analysis of IEEE 802.11 MAC layer. The model is applied for performance analysis of voice communications over IEEE 802.11 single-hop ad hoc networks. By using the model, we finish the performance optimization of IEEE MAC layer and obtain the maximum number of voice calls in IEEE 802.11 ad hoc networks as well as the statistical performance bounds. Furthermore, we design a fully distributed call admission control (CAC) algorithm which can provide strict statistical QoS guarantee for voice communications over IEEE 802.11 ad hoc networks. Extensive simulations indicate the accuracy of the analytical model and the CAC scheme.

  6. Financial Analysis, Budgeting, Decision and Control

    Directory of Open Access Journals (Sweden)

    Mariana Rodica TIRLEA

    2013-12-01

    Full Text Available The economic processes taking place in the economic environment are stochastic processes that involve and imply risks, arising from product diversification, competition, financial derivatives transactions: swaps, futures, options and from the large number of actors involved in the stock market with a higher or a smaller uncertainty degree. Competition and competitiveness, led to major and rapid change in the business environment, they determined actors participating in the economy to find solutions and methods of collecting and processing data, in such a way that, after being transformed into information they quickly help based on their analysis in decision making, planning and financial forecasting, having an effect on increasing their economic efficiency. In these circumstances the financial analysis, decision, forecasting and control, should be based on quality information that should be a value creation source. The active nature of the financial function implies the existence of a substantially large share of financial analysis, financial decision, forecasting and control.

  7. The effect of gun control laws on hospital admissions for children in the United States.

    Science.gov (United States)

    Tashiro, Jun; Lane, Rebecca S; Blass, Lawrence W; Perez, Eduardo A; Sola, Juan E

    2016-10-01

    Gun control laws vary greatly between states within the United States. We hypothesized that states with strict gun laws have lower mortality and resource utilization rates from pediatric firearms-related injury admissions. Kids' Inpatient Database (1997-2012) was searched for accidental (E922), self-inflicted (E955), assault (E965), legal intervention-related (E970), or undetermined circumstance (E985) firearm injuries. Patients were younger than 20 years and admitted for their injuries. Case incidence trends were examined for the study period. Propensity score-matched analyses were performed using 38 covariates to compare outcomes between states with strict or lenient gun control laws. Overall, 38,424 cases were identified, with an overall mortality of 7%. Firearm injuries were most commonly assault (64%), followed by accidental (25%), undetermined circumstance (7%), or self-inflicted (3%). A small minority involved military-grade weapons (0.2%). Most cases occurred in lenient gun control states (48%), followed by strict (47%) and neutral (6%).On 1:1 propensity score-matched analysis, in-hospital mortality by case was higher in lenient (7.5%) versus strict (6.5%) states, p = 0.013. Lenient states had a proportionally higher rate of accidental (31%) and self-inflicted injury (4%) versus strict states (17% and 1.6%, respectively), p gun control contributes not only to worse outcomes per case, but also to a more significant and detrimental impact on public health. Epidemiologic study, level III.

  8. Admission Control of Integrated Voice and Data CDMA/TDD System Considering Asymmetric Traffic and Power Limit

    Institute of Scientific and Technical Information of China (English)

    CAOYanbo; ZHOUBin; LIChengshu

    2004-01-01

    In this paper, we research an admission control scheme of integrated voice and data CDMA/TDD (Code division multiple access/Time division duplex) system considering asymmetric traffic and power limit. A new user can access the system only if the outage probabilities it experiences on the uplink and downlink time slots are below a threshold value. Based on the power limit the results show the voice and data blocking probabilities under different cell coverage~ arrival rates and various uplink/downlink time slot allocation patterns. Furthermore, multicode and multislot schemes are also evaluated under the presented admission control scheme.

  9. Patient-controlled hospital admission for patients with severe mental disorders: a nationwide prospective multicentre study.

    Science.gov (United States)

    Thomsen, C T; Benros, M E; Maltesen, T; Hastrup, L H; Andersen, P K; Giacco, D; Nordentoft, M

    2018-04-01

    To assess whether implementing patient-controlled admission (PCA) can reduce coercion and improve other clinical outcomes for psychiatric in-patients. During 2013-2016, 422 patients in the PCA group were propensity score matched 1:5 with a control group (n = 2110) that received treatment as usual (TAU). Patients were followed up for at least one year using the intention to treat principle utilising nationwide registers. In a paired design, the outcomes of PCA patients during the year after signing a contract were compared with the year before. No reduction in coercion (risk difference = 0.001; 95% CI: -0.038; 0.040) or self-harming behaviour (risk difference = 0.005; 95% CI: -0.008; 0.018) was observed in the PCA group compared with the TAU group. The PCA group had more in-patient bed days (mean difference = 28.4; 95% CI: 21.3; 35.5) and more medication use (P < 0.0001) than the TAU group. Before and after analyses showed reduction in coercion (P = 0.0001) and in-patient bed days (P = 0.0003). Implementing PCA did not reduce coercion, service use or self-harm behaviour when compared with TAU. Beneficial effects of PCA were observed only in the before and after PCA comparisons. Further research should investigate whether PCA affects other outcomes to better establish its clinical value. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Rational decision-making in inhibitory control.

    Science.gov (United States)

    Shenoy, Pradeep; Yu, Angela J

    2011-01-01

    An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability.

  11. Rational Decision-Making in Inhibitory Control

    Science.gov (United States)

    Shenoy, Pradeep; Yu, Angela J.

    2011-01-01

    An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability. PMID:21647306

  12. The effect of completing a surrogacy information and decision-making tool upon admission to an intensive care unit on length of stay and charges.

    Science.gov (United States)

    Hatler, Carol W; Grove, Charlene; Strickland, Stephanie; Barron, Starr; White, Bruce D

    2012-01-01

    Many critically ill patients in intensive care units (ICUs) are unable to communicate their wishes about goals of care, particularly about the use of life-sustaining treatments. Surrogates and clinicians struggle with medical decisions because of a lack of clarity regarding patients' preferences, leading to prolonged hospitalizations and increased costs. This project focused on the development and implementation of a tool to facilitate a better communication process by (1) assuring the early identification of a surrogate if indicated on admission and (2) clarifying the decision-making standards that the surrogate was to use when participating in decision making. Before introducing the tool into the admissions routine, the staff were educated about its use and value to the decision-making process. PROJECT AND METHODS: The study was to determine if early use of a simple method of identifying a patient's surrogate and treatment preferences might impact length of stay (LOS) and total hospital charges. A pre- and post-intervention study design was used. Nurses completed the surrogacy information tool for all patients upon admission to the neuroscience ICU. Subjects (total N = 203) were critically ill patients who had been on a mechanical ventilator for 96 hours or longer, or in the ICU for seven days or longer.The project included staff education on biomedical ethics, critical communication skills, early identification of families and staff in crisis, and use of a simple tool to document patients' surrogates and previously expressed care wishes. Data on hospital LOS and hospital charges were collected through a retrospective review of medical records for similar four-month time frames pre- and post-implementation of the assessment tool. Significant differences were found between pre- and post-groups in terms of hospital LOS (F = 6.39, p = .01) and total hospital charges (F = 7.03, p = .009). Project findings indicate that the use of a simple admission assessment tool

  13. Investment decisions with benefits of control

    DEFF Research Database (Denmark)

    Poulsen, Thomas

    This paper studies how large shareholders with benefits of control affect firms' equity issue behavior and investment decisions. I introduce an explicit agency cost structure based on the large shareholder's benefits of control. In a simple extension of Myers and Majluf [1984], I show that underi......This paper studies how large shareholders with benefits of control affect firms' equity issue behavior and investment decisions. I introduce an explicit agency cost structure based on the large shareholder's benefits of control. In a simple extension of Myers and Majluf [1984], I show...... that underinvestment is aggravated when there are benefits of being in control, and these benefits are diluted if equity is issued to finance the investment project. I assume that large shareholders are constrained from further investments in their firms, and that they maximize their own wealth, which includes...... as a representation of the large shareholders' expected private benefits. Using a large panel of U.S. data, I find that large shareholders' concern with dilution of ownership and control cause firms to issue less equity and to invest less. I also find that it has no significant effect whether new shares are issued...

  14. Performance Analysis and Optimization of an Adaptive Admission Control Scheme in Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Shunfu Jin

    2013-01-01

    Full Text Available In cognitive radio networks, if all the secondary user (SU packets join the system without any restrictions, the average latency of the SU packets will be greater, especially when the traffic load of the system is higher. For this, we propose an adaptive admission control scheme with a system access probability for the SU packets in this paper. We suppose the system access probability is inversely proportional to the total number of packets in the system and introduce an Adaptive Factor to adjust the system access probability. Accordingly, we build a discrete-time preemptive queueing model with adjustable joining rate. In order to obtain the steady-state distribution of the queueing model exactly, we construct a two-dimensional Markov chain. Moreover, we derive the formulas for the blocking rate, the throughput, and the average latency of the SU packets. Afterwards, we provide numerical results to investigate the influence of the Adaptive Factor on different performance measures. We also give the individually optimal strategy and the socially optimal strategy from the standpoints of the SU packets. Finally, we provide a pricing mechanism to coordinate the two optimal strategies.

  15. Admission Control Over Internet of Vehicles Attached With Medical Sensors for Ubiquitous Healthcare Applications.

    Science.gov (United States)

    Lin, Di; Labeau, Fabrice; Yao, Yuanzhe; Vasilakos, Athanasios V; Tang, Yu

    2016-07-01

    Wireless technologies and vehicle-mounted or wearable medical sensors are pervasive to support ubiquitous healthcare applications. However, a critical issue of using wireless communications under a healthcare scenario rests at the electromagnetic interference (EMI) caused by radio frequency transmission. A high level of EMI may lead to a critical malfunction of medical sensors, and in such a scenario, a few users who are not transmitting emergency data could be required to reduce their transmit power or even temporarily disconnect from the network in order to guarantee the normal operation of medical sensors as well as the transmission of emergency data. In this paper, we propose a joint power and admission control algorithm to schedule the users' transmission of medical data. The objective of this algorithm is to minimize the number of users who are forced to disconnect from the network while keeping the EMI on medical sensors at an acceptable level. We show that a fixed point of proposed algorithm always exists, and at the fixed point, our proposed algorithm can minimize the number of low-priority users who are required to disconnect from the network. Numerical results illustrate that the proposed algorithm can achieve robust performance against the variations of mobile hospital environments.

  16. Metacognitive control of categorial neurobehavioral decision systems

    Directory of Open Access Journals (Sweden)

    Gordon Robert Foxall

    2016-02-01

    Full Text Available The competing neuro-behavioral decision systems (CNDS model proposes that the degree to which an individual discounts the future is a function of the relative hyperactivity of an impulsive system based on the limbic and paralimbic brain regions and the relative hypoactivity of an executive system based in prefrontal cortex (PFC. The model depicts the relationship between these categorial systems in terms of the antipodal neurophysiological, behavioral, and decision (cognitive functions that engender classes normal and addictive responding. However, a case may be made for construing several components of the impulsive and executive systems depicted in the model as categories (elements of additional systems that are concerned with the metacognitive control of behavior. Hence, this paper proposes a category-based structure for understanding the effects on behavior of CNDS, which includes not only the impulsive and executive systems of the basic model but, a superordinate level of reflective or rational decision-making. Following recent developments in the modeling of cognitive control which contrasts Type 1 (rapid, autonomous, parallel processing with Type 2 (slower, computationally-demanding, sequential processing, the proposed model incorporates an arena in which the potentially conflicting imperatives of impulsive and executive systems are examined and from which a more appropriate behavioral response than impulsive choice emerges. This configuration suggests a forum in which the interaction of picoeconomic interests, which provide a cognitive dimension for CNDS, can be conceptualized. This proposition is examined in light of the resolution of conflict by means of bundling.

  17. A framework of call admission control procedures for integrated services mobile wireless networks

    International Nuclear Information System (INIS)

    Mahmoud, Ashraf S. Hasan; Al-Qahtani, Salman A.

    2007-01-01

    This paper presents a general framework for a wide range of call admission control (CAC) algorithms. For several CAC schemes, which are a subset of this general framework, an analytical performance evaluation is presented for a multi-traffic mobile wireless network. These CAC algorithms consider a variety of mechanisms to prioritize traffic in an attempt to support different levels of quality of service (QoS) for different types of calls. These mechanisms include dividing the handoff traffic into more than one class and using guard channels or allowing channel splitting to admit more handoff calls. Other mechanisms aimed at adding priority for handoff calls consider employing queuing of handoff calls or dynamically reducing the number lower priority calls. Furthermore our analysis relaxes the typically used assumptions of equal channel holding time and equal resource usage for voice and data calls. The main contribution of this paper is the development of an analytical model for each of the three CAC algorithms specified in this study. In addition to the call blocking and termination probabilities which are usually cited as the performance metrics, in this work we derive and evaluate other metrics that not have be considered by the previous work such as the average queue length, the average queue residency, and the time-out probability for handoff calls. We also develop a simulation tool to test and verify our results. Finally, we present numerical examples to demonstrate the performance of the proposed CAG algorithms and we show that analytical and simulation results are in total agreement. (author)

  18. The IDEA Assessment Tool: Assessing the Reporting, Diagnostic Reasoning, and Decision-Making Skills Demonstrated in Medical Students' Hospital Admission Notes.

    Science.gov (United States)

    Baker, Elizabeth A; Ledford, Cynthia H; Fogg, Louis; Way, David P; Park, Yoon Soo

    2015-01-01

    Construct: Clinical skills are used in the care of patients, including reporting, diagnostic reasoning, and decision-making skills. Written comprehensive new patient admission notes (H&Ps) are a ubiquitous part of student education but are underutilized in the assessment of clinical skills. The interpretive summary, differential diagnosis, explanation of reasoning, and alternatives (IDEA) assessment tool was developed to assess students' clinical skills using written comprehensive new patient admission notes. The validity evidence for assessment of clinical skills using clinical documentation following authentic patient encounters has not been well documented. Diagnostic justification tools and postencounter notes are described in the literature (1,2) but are based on standardized patient encounters. To our knowledge, the IDEA assessment tool is the first published tool that uses medical students' H&Ps to rate students' clinical skills. The IDEA assessment tool is a 15-item instrument that asks evaluators to rate students' reporting, diagnostic reasoning, and decision-making skills based on medical students' new patient admission notes. This study presents validity evidence in support of the IDEA assessment tool using Messick's unified framework, including content (theoretical framework), response process (interrater reliability), internal structure (factor analysis and internal-consistency reliability), and relationship to other variables. Validity evidence is based on results from four studies conducted between 2010 and 2013. First, the factor analysis (2010, n = 216) yielded a three-factor solution, measuring patient story, IDEA, and completeness, with reliabilities of .79, .88, and .79, respectively. Second, an initial interrater reliability study (2010) involving two raters demonstrated fair to moderate consensus (κ = .21-.56, ρ =.42-.79). Third, a second interrater reliability study (2011) with 22 trained raters also demonstrated fair to moderate agreement

  19. Mental workload in decision and control

    Science.gov (United States)

    Sheridan, T. B.

    1979-01-01

    This paper briefly reviews the problems of defining and measuring the 'mental workload' of aircraft pilots and other human operators of complex dynamic systems. Of the alternative approaches the author indicates a clear preference for the use of subjective scaling. Some recent experiments from MIT and elsewhere are described which utilize subjective mental workload scales in conjunction with human decision and control tasks in the laboratory. Finally a new three-dimensional mental workload rating scale, under current development for use by IFR aircraft pilots, is presented.

  20. Motor control is decision-making.

    Science.gov (United States)

    Wolpert, Daniel M; Landy, Michael S

    2012-12-01

    Motor behavior may be viewed as a problem of maximizing the utility of movement outcome in the face of sensory, motor and task uncertainty. Viewed in this way, and allowing for the availability of prior knowledge in the form of a probability distribution over possible states of the world, the choice of a movement plan and strategy for motor control becomes an application of statistical decision theory. This point of view has proven successful in recent years in accounting for movement under risk, inferring the loss function used in motor tasks, and explaining motor behavior in a wide variety of circumstances. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Patient-controlled hospital admission for patients with severe mental disorders: study protocol for a nationwide prospective multicentre study.

    Science.gov (United States)

    Thomsen, Christoffer Torgaard; Benros, Michael Eriksen; Hastrup, Lene Halling; Andersen, Per Kragh; Giacco, Domenico; Nordentoft, Merete

    2016-09-28

    Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled hospital admission on the use of coercion and of healthcare services. We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare the use of coercive measures and of healthcare services, the use of medications and suicidal behaviour. Descriptive statistics will be used to investigate hospitalisations, global assessment of functioning (GAF) and patient satisfaction with treatment. To minimise selection bias, we will match individuals using patient-controlled hospital admission and controls with a 1:5 ratio via a propensity score based on the following factors: sex, age group, primary diagnosis, substance abuse as secondary diagnosis, coercion, number of psychiatric bed days, psychiatric history, urbanity and suicidal behaviour. Additionally, a historical control study will be undertaken in which patients serve as their own control group prior to index date. The study has been approved by The Danish Health and Medicines Authority (j.nr.: 3-3013-934/1/) and by The Danish Data Protection Agency (j.nr.: 2012-58-0004). The study was categorised as a register study by The Danish Health Research Ethics Committee and therefore no further approval was needed (j.nr.: H-2-2014-FSP70). Findings will be disseminated through scientific

  2. Merging paradigms: Decision Making, Management, and Cognitive Control

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1996-01-01

    The paper discusses the trend in paradigms within decision research, drifting from concepts of decision making in terms of normative models of 'rational decision making, through behavioral models in terms of 'biases' - deviations from rational models, toward models of actual decision making...... behavior, such as the SRK concept, naturalistic decision making, and dynamic decision making.In this evolution, concepts such as decision making, management, and behavioral control merge and a concurrent change in concepts underlying design of systems aiming at control of behavior is visible, from...

  3. Decision making in the reactor control room

    International Nuclear Information System (INIS)

    Nelson, W.R.

    1982-01-01

    One of the most important roles of the nuclear reactor operator is that of decision maker. This paper discusses a simple model of the decision process used by the reactor operator. Resources that must be available so that he can perform the decision process are presented. Decision aids which have been investigated at EG and G Idaho, Inc., as part of the LOFT Augmented Operator Capability Program are briefly discussed. Some general concepts of computerized decision aiding are developed, and the promises and pitfalls of such decision aids are explored

  4. Construction of admissible linear orders for interval-valued Atanassov intuitionistic fuzzy sets with an application to decision making

    Czech Academy of Sciences Publication Activity Database

    De Miguel, L.; Bustince, H.; Fernandez, J.; Indurain, E.; Kolesárová, A.; Mesiar, Radko

    2016-01-01

    Roč. 27, č. 1 (2016), s. 189-197 ISSN 1566-2535 Institutional support: RVO:67985556 Keywords : Mulit-expert decision making * Interval-valued Atanassov intuitionistic fuzzy set * Interval linear order Subject RIV: BA - General Mathematics Impact factor: 5.667, year: 2016 http://library.utia.cas.cz/separaty/2016/E/mesiar-0462471.pdf

  5. Using simulation to isolate physician variation in intensive care unit admission decision making for critically ill elders with end-stage cancer: a pilot feasibility study.

    Science.gov (United States)

    Barnato, Amber E; Hsu, Heather E; Bryce, Cindy L; Lave, Judith R; Emlet, Lillian L; Angus, Derek C; Arnold, Robert M

    2008-12-01

    To determine the feasibility of high-fidelity simulation for studying variation in intensive care unit admission decision making for critically ill elders with end-stage cancer. Mixed qualitative and quantitative analysis of physician subjects participating in a simulation scenario using hospital set, actors, medical chart, and vital signs tracings. The simulation depicted a 78-yr-old man with metastatic gastric cancer, life-threatening hypoxia most likely attributable to cancer progression, and stable preferences to avoid intensive care unit admission and intubation. Two independent raters assessed the simulations and subjects completed a postsimulation web-based survey and debriefing interview. Peter M. Winter Institute for Simulation Education and Research at the University of Pittsburgh. Twenty-seven hospital-based attending physicians, including 6 emergency physicians, 13 hospitalists, and 8 intensivists. Outcomes included qualitative report of clinical verisimilitude during the debriefing interview, survey-reported diagnosis and prognosis, and observed treatment decisions. Independent variables included physician demographics, risk attitude, and reactions to uncertainty. All (100%) reported that the case and simulation were highly realistic, and their diagnostic and prognostic assessments were consistent with our intent. Eight physicians (29.6%) admitted the patient to the intensive care unit. Among the eight physicians who admitted the patient to the intensive care unit, three (37%) initiated palliation, two (25%) documented the patient's code status (do not intubate/do not resuscitate), and one intubated the patient. Among the 19 physicians who did not admit the patient to the intensive care unit, 13 (68%) initiated palliation and 5 (42%) documented code status. Intensivists and emergency physicians (p = 0.048) were more likely to admit the patient to the intensive care unit. Years since medical school graduation were inversely associated with the

  6. An experimental study on load-peak shaving in smart homes by means of online admission control

    DEFF Research Database (Denmark)

    Costanzo, Giuseppe Tommaso; Kosek, Anna Magdalena; Zhu, Guchuan

    2012-01-01

    and appliances' operation is modeled as a finite state machine, which enables an efficient load control using scheduling techniques borrowed from real-time computing systems. In this study the Admission Control, which is the bottom layer of the presented architecture interacting in real-time with physical...... equipments, is addressed and the real-time power consumption management in a residential dwelling is implemented and tested in a real office building. The experimental results provide a proof of concept for the proposed architecture and demonstrate the applicability of the on-line scheduling approach...

  7. Effect of Continuous Glucose Monitoring on Glycemic Control, Acute Admissions, and Quality of Life: A Real-World Study.

    Science.gov (United States)

    Charleer, Sara; Mathieu, Chantal; Nobels, Frank; De Block, Christophe; Radermecker, Regis P; Hermans, Michel P; Taes, Youri; Vercammen, Chris; T'Sjoen, Guy; Crenier, Laurent; Fieuws, Steffen; Keymeulen, Bart; Gillard, Pieter

    2018-03-01

    Randomized controlled trials evaluating real-time continuous glucose monitoring (RT-CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use. To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism, and quality of life (QOL). Prospective, observational, multicenter, cohort study. A total of 515 adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program. Initiation of RT-CGM reimbursement. Hemoglobin A1c (HbA1c) evolution from baseline to 12 months. Between September 1, 2014, and December 31, 2016, 515 adults entered the reimbursement system. Over this period, 417 (81%) patients used RT-CGM for at least 12 months. Baseline HbA1c was 7.7 ± 0.9% (61 ± 9.8 mmol/mol) and decreased to 7.4 ± 0.8% (57 ± 8.7 mmol/mol) at 12 months (P < 0.0001). Subjects who started RT-CGM because of insufficient glycemic control showed stronger decrease in HbA1c at 4, 8, and 12 months compared with patients who started because of hypoglycemia or pregnancy. In the year preceding reimbursement, 16% of patients were hospitalized for severe hypoglycemia or ketoacidosis in contrast to 4% (P < 0.0005) the following year, with decrease in admission days from 54 to 18 per 100 patient years (P < 0.0005). In the same period, work absenteeism decreased and QOL improved significantly, with strong decline in fear of hypoglycemia. Sensor-augmented pump therapy in patients with T1D followed in specialized centers improves HbA1c, fear of hypoglycemia, and QOL, whereas work absenteeism and admissions for acute diabetes complications decreased.

  8. Glycaemic control in diabetic patients during hospital admission is not optimal

    DEFF Research Database (Denmark)

    Hellquist, Fanny; Budde, Line; Feldt-Rasmussen, Bo Friis

    2011-01-01

    of admission was collected, including: bedside p-glucose readings, scheduled and supplemental insulin treatment. RESULTS: In total, 111 observation days were included from 37 diabetic patients (27 medical and ten surgical). P-glucose was measured on average four and 2.5 times daily at the medical...... was not given despite being indicated in 37% of the elevated glucose episodes. Increments in scheduled insulin dose were rarely observed despite being indicated. CONCLUSION: Despite acceptable median p-glucose levels, hyperglycaemia was frequent. The number of glucose readings was low and clinical inertia...

  9. Lack of utility of a decision support system to mitigate delays in admission from the operating room to the postanesthesia care unit.

    Science.gov (United States)

    Ehrenfeld, Jesse M; Dexter, Franklin; Rothman, Brian S; Minton, Betty Sue; Johnson, Diane; Sandberg, Warren S; Epstein, Richard H

    2013-12-01

    When the phase I postanesthesia care unit (PACU) is at capacity, completed cases need to be held in the operating room (OR), causing a "PACU delay." Statistical methods based on historical data can optimize PACU staffing to achieve the least possible labor cost at a given service level. A decision support process to alert PACU charge nurses that the PACU is at or near maximum census might be effective in lessening the incidence of delays and reducing over-utilized OR time, but only if alerts are timely (i.e., neither too late nor too early to act upon) and the PACU slot can be cleared quickly. We evaluated the maximum potential benefit of such a system, using assumptions deliberately biased toward showing utility. We extracted 3 years of electronic PACU data from a tertiary care medical center. At this hospital, PACU admissions were limited by neither inadequate PACU staffing nor insufficient PACU beds. We developed a model decision support system that simulated alerts to the PACU charge nurse. PACU census levels were reconstructed from the data at a 1-minute level of resolution and used to evaluate if subsequent delays would have been prevented by such alerts. The model assumed there was always a patient ready for discharge and an available hospital bed. The time from each alert until the maximum census was exceeded ("alert lead time") was determined. Alerts were judged to have utility if the alert lead time fell between various intervals from 15 or 30 minutes to 60, 75, or 90 minutes after triggering. In addition, utility for reducing over-utilized OR time was assessed using the model by determining if 2 patients arrived from 5 to 15 minutes of each other when the PACU census was at 1 patient less than the maximum census. At most, 23% of alerts arrived 30 to 60 minutes prior to the admission that resulted in the PACU exceeding the specified maximum capacity. When the notification window was extended to 15 to 90 minutes, the maximum utility was system to mitigate

  10. Control, Contingency and Delegation in Decision-Making.

    Science.gov (United States)

    Michael, Stephen R.

    1979-01-01

    Proposes a model which emphasizes the delegation of decision-making authority and managerial control of operations. Suggests that risks can be reduced by using (1) a contingency approach to delegation, (2) decision rules for consistency, (3) decision models for specific situations, (4) vital indicator reports, (5) management by objectives, and (6)…

  11. Control Decisions for Flammable Gas Hazards in Waste Transfer Systems

    International Nuclear Information System (INIS)

    KRIPPS, L.J.

    2000-01-01

    This report describes the control decisions for flammable gas hazards in waste transfer systems (i.e., waste transfer piping and waste transfer-associated structures) made at control decision meetings on November 30, 1999a and April 19, 2000, and their basis. These control decisions, and the analyses that support them, will be documented in an amendment to the Final Safety Analysis Report (FSAR) (CHG 2000a) and Technical Safety Requirements (TSR) (CHG 2000b) to close the Flammable Gas Unreviewed Safety Question (USQ) (Bacon 1996 and Wagoner 1996). Following the Contractor Tier I review of the FSAR and TSR amendment, it will be submitted to the US. Department of Energy (DOE), Office of River Protection (ORP) for review and approval. The control decision meeting on November 30, 1999 to address flammable gas hazards in waste transfer systems followed the control decision process and the criteria for control decisions described in Section 3.3.1.5 of the FSAR. The control decision meeting agenda, attendance list, and introductory and background presentations are included in Attachments 1 through 4. The control decision discussions on existing and other possible controls for flammable gas hazards in waste transfer systems and the basis for selecting or not selecting specific controls are summarized in this report

  12. A Cross-Entropy-Based Admission Control Optimization Approach for Heterogeneous Virtual Machine Placement in Public Clouds

    Directory of Open Access Journals (Sweden)

    Li Pan

    2016-03-01

    Full Text Available Virtualization technologies make it possible for cloud providers to consolidate multiple IaaS provisions into a single server in the form of virtual machines (VMs. Additionally, in order to fulfill the divergent service requirements from multiple users, a cloud provider needs to offer several types of VM instances, which are associated with varying configurations and performance, as well as different prices. In such a heterogeneous virtual machine placement process, one significant problem faced by a cloud provider is how to optimally accept and place multiple VM service requests into its cloud data centers to achieve revenue maximization. To address this issue, in this paper, we first formulate such a revenue maximization problem during VM admission control as a multiple-dimensional knapsack problem, which is known to be NP-hard to solve. Then, we propose to use a cross-entropy-based optimization approach to address this revenue maximization problem, by obtaining a near-optimal eligible set for the provider to accept into its data centers, from the waiting VM service requests in the system. Finally, through extensive experiments and measurements in a simulated environment with the settings of VM instance classes derived from real-world cloud systems, we show that our proposed cross-entropy-based admission control optimization algorithm is efficient and effective in maximizing cloud providers’ revenue in a public cloud computing environment.

  13. A Unified Electronic Tool for CPR and Emergency Treatment Escalation Plans Improves Communication and Early Collaborative Decision Making for Acute Hospital Admissions.

    Science.gov (United States)

    Johnson, Mae; Whyte, Martin; Loveridge, Robert; Yorke, Richard; Naleem, Shairana

    2017-01-01

    The National Confidential Enquiry into Patient Outcomes and Death (NCEPOD) report 'Time to Intervene' (2012) stated that in a substantial number of cases, resuscitation is attempted when it was thought a 'do not attempt cardiopulmonary resuscitation' (DNACPR) decision should have been in place. Early decisions about CPR status and advance planning about limits of care now form part of national recommendations by the UK Resuscitation Council (2016). Treatment escalation plans (TEP) document what level of treatment intervention would be appropriate if a patient were to become acutely unwell and were not previously formally in place at King's College Hospital. A unifying paper based form was successfully piloted in the Acute Medical Unit, introducing the TEP and bringing together decision making around both treatment escalation and CPR status. Subsequently an electronic order-set for CPR status and treatment escalation was launched in April 2015 which led to a highly visible CPR and escalation status banner on the main screen at the top of the patient's electronic record. Ultimately due to further iterations in the electronic process by December 2016, all escalation decisions for acutely admitted patients now have high quality supporting, explanatory documentation with 100% having TEPs in place. There is now widespread multidisciplinary engagement in the process of defining limits of care for acutely admitted medical patients within the first 14 hours of admission and a strategy for rolling this process out across all the divisions of the hospital through our Deteriorating Patient Group (DPG). The collaborative design with acute medical, palliative and intensive care teams and the high visibility provided by the electronic process in the Electronic Patient Record (EPR) has enhanced communication with these teams, patients, nursing staff and the multidisciplinary team by ensuring clarity through a universally understood process about escalation and CPR. Clarity and

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

    Science.gov (United States)

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

    2017-07-01

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

  15. Decision theory applied to image quality control in radiology.

    Science.gov (United States)

    Lessa, Patrícia S; Caous, Cristofer A; Arantes, Paula R; Amaro, Edson; de Souza, Fernando M Campello

    2008-11-13

    The present work aims at the application of the decision theory to radiological image quality control (QC) in diagnostic routine. The main problem addressed in the framework of decision theory is to accept or reject a film lot of a radiology service. The probability of each decision of a determined set of variables was obtained from the selected films. Based on a radiology service routine a decision probability function was determined for each considered group of combination characteristics. These characteristics were related to the film quality control. These parameters were also framed in a set of 8 possibilities, resulting in 256 possible decision rules. In order to determine a general utility application function to access the decision risk, we have used a simple unique parameter called r. The payoffs chosen were: diagnostic's result (correct/incorrect), cost (high/low), and patient satisfaction (yes/no) resulting in eight possible combinations. Depending on the value of r, more or less risk will occur related to the decision-making. The utility function was evaluated in order to determine the probability of a decision. The decision was made with patients or administrators' opinions from a radiology service center. The model is a formal quantitative approach to make a decision related to the medical imaging quality, providing an instrument to discriminate what is really necessary to accept or reject a film or a film lot. The method presented herein can help to access the risk level of an incorrect radiological diagnosis decision.

  16. Working memory capacity as controlled attention in tactical decision making.

    Science.gov (United States)

    Furley, Philip A; Memmert, Daniel

    2012-06-01

    The controlled attention theory of working memory capacity (WMC, Engle 2002) suggests that WMC represents a domain free limitation in the ability to control attention and is predictive of an individual's capability of staying focused, avoiding distraction and impulsive errors. In the present paper we test the predictive power of WMC in computer-based sport decision-making tasks. Experiment 1 demonstrated that high-WMC athletes were better able at focusing their attention on tactical decision making while blocking out irrelevant auditory distraction. Experiment 2 showed that high-WMC athletes were more successful at adapting their tactical decision making according to the situation instead of relying on prepotent inappropriate decisions. The present results provide additional but also unique support for the controlled attention theory of WMC by demonstrating that WMC is predictive of controlling attention in complex settings among different modalities and highlight the importance of working memory in tactical decision making.

  17. COMMAND-AND-CONTROL AND MANAGEMENT DECISION MAKING,

    Science.gov (United States)

    Reports that the development of command-and-con trol systems in support of decision making and action taking has been accomplished by military...methods applicable to management systems. Concludes that the command-and-control type system for top management decision making is a man-machine system having as its core an on going, dynamic operation. (Author)

  18. Strategic control in decision-making under uncertainty.

    Science.gov (United States)

    Venkatraman, Vinod; Huettel, Scott A

    2012-04-01

    Complex economic decisions - whether investing money for retirement or purchasing some new electronic gadget - often involve uncertainty about the likely consequences of our choices. Critical for resolving that uncertainty are strategic meta-decision processes, which allow people to simplify complex decision problems, evaluate outcomes against a variety of contexts, and flexibly match behavior to changes in the environment. In recent years, substantial research has implicated the dorsomedial prefrontal cortex (dmPFC) in the flexible control of behavior. However, nearly all such evidence comes from paradigms involving executive function or response selection, not complex decision-making. Here, we review evidence that demonstrates that the dmPFC contributes to strategic control in complex decision-making. This region contains a functional topography such that the posterior dmPFC supports response-related control, whereas the anterior dmPFC supports strategic control. Activation in the anterior dmPFC signals changes in how a decision problem is represented, which in turn can shape computational processes elsewhere in the brain. Based on these findings, we argue for both generalized contributions of the dmPFC to cognitive control, and specific computational roles for its subregions depending upon the task demands and context. We also contend that these strategic considerations are likely to be critical for decision-making in other domains, including interpersonal interactions in social settings. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

  19. To the problem of control methods unification of natural and artificial radionuclide admission into environment

    International Nuclear Information System (INIS)

    Gedeonov, L.I.

    1981-01-01

    Radioactive substances (RAS) released into the environment during NPP operation form the fields of increased radiation level as compared with the natural background. Preservation of the environment from intolerable contamination requires deter-- mination of the effluent norm by concentration and quantity of RAS released to the environment for every source. The necessity of unification of the methods for radioactive nuclide control of the environment as well as means and conditions of this control are discussed [ru

  20. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

    Science.gov (United States)

    Hawken, Steven; Kwong, Jeffrey C; Deeks, Shelley L; Crowcroft, Natasha S; Ducharme, Robin; Manuel, Douglas G; Wilson, Kumanan

    2013-01-01

    We investigated the association between a child's birth order and emergency room (ER) visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. We included all children born in Ontario between April 1(st), 2006 and March 31(st), 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI) of events among 1(st)-born and later-born children using relative incidence ratios (RIR). For the 2-month vaccination, the RIR for 1(st)-borns versus later-born children was 1.37 (95% CI: 1.19-1.57), which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st)-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99), representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st) vs. later-borns was 1.27 (95% CI: 1.09-1.48), or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21), or 249 excess events/100,000 vaccinated. Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st)-born children had significantly higher relative incidence of events compared to later-born children.

  1. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

    Directory of Open Access Journals (Sweden)

    Steven Hawken

    Full Text Available OBJECTIVE: We investigated the association between a child's birth order and emergency room (ER visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. METHODS: We included all children born in Ontario between April 1(st, 2006 and March 31(st, 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI of events among 1(st-born and later-born children using relative incidence ratios (RIR. RESULTS: For the 2-month vaccination, the RIR for 1(st-borns versus later-born children was 1.37 (95% CI: 1.19-1.57, which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99, representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st vs. later-borns was 1.27 (95% CI: 1.09-1.48, or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21, or 249 excess events/100,000 vaccinated. CONCLUSIONS: Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st-born children had significantly higher relative incidence of events compared to later-born children.

  2. Relevant Costs for Decision in an Effective Controlling System

    Directory of Open Access Journals (Sweden)

    Mihaela TULVINSCHI

    2010-05-01

    Full Text Available Controlling is considered a leading concept in the sense of coordination, planning, control and automation, in order to produce the synthesis necessary in decision making. The purpose of article is to highlight the link between a dynamic accounting system and an effective controlling system. The research method used is based on the idea that the cost analysis in an efficient controlling system involves obtaining accounting information from within the entity which management then uses in decision making. In conclusion, we emphasize that an effective controlling system must provide managers the tools to meet their informational needs.

  3. Airport Casualties: Non-Admission and Return Risks at Times of Internalized/Externalized Border Controls

    Directory of Open Access Journals (Sweden)

    Maybritt Jill Alpes

    2015-09-01

    Full Text Available This article analyzes what can happen to forced returnees upon arrival in their country of nationality. Subjective configurations of state agents in the Global South have created return risks, which in turn transform subjectivities of post-colonial citizens. The article contributes to this Special Issue by tracing repercussions of the externalization and internalization of border controls. In the case of Cameroon, these connections have resulted in the criminalization of emigration. Aspiring migrants are prosecuted if their departure projects fail to respect the entry requirements of countries in the Global North. The article is based on research conducted in Douala, Cameroon, in the form of discussions with control agents at the international airport, investigations at a prison, a review of related case law, police registers and interviews with Cameroonians returnees (November 2013–January 2014. Border controls and connected anti-fraud programs suppress family-based forms of solidarity and allow only for subjectivities rooted in state-managed forms of national identity. The article illustrates how efforts to combat fraud fuel corruption in returnees’ social networks, whereby, instead of receiving remittances, families in emigration countries have to mobilize financial resources in order to liberate returnees from police stations or prison complexes. Migration related detention of nationals in the Global South highlights the growing significance of exit controls in migration management.

  4. Development of cognitive and affective control networks and decision making.

    Science.gov (United States)

    Kar, Bhoomika R; Vijay, Nivita; Mishra, Shreyasi

    2013-01-01

    Cognitive control and decision making are two important research areas in the realm of higher-order cognition. Control processes such as interference control and monitoring in cognitive and affective contexts have been found to influence the process of decision making. Development of control processes follows a gradual growth pattern associated with the prolonged maturation of underlying neural circuits including the lateral prefrontal cortex, anterior cingulate, and the medial prefrontal cortex. These circuits are also involved in the control of processes that influences decision making, particularly with respect to choice behavior. Developmental studies on affective control have shown distinct patterns of brain activity with adolescents showing greater activation of amygdala whereas adults showing greater activity in ventral prefrontal cortex. Conflict detection, monitoring, and adaptation involve anticipation and subsequent performance adjustments which are also critical to complex decision making. We discuss the gradual developmental patterns observed in two of our studies on conflict monitoring and adaptation in affective and nonaffective contexts. Findings of these studies indicate the need to look at the differences in the effects of the development of cognitive and affective control on decision making in children and particularly adolescents. Neuroimaging studies have shown the involvement of separable neural networks for cognitive (medial prefrontal cortex and anterior cingulate) and affective control (amygdala, ventral medial prefrontal cortex) shows that one system can affect the other also at the neural level. Hence, an understanding of the interaction and balance between the cognitive and affective brain networks may be crucial for self-regulation and decision making during the developmental period, particularly late childhood and adolescence. The chapter highlights the need for empirical investigation on the interaction between the different aspects

  5. Risk based decision aid for damage control

    NARCIS (Netherlands)

    Meesters, J.L.; Keijer, W.; Gillis, M.P.W.

    2003-01-01

    The current trend in ship design is to reduce the crew. Special attention should be paid to damage control, which is a labour intensive task. Having less crew members implies that more tasks have to be automated. It also means a reduction of the available 'human sensors’, which leads to difficulties

  6. Incorporating biological control into IPM decision making

    Science.gov (United States)

    Of the many ways biological control can be incorporated into Integrated Pest Management (IPM) programs, natural enemy thresholds are arguably most easily adopted by stakeholders. Integration of natural enemy thresholds into IPM programs requires ecological and cost/benefit crop production data, thr...

  7. Is the admission test for a course in medicine a good predictor of academic performance? A case-control experience at the school of medicine of Turin.

    Science.gov (United States)

    Migliaretti, Giuseppe; Bozzaro, Salvatore; Siliquini, Roberta; Stura, Ilaria; Costa, Giuseppe; Cavallo, Franco

    2017-12-01

    The usefulness of university admission tests to medical schools has been discussed in recent years. In the academic year 2014-15 in Italy, several students who failed the admission test appealed to the regional administrative court ('Tribunale Amministrativo Regionale'-TAR) requesting to be included, despite their test results, and all were admitted to their respective courses. The existence of this population of students generated a control group, in order to evaluate the predictive capacity of the admission test. The aim of the present work is to discuss the ability of university admission tests to predict subsequent academic success. The study involved 683 students who enrolled onto the first year of the degree course in medicine in the academic year 2014-15 at the University of Turin (Molinette and San Luigi Gonzaga colleges). The students were separated into two categories: those who passed the admission test (n1=531) and those who did not pass the admission test but won their appeal in the TAR (n2=152). The validity of the admission test was analysed using specificity, sensitivity, positive and negative likelihood ratios (LH+, LH-), receiver operating characteristic (ROC) curves, area under the ROC curve (AUC), and relative (95% CI). The results showed that the admission test appeared to be a good tool for predicting the academic performances in the first year of the course (AUC=0.70, 95% CI 0.64 to 0.76). Moreover, some subject areas seemed to have a greater discriminating capacity than others. In general, students who obtained a high score in scientific questions were more likely to obtain the required standards during the first year (LH+ 1.22, 95% CI 1.14 to 1.25). Based on a consistent statistical approach, our study seems to confirm the ability of the admission test to predict academic success in the first year at the school of medicine of Turin. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All

  8. Perceived effort for motor control and decision-making.

    Directory of Open Access Journals (Sweden)

    Ignasi Cos

    2017-08-01

    Full Text Available How effort is internally quantified and how it influences both movement generation and decisions between potential movements are 2 difficult questions to answer. Physical costs are known to influence motor control and decision-making, yet we lack a general, principled characterization of how the perception of effort operates across tasks and conditions. Morel and colleagues introduce an insightful approach to that end, assessing effort indifference points and presenting a quadratic law between perceived effort and force production.

  9. Generation companies decision-making modeling by linear control theory

    International Nuclear Information System (INIS)

    Gutierrez-Alcaraz, G.; Sheble, Gerald B.

    2010-01-01

    This paper proposes four decision-making procedures to be employed by electric generating companies as part of their bidding strategies when competing in an oligopolistic market: naive, forward, adaptive, and moving average expectations. Decision-making is formulated in a dynamic framework by using linear control theory. The results reveal that interactions among all GENCOs affect market dynamics. Several numerical examples are reported, and conclusions are presented. (author)

  10. Concurrent Learning of Control in Multi agent Sequential Decision Tasks

    Science.gov (United States)

    2018-04-17

    Concurrent Learning of Control in Multi-agent Sequential Decision Tasks The overall objective of this project was to develop multi-agent reinforcement... learning (MARL) approaches for intelligent agents to autonomously learn distributed control policies in decentral- ized partially observable... learning of policies in Dec-POMDPs, established performance bounds, evaluated these algorithms both theoretically and empirically, The views

  11. Personal Qualities and College Admissions.

    Science.gov (United States)

    Willingham, Warren W.; Breland, Hunter M.

    The extent to which personal and academic factors are important in college admission decisions was studied in 1978, based on data on 25,000 applicants to 9 colleges (Colgate University, Williams College, Ohio Wesleyan University, Kenyon College, Kalamazoo College, Occidental College, Hartwick College, University of Richmond, and Bucknell…

  12. Nonimmigrant Admissions - Annual Report

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  13. Detailed systematic analysis of recruitment strategies in randomised controlled trials in patients with an unscheduled admission to hospital

    Science.gov (United States)

    Rooshenas, Leila; Fairhurst, Katherine; Rees, Jonathan; Gamble, Carrol; Blazeby, Jane M

    2018-01-01

    Objectives To examine the design and findings of recruitment studies in randomised controlled trials (RCTs) involving patients with an unscheduled hospital admission (UHA), to consider how to optimise recruitment in future RCTs of this nature. Design Studies within the ORRCA database (Online Resource for Recruitment Research in Clinical TriAls; www.orrca.org.uk) that reported on recruitment to RCTs involving UHAs in patients >18 years were included. Extracted data included trial clinical details, and the rationale and main findings of the recruitment study. Results Of 3114 articles populating ORRCA, 39 recruitment studies were eligible, focusing on 68 real and 13 hypothetical host RCTs. Four studies were prospectively planned investigations of recruitment interventions, one of which was a nested RCT. Most recruitment papers were reports of recruitment experiences from one or more ‘real’ RCTs (n=24) or studies using hypothetical RCTs (n=11). Rationales for conducting recruitment studies included limited time for informed consent (IC) and patients being too unwell to provide IC. Methods to optimise recruitment included providing patients with trial information in the prehospital setting, technology to allow recruiters to cover multiple sites, screening logs to uncover recruitment barriers, and verbal rather than written information and consent. Conclusion There is a paucity of high-quality research into recruitment in RCTs involving UHAs with only one nested randomised study evaluating a recruitment intervention. Among the remaining studies, methods to optimise recruitment focused on how to improve information provision in the prehospital setting and use of screening logs. Future research in this setting should focus on the prospective evaluation of the well-developed interventions to optimise recruitment. PMID:29420230

  14. Detailed systematic analysis of recruitment strategies in randomised controlled trials in patients with an unscheduled admission to hospital.

    Science.gov (United States)

    Rowlands, Ceri; Rooshenas, Leila; Fairhurst, Katherine; Rees, Jonathan; Gamble, Carrol; Blazeby, Jane M

    2018-02-02

    To examine the design and findings of recruitment studies in randomised controlled trials (RCTs) involving patients with an unscheduled hospital admission (UHA), to consider how to optimise recruitment in future RCTs of this nature. Studies within the ORRCA database (Online Resource for Recruitment Research in Clinical TriAls; www.orrca.org.uk) that reported on recruitment to RCTs involving UHAs in patients >18 years were included. Extracted data included trial clinical details, and the rationale and main findings of the recruitment study. Of 3114 articles populating ORRCA, 39 recruitment studies were eligible, focusing on 68 real and 13 hypothetical host RCTs. Four studies were prospectively planned investigations of recruitment interventions, one of which was a nested RCT. Most recruitment papers were reports of recruitment experiences from one or more 'real' RCTs (n=24) or studies using hypothetical RCTs (n=11). Rationales for conducting recruitment studies included limited time for informed consent (IC) and patients being too unwell to provide IC. Methods to optimise recruitment included providing patients with trial information in the prehospital setting, technology to allow recruiters to cover multiple sites, screening logs to uncover recruitment barriers, and verbal rather than written information and consent. There is a paucity of high-quality research into recruitment in RCTs involving UHAs with only one nested randomised study evaluating a recruitment intervention. Among the remaining studies, methods to optimise recruitment focused on how to improve information provision in the prehospital setting and use of screening logs. Future research in this setting should focus on the prospective evaluation of the well-developed interventions to optimise recruitment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Autonomy and coordination: Controlling external influences on decision making

    NARCIS (Netherlands)

    Vecht, B. van der; Dignum, F.; Meyer, J.J.C.

    2009-01-01

    In order to achieve optimal results, an agent's way of decision making might need to change according to the circumstances. One of the aspects an agent can adapt is the way it processes external events. Therewith it controls to what extend it is being influenced by external factors. We argue that

  16. Automated system for individual control for admission of staff in the controlled zones of the Kozloduy NPP

    International Nuclear Information System (INIS)

    Avramski, D.; Jordanova, V.

    2008-01-01

    The development of the system leads to the following: automated registering of the staff in the personnel database; real time reading of the personal dosimeters; real time reading of the collective dose; the control over the working people (especially external) concerning the dose limits or restrictions are performed in real time

  17. Controlling Uncertainty Decision Making and Learning in Complex Worlds

    CERN Document Server

    Osman, Magda

    2010-01-01

    Controlling Uncertainty: Decision Making and Learning in Complex Worlds reviews and discusses the most current research relating to the ways we can control the uncertain world around us.: Features reviews and discussions of the most current research in a number of fields relevant to controlling uncertainty, such as psychology, neuroscience, computer science and engineering; Presents a new framework that is designed to integrate a variety of disparate fields of research; Represents the first book of its kind to provide a general overview of work related to understanding control

  18. Inappropriate Intensive Care Unit admissions: Nigerian doctors ...

    African Journals Online (AJOL)

    2015-12-04

    Dec 4, 2015 ... Background: Nonclinical factors are said to influence decisions to admit patients into the ... admissions per year did not affect possible steps in the setting of a full ICU. ... hospital management, patient's family, threat of legal.

  19. Dynamic adjustments of cognitive control during economic decision making.

    Science.gov (United States)

    Soutschek, Alexander; Schubert, Torsten

    2014-10-01

    Decision making in the Ultimatum game requires the resolution of conflicts between economic self-interest and fairness intuitions. Since cognitive control processes play an important role in conflict resolution, the present study examined how control processes that are triggered by conflicts between fairness and self-interest in unfair offers affect subsequent decisions in the Ultimatum game. Our results revealed that more unfair offers were accepted following previously unfair, compared to previously fair offers. Interestingly, the magnitude of this conflict adaptation effect correlated with the individual subjects' focus on economic self-interest. We concluded that conflicts between fairness and self-interest trigger cognitive control processes, which reinforce the focus on the current task goal. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Emergent collective decision-making: Control, model and behavior

    Science.gov (United States)

    Shen, Tian

    In this dissertation we study emergent collective decision-making in social groups with time-varying interactions and heterogeneously informed individuals. First we analyze a nonlinear dynamical systems model motivated by animal collective motion with heterogeneously informed subpopulations, to examine the role of uninformed individuals. We find through formal analysis that adding uninformed individuals in a group increases the likelihood of a collective decision. Secondly, we propose a model for human shared decision-making with continuous-time feedback and where individuals have little information about the true preferences of other group members. We study model equilibria using bifurcation analysis to understand how the model predicts decisions based on the critical threshold parameters that represent an individual's tradeoff between social and environmental influences. Thirdly, we analyze continuous-time data of pairs of human subjects performing an experimental shared tracking task using our second proposed model in order to understand transient behavior and the decision-making process. We fit the model to data and show that it reproduces a wide range of human behaviors surprisingly well, suggesting that the model may have captured the mechanisms of observed behaviors. Finally, we study human behavior from a game-theoretic perspective by modeling the aforementioned tracking task as a repeated game with incomplete information. We show that the majority of the players are able to converge to playing Nash equilibrium strategies. We then suggest with simulations that the mean field evolution of strategies in the population resemble replicator dynamics, indicating that the individual strategies may be myopic. Decisions form the basis of control and problems involving deciding collectively between alternatives are ubiquitous in nature and in engineering. Understanding how multi-agent systems make decisions among alternatives also provides insight for designing

  1. A Decision Support Tool for Transient Stability Preventive Control

    DEFF Research Database (Denmark)

    Pertl, Michael; Weckesser, Johannes Tilman Gabriel; Rezkalla, Michel M.N.

    2017-01-01

    The paper presents a decision support tool for transient stability preventive control contributing to increased situation awareness of control room operators by providing additional information about the state of the power system in terms of transient stability. A time-domain approach is used...... a predefined minimum critical clearing time for faults at all buses is proposed, while costs are minimized. The results of the assessment are presented to the control room operator, who decides to accept the suggested dispatch or to repeat the assessment considering additional user-specific constraints...

  2. The features of decision making process in international companies. Are companies in control of their own decisions?

    Directory of Open Access Journals (Sweden)

    Anastasia JELEVA

    2017-06-01

    Full Text Available The following article deals with the main causes of irrational decision making process in companies and with respective solutions to make decisions more rational and effective. With the aid of relevant literature, the ways managers, groups and leaders make decisions in reality will be clarified. Besides, the solutions to rational decisions examined through the perspective of managers, leaders and groups. Thus, the background of this article is the question “Are companies in control of their own decisions?” In addition, this paper includes relevant information about the features of decision making process, basic types of decisions, describes the most essential approach in management regarding to decision making and presents the top worst and best business decisions of all time.

  3. Mathematics Admission Test Remarks

    Directory of Open Access Journals (Sweden)

    Ideon Erge

    2016-12-01

    Full Text Available Since 2014, there have been admission tests in mathematics for applicants to the Estonian University of Life Sciences for Geodesy, Land Management and Real Estate Planning; Civil Engineering; Hydraulic Engineering and Water Pollution Control; Engineering and Technetronics curricula. According to admission criteria, the test must be taken by students who have not passed the specific mathematics course state exam or when the score was less than 20 points. The admission test may also be taken by those who wish to improve their state exam score. In 2016, there were 126 such applicants of whom 63 took the test. In 2015, the numbers were 129 and 89 and in 2014 150 and 47 accordingly. The test was scored on scale of 100. The arithmetic average of the score was 30.6 points in 2016, 29.03 in 2015 and 18.84 in 2014. The test was considered to be passed with 1 point in 2014 and 20 points in 2015 and 2016. We analyzed test results and gave examples of problems which were solved exceptionally well or not at all.

