WorldWideScience

Sample records for high quality decision

  1. The perspective awareness model - Eliciting multiple perspectives to formulate high quality decisions

    International Nuclear Information System (INIS)

    Boucher, Laurel

    2013-01-01

    A great deal of attention is given to the importance of communication in environmental remediation and radioactive waste management. However, very little attention is given to eliciting multiple perspectives so as to formulate high quality decisions. Plans that are based on a limited number of perspectives tend to be narrowly focused whereas those that are based on a wide variety of perspectives tend to be comprehensive, higher quality, and more apt to be put into application. In addition, existing methods of dialogue have built-in limitations in that they typically draw from the predominant thinking patterns which focus in some areas but ignore others. This can result in clarity but a lack of comprehensiveness. This paper presents a Perspective Awareness Model which helps groups such as partnering teams, interagency teams, steering committees, and working groups elicit a wide net of perspectives and viewpoints. The paper begins by describing five factors that makes cooperation among such groups challenging. Next, a Perspective Awareness Model that makes it possible to manage these five factors is presented. The two primary components of this model --- the eight 'Thinking Directions' and the 'Shared Documentation' --- are described in detail. Several examples are given to illustrate how the Perspective Awareness Model can be used to elicit multiple perspectives to formulate high quality decisions in the area of environmental remediation and radioactive waste management. (authors)

  2. Decision Dissonance: Evaluating an Approach to Measuring the Quality of Surgical Decision Making

    Science.gov (United States)

    Fowler, Floyd J.; Gallagher, Patricia M.; Drake, Keith M.; Sepucha, Karen R.

    2013-01-01

    Background Good decision making has been increasingly cited as a core component of good medical care, and shared decision making is one means of achieving high decision quality. If it is to be a standard, good measures and protocols are needed for assessing the quality of decisions. Consistency with patient goals and concerns is one defining characteristic of a good decision. A new method for evaluating decision quality for major surgical decisions was examined, and a methodology for collecting the needed data was developed. Methods For a national probability sample of fee-for-service Medicare beneficiaries who had a coronary artery bypass graft (CABG), a lumpectomy or a mastectomy for breast cancer, or surgery for prostate cancer during the last half of 2008, a mail survey of selected patients was carried out about one year after the procedures. Patients’ goals and concerns, knowledge, key aspects of interactions with clinicians, and feelings about the decisions were assessed. A Decision Dissonance Score was created that measured the extent to which patient ratings of goals ran counter to the treatment received. The construct and predictive validity of the Decision Dissonance Score was then assessed. Results When data were averaged across all four procedures, patients with more knowledge and those who reported more involvement reported significantly lower Decision Dissonance Scores. Patients with lower Decision Dissonance Scores also reported more confidence in their decisions and feeling more positively about how the treatment turned out, and they were more likely to say that they would make the same decision again. Conclusions Surveying discharged surgery patients is a feasible way to evaluate decision making, and Decision Dissonance appears to be a promising approach to validly measuring decision quality. PMID:23516764

  3. Development and preliminary user testing of the DCIDA (Dynamic computer interactive decision application) for 'nudging' patients towards high quality decisions.

    Science.gov (United States)

    Bansback, Nick; Li, Linda C; Lynd, Larry; Bryan, Stirling

    2014-08-01

    Patient decision aids (PtDA) are developed to facilitate informed, value-based decisions about health. Research suggests that even when informed with necessary evidence and information, cognitive errors can prevent patients from choosing the option that is most congruent with their own values. We sought to utilize principles of behavioural economics to develop a computer application that presents information from conventional decision aids in a way that reduces these errors, subsequently promoting higher quality decisions. The Dynamic Computer Interactive Decision Application (DCIDA) was developed to target four common errors that can impede quality decision making with PtDAs: unstable values, order effects, overweighting of rare events, and information overload. Healthy volunteers were recruited to an interview to use three PtDAs converted to the DCIDA on a computer equipped with an eye tracker. Participants were first used a conventional PtDA, and then subsequently used the DCIDA version. User testing was assessed based on whether respondents found the software both usable: evaluated using a) eye-tracking, b) the system usability scale, and c) user verbal responses from a 'think aloud' protocol; and useful: evaluated using a) eye-tracking, b) whether preferences for options were changed, and c) and the decisional conflict scale. Of the 20 participants recruited to the study, 11 were male (55%), the mean age was 35, 18 had at least a high school education (90%), and 8 (40%) had a college or university degree. Eye-tracking results, alongside a mean system usability scale score of 73 (range 68-85), indicated a reasonable degree of usability for the DCIDA. The think aloud study suggested areas for further improvement. The DCIDA also appeared to be useful to participants wherein subjects focused more on the features of the decision that were most important to them (21% increase in time spent focusing on the most important feature). Seven subjects (25%) changed their

  4. Conceptualizing, Understanding, and Predicting Responsible Decisions and Quality Input

    Science.gov (United States)

    Wall, N.; PytlikZillig, L. M.

    2012-12-01

    In areas such as climate change, where uncertainty is high, it is arguably less difficult to tell when efforts have resulted in changes in knowledge, than when those efforts have resulted in responsible decisions. What is a responsible decision? More broadly, when it comes to citizen input, what is "high quality" input? And most importantly, how are responsible decisions and quality input enhanced? The aim of this paper is to contribute to the understanding of the different dimensions of "responsible" or "quality" public input and citizen decisions by comparing and contrasting the different predictors of those different dimensions. We first present different possibilities for defining, operationalizing and assessing responsible or high quality decisions. For example, responsible decisions or quality input might be defined as using specific content (e.g., using climate change information in decisions appropriately), as using specific processes (e.g., investing time and effort in learning about and discussing the issues prior to making decisions), or on the basis of some judgment of the decision or input itself (e.g., judgments of the rationale provided for the decisions, or number of issues considered when giving input). Second, we present results from our work engaging people with science policy topics, and the different ways that we have tried to define these two constructs. In the area of climate change specifically, we describe the development of a short survey that assesses exposure to climate information, knowledge of and attitudes toward climate change, and use of climate information in one's decisions. Specifically, the short survey was developed based on a review of common surveys of climate change related knowledge, attitudes, and behaviors, and extensive piloting and cognitive interviews. Next, we analyze more than 200 responses to that survey (data collection is currently ongoing and will be complete after the AGU deadline), and report the predictors of

  5. Development and preliminary user testing of the DCIDA (Dynamic computer interactive decision application) for ‘nudging’ patients towards high quality decisions

    Science.gov (United States)

    2014-01-01

    Background Patient decision aids (PtDA) are developed to facilitate informed, value-based decisions about health. Research suggests that even when informed with necessary evidence and information, cognitive errors can prevent patients from choosing the option that is most congruent with their own values. We sought to utilize principles of behavioural economics to develop a computer application that presents information from conventional decision aids in a way that reduces these errors, subsequently promoting higher quality decisions. Method The Dynamic Computer Interactive Decision Application (DCIDA) was developed to target four common errors that can impede quality decision making with PtDAs: unstable values, order effects, overweighting of rare events, and information overload. Healthy volunteers were recruited to an interview to use three PtDAs converted to the DCIDA on a computer equipped with an eye tracker. Participants were first used a conventional PtDA, and then subsequently used the DCIDA version. User testing was assessed based on whether respondents found the software both usable: evaluated using a) eye-tracking, b) the system usability scale, and c) user verbal responses from a ‘think aloud’ protocol; and useful: evaluated using a) eye-tracking, b) whether preferences for options were changed, and c) and the decisional conflict scale. Results Of the 20 participants recruited to the study, 11 were male (55%), the mean age was 35, 18 had at least a high school education (90%), and 8 (40%) had a college or university degree. Eye-tracking results, alongside a mean system usability scale score of 73 (range 68–85), indicated a reasonable degree of usability for the DCIDA. The think aloud study suggested areas for further improvement. The DCIDA also appeared to be useful to participants wherein subjects focused more on the features of the decision that were most important to them (21% increase in time spent focusing on the most important feature

  6. Automation of information decision support to improve e-learning resources quality

    Directory of Open Access Journals (Sweden)

    A.L. Danchenko

    2013-06-01

    Full Text Available Purpose. In conditions of active development of e-learning the high quality of e-learning resources is very important. Providing the high quality of e-learning resources in situation with mass higher education and rapid obsolescence of information requires the automation of information decision support for improving the quality of e-learning resources by development of decision support system. Methodology. The problem is solved by methods of artificial intelligence. The knowledge base of information structure of decision support system that is based on frame model of knowledge representation and inference production rules are developed. Findings. According to the results of the analysis of life cycle processes and requirements to the e-learning resources quality the information model of the structure of the knowledge base of the decision support system, the inference rules for the automatically generating of recommendations and the software implementation are developed. Practical value. It is established that the basic requirements for quality are performance, validity, reliability and manufacturability. It is shown that the using of a software implementation of decision support system for researched courses gives a growth of the quality according to the complex quality criteria. The information structure of a knowledge base system to support decision-making and rules of inference can be used by methodologists and content developers of learning systems.

  7. Seminal Quality Prediction Using Clustering-Based Decision Forests

    Directory of Open Access Journals (Sweden)

    Hong Wang

    2014-08-01

    Full Text Available Prediction of seminal quality with statistical learning tools is an emerging methodology in decision support systems in biomedical engineering and is very useful in early diagnosis of seminal patients and selection of semen donors candidates. However, as is common in medical diagnosis, seminal quality prediction faces the class imbalance problem. In this paper, we propose a novel supervised ensemble learning approach, namely Clustering-Based Decision Forests, to tackle unbalanced class learning problem in seminal quality prediction. Experiment results on real fertility diagnosis dataset have shown that Clustering-Based Decision Forests outperforms decision tree, Support Vector Machines, random forests, multilayer perceptron neural networks and logistic regression by a noticeable margin. Clustering-Based Decision Forests can also be used to evaluate variables’ importance and the top five important factors that may affect semen concentration obtained in this study are age, serious trauma, sitting time, the season when the semen sample is produced, and high fevers in the last year. The findings could be helpful in explaining seminal concentration problems in infertile males or pre-screening semen donor candidates.

  8. Evaluating the Quality of Patient Decision-Making Regarding Post-Acute Care.

    Science.gov (United States)

    Burke, Robert E; Jones, Jacqueline; Lawrence, Emily; Ladebue, Amy; Ayele, Roman; Leonard, Chelsea; Lippmann, Brandi; Matlock, Daniel D; Allyn, Rebecca; Cumbler, Ethan

    2018-05-01

    Despite a national focus on post-acute care brought about by recent payment reforms, relatively little is known about how hospitalized older adults and their caregivers decide whether to go to a skilled nursing facility (SNF) after hospitalization. We sought to understand to what extent hospitalized older adults and their caregivers are empowered to make a high-quality decision about utilizing an SNF for post-acute care and what contextual or process elements led to satisfaction with the outcome of their decision once in SNF. Qualitative inquiry using the Ottawa Decision Support Framework (ODSF), a conceptual framework that describes key components of high-quality decision-making. Thirty-two previously community-dwelling older adults (≥ 65 years old) and 22 caregivers interviewed at three different hospitals and three skilled nursing facilities. We used key components of the ODSF to identify elements of context and process that affected decision-making and to what extent the outcome was characteristic of a high-quality decision: informed, values based, and not associated with regret or blame. The most important contextual themes were the presence of active medical conditions in the hospital that made decision-making difficult, prior experiences with hospital readmission or SNF, relative level of caregiver support, and pressure to make a decision quickly for which participants felt unprepared. Patients described playing a passive role in the decision-making process and largely relying on recommendations from the medical team. Patients commonly expressed resignation and a perceived lack of choice or autonomy, leading to dissatisfaction with the outcome. Understanding and intervening to improve the quality of decision-making regarding post-acute care supports is essential for improving outcomes of hospitalized older adults. Our results suggest that simply providing information is not sufficient; rather, incorporating key contextual factors and improving the

  9. 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.

  10. Military Service and Decision Quality in the Management of Knee Osteoarthritis.

    Science.gov (United States)

    Henderson, Eric R; Titus, Alexander J; Keeney, Benjamin J; Goodney, Philip P; Lurie, Jon D; Ibrahim, Said A

    2018-05-18

    Decision quality measures the degree to which care decisions are knowledge-based and value-aligned. Because military service emphasizes hierarchy, command, and mandates some healthcare decisions, military service may attenuate patient autonomy in healthcare decisions and lower decision quality. VA is the nation's largest provider of orthopedic care. We compared decision quality in a sample of VA and non-VA patients seeking care for knee osteoarthritis. Our study sample consisted of patients newly referred to our orthopedic clinic for the management of knee osteoarthritis. None of the study patients were exposed to a knee osteoarthritis decision aid. Consenting patients were administered the Hip/Knee Decision Quality Instrument (HK-DQI). In addition, they were surveyed about decision-making preferences and demographics. We compared results to a non-VA cohort from our academic institution's arthroplasty database. The HK-DQI Knowledge Score was lower in the VA cohort (45%, SD = 22, n = 25) compared with the non-VA cohort (53%, SD = 21, n = 177) (p = 0.04). The Concordance Score was lower in the VA cohort (36%, SD = 49%) compared with the control cohort (70%, SD 46%) (p = 0.003). Non-VA patients were more likely to make a high-quality decision (p = 0.05). Non-VA patients were more likely to favor a shared decision-making process (p = 0.002). Decision quality is lower in Veterans with knee osteoarthritis compared with civilians, placing them at risk for lower treatment satisfaction and possibly unwarranted surgical utilization. Our future work will examine if this difference is from conditioned military service behaviors or confounding demographic factors, and if conventional shared decision-making techniques will correct this deficiency.

  11. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi.

    Directory of Open Access Journals (Sweden)

    Glyn Elwyn

    Full Text Available To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids.Scale development study, involving construct, item and scale development, validation and reliability testing.There has been increasing use of decision support technologies--adjuncts to the discussions clinicians have with patients about difficult decisions. A global interest in developing these interventions exists among both for-profit and not-for-profit organisations. It is therefore essential to have internationally accepted standards to assess the quality of their development, process, content, potential bias and method of field testing and evaluation.Scale development study, involving construct, item and scale development, validation and reliability testing.Twenty-five researcher-members of the International Patient Decision Aid Standards Collaboration worked together to develop the instrument (IPDASi. In the fourth Stage (reliability study, eight raters assessed thirty randomly selected decision support technologies.IPDASi measures quality in 10 dimensions, using 47 items, and provides an overall quality score (scaled from 0 to 100 for each intervention. Overall IPDASi scores ranged from 33 to 82 across the decision support technologies sampled (n = 30, enabling discrimination. The inter-rater intraclass correlation for the overall quality score was 0.80. Correlations of dimension scores with the overall score were all positive (0.31 to 0.68. Cronbach's alpha values for the 8 raters ranged from 0.72 to 0.93. Cronbach's alphas based on the dimension means ranged from 0.50 to 0.81, indicating that the dimensions, although well correlated, measure different aspects of decision support technology quality. A short version (19 items was also developed that had very similar mean scores to IPDASi and high correlation between short score and overall score 0.87 (CI 0.79 to 0.92.This work

  12. Make or buy strategy decision making in supply quality chain

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Seyedhosseini

    2012-04-01

    Full Text Available Minimizing the total cost is absolutely the goal of each supply chain, which is most of the time pursued. In this regards, quality related costs that have significant roles are sometimes neglected. Selecting suppliers, which supply relatively high quality raw materials in a lower cost is considered as a strategic decision. Make or Buy decision can be also noticed in supplier selection process. In this paper, the supply strategy: Make or Buy decision (SS: MOB is studied in order to find which strategy (Make or Buy should be chosen to minimize the total costs of supply chain. Therefore, two separate models are generated for each strategy and several examples are solved for the respective models. Computational experiments show the efficiency of the proposed models for making decision about selecting the best strategy.

  13. Strategic-decision quality in public organizations : an information processing perspective

    OpenAIRE

    George, Bert; Desmidt, Sebastian

    2018-01-01

    textabstractThis study draws on information processing theory to investigate predictors of strategic-decision quality in public organizations. Information processing theory argues that (a) rational planning practices contribute to strategic-decision quality by injecting information into decision making and (b) decision makers contribute to strategic-decision quality by exchanging information during decision making. These assumptions are tested upon 55 Flemish pupil guidance centers. Rational ...

  14. High Decision Latitude at Work Combined with Traumatic Life Events in Private Life is Associated with Reduced Sleep Quality: Results from the GAZEL Study

    Directory of Open Access Journals (Sweden)

    Nadya Dich

    2018-04-01

    Full Text Available Psychosocial stress, both at work and at home, plays a role in sleep disturbances. Theoretical models of stress underscore the cumulative effect of stress from different domains in affecting health and well-being. However, previous research has not considered how work stress and stress in private life might interact to affect sleep. The study investigated potential synergistic effects of work stress and traumatic events in private life on sleep quality. Participants ('N' = 6552, average baseline age = 52 were a subset of the French GAZEL cohort who were working in 1999. Work stress was operationalized as high job demands and low decision latitude. These working conditions were self-reported in 1999 (study baseline. Traumatic events in the past 12 months were reported in 2000. Sleep quality was assessed in 2000 as disturbed sleep in the past 12 months, and current sleep problems was indexed by the sleep subscale of the Nottingham Health Profile questionnaire. The results showed that recent events interacted with decision latitude, but not job demands, in predicting sleep quality. However, contrary to our expectations, it was 'high' and not low decision latitude at work that amplified the negative association between stressful events and sleep quality. Adjusted for baseline health, individuals with highest numbers of events and highest levels of decision latitude were at highest risk for impaired sleep. These results challenge the idea that high decision latitude always serves as a protective factor, and underscore the necessity for considering a broader life context when studying stress in a particular domain of life.

  15. Strategic decision quality in Flemish municipalities

    NARCIS (Netherlands)

    B.R.J. George (Bert); S. Desmidt (Sebastian); J. De Moyer (Julie)

    2016-01-01

    textabstractStrategic planning (SP) has taken the public sector by storm because it is widely believed that SP’s approach to strategic decision-making strengthens strategic decision quality (SDQ) in public organizations. However, if or how SP relates to SDQ seems to lack empirical evidence. Drawing

  16. Assessing decision quality in patient-centred care requires a preference-sensitive measure

    Science.gov (United States)

    Kaltoft, Mette; Cunich, Michelle; Salkeld, Glenn; Dowie, Jack

    2014-01-01

    A theory-based instrument for measuring the quality of decisions made using any form of decision technology, including both decision-aided and unaided clinical consultations is required to enable person- and patient-centred care and to respond positively to individual heterogeneity in the value aspects of decision making. Current instruments using the term ‘decision quality’ have adopted a decision- and thus condition-specific approach. We argue that patient-centred care requires decision quality to be regarded as both preference-sensitive across multiple relevant criteria and generic across all conditions and decisions. MyDecisionQuality is grounded in prescriptive multi criteria decision analysis and employs a simple expected value algorithm to calculate a score for the quality of a decision that combines, in the clinical case, the patient’s individual preferences for eight quality criteria (expressed as importance weights) and their ratings of the decision just taken on each of these criteria (expressed as performance rates). It thus provides an index of decision quality that encompasses both these aspects. It also provides patients with help in prioritizing quality criteria for future decision making by calculating, for each criterion, the Incremental Value of Perfect Rating, that is, the increase in their decision quality score that would result if their performance rating on the criterion had been 100%, weightings unchanged. MyDecisionQuality, which is a web-based generic and preference-sensitive instrument, can constitute a key patient-reported measure of the quality of the decision-making process. It can provide the basis for future decision improvement, especially when the clinician (or other stakeholders) completes the equivalent instrument and the extent and nature of concordance and discordance can be established. Apart from its role in decision preparation and evaluation, it can also provide real time and relevant documentation for the patient

  17. Conceptualising a system for quality clinical decision-making in ...

    African Journals Online (AJOL)

    As a feedback mechanism to promote or improve the quality of clinical decisions in nursing, standards for quality clinical decision-making are proposed in an exemplary manner. In addition, a system for quality clinical decisionmaking in nursing capitalises on the heritage of the nursing process. Considering the changes and ...

  18. Strategic-Decision Quality in Public Organizations: An Information Processing Perspective.

    NARCIS (Netherlands)

    B.R.J. George (Bert); S. Desmidt (Sebastian)

    2016-01-01

    textabstractThis study draws on information processing theory to investigate predictors of strategic-decision quality in public organizations. Information processing theory argues that (a) rational planning practices contribute to strategic-decision quality by injecting information into decision

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

    Science.gov (United States)

    Stepanovich, P L; Uhrig, J D

    1999-01-01

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

  20. Quality of decision making and group norms

    NARCIS (Netherlands)

    Postmes, T; Spears, R; Cihangir, S

    Two studies investigated the impact of group norms for maintaining consensus versus norms for critical thought on group decisions in a modification of the biased sampling paradigm (G. Stasser & W. Titus, 1985). Both studies showed that critical norms improved the quality of decisions, whereas

  1. Quality of decision making and group norms

    NARCIS (Netherlands)

    Postmes, T.; Spears, R.; Cihangir, S.

    2001-01-01

    Two studies investigated the impact of group norms for maintaining consensus versus norms for critical thought on group decisions in a modification of the biased sampling paradigm (G. Stasser & W. Titus, 1985). Both studies showed that critical norms improved the quality of decisions, whereas

  2. Dissociating neural variability related to stimulus quality and response times in perceptual decision-making.

    Science.gov (United States)

    Bode, Stefan; Bennett, Daniel; Sewell, David K; Paton, Bryan; Egan, Gary F; Smith, Philip L; Murawski, Carsten

    2018-03-01

    According to sequential sampling models, perceptual decision-making is based on accumulation of noisy evidence towards a decision threshold. The speed with which a decision is reached is determined by both the quality of incoming sensory information and random trial-by-trial variability in the encoded stimulus representations. To investigate those decision dynamics at the neural level, participants made perceptual decisions while functional magnetic resonance imaging (fMRI) was conducted. On each trial, participants judged whether an image presented under conditions of high, medium, or low visual noise showed a piano or a chair. Higher stimulus quality (lower visual noise) was associated with increased activation in bilateral medial occipito-temporal cortex and ventral striatum. Lower stimulus quality was related to stronger activation in posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (DLPFC). When stimulus quality was fixed, faster response times were associated with a positive parametric modulation of activation in medial prefrontal and orbitofrontal cortex, while slower response times were again related to more activation in PPC, DLPFC and insula. Our results suggest that distinct neural networks were sensitive to the quality of stimulus information, and to trial-to-trial variability in the encoded stimulus representations, but that reaching a decision was a consequence of their joint activity. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Effect of Training in Rational Decision Making on the Quality of Simulated Career Decisions.

    Science.gov (United States)

    Krumboltz, John D.; And Others

    1982-01-01

    Determined if training in rational decision making improves the quality of simulated career decisions. Training in rational decision making resulted in superior performance for females on one subscore of the knowledge measure. It also resulted in superior simulated career choices by females and younger males. (Author)

  4. Assessing decision quality in patient-centred care requires a preference-sensitive measure

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Cunich, Michelle; Salkeld, Glenn

    2014-01-01

    A theory-based instrument for measuring the quality of decisions made using any form of decision technology, including both decision-aided and unaided clinical consultations is required to enable person- and patient-centred care and to respond positively to individual heterogeneity in the value...... aspects of decision making. Current instruments using the term 'decision quality' have adopted a decision- and thus condition-specific approach. We argue that patient-centred care requires decision quality to be regarded as both preference-sensitive across multiple relevant criteria and generic across all...

  5. Enhancing shared decision making through assessment of patient-clinician concordance on decision quality

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Selby, Warwick; Salkeld, Glenn

    to quantify, document, and suggest how future dyadic decisions can be enhanced by criterion prioritisation. Associations between patient’s MDQ-W before, and MDQ-R after consultation with their clinician were analysed along with patient scores from the Satisfaction With Decision (SWD) instrument. Results...... and clinician using the dually-personalised decomposable MyDecisionQuality (MDQ) instrument. This has the potential to guide future work on optimising dyad-specific patient-clinician communication for shared decision making and informed consent....

  6. Decision Analysis for Metric Selection on a Clinical Quality Scorecard.

    Science.gov (United States)

    Guth, Rebecca M; Storey, Patricia E; Vitale, Michael; Markan-Aurora, Sumita; Gordon, Randolph; Prevost, Traci Q; Dunagan, Wm Claiborne; Woeltje, Keith F

    2016-09-01

    Clinical quality scorecards are used by health care institutions to monitor clinical performance and drive quality improvement. Because of the rapid proliferation of quality metrics in health care, BJC HealthCare found it increasingly difficult to select the most impactful scorecard metrics while still monitoring metrics for regulatory purposes. A 7-step measure selection process was implemented incorporating Kepner-Tregoe Decision Analysis, which is a systematic process that considers key criteria that must be satisfied in order to make the best decision. The decision analysis process evaluates what metrics will most appropriately fulfill these criteria, as well as identifies potential risks associated with a particular metric in order to identify threats to its implementation. Using this process, a list of 750 potential metrics was narrowed to 25 that were selected for scorecard inclusion. This decision analysis process created a more transparent, reproducible approach for selecting quality metrics for clinical quality scorecards. © The Author(s) 2015.

  7. Decision making in a multidisciplinary cancer team: does team discussion result in better quality decisions?

    Science.gov (United States)

    Kee, Frank; Owen, Tracy; Leathem, Ruth

    2004-01-01

    To establish whether treatment recommendations made by clinicians concur with the best outcomes predicted from their prognostic estimates and whether team discussion improves the quality or outcome of their decision making, the authors studied real-time decision making by a lung cancer team. Clinicians completed pre- and postdiscussion questionnaires for 50 newly diagnosed patients. For each patient/doctor pairing, a decision model determined the expected patient outcomes from the clinician's prognostic estimates. The difference between the expected utility of the recommended treatment and the maximum utility derived from the clinician's predictions of the outcomes (the net utility loss) following all potential treatment modalities was calculated as an indicator of quality of the decision. The proportion of treatment decisions changed by the multidisciplinary team discussion was also calculated. Insofar as the change in net utility loss brought about by multidisciplinary team discussion was not significantly different from zero, team discussion did not improve the quality of decision making overall. However, given the modest power of the study, these findings must be interpreted with caution. In only 23 of 87 instances (26%) in which an individual specialist's initial treatment preference differed from the final group judgment did the specialist finally concur with the group treatment choice after discussion. This study does not support the theory that team discussion improves decision making by closing a knowledge gap.

  8. Retail service quality as a base in purchasing decision

    Directory of Open Access Journals (Sweden)

    Sokolov-Mladenović Svetlana

    2015-01-01

    Full Text Available Retail is a service activity, and services are something that makes the retail companies differ from production companies. Retailers are trying to differentiate the 'package' offer, build customer loyalty and make their position through the provision of high service quality. In addition, the services provided can be varied, such as exterior and interior design of retail stores, preparation of goods for sale, appearance and behavior of sales personnel, culture of communication with customers, and services provided after the sales process. Consumers require the service quality when making purchasing decision. For retail companies and retail stores it is important to continuously monitor the level of service quality. In order to measure the service quality, the method that found its application in the theory and practice is SERVQUAL. This model was created as a combination of theoretical and practical research and it looks at the quality of service as the content of the following dimensions: tangibles, reliability, sensitivity, security and empathy. As such, it is a function of the difference between perceptions and expectations (Q = P-E and is widely accepted to measure the service quality in traditional retail stores, public sector, higher education, real estate, hospitals, courts and so on. In addition, this model is widely used to measure service quality in e-retailing, e-banking, e-selling of travel packages and other services provided by electronic means. The main assumption is that services are a key factor in making purchasing decision. The aim of this paper is to, through theoretical and practical research with special emphasis on SERVQUAL method, test the initial hypothesis and recognize the level of service quality in retail chains in Southeast Serbia.

  9. High quality data: An evaluation of AIM data quality and data quality procedures

    Science.gov (United States)

    The goal of every monitoring program is to collect high-quality data which can then be used to provide information to decision makers. The Bureau of Land Management (BLM) Assessment, Inventory, and Monitoring (AIM) program is one such data set which provides rangeland status, condition, and trend in...

  10. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors

    Directory of Open Access Journals (Sweden)

    Shahar eAyal

    2015-07-01

    Full Text Available A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions.

  11. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors

    Science.gov (United States)

    Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

    2015-01-01

    A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions. PMID:26284011

  12. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors.

    Science.gov (United States)

    Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

    2015-01-01

    A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions.

  13. Competence and Quality in Real-Life Decision Making

    OpenAIRE

    Geisler, Martin; Allwood, Carl Martin

    2015-01-01

    What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definiti...

  14. Decision theory on the quality evaluation of medical images

    International Nuclear Information System (INIS)

    Lessa, Patricia Silva

    2001-10-01

    The problem of quality has been a constant issue in every organization.One is always seeking to produce more, to do it at a lower cost, and to do it with better quality. However, in this country, there is no radiographic film quality control system for radiographic services. The tittle that actually gets done is essentially ad hoc and superficial. The implications of this gap, along with some other shortcomings that exist in process as a whole (the state of the x-ray equipment, the adequate to use in order to obtain a radiography, the quality of the film, the processing of the film, the brightness and homogeneity of the viewing boxes, the ability of the radiologist), have a very negative impact on the quality of the medical image, and, as result, to the quality of the medical diagnosis and therapy. It frequently happens that many radiographs have to be repeated, which leads to an increase of the patient's exposure to radiation, as well as of the cost of the procedure for the patient. Low quality radiographs that are not repeated greatly increase the probability of a wrong diagnosis, and consequently, of inadequate therapeutical procedures, thus producing increased incidence of bad outcomes and higher costs. The paradigm proposed in order to establish a system for the measurement of the image's quality is Decision Theory. The problem of the assessment of the image is studied by proposing a Decision Theory approach. The review of the literature reveals a great concern with the quality of the image, along with an absence of an adequate paradigm and several essentially empirical procedures. Image parameters are developed in order to formalize the problem in terms of Decision Theory, and various aspects of image digitalisation are exposed. Finally, a solution is presented, including a protocol for quality control. (author)

  15. Competence and Quality in Real-Life Decision Making.

    Science.gov (United States)

    Geisler, Martin; Allwood, Carl Martin

    2015-01-01

    What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definition of decision-making competence could be beneficially expanded by adding aspects of competence in terms of social skills and time-approach. The predictive power for each of these three aspects of decision-making competence was explored for different indicators of real-life decision-making success. Overall, our results suggest that research on decision-making competence would benefit by expanding the definition of competence, by including decision-related abilities in terms of social skills and time-approach. Finally, the results also indicate that individual differences in real-life decision-making success profitably can be approached and measured by different criteria.

  16. Competence and Quality in Real-Life Decision Making

    Science.gov (United States)

    2015-01-01

    What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definition of decision-making competence could be beneficially expanded by adding aspects of competence in terms of social skills and time-approach. The predictive power for each of these three aspects of decision-making competence was explored for different indicators of real-life decision-making success. Overall, our results suggest that research on decision-making competence would benefit by expanding the definition of competence, by including decision-related abilities in terms of social skills and time-approach. Finally, the results also indicate that individual differences in real-life decision-making success profitably can be approached and measured by different criteria. PMID:26545239

  17. Superintendents and Principals Need Quality Public Information That Informs Decisions, Empowers Action. Don't Make Decisions in the Dark

    Science.gov (United States)

    Data Quality Campaign, 2014

    2014-01-01

    District superintendents or school principals need to be able to access and use high-quality data to make good decisions. Often this data is collected and stored locally, but information that is publicly reported by the state can provide additional value. Although public reporting in a few states is designed to serve information needs, states'…

  18. Decision quality instrument for treatment of hip and knee osteoarthritis: a psychometric evaluation

    Directory of Open Access Journals (Sweden)

    Kearing Stephen A

    2011-07-01

    Full Text Available Abstract Background A high quality decision requires that patients who meet clinical criteria for surgery are informed about the options (including non-surgical alternatives and receive treatments that match their goals. The aim of this study was to evaluate the psychometric properties and clinical sensibility of a patient self report instrument, to measure the quality of decisions about total joint replacement for knee or hip osteoarthritis. Methods The performance of the Hip/Knee Osteoarthritis Decision Quality Instrument (HK-DQI was evaluated in two samples: (1 a cross-sectional mail survey with 489 patients and 77 providers (study 1; and (2 a randomized controlled trial of a patient decision aid with 138 osteoarthritis patients considering total joint replacement (study 2. The HK-DQI results in two scores. Knowledge items are summed to create a total knowledge score, and a set of goals and concerns are used in a logistic regression model to develop a concordance score. The concordance score measures the proportion of patients whose treatment matched their goals. Hypotheses related to acceptability, feasibility, reliability and validity of the knowledge and concordance scores were examined. Results In study 1, the HK-DQI was completed by 382 patients (79% and 45 providers (58%, and in study 2 by 127 patients (92%, with low rates of missing data. The DQI-knowledge score was reproducible (ICC = 0.81 and demonstrated discriminant validity (68% decision aid vs. 54% control, and 78% providers vs. 61% patients and content validity. The concordance score demonstrated predictive validity, as patients whose treatments were concordant with their goals had more confidence and less regret with their decision compared to those who did not. Conclusions The HK-DQI is feasible and acceptable to patients. It can be used to assess whether patients with osteoarthritis are making informed decisions about surgery that are concordant with their goals.

  19. The effect of voice quality on hiring decisions

    Directory of Open Access Journals (Sweden)

    Lea Tylečková

    2017-09-01

    Full Text Available This paper examines the effect of voice quality on hiring decisions. Considering voice quality an important tool in an individual’s self-presentation in the job market, it may very well enhance his/her job prospects, while some voice qualities may affect employers’ judgments in a negative way. Five men and five women were recorded reading four different utterances representing answers to job interviewers’ questions in four different phonation guises: modal, breathy, creaky and pressed. 38 professional employment interviewers recorded the speakers’ hireability and personality ratings (likeability, self-confidence and trustworthiness on 7-point semantic differential scales based on the speakers’ voice. The results revealed a significant effect of the phonation guises on the speakers’ ratings with the modal voice being superior to the cluster of non-modal voices. Interestingly, the non-modal guises were evaluated in a very similar way, except for the self-confidence category with the breathy voice getting the lowest scores on the one hand and the pressed voice correlating with high self-confidence ratings on the other.

  20. On the Quality of Collective Decisions in Sociotechnical Systems: Transparency, Fairness, and Efficiency

    Science.gov (United States)

    Porello, Daniele

    The aim of this paper is to propose a methodology for evaluating the quality of collective decisions in sociotechnical systems (STS). We propose using a foundational ontology for conceptualizing the complex hierarchy of information involved in decisions in STS (e.g., normative, conceptual, factual, perceptual). Moreover, we introduce the concept of transparency of decisions as a necessary condition in order to assess the quality of decision-making in STS. We further view transparency as an entitlement of the agent affected by the decision: i.e., the collective decision should be justified.

  1. Decision making in the context of business intelligence and data quality

    Directory of Open Access Journals (Sweden)

    L. Marshall

    2009-02-01

    Full Text Available delaharper@cput.ac.za Making decisions in a business intelligence (BI environment can become extremely challenging and sometimes even impossible if the data on which the decisions are based are of poor quality. It is only possible to utilise data effectively when it is accurate, up-to-date, complete and available when needed. The BI decision makers and users are in the best position to determine the quality of the data available to them. It is important to ask the right questions of them; therefore the issues of information quality in the BI environment were established through a literature study. Information-related problems may cause supplier relationships to deteriorate, reduce internal productivity and the business' confidence in IT. Ultimately it can have implications for an organisation's ability to perform and remain competitive. The purpose of this article is aimed at identifying the underlying factors that prevent information from being easily and effectively utilised and understanding how these factors can influence the decision-making process, particularly within a BI environment. An exploratory investigation was conducted at a large retail organisation in South Africa to collect empirical data from BI users through unstructured interviews. Some of the main findings indicate specific causes that impact the decisions of BI users, including accuracy, inconsistency, understandability and availability of information. Key performance measures that are directly impacted by the quality of data on decision-making include waste, availability, sales and supplier fulfilment. The time spent on investigating and resolving data quality issues has a major impact on productivity. The importance of documentation was highlighted as an important issue that requires further investigation. The initial results indicate the value of

  2. Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy.

    Science.gov (United States)

    Lee, Clara N; Wetschler, Matthew H; Chang, Yuchiao; Belkora, Jeffrey K; Moy, Beverly; Partridge, Ann; Sepucha, Karen R

    2014-08-20

    Women diagnosed with early stage (I or II) breast cancer face a highly challenging decision - whether or not to undergo adjuvant chemotherapy. We developed a decision quality instrument for chemotherapy for early stage breast cancer and sought to evaluate its performance. Cross-sectional, mailed survey of recent breast cancer survivors, providers, and healthy controls and a retest survey of survivors. The decision quality instrument includes questions on knowledge and personal goals. It results in a knowledge score and concordance score, which reflects the percentage of patients who received treatments that match their goals. Hypotheses related to acceptability, feasibility, validity, and reliability of the survey instrument were examined. Responses were received from 352 patients, 89 providers and 35 healthy controls. The decision quality instrument was feasible to implement with few missing data. The knowledge scores had good retest reliability (intraclass correlation coefficient (ICC) =0.75). Knowledge scores discriminated between providers and patients (mean difference 31.1%, 95% CI 26.9, 35.3) and between patients and healthy controls (mean difference 11.2, 95% CI 5.4, 17.1). Most providers reported that the knowledge items covered essential content. Two of the five goal items had a ceiling effect, and one goal had low content validity. The goal items had moderate retest reliability (ICC's 0.57 to 0.78). In the multivariable model of treatment, none of the patient goals was associated with receipt of chemotherapy. Age and hormone receptor status were the only variables independently associated with chemotherapy. Most patients (77.6%) had treatment concordant with that predicted by the model. Patients who had concordant treatment had similar levels of confidence and regret as those who did not. The Decision Quality Instrument is a reliable and valid measure of patient knowledge about chemotherapy, but its ability to measure concordance with patient goals is

  3. Local School Board Members Need Quality Public Information That Informs Decisions, Empowers Action. Don't Make Decisions in the Dark

    Science.gov (United States)

    Data Quality Campaign, 2014

    2014-01-01

    Local school board members need to be able to access and use high-quality data to make good decisions. Often this data is collected and stored locally, but information that is publicly reported by the state can provide additional value. Most state public reporting is designed to serve information needs, and are geared toward compliance with state…

  4. Informed Decision Making: Assessment of the Quality of Physician Communication about Prostate Cancer Diagnosis and Treatment.

    Science.gov (United States)

    Holmes-Rovner, Margaret; Montgomery, Jeffrey S; Rovner, David R; Scherer, Laura D; Whitfield, Jesse; Kahn, Valerie C; Merkle, Edgar C; Ubel, Peter A; Fagerlin, Angela

    2015-11-01

    Little is known about how physicians present diagnosis and treatment planning in routine practice in preference-sensitive treatment decisions. We evaluated completeness and quality of informed decision making in localized prostate cancer post biopsy encounters. We analyzed audio-recorded office visits of 252 men with presumed localized prostate cancer (Gleason 6 and Gleason 7 scores) who were seeing 45 physicians at 4 Veterans Affairs Medical Centers. Data were collected between September 2008 and May 2012 in a trial of 2 decision aids (DAs). Braddock's previously validated Informed Decision Making (IDM) system was used to measure quality. Latent variable models for ordinal data examined the relationship of IDM score to treatment received. Mean IDM score showed modest quality (7.61±2.45 out of 18) and high variability. Treatment choice and risks and benefits were discussed in approximately 95% of encounters. However, in more than one-third of encounters, physicians provided a partial set of treatment options and omitted surveillance as a choice. Informing quality was greater in patients treated with surveillance (β = 1.1, p = .04). Gleason score (7 vs 6) and lower age were often cited as reasons to exclude surveillance. Patient preferences were elicited in the majority of cases, but not used to guide treatment planning. Encounter time was modestly correlated with IDM score (r = 0.237, p = .01). DA type was not associated with IDM score. Physicians informed patients of options and risks and benefits, but infrequently engaged patients in core shared decision-making processes. Despite patients having received DAs, physicians rarely provided an opportunity for preference-driven decision making. More attention to the underused patient decision-making and engagement elements could result in improved shared decision making. © The Author(s) 2015.

  5. Quality of online information to support patient decision-making in breast cancer surgery.

    Science.gov (United States)

    Bruce, Jordan G; Tucholka, Jennifer L; Steffens, Nicole M; Neuman, Heather B

    2015-11-01

    Breast cancer patients commonly use the internet as an information resource. Our objective was to evaluate the quality of online information available to support patients facing a decision for breast surgery. Breast cancer surgery-related queries were performed (Google and Bing), and reviewed for content pertinent to breast cancer surgery. The DISCERN instrument was used to evaluate websites' structural components that influence publication reliability and ability of information to support treatment decision-making. Scores of 4/5 were considered "good." 45 unique websites were identified. Websites satisfied a median 5/9 content questions. Commonly omitted topics included: having a choice between breast conservation and mastectomy (67%) and potential for 2nd surgery to obtain negative margins after breast conservation (60%). Websites had a median DISCERN score of 2.9 (range 2.0-4.5). Websites achieved higher scores on structural criteria (median 3.6 [2.1-4.7]), with 24% rated as "good." Scores on supporting decision-making questions were lower (2.6 [1.3-4.4]), with only 7% scoring "good." Although numerous breast cancer-related websites exist, most do a poor job providing women with essential information necessary to actively participate in decision-making for breast cancer surgery. Providing easily- accessible, high-quality online information has the potential to significantly improve patients' experiences with decision-making. © 2015 Wiley Periodicals, Inc.

  6. What mental process favours quality decision-making in young soccer players?

    Directory of Open Access Journals (Sweden)

    Grégory Hallé Petiot

    2017-08-01

    Full Text Available Abstract Aim The aim of this research is to identify the mechanisms that lead soccer players to make quality tactical decisions, and how these mechanisms evolve over time. Methods Ninety male youth players training in a professional club in Brazil were submitted to a soccer video test which consists in making tactical decisions when the image freezes. These participants were divided in five groups with 18 players in each of following age levels: Under-11, Under-13, Under-15, Under-17 and Under-20. The dominant statements of verbal reports were distributed in categories that reflect key mechanisms. The frequency of correct tactical answers was calculated for each statement types and Standard Residuals (e were calculated to verify the influence of the mechanisms on the quality of tactical decision for each age level. Results Results revealed that evaluation statement was related to accurate tactical decisions from Under-15 age level. Conclusion In conclusion, evaluation of perceived information makes better decision makers.

  7. The Development and Validation of a Generic Instrument, QoDoS, for Assessing the Quality of Decision Making.

    Science.gov (United States)

    Donelan, Ronan; Walker, Stuart; Salek, Sam

    2016-01-01

    The impact of decision-making during the development and the regulatory review of medicines greatly influences the delivery of new medicinal products. Currently, there is no generic instrument that can be used to assess the quality of decision-making. This study describes the development of the Quality of Decision-Making Orientation Scheme QoDoS(©) instrument for appraising the quality of decision-making. Semi-structured interviews about decision-making were carried out with 29 senior decision makers from the pharmaceutical industry (10), regulatory authorities (9) and contract research organizations (10). The interviews offered a qualified understanding of the subjective decision-making approach, influences, behaviors and other factors that impact such processes for individuals and organizations involved in the delivery of new medicines. Thematic analysis of the transcribed interviews was carried out using NVivo8® software. Content validity was carried out using qualitative and quantitative data by an expert panel, which led to the developmental version of the QoDoS. Further psychometric evaluations were performed, including factor analysis, item reduction, reliability testing and construct validation. The thematic analysis of the interviews yielded a 94-item initial version of the QoDoS(©) with a 5-point Likert scale. The instrument was tested for content validity using a panel of experts for language clarity, completeness, relevance and scaling, resulting in a favorable agreement by panel members with an intra-class correlation coefficient value of 0.89 (95% confidence interval = 0.56, 0.99). A 76-item QoDoS(©) (version 2) emerged from content validation. Factor analysis produced a 47-item measure with four domains. The 47-item QoDoS(©) (version 3) showed high internal consistency (n = 120, Cronbach's alpha = 0.89), high reproducibility (n = 20, intra-class correlation = 0.77) and a mean completion time of 10 min. Reliability testing and construct

  8. Merging Air Quality and Public Health Decision Support Systems

    Science.gov (United States)

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

    2003-12-01

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

  9. [Prediction of regional soil quality based on mutual information theory integrated with decision tree algorithm].

    Science.gov (United States)

    Lin, Fen-Fang; Wang, Ke; Yang, Ning; Yan, Shi-Guang; Zheng, Xin-Yu

    2012-02-01

    In this paper, some main factors such as soil type, land use pattern, lithology type, topography, road, and industry type that affect soil quality were used to precisely obtain the spatial distribution characteristics of regional soil quality, mutual information theory was adopted to select the main environmental factors, and decision tree algorithm See 5.0 was applied to predict the grade of regional soil quality. The main factors affecting regional soil quality were soil type, land use, lithology type, distance to town, distance to water area, altitude, distance to road, and distance to industrial land. The prediction accuracy of the decision tree model with the variables selected by mutual information was obviously higher than that of the model with all variables, and, for the former model, whether of decision tree or of decision rule, its prediction accuracy was all higher than 80%. Based on the continuous and categorical data, the method of mutual information theory integrated with decision tree could not only reduce the number of input parameters for decision tree algorithm, but also predict and assess regional soil quality effectively.

  10. Bundle Pricing Decisions for Fresh Products with Quality Deterioration

    OpenAIRE

    Fang, Yan; Jiang, Yiping; Han, Xingxing

    2018-01-01

    How to sell fresh products quickly to decrease the storage cost and to meet customer quality requirement is of vital importance in the food supply chain. Bundling fresh products is an efficient strategy to promote sales and reduce storage pressure of retailers. In this paper, we consider the bundle pricing decisions for homogeneous fresh products with quality deterioration. The value of fresh products with quality deterioration is approximated as an exponential function based on which custome...

  11. The Impact of Weights on the Quality of Agricultural Producers' Multicriteria Decision Models

    Directory of Open Access Journals (Sweden)

    Agata Sielska

    2015-01-01

    Full Text Available Decisions regarding agricultural production involve multiple goals. A multicriteria approach allows decision makers to consider more aspects of the decision scenario, although it also leads to other problems, such as difficulties with the selection of goals or criteria, as well as assigning them appropriate weights. It is argued that not only do goals vary depending on the decision-makers' socioeconomic features, but their relative importance changes as well. A simulation study has been conducted based on the Farm Accountancy Data Network (FADN database. We use the distance-to-the-negative-solution maximization model. Seven sets of criteria and different sets of weights are considered. The main purpose of the study is to determine the impact of weights on the quality of the model. Quality is assessed by comparing the optimal and observed values of the decision variables. The results lead to the conclusion that the differences between the quality of various models are small. (original abstract

  12. Process quality of decision-making in multidisciplinary cancer team meetings: a structured observational study.

    Science.gov (United States)

    Hahlweg, Pola; Didi, Sarah; Kriston, Levente; Härter, Martin; Nestoriuc, Yvonne; Scholl, Isabelle

    2017-11-17

    The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation. An adaptation of the observer rating scale Multidisciplinary Tumor Board Metric for the Observation of Decision-Making (MDT-MODe) was used to assess the quality of the presented information and team processes in MDTMs. Data was analyzed using descriptive statistics and mixed logistic regression analysis. N = 249 cases were observed in N = 29 MDTMs. While cancer-specific medical information was judged to be of high quality, psychosocial information and information regarding patient views were considered to be of low quality. In 25% of the cases no, in 64% one, and in 10% more than one treatment recommendations were given (1% missing data). Giving no treatment recommendation was associated with duration of case discussion, duration of the MDTM session, quality of case history, quality of radiological information, and specialization of the MDTM. Higher levels of medical and treatment uncertainty during discussions were found to be associated with a higher probability for more than one treatment recommendation. The quality of different aspects of information was observed to differ greatly. In general, we did not find MDTMs to be in line with the principles of patient-centered care. Recommendation outcome varied substantially between different specializations of MDTMs. The quality of certain information was associated with the recommendation outcome. Uncertainty during discussions was related to more than one recommendation being considered. Time constraints

  13. The quality of instruments to assess the process of shared decision making: A systematic review

    Science.gov (United States)

    Bomhof-Roordink, Hanna; Smith, Ian P.; Scholl, Isabelle; Stiggelbout, Anne M.; Pieterse, Arwen H.