  4. Arousal, Executive Control and Decision Making in Compulsive Buying Disorder

    DEFF Research Database (Denmark)

    Ramsøy, Thomas Zöega; Zuraigat, Farah Qureshi; Jacobsen, Catrine

    2013-01-01

    Compulsive buying disorder (CBD) is noted by an obsession with shopping and a chronic, repetitive purchasing behavior with adverse consequences for the sufferer and their social surroundings. While CBD is often classified as an impulse control disorder (ICD), little is still known about the actua......, products of interest (e.g. fashion items) produce bottom-up emotional responses that skews the decision-making process, leading CBD sufferers to make bad purchase decisions.......Compulsive buying disorder (CBD) is noted by an obsession with shopping and a chronic, repetitive purchasing behavior with adverse consequences for the sufferer and their social surroundings. While CBD is often classified as an impulse control disorder (ICD), little is still known about the actual...

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

    Science.gov (United States)

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

    2018-03-24

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

  6. Evolutionary game dynamics of controlled and automatic decision-making.

    Science.gov (United States)

    Toupo, Danielle F P; Strogatz, Steven H; Cohen, Jonathan D; Rand, David G

    2015-07-01

    We integrate dual-process theories of human cognition with evolutionary game theory to study the evolution of automatic and controlled decision-making processes. We introduce a model in which agents who make decisions using either automatic or controlled processing compete with each other for survival. Agents using automatic processing act quickly and so are more likely to acquire resources, but agents using controlled processing are better planners and so make more effective use of the resources they have. Using the replicator equation, we characterize the conditions under which automatic or controlled agents dominate, when coexistence is possible and when bistability occurs. We then extend the replicator equation to consider feedback between the state of the population and the environment. Under conditions in which having a greater proportion of controlled agents either enriches the environment or enhances the competitive advantage of automatic agents, we find that limit cycles can occur, leading to persistent oscillations in the population dynamics. Critically, however, these limit cycles only emerge when feedback occurs on a sufficiently long time scale. Our results shed light on the connection between evolution and human cognition and suggest necessary conditions for the rise and fall of rationality.

  7. Evolutionary game dynamics of controlled and automatic decision-making

    Science.gov (United States)

    Toupo, Danielle F. P.; Strogatz, Steven H.; Cohen, Jonathan D.; Rand, David G.

    2015-07-01

    We integrate dual-process theories of human cognition with evolutionary game theory to study the evolution of automatic and controlled decision-making processes. We introduce a model in which agents who make decisions using either automatic or controlled processing compete with each other for survival. Agents using automatic processing act quickly and so are more likely to acquire resources, but agents using controlled processing are better planners and so make more effective use of the resources they have. Using the replicator equation, we characterize the conditions under which automatic or controlled agents dominate, when coexistence is possible and when bistability occurs. We then extend the replicator equation to consider feedback between the state of the population and the environment. Under conditions in which having a greater proportion of controlled agents either enriches the environment or enhances the competitive advantage of automatic agents, we find that limit cycles can occur, leading to persistent oscillations in the population dynamics. Critically, however, these limit cycles only emerge when feedback occurs on a sufficiently long time scale. Our results shed light on the connection between evolution and human cognition and suggest necessary conditions for the rise and fall of rationality.

  8. A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skåne randomized controlled trial protocol (BASRCT).

    Science.gov (United States)

    Liljedahl, Sophie I; Helleman, Marjolein; Daukantaité, Daiva; Westrin, Åsa; Westling, Sofie

    2017-06-15

    Brief Admission is a crisis and risk management strategy in which self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder self-admit to hospital at times of increasing risk when other efforts to stay safe are failing. Standardized in the current randomized controlled trial, the intensity of Brief Admission Skåne is implemented in durations of three days, with a maximum frequency of three times a month. Brief Admission is integrated into existing treatment plans in advance of crises to prevent reliance on general psychiatric admissions for risk management, as these may be lengthy, unstructured, and of uncertain therapeutic value. The overall objective of the Brief Admission Skåne randomized controlled trial is to determine if Brief Admission can replace general psychiatric admission for self-harming and suicidal individuals with complex mental illness at times of escalating risk. Other objectives of the study are to evaluate whether Brief Admission increases daily functioning and enhances coping, reduces psychiatric symptoms including frequency and severity of self-harm and suicidal behaviours. A final objective is to determine if Brief Admission is an effective crisis management model for this population. Participants are randomized at an individual level to either Brief Admission Skåne plus Treatment as Usual or Treatment As Usual. Based on a priori power analyses, N = 124 participants will be recruited to the study. Data collection is in progress, and will continue until June 2018. All participant data are single-blinded and will be handled with intention-to-treat analysis. Based on the combined clinical experience of our international research group, the Brief Admission Skåne randomized controlled trial upon which the current protocol is based represents the first initiative to standardize, implement and evaluate Brief Admission amongst self-harming and suicidal individuals, including those with

  9. SLUDGE TREATMENT PROJECT KOP CONCEPTUAL DESIGN CONTROL DECISION REPORT

    International Nuclear Information System (INIS)

    Carro, C.A.

    2010-01-01

    This control decision addresses the Knock-Out Pot (KOP) Disposition KOP Processing System (KPS) conceptual design. The KPS functions to (1) retrieve KOP material from canisters, (2) remove particles less than 600 (micro)m in size and low density materials from the KOP material, (3) load the KOP material into Multi-Canister Overpack (MCO) baskets, and (4) stage the MCO baskets for subsequent loading into MCOs. Hazard and accident analyses of the KPS conceptual design have been performed to incorporate safety into the design process. The hazard analysis is documented in PRC-STP-00098, Knock-Out Pot Disposition Project Conceptual Design Hazard Analysis. The accident analysis is documented in PRC-STP-CN-N-00167, Knock-Out Pot Disposition Sub-Project Canister Over Lift Accident Analysis. Based on the results of these analyses, and analyses performed in support of MCO transportation and MCO processing and storage activities at the Cold Vacuum Drying Facility (CVDF) and Canister Storage Building (CSB), control decision meetings were held to determine the controls required to protect onsite and offsite receptors and facility workers. At the conceptual design stage, these controls are primarily defined by their safety functions. Safety significant structures, systems, and components (SSCs) that could provide the identified safety functions have been selected for the conceptual design. It is anticipated that some safety SSCs identified herein will be reclassified based on hazard and accident analyses performed in support of preliminary and detailed design.

  10. Control Design for Untimed Petri Nets Using Markov Decision Processes

    Directory of Open Access Journals (Sweden)

    Cherki Daoui

    2017-01-01

    Full Text Available Design of control sequences for discrete event systems (DESs has been presented modelled by untimed Petri nets (PNs. PNs are well-known mathematical and graphical models that are widely used to describe distributed DESs, including choices, synchronizations and parallelisms. The domains of application include, but are not restricted to, manufacturing systems, computer science and transportation networks. We are motivated by the observation that such systems need to plan their production or services. The paper is more particularly concerned with control issues in uncertain environments when unexpected events occur or when control errors disturb the behaviour of the system. To deal with such uncertainties, a new approach based on discrete time Markov decision processes (MDPs has been proposed that associates the modelling power of PNs with the planning power of MDPs. Finally, the simulation results illustrate the benefit of our method from the computational point of view. (original abstract

  11. Multistable decision switches for flexible control of epigenetic differentiation.

    Directory of Open Access Journals (Sweden)

    Raúl Guantes

    2008-11-01

    Full Text Available It is now recognized that molecular circuits with positive feedback can induce two different gene expression states (bistability under the very same cellular conditions. Whether, and how, cells make use of the coexistence of a larger number of stable states (multistability is however largely unknown. Here, we first examine how autoregulation, a common attribute of genetic master regulators, facilitates multistability in two-component circuits. A systematic exploration of these modules' parameter space reveals two classes of molecular switches, involving transitions in bistable (progression switches or multistable (decision switches regimes. We demonstrate the potential of decision switches for multifaceted stimulus processing, including strength, duration, and flexible discrimination. These tasks enhance response specificity, help to store short-term memories of recent signaling events, stabilize transient gene expression, and enable stochastic fate commitment. The relevance of these circuits is further supported by biological data, because we find them in numerous developmental scenarios. Indeed, many of the presented information-processing features of decision switches could ultimately demonstrate a more flexible control of epigenetic differentiation.

  12. The role of consciousness in cognitive control and decision making

    Directory of Open Access Journals (Sweden)

    Simon evan Gaal

    2012-05-01

    Full Text Available Here we review studies on the complexity and strength of unconscious information processing. We focus on empirical evidence that relates awareness of information to cognitive control processes (e.g. response inhibition, conflict resolution, and task-switching, the life-time of information maintenance (e.g. working memory and the possibility to integrate multiple pieces of information across space and time. Overall, the results that we review paint a picture of local and specific effects of unconscious information on various (high-level brain regions, including areas in the prefrontal cortex. Although this neural activation does not elicit any conscious experience, it is functional and capable of influencing many perceptual, cognitive (control and decision-related processes, sometimes even for relatively long periods of time. However, recent evidence also points out interesting dissociations between conscious and unconscious information processing when it comes to the duration, flexibility and the strategic use of that information for complex operations and decision-making. Based on the available evidence, we conclude that the role of task-relevance of subliminal information and meta-cognitive factors in unconscious cognition need more attention in future work.

  13. Cost and effects of different admission screening strategies to control the spread of methicillin-resistant Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Tanya Gurieva

    Full Text Available Nosocomial infection rates due to antibiotic-resistant bacteriae, e.g., methicillin-resistant Staphylococcus aureus (MRSA remain high in most countries. Screening for MRSA carriage followed by barrier precautions for documented carriers (so-called screen and isolate (S&I has been successful in some, but not all settings. Moreover, different strategies have been proposed, but comparative studies determining their relative effects and costs are not available. We, therefore, used a mathematical model to evaluate the effect and costs of different S&I strategies and to identify the critical parameters for this outcome. The dynamic stochastic simulation model consists of 3 hospitals with general wards and intensive care units (ICUs and incorporates readmission of carriers of MRSA. Patient flow between ICUs and wards was based on real observations. Baseline prevalence of MRSA was set at 20% in ICUs and hospital-wide at 5%; ranges of costs and infection rates were based on published data. Four S&I strategies were compared to a do-nothing scenario: S&I of previously documented carriers ("flagged" patients; S&I of flagged patients and ICU admissions; S&I of flagged and group of "frequent" patients; S&I of all hospital admissions (universal screening. Evaluated levels of efficacy of S&I were 10%, 25%, 50% and 100%. Our model predicts that S&I of flagged and S&I of flagged and ICU patients are the most cost-saving strategies with fastest return of investment. For low isolation efficacy universal screening and S&I of flagged and "frequent" patients may never become cost-saving. Universal screening is predicted to prevent hardly more infections than S&I of flagged and "frequent" patients, albeit at higher costs. Whether an intervention becomes cost-saving within 10 years critically depends on costs per infection in ICU, costs of screening and isolation efficacy.

  14. Memory-Based Decision-Making with Heuristics: Evidence for a Controlled Activation of Memory Representations

    Science.gov (United States)

    Khader, Patrick H.; Pachur, Thorsten; Meier, Stefanie; Bien, Siegfried; Jost, Kerstin; Rosler, Frank

    2011-01-01

    Many of our daily decisions are memory based, that is, the attribute information about the decision alternatives has to be recalled. Behavioral studies suggest that for such decisions we often use simple strategies (heuristics) that rely on controlled and limited information search. It is assumed that these heuristics simplify decision-making by…

  15. Combined Intelligent Control (CIC an Intelligent Decision Making Algorithm

    Directory of Open Access Journals (Sweden)

    Moteaal Asadi Shirzi

    2007-03-01

    Full Text Available The focus of this research is to introduce the concept of combined intelligent control (CIC as an effective architecture for decision-making and control of intelligent agents and multi-robot sets. Basically, the CIC is a combination of various architectures and methods from fields such as artificial intelligence, Distributed Artificial Intelligence (DAI, control and biological computing. Although any intelligent architecture may be very effective for some specific applications, it could be less for others. Therefore, CIC combines and arranges them in a way that the strengths of any approach cover the weaknesses of others. In this paper first, we introduce some intelligent architectures from a new aspect. Afterward, we offer the CIC by combining them. CIC has been executed in a multi-agent set. In this set, robots must cooperate to perform some various tasks in a complex and nondeterministic environment with a low sensory feedback and relationship. In order to investigate, improve, and correct the combined intelligent control method, simulation software has been designed which will be presented and considered. To show the ability of the CIC algorithm as a distributed architecture, a central algorithm is designed and compared with the CIC.

  16. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data.

    Science.gov (United States)

    Myles, Puja R; Nguyen-Van-Tam, Jonathan S; Lim, Wei Shen; Nicholson, Karl G; Brett, Stephen J; Enstone, Joanne E; McMenamin, James; Openshaw, Peter J M; Read, Robert C; Taylor, Bruce L; Bannister, Barbara; Semple, Malcolm G

    2012-01-01

    Triage tools have an important role in pandemics to identify those most likely to benefit from higher levels of care. We compared Community Assessment Tools (CATs), the CURB-65 score, and the Pandemic Medical Early Warning Score (PMEWS); to predict higher levels of care (high dependency--Level 2 or intensive care--Level 3) and/or death in patients at or shortly after admission to hospital with A/H1N1 2009 pandemic influenza. This was a case-control analysis using retrospectively collected data from the FLU-CIN cohort (1040 adults, 480 children) with PCR-confirmed A/H1N1 2009 influenza. Area under receiver operator curves (AUROC), sensitivity, specificity, positive predictive values and negative predictive values were calculated. CATs best predicted Level 2/3 admissions in both adults [AUROC (95% CI): CATs 0.77 (0.73, 0.80); CURB-65 0.68 (0.64, 0.72); PMEWS 0.68 (0.64, 0.73), ptools for predicting need for higher levels of care and/or mortality in patients of all ages.

  17. Risk factors for hospital admission due to acute lower respiratory tract infection in Guarani indigenous children in southern Brazil: a population-based case-control study.

    Science.gov (United States)

    Cardoso, Andrey M; Coimbra, Carlos E A; Werneck, Guilherme L

    2013-05-01

    To assess risk factors associated with hospital admission due to acute lower respiratory tract infection (ALRTI) in indigenous Guarani children <5 years of age in southern Brazil. Population-based matched case-control study from May 2007 to June 2008 in 81 Guarani villages. Cases were defined as hospital admissions due to confirmed ALRTI. Two controls free from acute respiratory infection, matched according to age, sex and place of residence, were selected for each case at the time of the case's hospitalisation. Both cases and controls were recruited by a surveillance routine established for the study. The analysis was performed on 120 cases and 201 controls. The risk factors that remained significantly associated with hospitalisation due to ALRTI in the hierarchical multivariate conditional logistic regression were: low stable monthly per capita household income (

  18. Mathematical models of decision making on space vehicle motion control at fuzzy conditions

    International Nuclear Information System (INIS)

    Arslanov, M.Z.; Ismail, E.E.; Oryspaev, D.O.

    2005-01-01

    the structure of decision making for control of spacecraft motion is considered. Mathematical models of decision making problems are investigated. New methods of criteria convolution are received. New convolution have properties of smoothness. (author)

  19. Reasons for refusal of admission to intensive care and impact on mortality.

    Science.gov (United States)

    Iapichino, Gaetano; Corbella, Davide; Minelli, Cosetta; Mills, Gary H; Artigas, Antonio; Edbooke, David L; Pezzi, Angelo; Kesecioglu, Jozef; Patroniti, Nicolò; Baras, Mario; Sprung, Charles L

    2010-10-01

    To identify factors influencing triage decisions and investigate whether admission to the intensive care unit (ICU) could reduce mortality compared with treatment on the ward. A multicentre cohort study in 11 university hospitals from seven countries, evaluating triage decisions and outcomes of patients referred for admission to ICU who were either accepted, or refused and treated on the ward. Confounding in the estimation of the effect of ICU admission on mortality was controlled by use of a propensity score approach, which adjusted for the probability of being admitted. Variability across centres was accounted for in both analyses of factors influencing ICU admission and effect of ICU admission on mortality. Eligible were 8,616 triages in 7,877 patients referred for ICU admission. Variables positively associated with probability of being admitted to ICU included: ventilators in ward; bed availability; Karnofsky score; absence of comorbidity; presence of haematological malignancy; emergency surgery and elective surgery (versus medical treatment); trauma, vascular involvement, liver involvement; acute physiologic score II; ICU treatment (versus ICU observation). Multiple triages during patient's hospital stay and age were negatively associated with ICU admission. The area under the receiver operating characteristic (ROC) curve of the model was 0.83 [95% confidence interval (CI): 0.81-0.84], with Hosmer-Lemeshow test P = 0.300. ICU admission was associated with a statistically significant reduction of both 28-day mortality [odds ratio (OR): 0.73; 95% CI: 0.62-0.87] and 90-day mortality (0.79; 0.66-0.93). The benefit of ICU admission increased substantially in patients with greater severity of illness. We suggest that intensivists take great care to avoid ICU admission of patients judged not severe enough for ICU or with low performance status, and they tend to admit surgical patients more readily than medical patients. Interestingly, they do not judge age per se as

  20. Migratory decisions in birds: Extent of genetic versus environmental control

    Science.gov (United States)

    Ogonowski, M.S.; Conway, C.J.

    2009-01-01

    Migration is one of the most spectacular of animal behaviors and is prevalent across a broad array of taxa. In birds, we know much about the physiological basis of how birds migrate, but less about the relative contribution of genetic versus environmental factors in controlling migratory tendency. To evaluate the extent to which migratory decisions are genetically determined, we examined whether individual western burrowing owls (Athene cunicularia hypugaea) change their migratory tendency from one year to the next at two sites in southern Arizona. We also evaluated the heritability of migratory decisions by using logistic regression to examine the association between the migratory tendency of burrowing owl parents and their offspring. The probability of migrating decreased with age in both sexes and adult males were less migratory than females. Individual owls sometimes changed their migratory tendency from one year to the next, but changes were one-directional: adults that were residents during winter 2004-2005 remained residents the following winter, but 47% of adults that were migrants in winter 2004-2005 became residents the following winter. We found no evidence for an association between the migratory tendency of hatch-year owls and their male or female parents. Migratory tendency of hatch-year owls did not differ between years, study sites or sexes or vary by hatching date. Experimental provision of supplemental food did not affect these relationships. All of our results suggest that heritability of migratory tendency in burrowing owls is low, and that intraspecific variation in migratory tendency is likely due to: (1) environmental factors, or (2) a combination of environmental factors and non-additive genetic variation. The fact that an individual's migratory tendency can change across years implies that widespread anthropogenic changes (i.e., climate change or changes in land use) could potentially cause widespread changes in the migratory tendency of

  1. THE INTEGRATED LAYOUT DECISIONS FOR AUTOMATIC CONTROL OF PACKING SYSTEMS

    Directory of Open Access Journals (Sweden)

    A. Volodin

    2017-06-01

    Full Text Available On many industrial objects regulators of pressure are used. Following initial data are necessary for proper selection of a regulator and calculation of throughput: a working environment, entrance and target pressure, expense, temperature of a working environment, accuracy of regulation, a class of tightness, diameter of the pipeline, type of accession, constructional materials, external or internal registration of target pressure, protection against excess of pressure.The decision of this problem is closely connected with the proved choice of types of the process equipment, wide automation of technological processes, introduction of new technical decisions, use of necessary means of the control over realization of problems of complex mechanization of technological operations. In article the analysis of work of the functional module of a vertical multiline automatic packing machine on the basis of a proportional regulator of pressure «CAMOZZI» with realization of a feedback by means of an analog signal of regulator МХ-PRO [1-3] is lead. The drive of the holder for a rolled material has been tested on proportional management of position of the directing rollers used on a technological site of supply and regulation of a tension of a tape of a roll of a packing material at formation of packing.Results on use as the operating module of regulator МХ-PRO for management of a drive of the holder for a roll of a material in view of a course and pressure in a pneumatic system are received. Carried out researches provide the way to raise operational properties of a transportation system of supply of a packing material for technological processes of packing modules at the food enterprises.

  2. Future Tense and Economic Decisions: Controlling for Cultural Evolution.

    Science.gov (United States)

    Roberts, Seán G; Winters, James; Chen, Keith

    2015-01-01

    A previous study by Chen demonstrates a correlation between languages that grammatically mark future events and their speakers' propensity to save, even after controlling for numerous economic and demographic factors. The implication is that languages which grammatically distinguish the present and the future may bias their speakers to distinguish them psychologically, leading to less future-oriented decision making. However, Chen's original analysis assumed languages are independent. This neglects the fact that languages are related, causing correlations to appear stronger than is warranted (Galton's problem). In this paper, we test the robustness of Chen's correlations to corrections for the geographic and historical relatedness of languages. While the question seems simple, the answer is complex. In general, the statistical correlation between the two variables is weaker when controlling for relatedness. When applying the strictest tests for relatedness, and when data is not aggregated across individuals, the correlation is not significant. However, the correlation did remain reasonably robust under a number of tests. We argue that any claims of synchronic patterns between cultural variables should be tested for spurious correlations, with the kinds of approaches used in this paper. However, experiments or case-studies would be more fruitful avenues for future research on this specific topic, rather than further large-scale cross-cultural correlational studies.

  3. An Admissions Officer's Credentials

    Science.gov (United States)

    Chronicle of Higher Education, 2007

    2007-01-01

    Marilee Jones has resigned as a dean of admissions at the Massachusetts Institute of Technology after admitting that she had misrepresented her academic degrees when first applying to work at the university in 1979. As one of the nation's most prominent admissions officers--and a leader in the movement to make the application process less…

  4. A Stunning Admission

    Science.gov (United States)

    Hu, Helen

    2012-01-01

    Few people set out to become admissions counselors, say people in the profession. But the field is requiring skills that are more demanding and varied than ever. And at a time when universities are looking especially hard at the bottom line, people in admissions need to constantly learn new things and make themselves indispensable. Counselors…

  5. Advice on Admissions Transparency

    Science.gov (United States)

    Australian Government Tertiary Education Quality and Standards Agency, 2018

    2018-01-01

    Admissions transparency means that prospective domestic undergraduate students can easily find good quality admissions information that allows them to compare courses and providers and make informed study choices. In October 2016 the Higher Education Standards Panel (HESP) made recommendations to achieve greater transparency in higher education…

  6. Theoretical Background for the Decision-Making Process Modelling under Controlled Intervention Conditions

    OpenAIRE

    Bakanauskienė Irena; Baronienė Laura

    2017-01-01

    This article is intended to theoretically justify the decision-making process model for the cases, when active participation of investing entities in controlling the activities of an organisation and their results is noticeable. Based on scientific literature analysis, a concept of controlled conditions is formulated, and using a rational approach to the decision-making process, a model of the 11-steps decision-making process under controlled intervention is presented. Also, there have been u...

  7. Theoretical Background for the Decision-Making Process Modelling under Controlled Intervention Conditions

    Directory of Open Access Journals (Sweden)

    Bakanauskienė Irena

    2017-12-01

    Full Text Available This article is intended to theoretically justify the decision-making process model for the cases, when active participation of investing entities in controlling the activities of an organisation and their results is noticeable. Based on scientific literature analysis, a concept of controlled conditions is formulated, and using a rational approach to the decision-making process, a model of the 11-steps decision-making process under controlled intervention is presented. Also, there have been unified conditions, describing the case of controlled interventions thus providing preconditions to ensure the adequacy of the proposed decision-making process model.

  8. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data.

    Directory of Open Access Journals (Sweden)

    Puja R Myles

    Full Text Available Triage tools have an important role in pandemics to identify those most likely to benefit from higher levels of care. We compared Community Assessment Tools (CATs, the CURB-65 score, and the Pandemic Medical Early Warning Score (PMEWS; to predict higher levels of care (high dependency--Level 2 or intensive care--Level 3 and/or death in patients at or shortly after admission to hospital with A/H1N1 2009 pandemic influenza. This was a case-control analysis using retrospectively collected data from the FLU-CIN cohort (1040 adults, 480 children with PCR-confirmed A/H1N1 2009 influenza. Area under receiver operator curves (AUROC, sensitivity, specificity, positive predictive values and negative predictive values were calculated. CATs best predicted Level 2/3 admissions in both adults [AUROC (95% CI: CATs 0.77 (0.73, 0.80; CURB-65 0.68 (0.64, 0.72; PMEWS 0.68 (0.64, 0.73, p<0.001] and children [AUROC: CATs 0.74 (0.68, 0.80; CURB-65 0.52 (0.46, 0.59; PMEWS 0.69 (0.62, 0.75, p<0.001]. CURB-65 and CATs were similar in predicting death in adults with both performing better than PMEWS; and CATs best predicted death in children. CATs were the best predictor of Level 2/3 care and/or death for both adults and children. CATs are potentially useful triage tools for predicting need for higher levels of care and/or mortality in patients of all ages.

  9. Prospective, randomised, controlled study evaluating early modification of oral microbiota following admission to the intensive care unit and oral hygiene with chlorhexidine.

    Science.gov (United States)

    Tuon, Felipe Francisco; Gavrilko, Oleg; Almeida, Saulo de; Sumi, Eigi Ricardo; Alberto, Thiago; Rocha, Jaime Luis; Rosa, Edvaldo Antonio

    2017-03-01

    Chlorhexidine (CHX) is the most commonly used oral hygiene product for the prevention of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation (MV). The change in dental plaque (DP) microbiota following CHX use in patients under MV has not been described previously. The aim of this study was to evaluate the incidence of pathogenic bacteria associated with VAP and the coverage of DP within the oral cavity in patients administered CHX. This was a prospective, randomised, controlled, double-blind study in patients (n=16) under MV who were mouth-rinsed with either CHX or placebo. Microbiology samples were collected from the oral mucosa (OM) and DP after admission to the ICU and on Days 3, 5, 7 and 10. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of CHX were determined. Upon admission, the occurrence of multidrug-resistant (MDR) bacteria, including carbapenem-resistant Klebsiella pneumoniae, was reported. The CHX group had a lower incidence of methicillin-resistant Staphylococcus aureus (MRSA) compared with the placebo group for the OM (RR=0.51, 95% CI 0.27-0.98; P=0.011). There was high agreement between the culture results of OM and DP (κ=0.825). VAP developed in six patients. The species identified following tracheal aspiration of VAP patients were similar to those found in the OM for four cases. The strains showed low MICs and MBCs for CHX (<0.039mg/mL). Although DP is rapidly colonised by MDR bacteria, use of 2% CHX reduced the incidence of S. aureus colonisation. Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  10. Modeling, control and optimization of water systems systems engineering methods for control and decision making tasks

    CERN Document Server

    2016-01-01

    This book provides essential background knowledge on the development of model-based real-world solutions in the field of control and decision making for water systems. It presents system engineering methods for modelling surface water and groundwater resources as well as water transportation systems (rivers, channels and pipelines). The models in turn provide information on both the water quantity (flow rates, water levels) of surface water and groundwater and on water quality. In addition, methods for modelling and predicting water demand are described. Sample applications of the models are presented, such as a water allocation decision support system for semi-arid regions, a multiple-criteria control model for run-of-river hydropower plants, and a supply network simulation for public services.

  11. Online decision trees to support the control of gastrointestinal worms in ruminants

    OpenAIRE

    Koopmann, Regine; Dämmrich, Michaela; Ploeger, Harm

    2014-01-01

    Control of gastrointestinal worms is crucial to any pasture system for ruminants. To support the farmer's foresighted planning of pasturage and to avoid excessive deworm-ing in Germany we created four decision trees and put them online. They are freely accessible at www.weide-parasiten.de. There is one decision tree for young first season cattle in intensive dairy husbandry, one decision tree for young cattle in suckling-cow management and one decision tree for sheep and goats, respectively.

  12. Specialist clinics for reducing emergency admissions in patients with heart failure: a systematic review and meta-analysis of randomised controlled trials

    NARCIS (Netherlands)

    Thomas, R.; Huntley, A.; Mann, M.; Huws, D.; Paranjothy, S.; Elwyn, G.; Purdy, S.

    2013-01-01

    Unplanned admissions for heart failure are common and some are considered preventable. OBJECTIVE: Undertake a systematic literature review and meta-analysis to evaluate the effectiveness of specialist clinics in reducing unplanned hospital admissions in people with heart failure. DATA SOURCES: 18

  13. Admission predictability of children with acute asthma

    Directory of Open Access Journals (Sweden)

    Maan Alherbish

    2018-01-01

    CONCLUSIONS: Decision of admission could be made to many children with moderate-to-severe acute asthma at the 2nd h of ED stay based on their total PAS. OS and RR should be part of any scoring system to evaluate acute asthma in children.

  14. Undergraduate Admissions | NSU

    Science.gov (United States)

    . Continuing Education Financial Aid Career Development Regional Campuses International Affairs Veterans Admissions Honors College Experiential Education Study Abroad Research Opportunities Career Preparation SharkLink California Disclosure International Affairs Undergraduate Advising Career Development Libraries at

  15. Real-Time Optimal Flood Control Decision Making and Risk Propagation Under Multiple Uncertainties

    Science.gov (United States)

    Zhu, Feilin; Zhong, Ping-An; Sun, Yimeng; Yeh, William W.-G.

    2017-12-01

    Multiple uncertainties exist in the optimal flood control decision-making process, presenting risks involving flood control decisions. This paper defines the main steps in optimal flood control decision making that constitute the Forecast-Optimization-Decision Making (FODM) chain. We propose a framework for supporting optimal flood control decision making under multiple uncertainties and evaluate risk propagation along the FODM chain from a holistic perspective. To deal with uncertainties, we employ stochastic models at each link of the FODM chain. We generate synthetic ensemble flood forecasts via the martingale model of forecast evolution. We then establish a multiobjective stochastic programming with recourse model for optimal flood control operation. The Pareto front under uncertainty is derived via the constraint method coupled with a two-step process. We propose a novel SMAA-TOPSIS model for stochastic multicriteria decision making. Then we propose the risk assessment model, the risk of decision-making errors and rank uncertainty degree to quantify the risk propagation process along the FODM chain. We conduct numerical experiments to investigate the effects of flood forecast uncertainty on optimal flood control decision making and risk propagation. We apply the proposed methodology to a flood control system in the Daduhe River basin in China. The results indicate that the proposed method can provide valuable risk information in each link of the FODM chain and enable risk-informed decisions with higher reliability.

  16. Nonimmigrant Admissions: Fiscal Year 2008

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  17. Nonimmigrant Admissions: Fiscal Year 2012

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  18. Nonimmigrant Admissions - Fiscal Year 2013

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  19. Nonimmigrant Admissions: Fiscal Year 2005

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  20. Nonimmigrant Admissions: Fiscal Year 2016

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  1. Nonimmigrant Admissions: Fiscal Year 2010

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  2. Nonimmigrant Admissions: Fiscal Year 2006

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  3. Nonimmigrant Admission: Fiscal Year 2007

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  4. Nonimmigrant Admissions: Fiscal Year 2014

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  5. Nonimmigrant Admissions: Fiscal Year 2009

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  6. Nonimmigrant Admissions: Fiscal Year 2011

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  7. Nonimmigrant Admissions: Fiscal Year 2004

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  8. Nonimmigrant Admissions: Fiscal Year 2015

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  9. The Application of Time-Delay Dependent H∞ Control Model in Manufacturing Decision Optimization

    Directory of Open Access Journals (Sweden)

    Haifeng Guo

    2015-01-01

    Full Text Available This paper uses a time-delay dependent H∞ control model to analyze the effect of manufacturing decisions on the process of transmission from resources to capability. We establish a theoretical framework of manufacturing management process based on three terms: resource, manufacturing decision, and capability. Then we build a time-delay H∞ robust control model to analyze the robustness of manufacturing management. With the state feedback controller between manufacturing resources and decision, we find that there is an optimal decision to adjust the process of transmission from resources to capability under uncertain environment. Finally, we provide an example to prove the robustness of this model.

  10. Primary and Secondary Selection Tools in an Optometry Admission Process.

    Science.gov (United States)

    Spafford, Marlee M.

    2000-01-01

    A five-year evaluation of the admissions decision process at the University of Waterloo (Ontario) School of Optometry found that when primary tools (i.e., university grades, Optometry Admission Test scores) did not differentiate candidates, there was an increased emphasis on secondary tools (i.e., interview, autobiographic sketch, prerequisite…

  11. The Use of Tests in Admissions to Higher Education.

    Science.gov (United States)

    Fruen, Mary

    1978-01-01

    There are both strengths and weaknesses of using standardized test scores as a criterion for admission to institutions of higher education. The relative importance of scores is dependent on the institution's degree of selectivity. In general, decision processes and admissions criteria are not well defined. Advantages of test scores include: use of…

  12. Information support for decision making on dispatching control of water distribution in irrigation

    Science.gov (United States)

    Yurchenko, I. F.

    2018-05-01

    The research has been carried out on developing the technique of supporting decision making for on-line control, operational management of water allocation for the interfarm irrigation projects basing on the analytical patterns of dispatcher control. This technique provides an increase of labour productivity as well as higher management quality due to the improved level of automation, as well as decision making optimization taking into account diagnostics of the issues, solutions classification, information being required to the decision makers.

  13. "Doctor, Make My Decisions": Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults.

    Science.gov (United States)

    Chiu, Catherine; Feuz, Mariko A; McMahan, Ryan D; Miao, Yinghui; Sudore, Rebecca L

    2016-01-01

    Culturally diverse older adults may prefer varying control over medical decisions. Decision control preferences (DCPs) may profoundly affect advance care planning (ACP) and communication. To determine the DCPs of diverse, older adults and whether DCPs are associated with participant characteristics, ACP, and communication satisfaction. A total of 146 participants were recruited from clinics and senior centers in San Francisco. We assessed DCPs using the control preferences scale: doctor makes all decisions (low), shares with doctor (medium), makes own decisions (high). We assessed associations between DCPs and demographics; prior advance directives; ability to make in-the-moment goals of care decisions; self-efficacy, readiness, and prior asked questions; and satisfaction with patient-doctor communication (on a five-point Likert scale), using Chi-square and Kruskal-Wallis analysis of variance. Mean age was 71 ± 10 years, 53% were non-white, 47% completed an advance directive, and 70% made goals of care decisions. Of the sample, 18% had low DCPs, 33% medium, and 49% high. Older age was the only characteristic associated with DCPs (low: 75 ± 11 years, medium: 69 ± 10 years, high: 70 ± 9 years, P = 0.003). DCPs were not associated with ACP, in-the-moment decisions, or communication satisfaction. Readiness was the only question-asking behavior associated (low: 3.8 ± 1.2, medium: 4.1 ± 1.2, high: 4.3 ± 1.2, P = 0.05). Nearly one-fifth of diverse, older adults want doctors to make their medical decisions. Older age and lower readiness to ask questions were the only demographic variables significantly associated with low DCPs. Yet, older adults with low DCPs still engaged in ACP, asked questions, and reported communication satisfaction. Clinicians can encourage ACP and questions for all patients, but should assess DCPs to provide the desired amount of decision support. Copyright © 2016 American Academy of Hospice and Palliative Medicine. All

  14. Disciplined Decision Making in an Interdisciplinary Environment: Some Implications for Clinical Applications of Statistical Process Control.

    Science.gov (United States)

    Hantula, Donald A.

    1995-01-01

    Clinical applications of statistical process control (SPC) in human service organizations are considered. SPC is seen as providing a standard set of criteria that serves as a common interface for data-based decision making, which may bring decision making under the control of established contingencies rather than the immediate contingencies of…

  15. Feedback-Based Admission Control for Firm Real-Time Task Allocation with Dynamic Voltage and Frequency Scaling

    Directory of Open Access Journals (Sweden)

    Piotr Dziurzanski

    2018-04-01

    Full Text Available Feedback-based mechanisms can be employed to monitor the performance of Multiprocessor Systems-on-Chips (MPSoCs and steer the task execution even if the exact knowledge of the workload is unknown a priori. In particular, traditional proportional-integral controllers can be used with firm real-time tasks to either admit them to the processing cores or reject in order not to violate the timeliness of the already admitted tasks. During periods with a lower computational power demand, dynamic voltage and frequency scaling (DVFS can be used to reduce the dissipation of energy in the cores while still not violating the tasks’ time constraints. Depending on the workload pattern and weight, platform size and the granularity of DVFS, energy savings can reach even 60% at the cost of a slight performance degradation.

  16. Assessing the Structure of Non-Routine Decision Processes in Airline Operations Control

    NARCIS (Netherlands)

    Richters, Floor; Schraagen, Johannes Martinus Cornelis; Heerkens, Johannes M.G.

    2015-01-01

    Unfamiliar severe disruptions challenge airline operations control professionals most, as their expertise is stretched to its limits. This study has elicited the structure of airline operations control professionals’ decision process during unfamiliar disruptions by mapping three macrocognitive

  17. Assessing the structure of non-routine decision processes in Airline Operations Control

    NARCIS (Netherlands)

    Richters, F.; Schraagen, J.M.C.; Heerkens, H.

    2015-01-01

    Unfamiliar severe disruptions challenge Airline Operations Control professionals most, as their expertise is stretched to its limits. This study has elicited the structure of Airline Operations Control professionals’ decision process during unfamiliar disruptions by mapping three macrocognitive

  18. Flexible Decision Control in an Autonomous Trading Agent

    NARCIS (Netherlands)

    J. Collins (John); W. Ketter (Wolfgang); M. Gini (Maria)

    2007-01-01

    textabstractAn autonomous trading agent is a complex piece of software that must operate in a competitive economic environment and support a research agenda. We describe the structure of decision processes in the MinneTAC trading agent, focusing on the use of evaluators – configurable, composable

  19. Decision support for dynamic greenhouse climate control strategies

    NARCIS (Netherlands)

    Körner, O.; Straten, van G.

    2008-01-01

    Earlier, different dynamic greenhouse climate regimes were designed with various aims as energy saving, biocide reduction or reduction of chemical growth retardants that are used for quality improvement. The aim of this research was to create a decision support tool in order to decide at which week

  20. Impact of a clinical decision model for febrile children at risk for serious bacterial infections at the emergency department: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Evelien de Vos-Kerkhof

    Full Text Available To assess the impact of a clinical decision model for febrile children at risk for serious bacterial infections (SBI attending the emergency department (ED.Randomized controlled trial with 439 febrile children, aged 1 month-16 years, attending the pediatric ED of a Dutch university hospital during 2010-2012. Febrile children were randomly assigned to the intervention (clinical decision model; n = 219 or the control group (usual care; n = 220. The clinical decision model included clinical symptoms, vital signs, and C-reactive protein and provided high/low-risks for "pneumonia" and "other SBI". Nurses were guided by the intervention to initiate additional tests for high-risk children. The clinical decision model was evaluated by 1 area-under-the-receiver-operating-characteristic-curve (AUC to indicate discriminative ability and 2 feasibility, to measure nurses' compliance to model recommendations. Primary patient outcome was defined as correct SBI diagnoses. Secondary process outcomes were defined as length of stay; diagnostic tests; antibiotic treatment; hospital admission; revisits and medical costs.The decision model had good discriminative ability for both pneumonia (n = 33; AUC 0.83 (95% CI 0.75-0.90 and other SBI (n = 22; AUC 0.81 (95% CI 0.72-0.90. Compliance to model recommendations was high (86%. No differences in correct SBI determination were observed. Application of the clinical decision model resulted in less full-blood-counts (14% vs. 22%, p-value < 0.05 and more urine-dipstick testing (71% vs. 61%, p-value < 0.05.In contrast to our expectations no substantial impact on patient outcome was perceived. The clinical decision model preserved, however, good discriminatory ability to detect SBI, achieved good compliance among nurses and resulted in a more standardized diagnostic approach towards febrile children, with less full blood-counts and more rightfully urine-dipstick testing.Nederlands Trial Register NTR2381.

  1. A model of reward- and effort-based optimal decision making and motor control.

    Directory of Open Access Journals (Sweden)

    Lionel Rigoux

    Full Text Available Costs (e.g. energetic expenditure and benefits (e.g. food are central determinants of behavior. In ecology and economics, they are combined to form a utility function which is maximized to guide choices. This principle is widely used in neuroscience as a normative model of decision and action, but current versions of this model fail to consider how decisions are actually converted into actions (i.e. the formation of trajectories. Here, we describe an approach where decision making and motor control are optimal, iterative processes derived from the maximization of the discounted, weighted difference between expected rewards and foreseeable motor efforts. The model accounts for decision making in cost/benefit situations, and detailed characteristics of control and goal tracking in realistic motor tasks. As a normative construction, the model is relevant to address the neural bases and pathological aspects of decision making and motor control.

  2. An engineering approach to modelling, decision support and control for sustainable systems.

    Science.gov (United States)

    Day, W; Audsley, E; Frost, A R

    2008-02-12

    Engineering research and development contributes to the advance of sustainable agriculture both through innovative methods to manage and control processes, and through quantitative understanding of the operation of practical agricultural systems using decision models. This paper describes how an engineering approach, drawing on mathematical models of systems and processes, contributes new methods that support decision making at all levels from strategy and planning to tactics and real-time control. The ability to describe the system or process by a simple and robust mathematical model is critical, and the outputs range from guidance to policy makers on strategic decisions relating to land use, through intelligent decision support to farmers and on to real-time engineering control of specific processes. Precision in decision making leads to decreased use of inputs, less environmental emissions and enhanced profitability-all essential to sustainable systems.

  3. Causes of Hospital Admissions in Domus

    DEFF Research Database (Denmark)

    Skov Benthien, Kirstine; Nordly, Mie; von Heymann-Horan, Annika

    2018-01-01

    CONTEXT: Avoidable hospital admissions are important negative indicators of quality of end-of-life care. Specialized palliative care (SPC) may support patients remaining at home. OBJECTIVES: Therefore, the purpose of this study was to investigate if SPC at home could prevent hospital admissions...... in patients with incurable cancer. METHODS: These are secondary results of Domus: a randomized controlled trial of accelerated transition to SPC with psychological intervention at home (Clinicaltrials.gov: NCT01885637). Participants were patients with incurable cancer and limited antineoplastic treatment...... significantly in overall potentially avoidable admissions. Both groups felt mostly safe about their place of care. CONCLUSION: The intervention did not prevent hospital admissions. Likely, any intervention effects were outweighed by increased identification of problems in the intervention group leading...

  4. Control of a Braitenberg Lizard in a Phonotaxis Task with Decision Models

    DEFF Research Database (Denmark)

    Shaikh, Danish; Hallam, John; Christensen-Dalsgaard, Jakob

    2009-01-01

    a Braitenberg vehicle–like mobile robot without any decision model in a phonotaxis task. In this paper we extend the Braitenberg vehicle model to include two separate decision models in the control and recreate the phonotaxis task. We compare the performance of the robot, in terms of successful phonotaxis...

  5. High School Students' Career Decision-Making Difficulties According to Locus of Control

    Science.gov (United States)

    Kirdök, Oguzhan; Harman, Esranur

    2018-01-01

    This study intends to elaborate upon difficulties in career decisions of high school students with different locus of control. 9th, 10th, 11th and 12th grade students aged 14-19, 282 (%55.4) females, 227 (%44.6) males totaling 509 participants involved in research located in the south of Turkey. Career Decision-Making Difficulties Questionnaire…

  6. Wide Variability in Emergency Physician Admission Rates: A Target to Reduce Costs Without Compromising Quality

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Guterman

    2016-09-01

    Full Text Available Introduction: Attending physician judgment is the traditional standard of care for emergency department (ED admission decisions. The extent to which variability in admission decisions affect cost and quality is not well understood. We sought to determine the impact of variability in admission decisions on cost and quality. Methods: We performed a retrospective observational study of patients presenting to a university-affiliated, urban ED from October 1, 2007, through September 30, 2008. The main outcome measures were admission rate, fiscal indicators (Medicaid-denied payment days, and quality indicators (15- and 30-day ED returns; delayed hospital admissions. We asked each Attending to estimate their inpatient admission rate and correlated their personal assessment with actual admission rates. Results: Admission rates, even after adjusting for known confounders, were highly variable (15.2%-32.0% and correlated with Medicaid denied-payment day rates (p=0.038. There was no correlation with quality outcome measures (30-day ED return or delayed hospital admission. There was no significant correlation between actual and self-described admission rate; the range of mis-estimation was 0% to 117%. Conclusion: Emergency medicine attending admission rates at this institution are highly variable, unexplained by known confounding variables, and unrelated to quality of care, as measured by 30-day ED return or delayed hospital admission. Admission optimization represents an important untapped potential for cost reduction through avoidable hospitalizations, with no apparent adverse effects on quality.

  7. Investigating Postgraduate College Admission Interviews: Generalizability Theory Reliability and Incremental Predictive Validity

    Science.gov (United States)

    Arce-Ferrer, Alvaro J.; Castillo, Irene Borges

    2007-01-01

    The use of face-to-face interviews is controversial for college admissions decisions in light of the lack of availability of validity and reliability evidence for most college admission processes. This study investigated reliability and incremental predictive validity of a face-to-face postgraduate college admission interview with a sample of…

  8. Modeling College Graduation GPA Considering Equity in Admissions: Evidence from the University of Puerto Rico

    Science.gov (United States)

    Matos-Díaz, Horacio; García, Dwight

    2014-01-01

    Over concerns about private school students' advantages in standardized tests, beginning in 1995-96 the University of Puerto Rico (UPR) implemented a new admissions formula that reduced the weight they previously had in the General Admissions Index (GAI), on which its admissions decisions are based. This study seeks to determine the possible…

  9. Growing old at home – A randomized controlled trial to investigate the effectiveness and cost-effectiveness of preventive home visits to reduce nursing home admissions: study protocol [NCT00644826

    Directory of Open Access Journals (Sweden)

    Riedel-Heller Steffi G

    2008-05-01

    Full Text Available Abstract Background Regarding demographic changes in Germany it can be assumed that the number of elderly and the resulting need for long term care is increasing in the near future. It is not only an individual's interest but also of public concern to avoid a nursing home admission. Current evidence indicates that preventive home visits can be an effective way to reduce the admission rate in this way making it possible for elderly people to stay longer at home than without home visits. As the effectiveness and cost-effectiveness of preventive home visits strongly depends on existing services in the social and health system existing international results cannot be merely transferred to Germany. Therefore it is necessary to investigate the effectiveness and cost-effectiveness of such an intervention in Germany by a randomized controlled trial. Methods The trial is designed as a prospective multi-center randomized controlled trial in the cities of Halle and Leipzig. The trial includes an intervention and a control group. The control group receives usual care. The intervention group receives three additional home visits by non-physician health professionals (1 geriatric assessment, (2 consultation, (3 booster session. The nursing home admission rate after 18 months will be defined as the primary outcome. An absolute risk reduction from a 20% in the control-group to a 7% admission rate in the intervention group including an assumed drop out rate of 30% resulted in a required sample size of N = 320 (n = 160 vs. n = 160. Parallel to the clinical outcome measurement the intervention will be evaluated economically. The economic evaluation will be performed from a society perspective. Discussion To the authors' knowledge for the first time a trial will investigate the effectiveness and cost-effectiveness of preventive home visits for people aged 80 and over in Germany using the design of a randomized controlled trial. Thus, the trial will contribute to

  10. Aid to Families with Dependent Children Quality Control Review Panel Decisions

    Data.gov (United States)

    U.S. Department of Health & Human Services — Decisions issued by the Aid to Families with Dependent Children (AFDC) Quality Control Review Panel of the Departmental Appeals Board concerning the AFDC program...

  11. What is a “good” treatment decision?: Decisional control, knowledge, treatment decision-making, and quality of life in men with clinically localized prostate cancer

    Science.gov (United States)

    Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J.; Homish, D. Lynn

    2016-01-01

    Objective We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision-making is an advantageous model for studying patient treatment decision-making dynamics as there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Methods Men with newly diagnosed clinically localized prostate cancer (N=1529) completed measures of decisional control, prostate cancer knowledge, and their decision-making experience (decisional conflict, and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed 6-months after treatment. Results More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction, but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control predicted better QOL 6-months post-treatment. Conclusion Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. PMID:26957566

  12. Investigating the Decision Heuristics of Candidate Teachers Who Are Different in Their Responsibility Controls

    Science.gov (United States)

    Özen, Yener

    2016-01-01

    In this study, decision heuristics used by individuals with different responsibility controls were investigated. In the research, 370 final grade university students studying at Erzincan University Faculty of Education were included. In order to collect data, Internally Controlled Responsibility-Externally Controlled Responsibility Scale of Özen…

  13. Proceedings of the eighth European annual conference on human decision making and manual control

    International Nuclear Information System (INIS)

    Lind, M.; Hollnagel, E.

    1989-01-01

    The papers contributed at the eighth European annual conference on human decision making and manual control cover the subject areas of vehicle control, robotics, modeling, operator support and cognitive engineering, artificial intelligence and neural network. Some of the papers are relevant to power plant control and in this respect to nuclear safety. (AB)

  14. Admissibility and hyperbolicity

    CERN Document Server

    Barreira, Luís; Valls, Claudia

    2018-01-01

    This book gives a comprehensive overview of the relationship between admissibility and hyperbolicity. Essential theories and selected developments are discussed with highlights to applications. The dedicated readership includes researchers and graduate students specializing in differential equations and dynamical systems (with emphasis on hyperbolicity) who wish to have a broad view of the topic and working knowledge of its techniques. The book may also be used as a basis for appropriate graduate courses on hyperbolicity; the pointers and references given to further research will be particularly useful. The material is divided into three parts: the core of the theory, recent developments, and applications. The first part pragmatically covers the relation between admissibility and hyperbolicity, starting with the simpler case of exponential contractions. It also considers exponential dichotomies, both for discrete and continuous time, and establishes corresponding results building on the arguments for exponent...

  15. Fluid balance and chloride load in the first 24h of ICU admission and its relation with renal replacement therapies through a multicentre, retrospective, case-control study paired by APACHE-II.

    Science.gov (United States)

    González-Castro, A; Ortiz-Lasa, M; Leizaola, O; Salgado, E; Irriguible, T; Sánchez-Satorra, M; Lomas-Fernández, C; Barral-Segade, P; Cordero-Vallejo, M; Rodrigo-Calabia, E; Dierssen-Sotos, T

    2017-05-01

    To analyse the association between water balance during the first 24h of admission to ICU and the variables related to chloride levels (chloride loading, type of fluid administered, hyperchloraemia), with the development of acute kidney injury renal replacement therapy (AKI-RRT) during patients' admission to ICU. Multicentre case-control study. Hospital-based, national, carried out in 6 ICUs. Cases were patients older than 18 years who developed an AKI-RRT. Controls were patients older than 18 years admitted to the same institutions during the study period, who did not develop AKI-RRT during ICU admission. Pairing was done by APACHE-II. An analysis of unconditional logistic regression adjusted for age, sex, APACHE-II and water balance (in evaluating the type of fluid). We analysed the variables of 430 patients: 215 cases and 215 controls. An increase of 10% of the possibility of developing AKI-RRT per 500ml of positive water balance was evident (OR: 1.09 [95% CI: 1.05 to 1.14]; P<.001). The study of mean values of chloride load administered did not show differences between the group of cases and controls (299.35±254.91 vs. 301.67±234.63; P=.92). The water balance in the first 24h of ICU admission relates to the development of IRA-TRR, regardless of chloraemia. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Decision making, cognitive distortions and emotional distress: A comparison between pathological gamblers and healthy controls.

    Science.gov (United States)

    Ciccarelli, Maria; Griffiths, Mark D; Nigro, Giovanna; Cosenza, Marina

    2017-03-01

    The etiology of problem gambling is multifaceted and complex. Among others factors, poor decision making, cognitive distortions (i.e., irrational beliefs about gambling), and emotional factors (e.g., negative mood states) appear to be among the most important factors in the development and maintenance of problem gambling. Although empirical evidence has suggested that cognitive distortions facilitate gambling and negative emotions are associated with gambling, the interplay between cognitive distortions, emotional states, and decision making in gambling remains unexplored. Pathological gamblers (N = 54) and healthy controls (N = 54) completed the South Oaks Gambling Screen (SOGS), the Iowa Gambling Task (IGT), the Gambling Related Cognitions Scale (GRCS), and the Depression Anxiety Stress Scale (DASS-21). Compared to healthy controls, pathological gamblers showed poorer decision making and reported higher scores on measures assessing cognitive distortions and emotional distress. All measures were positively associated with gambling severity. A significant negative correlation between decision making and cognitive distortions was also observed. No associations were found between poor decision making and emotional distress. Logistic regression analysis indicated that cognitive distortions, emotional distress, and poor decision making were significant predictors of problem gambling. The use of self-report measures and the absence of female participants limit the generalizability of the reported findings. The present study is the first to demonstrate the mutual influence between irrational beliefs and poor decision making, as well as the role of cognitive bias, emotional distress, and poor decision making in gambling disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Feasibility of a randomized controlled trial to evaluate the impact of decision boxes on shared decision-making processes.