    2018-01-01

    Objective To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. Methods In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. Results We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Conclusions Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument’s content and characteristics such as the perspective that they assess. We recommend refinement and validation of

  14. The effects of diversity faultlines and team task autonomy on decision quality and social integration

    NARCIS (Netherlands)

    Rico, Ramon; Molleman, Eric; Sanchez-Manzanares, Miriam; Van der Vegt, Gerben S.

    This study examines the effects of diversity faultlines stemming from educational background and conscientiousness on team decision quality and social integration and the moderating role of team task autonomy. Using a 2 x 2 (Weak/Strong Faultlines x Low/High Team Task Autonomy) factorial design, 52

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

    Science.gov (United States)

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

    2015-01-07

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

  16. Quality and Pricing Decisions in a Two-Echelon Supply Chain with Nash Bargaining Fairness Concerns

    Directory of Open Access Journals (Sweden)

    Ji-cai Li

    2018-01-01

    Full Text Available Product quality and pricing, as the important competitive tools, play a key role in attracting consumers. In a supply chain, the decisions on product quality and pricing are usually interlinked and would influence the cooperation relation between the members, especially when they are fairness-concerned and have different bargaining power. However, linking the quality and pricing decisions to the decision-makers’ behavioral factors such as fairness concern draws a little attention in the literature of supply chain management. This paper incorporates the members’ fairness preference and bargaining power into the product quality and pricing decisions in a two-echelon supply chain, where the supplier offers core components with a certain quality level to the downstream manufacturer, who subsequently sells the final products in the end market. Both the supplier and the manufacturer are assumed to be fairness-concerned by adopting Nash bargaining solutions as their fairness reference points. We use game-theoretic models to analyze the equilibrium product quality and pricing strategies under the setting of integrated and decentralized supply chain, respectively. Detailed comparisons and sensitivity analysis are further conducted to examine the impacts of members’ strengths of fairness concern, bargaining power, and decision structure on their equilibrium product quality and pricing strategies and corresponding payoffs.

  17. Automatic evidence quality prediction to support evidence-based decision making.

    Science.gov (United States)

    Sarker, Abeed; Mollá, Diego; Paris, Cécile

    2015-06-01

    Evidence-based medicine practice requires practitioners to obtain the best available medical evidence, and appraise the quality of the evidence when making clinical decisions. Primarily due to the plethora of electronically available data from the medical literature, the manual appraisal of the quality of evidence is a time-consuming process. We present a fully automatic approach for predicting the quality of medical evidence in order to aid practitioners at point-of-care. Our approach extracts relevant information from medical article abstracts and utilises data from a specialised corpus to apply supervised machine learning for the prediction of the quality grades. Following an in-depth analysis of the usefulness of features (e.g., publication types of articles), they are extracted from the text via rule-based approaches and from the meta-data associated with the articles, and then applied in the supervised classification model. We propose the use of a highly scalable and portable approach using a sequence of high precision classifiers, and introduce a simple evaluation metric called average error distance (AED) that simplifies the comparison of systems. We also perform elaborate human evaluations to compare the performance of our system against human judgments. We test and evaluate our approaches on a publicly available, specialised, annotated corpus containing 1132 evidence-based recommendations. Our rule-based approach performs exceptionally well at the automatic extraction of publication types of articles, with F-scores of up to 0.99 for high-quality publication types. For evidence quality classification, our approach obtains an accuracy of 63.84% and an AED of 0.271. The human evaluations show that the performance of our system, in terms of AED and accuracy, is comparable to the performance of humans on the same data. The experiments suggest that our structured text classification framework achieves evaluation results comparable to those of human performance

  18. Management of safety and quality and the relationship with employee decisions in country grain elevators.

    Science.gov (United States)

    Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

    2012-07-01

    Human factors play an important role in the management of safety and quality in an agricultural work environment. Although employee actions and decisions have been identified as a key component of successful occupational safety programs and quality management programs, little attention has been given to the employees' role in these types of programs. This research explored two safety relationships that have theoretical connections but little previous research: the relationship between safety climate and quality climate, and the relationship of the safety and quality climates between the organizational level and the group level within a workplace. Survey data were collected at three commercial grain handling facilities from 177 employees. Employees also participated in safety and quality decision-making simulations. Significant positive predictions were noted for safety and quality climate. Decision-making predictions are also discussed. This research suggests that organizational safety is an important predictor of group safety. In addition, recognizing the larger role that supervisors play in group workplace behavior, more should be done to increase employee perceptions of group-level involvement in quality climate to promote more quality-oriented decision-making by employees.

  19. Two-echelon logistics service supply chain decision game considering quality supervision

    Science.gov (United States)

    Shi, Jiaying

    2017-10-01

    Due to the increasing importance of supply chain logistics service, we established the Stackelberg game model between single integrator and single subcontractors under decentralized and centralized circumstances, and found that logistics services integrators as a leader prefer centralized decision-making but logistics service subcontractors tend to the decentralized decision-making. Then, we further analyzed why subcontractor chose to deceive and rebuilt a principal-agent game model to monitor the logistics services quality of them. Mixed Strategy Nash equilibrium and related parameters were discussed. The results show that strengthening the supervision and coordination can improve the quality level of logistics service supply chain.

  20. Does empowering resident families or nursing home employees in decision making improve service quality?

    Science.gov (United States)

    Hamann, Darla J

    2014-08-01

    This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

  1. A quality-of-data aware mobile decision support system for patients with chronic illnesses

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; van Schooten, B.W.; Shalom, Erez; Fung, L.S.N.; van Sinderen, Marten J.; Hermens, Hermanus J.; Jones, Valerie M.; Riano, David; Lenz, Richard; Miksch, Silvia; Peleg, Mor; Reichert, M.U.; ten Teije, Annette

    2015-01-01

    We present a mobile decision support system (mDSS) which runs on a patient Body Area Network consisting of a smartphone and a set of biosensors. Quality-of-Data (QoD) awareness in decision making is achieved by means of a component known as the Quality-of-Data Broker, which also runs on the

  2. Measuring decision quality: psychometric evaluation of a new instrument for breast cancer surgery

    Directory of Open Access Journals (Sweden)

    Sepucha Karen R

    2012-06-01

    Full Text Available Abstract Background The purpose of this paper is to examine the acceptability, feasibility, reliability and validity of a new decision quality instrument that assesses the extent to which patients are informed and receive treatments that match their goals. Methods Cross-sectional mail survey of recent breast cancer survivors, providers and healthy controls and a retest survey of survivors. The decision quality instrument includes knowledge questions and a set of goals, and results in two scores: a breast cancer surgery knowledge score and a concordance score, which reflects the percentage of patients who received treatments that match their goals. Hypotheses related to acceptability, feasibility, discriminant validity, content validity, predictive validity and retest reliability of the survey instrument were examined. Results We had responses from 440 eligible patients, 88 providers and 35 healthy controls. The decision quality instrument was feasible to implement in this study, with low missing data. The knowledge score had good retest reliability (intraclass correlation coefficient = 0.70 and discriminated between providers and patients (mean difference 35%, p  Conclusions The decision quality instrument met the criteria of feasibility, reliability, discriminant and content validity in this sample. Additional research to examine performance of the instrument in prospective studies and more diverse populations is needed.

  3. Is patient autonomy a critical determinant of quality of life in Korea? End-of-life decision making from the perspective of the patient.

    Science.gov (United States)

    Mo, Ha Na; Shin, Dong Wook; Woo, Jae Ha; Choi, Jin Young; Kang, Jina; Baik, Young Ji; Huh, Yu Rae; Won, Joo Hee; Park, Myung Hee; Cho, Sang Hee

    2012-04-01

    We aimed to investigate the current practice of the involvement in decision making from the perspectives of terminal cancer patients, and to explore its possible associations with quality of life and quality of death in Korea. A multi-center, cross-sectional survey was performed on 93 terminal cancer patients. The questionnaire solicited their opinions regarding participation in treatment decision making, as well as quality of life (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire for Palliative Care) and quality of death (Good Death Inventory-Patient Version). A total of 78.5% of the patients had awareness of their terminal status, while 21.5% did not; 42.4% stated that they knew their condition and shared the decision-making responsibility with the medical staff and their family, while 21.7% made decisions on their own, and 35.9% left the decision-making responsibility to others. Patients who were aware of their illness and who actively participated in the decision making did not score higher than others on outcome measures of quality of life and quality of death. Moreover, the former even showed lower scores in some domains, including the 'physical and psychological comfort' (4.99 versus 5.61, p = 0.03), 'environmental comfort' (5.51 versus 6.04, p = 0.08), and 'emotional functioning' (55.70 versus 71.01, p = 0.06). in Korea, patient autonomy is not a universally accepted value from the perspectives of terminal cancer patients, nor is patient involvement in decision making always conducive to high quality of life or quality of death. The level of information and the pace at which it is provided should be tailored to each individual's ability, preference, need, and culture.

  4. The Effect of Brand Equity and Prodcut Quality Toward Consumer's Purchase Decision (Case Study: J.co Donuts & Coffee Manado)

    OpenAIRE

    Kiling, Christika; Tumewu, Ferdinand F. J

    2017-01-01

    Purchasing decisions are in the stage of the buyer decision-making process in which consumer actually buy. Some of the factors that influence consumer purchase decisions are brand equity and product quality. This research aimed to analyze simultaneously and partially effect of brand equity and product quality toward consumer purchase decision of J.CO Donuts & Coffee Manado. Theories supporting research are brand equity, product quality and purchase decision. The population refers to J.CO Donu...

  5. Design decisions in workflow management and quality of work.

    NARCIS (Netherlands)

    Waal, B.M.E. de; Batenburg, R.

    2009-01-01

    In this paper, the design and implementation of a workflow management (WFM) system in a large Dutch social insurance organisation is described. The effect of workflow design decisions on the quality of work is explored theoretically and empirically, using the model of Zur Mühlen as a frame of

  6. The neuropeptide oxytocin enhances information sharing and group decision making quality

    OpenAIRE

    De, Wilde T.R.W.; Ten, Velden F.S.; De, Dreu C.K.W.

    2017-01-01

    Groups can make better decisions than individuals when members cooperatively exchange and integrate their uniquely held information and insights. However, under conformity pressures group members are biased towards exchanging commonly known information, and away from exchanging unique information, thus undermining group decision-making quality. At the neurobiological level, conformity associates with the neuropeptide oxytocin. A double-blind placebo controlled study found no evidence for oxyt...

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

    Directory of Open Access Journals (Sweden)

    Kihlgren Mona

    2007-04-01

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

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

    Science.gov (United States)

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

    2007-04-10

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

  9. Robust Decision Making to Support Water Quality Climate Adaptation: a Case Study in the Chesapeake Bay Watershed

    Science.gov (United States)

    Fischbach, J. R.; Lempert, R. J.; Molina-Perez, E.

    2017-12-01

    The U.S. Environmental Protection Agency (USEPA), together with state and local partners, develops watershed implementation plans designed to meet water quality standards. Climate uncertainty, along with uncertainty about future land use changes or the performance of water quality best management practices (BMPs), may make it difficult for these implementation plans to meet water quality goals. In this effort, we explored how decision making under deep uncertainty (DMDU) methods such as Robust Decision Making (RDM) could help USEPA and its partners develop implementation plans that are more robust to future uncertainty. The study focuses on one part of the Chesapeake Bay watershed, the Patuxent River, which is 2,479 sq km in area, highly urbanized, and has a rapidly growing population. We simulated the contribution of stormwater contaminants from the Patuxent to the overall Total Maximum Daily Load (TMDL) for the Chesapeake Bay under multiple scenarios reflecting climate and other uncertainties. Contaminants considered included nitrogen, phosphorus, and sediment loads. The assessment included a large set of scenario simulations using the USEPA Chesapeake Bay Program's Phase V watershed model. Uncertainties represented in the analysis included 18 downscaled climate projections (based on 6 general circulation models and 3 emissions pathways), 12 land use scenarios with different population projections and development patterns, and alternative assumptions about BMP performance standards and efficiencies associated with different suites of stormwater BMPs. Finally, we developed cost estimates for each of the performance standards and compared cost to TMDL performance as a key tradeoff for future water quality management decisions. In this talk, we describe how this research can help inform climate-related decision support at USEPA's Chesapeake Bay Program, and more generally how RDM and other DMDU methods can support improved water quality management under climate

  10. Analytical performance, reference values and decision limits. A need to differentiate between reference intervals and decision limits and to define analytical quality specifications

    DEFF Research Database (Denmark)

    Petersen, Per Hyltoft; Jensen, Esther A; Brandslund, Ivan

    2012-01-01

    of the values of analytical components measured on reference samples from reference individuals. Decision limits are based on guidelines from national and international expert groups defining specific concentrations of certain components as limits for decision about diagnosis or well-defined specific actions....... Analytical quality specifications for reference intervals have been defined for bias since the 1990s, but in the recommendations specified in the clinical guidelines analytical quality specifications are only scarcely defined. The demands for negligible biases are, however, even more essential for decision...... limits, as the choice is no longer left to the clinician, but emerge directly from the concentration. Even a small bias will change the number of diseased individuals, so the demands for negligible biases are obvious. A view over the analytical quality as published gives a variable picture of bias...

  11. 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...

  12. Patient Decision Aids Improve Decision Quality and Patient Experience and Reduce Surgical Rates in Routine Orthopaedic Care: A Prospective Cohort Study.

    Science.gov (United States)

    Sepucha, Karen; Atlas, Steven J; Chang, Yuchiao; Dorrwachter, Janet; Freiberg, Andrew; Mangla, Mahima; Rubash, Harry E; Simmons, Leigh H; Cha, Thomas

    2017-08-02

    Patient decision aids are effective in randomized controlled trials, yet little is known about their impact in routine care. The purpose of this study was to examine whether decision aids increase shared decision-making when used in routine care. A prospective study was designed to evaluate the impact of a quality improvement project to increase the use of decision aids for patients with hip or knee osteoarthritis, lumbar disc herniation, or lumbar spinal stenosis. A usual care cohort was enrolled before the quality improvement project and an intervention cohort was enrolled after the project. Participants were surveyed 1 week after a specialist visit, and surgical status was collected at 6 months. Regression analyses adjusted for clustering of patients within clinicians and examined the impact on knowledge, patient reports of shared decision-making in the visit, and surgical rates. With 550 surveys, the study had 80% to 90% power to detect a difference in these key outcomes. The response rates to the 1-week survey were 70.6% (324 of 459) for the usual care cohort and 70.2% (328 of 467) for the intervention cohort. There was no significant difference (p > 0.05) in any patient characteristic between the 2 cohorts. More patients received decision aids in the intervention cohort at 63.6% compared with the usual care cohort at 27.3% (p = 0.007). Decision aid use was associated with higher knowledge scores, with a mean difference of 18.7 points (95% confidence interval [CI], 11.4 to 26.1 points; p < 0.001) for the usual care cohort and 15.3 points (95% CI, 7.5 to 23.0 points; p = 0.002) for the intervention cohort. Patients reported more shared decision-making (p = 0.009) in the visit with their surgeon in the intervention cohort, with a mean Shared Decision-Making Process score (and standard deviation) of 66.9 ± 27.5 points, compared with the usual care cohort at 62.5 ± 28.6 points. The majority of patients received their preferred treatment, and this did not differ

  13. Design of environmental decision support system and its application to water quality management

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    EDSS is a comprehensive software system for water quality management in tidal river networks in general and for the Pearl River Delta in particular. Its purpose is to provide a practical tool that could assist government agencies in decision making for the efficient management of water resources in terms of both quantity and quality. By combining the capabilities of geographical information system (GIS), database management system (DBMS), model base management system (MBMS) and expert system, the aim is to improve the quality of decision making in what is becoming an increasingly complex area. This paper first outlines the basic concepts and philosophy adopted in developing EDSS, the system architecture, design features, implementation techniques and facilities provided. Thereafter, the core part of the system the hydrodynamic and water quality models are described briefly. The final contribution in this paper describes the application of EDSS to the Pearl River Delta, which has the most complicated tidal river network patterns as well as the fastest economic development in the world. Examples are given of the real-world problems that can be addressed using the system, including cross-boundary water pollution analysis, regional drinking water take-up site selection, screening of important polluters, environmental impact assessment, and water quality zoning and planning. It is illustrated that EDSS can provide efficient and scientific analytical tools for planning and decision-making purposes in the information era.

  14. The Neuropeptide Oxytocin Enhances Information Sharing and Group Decision Making Quality.

    Science.gov (United States)

    De Wilde, Tim R W; Ten Velden, Femke S; De Dreu, Carsten K W

    2017-01-11

    Groups can make better decisions than individuals when members cooperatively exchange and integrate their uniquely held information and insights. However, under conformity pressures group members are biased towards exchanging commonly known information, and away from exchanging unique information, thus undermining group decision-making quality. At the neurobiological level, conformity associates with the neuropeptide oxytocin. A double-blind placebo controlled study found no evidence for oxytocin induced conformity. Compared to placebo groups, three-person groups whose members received intranasal oxytocin, focused more on unique information (i) and repeated this information more often (ii). These findings reveal oxytocin as a neurobiological driver of group decision-making processes.

  15. DEMAND AND QUALITY UNCERTAINTY IN PECAN PURCHASING DECISIONS

    OpenAIRE

    Park, Timothy A.; Florkowski, Wojciech J.

    1996-01-01

    A generalized Heckman model of purchase decisions incorporating perceived consumer quality attributes, ease of purchase, and familiarity with marketing outlets as factors influencing pecan purchases is estimated. Marketing efforts that encourage consumers to expand expenditures on nut products increase both the probability of pecan purchases and the amount purchased. Consumers who use all types of nuts in a wider variety of foods tend to purchase pecans more frequently. A diverse set of marke...

  16. Applying Machine Learning and High Performance Computing to Water Quality Assessment and Prediction

    Directory of Open Access Journals (Sweden)

    Ruijian Zhang

    2017-12-01

    Full Text Available Water quality assessment and prediction is a more and more important issue. Traditional ways either take lots of time or they can only do assessments. In this research, by applying machine learning algorithm to a long period time of water attributes’ data; we can generate a decision tree so that it can predict the future day’s water quality in an easy and efficient way. The idea is to combine the traditional ways and the computer algorithms together. Using machine learning algorithms, the assessment of water quality will be far more efficient, and by generating the decision tree, the prediction will be quite accurate. The drawback of the machine learning modeling is that the execution takes quite long time, especially when we employ a better accuracy but more time-consuming algorithm in clustering. Therefore, we applied the high performance computing (HPC System to deal with this problem. Up to now, the pilot experiments have achieved very promising preliminary results. The visualized water quality assessment and prediction obtained from this project would be published in an interactive website so that the public and the environmental managers could use the information for their decision making.

  17. Quality Dimensions of Purchase Behavior Decision on Fishery Products

    Directory of Open Access Journals (Sweden)

    Nurliza Nurliza

    2017-08-01

    Full Text Available The role of fishery product has been developed and acknowledged in terms of food security both as income sources and food supplies for developing countries. On the other hand, quality control has become a challenge in overcoming consumers’ decision to purchase the products. The objective of research is to understand and evaluate consumer behavior in purchasing the products in regards to quality dimension on fishery products by using non-probability sampling technique to 142 consumers in three different locations in Pontianak (shops, mini/supermarkets, and local markets. Data were gathered by in-depth interviews divided into four categories consisting of consumer profiles; product knowledge; perception and preference; and quality dimension variable with conjoint analysis. The result shows that price, flavor, moistness, texture, nutrition, packaging color, and packaging size do not affect consumers’ decision to purchase the products. On the contrary, package durability attribute is the primary factor in their decision to purchase, and it is then followed by packaging material, availability, flavor, guarantee, guarantee source, brand, packaging form, and product form. This is beneficial for producers to improve the quality factors and develop market opportunities in the future. Besides, consumers can obtain information on product characteristics to fulfill their expectation and satisfaction.Keywords: conjoint analysis, fishery products, non-probability sampling, purchase behavior, quality dimensionsABSTRAKPeran produk olahan perikanan telah berkembang dan diakui dalam keamanan pangan–baik sebagai sumber pendapatan maupun sumber makanan bagi negara-negara berkembang. Namun, pengendalian terhadap karakteristik mutu menjadi sebuah tantangan dalam menghadapi keputusan pembelian konsumen. Tujuan penelitian adalah memahami dan mengevaluasi perilaku keputusan pembelian konsumen terkait dimensi mutu pada produk olahan perikanan menggunakan teknik non

  18. Staff Involvement in Leadership Decision Making in the UK Further Education Sector: Perceptions of Quality and Social Justice

    Science.gov (United States)

    Maringe, Felix

    2012-01-01

    Purpose: The purpose of the paper is to explore the quality of leadership decision making at various leadership levels in the further education (FE) sector. Using Hoffberg and Korver's model for integrated decision making, the paper aims to examine how staff in five UK FE colleges perceive the quality of their involvement in decision-making teams…

  19. Impact of Risk Aversion on Price and Quality Decisions under Demand Uncertainty via the CARA Utility Function

    Directory of Open Access Journals (Sweden)

    Qinqin Li

    2014-01-01

    Full Text Available This paper investigates optimal price and quality decisions of a manufacturer-retailer supply chain under demand uncertainty, in which players are both risk-averse decision makers. The manufacturer determines the wholesale price and quality of the product, and the retailer determines the retail price. By means of game theory, we employ the constant absolute risk aversion (CARA function to analyze two different supply chain structures, that is, manufacturer Stackelberg model (MS and retailer Stackelberg model (RS. We then analyze the results to explore the effects of risk aversion of the manufacturer and the retailer upon the equilibrium decisions. Our results imply that both the risk aversion of the manufacturer and the retailer play an important role in the price and quality decisions. We find that, in general, in MS and RS models, the optimal wholesale price and quality decrease with the risk aversion of the manufacturer but increase with the risk aversion of the retailer, while the retail price decreases with the risk aversion of the manufacturer as well as the retailer. We also examine the impact of quality cost coefficient on the optimal decisions. Finally, numerical examples are presented to illustrate the different degree of effects of players’ risk aversion on equilibrium results and to compare results in different models considered.

  20. GLIMPSE: A decision support tool for simultaneously achieving our air quality management and climate change mitigation goals

    Science.gov (United States)

    Pinder, R. W.; Akhtar, F.; Loughlin, D. H.; Henze, D. K.; Bowman, K. W.

    2012-12-01

    Poor air quality, ecosystem damages, and climate change all are caused by the combustion of fossil fuels, yet environmental management often addresses each of these challenges separately. This can lead to sub-optimal strategies and unintended consequences. Here we present GLIMPSE -- a decision support tool for simultaneously achieving our air quality and climate change mitigation goals. GLIMPSE comprises of two types of models, (i) the adjoint of the GEOS-Chem chemical transport model, to calculate the relationship between emissions and impacts at high spatial resolution, and (ii) the MARKAL energy system model, to calculate the relationship between energy technologies and emissions. This presentation will demonstrate how GLIMPSE can be used to explore energy scenarios to better achieve both improved air quality and mitigate climate change. Second, this presentation will discuss how space-based observations can be incorporated into GLIMPSE to improve decision-making. NASA satellite products, namely ozone radiative forcing from the Tropospheric Emission Spectrometer (TES), are used to extend GLIMPSE to include the impact of emissions on ozone radiative forcing. This provides a much needed observational constraint on ozone radiative forcing.