    Science.gov (United States)

    Giguere, Anik Mc; Labrecque, Michel; Légaré, France; Grad, Roland; Cauchon, Michel; Greenway, Matthew; Haynes, R Brian; Pluye, Pierre; Syed, Iqra; Banerjee, Debi; Carmichael, Pierre-Hugues; Martin, Mélanie

    2015-02-25

    Decision boxes (DBoxes) are two-page evidence summaries to prepare clinicians for shared decision making (SDM). We sought to assess the feasibility of a clustered Randomized Controlled Trial (RCT) to evaluate their impact. A convenience sample of clinicians (nurses, physicians and residents) from six primary healthcare clinics who received eight DBoxes and rated their interest in the topic and satisfaction. After consultations, their patients rated their involvement in decision-making processes (SDM-Q-9 instrument). We measured clinic and clinician recruitment rates, questionnaire completion rates, patient eligibility rates, and estimated the RCT needed sample size. Among the 20 family medicine clinics invited to participate in this study, four agreed to participate, giving an overall recruitment rate of 20%. Of 148 clinicians invited to the study, 93 participated (63%). Clinicians rated an interest in the topics ranging 6.4-8.2 out of 10 (with 10 highest) and a satisfaction with DBoxes of 4 or 5 out of 5 (with 5 highest) for 81% DBoxes. For the future RCT, we estimated that a sample size of 320 patients would allow detecting a 9% mean difference in the SDM-Q-9 ratings between our two arms (0.02 ICC; 0.05 significance level; 80% power). Clinicians' recruitment and questionnaire completion rates support the feasibility of the planned RCT. The level of interest of participants for the DBox topics, and their level of satisfaction with the Dboxes demonstrate the acceptability of the intervention. Processes to recruit clinics and patients should be optimized.

  18. Randomized controlled trial of a video decision support tool for cardiopulmonary resuscitation decision making in advanced cancer.

    Science.gov (United States)

    Volandes, Angelo E; Paasche-Orlow, Michael K; Mitchell, Susan L; El-Jawahri, Areej; Davis, Aretha Delight; Barry, Michael J; Hartshorn, Kevan L; Jackson, Vicki Ann; Gillick, Muriel R; Walker-Corkery, Elizabeth S; Chang, Yuchiao; López, Lenny; Kemeny, Margaret; Bulone, Linda; Mann, Eileen; Misra, Sumi; Peachey, Matt; Abbo, Elmer D; Eichler, April F; Epstein, Andrew S; Noy, Ariela; Levin, Tomer T; Temel, Jennifer S

    2013-01-20

    Decision making regarding cardiopulmonary resuscitation (CPR) is challenging. This study examined the effect of a video decision support tool on CPR preferences among patients with advanced cancer. We performed a randomized controlled trial of 150 patients with advanced cancer from four oncology centers. Participants in the control arm (n = 80) listened to a verbal narrative describing CPR and the likelihood of successful resuscitation. Participants in the intervention arm (n = 70) listened to the identical narrative and viewed a 3-minute video depicting a patient on a ventilator and CPR being performed on a simulated patient. The primary outcome was participants' preference for or against CPR measured immediately after exposure to either modality. Secondary outcomes were participants' knowledge of CPR (score range of 0 to 4, with higher score indicating more knowledge) and comfort with video. The mean age of participants was 62 years (standard deviation, 11 years); 49% were women, 44% were African American or Latino, and 47% had lung or colon cancer. After the verbal narrative, in the control arm, 38 participants (48%) wanted CPR, 41 (51%) wanted no CPR, and one (1%) was uncertain. In contrast, in the intervention arm, 14 participants (20%) wanted CPR, 55 (79%) wanted no CPR, and 1 (1%) was uncertain (unadjusted odds ratio, 3.5; 95% CI, 1.7 to 7.2; P advanced cancer who viewed a video of CPR were less likely to opt for CPR than those who listened to a verbal narrative.

  19. Assessing the structure of non-routine decision processes in Airline Operations Control.

    Science.gov (United States)

    Richters, Floor; Schraagen, Jan Maarten; Heerkens, Hans

    2016-03-01

    Unfamiliar severe disruptions challenge Airline Operations Control professionals most, as their expertise is stretched to its limits. This study has elicited the structure of Airline Operations Control professionals' decision process during unfamiliar disruptions by mapping three macrocognitive activities on the decision ladder: sensemaking, option evaluation and action planning. The relationship between this structure and decision quality was measured. A simulated task was staged, based on which think-aloud protocols were obtained. Results show that the general decision process structure resembles the structure of experts working under routine conditions, in terms of the general structure of the macrocognitive activities, and the rule-based approach used to identify options and actions. Surprisingly, high quality of decision outcomes was found to relate to the use of rule-based strategies. This implies that successful professionals are capable of dealing with unfamiliar problems by reframing them into familiar ones, rather than to engage in knowledge-based processing. Practitioner Summary: We examined the macrocognitive structure of Airline Operations Control professionals' decision process during a simulated unfamiliar disruption in relation to decision quality. Results suggest that successful professionals are capable of dealing with unfamiliar problems by reframing them into familiar ones, rather than to engage in knowledge-based processing.

  20. The role of consciousness in cognitive control and decision making

    NARCIS (Netherlands)

    van Gaal, S.; de Lange, F.P.; Cohen, M.X.

    2012-01-01

    Here we review studies on the complexity and strength of unconscious information processing. We focus on empirical evidence that relates awareness of information to cognitive control processes (e.g., response inhibition, conflict resolution, and task-switching), the life-time of information

  1. Adaptive Automation Based on Air Traffic Controller Decision-Making

    NARCIS (Netherlands)

    IJtsma (Student TU Delft), Martijn; Borst, C.; Mercado Velasco, G.A.; Mulder, M.; van Paassen, M.M.; Tsang, P.S.; Vidulich, M.A.

    2017-01-01

    Through smart scheduling and triggering of automation support, adaptive automation has the potential to balance air traffic controller workload. The challenge in the design of adaptive automation systems is to decide how and when the automation should provide support. This paper describes the design

  2. Reserves reporting for decision-making planning and control

    International Nuclear Information System (INIS)

    Higgins, G.

    1992-01-01

    This paper shows how the established Monte Carlo simulation approach to estimating hydrocarbon reserves can be expanded to provide the basis of a comprehensive valuation, planning and control system meeting all the reserve reporting requirements of an oil exploration and production company. The approach presented is also appropriate for other mining and extractive industries. The paper demonstrates how individual expectation curves can be modified to reflect both technically and commercially recoverable reserves and how these are in turn combined into the economic valuation, planning and control processes of an enterprise. Estimates across the full range of risk and reserves can be aggregated to provide a powerful planning tool that can be used to set corporate, divisional and individual objectives

  3. Automatic and controlled components of judgment and decision making

    OpenAIRE

    Ferreira, MB; Garcia-Marques, L; Sherman, SJ; Sherman, JW

    2006-01-01

    The categorization of inductive reasoning into largely automatic processes (heuristic reasoning) and controlled analytical processes (rule-based reasoning) put forward by dual-process approaches of judgment under uncertainty (e.g., K. E. Stanovich & R. F. West, 2000) has been primarily a matter of assumption with a scarcity of direct empirical findings supporting it. The present authors use the process dissociation procedure (L. L. Jacoby, 1991) to provide convergent evidence validating a d...

  4. Is decision making in hypoxia affected by pre-acclimatisation? A randomized controlled trial.

    Science.gov (United States)

    Niedermeier, Martin; Weisleitner, Andreas; Lamm, Claus; Ledochowski, Larissa; Frühauf, Anika; Wille, Maria; Burtscher, Martin; Kopp, Martin

    2017-05-01

    Decision making is impaired in hypoxic environments, which may have serious or even lethal consequences for mountaineers. An acclimatisation period prior to high altitude exposures may help to overcome adverse effects of hypoxia. Thus, we investigated possible effects of short-term pre-acclimatisation on decision making in hypoxia. In a randomized controlled study design, 52 healthy participants were allocated to a hypoxia group (HG: short-term pre-acclimatisation by the use of intermittent hypoxia 7×1h at F i O 2 =12.6%, equivalent to 4500m) or a control group (CG: sham pre-acclimatisation 7×1h at F i O 2 =20.9%, equivalent to 600m). The number of risky decisions was assessed using the Game of Dice Task at four time points during a 12-hours stay in hypoxia (F i O 2 =12.6%). 42 (HG: 27, CG: 25) participants completed the study. The number of risky decisions was significantly (p=0.048 as determined by 4×2 ANCOVA) reduced in the hypoxia group compared to the control group, partial η 2 =0.11, when the age-effect on decision making was controlled. Self-reported positive affective valence prior to decision making was negatively related to the number of risky decisions, rdecision making in hypoxia in a positive way and might be considered as a risk-reducing preparation method prior to exposures to hypoxic environments. Positive affective states seem to have a medium-sized protective effect against risky decision making. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Automatic and controlled components of judgment and decision making.

    Science.gov (United States)

    Ferreira, Mario B; Garcia-Marques, Leonel; Sherman, Steven J; Sherman, Jeffrey W

    2006-11-01

    The categorization of inductive reasoning into largely automatic processes (heuristic reasoning) and controlled analytical processes (rule-based reasoning) put forward by dual-process approaches of judgment under uncertainty (e.g., K. E. Stanovich & R. F. West, 2000) has been primarily a matter of assumption with a scarcity of direct empirical findings supporting it. The present authors use the process dissociation procedure (L. L. Jacoby, 1991) to provide convergent evidence validating a dual-process perspective to judgment under uncertainty based on the independent contributions of heuristic and rule-based reasoning. Process dissociations based on experimental manipulation of variables were derived from the most relevant theoretical properties typically used to contrast the two forms of reasoning. These include processing goals (Experiment 1), cognitive resources (Experiment 2), priming (Experiment 3), and formal training (Experiment 4); the results consistently support the author's perspective. They conclude that judgment under uncertainty is neither an automatic nor a controlled process but that it reflects both processes, with each making independent contributions.

  6. False confessions, expert testimony, and admissibility.

    Science.gov (United States)

    Watson, Clarence; Weiss, Kenneth J; Pouncey, Claire

    2010-01-01

    The confession of a criminal defendant serves as a prosecutor's most compelling piece of evidence during trial. Courts must preserve a defendant's constitutional right to a fair trial while upholding the judicial interests of presenting competent and reliable evidence to the jury. When a defendant seeks to challenge the validity of that confession through expert testimony, the prosecution often contests the admissibility of the expert's opinion. Depending on the content and methodology of the expert's opinion, testimony addressing the phenomenon of false confessions may or may not be admissible. This article outlines the scientific and epistemological bases of expert testimony on false confession, notes the obstacles facing its admissibility, and provides guidance to the expert in formulating opinions that will reach the judge or jury. We review the 2006 New Jersey Superior Court decision in State of New Jersey v. George King to illustrate what is involved in the admissibility of false-confession testimony and use the case as a starting point in developing a best-practice approach to working in this area.

  7. Development of an Automated Decision-Making Tool for Supervisory Control System

    Energy Technology Data Exchange (ETDEWEB)

    Cetiner, Sacit M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Muhlheim, Michael David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Flanagan, George F. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Fugate, David L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kisner, Roger A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-09-01

    This technical report was generated as a product of the Supervisory Control for Multi-Modular Small Modular Reactor (SMR) Plants project within the Instrumentation, Control and Human-Machine Interface technology area under the Advanced Small Modular Reactor (AdvSMR) Research and Development Program of the US Department of Energy. The report documents the definition of strategies, functional elements, and the structural architecture of a supervisory control system for multi-modular AdvSMR plants. This research activity advances the state of the art by incorporating real-time, probabilistic-based decision-making into the supervisory control system architectural layers through the introduction of a tiered-plant system approach. The report provides background information on the state of the art of automated decision-making, including the description of existing methodologies. It then presents a description of a generalized decision-making framework, upon which the supervisory control decision-making algorithm is based. The probabilistic portion of automated decision-making is demonstrated through a simple hydraulic loop example.

  8. Use of web services for computerized medical decision support, including infection control and antibiotic management, in the intensive care unit.

    Science.gov (United States)

    Steurbaut, Kristof; Van Hoecke, Sofie; Colpaert, Kirsten; Lamont, Kristof; Taveirne, Kristof; Depuydt, Pieter; Benoit, Dominique; Decruyenaere, Johan; De Turck, Filip

    2010-01-01

    The increasing complexity of procedures in the intensive care unit (ICU) requires complex software services, to reduce improper use of antibiotics and inappropriate therapies, and to offer earlier and more accurate detection of infections and antibiotic resistance. We investigated whether web-based software can facilitate the computerization of complex medical processes in the ICU. The COSARA application contains the following modules: Infection overview, Thorax, Microbiology, Antibiotic therapy overview, Admission cause with comorbidity and admission diagnosis, Infection linking and registration, and Feedback. After the implementation and test phase, the COSARA software was installed on a physician's office PC and then on the bedside PCs of the patients. Initial evaluation indicated that the services had been integrated easily into the daily clinical workflow of the medical staff. The use of a service oriented architecture with web service technology for the development of advanced decision support in the ICU offers several advantages over classical software design approaches.

  9. Control Decisions for Flammable Gas Hazards in Double Contained Receiver Tanks (DCRTs)

    Energy Technology Data Exchange (ETDEWEB)

    KRIPPS, L.J.

    2000-06-28

    This report describes the control decisions for flammable gas hazards in double-contained receiver tanks (DCRTs) made at control decision meetings on November 16, 17, and 18, 1999, on April 19,2000, and on May 10,2000, and their basis. These control decisions, and the analyses that support them, will be documented in an amendment to the Final Safety Analysis Report (FSAR) (CHG 2000a) and Technical Safety Requirements (TSR) (CHG 2000b) to close the Flammable Gas Unreviewed Safety Question (USQ) (Bacon 1996 and Wagoner 1996) for DCRTs. Following the contractor Tier I review of the FSAR and TSR amendment, it will be submitted to the U.S. Department of Energy (DOE), Office of River Protection (ORP) for review and approval.

  10. Risky decision-making and affective features of impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Martini, Alice; Ellis, Simon J; Grange, James A; Tamburin, Stefano; Dal Lago, Denise; Vianello, Greta; Edelstyn, Nicola M J

    2018-02-01

    Impulse control disorders (ICDs) in Parkinson's disease (PD) are considered dopaminergic treatment side effects. Cognitive and affective factors may increase the risk of ICD in PD. The aim is to investigate risky decision-making and associated cognitive processes in PD patients with ICDs within a four-stage conceptual framework. Relationship between ICDs and affective factors was explored. Thirteen PD patients with ICD (ICD+), 12 PD patients without ICD (ICD-), and 17 healthy controls were recruited. Overall risky decision-making and negative feedback effect were examined with the Balloon Analogue Risk Task (BART). A cognitive battery dissected decision-making processes according to the four-stage conceptual framework. Affective and motivational factors were measured. ANOVA showed no effect of group on overall risky decision-making. However, there was a group × feedback interaction [F (2, 39) = 3.31, p = 0.047]. ICD+, unlike ICD- and healthy controls, failed to reduce risky behaviour following negative feedback. A main effect of group was found for anxiety and depression [F(2, 38) = 8.31, p = 0.001], with higher symptoms in ICD+ vs. healthy controls. Groups did not differ in cognitive outcomes or affective and motivational metrics. ICD+ may show relatively preserved cognitive function, but reduced sensitivity to negative feedback during risky decision-making and higher symptoms of depression and anxiety.

  11. Modelling risk aversion to support decision-making for controlling zoonotic livestock diseases.

    Science.gov (United States)

    van Asseldonk, M A P M; Bergevoet, R H M; Ge, L

    2013-12-01

    Zoonotic infectious livestock diseases are becoming a significant burden for both animal and human health and are rapidly gaining the attention of decision-makers who manage public health programmes. If control decisions have only monetary components, governments are generally regarded as being risk-neutral and the intervention strategy with the highest expected benefit (lowest expected net costs) should be preferred. However, preferences will differ and alternative intervention plans will prevail if (human) life and death outcomes are involved. A rational decision framework must therefore consider risk aversion in the decision-maker and controversial values related to public health. In the present study, risk aversion and its impact on both the utility for the monetary component and the utility for the non-monetary component is shown to be an important element when dealing with emerging zoonotic infectious livestock diseases and should not be ignored in the understanding and support of decision-making. The decision framework was applied to several control strategies for the reduction of human cases of brucellosis (Brucella melitensis) originating from sheep in Turkey.

  12. Effect of reclassification of cannabis on hospital admissions for cannabis psychosis: a time series analysis.

    Science.gov (United States)

    Hamilton, Ian; Lloyd, Charlie; Hewitt, Catherine; Godfrey, Christine

    2014-01-01

    The UK Misuse of Drugs Act (1971) divided controlled drugs into three groups A, B and C, with descending criminal sanctions attached to each class. Cannabis was originally assigned by the Act to Group B but in 2004, it was transferred to the lowest risk group, Group C. Then in 2009, on the basis of increasing concerns about a link between high strength cannabis and schizophrenia, it was moved back to Group B. The aim of this study is to test the assumption that changes in classification lead to changes in levels of psychosis. In particular, it explores whether the two changes in 2004 and 2009 were associated with changes in the numbers of people admitted for cannabis psychosis. An interrupted time series was used to investigate the relationship between the two changes in cannabis classification and their impact on hospital admissions for cannabis psychosis. Reflecting the two policy changes, two interruptions to the time series were made. Hospital Episode Statistics admissions data was analysed covering the period 1999 through to 2010. There was a significantly increasing trend in cannabis psychosis admissions from 1999 to 2004. However, following the reclassification of cannabis from B to C in 2004, there was a significant change in the trend such that cannabis psychosis admissions declined to 2009. Following the second reclassification of cannabis back to class B in 2009, there was a significant change to increasing admissions. This study shows a statistical association between the reclassification of cannabis and hospital admissions for cannabis psychosis in the opposite direction to that predicted by the presumed relationship between the two. However, the reasons for this statistical association are unclear. It is unlikely to be due to changes in cannabis use over this period. Other possible explanations include changes in policing and systemic changes in mental health services unrelated to classification decisions. Copyright © 2013 Elsevier B.V. All rights

  13. Cost account in agriculture with particular accordance to requirements of decision making process and controls

    Directory of Open Access Journals (Sweden)

    Tomasz Kondraszuk

    2009-01-01

    Full Text Available The article presents cost account applicability in the agricultural companies regarding the general theory of economic and organisation of enterprises. The main focus was laid down to analyse the unit total cost account with variable costs and their applicability in three spheres: stock valuation and profit, requirements of planning and decision making processes and controlling. It was concluded that cost calculation at the level of agricultural enterprise should be an inherent element of integrated information system at the level of registry, planning, decision making and control.

  14. Enhanced situation awareness and decision making for an intelligent reconfigurable reactor power controller

    International Nuclear Information System (INIS)

    Kenney, S.J.; Edwards, R.M.

    1996-01-01

    A Learning Automata based intelligent reconfigurable controller has been adapted for use as a reactor power controller to achieve improved reactor temperature performance. The intelligent reconfigurable controller is capable of enforcing either a classical or an optimal reactor power controller based on control performance feedback. Four control performance evaluation measures: dynamically estimated average quadratic temperature error, power, rod reactivity and rod reactivity rate were developed to provide feedback to the control decision component of the intelligent reconfigurable controller. Fuzzy Logic and Neural Network controllers have been studied for inclusion in the bank of controllers that form the intermediate level of an enhanced intelligent reconfigurable reactor power controller (IRRPC). The increased number of alternatives available to the supervisory level of the IRRPC requires enhanced situation awareness. Additional performance measures have been designed and a method for synthesizing them into a single indication of the overall performance of the currently enforced reactor power controller has been conceptualized. Modification of the reward/penalty scheme implemented in the existing IRRPC to increase the quality of the supervisory level decision process has been studied. The logogen model of human memory (Morton, 1969) and individual controller design information could be used to allocate reward to the most appropriate controller. Methods for allocating supervisory level attention were also studied with the goal of maximizing learning rate

  15. Risk Stratification and Shared Decision Making for Colorectal Cancer Screening: A Randomized Controlled Trial.

    Science.gov (United States)

    Schroy, Paul C; Duhovic, Emir; Chen, Clara A; Heeren, Timothy C; Lopez, William; Apodaca, Danielle L; Wong, John B

    2016-05-01

    Eliciting patient preferences within the context of shared decision making has been advocated for colorectal cancer (CRC) screening, yet providers often fail to comply with patient preferences that differ from their own. To determine whether risk stratification for advanced colorectal neoplasia (ACN) influences provider willingness to comply with patient preferences when selecting a desired CRC screening option. Randomized controlled trial. Asymptomatic, average-risk patients due for CRC screening in an urban safety net health care setting. Patients were randomized 1:1 to a decision aid alone (n= 168) or decision aid plus risk assessment (n= 173) arm between September 2012 and September 2014. The primary outcome was concordance between patient preference and test ordered; secondary outcomes included patient satisfaction with the decision-making process, screening intentions, test completion rates, and provider satisfaction. Although providers perceived risk stratification to be useful in selecting an appropriate screening test for their average-risk patients, no significant differences in concordance were observed between the decision aid alone and decision aid plus risk assessment groups (88.1% v. 85.0%,P= 0.40) or high- and low-risk groups (84.5% v. 87.1%,P= 0.51). Concordance was highest for colonoscopy and relatively low for tests other than colonoscopy, regardless of study arm or risk group. Failure to comply with patient preferences was negatively associated with satisfaction with the decision-making process, screening intentions, and test completion rates. Single-institution setting; lack of provider education about the utility of risk stratification into their decision making. Providers perceived risk stratification to be useful in their decision making but often failed to comply with patient preferences for tests other than colonoscopy, even among those deemed to be at low risk of ACN. © The Author(s) 2016.

  16. Nonflexible Lie-admissible algebras

    International Nuclear Information System (INIS)

    Myung, H.C.

    1978-01-01

    We discuss the structure of Lie-admissible algebras which are defined by nonflexible identities. These algebras largely arise from the antiflexible algebras, 2-varieties and associator dependent algebras. The nonflexible Lie-admissible algebras in our discussion are in essence byproducts of the study of nonassociative algebras defined by identities of degree 3. The main purpose is to discuss the classification of simple Lie-admissible algebras of nonflexible type

  17. Robust Economic Control Decision Method of Uncertain System on Urban Domestic Water Supply.

    Science.gov (United States)

    Li, Kebai; Ma, Tianyi; Wei, Guo

    2018-03-31

    As China quickly urbanizes, urban domestic water generally presents the circumstances of both rising tendency and seasonal cycle fluctuation. A robust economic control decision method for dynamic uncertain systems is proposed in this paper. It is developed based on the internal model principle and pole allocation method, and it is applied to an urban domestic water supply system with rising tendency and seasonal cycle fluctuation. To achieve this goal, first a multiplicative model is used to describe the urban domestic water demand. Then, a capital stock and a labor stock are selected as the state vector, and the investment and labor are designed as the control vector. Next, the compensator subsystem is devised in light of the internal model principle. Finally, by using the state feedback control strategy and pole allocation method, the multivariable robust economic control decision method is implemented. The implementation with this model can accomplish the urban domestic water supply control goal, with the robustness for the variation of parameters. The methodology presented in this study may be applied to the water management system in other parts of the world, provided all data used in this study are available. The robust control decision method in this paper is also applicable to deal with tracking control problems as well as stabilization control problems of other general dynamic uncertain systems.

  18. Insular neural system controls decision-making in healthy and methamphetamine-treated rats.

    Science.gov (United States)

    Mizoguchi, Hiroyuki; Katahira, Kentaro; Inutsuka, Ayumu; Fukumoto, Kazuya; Nakamura, Akihiro; Wang, Tian; Nagai, Taku; Sato, Jun; Sawada, Makoto; Ohira, Hideki; Yamanaka, Akihiro; Yamada, Kiyofumi

    2015-07-21

    Patients suffering from neuropsychiatric disorders such as substance-related and addictive disorders exhibit altered decision-making patterns, which may be associated with their behavioral abnormalities. However, the neuronal mechanisms underlying such impairments are largely unknown. Using a gambling test, we demonstrated that methamphetamine (METH)-treated rats chose a high-risk/high-reward option more frequently and assigned higher value to high returns than control rats, suggestive of changes in decision-making choice strategy. Immunohistochemical analysis following the gambling test revealed aberrant activation of the insular cortex (INS) and nucleus accumbens in METH-treated animals. Pharmacological studies, together with in vivo microdialysis, showed that the insular neural system played a crucial role in decision-making. Moreover, manipulation of INS activation using designer receptor exclusively activated by designer drug technology resulted in alterations to decision-making. Our findings suggest that the INS is a critical region involved in decision-making and that insular neural dysfunction results in risk-taking behaviors associated with altered decision-making.

  19. Decision making in pathological gambling: A comparison between pathological gamblers, alcohol dependents, persons with Tourette syndrome, and normal controls

    NARCIS (Netherlands)

    Goudriaan, Anna E.; Oosterlaan, Jaap; de Beurs, Edwin; van den Brink, Wim

    2005-01-01

    Decision making deficits play an important role in the definition of pathological gambling (PG). However, only few empirical studies are available regarding decision making processes in PG. This study therefore compares decision making processes in PG and normal controls in detail using three

  20. Towards a decision support system for control of multiple food safety hazards in raw milk production

    NARCIS (Netherlands)

    Spiegel, van der M.; Sterrenburg, P.; Haasnoot, W.; Fels-Klerx, van der H.J.

    2013-01-01

    Decision support systems (DSS) for controlling multiple food safety hazards in raw milk production have not yet been developed, but the underlying components are fragmentarily available. This article presents the state-of-the-art of essential DSS elements for judging food safety compliance of raw

  1. Future command and control systems should combine decision support and personalization interface features

    NARCIS (Netherlands)

    Streefkerk, J.W.; Smets, N.; Varkevisser, M.; Hiemstra-Van Mastrigt, S.

    2014-01-01

    On future battlefields, increasingly more sensor information will become available for military commanders to support mission execution. To improve (shared) situational awareness, decision-making and communication in face of this increased amount of information, the design of command and control

  2. Atomos IV : enabling integrated decision support in the supervisory control of ships

    NARCIS (Netherlands)

    Breda, L. van; Veen, H.A.H.C. van

    2005-01-01

    TNO participated during eight years in a European Consortium ATOMOS IV (Advanced Technology ro Optimise Marine Operational Safety - Intelligent Vessels), performing research in the human-centred development of decision support systems for ship control centers. New concepts were developed and tested,

  3. Measuring the Extent of European State Aid Control : An Econometric Analysis of the European Commission Decisions

    NARCIS (Netherlands)

    Brouwer, E.; Ozbugday, F.C.

    2011-01-01

    This paper provides an analysis of the European Commission (EC) decisions on state aid control using data on 550 state aid cases approved by the EC between 1998 and 2009. More specifically, we measure the determinants of the duration of state aid, total budget of state aid and daily budget of state

  4. Measuring the Extent of European State Aid Control : An Econometric Analysis of the European Commission Decisions

    NARCIS (Netherlands)

    Brouwer, E.; Ozbugday, F.C.

    2010-01-01

    This paper provides an analysis of the European Commission (EC) decisions on state aid control using data on 550 state aid cases approved by the EC between 1998 and 2009. More specifically, we measure the determinants of the duration of state aid, total budget of state aid and daily budget of state

  5. Improving Decision Making for Feeding Options in Advanced Dementia: A Randomized, Controlled Trial

    Science.gov (United States)

    Hanson, Laura C.; Carey, Timothy S.; Caprio, Anthony J.; Lee, Tae Joon; Ersek, Mary; Garrett, Joanne; Jackman, Anne; Gilliam, Robin; Wessell, Kathryn; Mitchell, Susan L.

    2011-01-01

    Background Feeding problems are common in dementia, and decision-makers have limited understanding of treatment options. Objectives To test whether a decision aid improves quality of decision-making about feeding options in advanced dementia. Design Cluster randomized controlled trial. Setting 24 nursing homes in North Carolina Participants Residents with advanced dementia and feeding problems and their surrogates. Intervention Intervention surrogates received an audio or print decision aid on feeding options in advanced dementia. Controls received usual care. Measurements Primary outcome was the Decisional Conflict Scale (range 1–5) measured at 3 months; other main outcomes were surrogate knowledge, frequency of communication with providers, and feeding treatment use. Results 256 residents and surrogate decision-makers were recruited. Residents’ average age was 85; 67% were Caucasian and 79% were women. Surrogates’ average age was 59; 67% were Caucasian, and 70% were residents’ children. The intervention improved knowledge scores (16.8 vs 15.1, paid about feeding options in advanced dementia reduced decisional conflict for surrogates and increased their knowledge and communication about feeding options with providers. PMID:22091750

  6. Formal Process Modeling to Improve Human Decision-Making in Test and Evaluation Acoustic Range Control

    Science.gov (United States)

    2017-09-01

    MODELING TO IMPROVE HUMAN DECISION-MAKING DURING TEST AND EVALUATION RANGE CONTROL by William Carlson September 2017 Thesis Advisor...the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT...MAKING DURING TEST AND EVALUATION RANGE CONTROL 5. FUNDING NUMBERS 6. AUTHOR(S) William Carlson 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES

  7. Labour Court Karlsruhe, decision of October 15, 1985 (co-determination in matters of security control)

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    In its decision of October 15, 1985, the Labour Court of Karlsruhe deals with the order for security controls in nuclear research centres. The co-determination of the works council in this field is excluded, if the operator is obliged by the licensing authority to carry out these controls pursuant to the operating licence according to sec. 7 and sec. 17 of the Atomic Energy Act. (WG) [de

  8. Promoting Inclusive Holistic Graduate Admissions in Educational Leadership Preparation Programs

    Directory of Open Access Journals (Sweden)

    Christa Boske

    2018-04-01

    Full Text Available Aspiring and practicing school leaders often identify graduate degrees as playing a significant role in achieving educational access and engaging in building, district-wide, regional, state, and national decision-making regarding practice and policy impacting marginalized populations in K–12 U.S. schools. The rationale behind initiating discourse on graduate student involvement grows out of current policy and reform initiatives requiring increased accountability for improved student performance, especially for children from predetermined “subgroups” due to race, class, native language, and ability (i.e., emotional, social, cognitive, and physical. The call for more deliberate involvement in understanding graduate admissions also arises in regard to student attrition and retention concerns. Faculty often play an under-examined role as gatekeepers throughout the admissions process. The way in which they understand graduate requirements, holistic evaluation, and merit affords opportunities to positively address significant implications for racial equity and diversity in graduate education. To understand faculty reliance upon graduate admissions criteria that undermine espoused university strategic plans, college-level diversity goals, and programmatic decision-making, four professors across the U.S. explore graduate admissions processes and the significance of implementing holistic admissions criteria. We present a holistic graduate admissions conceptual model for school leadership preparation programs to consider when increasing equity and access for minoritized candidates.

  9. SITUATIONAL CONTROL OF HOT BLAST STOVES GROUP BASED ON DECISION TREE

    Directory of Open Access Journals (Sweden)

    E. I. Kobysh

    2016-09-01

    Full Text Available In this paper was developed the control system of group of hot blast stoves, which operates on the basis of the packing heating control subsystem and subsystem of forecasting of modes duration in the hot blast stoves APCS of iron smelting in a blast furnace. With the use of multi-criteria optimization methods, implemented the adjustment of control system conduct, which takes into account the current production situation that has arisen in the course of the heating packing of each hot blast stove group. Developed a situation recognition algorithm and the choice of scenarios of control based on a decision tree.

  10. Theoretical Aspects of Erroneous Actions During the Process of Decision Making by Air Traffic Control

    Directory of Open Access Journals (Sweden)

    Andersone Silva

    2017-08-01

    Full Text Available The Theoretical Aspects of Erroneous Actions During the Process of Decision Making by Air Traffic Control evaluates the factors affecting the operational decision-making of a human air traffic controller, interacting in a dynamic environment with the flight crew, surrounding aircraft traffic and environmental conditions of the airspace. This article reviews the challenges of air traffic control in different conditions, ranging from normal and complex to emergency and catastrophic. Workload factors and operating conditions make an impact on air traffic controllers’ decision-making. The proposed model compares various operating conditions within an assumed air traffic control environment subsequently comparing them against a theoretically “perfect” air traffic control system. A mathematical model of flight safety assessment has been proposed for the quantitative assessment of various hazards arising during the process of Air Traffic Control. The model assumes events of various severity and probability ranging from high frequency and low severity up to less likely and catastrophic ones. Certain limitations of the model have been recognised and further improvements for effective hazard evaluation have been suggested.

  11. Optimal admission to higher education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    2016-01-01

    that documents the relevance of theory and illustrates how to apply optimal admission procedures. Indirect gains from optimal admission procedures include the potential for increasing entire cohorts of students' probability of graduating with a higher education degree, thereby increasing the skill level...

  12. A decision support tool for identifying abuse of controlled substances by ForwardHealth Medicaid members.

    Science.gov (United States)

    Mailloux, Allan T; Cummings, Stephen W; Mugdh, Mrinal

    2010-01-01

    Our objective was to use Wisconsin's Medicaid Evaluation and Decision Support (MEDS) data warehouse to develop and validate a decision support tool (DST) that (1) identifies Wisconsin Medicaid fee-for-service recipients who are abusing controlled substances, (2) effectively replicates clinical pharmacist recommendations for interventions intended to curb abuse of physician and pharmacy services, and (3) automates data extraction, profile generation and tracking of recommendations and interventions. From pharmacist manual reviews of medication profiles, seven measures of overutilization of controlled substances were developed, including (1-2) 6-month and 2-month "shopping" scores, (3-4) 6-month and 2-month forgery scores, (5) duplicate/same day prescriptions, (6) count of controlled substance claims, and the (7) shopping 6-month score for the individual therapeutic class with the highest score. The pattern analysis logic for the measures was encoded into SQL and applied to the medication profiles of 190 recipients who had already undergone manual review. The scores for each measure and numbers of providers were analyzed by exhaustive chi-squared automatic interaction detection (CHAID) to determine significant thresholds and combinations of predictors of pharmacist recommendations, resulting in a decision tree to classify recipients by pharmacist recommendations. The overall correct classification rate of the decision tree was 95.3%, with a 2.4% false positive rate and 4.0% false negative rate for lock-in versus prescriber-alert letter recommendations. Measures used by the decision tree include the 2-month and 6-month shopping scores, and the number of pharmacies and prescribers. The number of pharmacies was the best predictor of abuse of controlled substances. When a Medicaid recipient receives prescriptions for controlled substances at 8 or more pharmacies, the likelihood of a lock-in recommendation is 90%. The availability of the Wisconsin MEDS data warehouse has

  13. The Effect of Dexamethasone on Symptoms of Posttraumatic Stress Disorder and Depression After Cardiac Surgery and Intensive Care Admission: Longitudinal Follow-Up of a Randomized Controlled Trial.

    Science.gov (United States)

    Kok, Lotte; Hillegers, Manon H; Veldhuijzen, Dieuwke S; Cornelisse, Sandra; Nierich, Arno P; van der Maaten, Joost M; Rosseel, Peter M; Hofland, Jan; Sep, Milou S; Dieleman, Jan M; Vinkers, Christiaan H; Peelen, Linda M; Joëls, Marian; van Dijk, Diederik

    2016-03-01

    Cardiac surgery and postoperative admission to the ICU may lead to posttraumatic stress disorder and depression. Perioperatively administered corticosteroids potentially alter the risk of development of these psychiatric conditions, by affecting the hypothalamic-pituitary-adrenal axis. However, findings of previous studies are inconsistent. We aimed to assess the effect of a single dose of dexamethasone compared with placebo on symptoms of posttraumatic stress disorder and depression and health-related quality of life after cardiac surgery and ICU admission. Follow-up study of a randomized clinical trial. Five Dutch heart centers. Cardiac surgery patients (n = 1,244) who participated in the Dexamethasone for Cardiac Surgery trial. A single intraoperative IV dose of dexamethasone or placebo was administered in a randomized, double-blind way. Symptoms of posttraumatic stress disorder, depression, and health-related quality of life were assessed with validated questionnaires 1.5 years after randomization. Data were available for 1,125 patients (90.4%); of which 561 patients received dexamethasone and 564 patients received placebo. Overall, the prevalence of psychopathology was not influenced by dexamethasone. Posttraumatic stress disorder and depression were present in, respectively, 52 patients (9.3%) and 69 patients (12.3%) who received dexamethasone and in 66 patients (11.7%) and 78 patients (13.8%) who received placebo (posttraumatic stress disorder: odds ratio, 0.82; 95% CI, 0.55-1.20; p = 0.30; depression: odds ratio, 0.92; 95% CI, 0.64-1.31; p = 0.63). Subgroup analysis revealed a lower prevalence of posttraumatic stress disorder (odds ratio, 0.23; 95% CI, 0.07-0.72; p stress disorder and depression. However, in female patients, beneficial effects on the occurrence of posttraumatic stress disorder and depression may be present.

  14. Decisions on control of foot-and-mouth disease informed using model predictions

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq; Willeberg, P.; Christiansen, Lasse Engbo

    2013-01-01

    , epidemic duration, geographical size and costs. The first 14 days spatial spread (FFS) was also included to further support the prediction. The epidemic data was obtained from a Danish version (DTU-DADS) of a pre-existing FMD simulation model (Davis Animal Disease Spread – DADS) adapted to model the spread......The decision on whether or not to change the control strategy, such as introducing emergency vaccination, is perhaps one of the most difficult decisions faced by the veterinary authorities during a foot-and-mouth disease (FMD) epidemic. A simple tool that may predict the epidemic outcome...... and consequences would be useful to assist the veterinary authorities in the decision-making process. A previously proposed simple quantitative tool based on the first 14 days outbreaks (FFO) of FMD was used with results from an FMD simulation exercise. Epidemic outcomes included the number of affected herds...

  15. Decision Support in Supervisory Control of High-Risk Industrial Systems

    DEFF Research Database (Denmark)

    Rasmussen, Jens; Goodstein, L. P.

    1987-01-01

    available to the operators their conceptual models and their processing resources so as to allow the operators to function as their extended arm in coping with the plant. Such as interactive decision-making activity would thus benefit from this simultaneous availability of the design basis, up......It is argued that the supervisory control of complex industrial processes having a potential for serious consequences in case of accidents requires careful consideration of the allocation of decision making between the three main agents of control; namely the designer, the operator...... and the automatic control system. In particular, it is advocated that, instead of continuing their efforts to make their preplanning of responses and countermeasures more and more complete and thus restrict the operators' own initiative, designers should take advantage of modern information technology to make...

  16. Deviant Peer Behavior and Adolescent Delinquency: Protective Effects of Inhibitory Control, Planning, or Decision Making?

    Science.gov (United States)

    Hinnant, J Benjamin; Forman-Alberti, Alissa B

    2018-05-09

    We examined relations between adolescent perceptions of deviant peer behavior and delinquency as moderated by inhibitory control, planning, and decision making in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development at age 15 (N = 991). Adolescents reported perceptions of deviant peer behavior. Inhibitory control, planning, and decision making were assessed behaviorally. Delinquency was evaluated with a latent variable comprised of parent-guardian perceptions of adolescent delinquency and adolescent self-reports. Only inhibitory control moderated the relationship between deviant peer behavior and delinquency, showing that better inhibition protected against delinquency in contexts of high levels of adolescent perceptions of deviant peer behavior. Findings are discussed in the context of theories of adolescent delinquency and risk taking. © 2018 Society for Research on Adolescence.

  17. Observability and Decision Support for Supervision of Distributed Power System Control

    DEFF Research Database (Denmark)

    Pertl, Michael

    in NorthernCalifornia. Two possible applications of the model are presented: peak reduction compared to uncontrolled charging, and an energy arbitrage scenario. Overall, it is shown that a combination of classical and innovative approaches can contribute to improved situation awareness of control room...... operational information, relevant to the current grid condition, need to be developed. This dissertation covers three areas where specific challenges for improved observability and decision support in future control rooms are addressed: Classical large power system stability issues, innovative data......-network-based approach for real-time voltage estimation in active distribution grids, and a modeling approach to harness the flexibility of an aggregation of electric vehicles. For improved monitoring and maintaining power system stability, a decision support tool for transient stability preventive control, based...

  18. Pilot/Controller Coordinated Decision Making in the Next Generation Air Transportation System

    Science.gov (United States)

    Bearman, Chris; Miller, Ronald c.; Orasanu, Judith M.

    2011-01-01

    Introduction: NextGen technologies promise to provide considerable benefits in terms of enhancing operations and improving safety. However, there needs to be a thorough human factors evaluation of the way these systems will change the way in which pilot and controllers share information. The likely impact of these new technologies on pilot/controller coordinated decision making is considered in this paper using the "operational, informational and evaluative disconnect" framework. Method: Five participant focus groups were held. Participants were four experts in human factors, between x and x research students and a technical expert. The participant focus group evaluated five key NextGen technologies to identify issues that made different disconnects more or less likely. Results: Issues that were identified were: Decision Making will not necessarily improve because pilots and controllers possess the same information; Having a common information source does not mean pilots and controllers are looking at the same information; High levels of automation may lead to disconnects between the technology and pilots/controllers; Common information sources may become the definitive source for information; Overconfidence in the automation may lead to situations where appropriate breakdowns are not initiated. Discussion: The issues that were identified lead to recommendations that need to be considered in the development of NextGen technologies. The current state of development of these technologies provides a good opportunity to utilize recommendations at an early stage so that NextGen technologies do not lead to difficulties in resolving breakdowns in coordinated decision making.

  19. Effects of Information Availability on Command-and-Control Decision Making: Performance, Trust, and Situation Awareness.

    Science.gov (United States)

    Marusich, Laura R; Bakdash, Jonathan Z; Onal, Emrah; Yu, Michael S; Schaffer, James; O'Donovan, John; Höllerer, Tobias; Buchler, Norbou; Gonzalez, Cleotilde

    2016-03-01

    We investigated how increases in task-relevant information affect human decision-making performance, situation awareness (SA), and trust in a simulated command-and-control (C2) environment. Increased information is often associated with an improvement of SA and decision-making performance in networked organizations. However, previous research suggests that increasing information without considering the task relevance and the presentation can impair performance. We used a simulated C2 task across two experiments. Experiment 1 varied the information volume provided to individual participants and measured the speed and accuracy of decision making for task performance. Experiment 2 varied information volume and information reliability provided to two participants acting in different roles and assessed decision-making performance, SA, and trust between the paired participants. In both experiments, increased task-relevant information volume did not improve task performance. In Experiment 2, increased task-relevant information volume reduced self-reported SA and trust, and incorrect source reliability information led to poorer task performance and SA. These results indicate that increasing the volume of information, even when it is accurate and task relevant, is not necessarily beneficial to decision-making performance. Moreover, it may even be detrimental to SA and trust among team members. Given the high volume of available and shared information and the safety-critical and time-sensitive nature of many decisions, these results have implications for training and system design in C2 domains. To avoid decrements to SA, interpersonal trust, and decision-making performance, information presentation within C2 systems must reflect human cognitive processing limits and capabilities. © 2016, Human Factors and Ergonomics Society.

  20. Use of a decision aid for prenatal testing of fetal abnormalities to improve women's informed decision making: a cluster randomised controlled trial [ISRCTN22532458].

    Science.gov (United States)

    Nagle, C; Gunn, J; Bell, R; Lewis, S; Meiser, B; Metcalfe, S; Ukoumunne, O C; Halliday, J

    2008-02-01

    To evaluate the effectiveness of a decision aid for prenatal testing of fetal abnormalities compared with a pamphlet in supporting women's decision making. A cluster randomised controlled trial. Primary health care. Women in early pregnancy consulting a GP. GPs were randomised to provide women with either a decision aid or a pamphlet. The decision aid was a 24-page booklet designed using the Ottowa Decision Framework. The pamphlet was an existing resource available in the trial setting. Validated scales were used to measure the primary outcomes, informed choice and decisional conflict, and the secondary outcomes, anxiety, depression, attitudes to the pregnancy/fetus and acceptability of the resource. Outcomes were measured at 14 weeks of gestation from questionnaires that women completed and returned by post. Women in the intervention group were more likely to make an informed decision 76% (126/165) than those in the control group 65% (107/165) (adjusted OR 2.08; 95% CI 1.14-3.81). A greater proportion of women in the intervention group 88% (147/167) had a 'good' level of knowledge than those in the control group 72% (123/171) (adjusted OR 3.43; 95% CI 1.79-6.58). Mean (SD) decisional conflict scores were low in both groups, decision aid 1.71 (0.49), pamphlet 1.65 (0.55) (adjusted mean difference 0.10; 95% CI -0.02 to 0.22). There was no strong evidence of differences between the trial arms in the measures of psychological or acceptability outcomes. A tailored prenatal testing decision aid plays an important role in improving women's knowledge of first and second trimester screening tests and assisting them to make decisions about screening and diagnostic tests that are consistent with their values.

  1. Control and decision strategies in wastewater treatment plants for operation improvement

    CERN Document Server

    Santín, Ignacio; Vilanova, Ramón

    2017-01-01

    This book examines the operation of biological wastewater treatment plants (WWTPs), with a focus on maintaining effluent water quality while keeping operational costs within constrained limits. It includes control operation and decision schemes and is based on the use of benchmarking scenarios that yield easily reproducible results that readers can implement for their own solutions. The final criterion is the effect of the applied control strategy on plant performance – specifically, improving effluent quality, reducing costs and avoiding violations of established effluent limits. The evaluation of the different control strategies is achieved with the help of two Benchmark Simulation Models (BSM1, BSM2). Given the complexity of the biological and biochemical processes involved and the major fluctuations in the influent flow rate, controlling WWTPs poses a serious challenge. Further, the importance of control goal formulation and control structure design in relation to WWTP process control is widely recogniz...

  2. Availability Control for Means of Transport in Decisive Semi-Markov Models of Exploitation Process

    Science.gov (United States)

    Migawa, Klaudiusz

    2012-12-01

    The issues presented in this research paper refer to problems connected with the control process for exploitation implemented in the complex systems of exploitation for technical objects. The article presents the description of the method concerning the control availability for technical objects (means of transport) on the basis of the mathematical model of the exploitation process with the implementation of the decisive processes by semi-Markov. The presented method means focused on the preparing the decisive for the exploitation process for technical objects (semi-Markov model) and after that specifying the best control strategy (optimal strategy) from among possible decisive variants in accordance with the approved criterion (criteria) of the activity evaluation of the system of exploitation for technical objects. In the presented method specifying the optimal strategy for control availability in the technical objects means a choice of a sequence of control decisions made in individual states of modelled exploitation process for which the function being a criterion of evaluation reaches the extreme value. In order to choose the optimal control strategy the implementation of the genetic algorithm was chosen. The opinions were presented on the example of the exploitation process of the means of transport implemented in the real system of the bus municipal transport. The model of the exploitation process for the means of transports was prepared on the basis of the results implemented in the real transport system. The mathematical model of the exploitation process was built taking into consideration the fact that the model of the process constitutes the homogenous semi-Markov process.

  3. A genetically mediated bias in decision making driven by failure of amygdala control.

    Science.gov (United States)

    Roiser, Jonathan P; de Martino, Benedetto; Tan, Geoffrey C Y; Kumaran, Dharshan; Seymour, Ben; Wood, Nicholas W; Dolan, Raymond J

    2009-05-06

    Genetic variation at the serotonin transporter-linked polymorphic region (5-HTTLPR) is associated with altered amygdala reactivity and lack of prefrontal regulatory control. Similar regions mediate decision-making biases driven by contextual cues and ambiguity, for example the "framing effect." We hypothesized that individuals hemozygous for the short (s) allele at the 5-HTTLPR would be more susceptible to framing. Participants, selected as homozygous for either the long (la) or s allele, performed a decision-making task where they made choices between receiving an amount of money for certain and taking a gamble. A strong bias was evident toward choosing the certain option when the option was phrased in terms of gains and toward gambling when the decision was phrased in terms of losses (the frame effect). Critically, this bias was significantly greater in the ss group compared with the lala group. In simultaneously acquired functional magnetic resonance imaging data, the ss group showed greater amygdala during choices made in accord, compared with those made counter to the frame, an effect not seen in the lala group. These differences were also mirrored by differences in anterior cingulate-amygdala coupling between the genotype groups during decision making. Specifically, lala participants showed increased coupling during choices made counter to, relative to those made in accord with, the frame, with no such effect evident in ss participants. These data suggest that genetically mediated differences in prefrontal-amygdala interactions underpin interindividual differences in economic decision making.

  4. Reducing the rate and duration of Re-ADMISsions among patients with unipolar disorder and bipolar disorder using smartphone-based monitoring and treatment - the RADMIS trials: study protocol for two randomized controlled trials.

    Science.gov (United States)

    Faurholt-Jepsen, Maria; Frost, Mads; Martiny, Klaus; Tuxen, Nanna; Rosenberg, Nicole; Busk, Jonas; Winther, Ole; Bardram, Jakob Eyvind; Kessing, Lars Vedel

    2017-06-15

    Unipolar and bipolar disorder combined account for nearly half of all morbidity and mortality due to mental and substance use disorders, and burden society with the highest health care costs of all psychiatric and neurological disorders. Among these, costs due to psychiatric hospitalization are a major burden. Smartphones comprise an innovative and unique platform for the monitoring and treatment of depression and mania. No prior trial has investigated whether the use of a smartphone-based system can prevent re-admission among patients discharged from hospital. The present RADMIS trials aim to investigate whether using a smartphone-based monitoring and treatment system, including an integrated clinical feedback loop, reduces the rate and duration of re-admissions more than standard treatment in unipolar disorder and bipolar disorder. The RADMIS trials use a randomized controlled, single-blind, parallel-group design. Patients with unipolar disorder and patients with bipolar disorder are invited to participate in each trial when discharged from psychiatric hospitals in The Capital Region of Denmark following an affective episode and randomized to either (1) a smartphone-based monitoring system including (a) an integrated feedback loop between patients and clinicians and (b) context-aware cognitive behavioral therapy (CBT) modules (intervention group) or (2) standard treatment (control group) for a 6-month trial period. The trial started in May 2017. The outcomes are (1) number and duration of re-admissions (primary), (2) severity of depressive and manic (only for patients with bipolar disorder) symptoms; psychosocial functioning; number of affective episodes (secondary), and (3) perceived stress, quality of life, self-rated depressive symptoms, self-rated manic symptoms (only for patients with bipolar disorder), recovery, empowerment, adherence to medication, wellbeing, ruminations, worrying, and satisfaction (tertiary). A total of 400 patients (200 patients with

  5. Foraging Value, Risk Avoidance, and Multiple Control Signals: How the Anterior Cingulate Cortex Controls Value-based Decision-making.

    Science.gov (United States)

    Brown, Joshua W; Alexander, William H

    2017-10-01

    Recent work on the role of the ACC in cognition has focused on choice difficulty, action value, risk avoidance, conflict resolution, and the value of exerting control among other factors. A main underlying question is what are the output signals of ACC, and relatedly, what is their effect on downstream cognitive processes? Here we propose a model of how ACC influences cognitive processing in other brain regions that choose actions. The model builds on the earlier Predicted Response Outcome model and suggests that ACC learns to represent specifically the states in which the potential costs or risks of an action are high, on both short and long timescales. It then uses those cost signals as a basis to bias decisions to minimize losses while maximizing gains. The model simulates both proactive and reactive control signals and accounts for a variety of empirical findings regarding value-based decision-making.

  6. Design of the decision aiding system for the control of the research nuclear reactor

    International Nuclear Information System (INIS)

    Adda, F.; Allek, M.; Larbes, C.

    2003-01-01

    Intelligent and decision aiding systems as support to operators are becoming increasingly a necessity in nuclear installations and in nuclear reactors in particular, specially after the Tree Mile Island. Development of new technologies based on linguistic approaches such as fuzzy logic has given rise to much interest during the last years. Fuzzy logic controller (FLC) has many advantage compared to conventional controllers using classical techniques. The aim of the present work is to use a fuzzy logic controller in parallel to actual semi-automatic controller in order to supervise in real time the operation of the research nuclear reactor. The principal of this controller is based on rules which are established previous from experiment using the semi-automatic controller and from the knowledge of the operators. (authors)

  7. Admissibility of appeals in atomic energy law

    International Nuclear Information System (INIS)

    Rengeling, H.W.

    1981-01-01

    Using two decisions made by the Federal Court of Administration on the Whyl reactor on July 17, 1980, and on the Stade reactor on December 22, 1980, which he considers as having at least an orientation effect, the author examines the admissibility of appeals filed according to the Atomic Energy Law. For substantiating the appeal, he discusses rules of law that protect third parties and the complainant's obligation to substantiate the appeal. In view of the preclusion of objectives, he differentiates between 'forfeiture' preclusion and 'validity' preclusion. In his view, the above-mentioned decisions produce effects that are to the benefit of the constitutional state and the necessary further development of economy and technology. (HSCH) [de

  8. Including Life Cycle Assessment for decision-making in controlling wastewater nutrient removal systems

    DEFF Research Database (Denmark)

    Corominas, Lluís; Larsen, Henrik Fred; Flores-Alsina, Xavier

    2013-01-01

    This paper focuses on the use of Life Cycle Assessment (LCA) to evaluate the performance of seventeen control strategies in wastewater treatment plants (WWTPs). It tackles the importance of using site-specific factors for nutrient enrichment when decision-makers have to select best operating....../or energy savings present an environmental benefit for N&P and P-deficient systems. This is not the case when addressing N-deficient systems for which the use of chemicals (even for improving N removal efficiencies) is not always beneficial for the environment. A sensitivity analysis on using weighting...... of the impact categories is conducted to assess how value choices (policy decisions) may affect the management of WWTPs. For the scenarios with only N-limitation, the LCA-based ranking of the control strategies is sensitive to the choice of weighting factors, whereas this is not the case for N&P or P...

  9. Methicillin-resistant Staphylococcus aureus in Saarland, Germany: a statewide admission prevalence screening study.

    Directory of Open Access Journals (Sweden)

    Mathias Herrmann

    Full Text Available BACKGROUND: The screening of hospital admission patients for methicillin resistant Staphylococcus aureus (MRSA is of undisputed value in controlling and reducing the overall MRSA burden; yet, a concerted parallel universal screening intervention throughout all hospitals of an entire German Federal State has not yet been performed. METHODOLOGY/PRINCIPAL FINDINGS: During a four-week period, all 24 acute care hospitals of the State of Saarland participated in admission prevalence screening. Overall, 436/20,027 screened patients revealed MRSA carrier status (prevalence, 2.2/100 patients with geriatrics and intensive care departments associated with highest prevalence (7.6/100 and 6.3/100, respectively. Risk factor analysis among 17,975 admission patients yielded MRSA history (OR, 4.3; CI₉₅ 2.7-6.8, a skin condition (OR, 3.2; CI₉₅ 2.1-5.0, and/or an indwelling catheter (OR, 2.2; CI₉₅ 1.4-3.5 among the leading risks. Hierarchical risk factor ascertainment of the six risk factors associated with highest odd's ratios would require 31% of patients to be laboratory screened to allow for detection of 67% of all MRSA positive admission patients in the State. CONCLUSIONS/SIGNIFICANCE: State-wide admission prevalence screening in conjunction with risk factor ascertainment yields important information on the distribution of the MRSA burden for hospitals, and allows for data-based decisions on local or institutional MRSA screening policies considering risk factor prevalence and expected MRSA identification rates.

  10. Regional Comparison of Enteral Nutrition-Related Admission Policies in Skilled Nursing Facilities.

    Science.gov (United States)

    Burgermaster, Marissa; Slattery, Eoin; Islam, Nafeesa; Ippolito, Paul R; Seres, David S

    2016-06-01

    Nursing home admission policies are one driver of increased and earlier gastrostomy placement, a procedure that is not always medically or ethically indicated among patients needing short-term nutrition support. This important clinical decision should be based upon patient prognosis, goals, and needs. We compared nursing home enteral nutrition-related admission policies in New York City and other regions of the United States. We also explored motivations for these policies. We conducted a telephone survey with skilled nursing facility administrators in New York City and a random sample of facilities throughout the United States about enteral nutrition-related admission policies. Survey data were matched with publically available data about facility characteristics from the Centers for Medicare and Medicaid Services. The relationship between facility location and admission policies was described with regression models. Reasons for these policies were thematically analyzed. New York City nursing homes were significantly less likely to admit patients with nasogastric feeding tubes than were nursing homes nationwide, after we controlled for facility characteristics (odds ratio = 0.111; 95% CI, 0.032-0.344). Reasons for refusing nasogastric tubes fell into 5 categories: safety, capacity, policy, perception of appropriate level of care, and patient quality of life. Our findings indicate that enteral nutrition-related admission policies vary greatly between nursing homes in New York City and nationwide. Many administrators cited safety and policy as factors guiding their institutional policies and practices, despite a lack of evidence. This gap in research, practice, and policy has implications for quality and cost of care, length of hospital stay, and patient morbidity and mortality. © 2016 American Society for Parenteral and Enteral Nutrition.

  11. Quality Control and Due Diligence in Project Management: Getting Decisions Right by Taking the Outside View

    OpenAIRE

    Bent Flyvbjerg

    2013-01-01

    This paper explores how theories of the planning fallacy and the outside view may be used to conduct quality control and due diligence in project management. First, a much-neglected issue in project management is identified, namely that the front-end estimates of costs and benefits--used in the business cases, cost-benefit analyses, and social and environmental impact assessments that typically support decisions on projects--are typically significantly different from actual ex post costs and ...

  12. Biased Decision Making in Realistic Extra-Procedural Nuclear Control Room Scenarios

    DEFF Research Database (Denmark)

    Andersen, Emil; Kozin, Igor; Maier, Anja

    In normal operations and emergency situations, operators of nuclear control rooms rely on procedures to guide their decision making. However, in emergency situations, where several interacting problems can cause unpredictable adverse effects, these procedures may be insufficient in guiding...... improve safety by creating procedures that bear the risks of these biases in mind, or by specifically aiming to debias the users. Avenues for debiasing through design are discussed....

  13. The control gap : the role of budgets, accounting information and (non-) decisions in hospital settings

    OpenAIRE

    Nyland, Kari; Pettersen, Inger Johanne

    2004-01-01

    This paper investigates the link between budgets, accounting information and the decisionmaking processes at both strategic and operational levels in a large Norwegian hospital, as this hospital now is facing the New Public Management reforms which are introduced in Norway. The study has examined the use of budget and accounting information in the management control process. The empirical data are based on interviews with key actors in the decision-making process at all management levels in t...

  14. 21 CFR 111.113 - What quality control operations are required for a material review and disposition decision?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false What quality control operations are required for a... Production and Process Control System: Requirements for Quality Control § 111.113 What quality control operations are required for a material review and disposition decision? (a) Quality control personnel must...

  15. A Model of Human Decision Making in Complex Systems and its Use for Design of System Control Strategies

    DEFF Research Database (Denmark)

    Rasmussen, Jens; Lind, Morten

    The paper describes a model of operators' decision making in complex system control, based on studies of event reports and performance in control rooms. This study shows how operators base their decisions on knowledge of system properties at different levels of abstraction depending on their perc...... representation of system properties in a multilevel flow model is described to provide a basis for an integrated control system design.......The paper describes a model of operators' decision making in complex system control, based on studies of event reports and performance in control rooms. This study shows how operators base their decisions on knowledge of system properties at different levels of abstraction depending...... on their perception of the system's immediate control requirements. These levels correspond to the abstraction hierarchy including system purpose, functions, and physical details, which is generally used to describe a formal design process. In emergency situations the task of the operator is to design a suitable...

  16. Financial Management and Control for Decision Making in Urban Local Bodies in India Using Statistical Techniques

    Science.gov (United States)

    Bhattacharyya, Sidhakam; Bandyopadhyay, Gautam

    2010-10-01

    The council of most of the Urban Local Bodies (ULBs) has a limited scope for decision making in the absence of appropriate financial control mechanism. The information about expected amount of own fund during a particular period is of great importance for decision making. Therefore, in this paper, efforts are being made to present set of findings and to establish a model of estimating receipts of own sources and payments thereof using multiple regression analysis. Data for sixty months from a reputed ULB in West Bengal have been considered for ascertaining the regression models. This can be used as a part of financial management and control procedure by the council to estimate the effect on own fund. In our study we have considered two models using multiple regression analysis. "Model I" comprises of total adjusted receipt as the dependent variable and selected individual receipts as the independent variables. Similarly "Model II" consists of total adjusted payments as the dependent variable and selected individual payments as independent variables. The resultant of Model I and Model II is the surplus or deficit effecting own fund. This may be applied for decision making purpose by the council.

  17. Cognitive control and individual differences in economic ultimatum decision-making.

    Directory of Open Access Journals (Sweden)

    Wim De Neys

    Full Text Available Much publicity has been given to the fact that people's economic decisions often deviate from the rational predictions of standard economic models. In the classic ultimatum game, for example, most people turn down financial gains by rejecting unequal monetary splits. The present study points to neglected individual differences in this debate. After participants played the ultimatum game we tested for individual differences in cognitive control capacity of the most and least economic responders. The key finding was that people who were higher in cognitive control, as measured by behavioral (Go/No-Go performance and neural (No-Go N2 amplitude markers, did tend to behave more in line with the standard models and showed increased acceptance of unequal splits. Hence, the cognitively highest scoring decision-makers were more likely to maximize their monetary payoffs and adhere to the standard economic predictions. Findings question popular claims with respect to the rejection of standard economic models and the irrationality of human economic decision-making.

  18. Economic analysis for upgrade decision-making using a control system replacement example

    International Nuclear Information System (INIS)

    De Grosbois, J.; Wichman, R.; Hepburn, G.A.; Basso, R.; Kumar, V.; Deregowska, D.

    2006-01-01

    This paper (3rd in a CNS series) provides insight on how nuclear power plants can achieve better efficiencies and reduced operations and maintenance (O and M) costs by making well-informed equipment upgrade decisions. An investment decision in a plant system upgrade will have various technical options and associated performance outcomes. These can be modelled and evaluated using economic and financial analysis methods. The economic analysis usually involves a comparison of an investment scenario versus a no-investment scenario called difference case analysis. The investment may include several scenarios due to the existence of various options, different investment timings, or desired performance results. Classical approaches, using financial tools such as net present value and internal rate of return calculations, may be used to quantify the financial benefits of the difference cases when certainty about the outcomes is assumed. When making decisions under risk, the classical approaches may be augmented with methods that consider life-cycle costs and benefits, the cost consequences of and probability of equipment failure, the timing of the replacement, and the uncertainties in estimating costs and benefits. The use of expected value and Monte Carlo simulation, among others, allow the incorporation of financial and technical uncertainty into the analysis. Finally, sensitivity analysis enables better understanding of the problem and may improve the decision and clarify the level of confidence that should be put in the outcomes. This paper illustrates the use of financial decision analysis methods for equipment replacements using a control system upgrade example. These methods may easily be generalized for other types of plant upgrades. (author)

  19. Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial.

    Science.gov (United States)

    Brownson, Ross C; Allen, Peg; Jacob, Rebekah R; deRuyter, Anna; Lakshman, Meenakshi; Reis, Rodrigo S; Yan, Yan

    2017-11-30

    Although practitioners in state health departments are ideally positioned to implement evidence-based interventions, few studies have examined how to build their capacity to do so. The objective of this study was to explore how to increase the use of evidence-based decision-making processes at both the individual and organization levels. We conducted a 2-arm, group-randomized trial with baseline data collection and follow-up at 18 to 24 months. Twelve state health departments were paired and randomly assigned to intervention or control condition. In the 6 intervention states, a multiday training on evidence-based decision making was conducted from March 2014 through March 2015 along with a set of supplemental capacity-building activities. Individual-level outcomes were evidence-based decision making skills of public health practitioners; organization-level outcomes were access to research evidence and participatory decision making. Mixed analysis of covariance models was used to evaluate the intervention effect by accounting for the cluster randomized trial design. Analysis was performed from March through May 2017. Participation 18 to 24 months after initial training was 73.5%. In mixed models adjusted for participant and state characteristics, the intervention group improved significantly in the overall skill gap (P = .01) and in 6 skill areas. Among the 4 organizational variables, only access to evidence and skilled staff showed an intervention effect (P = .04). Tailored and active strategies are needed to build capacity at the individual and organization levels for evidence-based decision making. Our study suggests several dissemination interventions for consideration by leaders seeking to improve public health practice.

  20. Multi-criteria decision making approaches for quality control of genome-wide association studies.

    Science.gov (United States)

    Malovini, Alberto; Rognoni, Carla; Puca, Annibale; Bellazzi, Riccardo

    2009-03-01

    Experimental errors in the genotyping phases of a Genome-Wide Association Study (GWAS) can lead to false positive findings and to spurious associations. An appropriate quality control phase could minimize the effects of this kind of errors. Several filtering criteria can be used to perform quality control. Currently, no formal methods have been proposed for taking into account at the same time these criteria and the experimenter's preferences. In this paper we propose two strategies for setting appropriate genotyping rate thresholds for GWAS quality control. These two approaches are based on the Multi-Criteria Decision Making theory. We have applied our method on a real dataset composed by 734 individuals affected by Arterial Hypertension (AH) and 486 nonagenarians without history of AH. The proposed strategies appear to deal with GWAS quality control in a sound way, as they lead to rationalize and make explicit the experimenter's choices thus providing more reproducible results.

  1. Impulsive Control for Continuous-Time Markov Decision Processes: A Linear Programming Approach

    Energy Technology Data Exchange (ETDEWEB)

    Dufour, F., E-mail: dufour@math.u-bordeaux1.fr [Bordeaux INP, IMB, UMR CNRS 5251 (France); Piunovskiy, A. B., E-mail: piunov@liv.ac.uk [University of Liverpool, Department of Mathematical Sciences (United Kingdom)

    2016-08-15

    In this paper, we investigate an optimization problem for continuous-time Markov decision processes with both impulsive and continuous controls. We consider the so-called constrained problem where the objective of the controller is to minimize a total expected discounted optimality criterion associated with a cost rate function while keeping other performance criteria of the same form, but associated with different cost rate functions, below some given bounds. Our model allows multiple impulses at the same time moment. The main objective of this work is to study the associated linear program defined on a space of measures including the occupation measures of the controlled process and to provide sufficient conditions to ensure the existence of an optimal control.

  2. Abortion, sexual abuse and medical control: the Argentinian Supreme Court decision on F., A.L.

    Directory of Open Access Journals (Sweden)

    María Eugenia Monte

    Full Text Available Abstract In Argentina, during the 2000s but increasingly since 2005 up to 2016, women and feminist´s organizations and lawyers disputed over the abortion juridical regulation at Courts facing conservative resistances. These disputes could be located in a broader process of judicialization of the socio-political conflict over abortion. The Argentinian Supreme Court took a decision over one of these judicial processes on March 13th, 2012, F., A.L. This paper analyses the Argentinian Supreme Court decision on F., A.L. regarding non-punishable abortion boundaries, medical and judicial practices and, specifically, sexual abuse and medical control. It also analyses its material effects on a subsequent struggle and judgment in the province of Córdoba.

  3. Testing In College Admissions: An Alternative to the Traditional Predictive Model.

    Science.gov (United States)

    Lunneborg, Clifford E.

    1982-01-01

    A decision-making or utility theory model (which deals effectively with affirmative action goals and allows standardized tests to be placed in the service of those goals) is discussed as an alternative to traditional predictive admissions. (Author/PN)

  4. 32 CFR 242.9 - Academic, intellectual, and personal requirements for admission to advanced standing.

    Science.gov (United States)

    2010-07-01

    ... aptitude and motivation for a career in medicine in the Uniformed Services will be prime considerations in making admissions decisions. Only the most promising of candidates will be accepted, as judged by...

  5. Randomized controlled trial of a patient decision-making aid for orthodontics.

    Science.gov (United States)

    Parker, Kate; Cunningham, Susan J; Petrie, Aviva; Ryan, Fiona S

    2017-08-01

    Patient decision-making aids (PDAs) are instruments that facilitate shared decision making and enable patients to reach informed, individual decisions regarding health care. The objective of this study was to assess the efficacy of a PDA compared with traditional information provision for adolescent patients considering fixed appliance orthodontic treatment. Before treatment, orthodontic patients were randomly allocated into 2 groups: the intervention group received the PDA and standard information regarding fixed appliances, and the control group received the standard information only. Decisional conflict was measured using the Decisional Conflict Scale, and the levels of decisional conflict were compared between the 2 groups. Seventy-two patients were recruited and randomized in a ratio of 1:1 to the PDA and control groups. Seventy-one patients completed the trial (control group, 36; PDA group, 35); this satisfied the sample size calculation. The median total Decisional Conflict Scale score in the PDA group was lower than in the control group (15.63 and 19.53, respectively). However, this difference was not statistically significant (difference between groups, 3.90; 95% confidence interval of the difference, -4.30 to 12.11). Sex, ethnicity, age, and the time point at which patients were recruited did not have significant effects on Decisional Conflict Scale scores. No harm was observed or reported for any participant in the study. The results of this study showed that the provision of a PDA to adolescents before they consented for fixed appliances did not significantly reduce decisional conflict. There may be a benefit in providing a PDA for some patients, but it is not yet possible to say how these patients could be identified. This trial was registered with the Harrow National Research Ethics Committee (reference 12/LO/0279). The protocol was not published before trial commencement. Copyright © 2017. Published by Elsevier Inc.

  6. Incongruence between Women's Survey- & Interview-Determined Decision Control Preferences: A Mixed Methods Study of Decision-Making in Metastatic Breast Cancer.

    Science.gov (United States)

    Ejem, Deborah; Nicholas Dionne-Odom, J; Turkman, Yasemin; Knight, Sara; Willis, Dan; Kaufman, Peter; Bakitas, Marie

    2018-04-30

    Women with metastatic breast cancer (MBC) face numerous, complex treatment and advance care planning (ACP) decisions. Our aim was to develop a better understanding of women with MBC's decision-making preferences overtime and relative to specific types of decisions. Convergent, parallel mixed-methods study. Participants completed the Control Preferences Scale (CPS) and a semi-structured interview of decision-making experiences at enrollment (T1; n=22) and when facing a decision or 3 months later (T2; n=19). We categorized women's decision-making experience descriptions into one of the CPS decisional styles and compared them to their CPS response. We constructed an analytic grid that aligned the interview-determined treatment and ACP decisional preferences with the CPS categories at T1 and T2 and calculated Cohen's kappa coefficient and congruence percentages. Participants (n=22) were White (100%), averaged 62 years, married (54%), retired (45%), and had a bachelor's degree (45%). Congruence between CPS response and interview-determined treatment preferences at T1 was 32% (kappa=0.083) and 33% (kappa=0.120) at T2. Congruence between CPS survey response and interview-determined ACP preferences at T1 was 22.7% (kappa =0.092) at T1 and 11% (kappa = 0.011) at T2. Although women selected a "shared" treatment decision-making style using the CPS validated tool, when interviewed their descriptions generally reflected a passive process in which they followed the oncologists' treatment suggestions. Future research should explore whether the incongruence between stated and actual decision-making style is a function of misinterpreting the CPS choices or a true inconsistency that could lead to adverse consequences such as decisional regret. This article is protected by copyright. All rights reserved.

  7. 44 CFR 68.9 - Admissible evidence.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Admissible evidence. 68.9 Section 68.9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... admissible. (b) Documentary and oral evidence shall be admissible. (c) Admissibility of non-expert testimony...

  8. Temperature effects on hospital admissions for kidney morbidity in Taiwan

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yu-Kai [Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (United States); Wang, Yu-Chun [Department of Bioenvironmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan (China); Research Center for Environmental Risk Management, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan (China); Ho, Tsung-Jung [The Division of Chinese Medicine, China Medical University Beigang Hospital, Taiwan (China); School Of Chinese Medicine, College of Chinese Medicine, China Medical University, 91 Xueshi Road, Taichung City 404, Taiwan (China); Lu, Chensheng, E-mail: cslu@hsph.harvard.edu [Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (United States)

    2013-01-15

    Objective: This study aimed to associate hospital admissions of kidney diseases with extreme temperature and prolonged heat/cold events in 7 regions of Taiwan. Methods: Age-specific (< 65 years, 65 + years and all ages) hospital admission records of nephritis, nephrotic syndrome, or nephrosis, in the form of electronic insurance reimbursement claims, were retrieved from Taiwan's National Health Insurance Research Database during the period of 2000–2008. The area–age-specific relative risk (RR) accounting for 8 days of lag for temperature on hospital admissions of kidney diseases were estimated using distributed lag non-linear models with the Poisson distribution controlling for extreme temperature events, levels of air pollutants (PM{sub 10}, O{sub 3}, and NO{sub 2}) and potential confounders. Results: We observed a V or J-shape association between daily average temperatures and the RR estimates for hospital admissions of kidney diseases in Taiwan. The lowest risk for hospital admissions of kidney diseases was found at around 25 °C, and risk increased as temperatures deviated from 25 °C. The pooled cumulative 8-day RR for all ages of population of the 7 study areas were 1.10 (95% confidence interval (CI): 1.01, 1.19) at 18 °C and 1.45 (95% CI: 1.27, 1.64) at 30 °C. High temperature has more profound influence on hospital admission of kidney diseases than low temperature. Temperature risks for hospital admissions were similar between younger (< 65 years) and elderly (65 + years) population. This study observed no significant effects of prolonged heat extremes on hospital admissions of kidney diseases. Conclusions: The heat effect for kidney morbidities leading to hospital admission was more significant than that of the cold temperature. This study did not find the age-dependent relative risks for temperature associating with hospital admissions of kidney diseases. - Highlights: ► V or J-shaped association was observed between daily temperatures and

  9. Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective.

    Science.gov (United States)

    Bechara, Antoine

    2005-11-01

    Here I argue that addicted people become unable to make drug-use choices on the basis of long-term outcome, and I propose a neural framework that explains this myopia for future consequences. I suggest that addiction is the product of an imbalance between two separate, but interacting, neural systems that control decision making: an impulsive, amygdala system for signaling pain or pleasure of immediate prospects, and a reflective, prefrontal cortex system for signaling pain or pleasure of future prospects. After an individual learns social rules, the reflective system controls the impulsive system via several mechanisms. However, this control is not absolute; hyperactivity within the impulsive system can override the reflective system. I propose that drugs can trigger bottom-up, involuntary signals originating from the amygdala that modulate, bias or even hijack the goal-driven cognitive resources that are needed for the normal operation of the reflective system and for exercising the willpower to resist drugs.

  10. Implementation of Fuzzy Decision to Control Patient Room Facilities using Eye Blink

    Science.gov (United States)

    Zaeni, Ilham A. E.; Wibawa, Aji P.; Aripriharta; Sendari, Siti

    2018-04-01

    This study proposed the implementation of Fuzzy decision to control patient’s room facilities. In this study, four icons were sequentially displayed on the computer screen. The icons representing four option that can be selected by the patient is including switch the light on/off, switch the fan on/off, moving the bed’s backrest downward, and moving the bed’s backrest upward. The eye blink was extracted from subject’s electroencephalograph (EEG) signals which acquired from the FP1 region. The attention was also extracted from subject’s EEG signals to ensure that subject concentrate to the task. The eye blink and attention level were used for Fuzzy decision inputs, while the output is a decision that states the selection is valid or not. The selected option is the command that appears on the screen when the selection is valid. In this study, subjects were asked to choose each command several times and the accuracy was computed based on the number of correct selection.

  11. Optimization of matrix tablets controlled drug release using Elman dynamic neural networks and decision trees.

    Science.gov (United States)

    Petrović, Jelena; Ibrić, Svetlana; Betz, Gabriele; Đurić, Zorica

    2012-05-30

    The main objective of the study was to develop artificial intelligence methods for optimization of drug release from matrix tablets regardless of the matrix type. Static and dynamic artificial neural networks of the same topology were developed to model dissolution profiles of different matrix tablets types (hydrophilic/lipid) using formulation composition, compression force used for tableting and tablets porosity and tensile strength as input data. Potential application of decision trees in discovering knowledge from experimental data was also investigated. Polyethylene oxide polymer and glyceryl palmitostearate were used as matrix forming materials for hydrophilic and lipid matrix tablets, respectively whereas selected model drugs were diclofenac sodium and caffeine. Matrix tablets were prepared by direct compression method and tested for in vitro dissolution profiles. Optimization of static and dynamic neural networks used for modeling of drug release was performed using Monte Carlo simulations or genetic algorithms optimizer. Decision trees were constructed following discretization of data. Calculated difference (f(1)) and similarity (f(2)) factors for predicted and experimentally obtained dissolution profiles of test matrix tablets formulations indicate that Elman dynamic neural networks as well as decision trees are capable of accurate predictions of both hydrophilic and lipid matrix tablets dissolution profiles. Elman neural networks were compared to most frequently used static network, Multi-layered perceptron, and superiority of Elman networks have been demonstrated. Developed methods allow simple, yet very precise way of drug release predictions for both hydrophilic and lipid matrix tablets having controlled drug release. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. The Tension between the Decision and Control Perspectives of Accounting Revisited

    DEFF Research Database (Denmark)

    Christensen, John

    2009-01-01

    to use different accounting systems for different purposes. That is not the norm. The tensions are managed within a single accounting system and that leads to trade-offs in the accounting system. I will revisit these conflicts of uses of accounting systems using product costing, transfer pricing and fair......The accounting system is a carefully managed information system which is used for multiple purposes. Traditionally, the uses are categorized using the main headings of decision and control. Numerous conflicts are the consequence of the multi-purpose accounting system. The easy way out is apparently...

  13. Psychosocial work environment and hospital admissions due to mental disorders: a 15-year prospective study of industrial employees.

    Science.gov (United States)

    Joensuu, Matti; Väänänen, Ari; Koskinen, Aki; Kivimäki, Mika; Virtanen, Marianna; Vahtera, Jussi

    2010-07-01

    Low levels of job control and social support may increase the risk of mental disorders, particularly depression, but the evidence is mostly based on self-reports. We examined whether components of job control and work-related social support predict medically-certified mental disorders. 13868 forest company employees with no previous hospital admissions for mental disorders responded to questionnaires on decision authority, skill discretion, co-worker and supervisor support. They were followed-up for hospital admissions due to mental disorders (ICD-9 codes 290 to 319), using national hospital discharge records (577 hospitalized, mean follow-up 15.1 years). In analyses adjusted for confounders, high skill discretion was associated with a reduced risk of hospital admission for mental disorders (HR 0.74, 95% CI 0.58-0.95). High decision authority was associated with an elevated risk (HR 1.48, 95% CI 1.17-1.87). Diagnosis-specific analyses showed high skill discretion to associate with a reduced risk of both depressive and non-depressive non-alcohol-related mental disorders. High decision authority was a risk factor for alcohol-related and depressive disorders. Good co-worker support was associated with a reduced risk of non-depressive non-alcohol-related mental disorders. Supervisor support was not associated with any mental disorders. We used a single time point estimate in an industrial sample comprising largely of men. Contrary to previous research on job control, high decision authority increased the risk of depressive and alcohol-related disorders, which suggest a need to reconsider the strategies for prevention and clinical practise in regard to psychosocial work environment and mental health.

  14. A decision support system for the control of Campylobacter in chickens at farm level using data from Denmark

    DEFF Research Database (Denmark)

    Garcia, A. B.; Madsen, A. L.; Vigre, Håkan

    2016-01-01

    strategy seems to be the use of fly screens. The use of cost-effective vaccines against Campylobacter is also desirable. In order to control Campylobacter, poultry producers need to make crucial decisions under conditions of uncertainty. With the aim of assisting poultry producers in decision making...... regarding Campylobacter control strategies, the objective of the present study was to produce a decision support system that integrated knowledge and used a Bayesian approach to handle uncertainty. This decision support system integrated epidemiological data, microbiological considerations, financial...... information and potential control strategies (the use of fly screens and hypothetical vaccines). In conclusion, results from model and sensitivity analyses indicated that the financial variables (cost–benefit functions) and the effectiveness of the different control strategies drove the results....

  15. Optimal Admission to Higher Education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    This paper constructs higher education admission rules that maximise graduation rates and thus increase the skill level of the work force. An application shows that students with a low level in mathematics in secondary school ought to find it easier to be admitted to an economics programme than...... to law or psychology programmes, even though economics is the most difficult programme from which to graduate without a strong background in mathematics. Indirect gains from optimal admission include the potential of making whole cohorts of students more able to graduate with a higher education degree....

  16. General Practitioners and Involuntary Admission

    DEFF Research Database (Denmark)

    Jepsen, Britta; Lomborg, Kirsten; Engberg, Marianne

    2010-01-01

    Background: In many countries, medical authorities are responsible for involuntary admissions of mentally ill patients. Nonetheless, very little is known about GPs' experiences with involuntary admission. Aim: The aim of the present study was to explore GP's experiences from participating....... They felt that sectioning patients was unpleasant, and felt nervous, but experienced relief and professional satisfaction if things went well. The GPs experienced the doctor-patient relationship to be at risk, but also reported that it could be improved. GPs felt that they were not taken seriously...

  17. A Decision Aid to Promote Appropriate Colorectal Cancer Screening among Older Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Lewis, Carmen L; Kistler, Christine E; Dalton, Alexandra F; Morris, Carolyn; Ferrari, Renée; Barclay, Colleen; Brewer, Noel T; Dolor, Rowena; Harris, Russell; Vu, Maihan; Golin, Carol E

    2018-07-01

    Concerns have been raised about both over- and underutilization of colorectal cancer (CRC) screening in older patients and the need to align screening behavior with likelihood of net benefit. The purpose of this study was to test a novel use of a patient decision aid (PtDA) to promote appropriate CRC screening in older adults. A total of 424 patients ages 70 to 84 y who were not up to date with CRC screening participated in a double-blinded randomized controlled trial of a PtDA targeted to older adults making decisions about whether to undergo CRC screening from March 2012 to February 2015. Patients were randomized to a targeted PtDA or an attention control. The PtDA was designed to facilitate individualized decision making-helping patients understand the potential risks, benefits, and uncertainties of CRC screening given advanced age, health state, preferences, and values. Two composite outcomes, appropriate CRC screening behavior 6 mo after the index visit and appropriate screening intent immediately after the visit, were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, and no screening or intent for patients in poor health. Health state was determined by age and Charlson Comorbidity Index. Four hundred twelve (97%) and 421 (99%) patients were analyzed for the primary and secondary outcomes, respectively. Appropriate screening behavior at 6 mo was higher in the intervention group (55% v. 45%, P = 0.023) as was appropriate screening intent following the provider visit (61% v. 47%, P = 0.003). The study took place in a single geographic region. The appropriate CRC screening classification system used in this study has not been formally validated. A PtDA for older adults promoted appropriate CRC screening behavior and intent. Clinicaltrials.gov, registration number NCT01575990. https://clinicaltrials.gov/ct2/show/NCT01575990?term=epic-d&rank=1.

  18. Analyzing the decision making process of certifying digital control systems of nuclear power plants

    International Nuclear Information System (INIS)

    Yih, Swu; Fan, Chin-Feng

    2012-01-01

    Highlights: ► We have performed basic research in analyzing certification process and developed a regulatory decision making model for nuclear digital control system certification. The model views certification as an evidence–confidence conversion process. ► We have applied this model to analyze previous nuclear digital I and C certification experiences and obtained valuable insights. ► Furthermore, a prototype of a computer-aided licensing support system based on the model has been developed to enhance regulatory review efficiency. - Abstract: Safety-critical computing systems need regulators’ approval before operation. Such a permit issue process is called “certification”. Digital instrumentation and Control (I and C) certification in the nuclear domain has always been problematic and lengthy. Thus, the certification efficiency has always been a crucial concern to the applicant whose business depends on the regulatory decision. However, to our knowledge, there is little basic research on this topic. This study presents a Regulatory Decision-Making Model aiming at analyzing the characteristics and efficiency influence factors in a generic certification process. This model is developed from a dynamic operational perspective by viewing the certification process as an evidence–confidence conversion process. The proposed model is then applied to previous nuclear digital I and C certification experiences to successfully explain why some cases were successful and some were troublesome. Lessons learned from these cases provide invaluable insights regarding to the regulatory review activity. Furthermore, to utilize the insights obtained from the model, a prototype of a computer-aided licensing support system has been developed to speed up review evidence preparation and manipulation; thus, regulatory review efficiency can be further improved.

  19. Trends in control and decision-making for human-robot collaboration systems

    CERN Document Server

    Zhang, Fumin

    2017-01-01

    This book provides an overview of recent research developments in the automation and control of robotic systems that collaborate with humans. A measure of human collaboration being necessary for the optimal operation of any robotic system, the contributors exploit a broad selection of such systems to demonstrate the importance of the subject, particularly where the environment is prone to uncertainty or complexity. They show how such human strengths as high-level decision-making, flexibility, and dexterity can be combined with robotic precision, and ability to perform task repetitively or in a dangerous environment. The book focuses on quantitative methods and control design for guaranteed robot performance and balanced human experience. Its contributions develop and expand upon material presented at various international conferences. They are organized into three parts covering: one-human–one-robot collaboration; one-human–multiple-robot collaboration; and human–swarm collaboration. Individual topic ar...

  20. Management of redundancy in flight control systems using optimal decision theory

    Science.gov (United States)

    1981-01-01

    The problem of using redundancy that exists between dissimilar systems in aircraft flight control is addressed. That is, using the redundancy that exists between a rate gyro and an accelerometer--devices that have dissimilar outputs which are related only through the dynamics of the aircraft motion. Management of this type of redundancy requires advanced logic so that the system can monitor failure status and can reconfigure itself in the event of one or more failures. An optimal decision theory was tutorially developed for the management of sensor redundancy and the theory is applied to two aircraft examples. The first example is the space shuttle and the second is a highly maneuvering high performance aircraft--the F8-C. The examples illustrate the redundancy management design process and the performance of the algorithms presented in failure detection and control law reconfiguration.

  1. Emergency-Dependent Supply Decisions with Risk Perception and Price Control

    Directory of Open Access Journals (Sweden)

    Shaofu Du

    2014-01-01

    Full Text Available This paper studies the impact of emergencies on the supplier’s decision-making behaviors including production and information sharing in consideration of consumer risk perception, consumer loss aversion phenomenon, and government price control. The intensity of emergencies is sequential and emergencies can be divided into two types (positive or negative according to their effect on demand. When emergencies have negative effect on demand, the supplier’s sales will reduce and he would share information to the market. When emergencies have positive effect on demand, we find that when the price is under price cap the supplier will not share information to the market; when the price reaches price cap, the supplier will share a certain amount of information to the market. We were surprised to find that increasing demand is not always good for the supplier when there exist government price control and lost sales penalty, and information helps the supplier to effectively manipulate demand.

  2. Open Admissions: Expanding Educational Opportunity

    Science.gov (United States)

    Benjamin, Jeanette Ann; Powell, Philip Edward

    1971-01-01

    A report on initial results of the open admissions policy (City University of New York) concludes that significant numbers of high risk students can make progress toward a degree. Program modifications are suggested as a response to the learning needs of these students. (Author/CJ)

  3. Admission to selective schools, alphabetically

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    2010-01-01

    Roč. 29, č. 6 (2010), s. 1100-1109 ISSN 0272-7757 R&D Projects: GA MŠk LC542 Institutional research plan: CEZ:MSM0021620846 Keywords : admissions to school * alphabetical order * order effects Subject RIV: AH - Economics Impact factor: 1.066, year: 2010

  4. Admission haematological abnormalities and postoperative ...

    African Journals Online (AJOL)

    Admission haematological abnormalities and postoperative outcomes in neonates with acute surgical conditions in Alexandria, Egypt. HL Wella, SMM Farahat. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...

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

    Energy Technology Data Exchange (ETDEWEB)

    Cetiner, Sacit M [ORNL; Kisner, Roger A [ORNL; Muhlheim, Michael David [ORNL; Fugate, David L [ORNL

    2015-07-01

    Decision-making is the process of identifying and choosing alternatives where each alternative offers a different approach or path to move from a given state or condition to a desired state or condition. The generation of consistent decisions requires that a structured, coherent process be defined, immediately leading to a decision-making framework. The overall objective of the generalized framework is for it to be adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or no human intervention. The overriding goal of automation is to replace or supplement human decision makers with reconfigurable decision- making modules that can perform a given set of tasks reliably. Risk-informed decision making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The implementation of the probabilistic portion of the decision-making engine of the proposed supervisory control system was detailed in previous milestone reports. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic multi-attribute decision-making framework uses variable sensor data (e.g., outlet temperature) and calculates where it is within the challenge state, its trajectory, and margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. Metrics to be evaluated include stability, cost, time to complete (action), power level, etc. The

  6. Statistical Learning and Adaptive Decision-Making Underlie Human Response Time Variability in Inhibitory Control

    Directory of Open Access Journals (Sweden)

    Ning eMa

    2015-08-01

    Full Text Available Response time (RT is an oft-reported behavioral measure in psychological and neurocognitive experiments, but the high level of observed trial-to-trial variability in this measure has often limited its usefulness. Here, we combine computational modeling and psychophysics to examine the hypothesis that fluctuations in this noisy measure reflect dynamic computations in human statistical learning and corresponding cognitive adjustments. We present data from the stop-signal task, in which subjects respond to a go stimulus on each trial, unless instructed not to by a subsequent, infrequently presented stop signal. We model across-trial learning of stop signal frequency, P(stop, and stop-signal onset time, SSD (stop-signal delay, with a Bayesian hidden Markov model, and within-trial decision-making with an optimal stochastic control model. The combined model predicts that RT should increase with both expected P(stop and SSD. The human behavioral data (n=20 bear out this prediction, showing P(stop and SSD both to be significant, independent predictors of RT, with P(stop being a more prominent predictor in 75% of the subjects, and SSD being more prominent in the remaining 25%. The results demonstrate that humans indeed readily internalize environmental statistics and adjust their cognitive/behavioral strategy accordingly, and that subtle patterns in RT variability can serve as a valuable tool for validating models of statistical learning and decision-making. More broadly, the modeling tools presented in this work can be generalized to a large body of behavioral paradigms, in order to extract insights about cognitive and neural processing from apparently quite noisy behavioral measures. We also discuss how this behaviorally validated model can then be used to conduct model-based analysis of neural data, in order to help identify specific brain areas for representing and encoding key computational quantities in learning and decision-making.

  7. Regulating outdoor advertisement boards; employing spatial decision support system to control urban visual pollution

    Science.gov (United States)

    Wakil, K.; Hussnain, MQ; Tahir, A.; Naeem, M. A.

    2016-06-01

    Unmanaged placement, size, location, structure and contents of outdoor advertisement boards have resulted in severe urban visual pollution and deterioration of the socio-physical living environment in urban centres of Pakistan. As per the regulatory instruments, the approval decision for a new advertisement installation is supposed to be based on the locational density of existing boards and their proximity or remoteness to certain land- uses. In cities, where regulatory tools for the control of advertisement boards exist, responsible authorities are handicapped in effective implementation due to the absence of geospatial analysis capacity. This study presents the development of a spatial decision support system (SDSS) for regularization of advertisement boards in terms of their location and placement. The knowledge module of the proposed SDSS is based on provisions and restrictions prescribed in regulatory documents. While the user interface allows visualization and scenario evaluation to understand if the new board will affect existing linear density on a particular road and if it violates any buffer restrictions around a particular land use. Technically the structure of the proposed SDSS is a web-based solution which includes open geospatial tools such as OpenGeo Suite, GeoExt, PostgreSQL, and PHP. It uses three key data sets including road network, locations of existing billboards and building parcels with land use information to perform the analysis. Locational suitability has been calculated using pairwise comparison through analytical hierarchy process (AHP) and weighted linear combination (WLC). Our results indicate that open geospatial tools can be helpful in developing an SDSS which can assist solving space related iterative decision challenges on outdoor advertisements. Employing such a system will result in effective implementation of regulations resulting in visual harmony and aesthetic improvement in urban communities.

  8. Statistical learning and adaptive decision-making underlie human response time variability in inhibitory control.

    Science.gov (United States)

    Ma, Ning; Yu, Angela J

    2015-01-01

    Response time (RT) is an oft-reported behavioral measure in psychological and neurocognitive experiments, but the high level of observed trial-to-trial variability in this measure has often limited its usefulness. Here, we combine computational modeling and psychophysics to examine the hypothesis that fluctuations in this noisy measure reflect dynamic computations in human statistical learning and corresponding cognitive adjustments. We present data from the stop-signal task (SST), in which subjects respond to a go stimulus on each trial, unless instructed not to by a subsequent, infrequently presented stop signal. We model across-trial learning of stop signal frequency, P(stop), and stop-signal onset time, SSD (stop-signal delay), with a Bayesian hidden Markov model, and within-trial decision-making with an optimal stochastic control model. The combined model predicts that RT should increase with both expected P(stop) and SSD. The human behavioral data (n = 20) bear out this prediction, showing P(stop) and SSD both to be significant, independent predictors of RT, with P(stop) being a more prominent predictor in 75% of the subjects, and SSD being more prominent in the remaining 25%. The results demonstrate that humans indeed readily internalize environmental statistics and adjust their cognitive/behavioral strategy accordingly, and that subtle patterns in RT variability can serve as a valuable tool for validating models of statistical learning and decision-making. More broadly, the modeling tools presented in this work can be generalized to a large body of behavioral paradigms, in order to extract insights about cognitive and neural processing from apparently quite noisy behavioral measures. We also discuss how this behaviorally validated model can then be used to conduct model-based analysis of neural data, in order to help identify specific brain areas for representing and encoding key computational quantities in learning and decision-making.

  9. The Trial of Ascertaining Individual Preferences for Loved Ones' Role in End-of-Life Decisions (TAILORED) Study: A Randomized Controlled Trial to Improve Surrogate Decision Making.

    Science.gov (United States)

    Sulmasy, Daniel P; Hughes, Mark T; Yenokyan, Gayane; Kub, Joan; Terry, Peter B; Astrow, Alan B; Johnson, Julie A; Ho, Grace; Nolan, Marie T

    2017-10-01

    Patients with terminal illnesses often require surrogate decision makers. Prior research has demonstrated high surrogate stress, and that despite standards promoting substituted judgment, most patients do not want their surrogates to make pure substituted judgments for them. It is not known how best to help loved ones fulfill the surrogate role. To test the effectiveness of an intervention to help surrogate decision makers. One hundred sixty-six patients (41% with amyotrophic lateral sclerosis and 59% with gastrointestinal cancers) and their surrogates at two university medical centers were randomized to an intensive nurse-directed discussion of the end-of-life decision control preferences of the patient (TAILORED) or a discussion of nutrition (CONTROL); 163 completed baseline interviews and underwent the intervention. Twelve patients died during follow-up and 137 dyads completed the study. Post-intervention, using all available data, TAILORED patients and surrogates became more likely to endorse mutual surrogate decision making, that is, a balance of their own wishes and what the surrogate thinks best (adjusted odds compared with baseline for patients = 1.78, P = 0.04; adjusted odds for surrogates = 2.05, P = 0.03). CONTROL patients became 40% less likely to endorse mutual surrogate decision making (P = 0.08), and CONTROL surrogates did not change significantly from baseline (adjusted odds = 1.44, P = 0.28). Stress levels decreased for TAILORED surrogates (impact of events scale = 23.1 ± 14.6 baseline, 20.8 ± 15.3 f/u, P = 0.046), but not for CONTROL (P = 0.85), and post-intervention stress was lower for TAILORED than CONTROL (P = 0.04). Surrogates' confidence was uniformly high at baseline and did not change. Caregiver burden (Zarit) increased from 12.5 ± 6.5 to 14.7 ± 8.1 for TAILORED (P decision making was higher at follow-up for TAILORED than for CONTROL (71% vs. 52%, P = 0.03). TAILORED patients and surrogates who

  10. Perinatal serotonergic activity: A decisive factor in the control of food intake

    Directory of Open Access Journals (Sweden)

    Isabeli Lins PINHEIRO

    Full Text Available ABSTRACT The serotoninergic system controls key events related to proper nervous system development. The neurotransmitter serotonin and the serotonin transporter are critical for this control. Availability of these components is minutely regulated during the development period, and the environment may affect their action on the nervous system. Environmental factors such as undernutrition and selective serotonin reuptake inhibitors may increase the availability of serotonin in the synaptic cleft and change its anorectic action. The physiological responses promoted by serotonin on intake control decrease when requested by acute stimuli or stress, demonstrating that animals or individuals develop adaptations in response to the environmental insults they experience during the development period. Diseases, such as anxiety and obesity, appear to be associated with the body’s response to stress or stimulus, and require greater serotonergic system action. These findings demonstrate the importance of the level of serotonin in the perinatal period to the development of molecular and morphological aspects of food intake control, and its decisive role in understanding the possible environmental factors that cause diseases in adulthood.

  11. Embedded system in Arduino platform with Fuzzy control to support the grain aeration decision

    Directory of Open Access Journals (Sweden)

    Albino Szesz Junior

    Full Text Available ABSTRACT: Aeration is currently the most commonly used technique to improve the drying and storage of grain, depending on temperature and water content of the grain, as of the temperature and relative humidity of the outside air. In order to monitor temperature and humidity of the grain mass, it is possible to have a network of sensors in the cells of both internal and external storage. Use of artificial intelligence through Fuzzy theory, has been used since the 60s and enables their application on various forms. Thus, it is observed that the aeration of grain in function of representing a system of controlled environment can be studied in relation to the application of this theory. Therefore, the aim of this paper is to present an embedded Fuzzy control system based on the mathematical model of CRUZ et al. (2002 and applied to the Arduino platform, for decision support in aeration of grain. For this, an embedded Arduino system was developed, which received the environmental values of temperature and humidity to then be processed in a Fuzzy controller and return the output as a recommendation to control the aeration process rationally. Comparing the results obtained from the graph presented by LASSERAN (1981 it was observed that the system is effective.

  12. Oxytocin Effect on Collective Decision Making: A Randomized Placebo Controlled Study.

    Directory of Open Access Journals (Sweden)

    Uri Hertz

    Full Text Available Collective decision making often benefits both the individuals and the group in a variety of contexts. However, for the group to be successful, individuals should be able to strike a balance between their level of competence and their influence on the collective decisions. The hormone oxytocin has been shown to promote trust, conformism and attention to social cues. We wondered if this hormone may increase participants' (unwarranted reliance on their partners' opinion, resulting in a reduction in collective benefit by disturbing the balance between influence and competence. To test this hypothesis we employed a randomized double-blind placebo-controlled design in which male dyads self-administered intranasal oxytocin or placebo and then performed a visual search task together. Compared to placebo, collective benefit did not decrease under oxytocin. Using an exploratory time dependent analysis, we observed increase in collective benefit over time under oxytocin. Moreover, trial-by-trial analysis showed that under oxytocin the more competent member of each dyad was less likely to change his mind during disagreements, while the less competent member showed a greater willingness to change his mind and conform to the opinion of his more reliable partner. This role-dependent effect may be mediated by enhanced monitoring of own and other's performance level under oxytocin. Such enhanced social learning could improve the balance between influence and competence and lead to efficient and beneficial collaboration.

  13. Oxytocin Effect on Collective Decision Making: A Randomized Placebo Controlled Study.

    Science.gov (United States)

    Hertz, Uri; Kelly, Maria; Rutledge, Robb B; Winston, Joel; Wright, Nicholas; Dolan, Raymond J; Bahrami, Bahador

    2016-01-01

    Collective decision making often benefits both the individuals and the group in a variety of contexts. However, for the group to be successful, individuals should be able to strike a balance between their level of competence and their influence on the collective decisions. The hormone oxytocin has been shown to promote trust, conformism and attention to social cues. We wondered if this hormone may increase participants' (unwarranted) reliance on their partners' opinion, resulting in a reduction in collective benefit by disturbing the balance between influence and competence. To test this hypothesis we employed a randomized double-blind placebo-controlled design in which male dyads self-administered intranasal oxytocin or placebo and then performed a visual search task together. Compared to placebo, collective benefit did not decrease under oxytocin. Using an exploratory time dependent analysis, we observed increase in collective benefit over time under oxytocin. Moreover, trial-by-trial analysis showed that under oxytocin the more competent member of each dyad was less likely to change his mind during disagreements, while the less competent member showed a greater willingness to change his mind and conform to the opinion of his more reliable partner. This role-dependent effect may be mediated by enhanced monitoring of own and other's performance level under oxytocin. Such enhanced social learning could improve the balance between influence and competence and lead to efficient and beneficial collaboration.

  14. The solution of target assignment problem in command and control decision-making behaviour simulation

    Science.gov (United States)

    Li, Ni; Huai, Wenqing; Wang, Shaodan

    2017-08-01

    C2 (command and control) has been understood to be a critical military component to meet an increasing demand for rapid information gathering and real-time decision-making in a dynamically changing battlefield environment. In this article, to improve a C2 behaviour model's reusability and interoperability, a behaviour modelling framework was proposed to specify a C2 model's internal modules and a set of interoperability interfaces based on the C-BML (coalition battle management language). WTA (weapon target assignment) is a typical C2 autonomous decision-making behaviour modelling problem. Different from most WTA problem descriptions, here sensors were considered to be available resources of detection and the relationship constraints between weapons and sensors were also taken into account, which brought it much closer to actual application. A modified differential evolution (MDE) algorithm was developed to solve this high-dimension optimisation problem and obtained an optimal assignment plan with high efficiency. In case study, we built a simulation system to validate the proposed C2 modelling framework and interoperability interface specification. Also, a new optimisation solution was used to solve the WTA problem efficiently and successfully.

  15. Metabolism and the Control of Cell Fate Decisions and Stem Cell Renewal

    Science.gov (United States)

    Ito, Kyoko; Ito, Keisuke

    2016-01-01

    Although the stem cells of various tissues remain in the quiescent state to maintain their undifferentiated state, they also undergo cell divisions as required, and if necessary, even a single stem cell is able to provide for lifelong tissue homeostasis. Stem cell populations are precisely controlled by the balance between their symmetric and asymmetric divisions, with their division patterns determined by whether the daughter cells involved retain their self-renewal capacities. Recent studies have reported that metabolic pathways and the distribution of mitochondria are regulators of the division balance of stem cells and that metabolic defects can shift division balance toward symmetric commitment, which leads to stem cell exhaustion. It has also been observed that in asymmetric division, old mitochondria, which are central metabolic organelles, are segregated to the daughter cell fated to cell differentiation, whereas in symmetric division, young and old mitochondria are equally distributed between both daughter cells. Thus, metabolism and mitochondrial biology play important roles in stem cell fate decisions. As these decisions directly affect tissue homeostasis, understanding their regulatory mechanisms in the context of cellular metabolism is critical. PMID:27482603

  16. Predicting Appropriate Admission of Bronchiolitis Patients in the Emergency Department: Rationale and Methods.

    Science.gov (United States)

    Luo, Gang; Stone, Bryan L; Johnson, Michael D; Nkoy, Flory L

    2016-03-07

    In young children, bronchiolitis is the most common illness resulting in hospitalization. For children less than age 2, bronchiolitis incurs an annual total inpatient cost of $1.73 billion. Each year in the United States, 287,000 emergency department (ED) visits occur because of bronchiolitis, with a hospital admission rate of 32%-40%. Due to a lack of evidence and objective criteria for managing bronchiolitis, ED disposition decisions (hospital admission or discharge to home) are often made subjectively, resulting in significant practice variation. Studies reviewing admission need suggest that up to 29% of admissions from the ED are unnecessary. About 6% of ED discharges for bronchiolitis result in ED returns with admission. These inappropriate dispositions waste limited health care resources, increase patient and parental distress, expose patients to iatrogenic risks, and worsen outcomes. Existing clinical guidelines for bronchiolitis offer limited improvement in patient outcomes. Methodological shortcomings include that the guidelines provide no specific thresholds for ED decisions to admit or to discharge, have an insufficient level of detail, and do not account for differences in patient and illness characteristics including co-morbidities. Predictive models are frequently used to complement clinical guidelines, reduce practice variation, and improve clinicians' decision making. Used in real time, predictive models can present objective criteria supported by historical data for an individualized disease management plan and guide admission decisions. However, existing predictive models for ED patients with bronchiolitis have limitations, including low accuracy and the assumption that the actual ED disposition decision was appropriate. To date, no operational definition of appropriate admission exists. No model has been built based on appropriate admissions, which include both actual admissions that were necessary and actual ED discharges that were unsafe. The

  17. Unplanned intensive care unit admission after general anaesthesia in children: A single centre retrospective analysis.

    Science.gov (United States)

    Mitchell, John; Clément de Clety, Stephan; Collard, Edith; De Kock, Marc; Detaille, Thierry; Houtekie, Laurent; Jadin, Laurence; Bairy, Laurent; Veyckemans, Francis

    2016-06-01

    To determine the main causes for unplanned admission of children to the paediatric intensive care unit (PICU) following anaesthesia in our centre. To compare the results with previous publications and propose a data sheet for the prospective collection of such information. Inclusion criteria were any patient under 16 years who had an unplanned post-anaesthetic admission to the PICU from 1999 to 2010 in our university hospital. Age, ASA score, type of procedure, origin and causes of the incident(s) that prompted admission and time of the admission decision were recorded. Out of a total of 44,559 paediatric interventions performed under anaesthesia during the study period, 85 were followed with an unplanned admission to the PICU: 67% of patients were younger than 5 years old. Their ASA status distribution from I to IV was 13, 47, 39 and 1%, respectively. The cause of admission was anaesthetic, surgical or mixed in 50, 37 and 13% of cases, respectively. The main causes of anaesthesia-related admission were respiratory or airway management problems (44%) and cardiac catheterisation complications (29%). In 62%, the admission decision was taken in the operating room. Unplanned admission to the PICU after general anaesthesia is a rare event. In our series, most cases were less than 5 years old and were associated with at least one comorbidity. The main cause of admission was respiratory distress and the main type of procedure associated with admission was cardiac catheterisation. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  18. Job demands and decision control predicted return to work: the rapid-RTW cohort study

    Directory of Open Access Journals (Sweden)

    Lise Aasen Haveraaen

    2017-02-01

    Full Text Available Abstract Background In order to help workers with long-term sickness absence return to work (RTW, it is important to understand factors that either impede or facilitate employee’s reintegration into the labour force. The aim of this study was therefore to examine the impact of psychological work characteristics on time-to first RTW in sick listed employees in Norway. Methods The study was designed as a cohort study of 543 employees participating in 50 different RTW programmes. The Job Content Questionnaire (JCQ was used to gather information on the psychological work conditions. The participants were followed for up to 18 months after they started treatment in the RTW programme. Survival analyses were used to investigate the association between psychological work conditions and time-to first RTW. Results Having high psychological job demands (HR = .654; 95% CI: .513–.832 and low decision control (HR = 1.297; 95% CI: 1.010–1.666 were both independent predictors of delayed RTW. Employees in low-strain jobs (low demands/high control (HR = 1.811; 95% CI: 1.287–2.549 and passive jobs (low demands/low control (HR = 1.599; 95% CI: 1.107–2.309, returned to work earlier compared to employees in high-strain jobs (high demands/low control. No difference was found for active jobs (high demands/high control. Conclusion This study revealed that high psychological demands, low control, and being in a high strain job reduced the probability of early RTW in sick listed employees. RTW programmes should therefore increase the focus on these issues.