  1. Fuzzy Modeled K-Cluster Quality Mining of Hidden Knowledge for Decision Support

    OpenAIRE

    S. Parkash  Kumar; K. S. Ramaswami

    2011-01-01

    Problem statement: The work presented Fuzzy Modeled K-means Cluster Quality Mining of hidden knowledge for Decision Support. Based on the number of clusters, number of objects in each cluster and its cohesiveness, precision and recall values, the cluster quality metrics is measured. The fuzzy k-means is adapted approach by using heuristic method which iterates the cluster to form an efficient valid cluster. With the obtained data clusters, quality assessment is made by predictive mining using...

  2. Use of quality information in decision-making about health and social care services--a systematic review.

    Science.gov (United States)

    Turnpenny, Agnes; Beadle-Brown, Julie

    2015-07-01

    User choice and personalisation have been at the centre of health and social care policies in many countries. Exercising choice can be especially challenging for people with long-term conditions (LTC) or disabilities. Information about the quality, cost and availability of services is central to user choice. This study used systematic review methods to synthesise evidence in three main areas: (i) how people with LTC or disabilities and their family carers find and access information about the quality of services; (ii) how quality information is used in decision-making; and (iii) what type of quality information is most useful. Quality information was defined broadly and could include formal quality reports (e.g. inspection reports, report cards, etc.), information about the characteristics of a service or provider (e.g. number and qualifications of staff, facilities, etc.) and informal reports about quality (e.g. personal experience, etc.). Literature searches were carried out using electronic databases in January 2012. Thirteen papers reporting findings from empirical studies published between 2001 and 2012 were included in the review. The majority of papers (n = 9) had a qualitative design. The analysis highlighted the use of multiple sources of information in decision-making about services and in particular the importance of informal sources and extended social networks in accessing information. There is limited awareness and use of 'official' and online information sources. Service users or family carers place greater emphasis on general information and structural indicators. Clinical or quality-of-life outcomes are often difficult to interpret and apply. Trust emerged a key issue in relation to quality information. Experiential and subjective information is highly valued and trusted. Various barriers to the effective use of quality information in making choices about services are identified. Implications for policy and future research are discussed. © 2014

  3. Taking the Next Step: Using Water Quality Data in a Decision Support System for County, State, and Federal Land Managers

    Science.gov (United States)

    Raby, K. S.; Williams, M. W.

    2004-12-01

    Each passing year amplifies the demands placed on communities across the US in terms of population growth, increased tourism, and stresses resulting from escalated use. The conflicting concerns of recreational users, local citizens, environmentalists, and traditional economic interests cause land managers to contend with controversial decisions regarding development and protection of watersheds. Local history and culture, politics, economic goals, and science are all influential factors in land use decision making. Here we report on a scientific study to determine the sensitivity of alpine areas, and the adaptation of this study into a decision support framework. We use water quality data as an indicator of ecosystem health across a variety of alpine and subalpine landscapes, and input this information into a spatially-based decision support tool that planners can use to make informed land use decisions. We develop this tool in a case study in San Juan County, Colorado, a site chosen because its largest town, Silverton, is a small mountain community experiencing a recent surge in tourism and development, and its fragile high elevation locale makes it more sensitive to environmental changes. Extensive field surveys were conducted in priority drainages throughout the county to map the spatial distribution and aerial extent of landscape types during the summers of 2003 and 2004. Surface water samples were collected and analyzed for inorganic and organic solutes, and water quality values were associated with different land covers to enable sensitivity analysis at the landscape scale. Water quality results for each watershed were entered into a module linked to a geographic information system (GIS), which displays maps of sensitive areas based on criteria selected by the user. The decision support system initially incorporates two major water quality parameters: acid neutralizing capacity (ANC) and nitrate (NO3-) concentration, and several categories of sensitivity were

  4. 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…

  5. Unicompartmental knee arthroplasty MRI: impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision

    International Nuclear Information System (INIS)

    Agten, Christoph A.; Pfirrmann, Christian W.A.; Sutter, Reto; Grande, Filippo del; Fucentese, Sandro F.; Blatter, Samuel

    2015-01-01

    To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. SEMAC reduced mean artefact size for STIR (11.8 cm 2 vs. 37.7 cm 2 ) and PD (16.8 cm 2 vs. 18.9 cm 2 ), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons' decisions towards surgery, while PD-SEMAC showed no clinical benefit. (orig.)

  6. Development and evaluation of a new survey instrument to measure the quality of colorectal cancer screening decisions.

    Science.gov (United States)

    Sepucha, Karen R; Feibelmann, Sandra; Cosenza, Carol; Levin, Carrie A; Pignone, Michael

    2014-08-20

    Guidelines for colorectal cancer screening recommend that patients be informed about options and be able to select preferred method of screening; however, there are no existing measures available to assess whether this happens. Colorectal Cancer Screening Decision Quality Instrument (CRC-DQI) includes knowledge items and patients' goals and concerns. Items were generated through literature review and qualitative work with patients and providers. Hypotheses relating to the acceptability, feasibility, discriminant validity and retest reliability of the survey were examined using data from three studies: (1) 2X2 randomized study of participants recruited online, (2) cross-sectional sample of patients recruited in community health clinics, and (3) cross-sectional sample of providers recruited from American Medical Association Master file. 338 participants were recruited online, 94 participants were recruited from community health centers, and 115 physicians were recruited. The CRC-DQI was feasible and acceptable with low missing data and high response rates for both online and paper-based administrations. The knowledge score was able to discriminate between those who had seen a decision aid or not (84% vs. 64%, p quality decisions about colon cancer screening.

  7. On the Cost-vs-Quality Tradeoff in Make-or-Buy Decisions

    OpenAIRE

    Andersson, Fredrik

    2010-01-01

    The make-or-buy decision is analyzed in a simple two-task principal-agent model. There is a cost-saving/quality tradeoff in effort provision. The principal faces a dichotomous choice between weak ("make") and strong ("buy") cost-saving incentives for the agent; the dichotomy is due to an incomplete-contracting limitation necessitating that one party be residual claimant. Choosing "buy" rather than "make" leads to higher cost-saving effort and -- in a plausible "main case" -- to lower quality ...

  8. A staffing decision support methodology using a quality loss function : a cross-disciplinary quantitative study

    NARCIS (Netherlands)

    Mincsovics, G.Z.

    2009-01-01

    Background Understanding the quality loss implications of short staffing is essential in maintaining service quality on a limited budget. Objectives For elaborate financial control on staffing decisions, it is necessary to quantify the cost of the incidental quality loss that a given workload and

  9. Make or buy decision model with multi-stage manufacturing process and supplier imperfect quality

    Science.gov (United States)

    Pratama, Mega Aria; Rosyidi, Cucuk Nur

    2017-11-01

    This research develops an make or buy decision model considering supplier imperfect quality. This model can be used to help companies make the right decision in case of make or buy component with the best quality and the least cost in multistage manufacturing process. The imperfect quality is one of the cost component that must be minimizing in this model. Component with imperfect quality, not necessarily defective. It still can be rework and used for assembly. This research also provide a numerical example and sensitivity analysis to show how the model work. We use simulation and help by crystal ball to solve the numerical problem. The sensitivity analysis result show that percentage of imperfect generally not affect to the model significantly, and the model is not sensitive to changes in these parameters. This is because the imperfect cost are smaller than overall total cost components.

  10. Dynamic Game Behavior of Retailers Considering the Quality of Substitute Products Based on Delay Decision

    Science.gov (United States)

    Bao, Binshuo; Ma, Junhai

    2017-12-01

    Motivated by the Silk Road Economic Belt and the 21st-Century Maritime Silk Road project, i.e. the Belt and Road (B&R), more goods will flow around the world. With this trading platform, people can buy products at relatively cheap prices, and it is easier for people to buy various goods. The quality and quantity of products thus attract more and more attention in the supply chains. This paper discusses the quantity decision by considering the product quality in parallel supply chains where two manufacturers produce substitute products and then sell them to their downstream retailers separately. In terms of the changing quantity, as well as the different quality, this paper establishes a dynamic game model to explore the dynamic behavior when the optimal profits of two retailers have been calculated. The dynamic behaviors of the system, such as stable region, bifurcation and chaos, strange attractors and the largest Lyapunov exponents (LLE) are analyzed. The effect of the quantity adjustment parameter on the stability of the supply chain system is investigated through numerical simulations. Furthermore, a dynamic game model is established based on the quality delay decision, to investigate the influence of the quality delay parameter on the dynamic game model and the profits. Finally, the optimal decisions are obtained and analyzed.

  11. Unicompartmental knee arthroplasty MRI: impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision

    Energy Technology Data Exchange (ETDEWEB)

    Agten, Christoph A.; Pfirrmann, Christian W.A.; Sutter, Reto [Balgrist University Hospital, Radiology Department, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Grande, Filippo del [Regional Hospital, Radiology, Lugano (Switzerland); Fucentese, Sandro F.; Blatter, Samuel [University of Zurich, Faculty of Medicine, Zurich (Switzerland); Balgrist University Hospital, Orthopedics, Zurich (Switzerland)

    2015-07-15

    To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. SEMAC reduced mean artefact size for STIR (11.8 cm{sup 2} vs. 37.7 cm{sup 2}) and PD (16.8 cm{sup 2} vs. 18.9 cm{sup 2}), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons' decisions towards surgery, while PD-SEMAC showed no clinical benefit. (orig.)

  12. The Effects Of Decision Framing Influences On Decision Performance

    OpenAIRE

    David Shelby Harrison; Sanela Porca

    2011-01-01

    This study investigates the effects of two components of decision framing [commitment and verbalization] in decision optimization, and how information quality impacts framing effects on decision performance. The theory of cognitive dissonance predicts that commitment to a decision will foster insensitivity to alternative choices. We find that such bias can be beneficial in certain decision strategies, and more powerfully influential as information quality worsens. We used an interactive compu...

  13. Small, Task-Oriented Groups: Conflict, Conflict Management, Satisfaction, and Decision Quality.

    Science.gov (United States)

    Wall, Victor D., Jr.; And Others

    1987-01-01

    Examined relationship among amount of conflict experienced, the style of its management, individual satisfaction, and decision quality of small, task-oriented groups using 129 college student subjects in 24 groups. Data suggest a curvilinear relationship between the number of conflict episodes experienced by group members and the subsequent…

  14. Instructional decision making of high school science teachers

    Science.gov (United States)

    Carver, Jeffrey S.

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

  15. Parental Decision Making about Technology and Quality in Child Care Programs

    Science.gov (United States)

    Rose, Katherine K.; Vittrup, Brigitte; Leveridge, Tinney

    2013-01-01

    Background: This study investigated parental decision making about non-parental child care programs based on the technological and quality components of the program, both child-focused and parent-focused. Child-focused variables related to children's access to technology such as computers, educational television programming, and the internet.…

  16. Evaluating Quality of Decision-Making Processes in Medicines' Development, Regulatory Review, and Health Technology Assessment: A Systematic Review of the Literature.

    Science.gov (United States)

    Bujar, Magdalena; McAuslane, Neil; Walker, Stuart R; Salek, Sam

    2017-01-01

    Introduction: Although pharmaceutical companies, regulatory authorities, and health technology assessment (HTA) agencies have been increasingly using decision-making frameworks, it is not certain whether these enable better quality decision making. This could be addressed by formally evaluating the quality of decision-making process within those organizations. The aim of this literature review was to identify current techniques (tools, questionnaires, surveys, and studies) for measuring the quality of the decision-making process across the three stakeholders. Methods: Using MEDLINE, Web of Knowledge, and other Internet-based search engines, a literature review was performed to systematically identify techniques for assessing quality of decision making in medicines development, regulatory review, and HTA. A structured search was applied using key words and a secondary review was carried out. In addition, the measurement properties of each technique were assessed and compared. Ten Quality Decision-Making Practices (QDMPs) developed previously were then used as a framework for the evaluation of techniques identified in the review. Due to the variation in studies identified, meta-analysis was inappropriate. Results: This review identified 13 techniques, where 7 were developed specifically to assess decision making in medicines' development, regulatory review, or HTA; 2 examined corporate decision making, and 4 general decision making. Regarding how closely each technique conformed to the 10 QDMPs, the 13 techniques assessed a median of 6 QDMPs, with a mode of 3 QDMPs. Only 2 techniques evaluated all 10 QDMPs, namely the Organizational IQ and the Quality of Decision Making Orientation Scheme (QoDoS), of which only one technique, QoDoS could be applied to assess decision making of both individuals and organizations, and it possessed generalizability to capture issues relevant to companies as well as regulatory authorities. Conclusion: This review confirmed a general

  17. The Influence of Marketing Mix and Service Quality on Corporate Reputation and Its Impact on Repurchase Decision

    OpenAIRE

    Bastaman, Aam; Royyansyah, Mufti

    2017-01-01

    . Retail business is a growing Industry in Indonesia. Among others there aretwo important variables in retail business: Marketing mix and service quality. Thisresearch are aimed first to know and to analysis the influence of marketing mix andservice quality on corporate reputation and its impact on repurchase decision directlyand indirectly. Secondly, to analysis which variables affect mostly on corporatereputation and on repurchase decision. The research approaches using quantitativeapproach...

  18. Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

    Science.gov (United States)

    Staszewska, Anna; Zaki, Pearl; Lee, Joon

    2017-10-06

    Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious

  19. Improving Breast Cancer Surgical Treatment Decision Making: The iCanDecide Randomized Clinical Trial.

    Science.gov (United States)

    Hawley, Sarah T; Li, Yun; An, Lawrence C; Resnicow, Kenneth; Janz, Nancy K; Sabel, Michael S; Ward, Kevin C; Fagerlin, Angela; Morrow, Monica; Jagsi, Reshma; Hofer, Timothy P; Katz, Steven J

    2018-03-01

    Purpose This study was conducted to determine the effect of iCanDecide, an interactive and tailored breast cancer treatment decision tool, on the rate of high-quality patient decisions-both informed and values concordant-regarding locoregional breast cancer treatment and on patient appraisal of decision making. Methods We conducted a randomized clinical trial of newly diagnosed patients with early-stage breast cancer making locoregional treatment decisions. From 22 surgical practices, 537 patients were recruited and randomly assigned online to the iCanDecide interactive and tailored Web site (intervention) or the iCanDecide static Web site (control). Participants completed a baseline survey and were mailed a follow-up survey 4 to 5 weeks after enrollment to assess the primary outcome of a high-quality decision, which consisted of two components, high knowledge and values-concordant treatment, and secondary outcomes (decision preparation, deliberation, and subjective decision quality). Results Patients in the intervention arm had higher odds of making a high-quality decision than did those in the control arm (odds ratio, 2.00; 95% CI, 1.37 to 2.92; P = .0004), which was driven primarily by differences in the rates of high knowledge between groups. The majority of patients in both arms made values-concordant treatment decisions (78.6% in the intervention arm and 81.4% in the control arm). More patients in the intervention arm had high decision preparation (estimate, 0.18; 95% CI, 0.02 to 0.34; P = .027), but there were no significant differences in the other decision appraisal outcomes. The effect of the intervention was similar for women who were leaning strongly toward a treatment option at enrollment compared with those who were not. Conclusion The tailored and interactive iCanDecide Web site, which focused on knowledge building and values clarification, positively affected high-quality decisions largely by improving knowledge compared with static online

  20. Tactical Decision Aids High Bandwidth Links Using Autonomous Vehicles

    Science.gov (United States)

    2004-01-01

    1 Tactical Decision Aids (High Bandwidth Links Using Autonomous Vehicles ) A. J. Healey, D. P. Horner, Center for Autonomous Underwater Vehicle...SUBTITLE Tactical Decision Aids (High Bandwidth Links Using Autonomous Vehicles ) 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  1. Dimensions of Decision-Making Process Quality and Company Performance: A Study of Top Managers in Slovenia

    Directory of Open Access Journals (Sweden)

    Grušovnik Damjan

    2017-12-01

    Full Text Available This paper investigates the relationship between the dimensions of the decisionmaking process quality and company performance of top managers’ in Slovenia. We found out that companies whose managers exhibit an above-average dimension of openness of spirit in the quality of the decision making process, on average, have a higher stance on foreign markets as companies in which managers show a below-average open spirit. For the managers who work in companies that are present in foreign markets, we could confirm that there is a low/weak correlation between the dimension of effort of the decision-making process quality and the number of employees in a company.

  2. Beef Quality Identification Using Thresholding Method and Decision Tree Classification Based on Android Smartphone

    Directory of Open Access Journals (Sweden)

    Kusworo Adi

    2017-01-01

    Full Text Available Beef is one of the animal food products that have high nutrition because it contains carbohydrates, proteins, fats, vitamins, and minerals. Therefore, the quality of beef should be maintained so that consumers get good beef quality. Determination of beef quality is commonly conducted visually by comparing the actual beef and reference pictures of each beef class. This process presents weaknesses, as it is subjective in nature and takes a considerable amount of time. Therefore, an automated system based on image processing that is capable of determining beef quality is required. This research aims to develop an image segmentation method by processing digital images. The system designed consists of image acquisition processes with varied distance, resolution, and angle. Image segmentation is done to separate the images of fat and meat using the Otsu thresholding method. Classification was carried out using the decision tree algorithm and the best accuracies were obtained at 90% for training and 84% for testing. Once developed, this system is then embedded into the android programming. Results show that the image processing technique is capable of proper marbling score identification.

  3. A Wireless Sensor Network-Based Approach with Decision Support for Monitoring Lake Water Quality.

    Science.gov (United States)

    Huang, Xiaoci; Yi, Jianjun; Chen, Shaoli; Zhu, Xiaomin

    2015-11-19

    Online monitoring and water quality analysis of lakes are urgently needed. A feasible and effective approach is to use a Wireless Sensor Network (WSN). Lake water environments, like other real world environments, present many changing and unpredictable situations. To ensure flexibility in such an environment, the WSN node has to be prepared to deal with varying situations. This paper presents a WSN self-configuration approach for lake water quality monitoring. The approach is based on the integration of a semantic framework, where a reasoner can make decisions on the configuration of WSN services. We present a WSN ontology and the relevant water quality monitoring context information, which considers its suitability in a pervasive computing environment. We also propose a rule-based reasoning engine that is used to conduct decision support through reasoning techniques and context-awareness. To evaluate the approach, we conduct usability experiments and performance benchmarks.

  4. Quality uncertainty and allocation of decision rights in the European protected designation of origin

    Directory of Open Access Journals (Sweden)

    Gaetano Martino

    2013-06-01

    Full Text Available The paper considers some issue in the governance of the European Protected Designation of Origin (PDO. The PDO systems are the outcomes of both farmers and consumers expectations and connect the valorisation of the agricultural and rural resources of given territories to the quality of typical products. A critical point in the governance of the PDO systems is represented by the connection between the quality strategies and the uncertainty. The paper argues that the PDO systems can be thought of as strictly coordinated subsystems in which the ex post governance play a critical role in coping with quality uncertainty. The study suggests that the society's inducements given raise to complex organizational systems in which the allocation of decision rights to PDO collective organizations play a major role. The empirical analysis is carried out by examining ten Italian PDO systems in order to identify the decision rights allocated.

  5. Data quality for decision makers a dialog between a board member and a DQ expert

    CERN Document Server

    Morbey, Guilherme

    2014-01-01

    Currently many companies are confronted with the decision how to deal with the new data quality requirements of the regulatory authorities. Future data quality statements for enterprise key figures and their origins are being demanded. Applying methods of a data quality management system can produce these statements best. Guilherme Morbey explains the introduction of such a system in the form of a dialogue.

  6. Monitoring And Modeling Environmental Water Quality To Support Environmental Water Purchase Decision-making

    Science.gov (United States)

    Null, S. E.; Elmore, L.; Mouzon, N. R.; Wood, J. R.

    2016-12-01

    More than 25 million cubic meters (20,000 acre feet) of water has been purchased from willing agricultural sellers for environmental flows in Nevada's Walker River to improve riverine habitat and connectivity with downstream Walker Lake. Reduced instream flows limit native fish populations, like Lahontan cutthroat trout, through warm daily stream temperatures and low dissolved oxygen concentrations. Environmental water purchases maintain instream flows, although effects on water quality are more varied. We use multi-year water quality monitoring and physically-based hydrodynamic and water quality modeling to estimate streamflow, water temperature, and dissolved oxygen concentrations with alternative environmental water purchases. We simulate water temperature and dissolved oxygen changes from increased streamflow to prioritize the time periods and locations that environmental water purchases most enhance trout habitat as a function of water quality. Monitoring results indicate stream temperature and dissolved oxygen limitations generally exist in the 115 kilometers upstream of Walker Lake (about 37% of the study area) from approximately May through September, and this reach acts as a water quality barrier for fish passage. Model results indicate that low streamflows generally coincide with critically warm stream temperatures, water quality refugia exist on a tributary of the Walker River, and environmental water purchases may improve stream temperature and dissolved oxygen conditions for some reaches and seasons, especially in dry years and prolonged droughts. This research supports environmental water purchase decision-making and allows water purchase decisions to be prioritized with other river restoration alternatives.

  7. Brand Image and Perceived Quality on Consumer Buying Decision of Samsung Mobile Phone in Manado

    OpenAIRE

    Tumewu, Ferdinand; Lapian, Joyce; Maindoka, Raiza

    2014-01-01

    Buying decision is the stage in which consumers make the decision or take an action whether to purchase a certain product or not. The purpose of this research is to analyze the simultaneous effect of brand images and perceived quality of consumer buying decision. This research, the population refers to people in the city of Manado which used mobile phone brand Samsung with sample size as many as 100 respondents. This research used quantitative analyze by using questionnaires and used Multiple...

  8. Continuous quality improvement for the clinical decision unit.

    Science.gov (United States)

    Mace, Sharon E

    2004-01-01

    Clinical decision units (CDUs) are a relatively new and growing area of medicine in which patients undergo rapid evaluation and treatment. Continuous quality improvement (CQI) is important for the establishment and functioning of CDUs. CQI in CDUs has many advantages: better CDU functioning, fulfillment of Joint Commission on Accreditation of Healthcare Organizations mandates, greater efficiency/productivity, increased job satisfaction, better performance improvement, data availability, and benchmarking. Key elements include a database with volume indicators, operational policies, clinical practice protocols (diagnosis specific/condition specific), monitors, benchmarks, and clinical pathways. Examples of these important parameters are given. The CQI process should be individualized for each CDU and hospital.

  9. Information Quality in Regulatory Decision Making: Peer Review versus Good Laboratory Practice.

    Science.gov (United States)

    McCarty, Lynn S; Borgert, Christopher J; Mihaich, Ellen M

    2012-07-01

    There is an ongoing discussion on the provenance of toxicity testing data regarding how best to ensure its validity and credibility. A central argument is whether journal peer-review procedures are superior to Good Laboratory Practice (GLP) standards employed for compliance with regulatory mandates. We sought to evaluate the rationale for regulatory decision making based on peer-review procedures versus GLP standards. We examined pertinent published literature regarding how scientific data quality and validity are evaluated for peer review, GLP compliance, and development of regulations. Some contend that peer review is a coherent, consistent evaluative procedure providing quality control for experimental data generation, analysis, and reporting sufficient to reliably establish relative merit, whereas GLP is seen as merely a tracking process designed to thwart investigator corruption. This view is not supported by published analyses pointing to subjectivity and variability in peer-review processes. Although GLP is not designed to establish relative merit, it is an internationally accepted quality assurance, quality control method for documenting experimental conduct and data. Neither process is completely sufficient for establishing relative scientific soundness. However, changes occurring both in peer-review processes and in regulatory guidance resulting in clearer, more transparent communication of scientific information point to an emerging convergence in ensuring information quality. The solution to determining relative merit lies in developing a well-documented, generally accepted weight-of-evidence scheme to evaluate both peer-reviewed and GLP information used in regulatory decision making where both merit and specific relevance inform the process.