  19. Job demands and decision control predicted return to work: the rapid-RTW cohort study.

    Science.gov (United States)

    Haveraaen, Lise Aasen; Skarpaas, Lisebet Skeie; Aas, Randi Wågø

    2017-02-02

    In order to help workers with long-term sickness absence return to work (RTW), it is important to understand factors that either impede or facilitate employee's reintegration into the labour force. The aim of this study was therefore to examine the impact of psychological work characteristics on time-to first RTW in sick listed employees in Norway. The study was designed as a cohort study of 543 employees participating in 50 different RTW programmes. The Job Content Questionnaire (JCQ) was used to gather information on the psychological work conditions. The participants were followed for up to 18 months after they started treatment in the RTW programme. Survival analyses were used to investigate the association between psychological work conditions and time-to first RTW. Having high psychological job demands (HR = .654; 95% CI: .513-.832) and low decision control (HR = 1.297; 95% CI: 1.010-1.666) were both independent predictors of delayed RTW. Employees in low-strain jobs (low demands/high control) (HR = 1.811; 95% CI: 1.287-2.549) and passive jobs (low demands/low control) (HR = 1.599; 95% CI: 1.107-2.309), returned to work earlier compared to employees in high-strain jobs (high demands/low control). No difference was found for active jobs (high demands/high control). This study revealed that high psychological demands, low control, and being in a high strain job reduced the probability of early RTW in sick listed employees. RTW programmes should therefore increase the focus on these issues.

  20. Racism, gun ownership and gun control: biased attitudes in US whites may influence policy decisions.

    Science.gov (United States)

    O'Brien, Kerry; Forrest, Walter; Lynott, Dermot; Daly, Michael

    2013-01-01

    Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US whites. Explanatory variables known to be related to gun ownership and gun control opposition (i.e., age, gender, education, income, conservatism, anti-government sentiment, southern vs. other states, political identification) were entered in logistic regression models, along with measures of racism, and the stereotype of blacks as violent. Outcome variables included; having a gun in the home, opposition to bans on handguns in the home, support for permits to carry concealed handguns. After accounting for all explanatory variables, logistic regressions found that for each 1 point increase in symbolic racism there was a 50% increase in the odds of having a gun at home. After also accounting for having a gun in the home, there was still a 28% increase in support for permits to carry concealed handguns, for each one point increase in symbolic racism. The relationship between symbolic racism and opposition to banning handguns in the home (OR1.27 CI 1.03,1.58) was reduced to non-significant after accounting for having a gun in the home (OR1.17 CI.94,1.46), which likely represents self-interest in retaining property (guns). Symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites' paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions.

  1. Racism, gun ownership and gun control: biased attitudes in US whites may influence policy decisions.

    Directory of Open Access Journals (Sweden)

    Kerry O'Brien

    Full Text Available OBJECTIVE: Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty. This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. METHOD: The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US whites. Explanatory variables known to be related to gun ownership and gun control opposition (i.e., age, gender, education, income, conservatism, anti-government sentiment, southern vs. other states, political identification were entered in logistic regression models, along with measures of racism, and the stereotype of blacks as violent. Outcome variables included; having a gun in the home, opposition to bans on handguns in the home, support for permits to carry concealed handguns. RESULTS: After accounting for all explanatory variables, logistic regressions found that for each 1 point increase in symbolic racism there was a 50% increase in the odds of having a gun at home. After also accounting for having a gun in the home, there was still a 28% increase in support for permits to carry concealed handguns, for each one point increase in symbolic racism. The relationship between symbolic racism and opposition to banning handguns in the home (OR1.27 CI 1.03,1.58 was reduced to non-significant after accounting for having a gun in the home (OR1.17 CI.94,1.46, which likely represents self-interest in retaining property (guns. CONCLUSIONS: Symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites' paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions.

  2. Racism, Gun Ownership and Gun Control: Biased Attitudes in US Whites May Influence Policy Decisions

    Science.gov (United States)

    O’Brien, Kerry; Forrest, Walter; Lynott, Dermot; Daly, Michael

    2013-01-01

    Objective Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. Method The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US whites. Explanatory variables known to be related to gun ownership and gun control opposition (i.e., age, gender, education, income, conservatism, anti-government sentiment, southern vs. other states, political identification) were entered in logistic regression models, along with measures of racism, and the stereotype of blacks as violent. Outcome variables included; having a gun in the home, opposition to bans on handguns in the home, support for permits to carry concealed handguns. Results After accounting for all explanatory variables, logistic regressions found that for each 1 point increase in symbolic racism there was a 50% increase in the odds of having a gun at home. After also accounting for having a gun in the home, there was still a 28% increase in support for permits to carry concealed handguns, for each one point increase in symbolic racism. The relationship between symbolic racism and opposition to banning handguns in the home (OR1.27 CI 1.03,1.58) was reduced to non-significant after accounting for having a gun in the home (OR1.17 CI.94,1.46), which likely represents self-interest in retaining property (guns). Conclusions Symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites’ paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions. PMID:24204867

  3. A nuclear decision support system built with a real-time process control AI shell

    International Nuclear Information System (INIS)

    Nevins, M.A.

    1990-01-01

    Managing large nuclear power plants is generally approached by creating separate management teams to handle major functional areas such as operations, maintenance, training and engineering. While this approach facilitates a general understanding of the specific functions and problem areas of a nuclear plant, such broad definitions diminish the integration of information needed to understand the overall problem domain. One solution utilizes a decision support system that integrates a real-time process control AI shell, relational database manager, graphic depiction of the real-time events, and distributed knowledge bases that reside within each of the departments. The goal is to create a living model between plant components, procedures, tech specs, specific functions, maintenance and training requirements. This paper describes such a model, called Engineering Model and Simulation System (EMASS)

  4. Improved Hypoxia Modeling for Nutrient Control Decisions in the Gulf of Mexico

    Science.gov (United States)

    Habib, Shahid; Pickering, Ken; Tzortziou, Maria; Maninio, Antonio; Policelli, Fritz; Stehr, Jeff

    2011-01-01

    The Gulf of Mexico Modeling Framework is a suite of coupled models linking the deposition and transport of sediment and nutrients to subsequent bio-geo chemical processes and the resulting effect on concentrations of dissolved oxygen in the coastal waters of Louisiana and Texas. Here, we examine the potential benefits of using multiple NASA remote sensing data products within this Modeling Framework for increasing the accuracy of the models and their utility for nutrient control decisions in the Gulf of Mexico. Our approach is divided into three components: evaluation and improvement of (a) the precipitation input data (b) atmospheric constituent concentrations in EPA's air quality/deposition model and (c) the calculation of algal biomass, organic carbon and suspended solids within the water quality/eutrophication models of the framework.

  5. Decisions on foot-and-mouth disease control informed by model prediction

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq; Willeberg, Preben; Christiansen, Lasse Engbo

    2013-01-01

    of affected herds, epidemic duration, geographical size, and costs. The first fourteen days spatial spread (FFS) was also included to support the prediction. The epidemic data were obtained from a Danish version (DTU-DADS) of the Davis Animal Disease Spread simulation model. The FFI and FFS showed good......The predictive capability of the first fortnight incidence (FFI), which is the number of detected herds within the first 14 days following detection of the disease, of the course of a foot-and-mouth disease (FMD) epidemic and its outcomes were investigated. Epidemic outcomes included the number...... correlations with the epidemic outcomes. The predictive capability of the FFI was high. This indicates that the FFI may take a part in the decision of whether or not to boost FMD control, which might prevent occurrence of a large epidemic in the face of an FMD incursion. The prediction power was improved...

  6. Observability and Decision Support for Supervision of Distributed Power System Control

    DEFF Research Database (Denmark)

    Pertl, Michael

    approach for real-time voltage estimation in active distribution grids, and a modeling approach to harness the flexibility of an aggregation of electric vehicles. For improved monitoring and maintaining power system stability, a decision support tool for transient stability preventive control, based...... stability margin is presented. The approach delivers a near optimal solution in terms of cost minimization due to its sequential nature and shows to be robust when applied to larger power systems. The general problem of low distribution grid observability is addressed by proposing a data-driven approach...... results in additional demand for charging which will require large investments in power distribution, transmission, and generation. However, this demand is often also flexible in time and can be actively managed to reduce the required investments and to enhance power system operation. Harnessing...

  7. Just-in-time information improved decision-making in primary care: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Jessie McGowan

    Full Text Available BACKGROUND: The "Just-in-time Information" (JIT librarian consultation service was designed to provide rapid information to answer primary care clinical questions during patient hours. This study evaluated whether information provided by librarians to answer clinical questions positively impacted time, decision-making, cost savings and satisfaction. METHODS AND FINDING: A randomized controlled trial (RCT was conducted between October 2005 and April 2006. A total of 1,889 questions were sent to the service by 88 participants. The object of the randomization was a clinical question. Each participant had clinical questions randomly allocated to both intervention (librarian information and control (no librarian information groups. Participants were trained to send clinical questions via a hand-held device. The impact of the information provided by the service (or not provided by the service, additional resources and time required for both groups was assessed using a survey sent 24 hours after a question was submitted. The average time for JIT librarians to respond to all questions was 13.68 minutes/question (95% CI, 13.38 to 13.98. The average time for participants to respond their control questions was 20.29 minutes/question (95% CI, 18.72 to 21.86. Using an impact assessment scale rating cognitive impact, participants rated 62.9% of information provided to intervention group questions as having a highly positive cognitive impact. They rated 14.8% of their own answers to control question as having a highly positive cognitive impact, 44.9% has having a negative cognitive impact, and 24.8% with no cognitive impact at all. In an exit survey measuring satisfaction, 86% (62/72 responses of participants scored the service as having a positive impact on care and 72% (52/72 indicated that they would use the service frequently if it were continued. CONCLUSIONS: In this study, providing timely information to clinical questions had a highly positive impact on

  8. Just-in-time information improved decision-making in primary care: a randomized controlled trial.

    Science.gov (United States)

    McGowan, Jessie; Hogg, William; Campbell, Craig; Rowan, Margo

    2008-01-01

    The "Just-in-time Information" (JIT) librarian consultation service was designed to provide rapid information to answer primary care clinical questions during patient hours. This study evaluated whether information provided by librarians to answer clinical questions positively impacted time, decision-making, cost savings and satisfaction. A randomized controlled trial (RCT) was conducted between October 2005 and April 2006. A total of 1,889 questions were sent to the service by 88 participants. The object of the randomization was a clinical question. Each participant had clinical questions randomly allocated to both intervention (librarian information) and control (no librarian information) groups. Participants were trained to send clinical questions via a hand-held device. The impact of the information provided by the service (or not provided by the service), additional resources and time required for both groups was assessed using a survey sent 24 hours after a question was submitted. The average time for JIT librarians to respond to all questions was 13.68 minutes/question (95% CI, 13.38 to 13.98). The average time for participants to respond their control questions was 20.29 minutes/question (95% CI, 18.72 to 21.86). Using an impact assessment scale rating cognitive impact, participants rated 62.9% of information provided to intervention group questions as having a highly positive cognitive impact. They rated 14.8% of their own answers to control question as having a highly positive cognitive impact, 44.9% has having a negative cognitive impact, and 24.8% with no cognitive impact at all. In an exit survey measuring satisfaction, 86% (62/72 responses) of participants scored the service as having a positive impact on care and 72% (52/72) indicated that they would use the service frequently if it were continued. In this study, providing timely information to clinical questions had a highly positive impact on decision-making and a high approval rating from

  9. Patient admission planning using Approximate Dynamic Programming

    NARCIS (Netherlands)

    Hulshof, P.J.H.; Mes, Martijn R.K.; Boucherie, Richardus J.; Hans, Elias W.

    2016-01-01

    Tactical planning in hospitals involves elective patient admission planning and the allocation of hospital resource capacities. We propose a method to develop a tactical resource allocation and patient admission plan that takes stochastic elements into consideration, thereby providing robust plans.

  10. Development of Decision-Making Automated System for Optimal Placement of Physical Access Control System’s Elements

    Science.gov (United States)

    Danilova, Olga; Semenova, Zinaida

    2018-04-01

    The objective of this study is a detailed analysis of physical protection systems development for information resources. The optimization theory and decision-making mathematical apparatus is used to formulate correctly and create an algorithm of selection procedure for security systems optimal configuration considering the location of the secured object’s access point and zones. The result of this study is a software implementation scheme of decision-making system for optimal placement of the physical access control system’s elements.

  11. Decision tree-based learning to predict patient controlled analgesia consumption and readjustment

    Directory of Open Access Journals (Sweden)

    Hu Yuh-Jyh

    2012-11-01

    Full Text Available Abstract Background Appropriate postoperative pain management contributes to earlier mobilization, shorter hospitalization, and reduced cost. The under treatment of pain may impede short-term recovery and have a detrimental long-term effect on health. This study focuses on Patient Controlled Analgesia (PCA, which is a delivery system for pain medication. This study proposes and demonstrates how to use machine learning and data mining techniques to predict analgesic requirements and PCA readjustment. Methods The sample in this study included 1099 patients. Every patient was described by 280 attributes, including the class attribute. In addition to commonly studied demographic and physiological factors, this study emphasizes attributes related to PCA. We used decision tree-based learning algorithms to predict analgesic consumption and PCA control readjustment based on the first few hours of PCA medications. We also developed a nearest neighbor-based data cleaning method to alleviate the class-imbalance problem in PCA setting readjustment prediction. Results The prediction accuracies of total analgesic consumption (continuous dose and PCA dose and PCA analgesic requirement (PCA dose only by an ensemble of decision trees were 80.9% and 73.1%, respectively. Decision tree-based learning outperformed Artificial Neural Network, Support Vector Machine, Random Forest, Rotation Forest, and Naïve Bayesian classifiers in analgesic consumption prediction. The proposed data cleaning method improved the performance of every learning method in this study of PCA setting readjustment prediction. Comparative analysis identified the informative attributes from the data mining models and compared them with the correlates of analgesic requirement reported in previous works. Conclusion This study presents a real-world application of data mining to anesthesiology. Unlike previous research, this study considers a wider variety of predictive factors, including PCA

  12. Analytical tools and functions of GIS in the process control and decision support of mining company

    Directory of Open Access Journals (Sweden)

    Semrád Peter

    2001-12-01

    Full Text Available The development of computer techniques, the increase in demands for the professional and possible fastest data processing, as well as for the fluency and efficiency of information gaining, exchanging and providing has a strong influence on forming the new generation of information technologies - Geografic Information Systems (GIS that rose in the second half of the twentieth century.Advancement in this area is still progressing and GIS gradually find the enforcement in individual fields where they play a great role in the process control and decision support. Nowadays, there are applications in mining and geology, where are used especially at processing and evaluating of mining - geological documentation, optimalization of mining and technical processes, planning, distributing and managing of mining as well as economic analysis that are important in terms of investment decisions to mining business.GIS are the systems for the effective keeping, updating, processing, analysing, modelling, simulating and presenting geographically oriented information. We can identify them as computer systems helping to solve real problems that should be normally required to solve by human expert.Well equipped GIS have graphic ability and accordingly manage descriptive (attribute data. They are able to secure mutual connection between graphical and descriptive data and in addition to command countless number of functions that enable the execution of spatial analysis. This fact is very important in mining and geological application.There are exploited mostly geostatistical analysis (e. g. modelling of distribution valuable and harmful components of mineral resouce in a mineral deposit, surface modelling and surface model analysis (e. g. at modelling the subsidence of mining territory, different methods of creating spatial and attribute queries about database for seeking necessary data (e. g. to find all mining blocks of deposit that meet required conditions and to

  13. Can we predict podiatric medical school grade point average using an admission screen?

    Science.gov (United States)

    Shaw, Graham P; Velis, Evelio; Molnar, David

    2012-01-01

    Most medical school admission committees use cognitive and noncognitive measures to inform their final admission decisions. We evaluated using admission data to predict academic success for podiatric medical students using first-semester grade point average (GPA) and cumulative GPA at graduation as outcome measures. In this study, we used linear multiple regression to examine the predictive power of an admission screen. A cross-validation technique was used to assess how the results of the regression model would generalize to an independent data set. Undergraduate GPA and Medical College Admission Test score accounted for only 22% of the variance in cumulative GPA at graduation. Undergraduate GPA, Medical College Admission Test score, and a time trend variable accounted for only 24% of the variance in first-semester GPA. Seventy-five percent of the individual variation in cumulative GPA at graduation and first-semester GPA remains unaccounted for by admission screens that rely on only cognitive measures, such as undergraduate GPA and Medical College Admission Test score. A reevaluation of admission screens is warranted, and medical educators should consider broadening the criteria used to select the podiatric physicians of the future.

  14. Puberty menorrhagia Requiring Inpatient Admission

    Directory of Open Access Journals (Sweden)

    AH Khosla

    2010-06-01

    Full Text Available INTRODUCTION: Puberty menorrhagia is a significant health problem in adolescent age group and severe cases may require admission and blood transfusion. Aim of this study was to evaluate the causes, associated complications and management of puberty menorrhagia. METHODS: Hospital records of all patients of puberty menorrhagia requiring admission were analyzed for etiology, duration since menarche, duration of bleeding, investigation profile and management. RESULTS: There were 18 patients of puberty menorrhagia requiring hospital admission. Etiology was anovulatory bleeding in 11 patients, bleeding disorders in five which included idiopathic thrombocytopenia purpura in three and one each with Von-Willebrand disease and leukemia. Two patients had hypothyroidism as the cause. Fourteen patients presented with severe anaemia and required blood transfusion. All except one responded to oral hormonal therapy. CONCLUSIONS: Puberty menorrhagia can be associated with severe complications and requiring blood transfusion. Although most common cause is anovulation but bleeding disorder, other medical condition and other organic causes must be ruled out in any patient of Puberty menorrhagia. KEYWORDS: anovulation, bleeding disorder, puberty, menorrhagia, anaemia.

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

    Science.gov (United States)

    Zendehrouh, Sareh

    2015-11-01

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

  16. A model of human decision making in complex systems and its use for design of system control strategies

    International Nuclear Information System (INIS)

    Rasmussen, J.; Lind, M.

    1982-04-01

    The paper describes a model of operators' decision making in complex system control, based on studies of event reports and performance in control rooms. This study shows how operators base their decisions on knowledge of system properties at different levels of abstraction depending on their preception of the system's immediate control requirements. These levels correspond to the abstraction hierarchy including system purpose, functions, and physical details, which is generally used to describe a formal design process. In emergency situations the task of the operator is to design a suitabel control strategy for systems recovery, and the control systems designer should provide a man-machine interface, supporting the operator in identification of his task and in communication with the system at the level of abstraction corresponding to the immedite control requirement. A formalized representation of system properties in a multilevel flow model is described to provide a basis for an integrated control system design. (author)

  17. The effect of postal questionnaire burden on response rate and answer patterns following admission to intensive care: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Robert Hatch

    2017-03-01

    Full Text Available Abstract Background The effects of postal questionnaire burden on return rates and answers given are unclear following treatment on an intensive care unit (ICU. We aimed to establish the effects of different postal questionnaire burdens on return rates and answers given. Methods Design: A parallel group randomised controlled trial. We assigned patients by computer-based randomisation to one of two questionnaire packs (Group A and Group B. Setting: Patients from 26 ICUs in the United Kingdom. Inclusion criteria: Patients who had received at least 24 h of level 3 care and were 16 years of age or older. Patients did not know that there were different questionnaire burdens. The study included 18,490 patients. 12,170 were eligible to be sent a questionnaire pack at 3 months. We sent 12,105 questionnaires (6112 to group A and 5993 to group B. Interventions: The Group A pack contained demographic and EuroQol group 5 Dimensions 3 level (EQ-5D-3 L questionnaires, making four questionnaire pages. The Group B pack also contained the Hospital Anxiety and Depression Score (HADS and the Post-Traumatic Stress Disorder Check List-Civilian (PCL-C questionnaires, making eight questionnaire pages in total. Main outcome measure: Questionnaire return rate 3 months after ICU discharge by group. Results In group A, 2466/6112 (40.3% participants responded at 3 months. In group B 2315/ 5993 (38.6% participants responded (difference 1.7% CI for difference 0–3.5% p = 0.053. Group A reported better functionality than group B in the EQ-5D-3 L mobility (41% versus 37% reporting no problems p = 0.003 and anxiety/depression (59% versus 55% reporting no problems p = 0.017 domains. Conclusions In survivors of intensive care, questionnaire burden had no effect on return rates. However, questionnaire burden affected answers to the same questionnaire (EQ-5D-3 L. Trial registration ISRCTN69112866 (assigned 02/05/2006.

  18. 32 CFR 575.2 - Admission; general.

    Science.gov (United States)

    2010-07-01

    ... MILITARY ACADEMY § 575.2 Admission; general. (a) In one major respect, the requirements for admission to the United States Military Academy differ from the normal requirements for admission to a civilian college or university; each candidate must obtain an official nomination to the Academy. The young person...

  19. Decision making concept of risk control: integration of decision criteria, top level risk indices and plant performance indices

    International Nuclear Information System (INIS)

    Vojnovic, D.; Mavko, B.; Kozuh, M.

    1993-01-01

    A support system for risk monitoring and control is suggested. The following concepts of system elements are briefly discussed: risk curve partitioning, the reliability cost function, the multi-objective optimization model, preference assessment, safety/risk indicators, and knowledge based systems. (Z.S.) 2 figs

  20. Is There a "Workable" Race-Neutral Alternative to Affirmative Action in College Admissions?

    Science.gov (United States)

    Long, Mark C.

    2015-01-01

    The 2013 decision by the U.S. Supreme Court in the Fisher v. University of Texas at Austin case clarified when and how it is legally permissible for universities to use an applicant's race or ethnicity in its admissions decisions. The court concluded that such use is permissible when "no workable race-neutral alternatives would produce…

  1. Durable decision-making is central to the control of risks

    International Nuclear Information System (INIS)

    Zebroski, E.L.

    1990-01-01

    In several capacities the author has promoted the importance of risk analysis techniques as a rational path to the improved assurance of safety. The interest in decisions arose from the persistent observation of only moderate or minor impacts or benefits to practical operations from the availability of wall documented risk analysis studies for many nuclear units. The complexity and number of variables in decisions on matters of safety of large scale operations defies ordinary intuitive decision making. The structured decision process is not a panacea, but is often the practical tool of choise for managing complexity in an orderly way. Typical basic sources for decision techniques are listed in references. (orig.)

  2. An Innovative Approach for Decreasing Fall Trauma Admissions from Geriatric Living Facilities: Preliminary Investigation.

    Science.gov (United States)

    Evans, Tracy; Gross, Brian; Rittenhouse, Katelyn; Harnish, Carissa; Vellucci, Ashley; Bupp, Katherine; Horst, Michael; Miller, Jo Ann; Baier, Ron; Chandler, Roxanne; Rogers, Frederick B

    2015-12-01

    Geriatric living facilities have been associated with a high rate of falls. We sought to develop an innovative intervention approach targeting geriatric living facilities that would reduce geriatric fall admissions to our Level II trauma center. In 2011, a Trauma Prevention Taskforce visited 5 of 28 local geriatric living facilities to present a fall prevention protocol composed of three sections: fall education, risk factor identification, and fall prevention strategies. To determine the impact of the intervention, the trauma registry was queried for all geriatric fall admissions attributed to patients living at local geriatric living facilities. The fall admission rate (total fall admissions/total beds) of the pre-intervention period (2010-2011) was compared with that of the postintervention period (2012-2013) at the 5 intervention and 23 control facilities. A P value fall admissions attributed to local geriatric living facilities (intervention: 179 fall admissions; control: 308 fall admissions). The unadjusted fall rate decreased at intervention facilities from 8.9 fall admissions/bed pre-intervention to 8.1 fall admissions/bed postintervention, whereas fall admission rates increased at control sites from 5.9 to 7.7 fall admissions/bed during the same period [control/intervention odds ratio (OR), 95% confidence interval (CI) = 1.32, 1.05-1.67; period OR, 95%CI = 1.55, 1.18-2.04, P = 0.002; interaction of control/intervention group and period OR 95% CI = 0.68, 0.46-1.00, P = 0.047]. An aggressive intervention program targeting high-risk geriatric living facilities resulted in a statistically significant decrease in geriatric fall admissions to our Level II trauma center.

  3. The Economics of an Admissions Holding Unit.

    Science.gov (United States)

    Schreyer, Kraftin E; Martin, Richard

    2017-06-01

    With increasing attention to the actual cost of delivering care, return-on-investment calculations take on new significance. Boarded patients in the emergency department (ED) are harmful to clinical care and have significant financial opportunity costs. We hypothesize that investment in an admissions holding unit for admitted ED patients not only captures opportunity cost but also significantly lowers direct cost of care. This was a three-phase study at a busy urban teaching center with significant walkout rate. We first determined the true cost of maintaining a staffed ED bed for one patient-hour and compared it to alternative settings. The opportunity cost for patients leaving without being seen was then conservatively estimated. Lastly, a convenience sample of admitted patients boarding in the ED was observed continuously from one hour after decision-to-admit until physical departure from the ED to capture a record of every interaction with a nurse or physician. Personnel costs per patient bed-hour were $58.20 for the ED, $24.80 for an inpatient floor, $19.20 for the inpatient observation unit, and $10.40 for an admissions holding area. An eight-bed holding unit operating at practical capacity would free 57.4 hours of bed space in the ED and allow treatment of 20 additional patients. This could yield increased revenues of $27,796 per day and capture opportunity cost of $6.09 million over 219 days, in return for extra staffing costs of $218,650. Analysis of resources used for boarded patients was determined by continuous observation of a convenience sample of ED-boarded patients, which found near-zero interactions with both nursing and physicians during the boarding interval. Resource expense per ED bed-hour is more than twice that in non-critical care inpatient units. Despite the high cost of available resources, boarded non-critical patients receive virtually no nursing or physician attention. An admissions holding unit is remarkably effective in avoiding the

  4. The Economics of an Admissions Holding Unit

    Directory of Open Access Journals (Sweden)

    Kraftin E. Schreyer

    2017-05-01

    Full Text Available Introduction: With increasing attention to the actual cost of delivering care, return-on-investment calculations take on new significance. Boarded patients in the emergency department (ED are harmful to clinical care and have significant financial opportunity costs. We hypothesize that investment in an admissions holding unit for admitted ED patients not only captures opportunity cost but also significantly lowers direct cost of care. Methods: This was a three-phase study at a busy urban teaching center with significant walkout rate. We first determined the true cost of maintaining a staffed ED bed for one patient-hour and compared it to alternative settings. The opportunity cost for patients leaving without being seen was then conservatively estimated. Lastly, a convenience sample of admitted patients boarding in the ED was observed continuously from one hour after decision-to-admit until physical departure from the ED to capture a record of every interaction with a nurse or physician. Results: Personnel costs per patient bed-hour were $58.20 for the ED, $24.80 for an inpatient floor, $19.20 for the inpatient observation unit, and $10.40 for an admissions holding area. An eight-bed holding unit operating at practical capacity would free 57.4 hours of bed space in the ED and allow treatment of 20 additional patients. This could yield increased revenues of $27,796 per day and capture opportunity cost of $6.09 million over 219 days, in return for extra staffing costs of $218,650. Analysis of resources used for boarded patients was determined by continuous observation of a convenience sample of ED-boarded patients, which found near-zero interactions with both nursing and physicians during the boarding interval. Conclusion: Resource expense per ED bed-hour is more than twice that in non-critical care inpatient units. Despite the high cost of available resources, boarded non-critical patients receive virtually no nursing or physician attention. An

  5. Prioritizing congenital syphilis control in south China: a decision analytic model to inform policy implementation.

    Directory of Open Access Journals (Sweden)

    Nicholas X Tan

    Full Text Available Syphilis is a major public health problem in many regions of China, with increases in congenital syphilis (CS cases causing concern. The Chinese Ministry of Health recently announced a comprehensive 10-y national syphilis control plan focusing on averting CS. The decision analytic model presented here quantifies the impact of the planned strategies to determine whether they are likely to meet the goals laid out in the control plan.Our model incorporated data on age-stratified fertility, female adult syphilis cases, and empirical syphilis transmission rates to estimate the number of CS cases associated with prenatal syphilis infection on a yearly basis. Guangdong Province was the focus of this analysis because of the availability of high-quality demographic and public health data. Each model outcome was simulated 1,000 times to incorporate uncertainty in model inputs. The model was validated using data from a CS intervention program among 477,656 women in China. Sensitivity analyses were performed to identify which variables are likely to be most influential in achieving Chinese and international policy goals. Increasing prenatal screening coverage was the single most effective strategy for reducing CS cases. An incremental increase in prenatal screening from the base case of 57% coverage to 95% coverage was associated with 106 (95% CI: 101, 111 CS cases averted per 100,000 live births (58% decrease. The policy strategies laid out in the national plan led to an outcome that fell short of the target, while a four-pronged comprehensive syphilis control strategy consisting of increased prenatal screening coverage, increased treatment completion, earlier prenatal screening, and improved syphilis test characteristics was associated with 157 (95% CI: 154, 160 CS cases averted per 100,000 live births (85% decrease.The Chinese national plan provides a strong foundation for syphilis control, but more comprehensive measures that include earlier and more

  6. TWRS FSAR integrated control decision meetings - January 22 - 31,1997

    Energy Technology Data Exchange (ETDEWEB)

    Saladin, V.L.

    1997-03-17

    U.S. Department of Energy (DOE), Richland Operations Office (RL) letter 97-MSD-163 dated January 15, 1997, directed the Project Hanford Management Contractor (Contractor), Fluor Daniel Hanford, inc., to form a joint RL-Contractor Integrated Control Decision Team (ICDT) to evaluate the Tank Waste Remediation System (TWRS) Final Safety Analysis Report (FSAR) accident scenarios that were identified to be above the risk evaluation guidelines (radiological and/or toxicological) defined by the April 8, 1996, letter from J. Kinzer, RL-TWRS (96-MSO-069) to Dr. A. L. Trego, Westinghouse Hanford Company. The ICDT evaluated six postulated accidents from the draft FSAR which had analyzed consequences above the DOE directed risk evaluation guidelines after controls were applied. The accidents were: (1) Organic Solvent Fires; (2) Organic Salt-Nitrate Fire; (3) Spray Leak; (4) Flammable Gas; (5) Steam Intrusion; and (6) Seismic Event. Five of the postulated accidents exceed radiological risk guidelines. Although the postulated steam intrusion accident does not exceed the radiological risk guidelines, it was considered in the ICDT evaluation because its calculated consequences exceed toxicological risk evaluation guidelines. Figure 1 delineates the mitigated and unmitigated risk evaluations performed for the FSAR.

  7. Interfacing An Intelligent Decision-Maker To A Real-Time Control System

    Science.gov (United States)

    Evers, D. C.; Smith, D. M.; Staros, C. J.

    1984-06-01

    This paper discusses some of the practical aspects of implementing expert systems in a real-time environment. There is a conflict between the needs of a process control system and the computational load imposed by intelligent decision-making software. The computation required to manage a real-time control problem is primarily concerned with routine calculations which must be executed in real time. On most current hardware, non-trivial AI software should not be forced to operate under real-time constraints. In order for the system to work efficiently, the two processes must be separated by a well-defined interface. Although the precise nature of the task separation will vary with the application, the definition of the interface will need to follow certain fundamental principles in order to provide functional separation. This interface was successfully implemented in the expert scheduling software currently running the automated chemical processing facility at Lockheed-Georgia. Potential applications of this concept in the areas of airborne avionics and robotics will be discussed.

  8. Risk-sensitivity and the mean-variance trade-off: decision making in sensorimotor control.

    Science.gov (United States)

    Nagengast, Arne J; Braun, Daniel A; Wolpert, Daniel M

    2011-08-07

    Numerous psychophysical studies suggest that the sensorimotor system chooses actions that optimize the average cost associated with a movement. Recently, however, violations of this hypothesis have been reported in line with economic theories of decision-making that not only consider the mean payoff, but are also sensitive to risk, that is the variability of the payoff. Here, we examine the hypothesis that risk-sensitivity in sensorimotor control arises as a mean-variance trade-off in movement costs. We designed a motor task in which participants could choose between a sure motor action that resulted in a fixed amount of effort and a risky motor action that resulted in a variable amount of effort that could be either lower or higher than the fixed effort. By changing the mean effort of the risky action while experimentally fixing its variance, we determined indifference points at which participants chose equiprobably between the sure, fixed amount of effort option and the risky, variable effort option. Depending on whether participants accepted a variable effort with a mean that was higher, lower or equal to the fixed effort, they could be classified as risk-seeking, risk-averse or risk-neutral. Most subjects were risk-sensitive in our task consistent with a mean-variance trade-off in effort, thereby, underlining the importance of risk-sensitivity in computational models of sensorimotor control.

  9. Regional Labour Court Baden-Wuerttemberg (Mannheim), decision of November 24, 1986 (co-determination in matters of security control)

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    In its decision of November 24, 1986, the Regional Court of Baden-Wuerttemberg deals with the direction of security controls in nuclear research plants. The co-determination of the works council in this field is excluded, if the operator is directed by the licensing authority to carry out these controls pursuant to an obligation of the operating licence according to sec. 7 and sec. 17 of the Atomic Energy Act. With regard to the security purpose in sec. 1 no. 2 Atomic Energy Act only the operator is competent to make decisions in these cases. (WG) [de

  10. A randomised controlled trial evaluating the utility of a patient Decision Aid to improve clinical trial (RAVES 08.03) related decision-making.

    Science.gov (United States)

    Sundaresan, Puma; Ager, Brittany; Turner, Sandra; Costa, Dan; Kneebone, Andrew; Pearse, Maria; Woo, Henry; Tesson, Stephanie; Juraskova, Ilona; Butow, Phyllis

    2017-10-01

    Randomised controlled trials (RCTs) are considered the 'gold-standard' for evaluating medical treatments. However, patients and clinicians report difficulties with informed consent and recruitment. We evaluated the utility of a Decision Aid (DA) in reducing RCT-related decisional conflict, and improving RCT knowledge and recruitment. Potential participants for a radiotherapy RCT were invited to participate in the current study. Participants were randomised to receive the RCT's participant information sheet with or without a DA. Questionnaires were administered at baseline, one and six months. The primary outcome measure was decisional conflict. Secondary outcome measures included knowledge regarding and recruitment to the RCT. 129 men were randomised to the DA (63) and control (66) arms. Decisional conflict was significantly lower over 6-months (p=0.048) in the DA arm. Knowledge regarding the RCT was significantly higher at 6months (p=0.033) in the DA arm. 20.6% of the DA arm (13 of 63) and 9% of the control arm (6 of 66) entered the RCT. This study demonstrates the utility of a DA in reducing decisional conflict and improving trial knowledge in men with cancer who are making decisions regarding RCT participation. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  11. A decision aid to assist decisions on disclosure of mental health status to an employer: protocol for the CORAL exploratory randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Henderson Claire

    2012-08-01

    Full Text Available Abstract Background The UK Equality Act 2010 makes it unlawful for employers to ask health questions before making an offer of employment except in certain circumstances. While the majority of employers would prefer applicants to disclose a mental illness at the application stage, many people either wait until they have accepted the job and then disclose to an occupational health professional, or do not do so at all due to the anticipation of discrimination or a wish for privacy. However, non disclosure precludes the ability to request reasonable adjustments in the workplace or to make a claim of direct discrimination. Disclosure to employers is therefore a difficult decision. A recent pilot study by our group of the CORAL decision aid showed that it helped mental health service users clarify their needs and values regarding disclosure and led to reduction in decisional conflict. The present proof of concept trial aims to determine whether a full scale randomised controlled trial (RCT is justifiable and feasible, and to optimise its design. Methods In this single blind exploratory RCT in London, a total of 80 participants (inclusion criteria: age ≥18 years, on the caseload of a specialist employment adviser working with people with mental illness; referred to the adviser either from primary care via Improving Access to Psychological Therapies or secondary mental health service; currently seeking or interested in either paid or voluntary employment, and a Decisional Conflict Scale score of 37.5 or greater and stage of decision score 1–5 will be recruited from vocational advice services. After completing a baseline assessment, participants will be randomly assigned to one of two conditions (1 Use of the CORAL Decision Aid (DA in addition to treatment as usual or (2 Treatment as usual. Those allocated to the DA condition will be given it to read and complete, and the researcher will be present to record the time taken and any content that

  12. The Constitutional Court in light of interpretive decisions in normative control proceedings

    Directory of Open Access Journals (Sweden)

    Stojanović Dragan

    2016-01-01

    -deprivation' in cases where the Constitutional Court may have had to abandon its primary constitutional mission and even 'tolerate' unconstitutional activity. In particular, this refers to the constructs such as 'a matter of legislative policy ' and a highly dubious term 'political acts' which are eo ipso excluded from constitutional control. On the other hand, when it comes to interpretative decisions, which rest on the dogmatic principle of statutory interpretation aimed at establishing the compliance of laws with the Constitution, the interpretation results may 'save' the legal act from being declared unconstitutional and invalid. In that case, the main problem is that the Constitutional Court has a slightly different role of shaping the positive law; thus, the practice of resorting (too frequently to interpretative decisions does not lead to the optimal exercise of the Constitutional Court mission. Therefore, we can conclude that the constitutional jurisprudence (which includes only a few interpretative decisions does not seem to entail a 'dangerous' divergence of the Constitutional Court from its constitutional mission, nor does it significantly affect the principal Constitutional Court activities.

  13. Admission Test and Pregnancy Outcome

    Directory of Open Access Journals (Sweden)

    Setareh Akhavan

    2017-07-01

    Full Text Available Background: The admission test (AT has been carried out for many years, but there are still debates about the prognostic value of the test. Therefore, we aimed to examine the value of the AT in predicting the adverse outcome in neonates. Methods: In this cross-sectional study, 425 pregnant women with normal vaginal delivery were studied between2009 and 2014at Vali-e-Asr Hospital. Based on the results, the women were divided into 2groups of normal and abnormal ATs. All the patients were followed up until the birth of their baby, when the status of mother and neonate was determined. The main outcomes of the study were cesarean rate, neonatal intensive care unit (NICU admission, fetus demise, neonatal acidosis, and Apgar score. The independent t-test, chi-square test, Fisher exact test, and logistic regression were used for statistical analysis. The data were analyzed using SPSS (version 17. Results: Of 425 pregnant women studied, 142 (33.4% had abnormal ATs with a mean age of 29 (±4.5 years. Multivariate analysis showed that an abnormal AT was able to predict the incidence of cesarean section, intrauterine growth restriction, turned cord, and Apgar<7, but it could not predict neonatal death and hypoxia. Conclusion: The AT was shown to be a useful screening test with risk factors such as oligohydramnios, bloody amniotic fluid, meconium amniotic fluid, intrauterine growth restriction, and turned cord. Additionally, the test was also able to predict NICU admission and the need for cesarean section, but it could not predict the occurrence of neonatal death.

  14. Investigating a training supporting shared decision making (IT'S SDM 2011: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Geiger Friedemann

    2011-10-01

    Full Text Available Background Shared Decision Making (SDM is regarded as the best practice model for the communicative challenge of decision making about treatment or diagnostic options. However, randomized controlled trials focusing the effectiveness of SDM trainings are rare and existing measures of SDM are increasingly challenged by the latest research findings. This study will 1 evaluate a new physicians' communication training regarding patient involvement in terms of SDM, 2 validate SDMMASS, a new compound measure of SDM, and 3 evaluate the effects of SDM on the perceived quality of the decision process and on the elaboration of the decision. Methods In a multi-center randomized controlled trial with a waiting control group, 40 physicians from 7 medical fields are enrolled. Each physician contributes a sequence of four medical consultations including a diagnostic or treatment decision. The intervention consists of two condensed video-based individual coaching sessions (15min. supported by a manual and a DVD. The interventions alternate with three measurement points plus follow up (6 months. Realized patient involvement is measured using the coefficient SDMMASS drawn from the Multifocal Approach to the Sharing in SDM (MAPPIN'SDM which includes objective involvement, involvement as perceived by the patient, and the doctor-patient concordance regarding their judges of the involvement. For validation purposes, all three components of SDMMASS are supplemented by similar measures, the OPTION observer scale, the Shared Decision Making Questionnaire (SDM-Q and the dyadic application of the Decisional Conflict Scale (DCS. Training effects are analyzed using t-tests. Spearman correlation coefficients are used to determine convergent validities, the influence of involvement (SDMMASS on the perceived decision quality (DCS and on the elaboration of the decision. The latter is operationalised by the ELAB coefficient from the UP24 (Uncertainty Profile, 24 items version

  15. Patients' perceptions and attitudes on recurrent prostate cancer and hormone therapy: Qualitative comparison between decision-aid and control groups.

    Science.gov (United States)

    Gorawara-Bhat, Rita; O'Muircheartaigh, Siobhan; Mohile, Supriya; Dale, William

    2017-09-01

    To compare patients' attitudes towards recurrent prostate cancer (PCa) and starting hormone therapy (HT) treatment in two groups-Decision-Aid (DA) (intervention) and Standard-of-care (SoC) (Control). The present research was conducted at three academic clinics-two in the Midwest and one in the Northeast U.S. Patients with biochemical recurrence of PCa (n=26) and follow-up oncology visits meeting inclusion criteria were randomized to either the SoC or DA intervention group prior to their consultation. Analysts were blinded to group assignment. Semi-structured phone interviews with patients were conducted 1-week post consultation. Interviews were audio-taped and transcribed. Qualitative analytic techniques were used to extract salient themes and conduct a comparative analysis of the two groups. Four salient themes emerged-1) knowledge acquisition, 2) decision-making style, 3) decision-making about timing of HT, and 4) anxiety-coping mechanisms. A comparative analysis showed that patients receiving the DA intervention had a better comprehension of Prostate-specific antigen (PSA), an improved understanding of HT treatment implications, an external locus-of-control, participation in shared decision-making and, support-seeking for anxiety reduction. In contrast, SoC patients displayed worse comprehension of PSA testing and HT treatment implications, internal locus-of-control, unilateral involvement in knowledge-seeking and decision-making, and no support-seeking for anxiety-coping. The DA was more effective than the SoC group in helping PCa patients understand the full implications of PSA testing and treatment; motivating shared decision-making, and support-seeking for anxiety relief. DA DVD interventions can be a useful patient education tool for bringing higher quality decision-making to prostate cancer care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Evaluation of a decision aid for women with breech presentation at term: a randomised controlled trial [ISRCTN14570598

    Science.gov (United States)

    Nassar, N; Roberts, CL; Raynes-Greenow, CH; Barratt, A; Peat, B

    2007-01-01

    Objectives To evaluate the effectiveness of a decision aid for women with a breech presentation compared with usual care. Design Randomised controlled trial. Setting Tertiary obstetric hospitals offering external cephalic version (ECV). Population Women with a singleton pregnancy were diagnosed antenatally with a breech presentation at term, and were clinically eligible for ECV. Methods Women were randomised to either receive a decision aid about the management options for breech presentation in addition to usual care or to receive usual care only with standard counselling from their usual pregnancy care provider. The decision aid comprised a 24-page booklet supplemented by a 30-minute audio-CD and worksheet that was designed for women to take home and review with a partner. Main outcome measures Decisional conflict (uncertainty), knowledge, anxiety and satisfaction with decision making, and were assessed using self-administered questionnaires. Results Compared with usual care, women reviewing the decision aid experienced significantly lower decisional conflict (mean difference −8.92; 95% CI −13.18, −4.66) and increased knowledge (mean difference 8.40; 95% CI 3.10, 13.71), were more likely to feel that they had enough information to make a decision (RR 1.30; 95% CI 1.14, 1.47), had no increase in anxiety and reported greater satisfaction with decision making and overall experience of pregnancy and childbirth. In contrast, 19% of women in the usual care group reported they would have made a different decision about their care. Conclusions A decision aid is an effective and acceptable tool for pregnant women that provides an important adjunct to standard counselling for the management of breech presentation. Please cite this paper as: Nassar N, Roberts C, Raynes-Greenow C, Barratt A, Peat B, on behalf of the Decision Aid for Breech Presentation Trial Collaborators. Evaluation of a decision aid for women with breech presentation at term: a randomised controlled

  17. Transactive System: Part I: Theoretical Underpinnings of Payoff Functions, Control Decisions, Information Privacy, and Solution Concepts

    Energy Technology Data Exchange (ETDEWEB)

    Lian, Jianming [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhang, Wei [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sun, Y. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Marinovici, Laurentiu D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Kalsi, Karanjit [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Widergren, Steven E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2018-01-17

    new transactive energy system design with demonstrable guarantees on stability and performance. Specifically, the goals are to (1) establish a theoretical basis for evaluating the performance of different transactive systems, (2) devise tools to address canonical problems that exemplify challenges and scenarios of transactive systems, and (3) provide guidelines for design of future transactive systems. This report, Part 1 of a two part series, advances the above-listed research objectives by reviewing existing transactive systems and identifying a theoretical foundation that integrates payoff functions, control decisions, information privacy, and mathematical solution concepts.

  18. Admissible invariant distributions on reductive

    CERN Document Server

    Harish-Chandra; Paul J Sally, Jr

    1999-01-01

    Harish-Chandra presented these lectures on admissible invariant distributions for p-adic groups at the Institute for Advanced Study in the early 1970s. He published a short sketch of this material as his famous "Queen's Notes". This book, which was prepared and edited by DeBacker and Sally, presents a faithful rendering of Harish-Chandra's original lecture notes. The main purpose of Harish-Chandra's lectures was to show that the character of an irreducible admissible representation of a connected reductive p-adic group G is represented by a locally summable function on G. A key ingredient in this proof is the study of the Fourier transforms of distributions on \\mathfrak g, the Lie algebra of G. In particular, Harish-Chandra shows that if the support of a G-invariant distribution on \\mathfrak g is compactly generated, then its Fourier transform has an asymptotic expansion about any semisimple point of \\mathfrak g. Harish-Chandra's remarkable theorem on the local summability of characters for p-adic groups was ...

  19. Admission Criteria for MBA Programs

    Directory of Open Access Journals (Sweden)

    Silvana Dakduk

    2016-11-01

    Full Text Available This paper reports a review of studies on admission criteria for MBA programs. The method consisted in a literary review based on a systematic search in international databases (Emerald, ABI/INFORM Global, ProQuest Education Journals, ProQuest European Business, ProQuest Science Journal, ProQuest Research Library, ProQuest Psychology Journals, ProQuest Social Science Journals and Business Source Complete of studies published from January 1990 to December 2013, which explore the academic performance of students or graduates of MBA programs. A quantitative review was performed. Results show that most researchers studied relations between GMAT (Graduate Management Admission Test and UGPA (Undergraduate Grade Point Average as predictors of GGPA (Graduate Grade Point Average. On the other hand, work experience and personal traits (such as personality, motivation, learning strategies, self-efficacy beliefs and achievement expectations and their relation with GGPA had been less studied, and results are not consistent enough to consider them valid predictors of student performance at this time.

  20. Explaining landholders' decisions about riparian zone management: the role of behavioural, normative, and control beliefs.

    Science.gov (United States)

    Fielding, Kelly S; Terry, Deborah J; Masser, Barbara M; Bordia, Prashant; Hogg, Michael A

    2005-10-01

    Water quality is a key concern in the current global environment, with the need to promote practices that help to protect water quality, such as riparian zone management, being paramount. The present study used the theory of planned behaviour as a framework for understanding how beliefs influence decisions about riparian zone management. Respondents completed a survey that assessed their behavioural, normative, and control beliefs in relation to intentions to manage riparian zones on their property. The results of the study showed that, overall, landholders with strong intentions to manage their riparian zones differed significantly in terms of their beliefs compared to landholders who had weak intentions to manage their riparian zones. Strong intentions to manage riparian zones were associated with a favourable cost-benefit analysis, greater perceptions of normative support for the practice and lower perceptions of the extent to which barriers would impede management of riparian zones. It was also evident that willingness to comply with the recommendations of salient referents, beliefs about the benefits of riparian zone management and perceptions of the extent to which barriers would impede riparian zone management were most important for determining intentions to manage riparian zones. Implications for policy and extension practice are discussed.

  1. Computer-Based Driving in Dementia Decision Tool With Mail Support: Cluster Randomized Controlled Trial.

    Science.gov (United States)

    Rapoport, Mark J; Zucchero Sarracini, Carla; Kiss, Alex; Lee, Linda; Byszewski, Anna; Seitz, Dallas P; Vrkljan, Brenda; Molnar, Frank; Herrmann, Nathan; Tang-Wai, David F; Frank, Christopher; Henry, Blair; Pimlott, Nicholas; Masellis, Mario; Naglie, Gary

    2018-05-25

    Physicians often find significant challenges in assessing automobile driving in persons with mild cognitive impairment and mild dementia and deciding when to report to transportation administrators. Care must be taken to balance the safety of patients and other road users with potential negative effects of issuing such reports. The aim of this study was to assess whether a computer-based Driving in Dementia Decision Tool (DD-DT) increased appropriate reporting of patients with mild dementia or mild cognitive impairment to transportation administrators. The study used a parallel-group cluster nonblinded randomized controlled trial design to test a multifaceted knowledge translation intervention. The intervention included a computer-based decision support system activated by the physician-user, which provides a recommendation about whether to report patients with mild dementia or mild cognitive impairment to transportation administrators, based on an algorithm derived from earlier work. The intervention also included a mailed educational package and Web-based specialized reporting forms. Specialists and family physicians with expertise in dementia or care of the elderly were stratified by sex and randomized to either use the DD-DT or a control version of the tool that required identical data input as the intervention group, but instead generated a generic reminder about the reporting legislation in Ontario, Canada. The trial ran from September 9, 2014 to January 29, 2016, and the primary outcome was the number of reports made to the transportation administrators concordant with the algorithm. A total of 69 participating physicians were randomized, and 36 of these used the DD-DT; 20 of the 35 randomized to the intervention group used DD-DT with 114 patients, and 16 of the 34 randomized to the control group used it with 103 patients. The proportion of all assessed patients reported to the transportation administrators concordant with recommendation did not differ

  2. Cognitive regulation during decision making shifts behavioral control between ventromedial and dorsolateral prefrontal value systems.

    Science.gov (United States)

    Hutcherson, Cendri A; Plassmann, Hilke; Gross, James J; Rangel, Antonio

    2012-09-26

    Cognitive regulation is often used to influence behavioral outcomes. However, the computational and neurobiological mechanisms by which it affects behavior remain unknown. We studied this issue using an fMRI task in which human participants used cognitive regulation to upregulate and downregulate their cravings for foods at the time of choice. We found that activity in both ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) correlated with value. We also found evidence that two distinct regulatory mechanisms were at work: value modulation, which operates by changing the values assigned to foods in vmPFC and dlPFC at the time of choice, and behavioral control modulation, which operates by changing the relative influence of the vmPFC and dlPFC value signals on the action selection process used to make choices. In particular, during downregulation, activation decreased in the value-sensitive region of dlPFC (indicating value modulation) but not in vmPFC, and the relative contribution of the two value signals to behavior shifted toward the dlPFC (indicating behavioral control modulation). The opposite pattern was observed during upregulation: activation increased in vmPFC but not dlPFC, and the relative contribution to behavior shifted toward the vmPFC. Finally, ventrolateral PFC and posterior parietal cortex were more active during both upregulation and downregulation, and were functionally connected with vmPFC and dlPFC during cognitive regulation, which suggests that they help to implement the changes to the decision-making circuitry generated by cognitive regulation.

  3. 40 CFR 85.1505 - Final admission of certified vehicles.

    Science.gov (United States)

    2010-07-01

    ... PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM MOBILE SOURCES Importation of Motor Vehicles and Motor... vehicle or engine from the previous test (e.g., adjusting the RPM, timing, air-to-fuel ratio, etc.) other... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Final admission of certified vehicles...

  4. Prioritizing Congenital Syphilis Control in South China: A Decision Analytic Model to Inform Policy Implementation

    Science.gov (United States)

    Tan, Nicholas X.; Rydzak, Chara; Yang, Li-Gang; Vickerman, Peter; Yang, Bin; Peeling, Rosanna W.; Hawkes, Sarah; Chen, Xiang-Sheng; Tucker, Joseph D.