  10. 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...

  11. Analysis of management quality and management decisions made using the example of russian oil and gas companies

    Directory of Open Access Journals (Sweden)

    Kostylev A.O.

    2016-03-01

    Full Text Available Results of empirical surveys performed by Russian and foreign researchers with regard to behavior patterns of managers, authorized by owners to make investment decisions, are systematized. Analysis of management quality and decisions made by Russian oil and gas managers are performed using the following 2 criteria: market capitalization change and opinion of professional society. The purpose of the research is to attract attention to low management quality in Russian statowned oil and gas companies.

  12. The Influence of Product Quality and Consumer Perception to Purchase Decision on Canon Dslr Camera in Manado

    OpenAIRE

    Gunadi, Nikita Prisilia

    2015-01-01

    Marketing is very important to the success of the company, marketing is used by employers as a tool to influence consumers, especially in making a purchase of a product. Consumer purchasing decision is a very important activity for the company, as one goal obtaining profits to the company. This study aimed to determine the influence of product quality, and consumer perception to purchase decision on canon DSLR camera in Manado. Quality has a direct impact on the performance products and servi...

  13. Consumers' expected quality and intention to purchase high quality pork meat.

    Science.gov (United States)

    Papanagiotou, P; Tzimitra-Kalogianni, I; Melfou, K

    2013-03-01

    Expected quality is believed to be one of the most important factors that influence consumers' intention to purchase food. The present study seeks to explore the concept of pork meat expected quality and compare it with self-stated consumer intention to purchase pork meat. The aim is attempted by means of a field research conducted in Greece, following a conjoint analytic procedure. Results show that quality expectations comply with intention to buy pork, in many aspects. However, several differences have been identified. More specifically, country of origin and marbling appear to be more important for respondents' purchase decisions than they are for their quality evaluations, while the opposite appears to be true for price. Finally, socio-demographic factors such as gender, level of education, place of purchase and consumption habits seem to influence perceptions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Involving patients in care decisions improves satisfaction: an outcomes-based quality improvement project.

    Science.gov (United States)

    Leff, Ellen W

    2004-05-01

    A home care agency used quality improvement processes to improve patient satisfaction survey ratings. The focus was on involving patients in decisions about their care. A multidisciplinary team developed creative strategies to increase staff awareness and enhance customer service skills, which had dramatic results.

  15. Use of the decision quality process for strategic planning in the Duri Field, Indonesia

    International Nuclear Information System (INIS)

    Neal, L. Jr.

    1994-01-01

    Strategic planning and rigorous decision analysis applications will be primary management tools for upstream companies in the 1990's. Merging the long term focus of a strategic planning process with the probabilistic output of decision analysis techniques can yield insightful views of the potential successes and failures of a business plan. Even with these insights, comparing and deciding among a group of alternatives will remain a difficult task. In addition to uncertainties, business partners do not always share common value measures. Marketers want more barrels to sell, field supervisors like low operating cost strategies, and stockholders like cashflow. This environment complicates the managers' ability to choose between available options. The Decision Quality Process, a combination of classical decision analysis techniques coupled with Quality Improvement (QI) principles, bridges this gap. The process allows managers to develop and decide between different long term strategic plans, explicitly accounting for uncertainties, unknowns, and differing value measures. Three teams consisting of engineers, geologists, front line managers, and the highest levels of management within Caltex Pacific Indonesia, Texaco, and Chevron, spent 18 months developing and evaluating a multitude of development scenarios for the Duri Field. More than 200,000 cases of economics were run to support the evaluation. The result was a significant increase in expected value for the field regardless of the value measure used

  16. Traditional ecological knowledge underlying herding decisions of pastoralists.

    Science.gov (United States)

    Tamou, C; de Boer, I J M; Ripoll-Bosch, R; Oosting, S J

    2018-04-01

    Pastoralists have traditional ecological knowledge (TEK), which is important for their livelihoods and for policies and interventions. Pastoralism is under pressure, however, which may result in a decline of pastoral lifestyle and its related TEK. We, therefore, addressed the following objectives (i) to inventorise and assess how pastoralists characterise and value soils and forages in their environment, (ii) to analyse how soil, forage and livestock (i.e. cattle) characteristics relate to herding decisions and (iii) to determine whether TEK underlying herding decisions differs across generations. Data were collected through focus groups and individual interviews with 72 pastoralists, belonging to three generations and to three agro-ecological zones. Using a three-point scale (high, medium, low), four grasses and three tree forages were assessed in terms of nutritional quality for milk, meat, health and strength. Using their own visual criteria, pastoralists identified five different soils, which they selected for herding at different times of the year. Pastoralists stated that Pokuri was the best soil because of its low moisture content, whereas Karaal was the worst because forage hardly grows on it. They stated that perennials, such as Andropogon gayanus and Loxoderra ledermannii, were of high nutritional quality, whereas annuals such as Andropogon pseudapricus and Hyparrhenia involucrata were of low nutritional quality. Afzelia africana was perceived of high quality for milk production, whereas Khaya senegalensis had the highest quality for meat, health and strength. Pastoralists first used soil, then forage and finally livestock characteristics in their herding decisions. Pastoralists' TEK was not associated with their generations, but with their agro-ecological zones. This study suggests that pastoralists had common and detailed TEK about soils, forages and livestock characteristics, underlying their herding decisions. To conclude, pastoralists use a holistic

  17. Decision aids for multiple-decision disease management as affected by weather input errors.

    Science.gov (United States)

    Pfender, W F; Gent, D H; Mahaffee, W F; Coop, L B; Fox, A D

    2011-06-01

    Many disease management decision support systems (DSSs) rely, exclusively or in part, on weather inputs to calculate an indicator for disease hazard. Error in the weather inputs, typically due to forecasting, interpolation, or estimation from off-site sources, may affect model calculations and management decision recommendations. The extent to which errors in weather inputs affect the quality of the final management outcome depends on a number of aspects of the disease management context, including whether management consists of a single dichotomous decision, or of a multi-decision process extending over the cropping season(s). Decision aids for multi-decision disease management typically are based on simple or complex algorithms of weather data which may be accumulated over several days or weeks. It is difficult to quantify accuracy of multi-decision DSSs due to temporally overlapping disease events, existence of more than one solution to optimizing the outcome, opportunities to take later recourse to modify earlier decisions, and the ongoing, complex decision process in which the DSS is only one component. One approach to assessing importance of weather input errors is to conduct an error analysis in which the DSS outcome from high-quality weather data is compared with that from weather data with various levels of bias and/or variance from the original data. We illustrate this analytical approach for two types of DSS, an infection risk index for hop powdery mildew and a simulation model for grass stem rust. Further exploration of analysis methods is needed to address problems associated with assessing uncertainty in multi-decision DSSs.

  18. Propagating Water Quality Analysis Uncertainty Into Resource Management Decisions Through Probabilistic Modeling

    Science.gov (United States)

    Gronewold, A. D.; Wolpert, R. L.; Reckhow, K. H.

    2007-12-01

    Most probable number (MPN) and colony-forming-unit (CFU) are two estimates of fecal coliform bacteria concentration commonly used as measures of water quality in United States shellfish harvesting waters. The MPN is the maximum likelihood estimate (or MLE) of the true fecal coliform concentration based on counts of non-sterile tubes in serial dilution of a sample aliquot, indicating bacterial metabolic activity. The CFU is the MLE of the true fecal coliform concentration based on the number of bacteria colonies emerging on a growth plate after inoculation from a sample aliquot. Each estimating procedure has intrinsic variability and is subject to additional uncertainty arising from minor variations in experimental protocol. Several versions of each procedure (using different sized aliquots or different numbers of tubes, for example) are in common use, each with its own levels of probabilistic and experimental error and uncertainty. It has been observed empirically that the MPN procedure is more variable than the CFU procedure, and that MPN estimates are somewhat higher on average than CFU estimates, on split samples from the same water bodies. We construct a probabilistic model that provides a clear theoretical explanation for the observed variability in, and discrepancy between, MPN and CFU measurements. We then explore how this variability and uncertainty might propagate into shellfish harvesting area management decisions through a two-phased modeling strategy. First, we apply our probabilistic model in a simulation-based analysis of future water quality standard violation frequencies under alternative land use scenarios, such as those evaluated under guidelines of the total maximum daily load (TMDL) program. Second, we apply our model to water quality data from shellfish harvesting areas which at present are closed (either conditionally or permanently) to shellfishing, to determine if alternative laboratory analysis procedures might have led to different

  19. An Effective Transform Unit Size Decision Method for High Efficiency Video Coding

    Directory of Open Access Journals (Sweden)

    Chou-Chen Wang

    2014-01-01

    Full Text Available High efficiency video coding (HEVC is the latest video coding standard. HEVC can achieve higher compression performance than previous standards, such as MPEG-4, H.263, and H.264/AVC. However, HEVC requires enormous computational complexity in encoding process due to quadtree structure. In order to reduce the computational burden of HEVC encoder, an early transform unit (TU decision algorithm (ETDA is adopted to pruning the residual quadtree (RQT at early stage based on the number of nonzero DCT coefficients (called NNZ-EDTA to accelerate the encoding process. However, the NNZ-ETDA cannot effectively reduce the computational load for sequences with active motion or rich texture. Therefore, in order to further improve the performance of NNZ-ETDA, we propose an adaptive RQT-depth decision for NNZ-ETDA (called ARD-NNZ-ETDA by exploiting the characteristics of high temporal-spatial correlation that exist in nature video sequences. Simulation results show that the proposed method can achieve time improving ratio (TIR about 61.26%~81.48% when compared to the HEVC test model 8.1 (HM 8.1 with insignificant loss of image quality. Compared with the NNZ-ETDA, the proposed method can further achieve an average TIR about 8.29%~17.92%.

  20. Shared Decisions That Count.

    Science.gov (United States)

    Schlechty, Phillip C.

    1993-01-01

    Advocates of participatory leadership, site-based management, and decentralization often assume that changing decision-making group composition will automatically improve the quality of decisions being made. Stakeholder satisfaction does not guarantee quality results. This article offers a framework for moving the decision-making discussion from…

  1. The impact of the mode of thought in complex decisions: intuitive decisions are better

    Directory of Open Access Journals (Sweden)

    Marius eUsher

    2011-03-01

    Full Text Available A number of recent studies have reported that decision-quality is enhanced under conditions of inattention or distraction (unconscious-thought; Dijksterhuis, 2004; Dijksterhuis et al., 2006; Dijksterhuis & Nordgren, 2006. These reports have generated considerable controversy, for both experimental (problems of replication and theoretical reasons (interpretation. Here we report the results of four experiments. The first experiment replicates the unconscious thought effect, under conditions that validate and control the subjective criterion of decision quality. The second and third experiments examine the impact of a mode of thought manipulation (without distraction on decision quality in immediate decisions. Here we find that intuitive or affective manipulations improve decision quality compared to analytic/deliberation manipulations. The fourth experiment combines the two methods (distraction and mode of thought manipulations and demonstrates enhanced decision quality, in a situation that attempts to preserve ecological validity. The results are interpreted within a framework that is based on two interacting subsystems of decision-making: an affective/intuition based system and an analytic/deliberation system.

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

    Science.gov (United States)

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

    2017-01-01

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

  3. Decision Making on the Labor and Delivery Unit: An Investigation of Influencing Factors.

    Science.gov (United States)

    Gregory, Megan E; Sonesh, Shirley C; Feitosa, Jennifer; Benishek, Lauren E; Hughes, Ashley M; Salas, Eduardo

    2017-09-01

    Objective The aim of this study was to describe the relationship between negative affect (NA), decision-making style, time stress, and decision quality in health care. Background Health care providers must often make swift, high-stakes decisions. Influencing factors of the decision-making process in this context have been understudied. Method Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state decision-making style, state time stress, and their relationship with decision quality on real clinical decisions. Results In Study 1, we found that trait NA significantly predicted avoidant decision-making style. Furthermore, those who were higher on trait time stress and trait avoidant decision-making style exhibited poorer decisions. In Study 2, we observed associations between state NA with state avoidant and analytical decision-making styles. We also observed that these decision-making styles, when considered in tandem with time stress, were influential in predicting clinical decision quality. Conclusion NA predicts some decision-making styles, and decision-making style can affect decision quality under time stress. This is particularly true for state factors. Application Individual differences, such as affect and decision-making style, should be considered during selection. Training to reduce time stress perceptions should be provided.

  4. Development of nuclear quality high pressure valve bellows in Canada

    International Nuclear Information System (INIS)

    Janzen, P.; Astill, C.J.

    1978-06-01

    Concurrent with the decision to use bellows stem sealed nuclear valves where feasible in commercial-scale CANDU plants, AECL undertook to develop an indigenous high pressure valve bellows technology. This program included developing the capability to fabricate improved high pressure valve bellows in conjunction with a Canadian manufacturer. This paper describes the evolution of a two-stage bellows fabrication process involving: (1) manufacture of discrete lengths of precision thin wall telescoping tubes - from preparation of strip blanks through edge grinding and edge forming to longitudinal welding; (2) forming of bellows from tube assemblies using a novel combination of mechanical inward forming followed by hydraulic outward forming. Bellows of Inconel 600 and Inconel 625 have been manufactured and evaluated. Test results indicate comparable to improved performance over alternative high quality bellows. (author)

  5. 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

  6. Evaluating the link between human resource management decisions and patient satisfaction with quality of care.

    Science.gov (United States)

    Oppel, Eva-Maria; Winter, Vera; Schreyögg, Jonas

    Patient satisfaction with quality of care is becoming increasingly important in the competitive hospital market. Simultaneously, the growing shortage of clinical staff poses a considerable challenge to ensuring a high quality of care. In this context, a question emerges regarding whether and how human resource management (HRM) might serve as a means to reduce staff shortage problems and to increase patient satisfaction. Although considerable efforts have been devoted to understanding the concepts of patient satisfaction and HRM, little is known about the interrelationships between these concepts or about the link between staff shortage problems and patients' satisfaction with quality of care. The aim of this study was to investigate the relationship between strategic human resource management (SHRM), staff shortage problems, and patients' satisfaction with care. Furthermore, we analyze how the HRM decision to fill short-term vacancies through temporary staffing affects patient satisfaction. We differentiate between physicians and nurses. We develop and empirically test a theoretical model. The data (n = 165) are derived from a survey on SHRM that was sent to 732 German hospitals and from a survey on patient satisfaction that comprises 436,848 patient satisfaction ratings. We use a structural equation modeling approach to test the model. The results indicate that SHRM significantly reduces staff shortage problems for both occupational groups. Having fewer physician shortage problems is significantly associated with higher levels of patient satisfaction, whereas this effect is not significant for nurses. Furthermore, the use of temporary staffing considerably reduces patients' satisfaction with care. Hospital managers are advised to consider the effects of HRM decisions on patients' satisfaction with care. In particular, investments in SHRM targeted at physicians have significantly positive effects on patient satisfaction, whereas the temporary staffing of physicians

  7. Validating evidence based decision making in health care

    DEFF Research Database (Denmark)

    Nüssler, Emil Karl; Eskildsen, Jacob Kjær; Håkonsson, Dorthe Døjbak

    Surgeons who perform prolapse surgeries face the dilemma of choosing to use mesh, with its assumed benefits, and the risks associated with mesh. In this paper, we examine whether decisions to use mesh is evidence based. Based on data of 30,398 patients from the Swedish National Quality Register o...... are highly influenced by the geographical placement of surgeons. Therfore, decisions to use mesh are boundedly rationality, rather than rational.......Surgeons who perform prolapse surgeries face the dilemma of choosing to use mesh, with its assumed benefits, and the risks associated with mesh. In this paper, we examine whether decisions to use mesh is evidence based. Based on data of 30,398 patients from the Swedish National Quality Register...... of Gynecological Surgery we examine factors related to decisions to use mesh. Our results indicate that decisions to use mesh are not evidence based, and cannot be explained neither by FDA safety communications, nor by medical conditions usually assumed to predict its usage. Instead, decisions to use mesh...

  8. Decision-making patterns and self-confidence in high school adolescents

    Directory of Open Access Journals (Sweden)

    Alejandro César Antonio Luna Bernal

    2014-07-01

    Full Text Available The present study aimed to analyse the factor structure of the Melbourne Decision Making Questionnaire (DMQ-II, and to examine the relationships between the factors identified and Self-confidence, in order to conceptualize the decision-making process in adolescents under the Conflict Model of Decision Making. Participants were 992 Mexican high-school students, aged between 15 and 19 years. The three factors were identified as decision-making patterns in adolescents: a Vigilance, b Hipervigilance/Procrastination and c Buck-passing. The Self-confidence showed a positive effect on Vigilance, and a negative effect on theother two patterns. Results are discussed considering the literature on decision making in adolescence.

  9. Setting Up Decision-Making Tools toward a Quality-Oriented Participatory Maize Breeding Program

    Science.gov (United States)

    Alves, Mara L.; Brites, Cláudia; Paulo, Manuel; Carbas, Bruna; Belo, Maria; Mendes-Moreira, Pedro M. R.; Brites, Carla; Bronze, Maria do Rosário; Gunjača, Jerko; Šatović, Zlatko; Vaz Patto, Maria C.

    2017-01-01

    Previous studies have reported promising differences in the quality of kernels from farmers' maize populations collected in a Portuguese region known to produce maize-based bread. However, several limitations have been identified in the previous characterizations of those populations, such as a limited set of quality traits accessed and a missing accurate agronomic performance evaluation. The objectives of this study were to perform a more detailed quality characterization of Portuguese farmers' maize populations; to estimate their agronomic performance in a broader range of environments; and to integrate quality, agronomic, and molecular data in the setting up of decision-making tools for the establishment of a quality-oriented participatory maize breeding program. Sixteen farmers' maize populations, together with 10 other maize populations chosen for comparison purposes, were multiplied in a common-garden experiment for quality evaluation. Flour obtained from each population was used to study kernel composition (protein, fat, fiber), flour's pasting behavior, and bioactive compound levels (carotenoids, tocopherols, phenolic compounds). These maize populations were evaluated for grain yield and ear weight in nine locations across Portugal; the populations' adaptability and stability were evaluated using additive main effects and multiplication interaction (AMMI) model analysis. The phenotypic characterization of each population was complemented with a molecular characterization, in which 30 individuals per population were genotyped with 20 microsatellites. Almost all farmers' populations were clustered into the same quality-group characterized by high levels of protein and fiber, low levels of carotenoids, volatile aldehydes, α- and δ-tocopherols, and breakdown viscosity. Within this quality-group, variability on particular quality traits (color and some bioactive compounds) could still be found. Regarding the agronomic performance, farmers' maize populations

  10. Setting Up Decision-Making Tools toward a Quality-Oriented Participatory Maize Breeding Program

    Directory of Open Access Journals (Sweden)

    Mara L. Alves

    2017-12-01

    Full Text Available Previous studies have reported promising differences in the quality of kernels from farmers' maize populations collected in a Portuguese region known to produce maize-based bread. However, several limitations have been identified in the previous characterizations of those populations, such as a limited set of quality traits accessed and a missing accurate agronomic performance evaluation. The objectives of this study were to perform a more detailed quality characterization of Portuguese farmers' maize populations; to estimate their agronomic performance in a broader range of environments; and to integrate quality, agronomic, and molecular data in the setting up of decision-making tools for the establishment of a quality-oriented participatory maize breeding program. Sixteen farmers' maize populations, together with 10 other maize populations chosen for comparison purposes, were multiplied in a common-garden experiment for quality evaluation. Flour obtained from each population was used to study kernel composition (protein, fat, fiber, flour's pasting behavior, and bioactive compound levels (carotenoids, tocopherols, phenolic compounds. These maize populations were evaluated for grain yield and ear weight in nine locations across Portugal; the populations' adaptability and stability were evaluated using additive main effects and multiplication interaction (AMMI model analysis. The phenotypic characterization of each population was complemented with a molecular characterization, in which 30 individuals per population were genotyped with 20 microsatellites. Almost all farmers' populations were clustered into the same quality-group characterized by high levels of protein and fiber, low levels of carotenoids, volatile aldehydes, α- and δ-tocopherols, and breakdown viscosity. Within this quality-group, variability on particular quality traits (color and some bioactive compounds could still be found. Regarding the agronomic performance, farmers

  11. Risk-based decision making to manage water quality failures caused by combined sewer overflows

    Science.gov (United States)

    Sriwastava, A. K.; Torres-Matallana, J. A.; Tait, S.; Schellart, A.

    2017-12-01

    Regulatory authorities set certain environmental permit for water utilities such that the combined sewer overflows (CSO) managed by these companies conform to the regulations. These utility companies face the risk of paying penalty or negative publicity in case they breach the environmental permit. These risks can be addressed by designing appropriate solutions such as investing in additional infrastructure which improve the system capacity and reduce the impact of CSO spills. The performance of these solutions is often estimated using urban drainage models. Hence, any uncertainty in these models can have a significant effect on the decision making process. This study outlines a risk-based decision making approach to address water quality failure caused by CSO spills. A calibrated lumped urban drainage model is used to simulate CSO spill quality in Haute-Sûre catchment in Luxembourg. Uncertainty in rainfall and model parameters is propagated through Monte Carlo simulations to quantify uncertainty in the concentration of ammonia in the CSO spill. A combination of decision alternatives such as the construction of a storage tank at the CSO and the reduction in the flow contribution of catchment surfaces are selected as planning measures to avoid the water quality failure. Failure is defined as exceedance of a concentration-duration based threshold based on Austrian emission standards for ammonia (De Toffol, 2006) with a certain frequency. For each decision alternative, uncertainty quantification results into a probability distribution of the number of annual CSO spill events which exceed the threshold. For each alternative, a buffered failure probability as defined in Rockafellar & Royset (2010), is estimated. Buffered failure probability (pbf) is a conservative estimate of failure probability (pf), however, unlike failure probability, it includes information about the upper tail of the distribution. A pareto-optimal set of solutions is obtained by performing mean

  12. How High School Students Construct Decision-Making Strategies for Choosing Colleges

    Science.gov (United States)

    Govan, George V.; Patrick, Sondra; Yen, Cherng-Jyn

    2006-01-01

    This study examined how high school seniors construct decision-making strategies for choosing a college to attend. To comprehend their decision-making strategies, we chose to examine this process through the theoretical lens of bounded rationality, which brings to light the complexity in constructing a college choice decision-making strategy…

  13. Improving life cycle assessment methodology for the application of decision support

    DEFF Research Database (Denmark)

    Herrmann, Ivan Tengbjerg

    for the application of decision support and evaluation of uncertainty in LCA. From a decision maker’s (DM’s) point of view there are at least three main “illness” factors influencing the quality of the information that the DM uses for making decisions. The factors are not independent of each other, but it seems......) refrain from making a decision based on an LCA and thus support a decision on other parameters than the LCA environmental parameters. Conversely, it may in some decision support contexts be acceptable to base a decision on highly uncertain information. This all depends on the specific decision support...... the different steps. A deterioration of the quality in each step is likely to accumulate through the statistical value chain in terms of increased uncertainty and bias. Ultimately this can make final decision support problematic. The "Law of large numbers" (LLN) is the methodological tool/probability theory...

  14. The Psychology and Neuroscience of Financial Decision Making.

    Science.gov (United States)

    Frydman, Cary; Camerer, Colin F

    2016-09-01

    Financial decisions are among the most important life-shaping decisions that people make. We review facts about financial decisions and what cognitive and neural processes influence them. Because of cognitive constraints and a low average level of financial literacy, many household decisions violate sound financial principles. Households typically have underdiversified stock holdings and low retirement savings rates. Investors overextrapolate from past returns and trade too often. Even top corporate managers, who are typically highly educated, make decisions that are affected by overconfidence and personal history. Many of these behaviors can be explained by well-known principles from cognitive science. A boom in high-quality accumulated evidence-especially how practical, low-cost 'nudges' can improve financial decisions-is already giving clear guidance for balanced government regulation. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Highlighting ethical decisions underlying the scoring of animal welfare in the Welfare Quality® scheme

    DEFF Research Database (Denmark)

    Veissier, I.; Jensen, Karsten Klint; Botreau, R.

    2011-01-01

    dimension of scoring and labelling does not mean that we should reject them, but it does mean that we need to make the normative and ethical background explicit. The Welfare Quality® scoring system is used as a case study in order to highlight the role of underlying value-based decisions. In this scoring......, but the rules governing the assignment of an animal unit to a category take into account what had been observed on European farms. The scientists behind Welfare Quality® are keen to make the value-based choices underlying assessments of animal welfare transparent. This is essential to allow stakeholder groups......All systems of scoring animal units (groups, farms, slaughter plants, etc.) according to the level of the animals’ welfare are based inevitably on normative decisions. Similarly, all methods of labelling, in terms of acceptability, are based on choices reflecting ethical values. The evaluative...

  16. Interference of partial visual analysis of root filling quality and apical status on retreatment decisions

    Directory of Open Access Journals (Sweden)

    Renata Dornelles Morgental

    2012-04-01

    Full Text Available OBJECTIVE: The presence of periapical radiolucency has been used as a criterion for endodontic treatment failure. However, in addition to the inherent limitations of radiographic examinations, radiographic interpretations are extremely subjective. Thus, this study investigated the effect of partial analysis of root filling quality and periapical status on retreatment decisions by general dentists. MATERIAL AND METHODS: Twelve digitalized periapical radiographs were analyzed by 10 observers. The study was conducted at three time points at 1-week intervals. Radiographs edited with the Adobe Photoshop CS4 software were analyzed at three time points: first, only root filling quality was analyzed; second, only the periapical areas of the teeth under study were visualized; finally, observers analyzed the unedited radiographic image. Spearman ’s coefficient was used to analyze the correlations between the scores assigned when the periapical area was not visible and when the unedited radiograph was analyzed, as well as between the scores assigned when root fillings where not visible and when the unedited radiograph was analyzed. Sensitivity, specificity, positive and negative predictive values between partial images and unedited radiographs were also used to analyze retreatment decisions. The level of significance was set at 5%. RESULTS: The visualization of the root filling on the unedited radiograph affected the interpretation of the periapical status and the technical quality of the fillings has a greater influence on the general dentist’s decision to prescribe endodontic retreatment than the periapical condition. CONCLUSION: In order to make endodontic diagnosis, radiographic interpretation process should not only emphasize technical aspects, but also consider biological factors.

  17. Zerodur polishing process for high surface quality and high efficiency

    International Nuclear Information System (INIS)

    Tesar, A.; Fuchs, B.

    1992-08-01

    Zerodur is a glass-ceramic composite importance in applications where temperature instabilities influence optical and mechanical performance, such as in earthbound and spaceborne telescope mirror substrates. Polished Zerodur surfaces of high quality have been required for laser gyro mirrors. Polished surface quality of substrates affects performance of high reflection coatings. Thus, the interest in improving Zerodur polished surface quality has become more general. Beyond eliminating subsurface damage, high quality surfaces are produced by reducing the amount of hydrated material redeposited on the surface during polishing. With the proper control of polishing parameters, such surfaces exhibit roughnesses of < l Angstrom rms. Zerodur polishing was studied to recommend a high surface quality polishing process which could be easily adapted to standard planetary continuous polishing machines and spindles. This summary contains information on a polishing process developed at LLNL which reproducibly provides high quality polished Zerodur surfaces at very high polishing efficiencies

  18. Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology.

    Science.gov (United States)

    Krieger, Janice L; Krok-Schoen, Jessica L; Dailey, Phokeng M; Palmer-Wackerly, Angela L; Schoenberg, Nancy; Paskett, Electra D; Dignan, Mark

    2017-07-01

    Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients ( N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed.

  19. [Quality management is associated with high quality services in health care].

    Science.gov (United States)

    Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

    2013-12-09

    In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

  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. Relations between mental workload and decision-making in an organizational setting

    Directory of Open Access Journals (Sweden)

    María Soria-Oliver

    2017-05-01

    Full Text Available Asbtract Background The complexity of current organizations implies a potential overload for workers. For this reason, it is of interest to study the effects that mental workload has on the performance of complex tasks in professional settings. Objective The objective of this study is to empirically analyze the relation between the quality of decision-making, on the one hand, and the expected and real mental workload, on the other. Methods The study uses an ex post facto prospective design with a sample of 176 professionals from a higher education organization. Expected mental workload (Pre-Task WL and real mental workload (Post-Task WL were measured with the unweighted NASA-Task Load Index (NASA-TLX questionnaire; difference between real WL and expected WL (Differential WL was also calculated; quality of decision-making was measured by means of the Decision-Making Questionnaire. Results General quality of decision-making and Pre-Task WL relation is compatible with an inverted U pattern, with slight variations depending on the specific dimension of decision-making that is considered. There were no verifiable relations between Post-Task WL and decision-making. The subjects whose expected WL matched the real WL showed worse quality in decision-making than subjects with high or low Differential WL. Conclusions The relations between mental workload and decision-making reveal a complex pattern, with evidence of nonlinear relations.

  2. Quality of Living and Dying: Pediatric Palliative Care and End-of-Life Decisions in the Netherlands.

    Science.gov (United States)

    Brouwer, Marije; Maeckelberghe, Els; DE Weerd, Willemien; Verhagen, Eduard

    2018-07-01

    In 2002, The Netherlands continued its leadership in developing rules and jurisdiction regarding euthanasia and end-of-life decisions by implementing the Euthanasia Act, which allows euthanasia for patients 12 years of age and older. Subsequently, in 2005, the regulation on active ending of life for newborns was issued. However, more and more physicians and parents have stated that the age gap between these two regulations-children between 1 and 12 years old-is undesirable. These children should have the same right to end their suffering as adults and newborn infants. An extended debate on pediatric euthanasia ensued, and currently the debate is ongoing as to whether legislation should be altered in order to allow pediatric euthanasia. An emerging major question regards the active ending of life in the context of palliative care: How does a request for active ending of life relate to the care that is given to children in the palliative phase? Until now, the distinction between palliative care and end-of-life decisions continues to remain unclear, making any discussion about their mutual in- and exclusiveness hazardous at best. In this report, therefore, we aim to provide insight into the relationship between pediatric palliative care and end-of-life decisions, as understood in the Netherlands. We do so by first providing an overview of the (legal) rules and regulations regarding euthanasia and active ending of life, followed by an analysis of the relationship between these two, using the Dutch National Guidelines for Palliative Care for Children. The results of this analysis revealed two major and related features of palliative care and end-of-life decisions for children: (1) palliative care and end-of-life decisions are part of the same process, one that focuses both on quality of living and quality of dying, and (2) although physicians are seen as ultimately responsible for making end-of-life decisions, the involvement of parents and children in this decision is

  3. Managerial Decision Making in Traffic

    Directory of Open Access Journals (Sweden)

    Teodor Perić

    2003-11-01

    Full Text Available Decision-making is defined as a selection of a certain actionamong several alternatives. It is the essence of planning, asin the managerial sense there is no plan until a decision of engagementof resources, reputation and direction of activities ismade. Decision-making is, in fact, only a step in planning, evenwhen it is performed quickly and without special consideration.It is what we all experience every day. It is one of the most fascinatingbiological activities and the subject of frightening implicationsfor the whole human race. Since various techniques improvethe system and the quality of managerial decision-making,they are classified into three assumptions: risk analysis, decision-making trees, and the theory of revealed preference. Allof these are based on the interaction of a certain number of importantvariables out of which many contain the elements ofuncertainty, but maybe also high level of probability.

  4. Applying air pollution modelling within a multi-criteria decision analysis framework to evaluate UK air quality policies

    Science.gov (United States)

    Chalabi, Zaid; Milojevic, Ai; Doherty, Ruth M.; Stevenson, David S.; MacKenzie, Ian A.; Milner, James; Vieno, Massimo; Williams, Martin; Wilkinson, Paul

    2017-10-01

    A decision support system for evaluating UK air quality policies is presented. It combines the output from a chemistry transport model, a health impact model and other impact models within a multi-criteria decision analysis (MCDA) framework. As a proof-of-concept, the MCDA framework is used to evaluate and compare idealized emission reduction policies in four sectors (combustion in energy and transformation industries, non-industrial combustion plants, road transport and agriculture) and across six outcomes or criteria (mortality, health inequality, greenhouse gas emissions, biodiversity, crop yield and air quality legal compliance). To illustrate a realistic use of the MCDA framework, the relative importance of the criteria were elicited from a number of stakeholders acting as proxy policy makers. In the prototype decision problem, we show that reducing emissions from industrial combustion (followed very closely by road transport and agriculture) is more advantageous than equivalent reductions from the other sectors when all the criteria are taken into account. Extensions of the MCDA framework to support policy makers in practice are discussed.

  5. Decision theory on the quality evaluation of medical images; A teoria da decisao na avaliacao da qualidade da imagem medica

    Energy Technology Data Exchange (ETDEWEB)

    Lessa, Patricia Silva

    2001-10-01

    The problem of quality has been a constant issue in every organization.One is always seeking to produce more, to do it at a lower cost, and to do it with better quality. However, in this country, there is no radiographic film quality control system for radiographic services. The tittle that actually gets done is essentially ad hoc and superficial. The implications of this gap, along with some other shortcomings that exist in process as a whole (the state of the x-ray equipment, the adequate to use in order to obtain a radiography, the quality of the film, the processing of the film, the brightness and homogeneity of the viewing boxes, the ability of the radiologist), have a very negative impact on the quality of the medical image, and, as result, to the quality of the medical diagnosis and therapy. It frequently happens that many radiographs have to be repeated, which leads to an increase of the patient's exposure to radiation, as well as of the cost of the procedure for the patient. Low quality radiographs that are not repeated greatly increase the probability of a wrong diagnosis, and consequently, of inadequate therapeutical procedures, thus producing increased incidence of bad outcomes and higher costs. The paradigm proposed in order to establish a system for the measurement of the image's quality is Decision Theory. The problem of the assessment of the image is studied by proposing a Decision Theory approach. The review of the literature reveals a great concern with the quality of the image, along with an absence of an adequate paradigm and several essentially empirical procedures. Image parameters are developed in order to formalize the problem in terms of Decision Theory, and various aspects of image digitalisation are exposed. Finally, a solution is presented, including a protocol for quality control. (author)

  6. Analysis of Availability of Data Sets Necessary for Decision Making in Air Quality Assessment

    Science.gov (United States)

    Sanzhapov, B. Kh; Rashevskiy, N. M.; Sinitsyn, A. A.

    2017-11-01

    The article analyzes the problems in obtaining the environmental information data sets necessary for decision making in the field of air quality assessment. The authors of this article describe their experience in search for data required to run the WRF and Calpuff systems to estimate the air quality in the city of Volgograd, the Russian Federation. The problems the authors encountered and other researchers may encounter are indicated. A conceptual scheme of the resource that will help to increase the speed of searching for necessary information and also inform users about the rules for use of a particular resource is suggested.

  7. Patient involvement in the decision-making process improves satisfaction and quality of life in postmastectomy breast reconstruction.

    Science.gov (United States)

    Ashraf, Azra A; Colakoglu, Salih; Nguyen, John T; Anastasopulos, Alexandra J; Ibrahim, Ahmed M S; Yueh, Janet H; Lin, Samuel J; Tobias, Adam M; Lee, Bernard T

    2013-09-01

    The patient-physician relationship has evolved from the paternalistic, physician-dominant model to the shared-decision-making and informed-consumerist model. The level of patient involvement in this decision-making process can potentially influence patient satisfaction and quality of life. In this study, patient-physician decision models are evaluated in patients undergoing postmastectomy breast reconstruction. All women who underwent breast reconstruction at an academic hospital from 1999-2007 were identified. Patients meeting inclusion criteria were mailed questionnaires at a minimum of 1 y postoperatively with questions about decision making, satisfaction, and quality of life. There were 707 women eligible for our study and 465 completed surveys (68% response rate). Patients were divided into one of three groups: paternalistic (n = 18), informed-consumerist (n = 307), shared (n = 140). There were differences in overall general satisfaction (P = 0.034), specifically comparing the informed group to the paternalistic group (66.7% versus 38.9%, P = 0.020) and the shared to the paternalistic group (69.3% versus 38.9%, P = 0.016). There were no differences in aesthetic satisfaction. There were differences found in the SF-12 physical component summary score across all groups (P = 0.033), and a difference was found between the informed and paternalistic groups (P mental component score (P = 0.42). Women undergoing breast reconstruction predominantly used the informed model of decision making. Patients who adopted a more active role, whether using an informed or shared approach, had higher general patient satisfaction and physical component summary scores compared with patients whose decision making was paternalistic. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Satisfaction with the decision to participate in cancer clinical trials is high, but understanding is a problem.

    Science.gov (United States)

    Jefford, M; Mileshkin, L; Matthews, J; Raunow, H; O'Kane, C; Cavicchiolo, T; Brasier, H; Anderson, M; Reynolds, J

    2011-03-01

    Partially presented in poster format at the 40th and 41st Annual Meetings of the American Society of Clinical Oncology, held in 2004 in New Orleans, Louisiana and in 2005 in Orlando, Florida. We aimed to: (a) assess patient knowledge about cancer clinical trials (CCT) and satisfaction with their decision to participate, (b) determine whether satisfaction correlates with objective understanding, or other factors, and (c) identify correlates of increased understanding. A convenience sample of 100 patients were recruited. Instruments assessed quality of informed consent (QuIC), quality of life (EORTC QLQ C-30), anxiety and depression (HADS), and preferences for information and involvement in decision making. Measures were completed within 2 weeks of clinical trial enrollment. One hundred two patients (68 male) with a median age of 58.4 years (29-85) were registered in 27 of the 33 therapeutic cancer clinical trials approved for the Consent Study. Mean QuIC objective knowledge (QuIC-A) was 77.6 (/100) (95% CI, 75.7-79.4) and perceived (subjective) understanding (QuIC-B) 91.5 (95% CI, 89.6-93.3). There was low but significant correlation between QuIC-A and B (R = 0.26, p = 0.008). Satisfaction was very high. Correlation between QuIC-B and satisfaction was moderate (0.430, p < 0.001). QuIC-B, but not QuIC-A was associated with QOL scores. Preferences regarding participation in decision making and whether these preferences were achieved did not impact upon knowledge, understanding or satisfaction. Patient knowledge regarding CCT is similar to published US data, and satisfaction is high. Satisfaction correlates with perceived but not objective understanding of CCT. Strategies to further improve the consent process need to be developed.

  9. Fast Interactive Decision Support for Modifying Stowage Plans Using Binary Decision Diagrams

    DEFF Research Database (Denmark)

    Jensen, Rune Møller; Leknes, Eilif; Bebbington, Thomas

    Low cost containerized shipping requires high quality stowage plans. Scalable stowage planning optimization algorithms have been developed recently. All of these algorithms, however, produce monolithic solutions that are hard for stowage coordinators to modify, which is necessary in practice due ...... fast, complete, and backtrack-free decision support. Our computational results show that the approach can solve real-sized instances when breaking symmetries among similar containers...

  10. [Shared decision-making as a new quality indicator in nephrology: a nationwide survey in Germany].

    Science.gov (United States)

    Scheibler, Fülöp; Stoffel, Markus P; Barth, Claudia; Kuch, Christine; Steffen, Petra; Baldamus, Conrad A; Pfaff, Holger

    2005-04-15

    Shared decision-making (SDM) as a model in physician-patient interaction is gaining relevance in the German health system. By applying this model, mid- and long-term improvements are expected especially in the outcomes of chronic diseases. Up to now, there has hardly been any empirical data available in German health services research regarding the state and development of SDM. This study establishes a baseline and provides actual data on this subject based on a German-wide survey of end-stage renal disease (ESRD) patients. Standardized German-wide survey of 6,614 patients with ESRD. The questionnaire included an instrument to measure the patients' perceived involvement in care (PICS) which had been translated and validated before. 82% of the questioned patients feel their physicians facilitated involvement in decision making. 81% of the patients actively inform themselves concerning their disease and treatment options. 69% state that SDM has taken place. Age, years on dialysis and gender correlate with perceived involvement. This paper provides a valid baseline for the prospective research of SDM in ESRD. The results indicate that dialysis patients are willing to participate in the process of medical decision-making. Characteristics and preferences of the patients should be taken into account not only in everyday clinical interactions. They could be monitored systematically within the framework of quality management and used as potential for quality improvement.

  11. Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach.

    Science.gov (United States)

    Montano, Diego

    2016-08-05

    The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.

  12. Self-Efficacy and Its Relationship with Social Skills and the Quality of Decision-Making among the Students of Prince Sattam Bin Abdul-Aziz University

    Science.gov (United States)

    Al-mehsin, Salama Aqeel

    2017-01-01

    The present study aimed to reveal the self-efficacy and social skills and their relationship to the quality of decision-making at Prince Sattam bin Abdulaziz University students, and determine the extent of the contribution of self-efficacy and social skills to the quality of decision-making. To achieve this, a questionnaire was built to identify…

  13. Beyond expected utility: rethinking behavioral decision research.

    Science.gov (United States)

    Frisch, D; Clemen, R T

    1994-07-01

    Much research in psychology has evaluated the quality of people's decisions by comparisons with subjective expected utility (SEU) theory. This article suggests that typical arguments made for the status of utility theory as normative do not justify its use by psychologists as a standard by which to evaluate decision quality. It is argued that to evaluate decision quality, researchers need to identify those decision processes that tend to lead to desirable outcomes. It is contended that a good decision-making process must be concerned with how (and whether) decision makers evaluate potential consequences of decisions, the extent to which they accurately identify all relevant consequences, and the way in which they make final choices. Research that bears on these issues is reviewed.

  14. High quality diesel fuels by VO-LSGO hydrotreatment

    Energy Technology Data Exchange (ETDEWEB)

    Stanica-Ezeanu, Dorin; Juganaru, Traian [Petroleum and Gas Univ. of Ploiesti (Romania)

    2013-06-01

    The aim of the paper is to obtain a high quality Diesel fuel by hydro-deoxigenation of vegetable oils (VO) mixed with a low sulfur gasoil (LSGO). The process is possible by using a bi-functional catalyst Ni-Mo supported by an activated Al{sub 2}O{sub 3} containing 2% Ultrastable Y-zeolite. The experimental conditions were: T =340 - 380 C, Pressure = 50 bar, LHSV = 1,5 h{sup -1}, H{sub 2}/Feed ratio = 15 mole H{sub 2} /mole liquid feed. The liquid product was separated in two fractions: a light distillate (similar to gasoline) and a heavy distillate (boiling point > 200 C) with very good characteristics for Diesel engines. The reaction chemistry is very complex, but the de-oxygenation process is decisive for the chemical structure of hydrocarbons from final product. Finally, a schema for the reaction mechanism is proposed. (orig.)

  15. Decision Making in Action

    Science.gov (United States)

    Orasanu, Judith; Statler, Irving C. (Technical Monitor)

    1994-01-01

    The importance of decision-making to safety in complex, dynamic environments like mission control centers and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. A similar observation has been made in nuclear power plants. Yet laboratory research on decision making has not proven especially helpful in improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multidimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication

  16. Decision Making In A High-Tech World: Automation Bias and Countermeasures

    Science.gov (United States)

    Mosier, Kathleen L.; Skitka, Linda J.; Burdick, Mark R.; Heers, Susan T.; Rosekind, Mark R. (Technical Monitor)

    1996-01-01

    Automated decision aids and decision support systems have become essential tools in many high-tech environments. In aviation, for example, flight management systems computers not only fly the aircraft, but also calculate fuel efficient paths, detect and diagnose system malfunctions and abnormalities, and recommend or carry out decisions. Air Traffic Controllers will soon be utilizing decision support tools to help them predict and detect potential conflicts and to generate clearances. Other fields as disparate as nuclear power plants and medical diagnostics are similarly becoming more and more automated. Ideally, the combination of human decision maker and automated decision aid should result in a high-performing team, maximizing the advantages of additional cognitive and observational power in the decision-making process. In reality, however, the presence of these aids often short-circuits the way that even very experienced decision makers have traditionally handled tasks and made decisions, and introduces opportunities for new decision heuristics and biases. Results of recent research investigating the use of automated aids have indicated the presence of automation bias, that is, errors made when decision makers rely on automated cues as a heuristic replacement for vigilant information seeking and processing. Automation commission errors, i.e., errors made when decision makers inappropriately follow an automated directive, or automation omission errors, i.e., errors made when humans fail to take action or notice a problem because an automated aid fails to inform them, can result from this tendency. Evidence of the tendency to make automation-related omission and commission errors has been found in pilot self reports, in studies using pilots in flight simulations, and in non-flight decision making contexts with student samples. Considerable research has found that increasing social accountability can successfully ameliorate a broad array of cognitive biases and

  17. Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments

    Directory of Open Access Journals (Sweden)

    Noortgate Nele

    2009-12-01

    Full Text Available Abstract Background The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. Methods A cross-sectional mail survey was sent to all acute hospitals (67 main campuses in Flanders (Belgium. The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. Results The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%. While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%. More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Conclusions Most Flemish acute hospitals have developed a policy on end-of-life practices

  18. Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments.

    Science.gov (United States)

    D'Haene, Ina; Vander Stichele, Robert H; Pasman, H Roeline W; Noortgate, Nele Van den; Bilsen, Johan; Mortier, Freddy; Deliens, Luc

    2009-12-30

    The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. A cross-sectional mail survey was sent to all acute hospitals (67 main campuses) in Flanders (Belgium). The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%). While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%). More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Most Flemish acute hospitals have developed a policy on end-of-life practices. However, communication, training and the education of health care

  19. The potential for intelligent decision support systems to improve the quality and consistency of medication reviews.

    Science.gov (United States)

    Bindoff, I; Stafford, A; Peterson, G; Kang, B H; Tenni, P

    2012-08-01

    Drug-related problems (DRPs) are of serious concern worldwide, particularly for the elderly who often take many medications simultaneously. Medication reviews have been demonstrated to improve medication usage, leading to reductions in DRPs and potential savings in healthcare costs. However, medication reviews are not always of a consistently high standard, and there is often room for improvement in the quality of their findings. Our aim was to produce computerized intelligent decision support software that can improve the consistency and quality of medication review reports, by helping to ensure that DRPs relevant to a patient are overlooked less frequently. A system that largely achieved this goal was previously published, but refinements have been made. This paper examines the results of both the earlier and newer systems. Two prototype multiple-classification ripple-down rules medication review systems were built, the second being a refinement of the first. Each of the systems was trained incrementally using a human medication review expert. The resultant knowledge bases were analysed and compared, showing factors such as accuracy, time taken to train, and potential errors avoided. The two systems performed well, achieving accuracies of approximately 80% and 90%, after being trained on only a small number of cases (126 and 244 cases, respectively). Through analysis of the available data, it was estimated that without the system intervening, the expert training the first prototype would have missed approximately 36% of potentially relevant DRPs, and the second 43%. However, the system appeared to prevent the majority of these potential expert errors by correctly identifying the DRPs for them, leaving only an estimated 8% error rate for the first expert and 4% for the second. These intelligent decision support systems have shown a clear potential to substantially improve the quality and consistency of medication reviews, which should in turn translate into

  20. A Behavioual and Brain Science Perspective on Decision Making in Sport

    OpenAIRE

    Parkin, Beth Louise

    2017-01-01

    The elite athlete routinely performs impressive cognitive feats. Not only do they undertake complex decision-making seemingly intuitively, they do so under conditions of intense pressure, limited time and restricted resources. Decision-making refers to the cognitive processes that underpin the selection of one course of action from several alternatives (Reason, 1990); it is essential for high-quality performance in sport (Farrow & Raab, 2008; Jordet & Hartman, 2008; Paserman, 2007). Decision-...