    2013-01-01

    Background Syphilis is a major public health problem in many regions of China, with increases in congenital syphilis (CS) cases causing concern. The Chinese Ministry of Health recently announced a comprehensive 10-y national syphilis control plan focusing on averting CS. The decision analytic model presented here quantifies the impact of the planned strategies to determine whether they are likely to meet the goals laid out in the control plan. Methods and Findings Our model incorporated data on age-stratified fertility, female adult syphilis cases, and empirical syphilis transmission rates to estimate the number of CS cases associated with prenatal syphilis infection on a yearly basis. Guangdong Province was the focus of this analysis because of the availability of high-quality demographic and public health data. Each model outcome was simulated 1,000 times to incorporate uncertainty in model inputs. The model was validated using data from a CS intervention program among 477,656 women in China. Sensitivity analyses were performed to identify which variables are likely to be most influential in achieving Chinese and international policy goals. Increasing prenatal screening coverage was the single most effective strategy for reducing CS cases. An incremental increase in prenatal screening from the base case of 57% coverage to 95% coverage was associated with 106 (95% CI: 101, 111) CS cases averted per 100,000 live births (58% decrease). The policy strategies laid out in the national plan led to an outcome that fell short of the target, while a four-pronged comprehensive syphilis control strategy consisting of increased prenatal screening coverage, increased treatment completion, earlier prenatal screening, and improved syphilis test characteristics was associated with 157 (95% CI: 154, 160) CS cases averted per 100,000 live births (85% decrease). Conclusions The Chinese national plan provides a strong foundation for syphilis control, but more comprehensive measures

  5. A Systematic Approach for Dynamic Security Assessment and the Corresponding Preventive Control Scheme Based on Decision Trees

    DEFF Research Database (Denmark)

    Liu, Leo; Sun, Kai; Rather, Zakir Hussain

    2014-01-01

    This paper proposes a decision tree (DT)-based systematic approach for cooperative online power system dynamic security assessment (DSA) and preventive control. This approach adopts a new methodology that trains two contingency-oriented DTs on a daily basis by the databases generated from power...... system simulations. Fed with real-time wide-area measurements, one DT of measurable variables is employed for online DSA to identify potential security issues, and the other DT of controllable variables provides online decision support on preventive control strategies against those issues. A cost......-effective algorithm is adopted in this proposed approach to optimize the trajectory of preventive control. The paper also proposes an importance sampling algorithm on database preparation for efficient DT training for power systems with high penetration of wind power and distributed generation. The performance...

  6. To Fear Is to Gain? The Role of Fear Recognition in Risky Decision Making in TBI Patients and Healthy Controls.

    Directory of Open Access Journals (Sweden)

    Annemarie C Visser-Keizer

    Full Text Available Fear is an important emotional reaction that guides decision making in situations of ambiguity or uncertainty. Both recognition of facial expressions of fear and decision making ability can be impaired after traumatic brain injury (TBI, in particular when the frontal lobe is damaged. So far, it has not been investigated how recognition of fear influences risk behavior in healthy subjects and TBI patients. The ability to recognize fear is thought to be related to the ability to experience fear and to use it as a warning signal to guide decision making. We hypothesized that a better ability to recognize fear would be related to a better regulation of risk behavior, with healthy controls outperforming TBI patients. To investigate this, 59 healthy subjects and 49 TBI patients were assessed with a test for emotion recognition (Facial Expression of Emotion: Stimuli and Tests and a gambling task (Iowa Gambling Task (IGT. The results showed that, regardless of post traumatic amnesia duration or the presence of frontal lesions, patients were more impaired than healthy controls on both fear recognition and decision making. In both groups, a significant relationship was found between better fear recognition, the development of an advantageous strategy across the IGT and less risk behavior in the last blocks of the IGT. Educational level moderated this relationship in the final block of the IGT. This study has important clinical implications, indicating that impaired decision making and risk behavior after TBI can be preceded by deficits in the processing of fear.

  7. To Fear Is to Gain? The Role of Fear Recognition in Risky Decision Making in TBI Patients and Healthy Controls.

    Science.gov (United States)

    Visser-Keizer, Annemarie C; Westerhof-Evers, Herma J; Gerritsen, Marleen J J; van der Naalt, Joukje; Spikman, Jacoba M

    2016-01-01

    Fear is an important emotional reaction that guides decision making in situations of ambiguity or uncertainty. Both recognition of facial expressions of fear and decision making ability can be impaired after traumatic brain injury (TBI), in particular when the frontal lobe is damaged. So far, it has not been investigated how recognition of fear influences risk behavior in healthy subjects and TBI patients. The ability to recognize fear is thought to be related to the ability to experience fear and to use it as a warning signal to guide decision making. We hypothesized that a better ability to recognize fear would be related to a better regulation of risk behavior, with healthy controls outperforming TBI patients. To investigate this, 59 healthy subjects and 49 TBI patients were assessed with a test for emotion recognition (Facial Expression of Emotion: Stimuli and Tests) and a gambling task (Iowa Gambling Task (IGT)). The results showed that, regardless of post traumatic amnesia duration or the presence of frontal lesions, patients were more impaired than healthy controls on both fear recognition and decision making. In both groups, a significant relationship was found between better fear recognition, the development of an advantageous strategy across the IGT and less risk behavior in the last blocks of the IGT. Educational level moderated this relationship in the final block of the IGT. This study has important clinical implications, indicating that impaired decision making and risk behavior after TBI can be preceded by deficits in the processing of fear.

  8. Modified personal interviews: resurrecting reliable personal interviews for admissions?

    Science.gov (United States)

    Hanson, Mark D; Kulasegaram, Kulamakan Mahan; Woods, Nicole N; Fechtig, Lindsey; Anderson, Geoff

    2012-10-01

    Traditional admissions personal interviews provide flexible faculty-student interactions but are plagued by low inter-interview reliability. Axelson and Kreiter (2009) retrospectively showed that multiple independent sampling (MIS) may improve reliability of personal interviews; thus, the authors incorporated MIS into the admissions process for medical students applying to the University of Toronto's Leadership Education and Development Program (LEAD). They examined the reliability and resource demands of this modified personal interview (MPI) format. In 2010-2011, LEAD candidates submitted written applications, which were used to screen for participation in the MPI process. Selected candidates completed four brief (10-12 minutes) independent MPIs each with a different interviewer. The authors blueprinted MPI questions to (i.e., aligned them with) leadership attributes, and interviewers assessed candidates' eligibility on a five-point Likert-type scale. The authors analyzed inter-interview reliability using the generalizability theory. Sixteen candidates submitted applications; 10 proceeded to the MPI stage. Reliability of the written application components was 0.75. The MPI process had overall inter-interview reliability of 0.79. Correlation between the written application and MPI scores was 0.49. A decision study showed acceptable reliability of 0.74 with only three MPIs scored using one global rating. Furthermore, a traditional admissions interview format would take 66% more time than the MPI format. The MPI format, used during the LEAD admissions process, achieved high reliability with minimal faculty resources. The MPI format's reliability and effective resource use were possible through MIS and employment of expert interviewers. MPIs may be useful for other admissions tasks.

  9. Rethinking Dental School Admission Criteria: Correlation Between Pre-Admission Variables and First-Year Performance for Six Classes at One Dental School.

    Science.gov (United States)

    Rowland, Kevin C; Rieken, Susan

    2018-04-01

    Admissions committees in dental schools are charged with the responsibility of selecting candidates who will succeed in school and become successful members of the profession. Identifying students who will have academic difficulty is challenging. The aim of this study was to determine the predictive value of pre-admission variables for the first-year performance of six classes at one U.S. dental school. The authors hypothesized that the variables undergraduate grade point average (GPA), undergraduate science GPA (biology, chemistry, and physics), and Dental Admission Test (DAT) scores would predict the level of performance achieved in the first year of dental school, measured by year-end GPA. Data were collected in 2015 from school records for all 297 students in the six cohorts who completed the first year (Classes of 2007 through 2013). In the results, statistically significant correlations existed between all pre-admission variables and first-year GPA, but the associations were only weak to moderate. Lower performing students at the end of the first year (lowest 10% of GPA) had, on average, lower pre-admission variables than the other students, but the differences were small (≤10.8% in all categories). When all the pre-admission variables were considered together in a multiple regression analysis, a significant association was found between pre-admission variables and first-year GPA, but the association was weak (adjusted R 2 =0.238). This weak association suggests that these students' first-year dental school GPAs were mostly determined by factors other than the pre-admission variables studied and has resulted in the school's placing greater emphasis on other factors for admission decisions.

  10. Volatile decision dynamics: experiments, stochastic description, intermittency control and traffic optimization

    Science.gov (United States)

    Helbing, Dirk; Schönhof, Martin; Kern, Daniel

    2002-06-01

    The coordinated and efficient distribution of limited resources by individual decisions is a fundamental, unsolved problem. When individuals compete for road capacities, time, space, money, goods, etc, they normally make decisions based on aggregate rather than complete information, such as TV news or stock market indices. In related experiments, we have observed a volatile decision dynamics and far-from-optimal payoff distributions. We have also identified methods of information presentation that can considerably improve the overall performance of the system. In order to determine optimal strategies of decision guidance by means of user-specific recommendations, a stochastic behavioural description is developed. These strategies manage to increase the adaptibility to changing conditions and to reduce the deviation from the time-dependent user equilibrium, thereby enhancing the average and individual payoffs. Hence, our guidance strategies can increase the performance of all users by reducing overreaction and stabilizing the decision dynamics. These results are highly significant for predicting decision behaviour, for reaching optimal behavioural distributions by decision support systems and for information service providers. One of the promising fields of application is traffic optimization.

  11. 40 CFR 85.1512 - Admission of catalyst and O2 sensor-equipped vehicles.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Admission of catalyst and O2 sensor... Vehicles and Motor Vehicle Engines § 85.1512 Admission of catalyst and O2 sensor-equipped vehicles. (a)(1... previously admitted under § 85.1505 or § 85.1509 (after June 30, 1988), with a catalyst emission control...

  12. Effective admissions practices to achieve greater student diversity in dental schools.

    Science.gov (United States)

    Price, Shelia S; Grant-Mills, Donna

    2010-10-01

    In this chapter we describe the institutional and policy-level strategies that dental schools in the Pipeline, Profession, and Practice: Community-Based Dental Education program used to modify their admissions practices to increase the diversity of their student bodies. Schools developed and used clear statements recognizing the value of diversity. They incorporated recent U.S. Supreme Court rulings regarding educational diversity into their revised admissions practices; these rulings cited diversity as both a "compelling interest" and its use in only "narrowly tailored" circumstances. We make a case for admissions decisions based on a comprehensive evaluation that balances the quantitative and qualitative qualities of a candidate. It refutes the practice of overreliance on standardized tests by detailing the whole-file review process to measure merit and professional promise. Also described is a range of noncognitive variables (e.g., leadership, ability to sustain academic achievement with competing priorities, volunteerism, communication, social background, and disadvantaged status) that schools can take into consideration in admissions decisions. Admissions committees can tie this comprehensive review of candidates into the case for promoting cross-cultural understanding and enhanced competence to provide care to patients from diverse backgrounds. In addition, the chapter reviews the challenges schools face in developing admissions policies and procedures that reflect the university's mission for diversity. It addresses the importance of a diverse composition of the admissions committee. It also describes how tailored workshops and technical assistance for admissions committees can help schools improve their student diversity and how admissions committees can engage in a process of periodic review of their diversity objectives in relationship to the school's mission.

  13. A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skane randomized controlled trial protocol (BASRCT)

    NARCIS (Netherlands)

    Liljedahl, S.I.; Helleman, M.; Daukantaite, D.; Westrin, A.; Westling, S.

    2017-01-01

    BACKGROUND: Brief Admission is a crisis and risk management strategy in which self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder self-admit to hospital at times of increasing risk when other efforts to stay safe are failing. Standardized

  14. Mindful decision making and inhibitory control training as complementary means to decrease snack consumption.

    Science.gov (United States)

    Forman, Evan M; Shaw, Jena A; Goldstein, Stephanie P; Butryn, Meghan L; Martin, Lindsay M; Meiran, Nachshon; Crosby, Ross D; Manasse, Stephanie M

    2016-08-01

    Obesity is largely attributable to excess caloric intake, in particular from "junk" foods, including salty snack foods. Evidence suggests that neurobiological preferences to consume highly hedonic foods translate (via implicit processes) into poor eating choices, unless overturned by inhibitory mechanisms or interrupted by explicit processes. The primary aim of the current study was to test the independent and combinatory effects of a computerized inhibitory control training (ICT) and a mindful decision-making training (MDT) designed to facilitate de-automatization. We randomized 119 habitual salty snack food eaters to one of four short, training conditions: MDT, ICT, both MDT and ICT, or neither (i.e., psychoeducation). For 7 days prior to the intervention and 7 days following the intervention, participants reported on their salty snack food consumption 2 times per day, on 3 portions of their days, using a smartphone-based ecological momentary assessment system. Susceptibility to emotional eating cues was measured at baseline. Results indicated that the effect of MDT was consistent across levels of trait emotional eating, whereas the benefit of ICT was apparent only at lower levels of emotional eating. No synergistic effect of MDT and ICT was detected. These results provide qualified support for the efficacy of both types of training for decreasing hedonically-motivated eating. Moderation effects suggest that those who eat snack foods for reasons unconnected to affective experiences (i.e., lower in emotional eating) may derive benefit from a combination of ICT and MDT. Future research should investigate the additive benefit of de-automization training to standard weight loss interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Radical Decisions in Cancer: Redox Control of Cell Growth and Death

    International Nuclear Information System (INIS)

    Sainz, Rosa M.; Lombo, Felipe; Mayo, Juan C.

    2012-01-01

    Free radicals play a key role in many physiological decisions in cells. Since free radicals are toxic to cellular components, it is known that they cause DNA damage, contribute to DNA instability and mutation and thus favor carcinogenesis. However, nowadays it is assumed that free radicals play a further complex role in cancer. Low levels of free radicals and steady state levels of antioxidant enzymes are responsible for the fine tuning of redox status inside cells. A change in redox state is a way to modify the physiological status of the cell, in fact, a more reduced status is found in resting cells while a more oxidative status is associated with proliferative cells. The mechanisms by which redox status can change the proliferative activity of cancer cells are related to transcriptional and posttranscriptional modifications of proteins that play a critical role in cell cycle control. Since cancer cells show higher levels of free radicals compared with their normal counterparts, it is believed that the anti-oxidative stress mechanism is also increased in cancer cells. In fact, the levels of some of the most important antioxidant enzymes are elevated in advanced status of some types of tumors. Anti-cancer treatment is compromised by survival mechanisms in cancer cells and collateral damage in normal non-pathological tissues. Though some resistance mechanisms have been described, they do not yet explain why treatment of cancer fails in several tumors. Given that some antitumoral treatments are based on the generation of free radicals, we will discuss in this review the possible role of antioxidant enzymes in the survival mechanism in cancer cells and then, its participation in the failure of cancer treatments

  16. Do Architectural Design Decisions Improve the Understanding of Software Architecture? Two Controlled Experiments

    NARCIS (Netherlands)

    Shahin, M.; Liang, P.; Li, Z.

    2014-01-01

    Architectural design decision (ADD) and its design rationale, as a paradigm shift on documenting and enriching architecture design description, is supposed to facilitate the understanding of architecture and the reasoning behind the design rationale, which consequently improves the architecting

  17. Out of control mortality matters: the effect of perceived uncontrollable mortality risk on a health-related decision.

    Science.gov (United States)

    Pepper, Gillian V; Nettle, Daniel

    2014-01-01

    Prior evidence from the public health literature suggests that both control beliefs and perceived threats to life are important for health behaviour. Our previously presented theoretical model generated the more specific hypothesis that uncontrollable, but not controllable, personal mortality risk should alter the payoff from investment in health protection behaviours. We carried out three experiments to test whether altering the perceived controllability of mortality risk would affect a health-related decision. Experiment 1 demonstrated that a mortality prime could be used to alter a health-related decision: the choice between a healthier food reward (fruit) and an unhealthy alternative (chocolate). Experiment 2 demonstrated that it is the controllability of the mortality risk being primed that generates the effect, rather than mortality risk per se. Experiment 3 showed that the effect could be seen in a surreptitious experiment that was not explicitly health related. Our results suggest that perceptions about the controllability of mortality risk may be an important factor in people's health-related decisions. Thus, techniques for adjusting perceptions about mortality risk could be important tools for use in health interventions. More importantly, tackling those sources of mortality that people perceive to be uncontrollable could have a dual purpose: making neighbourhoods and workplaces safer would have the primary benefit of reducing uncontrollable mortality risk, which could lead to a secondary benefit from improved health behaviours.

  18. Impaired decision-making and impulse control in Internet gaming addicts: evidence from the comparison with recreational Internet game users.

    Science.gov (United States)

    Wang, Yifan; Wu, Lingdan; Wang, Lingxiao; Zhang, Yifen; Du, Xiaoxia; Dong, Guangheng

    2017-11-01

    Although Internet games have been proven to be addictive, only a few game players develop online gaming addiction. A large number of players play online games recreationally without being addicted to it. These individuals are defined as recreational Internet gaming users (RGU). So far, no research has investigated decision-making and impulse control in RGU. In the current study, we used delay discounting (DD) task and probabilistic discounting (PD) task to examine decision-making and impulse control in 20 healthy controls, 20 subjects with Internet gaming disorder (IGD) and 23 RGU during fMRI scanning. At the behavioral level, RGU showed lower DD rate and higher PD rate than subjects with IGD and there was no significant difference between RGU and healthy controls on the DD and PD rates. At the neural level, RGU showed increased neural response in the parahippocampal gyrus, the anterior cingulate cortex, the medial frontal gyrus and the inferior frontal gyrus as compared with subjects with IGD. These brain regions may play an important role in preventing RGU from developing addiction. The results suggest that the RGU are capable of inhibiting impulse due to additional cognitive endeavor and the subjects with IGD have deficit in decision-making and impulsive control, which are associated with brain dysfunction. © 2016 Society for the Study of Addiction.

  19. Out of control mortality matters: the effect of perceived uncontrollable mortality risk on a health-related decision

    Directory of Open Access Journals (Sweden)

    Gillian V. Pepper

    2014-06-01

    Full Text Available Prior evidence from the public health literature suggests that both control beliefs and perceived threats to life are important for health behaviour. Our previously presented theoretical model generated the more specific hypothesis that uncontrollable, but not controllable, personal mortality risk should alter the payoff from investment in health protection behaviours. We carried out three experiments to test whether altering the perceived controllability of mortality risk would affect a health-related decision. Experiment 1 demonstrated that a mortality prime could be used to alter a health-related decision: the choice between a healthier food reward (fruit and an unhealthy alternative (chocolate. Experiment 2 demonstrated that it is the controllability of the mortality risk being primed that generates the effect, rather than mortality risk per se. Experiment 3 showed that the effect could be seen in a surreptitious experiment that was not explicitly health related. Our results suggest that perceptions about the controllability of mortality risk may be an important factor in people’s health-related decisions. Thus, techniques for adjusting perceptions about mortality risk could be important tools for use in health interventions. More importantly, tackling those sources of mortality that people perceive to be uncontrollable could have a dual purpose: making neighbourhoods and workplaces safer would have the primary benefit of reducing uncontrollable mortality risk, which could lead to a secondary benefit from improved health behaviours.

  20. Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

    Science.gov (United States)

    Schemann, K; Gillespie, J A; Toribio, J-A L M L; Ward, M P; Dhand, N K

    2014-10-01

    Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder

  1. Tactical resource allocation and elective patient admission planning in care processes.

    Science.gov (United States)

    Hulshof, Peter J H; Boucherie, Richard J; Hans, Erwin W; Hurink, Johann L

    2013-06-01

    Tactical planning of resources in hospitals concerns elective patient admission planning and the intermediate term allocation of resource capacities. Its main objectives are to achieve equitable access for patients, to meet production targets/to serve the strategically agreed number of patients, and to use resources efficiently. This paper proposes a method to develop a tactical resource allocation and elective patient admission plan. These tactical plans allocate available resources to various care processes and determine the selection of patients to be served that are at a particular stage of their care process. Our method is developed in a Mixed Integer Linear Programming (MILP) framework and copes with multiple resources, multiple time periods and multiple patient groups with various uncertain treatment paths through the hospital, thereby integrating decision making for a chain of hospital resources. Computational results indicate that our method leads to a more equitable distribution of resources and provides control of patient access times, the number of patients served and the fraction of allocated resource capacity. Our approach is generic, as the base MILP and the solution approach allow for including various extensions to both the objective criteria and the constraints. Consequently, the proposed method is applicable in various settings of tactical hospital management.

  2. A shared decision-making tool for obstructive sleep apnea without tonsillar hypertrophy: A randomized controlled trial.

    Science.gov (United States)

    Bergeron, Mathieu; Duggins, Angela L; Cohen, Aliza P; Tiemeyer, Karin; Mullen, Lisa; Crisalli, Joseph; McArthur, Angela; Ishman, Stacey L

    2018-04-01

    Shared decision-making is a process whereby patients and clinicians jointly establish a treatment plan integrating clinical evidence and patient values and preferences. Although this approach has been successfully employed in numerous medical disciplines, often using shared decision-making tools, otolaryngologic research assessing its use is scant. Our primary objective was therefore to determine if the tools we developed reduced decisional conflict for children with obstructive sleep apnea without tonsillar hypertrophy. Prospective, single-blind, randomized controlled trial. We enrolled consecutive patients meeting inclusion criteria who were referred to our multidisciplinary upper airway center. Study patients used a shared decision-making tool whereas controls did not. Measures of decisional conflict (SURE [Sure of myself, Understanding information, Risk benefit ratio, Encouragement], CollaboRATE, and the Decisional Conflict Scale [DCS]) were obtained pre- and postvisit. We assessed 50 families (study group = 24, controls = 26). The mean age was 8.8 ± 6.6 years, 44% were female, 86% were white, and the mean obstructive apnea-hypopnea index was 12.7 ± 15.6 events/hour. The previsit mean DCS score was similar for controls (42.7) and study patients (40.8) (P = .38). The postvisit mean DCS score for controls was 13.3 and for study patients 6.1 (P = .034). Improvement in this score was greater in the study group (P = .03). At previsit evaluation, 63% of controls and 58% of study patients were unsure about their options. Postvisit, this improved to 4.1% and 0%, respectively. Families counseled regarding treatment options using shared decision-making tools had significantly less decisional conflict than those who did not use these tools. These positive outcomes suggest that clinicians should consider integrating this approach into clinical practice. 1b. Laryngoscope, 128:1007-1015, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Greenhouse gas emissions control in integrated municipal solid waste management through mixed integer bilevel decision-making

    Energy Technology Data Exchange (ETDEWEB)

    He, Li, E-mail: li.he@iseis.org [MOE Key Laboratory of Regional Energy Systems Optimization, S and C Academy of Energy and Environmental Research, North China Electric Power University, Beijing 102206 (China); Huang, G.H.; Lu, Hongwei [MOE Key Laboratory of Regional Energy Systems Optimization, S and C Academy of Energy and Environmental Research, North China Electric Power University, Beijing 102206 (China)

    2011-10-15

    Highlights: {yields} We used bilevel analysis to treat two objectives at different levels. {yields} The model can identify allocation schemes for waste flows. {yields} The model can support waste timing, sizing, and siting for facility expansions. {yields} The model can estimate minimized total management cost and GHG emissions. - Abstract: Recent studies indicated that municipal solid waste (MSW) is a major contributor to global warming due to extensive emissions of greenhouse gases (GHGs). However, most of them focused on investigating impacts of MSW on GHG emission amounts. This study presents two mixed integer bilevel decision-making models for integrated municipal solid waste management and GHG emissions control: MGU-MCL and MCU-MGL. The MGU-MCL model represents a top-down decision process, with the environmental sectors at the national level dominating the upper-level objective and the waste management sectors at the municipal level providing the lower-level objective. The MCU-MGL model implies a bottom-up decision process where municipality plays a leading role. Results from the models indicate that: the top-down decisions would reduce metric tonne carbon emissions (MTCEs) by about 59% yet increase about 8% of the total management cost; the bottom-up decisions would reduce MTCE emissions by about 13% but increase the total management cost very slightly; on-site monitoring and downscaled laboratory experiments are still required for reducing uncertainty in GHG emission rate from the landfill facility.

  4. Consciência situacional, tomada de decisão e modos de controle cognitivo em ambientes complexos Situation awareness, decision making, and cognitive control in complex environments

    Directory of Open Access Journals (Sweden)

    Éder Henriqson

    2009-01-01

    Full Text Available O presente trabalho tem como objetivo analisar a consciência situacional, os processos de tomada de decisão naturalística e os modos de controle cognitivo utilizados por pilotos de aeronaves em um experimento em simulador de voo. Dessa forma, diferentes situações foram propostas durante a simulação objetivando o estudo da consciência situacional e tomada de decisão dos tripulantes. As ações dos participantes foram investigadas e classificadas de acordo com o modelo de controle cognitivo proposto. Os resultados sugerem que os fatores de complexidade contextual afetam a gestão da dificuldade, influenciando a consciência situacional, a tomada de decisão e os modos de controle cognitivo dos pilotos.This work aims to analyze situation awareness, natural decision-making processes and cognitive control modes used by airplane pilots in a flight simulator experiment. In this way, different situations during flight simulation were considered in order to study the crew's situation awareness and natural decision-making. The participants' actions were investigated and classified according to the cognitive control model proposed. Results suggest that context complexity factors affect difficulty management, influencing situation awareness, decision-making and pilots' cognitive control modes.

  5. Admission time to hospital: a varying standard for a critical definition for admissions to an intensive care unit from the emergency department.

    Science.gov (United States)

    Nanayakkara, Shane; Weiss, Heike; Bailey, Michael; van Lint, Allison; Cameron, Peter; Pilcher, David

    2014-11-01

    Time spent in the emergency department (ED) before admission to hospital is often considered an important key performance indicator (KPI). Throughout Australia and New Zealand, there is no standard definition of 'time of admission' for patients admitted through the ED. By using data submitted to the Australian and New Zealand Intensive Care Society Adult Patient Database, the aim was to determine the differing methods used to define hospital admission time and assess how these impact on the calculation of time spent in the ED before admission to an intensive care unit (ICU). Between March and December of 2010, 61 hospitals were contacted directly. Decision methods for determining time of admission to the ED were matched to 67,787 patient records. Univariate and multivariate analyses were conducted to assess the relationship between decision method and the reported time spent in the ED. Four mechanisms of recording time of admission were identified, with time of triage being the most common (28/61 hospitals). Reported median time spent in the ED varied from 2.5 (IQR 0.83-5.35) to 5.1 h (2.82-8.68), depending on the decision method. After adjusting for illness severity, hospital type and location, decision method remained a significant factor in determining measurement of ED length of stay. Different methods are used in Australia and New Zealand to define admission time to hospital. Professional bodies, hospitals and jurisdictions should ensure standardisation of definitions for appropriate interpretation of KPIs as well as for the interpretation of studies assessing the impact of admission time to ICU from the ED. WHAT IS KNOWN ABOUT THE TOPIC?: There are standards for the maximum time spent in the ED internationally, but these standards vary greatly across Australia. The definition of such a standard is critically important not only to patient care, but also in the assessment of hospital outcomes. Key performance indicators rely on quality data to improve decision

  6. How information about overdetection changes breast cancer screening decisions: a mediation analysis within a randomised controlled trial.

    Science.gov (United States)

    Hersch, Jolyn; McGeechan, Kevin; Barratt, Alexandra; Jansen, Jesse; Irwig, Les; Jacklyn, Gemma; Houssami, Nehmat; Dhillon, Haryana; McCaffery, Kirsten

    2017-10-06

    In a randomised controlled trial, we found that informing women about overdetection changed their breast screening decisions. We now present a mediation analysis exploring the psychological pathways through which study participants who received the intervention processed information about overdetection and how this influenced their decision-making. We examined a series of potential mediators in the causal chain between exposure to overdetection information and women's subsequently reported breast screening intentions. Serial multiple mediation analysis within a randomised controlled trial. New South Wales, Australia. 811 women aged 48-50 years with no personal history of breast cancer. Two versions of a decision aid giving women information about breast cancer deaths averted and false positives from mammography screening, either with (intervention) or without (control) information on overdetection. Intentions to undergo breast cancer screening in the next 2-3 years. Knowledge about overdetection, worry about breast cancer, attitudes towards breast screening and anticipated regret. The effect of information about overdetection on women's breast screening intentions was mediated through multiple cognitive and affective processes. In particular, the information led to substantial improvements in women's understanding of overdetection, and it influenced-both directly and indirectly via its effect on knowledge-their attitudes towards having screening. Mediation analysis showed that the mechanisms involving knowledge and attitudes were particularly important in determining women's intentions about screening participation. Even in this emotive context, new information influenced women's decision-making by changing their understanding of possible consequences of screening and their attitudes towards undergoing it. These findings emphasise the need to provide good-quality information on screening outcomes and to communicate this information effectively, so that women can

  7. A randomized controlled trial on teaching geriatric medical decision making and cost consciousness with the serious game GeriatriX.

    Science.gov (United States)

    Lagro, Joep; van de Pol, Marjolein H J; Laan, Annalies; Huijbregts-Verheyden, Fanny J; Fluit, Lia C R; Olde Rikkert, Marcel G M

    2014-12-01

    Medical students often lack training in complex geriatric medical decision making. We therefore developed the serious game, GeriatriX, for training medical decision making with weighing patient preferences, and appropriateness and costs of medical care. We hypothesized that education with GeriatriX would improve the ability to deal with geriatric decision making and also increase cost consciousness. A randomized, controlled pre-post measurement design. Fifth-year medical students. Playing the serious game GeriatriX as an additive to usual geriatric education. We evaluated the effects of playing GeriatriX on self-perceived knowledge of geriatric themes and the self-perceived competence of weighing patient preferences, appropriateness, and costs of medical care in geriatric decision making. Cost consciousness was evaluated with a postmeasurement to estimate costs of different diagnostic tests. There was a large positive increase in the self-perceived competence of weighing patient preferences, appropriateness, and costs of medical care in the intervention group (n = 71) (effect sizes of 0.7, 1.0, and 1.2, respectively), which was significantly better for the last 2 aspects than in the control group (n = 63). The intervention group performed better on cost consciousness. Although the self-perceived knowledge increased substantially on some geriatric topics, this improvement was not different between the intervention and control groups. After playing the serious game, GeriatriX, medical students have a higher self-perceived competence in weighing patient preferences, appropriateness, and costs of medical care in complex geriatric medical decision making. Playing GeriatriX also resulted in better cost consciousness. We therefore encourage wider use of GeriatriX to teach geriatrics in medical curricula and its further research on educational and health care outcomes. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier

  8. Emergency department admissions are more profitable than non-emergency department admissions.

    Science.gov (United States)

    Henneman, Philip L; Lemanski, Michael; Smithline, Howard A; Tomaszewski, Andrew; Mayforth, Janice A

    2009-02-01

    We compare the contribution margin per case per hospital day of emergency department (ED) admissions with non-ED admissions in a single hospital, a 600-bed, academic, tertiary referral, Level I trauma center with an annual ED census of 100,000. This was a retrospective comparison of the contribution margin per case per day for ED and non-ED inpatient admissions for fiscal years 2003, 2004, and 2005 (October 1 through September 30). Contribution margin is defined as net revenue minus total direct costs; it is then expressed per case per hospital day. Service lines are a set of linked patient care services. Observation admissions and outpatient services are not included. Resident expenses (eg, salary and benefits) and revenue (ie, Medicare payment of indirect medical expenses and direct medical expenses) are not included. Overhead expenses are not included (eg, building maintenance, utilities, information services support, administrative services). For fiscal year 2003 through fiscal year 2005, there were 51,213 ED and 57,004 non-ED inpatient admissions. Median contribution margin per day for ED admissions was higher than for non-ED admissions: ED admissions $769 (interquartile range $265 to $1,493) and non-ED admissions $595 (interquartile range $178 to $1,274). Median contribution margin per day varied by site of admissions, by diagnosis-related group, by service line, and by insurance type. In summary, ED admissions in our institution generate a higher contribution margin per day than non-ED admissions.

  9. The decision to engage cognitive control is driven by expected reward-value: neural and behavioral evidence.

    Directory of Open Access Journals (Sweden)

    Matthew L Dixon

    Full Text Available Cognitive control is a fundamental skill reflecting the active use of task-rules to guide behavior and suppress inappropriate automatic responses. Prior work has traditionally used paradigms in which subjects are told when to engage cognitive control. Thus, surprisingly little is known about the factors that influence individuals' initial decision of whether or not to act in a reflective, rule-based manner. To examine this, we took three classic cognitive control tasks (Stroop, Wisconsin Card Sorting Task, Go/No-Go task and created novel 'free-choice' versions in which human subjects were free to select an automatic, pre-potent action, or an action requiring rule-based cognitive control, and earned varying amounts of money based on their choices. Our findings demonstrated that subjects' decision to engage cognitive control was driven by an explicit representation of monetary rewards expected to be obtained from rule-use. Subjects rarely engaged cognitive control when the expected outcome was of equal or lesser value as compared to the value of the automatic response, but frequently engaged cognitive control when it was expected to yield a larger monetary outcome. Additionally, we exploited fMRI-adaptation to show that the lateral prefrontal cortex (LPFC represents associations between rules and expected reward outcomes. Together, these findings suggest that individuals are more likely to act in a reflective, rule-based manner when they expect that it will result in a desired outcome. Thus, choosing to exert cognitive control is not simply a matter of reason and willpower, but rather, conforms to standard mechanisms of value-based decision making. Finally, in contrast to current models of LPFC function, our results suggest that the LPFC plays a direct role in representing motivational incentives.

  10. Confronting the categories: Equitable admissions without apartheid ...

    African Journals Online (AJOL)

    I offer a critical-race-standpoint as an alternative conceptual orientation and method for transformative admissions committed to racial redress that is socially just. I conclude that admissions criteria should encompass the lived realities of inequality and be informed by a conception of humanism as critique. This requires ...

  11. Decline in adolescent treatment admissions for methamphetamine ...

    African Journals Online (AJOL)

    Background and objectives. The purpose of this report is to describe the changing trends in adolescent treatment admissions for methamphetamine in Cape Town, and to discuss possible implications. Method. Data were collected on admissions for drug abuse treatment through a regular monitoring system involving drug ...

  12. Asians in Higher Education: Conflicts over Admissions.

    Science.gov (United States)

    Hoachlander, E. Gareth; Brown, Cynthia L.

    1989-01-01

    Many Asian Americans believe that the admissions policies of many selective colleges are unfair to them. Demographic trends and the resultant political activity are discussed. The admissions policies and practices that Asian Americans consider objectionable are examined and some policy options are offered. (MLW)

  13. Service philosophies for hospital admission planning

    NARCIS (Netherlands)

    Adan, I.J.B.F.; Vissers, J.M.H.; Vissers, J.M.H.; Beech, R.

    2005-01-01

    The ‘traditional’ service philosophy underlying hospital admission planning has been one of optimising the use of scarce hospital resources without paying much attention to the level of service offered to patients. As patients nowadays do not accept long waiting times for hospital admission, it

  14. Lexical Profiles of Thailand University Admission Tests

    Science.gov (United States)

    Cherngchawano, Wirun; Jaturapitakkul, Natjiree

    2014-01-01

    University Admission Tests in Thailand are important documents which reflect Thailand's education system. To study at a higher education level, all students generally need to take the University Admission Tests designed by the National Institute of Educational Testing Service (NIETS). For the English test, vocabulary and reading comprehension is…

  15. Assessing academic potential for university admission: The ...

    African Journals Online (AJOL)

    A Biographical Questionnaire (BQ) has been used in the Faculty of Humanities at the University of the Witwatersrand since the mid-80s, to identify potential to succeed at university among applicants who have not met the requirements for automatic admission. As the key instrument in a special admissions process, the

  16. Seasonal variations in hospital admissions for mania

    DEFF Research Database (Denmark)

    Medici, Clara Reece; Vestergaard, Claus Høstrup; Hadzi-Pavlovic, Dusan

    2016-01-01

    in summer. Higher admission rates were associated with more sunshine, more ultraviolet radiation, higher temperature and less snow but were unassociated with rainfall. We did not find a secular trend in the seasonal pattern. Finally, neither gender nor admission status impacted on the overall seasonal...

  17. Admissions 2015 Indian Institute of Science, Bangalore

    Indian Academy of Sciences (India)

    IAS Admin

    2015-02-02

    Feb 2, 2015 ... advertisement that will appear in Employment News dated 14th February 2015 and also our website: www.iisc.ernet.in/admissions. Online submission of application be made by accessing the IISc website www.iisc.ernet.in/admissions for all the programmes. IMPORTANT DATES. Website opening and ...

  18. [Evaluation of hospital admissions: admission guidelines implementation in a pediatric emergency department].

    Science.gov (United States)

    Katz, Manuel; Warshawsky, Sheila S; Rosen, Shirley; Barak, Nurit; Press, Joseph

    2004-10-01

    To develop and implement locally tailored pediatric admission guidelines for use in a pediatric emergency department and evaluate the appropriateness of admissions based on these guidelines. Our Study was based on the development of admission guidelines by senior physicians, using the Delphi Consensus Process, for use in the Pediatric Emergency Department (PED) at Soroka University Medical Center (Soroka). We evaluated the appropriateness of admissions to the pediatric departments of Soroka on 33 randomly selected days in 1999 and 2000 prior to guideline implementation and 30 randomly selected days in 2001, after guideline implementation. A total of 1037 files were evaluated. A rate of 12.4% inappropriate admissions to the pediatric departments was found based on locally tailored admission guidelines. There was no change in the rate of inappropriate admissions after implementation of admission guidelines in PED. Inappropriate admissions were associated with age above 3 years, hospital stay of two days or less and the season. The main reasons for evaluating an admission as inappropriate were that the admission did not comply with the guidelines and that the case could be managed in an ambulatory setting. There were distinctive differences in the characteristics of the Bedouin and Jewish populations admitted to the pediatric departments, although no difference was found in the rate of inappropriate admissions between these populations. Patient management in Soroka PED is tailored to the conditions of this medical center and to the characteristics of the population it serves. The admission guidelines developed reflect these special conditions. Lack of change in the rate of inappropriate admissions following implementation of the guidelines indicates that the guidelines reflect the physicians' approach to patient management that existed in Soroka PED prior to guideline implementation. Hospital admission guidelines have a role in the health management system; however

  19. Vital Signs Predict Rapid-Response Team Activation within Twelve Hours of Emergency Department Admission

    Directory of Open Access Journals (Sweden)

    James M. Walston

    2016-05-01

    Full Text Available Introduction: Rapid-response teams (RRTs are interdisciplinary groups created to rapidly assess and treat patients with unexpected clinical deterioration marked by decline in vital signs. Traditionally emergency department (ED disposition is partially based on the patients’ vital signs (VS at the time of hospital admission. We aimed to identify which patients will have RRT activation within 12 hours of admission based on their ED VS, and if their outcomes differed. Methods: We conducted a case-control study of patients presenting from January 2009 to December 2012 to a tertiary ED who subsequently had RRT activations within 12 hours of admission (early RRT activations. The medical records of patients 18 years and older admitted to a non-intensive care unit (ICU setting were reviewed to obtain VS at the time of ED arrival and departure, age, gender and diagnoses. Controls were matched 1:1 on age, gender, and diagnosis. We evaluated VS using cut points (lowest 10%, middle 80% and highest 10% based on the distribution of VS for all patients. Our study adheres to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology guidelines for reporting observational studies. Results: A total of 948 patients were included (474 cases and 474 controls. Patients who had RRT activations were more likely to be tachycardic (odds ratio [OR] 2.02, 95% CI [1.25-3.27], tachypneic (OR 2.92, 95% CI [1.73-4.92], and had lower oxygen saturations (OR 2.25, 95% CI [1.42-3.56] upon arrival to the ED. Patients who had RRT activations were more likely to be tachycardic at the time of disposition from the ED (OR 2.76, 95% CI [1.65-4.60], more likely to have extremes of systolic blood pressure (BP (OR 1.72, 95% CI [1.08-2.72] for low BP and OR 1.82, 95% CI [1.19-2.80] for high BP, higher respiratory rate (OR 4.15, 95% CI [2.44-7.07] and lower oxygen saturation (OR 2.29, 95% CI [1.43-3.67]. Early RRT activation was associated with increased healthcare

  20. Vital Signs Predict Rapid-Response Team Activation Within Twelve Hours of Emergency Department Admission.

    Science.gov (United States)

    Walston, James M; Cabrera, Daniel; Bellew, Shawna D; Olive, Marc N; Lohse, Christine M; Bellolio, M Fernanda

    2016-05-01

    Rapid-response teams (RRTs) are interdisciplinary groups created to rapidly assess and treat patients with unexpected clinical deterioration marked by decline in vital signs. Traditionally emergency department (ED) disposition is partially based on the patients' vital signs (VS) at the time of hospital admission. We aimed to identify which patients will have RRT activation within 12 hours of admission based on their ED VS, and if their outcomes differed. We conducted a case-control study of patients presenting from January 2009 to December 2012 to a tertiary ED who subsequently had RRT activations within 12 hours of admission (early RRT activations). The medical records of patients 18 years and older admitted to a non-intensive care unit (ICU) setting were reviewed to obtain VS at the time of ED arrival and departure, age, gender and diagnoses. Controls were matched 1:1 on age, gender, and diagnosis. We evaluated VS using cut points (lowest 10%, middle 80% and highest 10%) based on the distribution of VS for all patients. Our study adheres to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for reporting observational studies. A total of 948 patients were included (474 cases and 474 controls). Patients who had RRT activations were more likely to be tachycardic (odds ratio [OR] 2.02, 95% CI [1.25-3.27]), tachypneic (OR 2.92, 95% CI [1.73-4.92]), and had lower oxygen saturations (OR 2.25, 95% CI [1.42-3.56]) upon arrival to the ED. Patients who had RRT activations were more likely to be tachycardic at the time of disposition from the ED (OR 2.76, 95% CI [1.65-4.60]), more likely to have extremes of systolic blood pressure (BP) (OR 1.72, 95% CI [1.08-2.72] for low BP and OR 1.82, 95% CI [1.19-2.80] for high BP), higher respiratory rate (OR 4.15, 95% CI [2.44-7.07]) and lower oxygen saturation (OR 2.29, 95% CI [1.43-3.67]). Early RRT activation was associated with increased healthcare utilization and worse outcomes including

  1. Should the MCAT exam be used for medical school admissions in Canada?

    Science.gov (United States)

    Eskander, Antoine; Shandling, Maureen; Hanson, Mark D

    2013-05-01

    In light of the structural and content changes to the Medical College Admission Test (MCAT) to be implemented in 2015 and the recent diversity- and social-accountability-based recommendations of the Future of Medical Education in Canada (FMEC) project, the authors review and reexamine the use of the MCAT exam in Canadian medical school admissions decisions.This Perspective article uses a point-counterpoint format to discuss three main advantages and disadvantages of using the MCAT exam in the medical school admissions process, from a Canadian perspective. The authors examine three questions regarding the FMEC recommendations and the revised MCAT exam: (1) Is the MCAT exam equal and useful in Canadian admissions? (2) Does the MCAT exam affect matriculant diversity? and (3) Is the MCAT exam a strong predictor of future performance? They present the most recent arguments and evidence for and against use of the MCAT exam, with the purpose of summarizing these different perspectives for readers.

  2. Evaluation of a Decision Aid for Women with Epilepsy Who Are Considering Pregnancy: A Randomized Controlled Trial.

    Science.gov (United States)

    McGrath, Amanda; Sharpe, Louise; Lah, Suncica; Parratt, Kaitlyn

    2017-07-01

    For many women with epilepsy (WWE), decision making about pregnancy is complicated by considerations such as the potential teratogenicity of antiepileptic drugs, offspring risk of epilepsy, seizure occurrence during pregnancy, and the challenges of parenting amidst poorly controlled seizures. This proof-of-concept, randomized controlled trial aimed to evaluate a decision aid (DA) developed to help WWE decide if they should start or enlarge their families. Seventy-nine WWE of childbearing age were recruited from Epilepsy Action Australia between October and November 2013 and randomized to receive the intervention (the DA) or not, and to complete a set of questionnaires pre- and post- intervention. The DA, delivered as a PDF booklet, provided balanced evidence-based information about options, risks and benefits, including probabilities; as well as steps for clarifying values and considering options within one's personal situation. Compared with the control group, the DA group had statistically significant improvements in knowledge about pregnancy and epilepsy (Cohen's d = 1.24; 95%CI = 0.77 to 1.83) and reduced decisional conflict (Cohen's d = 0.59; 95%CI = 0.21 to 0.99). Changes in decision self-efficacy, certainty of choice, patient-practitioner communication abilities and value congruence with choice were comparable between the DA and control group. Importantly, women's decisions about motherhood were not biased towards either direction, and there were no adverse effects on depression or anxiety. All women who received the DA indicated they would recommend it to other WWE. The DA has the potential to serve as a useful support tool for WWE who are considering motherhood. Future research is needed to test the DA in clinical settings with guidance from a health professional. The trial was registered with the Australian New Zealand Clinical Trials Registry (ID ACTRN12613001082796).

  3. Analysis of Communication between Main Control Room Operators in Decision-making Process in Steam Generator Tube Rupture Accident

    International Nuclear Information System (INIS)

    Petkov, M.; Petkov, G.

    2006-01-01

    The paper presents an investigation results for Main Control Room operators' reliability by Performance Evaluation of Teamwork method, based on FSS-1000 training archives in KNPP in case of Steam Generator Tube Rupture accident. The advantages of operators' teamwork are shown: a) group decision-making vs. individual one: b) positive influence of crew initiated communication consisting of orders and reports that are required by instruction. (authors)

  4. Affordances and Constraints of Intelligent Decision Support for Military Command and Control : Three Case Studies of Support Systems

    OpenAIRE

    Leifler, Ola

    2011-01-01

    Researchers in military command and control (C2) have for several decades sought to help commanders by introducing automated, intelligent decision support systems. These systems are still not widely used, however, and some researchers argue that this may be due to those problems that are inherent in the relationship between the affordances of technology and the requirements by the specific contexts of work in military C2. In this thesis, we study some specific properties of three support tech...

  5. Approaches to optimal aquifer management and intelligent control in a multiresolutional decision support system

    Science.gov (United States)

    Orr, Shlomo; Meystel, Alexander M.

    2005-03-01

    Despite remarkable new developments in stochastic hydrology and adaptations of advanced methods from operations research, stochastic control, and artificial intelligence, solutions of complex real-world problems in hydrogeology have been quite limited. The main reason is the ultimate reliance on first-principle models that lead to complex, distributed-parameter partial differential equations (PDE) on a given scale. While the addition of uncertainty, and hence, stochasticity or randomness has increased insight and highlighted important relationships between uncertainty, reliability, risk, and their effect on the cost function, it has also (a) introduced additional complexity that results in prohibitive computer power even for just a single uncertain/random parameter; and (b) led to the recognition in our inability to assess the full uncertainty even when including all uncertain parameters. A paradigm shift is introduced: an adaptation of new methods of intelligent control that will relax the dependency on rigid, computer-intensive, stochastic PDE, and will shift the emphasis to a goal-oriented, flexible, adaptive, multiresolutional decision support system (MRDS) with strong unsupervised learning (oriented towards anticipation rather than prediction) and highly efficient optimization capability, which could provide the needed solutions of real-world aquifer management problems. The article highlights the links between past developments and future optimization/planning/control of hydrogeologic systems. Malgré de remarquables nouveaux développements en hydrologie stochastique ainsi que de remarquables adaptations de méthodes avancées pour les opérations de recherche, le contrôle stochastique, et l'intelligence artificielle, solutions pour les problèmes complexes en hydrogéologie sont restées assez limitées. La principale raison est l'ultime confiance en les modèles qui conduisent à des équations partielles complexes aux paramètres distribués (PDE) à une

  6. The capacity investment decision for make-to-order production systems with demand rate control

    NARCIS (Netherlands)

    Bertrand, J.W.M.; Ooijen, van H.P.G.

    2012-01-01

    In this paper we study the capacity investment decision for make-to-order manufacturing firms that utilize a fixed capacity, operate in a stochastic, stationary market, and can influence their demand rate by increasing or decreasing their sales effort. We consider manufacturing situations that

  7. Decision-Making Style among Adolescents: Relationship with Sensation Seeking and Locus of Control

    Science.gov (United States)

    Baiocco, Roberto; Laghi, Fiorenzo; D'Alessio, Maria

    2009-01-01

    The principal aim of the study was to examine the psychometric properties and construct validity of the General Decision-Making Scale (GDMS) in a sample of 700 adolescents (aged 15-19 years). Confirmatory and exploratory factor analyses provide evidence for a solid five-dimension structure reflecting the theorized construct: rational, intuitive,…

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

    Science.gov (United States)

    Morgan, Grayson B.

    2013-01-01

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

  9. Importance Sampling Based Decision Trees for Security Assessment and the Corresponding Preventive Control Schemes: the Danish Case Study

    DEFF Research Database (Denmark)

    Liu, Leo; Rather, Zakir Hussain; Chen, Zhe

    2013-01-01

    Decision Trees (DT) based security assessment helps Power System Operators (PSO) by providing them with the most significant system attributes and guiding them in implementing the corresponding emergency control actions to prevent system insecurity and blackouts. DT is obtained offline from time...... and adopts a methodology of importance sampling to maximize the information contained in the database so as to increase the accuracy of DT. Further, this paper also studies the effectiveness of DT by implementing its corresponding preventive control schemes. These approaches are tested on the detailed model...

  10. Partial admission effect on the performance and vibration of a supersonic impulse turbine

    Science.gov (United States)

    Lee, Hang Gi; Shin, Ju Hyun; Choi, Chang-Ho; Jeong, Eunhwan; Kwon, Sejin

    2018-04-01

    This study experimentally investigates the effects of partial admission on the performance and vibration outcomes of a supersonic impulse turbine with circular nozzles. The turbine of a turbopump for a gas-generator-type liquid rocket engine in the Korea Space Launch Vehicle-II is of the supersonic impulse type with the partial admission configuration for obtaining a high specific power. Partial admission turbines with a low-flow-rate working gas exhibit benefits over turbines with full admission, such as loss reduction, ease of controllability of the turbine power output, and simple turbine configurations with separate starting sections. However, the radial force of the turbine rotor due to the partial admission causes an increase in turbine vibration. Few experimental studies have previously been conducted regarding the partial admission effects on supersonic impulse turbines with circular nozzles. In the present study, performance tests of supersonic impulse turbines with circular nozzles were conducted for various partial admission ratios using a turbine test facility with high-pressure air in order to investigate the resulting aerodynamic performance and vibration. Four types of turbines with partial admission ratios of 0.17, 0.42, 0.75 and 0.83 were tested. Results show that the efficiencies at the design point increase linearly as the partial admission ratios increase. Moreover, as the velocity ratios increase, the difference in efficiency from the reference turbine with a partial admission ratio of 0.83 becomes increasingly significant, and the magnitudes of these differences are proportional to the square of the velocity ratios. Likewise, the decrease in the partial admission ratio results in an increase in the turbine vibration level owing to the increase in the radial force.

  11. Assisting informed decision making for labour analgesia: a randomised controlled trial of a decision aid for labour analgesia versus a pamphlet

    Directory of Open Access Journals (Sweden)

    Torvaldsen Siranda

    2010-04-01

    Full Text Available Abstract Background Most women use some method of pain relief during labour. There is extensive research evidence available of pharmacological pain relief during labour; however this evidence is not readily available to pregnant women. Decision aids are tools that present evidence based information and allow preference elicitation. Methods We developed a labour analgesia decision aid. Using a RCT design women either received a decision aid or a pamphlet. Eligible women were primiparous, ≥ 37 weeks, planning a vaginal birth of a single infant and had sufficient English to complete the trial materials. We used a combination of affective (anxiety, satisfaction and participation in decision-making and behavioural outcomes (intention and analgesia use to assess the impact of the decision aid, which were assessed before labour. Results 596 women were randomised (395 decision aid group, 201 pamphlet group. There were significant differences in knowledge scores between the decision aid group and the pamphlet group (mean difference 8.6, 95% CI 3.70, 13.40. There were no differences between decisional conflict scores (mean difference -0.99 (95% CI -3.07, 1.07, or anxiety (mean difference 0.3, 95% CI -2.15, 1.50. The decision aid group were significantly more likely to consider their care providers opinion (RR 1.28 95%CI 0.64, 0.95. There were no differences in analgesia use and poor follow through between antenatal analgesia intentions and use. Conclusions This decision aid improves women's labour analgesia knowledge without increasing anxiety. Significantly, the decision aid group were more informed of labour analgesia options, and considered the opinion of their care providers more often when making their analgesia decisions, thus improving informed decision making. Trial Registration Trial registration no: ISRCTN52287533

  12. Pig farmers' perceptions, attitudes, influences and management of information in the decision-making process for disease control.