  1. Decision Making in the Airplane

    Science.gov (United States)

    Orasanu, Judith; Shafto, Michael G. (Technical Monitor)

    1995-01-01

    The Importance of decision-making to safety in complex, dynamic environments like mission control centers, aviation, and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. Yet laboratory research on decision making has not proven especially helpful In improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multi-dimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that

  2. Abstract analysis method facilitates filtering low-methodological quality and high-bias risk systematic reviews on psoriasis interventions.

    Science.gov (United States)

    Gómez-García, Francisco; Ruano, Juan; Aguilar-Luque, Macarena; Alcalde-Mellado, Patricia; Gay-Mimbrera, Jesús; Hernández-Romero, José Luis; Sanz-Cabanillas, Juan Luis; Maestre-López, Beatriz; González-Padilla, Marcelino; Carmona-Fernández, Pedro J; García-Nieto, Antonio Vélez; Isla-Tejera, Beatriz

    2017-12-29

    Article summaries' information and structure may influence researchers/clinicians' decisions to conduct deeper full-text analyses. Specifically, abstracts of systematic reviews (SRs) and meta-analyses (MA) should provide structured summaries for quick assessment. This study explored a method for determining the methodological quality and bias risk of full-text reviews using abstract information alone. Systematic literature searches for SRs and/or MA about psoriasis were undertaken on MEDLINE, EMBASE, and Cochrane database. For each review, quality, abstract-reporting completeness, full-text methodological quality, and bias risk were evaluated using Preferred Reporting Items for Systematic Reviews and Meta-analyses for abstracts (PRISMA-A), Assessing the Methodological Quality of Systematic Reviews (AMSTAR), and ROBIS tools, respectively. Article-, author-, and journal-derived metadata were systematically extracted from eligible studies using a piloted template, and explanatory variables concerning abstract-reporting quality were assessed using univariate and multivariate-regression models. Two classification models concerning SRs' methodological quality and bias risk were developed based on per-item and total PRISMA-A scores and decision-tree algorithms. This work was supported, in part, by project ICI1400136 (JR). No funding was received from any pharmaceutical company. This study analysed 139 SRs on psoriasis interventions. On average, they featured 56.7% of PRISMA-A items. The mean total PRISMA-A score was significantly higher for high-methodological-quality SRs than for moderate- and low-methodological-quality reviews. SRs with low-bias risk showed higher total PRISMA-A values than reviews with high-bias risk. In the final model, only 'authors per review > 6' (OR: 1.098; 95%CI: 1.012-1.194), 'academic source of funding' (OR: 3.630; 95%CI: 1.788-7.542), and 'PRISMA-endorsed journal' (OR: 4.370; 95%CI: 1.785-10.98) predicted PRISMA-A variability. Reviews with a

  3. Decision aids for people facing health treatment or screening decisions.

    Science.gov (United States)

    Stacey, Dawn; Légaré, France; Col, Nananda F; Bennett, Carol L; Barry, Michael J; Eden, Karen B; Holmes-Rovner, Margaret; Llewellyn-Thomas, Hilary; Lyddiatt, Anne; Thomson, Richard; Trevena, Lyndal; Wu, Julie H C

    2014-01-28

    conservative options (RR 0.79; 95% CI 0.68 to 0.93; n = 15). Exposure to decision aids compared to usual care reduced the number of people choosing to have prostate-specific antigen screening (RR 0.87; 95% CI 0.77 to 0.98; n = 9). When detailed compared to simple decision aids were used, fewer people chose menopausal hormone therapy (RR 0.73; 95% CI 0.55 to 0.98; n = 3). For other decisions, the effect on choices was variable.The effect of decision aids on length of consultation varied from 8 minutes shorter to 23 minutes longer (median 2.55 minutes longer) with 2 studies indicating statistically-significantly longer, 1 study shorter, and 6 studies reporting no difference in consultation length. Groups of patients receiving decision aids do not appear to differ from comparison groups in terms of anxiety (n = 30), general health outcomes (n = 11), and condition-specific health outcomes (n = 11). The effects of decision aids on other outcomes (adherence to the decision, costs/resource use) were inconclusive. There is high-quality evidence that decision aids compared to usual care improve people's knowledge regarding options, and reduce their decisional conflict related to feeling uninformed and unclear about their personal values. There is moderate-quality evidence that decision aids compared to usual care stimulate people to take a more active role in decision making, and improve accurate risk perceptions when probabilities are included in decision aids, compared to not being included. There is low-quality evidence that decision aids improve congruence between the chosen option and the patient's values.New for this updated review is further evidence indicating more informed, values-based choices, and improved patient-practitioner communication. There is a variable effect of decision aids on length of consultation. Consistent with findings from the previous review, decision aids have a variable effect on choices. They reduce the number of people choosing discretionary surgery

  4. A Computerised Business Ethics Expert System -A new approach to improving the ethical quality of business decision-making

    Directory of Open Access Journals (Sweden)

    Bernie Brenner

    2007-06-01

    Full Text Available Abstract Where unethical business decision-making arises from failures of ethical perception, there is an important role for ethical training and decision-making tools. These may help business people to consider all relevant issues when assessing the ethical status of potential decisions. Ethical training programmes give business people a basic understanding of the principles which underlie ethical judgements and equip them with many of the necessary skills for dealing with the ethical dilemmas which they face in their jobs. Similarly, ethical decision-making tools may guide managers through the various ethical considerations which are relevant to business decision-making and help them to develop their ethical-perceptual skills. Furthermore, by establishing and reinforcing good ethical decision-making practices, training programmes and decision-making tools may also reduce the incidence of self-consciously unethical decision-making. A new approach to improving the ethical quality of business decision-making by the use of computerized business ethics expert systems is proposed. These systems have the potential to guide business people through a process of ethical evaluation while simultaneously fulfilling an educational role, thus providing many of the benefits of both training programmes and decision-making tools. While the prospect of a computer system which could simply make ethical judgements for business people is both unrealistic and undesirable, a system which leads human decision-makers through a structured assessment process has the potential for genuine benefits. Keywords: Expert Systems, Ethical Decision Making

  5. The Effect of Structured Decision-Making Techniques and Gender on Student Reaction and Quality of Written Documents.

    Science.gov (United States)

    Neal, Joan; Echternacht, Lonnie

    1995-01-01

    Experimental groups used four decision-making techniques--reverse brainstorming (RS), dialectical inquiry (DI), devil's advocacy (DA), and consensus--in evaluating writing assignments. Control group produced a better quality document. Student reaction to negative features of RS, DI, and DA were not significant. (SK)

  6. Grand Challenges in Clinical Decision Support v10

    Science.gov (United States)

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

    2008-01-01

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

  7. Environmental Decision Making and Information Technology: Issues Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Barg, S.; Fletcher, T.; Mechling, J.; Tonn, B.; Turner, R.

    1999-05-01

    This report presents a summary of the Information Technology and Environmental Decision Making Workshop that was held at Harvard University, October 1-3, 1998. Over sixty participants from across the US took part in discussions that focused on the current practice of using information technology to support environmental decision making and on future considerations of information technology development, information policies, and data quality issues in this area. Current practice is focusing on geographic information systems and visualization tools, Internet applications, and data warehousing. In addition, numerous organizations are developing environmental enterprise systems to integrate environmental information resources. Plaguing these efforts are issues of data quality (and public trust), system design, and organizational change. In the future, much effort needs to focus on building community-based environmental decision-making systems and processes, which will be a challenge given that exactly what needs to be developed is largely unknown and that environmental decision making in this arena has been characterized by a high level of conflict. Experimentation and evaluation are needed to contribute to efficient and effective learning about how best to use information technology to improve environmental decision making.

  8. Optimal management of high-risk T1G3 bladder cancer: a decision analysis.

    Directory of Open Access Journals (Sweden)

    Girish S Kulkarni

    2007-09-01

    Full Text Available BACKGROUND: Controversy exists about the most appropriate treatment for high-risk superficial (stage T1; grade G3 bladder cancer. Immediate cystectomy offers the best chance for survival but may be associated with an impaired quality of life compared with conservative therapy. We estimated life expectancy (LE and quality-adjusted life expectancy (QALE for both of these treatments for men and women of different ages and comorbidity levels. METHODS AND FINDINGS: We evaluated two treatment strategies for high-risk, T1G3 bladder cancer using a decision-analytic Markov model: (1 Immediate cystectomy with neobladder creation versus (2 conservative management with intravesical bacillus Calmette-Guérin (BCG and delayed cystectomy in individuals with resistant or progressive disease. Probabilities and utilities were derived from published literature where available, and otherwise from expert opinion. Extensive sensitivity analyses were conducted to identify variables most likely to influence the decision. Structural sensitivity analyses modifying the base case definition and the triggers for cystectomy in the conservative therapy arm were also explored. Probabilistic sensitivity analysis was used to assess the joint uncertainty of all variables simultaneously and the uncertainty in the base case results. External validation of model outputs was performed by comparing model-predicted survival rates with independent published literature. The mean LE of a 60-y-old male was 14.3 y for immediate cystectomy and 13.6 y with conservative management. With the addition of utilities, the immediate cystectomy strategy yielded a mean QALE of 12.32 y and remained preferred over conservative therapy by 0.35 y. Worsening patient comorbidity diminished the benefit of early cystectomy but altered the LE-based preferred treatment only for patients over age 70 y and the QALE-based preferred treatment for patients over age 65 y. Sensitivity analyses revealed that patients

  9. Informed decision making does not affect health-related quality of life in lung cancer screening (NELSON trial)

    NARCIS (Netherlands)

    van den Bergh, Karien A. M.; Essink-Bot, Marie-Louise; van Klaveren, Rob J.; de Koning, Harry J.

    2010-01-01

    Background: It is believed that making an informed decision about (screening) participation is associated with better health-related quality of life (HRQoL) outcomes. This is the first study in cancer screening to explore this association in subjects participating in a lung cancer computed

  10. High-quality compressive ghost imaging

    Science.gov (United States)

    Huang, Heyan; Zhou, Cheng; Tian, Tian; Liu, Dongqi; Song, Lijun

    2018-04-01

    We propose a high-quality compressive ghost imaging method based on projected Landweber regularization and guided filter, which effectively reduce the undersampling noise and improve the resolution. In our scheme, the original object is reconstructed by decomposing of regularization and denoising steps instead of solving a minimization problem in compressive reconstruction process. The simulation and experimental results show that our method can obtain high ghost imaging quality in terms of PSNR and visual observation.

  11. 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.

  12. Assessment of bird populations in a high quality savanna/woodland: a banding approach

    Science.gov (United States)

    Wilmore, Sandra L.; Glowacki, Gary A.; Grundel, Ralph

    2005-01-01

    Between 1999 and 2004, Save the Dunes Conservation Fund's Miller Woods Bird Banding Program monitored migrating and breeding bird populations within a high quality black oak, dry-mesic sand savanna/woodland with ridge and swale topography. The objectives of this program were to collect consistent and reliable demographic and abundance data on the bird populations, to investigate long-term population trends, and to contribute to improved land management decisions at regional and national scales. The technique employed involved capturing birds in mist nets that were deployed for set periods of time at 17 net sites in two banding areas in Miller Woods.

  13. Geospatial decision support systems for societal decision making

    Science.gov (United States)

    Bernknopf, R.L.

    2005-01-01

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

  14. Decision-making and sampling size effect

    OpenAIRE

    Ismariah Ahmad; Rohana Abd Rahman; Roda Jean-Marc; Lim Hin Fui; Mohd Parid Mamat

    2010-01-01

    Sound decision-making requires quality information. Poor information does not help in decision making. Among the sources of low quality information, an important cause is inadequate and inappropriate sampling. In this paper we illustrate the case of information collected on timber prices.

  15. Development of shared decision-making resources to help inform difficult healthcare decisions: An example focused on dysvascular partial foot and transtibial amputations.

    Science.gov (United States)

    Quigley, Matthew; Dillon, Michael P; Fatone, Stefania

    2018-02-01

    Shared decision making is a consultative process designed to encourage patient participation in decision making by providing accurate information about the treatment options and supporting deliberation with the clinicians about treatment options. The process can be supported by resources such as decision aids and discussion guides designed to inform and facilitate often difficult conversations. As this process increases in use, there is opportunity to raise awareness of shared decision making and the international standards used to guide the development of quality resources for use in areas of prosthetic/orthotic care. To describe the process used to develop shared decision-making resources, using an illustrative example focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Development process: The International Patient Decision Aid Standards were used to guide the development of the decision aid and discussion guide focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Examples from these shared decision-making resources help illuminate the stages of development including scoping and design, research synthesis, iterative development of a prototype, and preliminary testing with patients and clinicians not involved in the development process. Lessons learnt through the process, such as using the International Patient Decision Aid Standards checklist and development guidelines, may help inform others wanting to develop similar shared decision-making resources given the applicability of shared decision making to many areas of prosthetic-/orthotic-related practice. Clinical relevance Shared decision making is a process designed to guide conversations that help patients make an informed decision about their healthcare. Raising awareness of shared decision making and the international standards for development of high-quality decision aids and discussion guides is important

  16. Does future-oriented thinking predict adolescent decision making?

    Science.gov (United States)

    Eskritt, Michelle; Doucette, Jesslyn; Robitaille, Lori

    2014-01-01

    A number of theorists, as well as plain common sense, suggest that future-oriented thinking (FOT) should be involved in decision making; therefore, the development of FOT should be related to better quality decision making. FOT and quality of the decision making were measured in adolescents as well as adults in 2 different experiments. Though the results of the first experiment revealed an increase in quality of decision making across adolescence into adulthood, there was no relationship between FOT and decision making. In the second experiment, FOT predicted performance on a more deliberative decision-making task independent of age, but not performance on the Iowa Gambling Task (IGT). Performance on the IGT was instead related to emotion regulation. The study's findings suggest that FOT can be related to reflective decision making but not necessarily decision making that is more intuitive.

  17. Embryo quality predictive models based on cumulus cells gene expression

    Directory of Open Access Journals (Sweden)

    Devjak R

    2016-06-01

    Full Text Available Since the introduction of in vitro fertilization (IVF in clinical practice of infertility treatment, the indicators for high quality embryos were investigated. Cumulus cells (CC have a specific gene expression profile according to the developmental potential of the oocyte they are surrounding, and therefore, specific gene expression could be used as a biomarker. The aim of our study was to combine more than one biomarker to observe improvement in prediction value of embryo development. In this study, 58 CC samples from 17 IVF patients were analyzed. This study was approved by the Republic of Slovenia National Medical Ethics Committee. Gene expression analysis [quantitative real time polymerase chain reaction (qPCR] for five genes, analyzed according to embryo quality level, was performed. Two prediction models were tested for embryo quality prediction: a binary logistic and a decision tree model. As the main outcome, gene expression levels for five genes were taken and the area under the curve (AUC for two prediction models were calculated. Among tested genes, AMHR2 and LIF showed significant expression difference between high quality and low quality embryos. These two genes were used for the construction of two prediction models: the binary logistic model yielded an AUC of 0.72 ± 0.08 and the decision tree model yielded an AUC of 0.73 ± 0.03. Two different prediction models yielded similar predictive power to differentiate high and low quality embryos. In terms of eventual clinical decision making, the decision tree model resulted in easy-to-interpret rules that are highly applicable in clinical practice.

  18. The impact of safety and quality of health care on Chinese nursing career decision-making.

    Science.gov (United States)

    Zhu, Junhong; Rodgers, Sheila; Melia, Kath M

    2014-05-01

    The aim of the study was to understand why nurses leave nursing practice in China by exploring the process from recruitment to final exit. This report examines the impact of safety and quality of health care on nursing career decision-making from the leavers' perspective. The nursing shortage in China is more serious than in most developed countries, but the loss of nurses through voluntarily leaving nursing practice has not attracted much attention. This qualitative study draws on a grounded theory approach. In-depth interviews with 19 nurses who have left nursing practice and were theoretically sampled from one provincial capital city in Mainland China. 'Loss of confidence in the safety and quality of health care' became one of the main categories from all leavers' accounts of their decision to leave nursing practice. It emerged from three themes 'Perceiving risk in clinical practice', 'Recognising organisational barriers to safety' and 'Failing to meet expectations of patients'. The findings indicate that the essential work value of nursing to the leavers is the safety and quality of care for their patients. When nurses perceived that they could not fulfil this essential work value in their nursing practice, some of them could not accept the compromise to their value of nursing and left voluntarily to get away from the physical and mental stress. However, some nurses had to stay and accept the limitations on the safety and quality of health care. The study suggests that well-qualified nurses voluntarily leaving nursing practice is a danger signal for patients and hospitals, and has caused deterioration in nursing morale for both current and potential nursing workforces. It suggests that safety and quality of health care could be improved when individual nurses are empowered to exercise nursing autonomy with organisational and managerial support. The priority retention strategies need to remove organisational barriers to the safety and quality of health care

  19. Fabrication of high-quality brazed joints

    International Nuclear Information System (INIS)

    Orlov, A.V.

    1980-01-01

    Problem of ensuring of joint high-quality when brazing different parts in power engineering is considered. To obtain high-quality joints it is necessary to correctly design brazed joint and to choose a gap width, overlap length and fillet radius; to clean up carefully the surfaces to be brazed and fix them properly one relative to another; to apply a solder so as to provide its flowing into the gap and sticking in it; to exactly regulate thermal conditions of brazing. High quality and reliability of brazed joints are ensured by the application of solders based on noble metals, and cheap solders based on nickel, manganese and copper. Joints brazed with nickel base solders may operate at temperatures as high as 888 deg C

  20. 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

  1. Evaluating survey quality in health services research: a decision framework for assessing nonresponse bias.

    Science.gov (United States)

    Halbesleben, Jonathon R B; Whitman, Marilyn V

    2013-06-01

    To address the issue of nonresponse as problematic and offer appropriate strategies for assessing nonresponse bias. A review of current strategies used to assess the quality of survey data and the challenges associated with these strategies is provided along with appropriate post-data collection techniques that researchers should consider. Response rates are an incomplete assessment of survey data quality, and quick reactions to response rate should be avoided. Based on a five-question decision making framework, we offer potential ways to assess nonresponse bias, along with a description of the advantages and disadvantages to each. It is important that the quality of survey data be considered to assess the relative contribution to the literature of a given study. Authors and funding agencies should consider the potential effects of nonresponse bias both before and after survey administration and report the results of assessments of nonresponse bias in addition to response rates. © Health Research and Educational Trust.

  2. Coordinating vendor-buyer decisions for imperfect quality items considering trade credit and fully backlogged shortages

    Science.gov (United States)

    Khanna, Aditi; Gautam, Prerna; Jaggi, Chandra K.

    2016-03-01

    Supply chain management has become a critical issue for modern business environments. In today's world of cooperative decision-making, individual decisions in order to reduce inventory costs may not lead to an overall optimal solution. Coordination is necessary among participants of supply chain to achieve better performance. There are legitimate and important efforts from the vendor to enhance the relation with buyer; one such effort is offering trade credit which has been a driver of growth and development of business between them. The cost of financing is a core consideration in effective financial management, in general and in context of business. Also, due to imperfect production a vendor may produce defective items which results in shortages. Motivated with these aspects, an integrated vendor-buyer inventory model is developed for imperfect quality items with allowable shortages; in which the vendor offers credit period to the buyer for payment. The objective is to minimize the total joint annual costs incurred by the vendor and the buyer by using integrated decision making approach. The expected total annual integrated cost is derived and a solution procedure is provided to find the optimal solution. Numerical analysis shows that the integrated model gives an impressive cost reduction, in comparison to independent decision policies by the vendor and the buyer.

  3. Characteristics Associated With Preferences for Parent-Centered Decision Making in Neonatal Intensive Care.

    Science.gov (United States)

    Weiss, Elliott Mark; Xie, Dawei; Cook, Noah; Coughlin, Katherine; Joffe, Steven

    2018-05-01

    Little is known about how characteristics of particular clinical decisions influence decision-making preferences by patients or their surrogates. A better understanding of the factors underlying preferences is essential to improve the quality of shared decision making. To identify the characteristics of particular decisions that are associated with parents' preferences for family- vs medical team-centered decision making across the spectrum of clinical decisions that arise in the neonatal intensive care unit (NICU). This cross-sectional survey assessed parents' preferences for parent- vs medical team-centered decision making across 16 clinical decisions, along with parents' assessments of 7 characteristics of those decisions. Respondents included 136 parents of infants in 1 of 3 academically affiliated hospital NICUs in Philadelphia, Pennsylvania, from January 7 to July 8, 2016. Respondents represented a wide range of educational levels, employment status, and household income but were predominantly female (109 [80.1%]), white (68 [50.0%]) or African American (53 [39.0%]), and married (81 of 132 responding [61.4%]). Preferences for parent-centered decision making. For each decision characteristic (eg, urgency), multivariable analyses tested whether middle and high levels of that characteristic (compared with low levels) were associated with a preference for parent-centered decision making, resulting in 2 odds ratios (ORs) per decision characteristic. Among the 136 respondents (109 women [80.1%] and 27 men [19.9%]; median age, 30 years [range, 18-43 years]), preferences for parent-centered decision making were positively associated with decisions that involved big-picture goals (middle OR, 2.01 [99% CI, 0.83-4.86]; high OR, 3.38 [99% CI, 1.48-7.75]) and that had the potential to harm the infant (middle OR, 1.32 [99% CI, 0.84-2.08]; high OR, 2.62 [99% CI, 1.67-4.11]). In contrast, preferences for parent-centered decision making were inversely associated with the

  4. Rationales behind irrationality of decision making in groundwater quality management.

    Science.gov (United States)

    Ronen, Daniel; Sorek, Shaul; Gilron, Jack

    2012-01-01

    This issue paper presents how certain policies regarding management of groundwater quality lead to unexpected and undesirable results, despite being backed by seemingly reasonable assumptions. This happened in part because the so-called reasonable decisions were not based on an integrative and quantitative methodology. The policies surveyed here are: (1) implementation of a program for aquifer restoration to pristine conditions followed, after failure, by leaving it to natural attenuation; (2) the "Forget About The Aquifer" (FATA) approach, while ignoring possible damage that contaminated groundwater can inflict on the other environmental systems; (3) groundwater recharge in municipal areas while neglecting the presence of contaminants in the unsaturated zone and conditions exerted by upper impervious surfaces; (4) the Soil Aquifer Treatment (SAT) practice considering aquifers to be "filters of infinite capacity"; and (5) focusing on well contamination vs. aquifer contamination to conveniently defer grappling with the problem of the aquifer as a whole. Possible reasons for the failure of these seemingly rational policies are: (1) the characteristic times of processes associated with groundwater that are usually orders of magnitude greater than the residence times of decision makers in their managerial position; (2) proliferation of improperly trained "groundwater experts" or policymakers with sectoral agendas alongside legitimate differences of opinion among groundwater scientists; (3) the neglect of the cyclic nature of natural phenomena; and (4) ignoring future long-term costs because of immediate costs. © 2011, The Author(s). Ground Water © 2011, National Ground Water Association.