    Science.gov (United States)

    Alarcon, Pablo; Wieland, Barbara; Mateus, Ana L P; Dewberry, Chris

    2014-10-01

    The objectives of this study were (1) to explore the factors involved in the decision-making process used by pig farmers for disease control and (2) to investigate pig farmers' attitudes and perceptions about different information sources relating to disease control. In 2011 a qualitative study involving 20 face-to-face interviews with English pig farmers was conducted. The questionnaire was composed of three parts. The first part required farmers to identify two diseases they had experienced and which were difficult to recognize and/or control. They were asked to report how the disease problem was recognized, how the need for control was decided, and what affected the choice of control approach. For the latter, a structure related to the Theory of Planned Behaviour was used. Their verbal responses were classified as associated with: (1) attitude and beliefs, (2) subjective norms, or (3) perceived behavioural control (PBC). In the second part, five key sources of information for disease control (Defra, BPEX, research from academia, internet and veterinarians) and the factors related to barriers to knowledge were investigated. Interviews were recorded and transcribed. A qualitative analysis of the text of the interview transcripts was carried out using templates. Drivers for disease control were 'pig mortality', 'feeling of entering in an economically critical situation', 'animal welfare' and 'feeling of despair'. Veterinarians were perceived by several participating farmers as the most trusted information source on disease control. However, in particular non-sustainable situations, other producers, and especially experiences from abroad, seemed to considerably influence the farmers' decision-making. 'Lack of knowledge', 'farm structure and management barriers' and 'economic constrains' were identified in relation to PBC. Several negative themes, such as 'lack of communication', 'not knowing where to look', and 'information bias' were associated with research from

  13. Enduring Changes in Decision Making in Patients with Full Remission from Anorexia Nervosa.

    Science.gov (United States)

    Steward, Trevor; Mestre-Bach, Gemma; Agüera, Zaida; Granero, Roser; Martín-Romera, Virginia; Sánchez, Isabel; Riesco, Nadine; Tolosa-Sola, Iris; Fernández-Formoso, Jose A; Fernández-García, Jose C; Tinahones, Francisco J; Casanueva, Felipe F; Baños, Rosa M; Botella, Cristina; Crujeiras, Ana B; de la Torre, Rafael; Fernández-Real, Jose M; Frühbeck, Gema; Ortega, Francisco J; Rodríguez, Amaia; Jiménez-Murcia, Susana; Menchón, Jose M; Fernández-Aranda, Fernando

    2016-11-01

    Deficits in neuropsychological functioning have consistently been identified in patients with anorexia nervosa (AN). However, little is known on how decision making in AN patients evolves in response to treatment or whether impairments are reversible. AN patients (n = 42) completed the Iowa Gambling Task (IGT) upon admission to a 3-month day-hospital treatment programme and at a 1-year follow-up. Patient IGT performance was compared to age-matched controls (n = 46). AN patients displayed poorer performance on the IGT at admission compared to controls (p decision-making impairments, and they might be most likely explained by clinical state rather than a trait vulnerability. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  14. Decision making, cognitive distortions and emotional distress: a comparison between pathological gamblers and healthy controls

    OpenAIRE

    Ciccarelli, M; Griffiths, MD; Nigro, G; Cosenza, M

    2017-01-01

    Background and objectives: The etiology of problem gambling is multifaceted and complex. Among others factors, poor decision making, cognitive distortions (i.e., irrational beliefs about gambling), and emotional factors (e.g., negative mood states) appear to be among the most important factors in the development and maintenance of problem gambling. Although empirical evidence has suggested that cognitive distortions facilitate gambling and negative emotions are associated with gambling, the i...

  15. Quantum Type Indeterminacy in Dynamic Decision-Making: Self-Control through Identity Management

    Directory of Open Access Journals (Sweden)

    Jerome Busemeyer

    2012-05-01

    Full Text Available The Type Indeterminacy model is a theoretical framework that uses some elements of quantum formalism to model the constructive preference perspective suggested by Kahneman and Tversky. In a dynamic decision context, type indeterminacy induces a game with multiple selves associated with a state transition process. We define a Markov perfect equilibrium among the selves with individual identity (preferences as the state variable. The approach allows to characterize generic personality types and derive some comparative static results.

  16. When the user is not the chooser: learning from stakeholder involvement in technology adoption decisions in infection control.

    Science.gov (United States)

    Ahmad, R; Kyratsis, Y; Holmes, A

    2012-07-01

    Health systems need efficient and effective innovation decisions to provide maximum benefit to patients, particularly in a climate of financial constraints. Although evidence-based innovations exist for helping to address healthcare-associated infections, the uptake and implementation of these is highly variable and in some cases very slow. To investigate innovation adoption decisions and implementation processes from an organizational perspective, focusing on the implications of stakeholder involvement during the innovation process. Thirty-eight technology adoption decisions and implementation processes were examined through 121 qualitative interviews in 12 National Health Service healthcare organizations across England. Stakeholder involvement varied across organizations with decisions highly exclusive to the infection prevention and control (IPC) team, to highly inclusive of wider organizational members. The context, including organizational culture, previous experience, and logistical factors influenced the level of stakeholder engagement. The timing of stakeholder involvement in the process impacted on: (i) the range of innovations considered; (ii) the technologies selected, and (iii) the success of technology implementation. Cases of non-adoption, discontinued adoption, and of successful implementation are presented to share learning. The potential benefits of stakeholder involvement for 'successful' innovation adoption are presented including a goal-oriented framework for involvement. Key stakeholder involvement can lead to innovation adoption and implementation compatible with structural and cultural contexts, particularly when involvement crosses the phases of initiation, decision-making and implementation. Involving members of the wider healthcare organization can raise the profile of IPC and reinforce efforts to make IPC everybody's business. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  17. Improving access to shared decision-making for Hispanics/Latinos with inadequately controlled type 2 diabetes mellitus.

    Science.gov (United States)

    Davidson, Jaime A; Rosales, Aracely; Shillington, Alicia C; Bailey, Robert A; Kabir, Chris; Umpierrez, Guillermo E

    2015-01-01

    To describe the cultural and linguistic adaptation and Spanish translation of an English-language patient decision aid (PDA) for use in supporting shared decision-making in Hispanics/Latinos with type 2 diabetes mellitus (T2DM), a group at a high risk for complications. A steering committee of endocrinologists, a primary care physician, a certified diabetes educator, and a dietician, each with extensive experience in providing care to Hispanics/Latinos was convened to assess a PDA developed for English-speaking patients with T2DM. English content was reviewed for cultural sensitivity and appropriateness for a Hispanic/Latino population. A consensus-building process and iterative version edits incorporated clinician perspectives. The content was adapted to be consistent with traditional Hispanic/Latino cultural communication precepts (eg, avoidance of hostile confrontation; value for warm interaction; respect for authority; value of family support for decisions). The PDA was translated by native-speaking individuals with diabetes expertise. The PDA underwent testing during cognitive interviews with ten Spanish-speaking Hispanics/Latinos with T2DM to ensure that the content is reflective of the experience, understanding, and language Hispanic/Latino patients use to describe diabetes and treatment. Content edits were made to assure a literacy level appropriate to the audience, and the PDA was produced for online video dissemination. High-quality, well-developed tools to facilitate shared decision-making in populations with limited access to culturally sensitive information can narrow gaps and align care with individual patient preferences. A newly developed PDA is available for shared decision-making that provides culturally appropriate treatment information for inadequately controlled Hispanics/Latinos with T2DM. The impact on the overall health of patients and care management of T2DM requires further study.

  18. Acute admissions among immigrants and asylum seekers to a psychiatric hospital in Norway.

    Science.gov (United States)

    Iversen, Valentina Cabral; Morken, Gunnar

    2003-09-01

    The purpose of the present study was to compare admission rates, including admission by coercion, length of hospital stay and diagnosis among immigrants, asylum seekers and Norwegian-born patients. All admissions (n=3053) to Østmarka Hospital during the period 1995-2000 were examined. A sample including all immigrants (94) and asylum seekers (39) as well as a control group of 133 Norwegians was analysed. Immigrants and Norwegians had the same relative risk of admission (1.07). The relative risk of admission was higher for asylum seekers compared to Norwegians (8.84). There were differences in the diagnoses given at discharge in the three groups of patients, both among men (chi2=22.33, df=6, pimmigrants. The number of admissions by coercion was highest among immigrants, and lowest among asylum seekers (chi2=12.03, df=2, pimmigrants, asylum seekers had high admission rates and low frequency of admissions by coercion. Schizophrenia was frequent among female immigrants admitted to hospital.

  19. Redundancy, Discrimination and Corruption in the Multibillion-Dollar Business of College Admissions Testing

    Science.gov (United States)

    Rizzo, Monica Ellen

    2012-01-01

    Most American colleges and universities require standardized entrance exams when making admissions decisions. Scores on these exams help determine if, when and where students will be allowed to pursue higher education. These scores are also used to determine eligibility for merit based financial aid. This testing persists even though half of the…

  20. Does Grade Inflation Affect the Credibility of Grades? Evidence from US Law School Admissions

    Science.gov (United States)

    Wongsurawat, Winai

    2009-01-01

    While the nature and causes of university grade inflation have been extensively studied, little empirical research on the consequence of this phenomenon is currently available. The present study uses data for 48 US law schools to analyze admission decisions in 1995, 2000, and 2007, a period during which university grade inflation appears to have…

  1. A Life-Cycle Cost Estimating Methodology for NASA-Developed Air Traffic Control Decision Support Tools

    Science.gov (United States)

    Wang, Jianzhong Jay; Datta, Koushik; Landis, Michael R. (Technical Monitor)

    2002-01-01

    This paper describes the development of a life-cycle cost (LCC) estimating methodology for air traffic control Decision Support Tools (DSTs) under development by the National Aeronautics and Space Administration (NASA), using a combination of parametric, analogy, and expert opinion methods. There is no one standard methodology and technique that is used by NASA or by the Federal Aviation Administration (FAA) for LCC estimation of prospective Decision Support Tools. Some of the frequently used methodologies include bottom-up, analogy, top-down, parametric, expert judgement, and Parkinson's Law. The developed LCC estimating methodology can be visualized as a three-dimensional matrix where the three axes represent coverage, estimation, and timing. This paper focuses on the three characteristics of this methodology that correspond to the three axes.

  2. Improving access to shared decision-making for Hispanics/Latinos with inadequately controlled type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Davidson JA

    2015-04-01

    -quality, well-developed tools to facilitate shared decision-making in populations with limited access to culturally sensitive information can narrow gaps and align care with individual patient preferences. A newly developed PDA is available for shared decision-making that provides culturally appropriate treatment information for inadequately controlled Hispanics/Latinos with T2DM. The impact on the overall health of patients and care management of T2DM requires further study.Keywords: patient decision aid, language adaptation, Hispanic, decision making, type 2 diabetes

  3. A Hierarchical Reliability Control Method for a Space Manipulator Based on the Strategy of Autonomous Decision-Making

    Directory of Open Access Journals (Sweden)

    Xin Gao

    2016-01-01

    Full Text Available In order to maintain and enhance the operational reliability of a robotic manipulator deployed in space, an operational reliability system control method is presented in this paper. First, a method to divide factors affecting the operational reliability is proposed, which divides the operational reliability factors into task-related factors and cost-related factors. Then the models describing the relationships between the two kinds of factors and control variables are established. Based on this, a multivariable and multiconstraint optimization model is constructed. Second, a hierarchical system control model which incorporates the operational reliability factors is constructed. The control process of the space manipulator is divided into three layers: task planning, path planning, and motion control. Operational reliability related performance parameters are measured and used as the system’s feedback. Taking the factors affecting the operational reliability into consideration, the system can autonomously decide which control layer of the system should be optimized and how to optimize it using a control level adjustment decision module. The operational reliability factors affect these three control levels in the form of control variable constraints. Simulation results demonstrate that the proposed method can achieve a greater probability of meeting the task accuracy requirements, while extending the expected lifetime of the space manipulator.

  4. Distinct alterations in value-based decision-making and cognitive control in suicide attempters: toward a dual neurocognitive model.

    Science.gov (United States)

    Richard-Devantoy, Stéphane; Olié, Emilie; Guillaume, Sébastien; Bechara, Antoine; Courtet, Philippe; Jollant, Fabrice

    2013-12-01

    The literature suggests that many suicide attempters show impairment in both decision-making and cognitive control. However, it is not clear if these deficits are linked to each other, and if they may be related to more basic alterations in attention. This is a relevant question in the perspective of future interventions targeting cognitive deficits to prevent suicidal acts. Two different populations of patients with histories of suicide attempts were assessed (N=142 and 119). The Iowa Gambling Task (IGT) was used to measure decision-making in both populations. We used a D2 cancellation task and a verbal working memory task in population 1; the Stroop test, the N-Back task, the Trail Making Test, and the Hayling Sentence Completion test in population 2. Regarding decision-making, we only found a small negative correlation between the Hayling test error score (r=-0.24; p=0.01), and the net score from the second half of the IGT. In contrast, working memory, cognitive flexibility and cognitive inhibition measures were largely inter-correlated. Most patients were medicated. Only patients with mood disorders. These results add to previous findings suggesting that the neurocognitive vulnerability to suicidal behavior may rely on impairments in two distinct anatomical systems, one processing value-based decision-making (associated with ventral prefrontal cortex, among others) and one underlying cognitive control (associated with more dorsal prefrontal regions). This distinction may result in tailored-made cognitive interventions. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. The effect of a decision aid on informed decision-making in the era of non-invasive prenatal testing : A randomised controlled trial

    NARCIS (Netherlands)

    Beulen, Lean; Van Den Berg, Michelle; Faas, Brigitte Hw; Feenstra, Ilse; Hageman, Michiel; Van Vugt, John Mg; Bekker, Mireille N.

    2016-01-01

    Early in pregnancy women and their partners face the complex decision on whether or not to participate in prenatal testing for fetal chromosomal abnormalities. Several studies show that the majority of pregnant women currently do not make informed decisions regarding prenatal testing. As the range

  6. Marketing in Admissions: The Information System Approach.

    Science.gov (United States)

    Wofford, O. Douglas; Timmerman, Ed

    1982-01-01

    A marketing information system approach for college admissions is outlined that includes objectives, information needs and sources, a data collection format, and information evaluation. Coordination with other institutional information systems is recommended. (MSE)

  7. Alphabetical order effects in school admissions

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    2016-01-01

    Roč. 31, č. 4 (2016), s. 483-498 ISSN 0267-1522 Institutional support: PRVOUK-P23 Keywords : admissions * alphabetical order * order effects Subject RIV: AH - Economics Impact factor: 1.033, year: 2016

  8. Cognitive issues in autonomous spacecraft-control operations: An investigation of software-mediated decision making in a scaled environment

    Science.gov (United States)

    Murphy, Elizabeth Drummond

    As advances in technology are applied in complex, semi-automated domains, human controllers are distanced from the controlled process. This physical and psychological distance may both facilitate and degrade human performance. To investigate cognitive issues in spacecraft ground-control operations, the present experimental research was undertaken. The primary issue concerned the ability of operations analysts who do not monitor operations to make timely, accurate decisions when autonomous software calls for human help. Another key issue involved the potential effects of spatial-visualization ability (SVA) in environments that present data in graphical formats. Hypotheses were derived largely from previous findings and predictions in the literature. Undergraduate psychology students were assigned at random to a monitoring condition or an on-call condition in a scaled environment. The experimental task required subjects to decide on the veracity of a problem diagnosis delivered by a software process on-board a simulated spacecraft. To support decision-making, tabular and graphical data displays presented information on system status. A level of software confidence in the problem diagnosis was displayed, and subjects reported their own level of confidence in their decisions. Contrary to expectations, the performance of on-call subjects did not differ significantly from that of continuous monitors. Analysis yielded a significant interaction of sex and condition: Females in the on-call condition had the lowest mean accuracy. Results included a preference for bar charts over line graphs and faster performance with tables than with line graphs. A significant correlation was found between subjective confidence and decision accuracy. SVA was found to be predictive of accuracy but not speed; and SVA was found to be a stronger predictor of performance for males than for females. Low-SVA subjects reported that they relied more on software confidence than did medium- or high

  9. Cholgate - a randomized controlled trial comparing the effect of automated and on-demand decision support on the management of cardiovascular disease factors in primary care

    NARCIS (Netherlands)

    J.T. van Wyk (Jacobus); M.A.M. van Wijk (Marc); P.W. Moorman (Peter); M. Mosseveld (Mees); J. van der Lei (Johan)

    2003-01-01

    textabstractAutomated and on-demand decision support systems integrated into an electronic medical record have proven to be an effective implementation strategy for guidelines. Cholgate is a randomized controlled trial comparing the effect of automated and on-demand decision

  10. Shared decision making for stroke prevention in atrial fibrillation: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Kunneman, Marleen; Branda, Megan E; Noseworthy, Peter A; Linzer, Mark; Burnett, Bruce; Dick, Sara; Spencer-Bonilla, Gabriela; Fernandez, Cara A; Gorr, Haeshik; Wambua, Mike; Keune, Shelly; Zeballos-Palacios, Claudia; Hargraves, Ian; Shah, Nilay D; Montori, Victor M

    2017-09-29

    Nonvalvular atrial fibrillation (AF) is a common ongoing health problem that places patients at risk of stroke. Whether and how a patient addresses this risk depends on each patient's goals, context, and values. Consequently, leading cardiovascular societies recommend using shared decision making (SDM) to individualize antithrombotic treatment in patients with AF. The aim of this study is to assess the extent to which the ANTICOAGULATION CHOICE conversation tool promotes high-quality SDM and influences anticoagulation uptake and adherence in patients with AF at risk of strokes. This study protocol describes a multicenter, encounter-level, randomized trial to assess the effect of using the ANTICOAGULATION CHOICE conversation tool in the clinical encounter, compared to usual care. The participating centers include an academic hospital system, a suburban community group practice, and an urban safety net hospital, all in Minnesota, USA. Patients with ongoing nonvalvular AF at risk of strokes (CHA 2 DS 2 -VASc score ≥ 1 in men, or ≥ 2 in women) will be eligible for participation. We aim to include 999 patients and their clinicians. The primary outcome is the quality of SDM as perceived by participants, and as assessed by a post-encounter survey that ascertains (a) knowledge transfer, (b) concordance of the decision made, (c) quality of communication, and (d) satisfaction with the decision-making process. Recordings of encounters will be reviewed to assess the extent of patient involvement and how participants use the tool (fidelity). Anticoagulant use, choice of agent, and adherence will be drawn from patients' medical and pharmacy records. Strokes and bleeding events will be drawn from patient records. This study will provide a valid and precise measure of the effect of the ANTICOAGULATION CHOICE conversation tool on SDM quality and processes, and on the treatment choices and adherence to therapy among AF patients at risk of stroke. ClinicalTrials.gov, NCT

  11. Is autophagy the key mechanism by which the sphingolipid rheostat controls the cell fate decision?

    Science.gov (United States)

    Lavieu, Gregory; Scarlatti, Francesca; Sala, Giusy; Levade, Thierry; Ghidoni, Riccardo; Botti, Joëlle; Codogno, Patrice

    2007-01-01

    Sphingolipids are major constituents of biological membrane and some of them behave as second messengers involved in the cell fate decision. Ceramide and sphingosine 1-phosphate (S1P) constitute a rheostat system in which ceramide promotes cell death and S1P increases cell survival. We have shown that both sphingolipids are able to trigger autophagy with opposing outcomes on cell survival. Here we discuss and speculate on the diverging functions of the autophagic pathways induced by ceramide and S1P, respectively.

  12. Using Old and New SAT® Scores for Admission: A Closer Look at Concordant Scores in Predictive Models. Research Report 2016-17

    Science.gov (United States)

    Marini, Jessica P.; Shaw, Emily J.; Young, Linda

    2016-01-01

    During the transition period between the use of exclusively old SAT® scores and the use of exclusively new SAT scores, college admission offices will be receiving both types of scores from students. Making an admission decision based on new SAT scores can be challenging at first because institutions have methods, procedures, and models based on…

  13. THE ADMISSION OF NEWLY CREATED STATES TO THE MEMBERSHIP OF THE UNITED NATIONS: THE CASE OF REPUBLIC OF MACEDONIA

    Directory of Open Access Journals (Sweden)

    Milorad Petreski

    2017-01-01

    Full Text Available The international law which regulates the formation, functioning and legal capacity of international organizations, and also the international law in the United Nations system, are always relevant and subject to progressive development, because the international relations are in constant dynamics. Each newly created state has one major foreign policy goal during its first years of formation or after obtaining independence – admission to the membership of the United Nations. That is because the decision of admission to the membership of the UN guarantees the country’s statehood which can no longer be questioned. The country becomes part of a global community of nations – the international community. Therefore, the present paper is a qualitative research regarding the admission of new states to the international community, and the decision-making process concerning the admission of new Member States to the UN.

  14. Decision model on the demographic profile for tuberculosis control using fuzzy logic

    Directory of Open Access Journals (Sweden)

    Laisa Ribeiro de Sá

    2015-06-01

    Full Text Available This study aimed to describe the relationship between demographic factors and the involvement of tuberculosis by applying a decision support model based on fuzzy logic to classify the regions as priority and non-priority in the city of João Pessoa, state of Paraíba (PB. As data source, we used the Notifiable Diseases Information System between 2009 and 2011. We chose the descriptive analysis, relative risk (RR, spatial distribution and fuzzy logic. The total of 1,245 cases remained in the study, accounting for 37.02% of cases in 2009. High and low risk clusters were identified, and the RR was higher among men (8.47, with 12 clusters, and among those uneducated (11.65, with 13 clusters. To demonstrate the functionality of the model was elected the year with highest number of cases, and the municipality district with highest population. The methodology identified priority areas, guiding managers to make decisions that respect the local particularities.

  15. Practical considerations to guide development of access controls and decision support for genetic information in electronic medical records

    Directory of Open Access Journals (Sweden)

    Darcy Diana C

    2011-11-01

    Full Text Available Abstract Background Genetic testing is increasingly used as a tool throughout the health care system. In 2011 the number of clinically available genetic tests is approaching 2,000, and wide variation exists between these tests in their sensitivity, specificity, and clinical implications, as well as the potential for discrimination based on the results. Discussion As health care systems increasingly implement electronic medical record systems (EMRs they must carefully consider how to use information from this wide spectrum of genetic tests, with whom to share information, and how to provide decision support for clinicians to properly interpret the information. Although some characteristics of genetic tests overlap with other medical test results, there are reasons to make genetic test results widely available to health care providers and counterbalancing reasons to restrict access to these test results to honor patient preferences, and avoid distracting or confusing clinicians with irrelevant but complex information. Electronic medical records can facilitate and provide reasonable restrictions on access to genetic test results and deliver education and decision support tools to guide appropriate interpretation and use. Summary This paper will serve to review some of the key characteristics of genetic tests as they relate to design of access control and decision support of genetic test information in the EMR, emphasizing the clear need for health information technology (HIT to be part of optimal implementation of genetic medicine, and the importance of understanding key characteristics of genetic tests when designing HIT applications.

  16. Practical considerations to guide development of access controls and decision support for genetic information in electronic medical records.

    Science.gov (United States)

    Darcy, Diana C; Lewis, Eleanor T; Ormond, Kelly E; Clark, David J; Trafton, Jodie A

    2011-11-02

    Genetic testing is increasingly used as a tool throughout the health care system. In 2011 the number of clinically available genetic tests is approaching 2,000, and wide variation exists between these tests in their sensitivity, specificity, and clinical implications, as well as the potential for discrimination based on the results. As health care systems increasingly implement electronic medical record systems (EMRs) they must carefully consider how to use information from this wide spectrum of genetic tests, with whom to share information, and how to provide decision support for clinicians to properly interpret the information. Although some characteristics of genetic tests overlap with other medical test results, there are reasons to make genetic test results widely available to health care providers and counterbalancing reasons to restrict access to these test results to honor patient preferences, and avoid distracting or confusing clinicians with irrelevant but complex information. Electronic medical records can facilitate and provide reasonable restrictions on access to genetic test results and deliver education and decision support tools to guide appropriate interpretation and use. This paper will serve to review some of the key characteristics of genetic tests as they relate to design of access control and decision support of genetic test information in the EMR, emphasizing the clear need for health information technology (HIT) to be part of optimal implementation of genetic medicine, and the importance of understanding key characteristics of genetic tests when designing HIT applications.

  17. The decision-making process in Brazil's ratification of the World Health Organization Framework Convention on Tobacco Control.

    Science.gov (United States)

    Rangel, Erica Cavalcanti; Pereira, Andre; Cavalcante, Tania Maria; Oliveira, Egléubia Andrade; Silva, Vera Luiza da Costa E

    2017-09-21

    Tobacco consumption is a leading cause of various types of cancer and other tobacco-related diseases. In 2003, the World Health Assembly adopted the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), which aims to protect citizens from the health, social, environmental, and economic consequences of tobacco consumption and exposure to tobacco smoke. The Convention was to be ratified by the Member States of the WHO; in Brazil's case, ratification involved the National Congress, which held public hearings in the country's leading tobacco growing communities (municipalities). The current study analyzes this decision-making process according to the different interests, positions, and stakeholders. In methodological terms, this is a qualitative study based on document research, drawing primarily on the shorthand notes from the public hearings. We analyze the interests and arguments for and against ratification. The article shows that although preceded by intense debates, the final decision in favor of ratification was made by a limited group of government stakeholders, characterizing a decision-making process similar to a funnel.

  18. Air pollution and emergency hospital admissions for cardiovascular diseases in Valencia, Spain.

    Science.gov (United States)

    Ballester, F; Tenías, J M; Pérez-Hoyos, S

    2001-01-01

    To estimate the short-term association between air pollution levels and emergency hospital admissions for cardiovascular diseases in Valencia, within 1994-1996 period. Daily levels of air pollution and emergency admissions for cardiovascular diseases were related to using an ecological time series design. The number of admissions was obtained from the hospital records database. Selected groups of causes were all cardiovascular diseases, heart admissions, and admissions for cerebrovascular diseases. The number of admissions for digestive diseases was used as control. Pollutants were black smoke, sulphur dioxide (SO(2)), nitrogen dioxide (NO(2)), carbon monoxide (CO) and ozone (O(3)). Magnitude of association was estimated by Poisson autoregressive regression. Estimations were calculated according the hottest (May to October) and the coldest (November to April) periods. City of Valencia, Spain, about 750,000 inhabitants. People being admitted to the two major hospitals in the city, with a catchment area of nearly 400,000 inhabitants. For the whole period, a significant association for SO(2)-24 h was found so a rise in its levels of 10 microg/m(3) was associated with an increment of 3% (95%CI 0.4 to 5.7%) in the expected number of cardiovascular admissions. A significant association for black smoke, SO(2)-24 h, SO(2)-1 h, and CO-1 h was found in the hottest semester. All these associations were verified with a lag of two days. The estimates of the associations for particles, SO(2), and CO were affected by the inclusion of the other pollutants in their models. NO(2) was independently associated with cerebrovascular admissions. There were no significant associations between air pollution and admissions for digestive diseases. Current levels of air pollution and emergency cardiovascular admissions are significantly related in Valencia.

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

    Directory of Open Access Journals (Sweden)

    Kadir Masood

    2007-01-01

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

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

    Science.gov (United States)

    Husain, Sara; Kadir, Masood; Fatmi, Zafar

    2007-01-23

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

  1. Introducing Emotioncy as an Invisible Force Controlling Causal Decisions: A Case of Attribution Theory

    Directory of Open Access Journals (Sweden)

    Pishghadam Reza

    2017-03-01

    Full Text Available Given the prominence of studies aimed at determining the factors influencing causal judgments, this study attempts to introduce the newly-developed concept of emotioncy as one of the guiding factors pushing attribution judgments toward a certain spectrum. To this end, two scales of attribution and emotioncy were designed using ten hypothetical situations. A total number of 309 participants filled out the scales. The construct validity of the scales was substantiated through confirmatory factor analysis (CFA. Afterwards, structural equation modeling (SEM was utilized to examine the possible relationships among the sub-constructs of attribution and emotioncy scales. The results indicated that as the participants’ emotioncy level increases, it becomes more likely for them to attribute probable causes to external factors. Moreover, it was revealed that while the involved individuals attribute causes to external factors, the exvolved ones attribute them to internal factors. In the end, implications of the findings were discussed in the realm of judgment and decision making.

  2. Simple decision tools to help optimize the control strategy 2 weeks into a Danish FMD epidemic

    DEFF Research Database (Denmark)

    Willeberg, Preben; Hisham Beshara Halasa, Tariq; Boklund, Anette

    2012-01-01

    The choice of whether or not to apply emergency vaccination is one of the most difficult decisions facing the authorities when foot-and-mouth disease (FMD) breaks out in a free country (Barnett et al. 2002). A simple quantitative tool has been proposed using the first 14-days incidence (FFI...... detected after day 14, the epidemic duration after day 14 and the size of the affected region at the end of the epidemic. Statistically significant positive correlations were found in all regression analyses of the data. There was, however, a high degree of variation (Fig. 1), which is to be expected...... to estimate predictive values by applying selected cut-off- values for both the dependent and the independent variables (Table 1). Emergency vaccination should be considered during an outbreak if the predicted cumulative size, duration or cost of the epidemic appears alarming (EU 2003, Kitching et al. 2005...

  3. Using Statistical Process Control to Make Data-Based Clinical Decisions.

    Science.gov (United States)

    Pfadt, Al; Wheeler, Donald J.

    1995-01-01

    Statistical process control (SPC), which employs simple statistical tools and problem-solving techniques such as histograms, control charts, flow charts, and Pareto charts to implement continual product improvement procedures, can be incorporated into human service organizations. Examples illustrate use of SPC procedures to analyze behavioral data…

  4. Investigating approaches to diversity in a national survey of physics doctoral degree programs: The graduate admissions landscape

    Science.gov (United States)

    Potvin, Geoff; Chari, Deepa; Hodapp, Theodore

    2017-12-01

    Graduate admissions play a critical gatekeeping role in the physics community not only because they select students who are allowed to begin their graduate studies, but also because they influence how students perceive graduate school, and in some cases whether or not they will even choose to apply. In conjunction with the APS Bridge Program, we conducted a national survey of graduate directors (and related faculty) of physics Ph.D. programs in the United States to explore graduate admissions practices. Our focus was on criteria used in determining admissions, mechanisms through which graduate applicants are handled, and how student representation considerations are incorporated into admissions (if at all). We report here on existing graduate admission practices in physics departments and highlight some critical issues for understanding barriers for diversifying graduate physics, including the use of GRE scores (and the relative importance placed on them). We find that the use of a minimum GRE score for admission, a practice in opposition to recommendations made by the tests designers, is reported to be used in many departments (more than one in three). We also find letters of recommendation to be highly valued in admissions decisions. Our data describe various initiatives at the institutional or individual level to increase gender diversity in admissions. A sizable number of departments also express a latent demand for greater numbers of students from traditionally marginalized racial or ethnic groups, but simultaneously report a lack of such applicants.

  5. Analysis of Criteria for Admission to the Polytechnic “Nikola Tesla” in Gospić

    Directory of Open Access Journals (Sweden)

    Kristina Devčić

    2013-07-01

    Full Text Available Much like in the rest of the world, higher education institutions in the Republic of Croatia are working in a turbulent environment. Croatian polytechnics must recognize and understand the changes in their environment in order to be able to properly respond to them. The Polytechnic “Nikola Tesla” in Gospić is one of the polytechnics facing a growing competition, but also the problem of decreasing enrolment. To solve these problems, it is necessary to apply marketing methods and techniques for understanding the process of deciding on applying for admission to the Polytechnic. In order to better understand this process and how it can be influenced, the authors examined the criteria that students use when making this decision. It was established during the research that some of the criteria had a greater impact on the decision to apply for admission (the location of the Polytechnic, professional orientation, reasonable admission requirements and applicability of professional knowledge in practice and employment prospects as the key decision factor, while others had a much smaller impact. In addition, the research has shown that there is no significant difference between male and female respondents with regard to the importance they attach to different criteria. Using factor analysis, the criteria for admission to the Polytechnic were grouped as follows: the quality of education, studying conditions, image of the institution, the cost of education, and the influence of friends and family.

  6. Pre-admission antibiotics for suspected cases of meningococcal disease.

    Science.gov (United States)

    Sudarsanam, Thambu D; Rupali, Priscilla; Tharyan, Prathap; Abraham, Ooriapadickal Cherian; Thomas, Kurien

    2017-06-14

    Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis. To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different pre-admission antibiotic regimens in decreasing mortality, clinical failure, and morbidity in people suspected of meningococcal disease. We searched CENTRAL (6 January 2017), MEDLINE (1966 to 6 January 2017), Embase (1980 to 6 January 2017), Web of Science (1985 to 6 January 2017), LILACS (1982 to 6 January 2017), and prospective trial registries to January 2017. We previously searched CAB Abstracts from 1985 to June 2015, but did not update this search in January 2017. Randomised controlled trials (RCTs) or quasi-RCTs comparing antibiotics versus placebo or no intervention, in people with suspected meningococcal infection, or different antibiotics administered before admission to hospital or confirmation of the diagnosis. Two review authors independently assessed trial quality and extracted data from the search results. We calculated the risk ratio (RR) and 95% confidence interval (CI) for dichotomous data. We included only one trial and so did not perform data synthesis. We assessed the overall quality of the evidence using the GRADE approach. We found no RCTs comparing pre-admission antibiotics versus no pre-admission antibiotics or placebo. We included one open-label, non-inferiority RCT with 510 participants, conducted during an epidemic in Niger, evaluating a single dose of intramuscular ceftriaxone versus a single dose of intramuscular long-acting (oily) chloramphenicol. Ceftriaxone was not inferior to chloramphenicol in reducing mortality (RR 1.21, 95% CI 0.57 to 2.56; N = 503; 308 confirmed meningococcal meningitis; 26 deaths; moderate-quality evidence), clinical failures (RR 0.83, 95% CI 0.32 to

  7. The Effect of Farmers' Decisions on Pest Control with Bt Crops: A Billion Dollar Game of Strategy.

    Science.gov (United States)

    Milne, Alice E; Bell, James R; Hutchison, William D; van den Bosch, Frank; Mitchell, Paul D; Crowder, David; Parnell, Stephen; Whitmore, Andrew P

    2015-12-01

    A farmer's decision on whether to control a pest is usually based on the perceived threat of the pest locally and the guidance of commercial advisors. Therefore, farmers in a region are often influenced by similar circumstances, and this can create a coordinated response for pest control that is effective at a landscape scale. This coordinated response is not intentional, but is an emergent property of the system. We propose a framework for understanding the intrinsic feedback mechanisms between the actions of humans and the dynamics of pest populations and demonstrate this framework using the European corn borer, a serious pest in maize crops. We link a model of the European corn borer and a parasite in a landscape with a model that simulates the decisions of individual farmers on what type of maize to grow. Farmers chose whether to grow Bt-maize, which is toxic to the corn borer, or conventional maize for which the seed is cheaper. The problem is akin to the snow-drift problem in game theory; that is to say, if enough farmers choose to grow Bt maize then because the pest is suppressed an individual may benefit from growing conventional maize. We show that the communication network between farmers' and their perceptions of profit and loss affects landscape scale patterns in pest dynamics. We found that although adoption of Bt maize often brings increased financial returns, these rewards oscillate in response to the prevalence of pests.

  8. The Effect of Farmers' Decisions on Pest Control with Bt Crops: A Billion Dollar Game of Strategy.

    Directory of Open Access Journals (Sweden)

    Alice E Milne

    2015-12-01

    Full Text Available A farmer's decision on whether to control a pest is usually based on the perceived threat of the pest locally and the guidance of commercial advisors. Therefore, farmers in a region are often influenced by similar circumstances, and this can create a coordinated response for pest control that is effective at a landscape scale. This coordinated response is not intentional, but is an emergent property of the system. We propose a framework for understanding the intrinsic feedback mechanisms between the actions of humans and the dynamics of pest populations and demonstrate this framework using the European corn borer, a serious pest in maize crops. We link a model of the European corn borer and a parasite in a landscape with a model that simulates the decisions of individual farmers on what type of maize to grow. Farmers chose whether to grow Bt-maize, which is toxic to the corn borer, or conventional maize for which the seed is cheaper. The problem is akin to the snow-drift problem in game theory; that is to say, if enough farmers choose to grow Bt maize then because the pest is suppressed an individual may benefit from growing conventional maize. We show that the communication network between farmers' and their perceptions of profit and loss affects landscape scale patterns in pest dynamics. We found that although adoption of Bt maize often brings increased financial returns, these rewards oscillate in response to the prevalence of pests.

  9. Does the Superior Colliculus Control Perceptual Sensitivity or Choice Bias during Attention? Evidence from a Multialternative Decision Framework

    Science.gov (United States)

    Steinmetz, Nicholas A.; Moore, Tirin; Knudsen, Eric I.

    2017-01-01

    Distinct networks in the forebrain and the midbrain coordinate to control spatial attention. The critical involvement of the superior colliculus (SC)—the central structure in the midbrain network—in visuospatial attention has been shown by four seminal, published studies in monkeys (Macaca mulatta) performing multialternative tasks. However, due to the lack of a mechanistic framework for interpreting behavioral data in such tasks, the nature of the SC's contribution to attention remains unclear. Here we present and validate a novel decision framework for analyzing behavioral data in multialternative attention tasks. We apply this framework to re-examine the behavioral evidence from these published studies. Our model is a multidimensional extension to signal detection theory that distinguishes between two major classes of attentional mechanisms: those that alter the quality of sensory information or “sensitivity,” and those that alter the selective gating of sensory information or “choice bias.” Model-based simulations and model-based analyses of data from these published studies revealed a converging pattern of results that indicated that choice-bias changes, rather than sensitivity changes, were the primary outcome of SC manipulation. Our results suggest that the SC contributes to attentional performance predominantly by generating a spatial choice bias for stimuli at a selected location, and that this bias operates downstream of forebrain mechanisms that enhance sensitivity. The findings lead to a testable mechanistic framework of how the midbrain and forebrain networks interact to control spatial attention. SIGNIFICANCE STATEMENT Attention involves the selection of the most relevant information for differential sensory processing and decision making. While the mechanisms by which attention alters sensory encoding (sensitivity control) are well studied, the mechanisms by which attention alters decisional weighting of sensory evidence (choice

  10. 30 CFR 773.28 - Written agency decision on challenges to ownership or control listings or findings.

    Science.gov (United States)

    2010-07-01

    ... will post all decisions made under this section on AVS. (e) Any person who receives a written decision... decision by a reviewing administrative or judicial tribunal, we must review the information in AVS to... AVS to reflect the decision. [65 FR 79666, Dec. 19, 2000, as amended at 72 FR 68030, Dec. 3, 2007] ...

  11. 32 CFR 776.66 - Bar admission and disciplinary matters.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Bar admission and disciplinary matters. 776.66... ADVOCATE GENERAL Rules of Professional Conduct § 776.66 Bar admission and disciplinary matters. (a) Bar admission and disciplinary matters. A covered attorney, in connection with any application for bar admission...

  12. The Pattern of Surgical Admissions in University of Nigeria Teaching ...

    African Journals Online (AJOL)

    The digestive system and genitourinary systems were the most commonly affected systems. Emergency admission accounted for 18.1% of all surgical admissions while elective admissions accounted for the rest. Conclusion: More detailed research on the pattern of admissions is important in planning and should be carried ...

  13. QUANTIFICATION OF THE DECISIONS OF CONTROL AND AUDIT IN INVENTORY MANAGEMENT IN CEMENT INDUSTRY ENTERPRISES

    OpenAIRE

    Sylwia £êgowik-Œwi¹cik

    2011-01-01

    Inventory management in enterprises of cement industry necessitates the assessment of the level of risk which is generated by production inventory. The processes of control and auditing allow for planning, monitoring and organization of inventory management in the analysed business entities. This paper is aimed at presentation of the phase of preparation of audit activities in the area of inventory and verification of model solutions for the processes of control and audit in terms of inventor...

  14. Racism, Gun Ownership and Gun Control: Biased Attitudes in US Whites May Influence Policy Decisions

    OpenAIRE

    O?Brien, Kerry; Forrest, Walter; Lynott, Dermot; Daly, Michael

    2013-01-01

    OBJECTIVE: Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. METHOD: The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US wh...

  15. THE AUTOMATIC SYSTEM’S MODEL OF DECISION-MAKING SUPPORT FOR DISPATCHING CONTROL OF THE CITY PASSENGER TRAFFIC

    Directory of Open Access Journals (Sweden)

    V. A. Lakhno

    2016-04-01

    Full Text Available Purpose. This scientific work considers the further development of mathematical models and algorithms for automatic decision support for dispatching management of the city passenger traffic. Methodology. Systems of dispatching management for the city passenger transport are to provide the carrying out of the routes according schedules with minimal deviations from the planned ones through the using of appropriate control actions. The systems’ algorithm focuses on the selection of control actions that compensate the disturbances. It is proposed to use the index of the waiting time minimum for passengers of buses and taxis at stops as a criterion for evaluating of dispatching control systems work. Findings. Based on the conducted analysis of the research within the existing theory of traffic flow of vehicles, it was proposed the model for the system of dispatching management for urban passenger moving units considering the effect of the most important stochastic factors on the schedule of buses and taxis movement in large cities. The obtained system of equations that models the parameter of movement on the bus routes allows you to assess quickly the influence of disturbing effects on the service quality indicators of passengers and, if necessary, to draw up the optimal schedule. Originality. The authors propose a new model for decision support of dispatching management for the city passenger transport. They take into account the effect of the most important stochastic factors, such as the overflowing buses and taxis, their descent from the lines, delays, deviations from the speed limit on the route, etc., on indicators of service quality, as well as optimizing the schedule. Practical value. The results allow to improve approaches to building models using in the systems of dispatching management of urban bus routes, as well as to improve the selection of control actions for similar systems in large cities of Ukraine.

  16. Importance measures in risk-informed decision making: Ranking, optimisation and configuration control

    Energy Technology Data Exchange (ETDEWEB)

    Vaurio, Jussi K., E-mail: jussi.vaurio@pp1.inet.fi [Prometh Solutions, Hiihtaejaenkuja 3K, 06100 Porvoo (Finland)

    2011-11-15

    This paper describes roles, extensions and applications of importance measures of components and configurations for making risk-informed decisions relevant to system operations, maintenance and safety. Basic importance measures and their relationships are described for independent and mutually exclusive events and for groups of events associated with common cause failures. The roles of importances are described mainly in two groups of activities: (a) ranking safety significance of systems, structures, components and human actions for preventive safety assurance activities, and (b) making decisions about permissible permanent and temporary configurations and allowed configuration times for regulation, technical specifications and for on-line risk monitoring. Criticality importance and sums of criticalities turn out to be appropriate measures for ranking and optimization. Several advantages are pointed out and consistent ranking of pipe segments for in-service inspection is provided as an example. Risk increase factor and its generalization risk gain are most appropriately used to assess corrective priorities and acceptability of a situation when components are already failed or when planning to take one or more components out of service for maintenance. Precise definitions are introduced for multi-failure configurations and it is shown how they can be assessed under uncertainties, in particular when common cause failures or success states may be involved. A general weighted average method is compared to other candidate methods in benchmark cases. It is the preferable method for prediction when a momentary configuration is known or only partially known. Potential applications and optimization of allowed outage times are described. The results show how to generalize and apply various importance measures to ranking and optimization and how to manage configurations in uncertain multi-failure situations. - Highlights: > Rigorous methods developed for using importances

  17. Importance measures in risk-informed decision making: Ranking, optimisation and configuration control

    International Nuclear Information System (INIS)

    Vaurio, Jussi K.

    2011-01-01

    This paper describes roles, extensions and applications of importance measures of components and configurations for making risk-informed decisions relevant to system operations, maintenance and safety. Basic importance measures and their relationships are described for independent and mutually exclusive events and for groups of events associated with common cause failures. The roles of importances are described mainly in two groups of activities: (a) ranking safety significance of systems, structures, components and human actions for preventive safety assurance activities, and (b) making decisions about permissible permanent and temporary configurations and allowed configuration times for regulation, technical specifications and for on-line risk monitoring. Criticality importance and sums of criticalities turn out to be appropriate measures for ranking and optimization. Several advantages are pointed out and consistent ranking of pipe segments for in-service inspection is provided as an example. Risk increase factor and its generalization risk gain are most appropriately used to assess corrective priorities and acceptability of a situation when components are already failed or when planning to take one or more components out of service for maintenance. Precise definitions are introduced for multi-failure configurations and it is shown how they can be assessed under uncertainties, in particular when common cause failures or success states may be involved. A general weighted average method is compared to other candidate methods in benchmark cases. It is the preferable method for prediction when a momentary configuration is known or only partially known. Potential applications and optimization of allowed outage times are described. The results show how to generalize and apply various importance measures to ranking and optimization and how to manage configurations in uncertain multi-failure situations. - Highlights: → Rigorous methods developed for using importances

  18. Inhibitory Control in the Cortico-Basal Ganglia-Thalamocortical Loop: Complex Regulation and Interplay with Memory and Decision Processes.

    Science.gov (United States)

    Wei, Wei; Wang, Xiao-Jing

    2016-12-07

    We developed a circuit model of spiking neurons that includes multiple pathways in the basal ganglia (BG) and is endowed with feedback mechanisms at three levels: cortical microcircuit, corticothalamic loop, and cortico-BG-thalamocortical system. We focused on executive control in a stop signal task, which is known to depend on BG across species. The model reproduces a range of experimental observations and shows that the newly discovered feedback projection from external globus pallidus to striatum is crucial for inhibitory control. Moreover, stopping process is enhanced by the cortico-subcortical reverberatory dynamics underlying persistent activity, establishing interdependence between working memory and inhibitory control. Surprisingly, the stop signal reaction time (SSRT) can be adjusted by weights of certain connections but is insensitive to other connections in this complex circuit, suggesting novel circuit-based intervention for inhibitory control deficits associated with mental illness. Our model provides a unified framework for inhibitory control, decision making, and working memory. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Does training family physicians in shared decision making promote optimal use of antibiotics for acute respiratory infections? Study protocol of a pilot clustered randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Côté Luc

    2007-11-01

    Full Text Available Abstract Background In North America, although it varies according to the specific type of acute respiratory infections (ARI, use of antibiotics is estimated to be well above the expected prevalence of bacterial infections. The objective of this pilot clustered randomized controlled trial (RCT is to assess the feasibility of a larger clustered RCT aiming at evaluating the impact of DECISION+, a continuing professional development (CPD program in shared decision making, on the optimal use of antibiotics in the context of ARI. Methods/design This pilot study is a cluster RCT conducted with family physicians from Family Medicine Groups (FMG in the Quebec City area, Canada. Participating FMG are randomised to an immediate DECISION+ group, a CPD program in shared decision making, (experimental group, or a delayed DECISION+ group (control group. Data collection involves recruiting five patients consulting for ARI per physician from both study groups before (Phase 1 and after (Phase 2 exposure of the experimental group to the DECISION+ program, and after exposure of the control group to the DECISION+ program (Phase 3. The primary outcome measures to assess the feasibility of a larger RCT include: 1 proportion of contacted FMG that agree to participate; 2 proportion of recruited physicians who participate in the DECISION+ program; 3 level of satisfaction of physicians regarding DECISION+; and 4 proportion of missing data in each data collection phase. Levels of agreement of the patient-physician dyad on the Decisional Conflict Scale and physicians' prescription profile for ARI are performed as secondary outcome measures. Discussion This study protocol is informative for researchers and clinicians interested in designing and/or conducting clustered RCT with FMG regarding training of physicians in shared decision making. Trial Registration ClinicalTrials.gov Identifier: NCT00354315

  20. Megasite Management Tool (mmt): a Decision Support System Built Using Mapwindow Activex Control

    Science.gov (United States)

    Pulsani, B. R.

    2017-11-01

    Megasite Management Tool (MMT) is planning and evaluation software for contaminated sites. Using different statistical modules, MMT produces maps which help decision makers in rehabilitating contaminated sites. The input data used by MMT is of geographic nature and exists as shapefile and raster format. As MMT is built using simple windows forms application, the objective of the study was to find a way to visualize geographic data and to allow the user to edit its attribute information. Therefore, the application requirement was to find GIS libraries which offer capabilities such as (1) map viewer with navigation tools (2) library to read/write geographic data and (3) software which allows free distribution of the developed components. A research on these requirements led to the discovery of MapWindow ActiveX components which not only offered these capabilities but also provided free and open source licensing options for redistribution. Although considerable amount of reports and publications exist on MMT, the major contribution provided by MapWindow libraries have been under played. The current study emphasises upon the contribution and advantages MapWindow ActiveX provides for incorporating GIS functionality to an already existing application. Similar components for other languages have also been reviewed.

  1. Feasible sampling plan for Bemisia tabaci control decision-making in watermelon fields.

    Science.gov (United States)

    Lima, Carlos Ho; Sarmento, Renato A; Pereira, Poliana S; Galdino, Tarcísio Vs; Santos, Fábio A; Silva, Joedna; Picanço, Marcelo C

    2017-11-01

    The silverleaf whitefly Bemisia tabaci is one of the most important pests of watermelon fields worldwide. Conventional sampling plans are the starting point for the generation of decision-making systems of integrated pest management programs. The aim of this study was to determine a conventional sampling plan for B. tabaci in watermelon fields. The optimal leaf for B. tabaci adult sampling was the 6 th most apical leaf. Direct counting was the best pest sampling technique. Crop pest densities fitted the negative binomial distribution and had a common aggregation parameter (K common ). The sampling plan consisted of evaluating 103 samples per plot. This sampling plan was conducted for 56 min, costing US$ 2.22 per sampling and with a 10% maximum evaluation error. The sampling plan determined in this study can be adopted by farmers because it enables the adequate evaluation of B. tabaci populations in watermelon fields (10% maximum evaluation error) and is a low-cost (US$ 2.22 per sampling), fast (56 min per sampling) and feasible (because it may be used in a standardized way throughout the crop cycle) technique. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  2. The therapeutic relationship after psychiatric admission.

    LENUS (Irish Health Repository)

    Roche, Eric

    2014-03-01

    The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.

  3. Impact of tornadoes on hospital admissions for acute cardiovascular events.

    Science.gov (United States)

    Silva-Palacios, Federico; Casanegra, Ana Isabel; Shapiro, Alan; Phan, Minh; Hawkins, Beau; Li, Ji; Stoner, Julie; Tafur, Alfonso

    2015-11-01

    There is a paucity of data describing cardiovascular events after tornado outbreaks. We proposed to study the effects of tornadoes on the incidence of cardiovascular events at a tertiary care institution. Hospital admission records from a single center situated in a tornado-prone area three months before and after a 2013 tornado outbreak were abstracted. To control for seasonal variation, we also abstracted data from the same period of the prior year (control). Hospital admissions for cardiovascular events (CVEs) including acute myocardial infarction, stroke and venous thromboembolism (VTE) were summated by zip codes, and compared by time period. There were 22,607 admissions analyzed, of which 6,705 (30%), 7,980 (35%), and 7,922 (35%) were during the pre-tornado, post-tornado, and control time frames, respectively. There were 344 CVE in the controls, 317 CVE in pre-tornado and 364 CVEs in post tornado periods. There was no difference in the prevalence of CVE during the post-tornado season compared with the control (PPR=1.05 95% CI: 0.91 to 1.21, p=0.50) or the pre-tornado season (PPR=0.96, 95% CI: 0.83 to 1.21, p=0.63). In conclusion, tornado outbreaks did not increase the prevalence of cardiovascular events. In contrast to the effect of hurricanes, implementation of a healthcare policy change directed toward the early treatment and prevention of cardiovascular events after tornadoes does not seem warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Threshold level as a criteria for arrowleaf sida control decision in soybeans

    OpenAIRE

    Fleck, Nilson Gilberto; Rizzardi, Mauro Antonio; Agostinetto, Dirceu

    2002-01-01

    O nível de dano econômico (NDE) é um conceito simples que integra fatores biológicos e econômicos que se destina a tornar os resultados de uma tomada de decisão lucrativos para o controle das plantas daninhas. O objetivo deste trabalho foi determinar o NDE para infestações de guanxuma (Sida rhombifolia), calculado na base de um único ano, que justifiquem aplicação econômica de medidas para seu controle na cultura da soja. Foram conduzidos experimentos em campo em Passo Fundo e Eldorado do Sul...

  5. Efficacy versus Equity: What Happens When States Tinker With College Admissions in a Race-Blind Era?

    Science.gov (United States)

    Black, Sandra E.; Cortes, Kalena E.; Lincove, Jane Arnold

    2016-01-01

    We investigate the efficacy and equity of college admissions criteria by estimating the effect of multiple measures of college readiness on college performance in the context of race-blind automatic admissions policies. We take advantage of a unique institutional feature of the Texas higher education system to control for selection into…

  6. Personal Control Over Decisions to Participate in Research by Persons With Histories of Both Substance Use Disorders and Criminal Justice Supervision.

    Science.gov (United States)

    Chen, Donna T; Ko, Tomohiro M; Allen, Ashleigh A; Bonnie, Richard J; Suratt, Colleen E; Appelbaum, Paul S; Nunes, Edward V; Friedmann, Peter D; Lee, Joshua D; Gordon, Michael S; McDonald, Ryan; Wilson, Donna; Boney, Tamara Y; Murphy, Sean M; O'Brien, Charles P

    2018-04-01

    Individuals must feel free to exert personal control over decisions regarding research participation. We present an examination of participants' perceived personal control over, as well as reported pressures and threats from others, influencing their decision to join a study assessing the effectiveness of extended-release naltrexone in preventing opioid dependence relapse. Most participants endorsed a strong sense of control over the decision; few reported pressures or threats. Although few in number, participants' brief narrative descriptions of the pressures and threats are illuminating and provide context for their perceptions of personal control. Based on this work, we propose a useful set of tools to help ascertain participants' sense of personal control in joining research.

  7. A web-based tool to support shared decision making for people with a psychotic disorder: randomized controlled trial and process evaluation.

    Science.gov (United States)

    van der Krieke, Lian; Emerencia, Ando C; Boonstra, Nynke; Wunderink, Lex; de Jonge, Peter; Sytema, Sjoerd

    2013-10-07

    Mental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes. This study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders. The study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions on perceived involvement in medical

  8. Existence and control of Go/No-Go decision transition threshold in the striatum.

    Directory of Open Access Journals (Sweden)

    Jyotika Bahuguna

    2015-04-01

    Full Text Available A typical Go/No-Go decision is suggested to be implemented in the brain via the activation of the direct or indirect pathway in the basal ganglia. Medium spiny neurons (MSNs in the striatum, receiving input from cortex and projecting to the direct and indirect pathways express D1 and D2 type dopamine receptors, respectively. Recently, it has become clear that the two types of MSNs markedly differ in their mutual and recurrent connectivities as well as feedforward inhibition from FSIs. Therefore, to understand striatal function in action selection, it is of key importance to identify the role of the distinct connectivities within and between the two types of MSNs on the balance of their activity. Here, we used both a reduced firing rate model and numerical simulations of a spiking network model of the striatum to analyze the dynamic balance of spiking activities in D1 and D2 MSNs. We show that the asymmetric connectivity of the two types of MSNs renders the striatum into a threshold device, indicating the state of cortical input rates and correlations by the relative activity rates of D1 and D2 MSNs. Next, we describe how this striatal threshold can be effectively modulated by the activity of fast spiking interneurons, by the dopamine level, and by the activity of the GPe via pallidostriatal backprojections. We show that multiple mechanisms exist in the basal ganglia for biasing striatal output in favour of either the `Go' or the `No-Go' pathway. This new understanding of striatal network dynamics provides novel insights into the putative role of the striatum in various behavioral deficits in patients with Parkinson's disease, including increased reaction times, L-Dopa-induced dyskinesia, and deep brain stimulation-induced impulsivity.

  9. Existence and control of Go/No-Go decision transition threshold in the striatum.

    Science.gov (United States)

    Bahuguna, Jyotika; Aertsen, Ad; Kumar, Arvind

    2015-04-01

    A typical Go/No-Go decision is suggested to be implemented in the brain via the activation of the direct or indirect pathway in the basal ganglia. Medium spiny neurons (MSNs) in the striatum, receiving input from cortex and projecting to the direct and indirect pathways express D1 and D2 type dopamine receptors, respectively. Recently, it has become clear that the two types of MSNs markedly differ in their mutual and recurrent connectivities as well as feedforward inhibition from FSIs. Therefore, to understand striatal function in action selection, it is of key importance to identify the role of the distinct connectivities within and between the two types of MSNs on the balance of their activity. Here, we used both a reduced firing rate model and numerical simulations of a spiking network model of the striatum to analyze the dynamic balance of spiking activities in D1 and D2 MSNs. We show that the asymmetric connectivity of the two types of MSNs renders the striatum into a threshold device, indicating the state of cortical input rates and correlations by the relative activity rates of D1 and D2 MSNs. Next, we describe how this striatal threshold can be effectively modulated by the activity of fast spiking interneurons, by the dopamine level, and by the activity of the GPe via pallidostriatal backprojections. We show that multiple mechanisms exist in the basal ganglia for biasing striatal output in favour of either the `Go' or the `No-Go' pathway. This new understanding of striatal network dynamics provides novel insights into the putative role of the striatum in various behavioral deficits in patients with Parkinson's disease, including increased reaction times, L-Dopa-induced dyskinesia, and deep brain stimulation-induced impulsivity.

  10. Coordination of Word Recognition and Oculomotor Control During Reading: The Role of Implicit Lexical Decisions

    Science.gov (United States)

    Choi, Wonil; Gordon, Peter C.

    2013-01-01

    The coordination of word-recognition and oculomotor processes during reading was evaluated in two eye-tracking experiments that examined how word skipping, where a word is not fixated during first-pass reading, is affected by the lexical status of a letter string in the parafovea and ease of recognizing that string. Ease of lexical recognition was manipulated through target-word frequency (Experiment 1) and through repetition priming between prime-target pairs embedded in a sentence (Experiment 2). Using the gaze-contingent boundary technique the target word appeared in the parafovea either with full preview or with transposed-letter (TL) preview. The TL preview strings were nonwords in Experiment 1 (e.g., bilnk created from the target blink), but were words in Experiment 2 (e.g., sacred created from the target scared). Experiment 1 showed greater skipping for high-frequency than low-frequency target words in the full preview condition but not in the TL preview (nonword) condition. Experiment 2 showed greater skipping for target words that repeated an earlier prime word than for those that did not, with this repetition priming occurring both with preview of the full target and with preview of the target’s TL neighbor word. However, time to progress from the word after the target was greater following skips of the TL preview word, whose meaning was anomalous in the sentence context, than following skips of the full preview word whose meaning fit sensibly into the sentence context. Together, the results support the idea that coordination between word-recognition and oculomotor processes occurs at the level of implicit lexical decisions. PMID:23106372

  11. Demerit control chart as a decision support tool in quality control of ductile cast-iron casting process

    Directory of Open Access Journals (Sweden)

    Sika Robert

    2017-01-01

    Full Text Available In many industrial areas the product quality can be unequivocally assigned to classes such as: “good”, “bad” or “to repair”. In case of casting processes, the product is approved to sales considering customer’s requirements. Except for common characteristics, such as structure, compactness and mechanical properties, physical state of the product is also important. This state is assessed by checking occurrence of specific kind of defects. They are often conditionally accepted by a customer if they do not have any influence on functionality of the product (e.g. negative adhesive and cohesive phenomena, fatigue strength, thermal shocks. Authors’ experience shows that current registering of the most frequently occurring defects and comparing them to customers’ requirements can be very useful and help a quality engineer to control the casting process. They suggest using the Demerit Control Chart (DCC, according to authors’ own methodology, in aspect of information about the castings accepted conditionally by a customer (DCC-recognition. DCC-recognition can be used to assess this quality by monitoring the value of just one aggregated measure for all kinds of defects instead of using a single attribute control chart for each of them. The test version of this tool considering severity of defects proved to be useful in one of the European foundries.

  12. The effect of a priori probability and complexity on decision making in a supervisory control task

    NARCIS (Netherlands)

    Kerstholt, J.H.; Passenier, P.O.; Houttuin, K.; Schuffel, H.

    1996-01-01

    In the present study we investigated how monitoring and fault management in a ship control task are affected by complexity and a priori probability of disturbances. Partici-pants were required to supervise four independent shipping subsystems and to adjust the subsystems whenever deviations

  13. Implementation of clinical decision support in young children with acute gastroenteritis: a randomized controlled trial at the emergency department.

    Science.gov (United States)

    Geurts, Dorien; de Vos-Kerkhof, Evelien; Polinder, Suzanne; Steyerberg, Ewout; van der Lei, Johan; Moll, Henriëtte; Oostenbrink, Rianne

    2017-02-01

    Acute gastroenteritis (AGE) is one of the most frequent reasons for young children to visit emergency departments (EDs). We aimed to evaluate (1) feasibility of a nurse-guided clinical decision support system for rehydration treatment in children with AGE and (2) the impact on diagnostics, treatment, and costs compared with usual care by attending physician. A randomized controlled trial was performed in 222 children, aged 1 month to 5 years at the ED of the Erasmus MC-Sophia Children's hospital in The Netherlands ( 2010-2012). Outcome included (1) feasibility, measured by compliance of the nurses, and (2) length of stay (LOS) at the ED, the number of diagnostic tests, treatment, follow-up, and costs. Due to failure of post-ED weight measurement, we could not evaluate weight difference as measure for dehydration. Patient characteristics were comparable between the intervention (N = 113) and the usual care group (N = 109). Implementation of the clinical decision support system proved a high compliance rate. The standardized use of oral ORS (oral rehydration solution) significantly increased from 52 to 65%(RR2.2, 95%CI 1.09-4.31 p children with AGE showed high compliance and increase standardized use of ORS, without differences in other outcome measures. What is Known: • Acute gastroenteritis is one of the most frequently encountered problems in pediatric emergency departments. • Guidelines advocate standardized oral treatment in children with mild to moderate dehydration, but appear to be applied infrequently in clinical practice. What is New: • Implementation of a nurse-guided clinical decision support system on treatment of AGE in young children showed good feasibility, resulting in a more standardized ORS use in children with mild to moderate dehydration, compared to usual care. • Given the challenges to perform research in emergency care setting, the ED should be experienced and adequately equipped, especially during peak times.

  14. Admission levels of serum Gc-globulin

    DEFF Research Database (Denmark)

    Schiødt, F V; Bondesen, S; Petersen, I

    1996-01-01

    Gc-globulin scavenges actin released from necrotic hepatocytes to the extracellular space. In 77 patients with fulminant hepatic failure (FHF) (excluding patients treated with liver transplantation), admission levels of serum Gc-globulin and degree of complexing with monomeric actin (complex ratio...... in the same range as the KCH criteria. An advantage of Gc-globulin is that it gives an estimate of the outcome already on admission. Acute liver transplantation should be considered in FHF patients with Gc-globulin less than 100 mg/L....

  15. The effects of photovoltaic electricity injection into microgrids: Combination of Geographical Information Systems, multicriteria decision methods and electronic control modeling

    International Nuclear Information System (INIS)

    Roa-Escalante, Gino de Jesús; Sánchez-Lozano, Juan Miguel; Faxas, Juan-Gabriel; García-Cascales, M. Socorro; Urbina, Antonio

    2015-01-01

    Highlights: • Geographical Information Systems can be used as a support to classify the viable locations for photovoltaic facilities. • Multicriteria decision methods are useful tools to choose the optimal locations for photovoltaic systems. • Variations of photovoltaic power injected into the grid have been calculated for the optimum locations. • Grid stabilization can be achieved within 500 ms with electronic control strategies. - Abstract: This article presents a model to calculate the impact on the grid of the injection of electricity generated from photovoltaic systems. The methodology combines the use of Geographical Information System tools to classify the optimal locations for the installation of photovoltaic systems with the calculation of the impact into microgrids of the electricity generated in such locations. The case study is focused on Murcia region, in South-east Spain, and on medium size photovoltaic systems. The locations have been selected from a Geographical Information System database including several parameters, and evaluated and classified using a fuzzy version of the multicriteria decision method called Technique for Order Preference by Similarity to Ideal Solution. In order to obtain the weights for the criteria used in the evaluation, the Analytic Hierarchy Process has been used. Finally, using meteorological data from a small set of possible locations, the impact on the grid arising from the injection of power generated from photovoltaic systems that are connected to the grid via a module implementing different control electronic strategies has been calculated. Different electronic control strategies have been modeled to demonstrate that stabilization of the electrical parameters of a microgrid can be obtained within 500 ms in all cases, even when a relatively large power surge, or slower variations, are injected into the grid from the medium size photovoltaic systems

  16. Auditory decision aiding in supervisory control of multiple unmanned aerial vehicles.

    Science.gov (United States)

    Donmez, Birsen; Cummings, M L; Graham, Hudson D

    2009-10-01

    This article is an investigation of the effectiveness of sonifications, which are continuous auditory alerts mapped to the state of a monitored task, in supporting unmanned aerial vehicle (UAV) supervisory control. UAV supervisory control requires monitoring a UAV across multiple tasks (e.g., course maintenance) via a predominantly visual display, which currently is supported with discrete auditory alerts. Sonification has been shown to enhance monitoring performance in domains such as anesthesiology by allowing an operator to immediately determine an entity's (e.g., patient) current and projected states, and is a promising alternative to discrete alerts in UAV control. However, minimal research compares sonification to discrete alerts, and no research assesses the effectiveness of sonification for monitoring multiple entities (e.g., multiple UAVs). The authors conducted an experiment with 39 military personnel, using a simulated setup. Participants controlled single and multiple UAVs and received sonifications or discrete alerts based on UAV course deviations and late target arrivals. Regardless of the number of UAVs supervised, the course deviation sonification resulted in reactions to course deviations that were 1.9 s faster, a 19% enhancement, compared with discrete alerts. However, course deviation sonifications interfered with the effectiveness of discrete late arrival alerts in general and with operator responses to late arrivals when supervising multiple vehicles. Sonifications can outperform discrete alerts when designed to aid operators to predict future states of monitored tasks. However, sonifications may mask other auditory alerts and interfere with other monitoring tasks that require divided attention. This research has implications for supervisory control display design.

  17. The impact of Daubert on the admissibility of forensic anthropology expert testimony.

    Science.gov (United States)

    Lesciotto, Kate M

    2015-05-01

    Forensic anthropologists anticipated a significant impact from the 1993 Supreme Court Daubert decision, which addressed the standard of admissibility for expert testimony. In response, many forensic articles cited Daubert in the search for objective techniques or a critique of established subjective methods. This study examines challenges to forensic anthropological expert testimony to evaluate whether Daubert has actually affected the admissibility of such testimony. Thirty cases were identified that addressed the admissibility of the testimony, including 14 cases prior to Daubert and 16 after Daubert. Examination of these cases indicates that post-Daubert cases do not result in more exclusions. Yet, this lack of exclusions may instead be viewed as a manifestation of the field's overall surge toward more objective and quantifiable techniques in a self-regulating response to Daubert. © 2015 American Academy of Forensic Sciences.

  18. Training family physicians and residents in family medicine in shared decision making to improve clinical decisions regarding the use of antibiotics for acute respiratory infections: protocol for a clustered randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Frémont Pierre

    2011-01-01

    Full Text Available Abstract Background To explore ways to reduce the overuse of antibiotics for acute respiratory infections (ARIs, we conducted a pilot clustered randomized controlled trial (RCT to evaluate DECISION+, a training program in shared decision making (SDM for family physicians (FPs. This pilot project demonstrated the feasibility of conducting a large clustered RCT and showed that DECISION+ reduced the proportion of patients who decided to use antibiotics immediately after consulting their physician. Consequently, the objective of this study is to evaluate, in patients consulting for ARIs, if exposure of physicians to a modified version of DECISION+, DECISION+2, would reduce the proportion of patients who decide to use antibiotics immediately after consulting their physician. Methods/design The study is a multi-center, two-arm, parallel clustered RCT. The 12 family practice teaching units (FPTUs in the network of the Department of Family Medicine and Emergency Medicine of Université Laval will be randomized to a DECISION+2 intervention group (experimental group or to a no-intervention control group. These FPTUs will recruit patients consulting family physicians and residents in family medicine enrolled in the study. There will be two data collection periods: pre-intervention (baseline including 175 patients with ARIs in each study arm, and post-intervention including 175 patients with ARIs in each study arm (total n = 700. The primary outcome will be the proportion of patients reporting a decision to use antibiotics immediately after consulting their physician. Secondary outcome measures include: 1 physicians and patients' decisional conflict; 2 the agreement between the parties' decisional conflict scores; and 3 perception of patients and physicians that SDM occurred. Also in patients, at 2 weeks follow-up, adherence to the decision, consultation for the same reason, decisional regret, and quality of life will be assessed. Finally, in both patients

  19. Decision making, central coherence and set-shifting: a comparison between Binge Eating Disorder, Anorexia Nervosa and Healthy Controls.

    Science.gov (United States)

    Aloi, Matteo; Rania, Marianna; Caroleo, Mariarita; Bruni, Antonella; Palmieri, Antonella; Cauteruccio, Maria Antonella; De Fazio, Pasquale; Segura-García, Cristina

    2015-01-24

    Several studies have investigated the cognitive profile in patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN); on the contrary few studies have evaluated it in patients with Binge Eating Disorder (BED). The purpose of this study was to compare decision making, central coherence and set-shifting between BED and AN patients. A battery of neuropsychological tests including the Iowa Gambling Task (IGT), the Rey-Osterrieth Complex Figure Test (RCFT), the Wisconsin Card Sorting Test (WCST), the Trial Making Task (TMT) and the Hayling Sentence Completion Task (HSCT) were administered in a sample of 135 women (45 AN, 45 BED, 45 Healthy Controls [HC]). Furthermore, Beck Depression Inventory (BDI) was administered to evaluate depressive symptoms. Years of education, age, Body Mass Index (BMI) and depression severity were considered as covariates in statistical analyses. BED and AN patients showed high rates of cognitive impairment compared to HC on the domains investigated; furthermore, the cognitive profile of BED patients was characterised by poorer decision making and cognitive flexibility compared to patients with AN. Cognitive performance was strongly associated with depressive symptoms. In the present sample, two different neurocognitive profiles emerged: a strong cognitive rigidity and a central coherence based on the details was predominant in patients with AN, while a lack of attention and difficulty in adapting to changes in a new situation seemed to better describe patients with BED. The knowledge of the different cognitive profiles of EDs patients may be important for the planning their psychotherapeutic intervention.

  20. Culling decisions of dairy farmers during a 3-year Salmonella control study

    DEFF Research Database (Denmark)

    Nielsen, Liza Rosenbaum; Dohoo, I.

    2011-01-01

    Dublin which is the most prevalent and most persistent serotype in the Danish cattle population. A field study in 10 dairy herds with persistent Salmonella infections was carried out over three years to gain experience with control procedures including risk assessment, targeted control actions and test...... animals into risk groups. These risk groups and all individual ELISA-results were communicated to the farmers as colour-coded lists four to six times per year. Farmers were advised to manage the risk of Salmonella transmission from cattle with repeatedly high ELISA results (flagged as “red”) or cows...... if animals with red and yellow flags had higher probability of being slaughtered or sold before first calving than animals without any risk flags. For adult cows a semi-parametric proportional hazard survival model was used to test the effect of number of red and yellow flags on hazards of culling...

  1. Robot Navigation Control Based on Monocular Images: An Image Processing Algorithm for Obstacle Avoidance Decisions

    Directory of Open Access Journals (Sweden)

    William Benn

    2012-01-01

    Full Text Available This paper covers the use of monocular vision to control autonomous navigation for a robot in a dynamically changing environment. The solution focused on using colour segmentation against a selected floor plane to distinctly separate obstacles from traversable space: this is then supplemented with canny edge detection to separate similarly coloured boundaries to the floor plane. The resulting binary map (where white identifies an obstacle-free area and black identifies an obstacle could then be processed by fuzzy logic or neural networks to control the robot’s next movements. Findings show that the algorithm performed strongly on solid coloured carpets, wooden, and concrete floors but had difficulty in separating colours in multicoloured floor types such as patterned carpets.

  2. Evaluation Of Decision Options For Industry Wide Control Of Salmonella In Dairy cattle

    DEFF Research Database (Denmark)

    Jordan, David; Nielsen, Liza Rosenbaum; Warnick, Lorin Dean

    2009-01-01

    dairy industry using data fields and logic mimicking the ecology, surveillance and control of S. Dublin. Superimposed on this was a system for simulating movement of cattle between herds and between regions accounting for the infection status of both the source and destination herds. Predictions from...... simulations showed that programs that enhance herd-level biosecurity (prevention of new outbreaks) and quickly resolve infections once they are detected are attractive additions to the current approach that has already resulted in substantial progress....

  3. Influences on Tobacco Control Funding Decisions: Explaining State Variation in Appropriations

    Science.gov (United States)

    2003-01-01

    18 and older) in all states was 23.3%, far short of the national goal of reducing adult smoking prevalence to 15% (CDC, 2002; Mendez & Warner, 2000...Multiple levels, multiple agendas. Quorum Books: Westport CT, 1995. Mendez D, Warner K. Smoking prevalence in 2010: Why the healthy people goal is...1998. Siegel M, Carol J, Jordan J, Hobart R, Schoenmarklin S, DuMelle F, Fisher P. Preemption in tobacco control: Review of an emerging public health

  4. Patient-reported Outcomes in Randomised Controlled Trials of Prostate Cancer: Methodological Quality and Impact on Clinical Decision Making

    Science.gov (United States)

    Efficace, Fabio; Feuerstein, Michael; Fayers, Peter; Cafaro, Valentina; Eastham, James; Pusic, Andrea; Blazeby, Jane

    2014-01-01

    Context Patient-reported outcomes (PRO) data from randomised controlled trials (RCTs) are increasingly used to inform patient-centred care as well as clinical and health policy decisions. Objective The main objective of this study was to investigate the methodological quality of PRO assessment in RCTs of prostate cancer (PCa) and to estimate the likely impact of these studies on clinical decision making. Evidence acquisition A systematic literature search of studies was undertaken on main electronic databases to retrieve articles published between January 2004 and March 2012. RCTs were evaluated on a predetermined extraction form, including (1) basic trial demographics and clinical and PRO characteristics; (2) level of PRO reporting based on the recently published recommendations by the International Society for Quality of Life Research; and (3) bias, assessed using the Cochrane Risk of Bias tool. Studies were systematically analysed to evaluate their relevance for supporting clinical decision making. Evidence synthesis Sixty-five RCTs enrolling a total of 22 071 patients were evaluated, with 31 (48%) in patients with nonmetastatic disease. When a PRO difference between treatments was found, it related in most cases to symptoms only (n = 29, 58%). Although the extent of missing data was generally documented (72% of RCTs), few reported details on statistical handling of this data (18%) and reasons for dropout (35%). Improvements in key methodological aspects over time were found. Thirteen (20%) RCTs were judged as likely to be robust in informing clinical decision making. Higher-quality PRO studies were generally associated with those RCTs that had higher internal validity. Conclusions Including PRO in RCTs of PCa patients is critical for better evaluating the treatment effectiveness of new therapeutic approaches. Marked improvements in PRO quality reporting over time were found, and it is estimated that at least one-fifth of PRO RCTs have provided sufficient

  5. Shared decision-making for prostate cancer screening and treatment: a systematic review of randomised controlled trials.

    Science.gov (United States)

    Martínez-González, Nahara Anani; Plate, Andreas; Senn, Oliver; Markun, Stefan; Rosemann, Thomas; Neuner-Jehle, Stefan

    2018-02-23

    Men facing prostate cancer screening and treatment need to make critical and highly preference-sensitive decisions that involve a variety of potential benefits and risks. Shared decision-making (SDM) is considered fundamental for "preference-sensitive" medical decisions and it is guideline-recommended. There is no single definition of SDM however. We systematically reviewed the extent of SDM implementation in interventions to facilitate SDM for prostate cancer screening and treatment. We searched Medline Ovid, Embase (Elsevier), CINHAL (EBSCOHost), The Cochrane Library (Wiley), PsychINFO (EBSCOHost), Scopus, clinicaltrials.gov, ISRCTN registry, the WHO search portal, ohri.ca, opengrey.eu, Google Scholar, and the reference lists of included studies, clinical guidelines and relevant reviews. We also contacted the authors of relevant abstracts without available full text. We included primary peer-reviewed and grey literature of randomised controlled trials (RCTs) reported in English, conducted in primary and specialised care, addressing interventions aiming to facilitate SDM for prostate cancer screening and treatment. Two reviewers independently selected studies, appraised interventions and assessed the extent of SDM implementation based on the key features of SDM, namely information exchange, deliberation and implementation. We considered bi-directional deliberation as a central and mandatory component of SDM. We performed a narrative synthesis. Thirty-six RCTs including 19 196 randomised patients met the eligibility criteria; they were mainly conducted in North America (n = 28). The median year of publication was 2008 (1997-2015). Twenty-three RCTs addressed decision-making for screening, twelve for treatment and one for both screening and treatment for prostate cancer. Bi-directional interactions between healthcare providers and patients were verified in 31 RCTs, but only 14 fulfilled the three key SDM features, 14 had at least "deliberation", one had "unclear

  6. Patients’ Admissions in Intensive Care Units: A Clustering Overview

    Directory of Open Access Journals (Sweden)

    Ana Ribeiro

    2017-02-01

    Full Text Available Intensive care is a critical area of medicine having a multidisciplinary nature requiring all types of healthcare professionals. Given the critical environment of intensive care units (ICUs, the need to use information technologies, like decision support systems, to improve healthcare services and ICU management is evident. It is proven that unplanned and prolonged admission to the ICU is not only prejudicial to a patient's health, but also such a situation implies a readjustment of ICU resources, including beds, doctors, nurses, financial resources, among others. By discovering the common characteristics of the admitted patients, it is possible to improve these outcomes. In this study clustering techniques were applied to data collected from admitted patients in an intensive care unit. The best results presented a silhouette of 1, with a distance to centroids of 6.2 × 10−17 and a Davies–Bouldin index of −0.652.

  7. Assessment and prediction of short term hospital admissions: the case of Athens, Greece

    Science.gov (United States)

    Kassomenos, P.; Papaloukas, C.; Petrakis, M.; Karakitsios, S.

    The contribution of air pollution on hospital admissions due to respiratory and heart diseases is a major issue in the health-environmental perspective. In the present study, an attempt was made to run down the relationships between air pollution levels and meteorological indexes, and corresponding hospital admissions in Athens, Greece. The available data referred to a period of eight years (1992-2000) including the daily number of hospital admissions due to respiratory and heart diseases, hourly mean concentrations of CO, NO 2, SO 2, O 3 and particulates in several monitoring stations, as well as, meteorological data (temperature, relative humidity, wind speed/direction). The relations among the above data were studied through widely used statistical techniques (multivariate stepwise analyses) and Artificial Neural Networks (ANNs). Both techniques revealed that elevated particulate concentrations are the dominant parameter related to hospital admissions (an increase of 10 μg m -3 leads to an increase of 10.2% in the number of admissions), followed by O 3 and the rest of the pollutants (CO, NO 2 and SO 2). Meteorological parameters also play a decisive role in the formation of air pollutant levels affecting public health. Consequently, increased/decreased daily hospital admissions are related to specific types of meteorological conditions that favor/do not favor the accumulation of pollutants in an urban complex. In general, the role of meteorological factors seems to be underestimated by stepwise analyses, while ANNs attribute to them a more important role. Comparison of the two models revealed that ANN adaptation in complicate environmental issues presents improved modeling results compared to a regression technique. Furthermore, the ANN technique provides a reliable model for the prediction of the daily hospital admissions based on air quality data and meteorological indices, undoubtedly useful for regulatory purposes.

  8. Patterns of admission to acute psychiatric in-patient facilities: a national survey in Italy.

    Science.gov (United States)

    Preti, A; Rucci, P; Santone, G; Picardi, A; Miglio, R; Bracco, R; Norcio, B; de Girolamo, G

    2009-03-01

    A proper understanding of patterns of care represents a crucial step in improving clinical decision making and enhancing service provision. Only a few studies, however, have explored global patterns of psychiatric admissions nationwide, and none have been undertaken in Italy. Sociodemographic, clinical and treatment-related information was collected for 1577 patients admitted to 130 public and 36 private in-patient facilities in Italy during an index period in the year 2004. All patients were also rated using the 24-item Brief Psychiatric Rating Scale (BPRS) and the Personal and Social Performance (PSP) rating scales. Non-affective psychoses (36%) were the most common diagnoses and accounted to a large extent for compulsory admissions. Private facilities were more likely to admit patients with organic mental disorders and substance abuse/dependence and less likely to admit patients with non-affective psychoses. Overall, 77.8% of patients had been receiving treatment by a mental health professional in the month prior to admission. In 54% of cases, the admission was solicited by patients' family members. The main factors preceding admission were impairment in work or social functioning, social withdrawal, and conflict with family members. Agitation, delusions and/or hallucinations, and the presence of multiple problems were associated with compulsory admissions, whereas depressive and anxiety symptoms were associated with voluntary admissions. In a mixed, public-private psychiatric care system, like the Italian one, public and private facilities admit patients with widely different clinical characteristics and needs. Family support represents an important resource for most patients, and interventions specifically addressed to relieving family burden are warranted.

  9. Example of decision support for trypanosomiasis control using a geographical information system in eastern Zambia.

    CSIR Research Space (South Africa)

    Robinson, TP

    2002-06-01

    Full Text Available , in whether the benebullet5 ts are private (e.g. trypanoci- dal drugs) or public (e.g. bait technology) and also in whether the onus is on the individual, the community or some external body to conduct and bullet5 nance them. The ecological, epidemiological..., G.A., Lovemore, D. F., Flint, S., and Cockbill, G. F., 1988, Odor-baited targets to control tsetse bullet6 ies, Glossina spp. (Diptera: Glossinidae), in Zimbabwe. Bulletin of Entomologica l Research, 78, 31–50. Vine, M. F., Degnan, D...

  10. Alphabetical order effects in school admissions

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    2016-01-01

    Roč. 31, č. 4 (2016), s. 483-498 ISSN 0267-1522 R&D Projects: GA ČR(CZ) GBP402/12/G130 Institutional support: RVO:67985998 Keywords : admissions * alphabetical order * order effects Subject RIV: AH - Economics Impact factor: 1.033, year: 2016

  11. Test-Based Admission to Selective Universities:

    DEFF Research Database (Denmark)

    Thomsen, Jens-Peter

    2016-01-01

    This article examines whether the existence of a secondary higher education admission system honouring more qualitative and extra-curricular merits has reduced the social class gap in access to highly sought-after university programmes in Denmark. I use administrative data to examine differences...

  12. Differential Prediction Generalization in College Admissions Testing

    Science.gov (United States)

    Aguinis, Herman; Culpepper, Steven A.; Pierce, Charles A.

    2016-01-01

    We introduce the concept of "differential prediction generalization" in the context of college admissions testing. Specifically, we assess the extent to which predicted first-year college grade point average (GPA) based on high-school grade point average (HSGPA) and SAT scores depends on a student's ethnicity and gender and whether this…

  13. Tricyclic antidepressant overdose necessitating ICU admission ...

    African Journals Online (AJOL)

    Tricyclic antidepressant (TCA) overdose necessitating intensive care unit (ICU) admission remains a significant problem in the Western Cape. In this retrospective study, we reviewed the course of life-threatening TCA overdose in our centre to identify potential prognostic indicators. TCA levels >1 000 ng/ml were associated ...

  14. 28 CFR 54.220 - Admissions.

    Science.gov (United States)

    2010-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN...) Admissions to educational institutions prior to June 24, 1973, are not covered by these Title IX regulations... §§ 54.300 through 54.310, each administratively separate unit shall be deemed to be an educational...

  15. 43 CFR 4.1141 - Admissions.

    Science.gov (United States)

    2010-10-01

    ... readily obtainable by him is insufficient to enable him to admit or deny. (d) The party who has requested... pending action only and is not an admission by him for any other purpose nor may it be used against him in...

  16. Perceptions of veterinary admissions committee members of ...

    African Journals Online (AJOL)

    Veterinary admission committees are asked to create and implement a fair, reliable, and valid system to select the candidates most likely to succeed in veterinary school from a large pool of applicants. Although numerous studies have explored grade point average (GPA) as a predictive value of later academic success, ...

  17. Can advanced paramedics in the field diagnose patients and predict hospital admission?

    LENUS (Irish Health Repository)

    Cummins, Niamh Maria

    2013-02-13

    BACKGROUND: Accurate patient diagnosis in the prehospital environment is essential to initiate suitable care pathways. The advanced paramedic (AP) is a relatively recent role in Ireland, and refers to a prehospital practitioner with advanced life-support skills and training. OBJECTIVES: The objectives of this study were to compare the diagnostic decisions of APs with emergency medicine (EM) physicians, and to investigate if APs, as currently trained, can predict the requirement for hospital admission. METHODS: A prospective study was initiated, whereby each emergency ambulance call received via the statutory 999 system was recorded by the attending AP. The AP was asked to provide a clinical diagnosis for each patient, and to predict if hospital admission was required. The data was then cross-referenced with the working diagnosis of the receiving emergency physician and the hospital admission records. RESULTS: A total of 17 APs participated in the study, and 1369 emergency calls were recorded over a 6-month period. Cases where a general practitioner attended the scene were excluded from the concordance analysis. Concordance with the receiving emergency physician represents 70% (525\\/748) for all cases of AP diagnosis, and is mirrored with 70% (604\\/859) correct hospital admission predictions. CONCLUSIONS: AP diagnosis and admission prediction for emergency calls is similar to other emergency medical services systems despite the relative recency of the AP programme in Ireland. Recognition of non-concordance case types may identify priorities for AP education, and drive future AP practice in areas such as \\'treat and refer\\'.

  18. What do farmers' weed control decisions imply about glyphosate resistance? Evidence from surveys of US corn fields.

    Science.gov (United States)

    Wechsler, Seth J; McFadden, Jonathan R; Smith, David J

    2018-05-01

    The first case of glyphosate-resistant weeds in the United States was documented in 1998, 2 years after the commercialization of genetically engineered herbicide-resistant (HR) corn and soybeans. Currently, over 15 glyphosate-resistant weed species affect US crop production areas. These weeds have the potential to reduce yields, increase costs, and lower farm profitability. The objective of our study is to develop a behavioral model of farmers' weed management decisions and use it to analyze weed resistance to glyphosate in US corn farms. On average, we find that weed control increased US corn yields by 3700 kg ha -1 (worth approximately $US 255 ha -1 ) in 2005 and 3500 kg ha -1 (worth approximately $US 575 ha -1 ) in 2010. If glyphosate resistant weeds were absent, glyphosate killed approximately 99% of weeds, on average, when applied at the label rate in HR production systems. Average control was dramatically lower in states where glyphosate resistance was widespread. We find that glyphosate resistance had a significant impact on weed control costs and corn yields of US farmers in 2005 and 2010. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  19. A perspective on medical school admission research and practice over the last 25 years.

    Science.gov (United States)

    Kreiter, Clarence D; Axelson, Rick D

    2013-01-01

    Over the last 25 years a large body of research has investigated how best to select applicants to study medicine. Although these studies have inspired little actual change in admission practice, the implications of this research are substantial. Five areas of inquiry are discussed: (1) the interview and related techniques, (2) admission tests, (3) other measures of personal competencies, (4) the decision process, and (5) defining and measuring the criterion. In each of these areas we summarize consequential developments and discuss their implication for improving practice. (1) The traditional interview has been shown to lack both reliability and validity. Alternatives have been developed that display promising measurement characteristics. (2) Admission test scores have been shown to predict academic and clinical performance and are generally the most useful measures obtained about an applicant. (3) Due to the high-stakes nature of the admission decision, it is difficult to support a logical validity argument for the use of personality tests. Although standardized letters of recommendation appear to offer some promise, more research is needed. (4) The methods used to make the selection decision should be responsive to validity research on how best to utilize applicant information. (5) Few resources have been invested in obtaining valid criterion measures. Future research might profitably focus on composite score as a method for generating a measure of a physician's career success. There are a number of social and organization factors that resist evidence-based change. However, research over the last 25 years does present important findings that could be used to improve the admission process.

  20. Non-native fish control below Glen Canyon Dam - Report from a structured decision-making project

    Science.gov (United States)

    Runge, Michael C.; Bean, Ellen; Smith, David; Kokos, Sonja

    2011-01-01

    This report describes the results of a structured decision-making project by the U.S. Geological Survey to provide substantive input to the Bureau of Reclamation (Reclamation) for use in the preparation of an Environmental Assessment concerning control of non-native fish below Glen Canyon Dam. A forum was created to allow the diverse cooperating agencies and Tribes to discuss, expand, and articulate their respective values; to develop and evaluate a broad set of potential control alternatives using the best available science; and to define individual preferences of each group on how to manage the inherent trade-offs in this non-native fish control problem. This project consisted of two face-to-face workshops, held in Mesa, Arizona, October 18-20 and November 8-10, 2010. At the first workshop, a diverse set of objectives was discussed, which represented the range of concerns of those agencies and Tribes present. A set of non-native fish control alternatives ('hybrid portfolios') was also developed. Over the 2-week period between the two workshops, four assessment teams worked to evaluate the control alternatives against the array of objectives. At the second workshop, the results of the assessment teams were presented. Multi-criteria decision analysis methods were used to examine the trade-offs inherent in the problem, and allowed the participating agencies and Tribes to express their individual judgments about how those trade-offs should best be managed in Reclamation`s selection of a preferred alternative. A broad array of objectives was identified and defined, and an effort was made to understand how these objectives are likely to be achieved by a variety of strategies. In general, the objectives reflected desired future conditions over 30 years. A rich set of alternative approaches was developed, and the complex structure of those alternatives was documented. Multi-criteria decision analysis methods allowed the evaluation of those alternatives against the array

  1. The Predictive Validity of using Admissions Testing and Multiple Mini-interviews in Undergraduate University Admissions

    DEFF Research Database (Denmark)

    Makransky, Guido; Havmose, Philip S.; Vang, Maria Louison

    2017-01-01

    The aim of this study was to evaluate the predictive validity of a two-step admissions procedure that included a cognitive ability test followed by multiple mini-interviews (MMI) used to assess non-cognitive skills compared to a grade-based admissions relative to subsequent drop-out rates...... and academic achievement after one and two years of study. The participants consisted of the entire population of 422 psychology students who were admitted to the University of Southern Denmark between 2010 and 2013. The results showed significantly lower drop-out rates after the first year of study, and non......-significant lower drop-out rates after the second year of study for the admission procedure that included the assessment of non-cognitive skills though the MMI. Furthermore, this admission procedure resulted in a significant lower risk of failing the final exam after the first and second year of study, compared...

  2. Discrete-Time Local Value Iteration Adaptive Dynamic Programming: Admissibility and Termination Analysis.

    Science.gov (United States)

    Wei, Qinglai; Liu, Derong; Lin, Qiao

    In this paper, a novel local value iteration adaptive dynamic programming (ADP) algorithm is developed to solve infinite horizon optimal control problems for discrete-time nonlinear systems. The focuses of this paper are to study admissibility properties and the termination criteria of discrete-time local value iteration ADP algorithms. In the discrete-time local value iteration ADP algorithm, the iterative value functions and the iterative control laws are both updated in a given subset of the state space in each iteration, instead of the whole state space. For the first time, admissibility properties of iterative control laws are analyzed for the local value iteration ADP algorithm. New termination criteria are established, which terminate the iterative local ADP algorithm with an admissible approximate optimal control law. Finally, simulation results are given to illustrate the performance of the developed algorithm.In this paper, a novel local value iteration adaptive dynamic programming (ADP) algorithm is developed to solve infinite horizon optimal control problems for discrete-time nonlinear systems. The focuses of this paper are to study admissibility properties and the termination criteria of discrete-time local value iteration ADP algorithms. In the discrete-time local value iteration ADP algorithm, the iterative value functions and the iterative control laws are both updated in a given subset of the state space in each iteration, instead of the whole state space. For the first time, admissibility properties of iterative control laws are analyzed for the local value iteration ADP algorithm. New termination criteria are established, which terminate the iterative local ADP algorithm with an admissible approximate optimal control law. Finally, simulation results are given to illustrate the performance of the developed algorithm.

  3. SCOPE safety-controls optimization by performance evaluation: A systematic approach for safety-related decisions at the Hanford Tank Remediation System. Phase 1, final report

    Energy Technology Data Exchange (ETDEWEB)

    Bergeron, K.D.; Williams, D.C.; Slezak, S.E.; Young, M.L. [and others

    1996-12-01

    The Department of Energy`s Hanford Tank Waste Remediation system poses a significant challenge for hazard management because of the uncertainty that surrounds many of the variables that must be considered in decisions on safety and control strategies. As a result, site managers must often operate under excessively conservative and expensive assumptions. This report describes a systematic approach to quantifying the uncertainties surrounding the critical parameters in control decisions (e.g., condition of the tanks, kinds of wastes, types of possible accidents) through the use of expert elicitation methods. The results of the elicitations would then be used to build a decision support system and accident analysis model that would allow managers to see how different control strategies would affect the cost and safety of a facility configuration.

  4. SCOPE safety-controls optimization by performance evaluation: A systematic approach for safety-related decisions at the Hanford Tank Remediation System. Phase 1, final report

    International Nuclear Information System (INIS)

    Bergeron, K.D.; Williams, D.C.; Slezak, S.E.; Young, M.L.

    1996-12-01

    The Department of Energy's Hanford Tank Waste Remediation system poses a significant challenge for hazard management because of the uncertainty that surrounds many of the variables that must be considered in decisions on safety and control strategies. As a result, site managers must often operate under excessively conservative and expensive assumptions. This report describes a systematic approach to quantifying the uncertainties surrounding the critical parameters in control decisions (e.g., condition of the tanks, kinds of wastes, types of possible accidents) through the use of expert elicitation methods. The results of the elicitations would then be used to build a decision support system and accident analysis model that would allow managers to see how different control strategies would affect the cost and safety of a facility configuration

  5. "In the beginning...": tools for talking about resuscitation and goals of care early in the admission.

    Science.gov (United States)

    White, Jocelyn; Fromme, Erik K

    2013-11-01

    Quality standards no longer allow physicians to delay discussing goals of care and resuscitation. We propose 2 novel strategies for discussing goals and resuscitation on admission. The first, SPAM (determine Surrogate decision maker, determine resuscitation Preferences, Assume full care, and advise them to expect More discussion especially with clinical changes), helps clinicians discover patient preferences and decision maker during routine admissions. The second, UFO-UFO (Understand what they know, Fill in knowledge gaps, ask about desired Outcomes, Understand their reasoning, discuss the spectrum Feasible Outcomes), helps patients with poor or uncertain prognosis or family-team conflict. Using a challenging case example, this article illustrates how SPAM and UFO-UFO can help clinicians have patient-centered resuscitation and goals of care discussions at the beginning of care.

  6. Admission Systems and Student Mobility: A Proposal for an EU-Wide Registry for University Admission

    Directory of Open Access Journals (Sweden)

    Cecile Hoareau McGrath

    2016-07-01

    Full Text Available Europe’s higher education systems are struggling to respond to the established mass demand for higher education, especially given the proportional decline in available resources per student and, more generally the demand for an ever longer education and reduction of the population of working age due to demographic decline. In addition, growing student mobility puts pressure on admission systems to set up relevant procedures for applicants who wish to enter a country. Admission systems to higher education constitute one key element in the mitigation of these challenges. Admissions can regulate student flows, and play a key role in guaranteeing the acquisition of skills in higher education by matching student profiles to their desired courses of study. This article puts European admission systems in perspective. The issue of regulation of student mobility is topical, given the broader and salient discussion on migration flows in Europe. The article uses international comparisons with systems such as the US, Australia and Japan, to provide a critical overview of the role of admission systems in an often overlooked but yet fundamental part of the European Higher Education Area, namely student mobility. The paper also argues for the creation of an information-sharing EU registry on admissions practices for mobile students.

  7. Managing the 'gaps' in a regimen of control - operational decision making in nuclear power

    International Nuclear Information System (INIS)

    McDougall, S.J.

    2014-01-01

    Nuclear power performance has significantly improved over the last thirty years. This improvement has been based on a philosophy of control. That is, for each issue that must be managed to achieve safe performance, a pre-determined constraint must be established. In addition to the barriers that were designed into the plant, a large range of programs, processes and procedures have been developed to direct the activities of anyone associated with the plant. The premise is that following pre-determined procedures, in a diligent way, will support ongoing plant safety. But what if an issue arises for which there is no procedure? For serious situations, emergency procedures exist to guide operations personnel to place the plant in a safe state. However, the vast majority of issues are much more mundane and form a part of the daily life in the plant. In these cases the nuclear industry has been encouraging the use of an 'Operational Decision Making' (ODM) process. This paper will review ODM as practiced within the context of the governing paradigm of control. The paper will show the strengths of the process and areas for development. ODM is an important tool for managers within the complex socio-technical system that is nuclear power today. This paper summarises key points from a research thesis completed by the author to meet the requirements of an MSc program in 'Human Factors and System Safety'. (author)

  8. Managing the 'gaps' in a regimen of control - operational decision making in nuclear power

    Energy Technology Data Exchange (ETDEWEB)

    McDougall, S.J. [Leading Safety Culture Inc., Port Elgin, ON (Canada)

    2014-07-01

    Nuclear power performance has significantly improved over the last thirty years. This improvement has been based on a philosophy of control. That is, for each issue that must be managed to achieve safe performance, a pre-determined constraint must be established. In addition to the barriers that were designed into the plant, a large range of programs, processes and procedures have been developed to direct the activities of anyone associated with the plant. The premise is that following pre-determined procedures, in a diligent way, will support ongoing plant safety. But what if an issue arises for which there is no procedure? For serious situations, emergency procedures exist to guide operations personnel to place the plant in a safe state. However, the vast majority of issues are much more mundane and form a part of the daily life in the plant. In these cases the nuclear industry has been encouraging the use of an 'Operational Decision Making' (ODM) process. This paper will review ODM as practiced within the context of the governing paradigm of control. The paper will show the strengths of the process and areas for development. ODM is an important tool for managers within the complex socio-technical system that is nuclear power today. This paper summarises key points from a research thesis completed by the author to meet the requirements of an MSc program in 'Human Factors and System Safety'. (author)

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

    Science.gov (United States)

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

    2018-01-01

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

  10. TWRS Final Safety Analysis Report (FSAR) integrated control decision team (ICDT) meetings January 22 - 31,1997

    International Nuclear Information System (INIS)

    Saladin, V.L.

    1997-01-01

    U.S. Department of Energy (DOE), Richland Operations Office (RL) letter 97-MSD-163 dated January 15, 1997, directed the Project Hanford Management Contractor (Contractor), Fluor Daniel Hanford, inc., to form a joint RL-Contractor Integrated Control Decision Team (ICDT) to evaluate the Tank Waste Remediation System (TWRS) Final Safety Analysis Report (FSAR) accident scenarios that were identified to be above the risk evaluation guidelines (radiological and/or toxicological) defined by the April 8, 1996, letter from J. Kinzer, RL-TWRS (96-MSO-069) to Dr. A. L. Trego, Westinghouse Hanford Company. The ICDT evaluated six postulated accidents from the draft FSAR which had analyzed consequences above the DOE directed risk evaluation guidelines after controls were applied. The accidents were: (1) Organic Solvent Fires; (2) Organic Salt-Nitrate Fire; (3) Spray Leak; (4) Flammable Gas; (5) Steam Intrusion; and (6) Seismic Event. Five of the postulated accidents exceed radiological risk guidelines. Although the postulated steam intrusion accident does not exceed the radiological risk guidelines, it was considered in the ICDT evaluation because its calculated consequences exceed toxicological risk evaluation guidelines. Figure 1 delineates the mitigated and unmitigated risk evaluations performed for the FSAR

  11. Policy and science of FMD control: the stakeholders' contribution to decision making. A call for integrated animal disease management.

    Science.gov (United States)

    Marshall, M; Roger, P

    Effective control of foot-and-mouth disease (FMD)--prevention, surveillance and response--requires integrated animal disease management as a cooperative effort between stakeholders, scientists and decision makers, at all levels: local, national, regional and international. This paper suggests a process and outlines specific critical issues that need to be addressed in order to best use the science and technology that is available now and to develop new technologies that will lead to significant improvements. The overall objective is not to allow the disease or the disease control measures to damage, violate or destroy public health, the environment, or the economy, or to allow politics to drive disease control policies at the expense of the ethical relationship between man and animals. Critical issues of prevention, surveillance and response policies are examined, and specific recommendations are made to reduce the risk or effect of natural and deliberate introductions. For prevention: a) rapid portable diagnostics and provision of vaccines to control and eradicate the reservoirs of disease. b) alerts, leading to increased controls at borders, animal movement restrictions and biosecurity on farms. For surveillance: a) reporting of unusual symptoms, rapid diagnostics and identification of patterns. b) enhanced role of geographic information systems (GIS) linked to an IT system. c) collection, storage and sharing of disease information. For response policies: a) the role and implementation of stamping out and of vaccination. b) simulation exercises with stakeholder participation. For all aspects of FMD control, consideration should be given to: a) the composition, responsibilities and role of the balanced, permanently operational Expert Group in EU member states as specified in the EU FMD Directive. b) establishment of a balanced, permanently operational European Expert Group. c) establishment of both a European and an International FMD Task Force. Stakeholders need

  12. The BioMedical Admissions Test for medical student selection: issues of fairness and bias.

    Science.gov (United States)

    Emery, Joanne L; Bell, John F; Vidal Rodeiro, Carmen L

    2011-01-01

    The BioMedical Admissions Test (BMAT) forms part of the undergraduate medical admission process at the University of Cambridge. The fairness of admissions tests is an important issue. Aims were to investigate the relationships between applicants' background variables and BMAT scores, whether they were offered a place or rejected and, for those admitted, performance on the first year course examinations. Multilevel regression models were employed with data from three combined applicant cohorts. Admission rates for different groups were investigated with and without controlling for BMAT performance. The fairness of the BMAT was investigated by determining, for those admitted, whether scores predicted examination performance equitably. Despite some differences in applicants' BMAT performance (e.g. by school type and gender), BMAT scores predicted mean examination marks equitably for all background variables considered. The probability of achieving a 1st class examination result, however, was slightly under-predicted for those admitted from schools and colleges entering relatively few applicants. Not all differences in admission rates were accounted for by BMAT performance. However, the test constitutes only one part of a compensatory admission system in which other factors, such as interview performance, are important considerations. Results are in support of the equity of the BMAT.

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Effect of advanced age and vital signs on admission from an ED observation unit.

    Science.gov (United States)

    Caterino, Jeffrey M; Hoover, Emily M; Moseley, Mark G

    2013-01-01

    The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission. We conducted a prospective, observational cohort study of ED patients placed in an ED-based observation unit. Multivariable penalized maximum likelihood logistic regression was used to identify independent predictors of need for hospital admission. Age was examined continuously and at a cutoff of 65 years or more. Vital signs were examined continuously and at commonly accepted cutoffs.We additionally controlled for demographics, comorbid conditions, laboratory values, and observation protocol. Three hundred patients were enrolled, 12% (n = 35) were 65 years or older, and 11% (n = 33) required admission. Admission rates were 2.9% (95% confidence interval [CI], 0.07%-14.9%) in older adults and 12.1% (95% CI, 8.4%-16.6%) in younger adults. In multivariable analysis, age was not associated with admission (odds ratio [OR], 0.30; 95% CI, 0.05-1.67). Predictors of admission included systolic pressure 180 mm Hg or greater (OR, 4.19; 95% CI, 1.08-16.30), log Charlson comorbidity score (OR, 2.93; 95% CI, 1.57-5.46), and white blood cell count 14,000/mm(3) or greater (OR, 11.35; 95% CI, 3.42-37.72). Among patients placed in an ED observation unit, age 65 years or more is not associated with need for admission. Older adults can successfully be discharged from these units. Systolic pressure 180 mm Hg or greater was the only predictive vital sign. In determining appropriateness of patients selected for an ED observation unit, advanced age should not be an automatic disqualifying criterion. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Effect of advanced age and vital signs on admission from an emergency department observation unit

    Science.gov (United States)

    Caterino, Jeffrey M.; Hoover, Emily; Moseley, Mark G.

    2012-01-01

    Objectives The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission. Methods We conducted a prospective, observational cohort study of ED patients placed in an ED-based observation unit. Multivariable penalized maximum likelihood logistic regression was used to identify independent predictors of need for hospital admission. Age was examined continuously and at a cutoff of ≥65 years. Vital signs were examined continuously and at commonly accepted cutoffs. We additionally controlled for demographics, co-morbid conditions, laboratory values, and observation protocol. Results Three hundred patients were enrolled, 12% (n=35) ≥65 years old and 11% (n=33) requiring admission. Admission rates were 2.9% (95% confidence interval [CI], 0.07-14.9%) in older adults and 12.1% (95% CI, 8.4-16.6%) in younger adults. In multivariable analysis, age was not associated with admission (odds ratio [OR] 0.30, 95% CI 0.05-1.67). Predictors of admission included: systolic pressure ≥180 mmHg (OR 4.19, 95% CI 1.08-16.30), log Charlson co-morbidity score (OR 2.93, 95% CI 1.57-5.46), and white blood cell count ≥14,000/mm3 (OR11.35, 95% CI 3.42-37.72). Conclusions Among patients placed in an ED observation unit, age ≥65 years is not associated with need for admission. Older adults can successfully be discharged from these units. Systolic pressure≥180 mmHg was the only predictive vital sign. In determining appropriateness of patients selected for an ED observation unit, advanced age should not be an automatic disqualifying criterion. PMID:22386358

  16. Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model.

    Science.gov (United States)

    Ben-Assuli, Ofir; Leshno, Moshe

    2016-09-01

    In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians' diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments. © The Author(s) 2015.

  17. Treatment Episode Data Set: Admissions (TEDS-A-2002)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  18. Treatment Episode Data Set: Admissions (TEDS-A-1994)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  19. Treatment Episode Data Set: Admissions (TEDS-A-2008)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  20. Treatment Episode Data Set: Admissions (TEDS-A-2003)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...