  5. Procurement in the Nuclear Industry, Quality, Safety and Decision Making

    International Nuclear Information System (INIS)

    Jakobsson, Marianne; Svenson, Ola; Salo, Ilkka

    2010-03-01

    The major purpose of the present study is partly to map and partly to make an analysis of the decision processes in the procurement routines in the nuclear industry in order to provide a basis for: 1. further development of safety inspections about procurements for Swedish Radiation Safety Authority 2. improvements of safety management in connection with procurement within a nuclear-power plant, 3 improvements of procurement routines in general in a nuclear power plant. The procurement processes at a nuclear power plant were analyzed from a decision theoretic perspective. Key staff at the plant was interviewed and written instructions as well as digitalized processes were used in the analysis. The results illustrate the most important moments during the procurement process with descriptions from interviews and documents. The staff at the nuclear power plant used a multi-attribute utility decision theory MAUT-inspired model in evaluation of alternatives and both compensatory (in which negative aspects can be compensated by positive aspects) and non-compensatory (in which certain 'pass' levels of attributes have to be exceeded for a choice) decision rules were used in the procurement process. Not surprising, nuclear safety was evaluated in a non-compensatory manner following regulatory criteria while costs were evaluated in trade-off compensatory rules, which means that a weakness in one consideration might be compensated by strength in another consideration. Thus, nuclear safety above the regulator's and law requirements are not integrated in a compensatory manner when procurement alternatives are evaluated. The nuclear plant assessed an organization's safety culture at an early stage of the purchasing process. A successful and a less successful procurement case were reported with the lessons learned from them. We find that the existing written instructions for purchase were well elaborated and adequate. There is a lack of personal resources when procurement teams

  6. Biotechnology and Consumer Decision-Making.

    Science.gov (United States)

    Sax, Joanna K

    Society is facing major challenges in climate change, health care and overall quality of life. Scientific advances to address these areas continue to grow, with overwhelming evidence that the application of highly tested forms of biotechnology is safe and effective. Despite scientific consensus in these areas, consumers appear reluctant to support their use. Research that helps to understand consumer decision-making and the public’s resistance to biotechnologies such as vaccines, fluoridated water programs and genetically engineered food, will provide great social value. This article is forward-thinking in that it suggests that important research in behavioral decision-making, specifically affect and ambiguity, can be used to help consumers make informed choices about major applications of biotechnology. This article highlights some of the most controversial examples: vaccinations, genetically engineered food, rbST treated dairy cows, fluoridated water, and embryonic stem cell research. In many of these areas, consumers perceive the risks as high, but the experts calculate the risks as low. Four major thematic approaches are proposed to create a roadmap for policymakers to consider for policy design and implementation in controversial areas of biotechnology. This article articulates future directions for studies that implement decision-making research to allow consumers to appropriately assign risk to their options and make informed decisions.

  7. Developing a Dynamic SPARROW Water Quality Decision Support System Using NASA Remotely-Sensed Products

    Science.gov (United States)

    Al-Hamdan, M. Z.; Smith, R. A.; Hoos, A.; Schwarz, G. E.; Alexander, R. B.; Crosson, W. L.; Srikishen, J.; Estes, M., Jr.; Cruise, J.; Al-Hamdan, A.; Ellenburg, W. L., II; Flores, A.; Sanford, W. E.; Zell, W.; Reitz, M.; Miller, M. P.; Journey, C. A.; Befus, K. M.; Swann, R.; Herder, T.; Sherwood, E.; Leverone, J.; Shelton, M.; Smith, E. T.; Anastasiou, C. J.; Seachrist, J.; Hughes, A.; Graves, D.

    2017-12-01

    The USGS Spatially Referenced Regression on Watershed Attributes (SPARROW) surface water quality modeling system has been widely used for long term, steady state water quality analysis. However, users have increasingly requested a dynamic version of SPARROW that can provide seasonal estimates of nutrients and suspended sediment to receiving waters. The goal of this NASA-funded project is to develop a dynamic decision support system to enhance the southeast SPARROW water quality model and finer-scale dynamic models for selected coastal watersheds through the use of remotely-sensed data and other NASA Land Information System (LIS) products. The spatial and temporal scale of satellite remote sensing products and LIS modeling data make these sources ideal for the purposes of development and operation of the dynamic SPARROW model. Remote sensing products including MODIS vegetation indices, SMAP surface soil moisture, and OMI atmospheric chemistry along with LIS-derived evapotranspiration (ET) and soil temperature and moisture products will be included in model development and operation. MODIS data will also be used to map annual land cover/land use in the study areas and in conjunction with Landsat and Sentinel to identify disturbed areas that might be sources of sediment and increased phosphorus loading through exposure of the bare soil. These data and others constitute the independent variables in a regression analysis whose dependent variables are the water quality constituents total nitrogen, total phosphorus, and suspended sediment. Remotely-sensed variables such as vegetation indices and ET can be proxies for nutrient uptake by vegetation; MODIS Leaf Area Index can indicate sources of phosphorus from vegetation; soil moisture and temperature are known to control rates of denitrification; and bare soil areas serve as sources of enhanced nutrient and sediment production. The enhanced SPARROW dynamic models will provide improved tools for end users to manage water

  8. Uncertain Quality Function Deployment Using a Hybrid Group Decision Making Model

    Directory of Open Access Journals (Sweden)

    Ze-Ling Wang

    2016-11-01

    Full Text Available Quality function deployment (QFD is a widely used quality system tool for translating customer requirements (CRs into the engineering design requirements (DRs of products or services. The conventional QFD analysis, however, has been criticized as having some limitations such as in the assessment of relationships between CRs and DRs, the determination of CR weights and the prioritization of DRs. This paper aims to develop a new hybrid group decision-making model based on hesitant 2-tuple linguistic term sets and an extended QUALIFLEX (qualitative flexible multiple criteria method approach for handling QFD problems with incomplete weight information. First, hesitant linguistic term sets are combined with interval 2-tuple linguistic variables to express various uncertainties in the assessment information of QFD team members. Borrowing the idea of grey relational analysis (GRA, a multiple objective optimization model is constructed to determine the relative weights of CRs. Then, an extended QUALIFLEX approach with an inclusion comparison method is suggested to determine the ranking of the DRs identified in QFD. Finally, an analysis of a market segment selection problem is conducted to demonstrate and validate the proposed QFD approach.

  9. Viewpoint: Decision-making in committees

    OpenAIRE

    Li Hao; Wing Suen

    2009-01-01

    This article reviews recent developments in the theory of committee decision-making. A committee consists of self-interested members who make a public decision by aggregating imperfect information dispersed among them according to a pre-specified decision rule. We focus on costly information acquisition, strategic information aggregation, and rules and processes that enhance the quality of the committee decision. Seeming inefficiencies of the committee decision-making process such as over-cau...

  10. Community representation in hospital decision making: a literature review.

    Science.gov (United States)

    Murray, Zoë

    2015-06-01

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

  11. Availability of high quality weather data measurements

    DEFF Research Database (Denmark)

    Andersen, Elsa; Johansen, Jakob Berg; Furbo, Simon

    In the period 2016-2017 the project “Availability of high quality weather data measurements” is carried out at Department of Civil Engineering at the Technical University of Denmark. The aim of the project is to establish measured high quality weather data which will be easily available...... for the building energy branch and the solar energy branch in their efforts to achieve energy savings and for researchers and students carrying out projects where measured high quality weather data are needed....

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

    Science.gov (United States)

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

    2014-03-20

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

  13. Working memory retrieval as a decision process.

    Science.gov (United States)

    Pearson, Benjamin; Raskevicius, Julius; Bays, Paul M; Pertzov, Yoni; Husain, Masud

    2014-02-03

    Working memory (WM) is a core cognitive process fundamental to human behavior, yet the mechanisms underlying it remain highly controversial. Here we provide a new framework for understanding retrieval of information from WM, conceptualizing it as a decision based on the quality of internal evidence. Recent findings have demonstrated that precision of WM decreases with memory load. If WM retrieval uses a decision process that depends on memory quality, systematic changes in response time distribution should occur as a function of WM precision. We asked participants to view sample arrays and, after a delay, report the direction of change in location or orientation of a probe. As WM precision deteriorated with increasing memory load, retrieval time increased systematically. Crucially, the shape of reaction time distributions was consistent with a linear accumulator decision process. Varying either task relevance of items or maintenance duration influenced memory precision, with corresponding shifts in retrieval time. These results provide strong support for a decision-making account of WM retrieval based on noisy storage of items. Furthermore, they show that encoding, maintenance, and retrieval in WM need not be considered as separate processes, but may instead be conceptually unified as operations on the same noise-limited, neural representation.

  14. A hierarchical Markov decision process modeling feeding and marketing decisions of growing pigs

    DEFF Research Database (Denmark)

    Pourmoayed, Reza; Nielsen, Lars Relund; Kristensen, Anders Ringgaard

    2016-01-01

    Feeding is the most important cost in the production of growing pigs and has a direct impact on the marketing decisions, growth and the final quality of the meat. In this paper, we address the sequential decision problem of when to change the feed-mix within a finisher pig pen and when to pick pigs...... for marketing. We formulate a hierarchical Markov decision process with three levels representing the decision process. The model considers decisions related to feeding and marketing and finds the optimal decision given the current state of the pen. The state of the system is based on information from on...

  15. High-volume image quality assessment systems: tuning performance with an interactive data visualization tool

    Science.gov (United States)

    Bresnahan, Patricia A.; Pukinskis, Madeleine; Wiggins, Michael

    1999-03-01

    Image quality assessment systems differ greatly with respect to the number and types of mags they need to evaluate, and their overall architectures. Managers of these systems, however, all need to be able to tune and evaluate system performance, requirements often overlooked or under-designed during project planning. Performance tuning tools allow users to define acceptable quality standards for image features and attributes by adjusting parameter settings. Performance analysis tools allow users to evaluate and/or predict how well a system performs in a given parameter state. While image assessment algorithms are becoming quite sophisticated, duplicating or surpassing the human decision making process in their speed and reliability, they often require a greater investment in 'training' or fine tuning of parameters in order to achieve optimum performance. This process may involve the analysis of hundreds or thousands of images, generating a large database of files and statistics that can be difficult to sort through and interpret. Compounding the difficulty is the fact that personnel charged with tuning and maintaining the production system may not have the statistical or analytical background required for the task. Meanwhile, hardware innovations have greatly increased the volume of images that can be handled in a given time frame, magnifying the consequences of running a production site with an inadequately tuned system. In this paper, some general requirements for a performance evaluation and tuning data visualization system are discussed. A custom engineered solution to the tuning and evaluation problem is then presented, developed within the context of a high volume image quality assessment, data entry, OCR, and image archival system. A key factor influencing the design of the system was the context-dependent definition of image quality, as perceived by a human interpreter. This led to the development of a five-level, hierarchical approach to image quality

  16. Evaluation of the improvement of the double-contrast radiographic image quality in the prone position brought about by the use of a decision tree in the screening examination

    International Nuclear Information System (INIS)

    Yamada, Yasuji; Nakamura, Syunichi; Ohno, Ryuichi; Azuma, Hiroshi; Fujinaga, Akira; Nagai, Makoto

    2009-01-01

    We designed a decision tree in order to improve the double-contrast radiographic image quality in the prone position and compensate for the disparity of technique among radiological technologists. We evaluated 391 consecutive individuals who underwent medical checkups at our hospital. Three decision trees, id est (i.e.), Tree 1, Tree 2 and Tree 3, were constructed based on the axis and contortion of the stomach with the use of a prone filling image, and then the insertion site of compression pillow was altered. The image quality at the gastric angulus, the gastric body and the antrum was evaluated based on our original numeric scale, and was compared between the previous method and the present method which employs a decision tree. The image quality improved more significantly in the present method employing a decision tree compared with the previous method, for each decision tree: from 90 points to 100 points for Tree 1, from 70 points to 95 points for Tree 2, and from 39.5 points for 85.7 points in Tree 3. These results indicate that our original procedure employing a decision tree improves the radiographic image quality in the prone position and compensates for the disparity of technique among radiological technologists. Therefore, the present method may be expected to serve as the standard procedure of double-contrast radiography in the prone position. (author)

  17. Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners.

    Science.gov (United States)

    Leland, Natalie E; Lepore, Michael; Wong, Carin; Chang, Sun Hwa; Freeman, Lynn; Crum, Karen; Gillies, Heather; Nash, Paul

    2018-03-01

    The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California. Purposive sampling of facilities was conducted to capture variation in key characteristics known to impact care delivery for this patient population (e.g., financial resources, staffing, and patient case-mix). Questions aimed to elicit practitioners' perspectives on high quality hip fracture rehabilitation practices. Each session was audio-recorded and transcribed. Data were systematically analyzed using a modified grounded theory approach. Seven themes emerged: objectives of care; first 72 h; positioning, pain, and precautions; use of standardized assessments; episode of care practices; facilitating insight into progress; and interdisciplinary collaboration. Clinical guidelines are critical tools to facilitate clinical decision-making and achieve desired patient outcomes. The findings of this study highlight the practitioners' perspective on what constitutes high quality hip fracture rehabilitation. This work provides critical information to advance the development of stakeholder-driven rehabilitation clinical guidelines. Future research is needed to verify the findings from other stakeholders (e.g., patients), ensure the alignment of our findings with current evidence, and develop measures for evaluating their delivery and relationship to desired outcomes. Implications for Rehabilitation This study highlights occupational and physiotherapy therapy practitioners' perspectives on the cumulative best

  18. Comparing perceptual and preferential decision making.

    Science.gov (United States)

    Dutilh, Gilles; Rieskamp, Jörg

    2016-06-01

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

  19. Conformance Testing: Measurement Decision Rules

    Science.gov (United States)

    Mimbs, Scott M.

    2010-01-01

    The goal of a Quality Management System (QMS) as specified in ISO 9001 and AS9100 is to provide assurance to the customer that end products meet specifications. Measuring devices, often called measuring and test equipment (MTE), are used to provide the evidence of product conformity to specified requirements. Unfortunately, processes that employ MTE can become a weak link to the overall QMS if proper attention is not given to the measurement process design, capability, and implementation. Documented "decision rules" establish the requirements to ensure measurement processes provide the measurement data that supports the needs of the QMS. Measurement data are used to make the decisions that impact all areas of technology. Whether measurements support research, design, production, or maintenance, ensuring the data supports the decision is crucial. Measurement data quality can be critical to the resulting consequences of measurement-based decisions. Historically, most industries required simplistic, one-size-fits-all decision rules for measurements. One-size-fits-all rules in some cases are not rigorous enough to provide adequate measurement results, while in other cases are overly conservative and too costly to implement. Ideally, decision rules should be rigorous enough to match the criticality of the parameter being measured, while being flexible enough to be cost effective. The goal of a decision rule is to ensure that measurement processes provide data with a sufficient level of quality to support the decisions being made - no more, no less. This paper discusses the basic concepts of providing measurement-based evidence that end products meet specifications. Although relevant to all measurement-based conformance tests, the target audience is the MTE end-user, which is anyone using MTE other than calibration service providers. Topics include measurement fundamentals, the associated decision risks, verifying conformance to specifications, and basic measurement

  20. Highly qualified does not equal high quality: A study of urban stakeholders' perceptions of quality in science teaching

    Science.gov (United States)

    Miranda, Rommel Joseph

    By employing qualitative methods, this study sought to determine the perceptions that urban stakeholders hold about what characteristics should distinguish a high school science teacher whom they would consider to demonstrate high quality in science teaching. A maximum variation sample of six science teachers, three school administrators, six parents and six students from a large urban public school district were interviewed using semi-structured, in-depth interview techniques. From these data, a list of observable characteristics which urban stakeholders hold as evidence of high quality in science teaching was generated. Observational techniques were utilized to determine the extent to which six urban high school science teachers, who meet the NCLB Act criteria for being "highly qualified", actually possessed the characteristics which these stakeholders hold as evidence of high quality in science teaching. Constant comparative analysis was used to analyze the data set. The findings suggest that urban stakeholders perceive that a high school science teacher who demonstrates high quality in science teaching should be knowledgeable about their subject matter, their student population, and should be resourceful; should possess an academic background in science and professional experience in science teaching; should exhibit professionalism, a passion for science and teaching, and a dedication to teaching and student learning; should be skillful in planning and preparing science lessons and in organizing the classroom, in presenting the subject matter to students, in conducting a variety of hands-on activities, and in managing a classroom; and should assess whether students complete class goals and objectives, and provide feedback about grades for students promptly. The findings further reveal that some of the urban high school science teachers who were deemed to be "highly qualified", as defined by the NCLB Act, engaged in practices that threatened quality in science

  1. Decision Making with Imperfect Decision Makers

    CERN Document Server

    Guy, Tatiana Valentine; Wolpert, David H

    2012-01-01

    Prescriptive Bayesian decision making has reached a high level of maturity and is well-supported algorithmically. However, experimental data shows that real decision makers choose such Bayes-optimal decisions surprisingly infrequently, often making decisions that are badly sub-optimal. So prevalent is such imperfect decision-making that it should be accepted as an inherent feature of real decision makers living within interacting societies. To date such societies have been investigated from an economic and gametheoretic perspective, and even to a degree from a physics perspective. However, lit

  2. Inclusion for Students with High-Functioning Autism Spectrum Disorders: Definitions and Decision Making

    Science.gov (United States)

    Sansosti, Jenine M.; Sansosti, Frank J.

    2012-01-01

    General education placements are believed to offer numerous benefits for students with high-functioning autism spectrum disorders (HFASDs), yet decisions about including students with HFASDs remain controversial. This article presents data from a qualitative analysis of definitions and decision making considerations for a school district with a…

  3. Fast High-Quality Noise

    DEFF Research Database (Denmark)

    Frisvad, Jeppe Revall; Wyvill, Geoff

    2007-01-01

    At the moment the noise functions available in a graphics programmer's toolbox are either slow to compute or they involve grid-line artifacts making them of lower quality. In this paper we present a real-time noise computation with no grid-line artifacts or other regularity problems. In other words......, we put a new tool in the box that computes fast high-quality noise. In addition to being free of artifacts, the noise we present does not rely on tabulated data (everything is computed on the fly) and it is easy to adjust quality vs. quantity for the noise. The noise is based on point rendering (like...... spot noise), but it extends to more than two dimensions. The fact that it is based on point rendering makes art direction of the noise much easier....

  4. Assuring quality in high-consequence engineering

    Energy Technology Data Exchange (ETDEWEB)

    Hoover, Marcey L.; Kolb, Rachel R.

    2014-03-01

    In high-consequence engineering organizations, such as Sandia, quality assurance may be heavily dependent on staff competency. Competency-dependent quality assurance models are at risk when the environment changes, as it has with increasing attrition rates, budget and schedule cuts, and competing program priorities. Risks in Sandia's competency-dependent culture can be mitigated through changes to hiring, training, and customer engagement approaches to manage people, partners, and products. Sandia's technical quality engineering organization has been able to mitigate corporate-level risks by driving changes that benefit all departments, and in doing so has assured Sandia's commitment to excellence in high-consequence engineering and national service.

  5. HIGH QUALITY ENVIRONMENTAL PRINCIPLES APPLIED TO THE ARCHITECTONIC DESIGN SELECTION PROCEDURE: THE NUTRE LAB CASE

    Directory of Open Access Journals (Sweden)

    Claudia Barroso Krause

    2012-06-01

    Full Text Available The need to produce more sustainable buildings has been influencing the design decisions all over the world. That’s why it is imperative, in Brazil, the development of strategies and method to aid the decision making during the design process, focused on high quality environmental. This paper presents a decision support tool based on the principles of sustainable construction developed by the Project, Architecture and Sustainability Research Group (GPAS of Federal University of Rio de Janeiro – Brazil. The methodology has been developed for the selection of a preliminary design of a laboratory to be built at Rio Technology Park at the University campus. The support provided by GPAS occurred in three stages: the elaboration of the Reference Guide for the competitors, the development of a methodology to evaluate the proposed solutions (based on environmental performance criteria and the assistance of the members of jury in the trial phase. The theoretical framework was based upon the concepts of the bioclimatic architecture, the procedures specified by the certification HQE® (Haute Qualité Environnementale and the method suggested by the ADDENDA® architecture office. The success of this experience points out the possibility to future application in similar cases.

  6. A high throughput DNA extraction method with high yield and quality

    Directory of Open Access Journals (Sweden)

    Xin Zhanguo

    2012-07-01

    Full Text Available Abstract Background Preparation of large quantity and high quality genomic DNA from a large number of plant samples is a major bottleneck for most genetic and genomic analyses, such as, genetic mapping, TILLING (Targeting Induced Local Lesion IN Genome, and next-generation sequencing directly from sheared genomic DNA. A variety of DNA preparation methods and commercial kits are available. However, they are either low throughput, low yield, or costly. Here, we describe a method for high throughput genomic DNA isolation from sorghum [Sorghum bicolor (L. Moench] leaves and dry seeds with high yield, high quality, and affordable cost. Results We developed a high throughput DNA isolation method by combining a high yield CTAB extraction method with an improved cleanup procedure based on MagAttract kit. The method yielded large quantity and high quality DNA from both lyophilized sorghum leaves and dry seeds. The DNA yield was improved by nearly 30 fold with 4 times less consumption of MagAttract beads. The method can also be used in other plant species, including cotton leaves and pine needles. Conclusion A high throughput system for DNA extraction from sorghum leaves and seeds was developed and validated. The main advantages of the method are low cost, high yield, high quality, and high throughput. One person can process two 96-well plates in a working day at a cost of $0.10 per sample of magnetic beads plus other consumables that other methods will also need.

  7. The Utility of the OMI HCHO/NO2 in Air Quality Decision-Making Activities

    Science.gov (United States)

    Duncan, Bryan

    2010-01-01

    I will discuss a novel and practical application of the OMI HCHU and NO2 data products to the "weight of evidence" in the air quality decision-making process (e.g., State Implementation Plan (SIP)) for a city, region, or state to demonstrate that it is making progress toward attainment of the National Ambient Air Quality Standard (NAAQS) for ozone. Any trend, or lack thereof, in the observed OMI HCHO/NO2 may support that an emission control strategy implemented to reduce ozone is or is not occurring for a metropolitan area. In addition, the observed OMI HCHO/NO2 may be used to define new emission control strategies as the photochemical environments of urban areas evolve over time. I will demonstrate the utility of the OMI HCHO/NO2 over the U.S. for air quality applications with support from simulations with both a regional model and a photochemical box model. These results support mission planning of an OMI-like instrument for the proposed GEO-CAPE satellite that has as one of its objectives to study air quality from space. However, I'm attending the meeting as the Aura Deputy Project Scientist, so I don't technically need to present anything to justify the travel.

  8. The Utility of the OMI HCHO and NO2 Data Products in Air Quality Decision- Making Activities

    Science.gov (United States)

    Duncan, Bryan N.

    2010-01-01

    We will present three related air quality applications of the OMI HCHO (formaldehyde) and NO2 (nitrogen dioxide) data products, which we us to support mission planning of an OMI-like instrument for the proposed GEO-CAPE satellite that has as one of its objectives to study air quality from space. First, we will discuss a novel and practical application of the data products to the "weight of evidence" in the air quality decision-making process (e.g., State Implementation Plan (SIP)) for a city, region, or state to demonstrate that it is making progress toward attainment of the National Ambient Air Quality Standard (NAAQS) for ozone. Any trend, or lack thereof, in the observed OMI HCHO/NO2, which we use as an air quality indicator, may support that an emission control strategy implemented to reduce ozone is or is not occurring for a metropolitan area. Second, we will discuss how we use variations in the OMI HCHO product as a proxy for variability in the biogenic hydrocarbon, isoprene, which is an important player for the formation of high levels of ozone and the dominant source of HCHO in the eastern U.S. Third, we will discuss the variability of NO2 in the U.S. as indicated by the OMI NO2 product. In addition, we will show the impact of the 2005 hurricanes on pollutant emissions, including those associated with the intensive oil extraction and refining activities, in the Gulf of Mexico region using the OMI NO2 product. The variability of HCHO and NO2 as indicated by OMI helps us to understand changes in the OMI HCHO/NO2 and the implications for ozone formation.

  9. Concrete Waste Recycling Process for High Quality Aggregate

    International Nuclear Information System (INIS)

    Ishikura, Takeshi; Fujii, Shin-ichi

    2008-01-01

    Large amount of concrete waste generates during nuclear power plant (NPP) dismantling. Non-contaminated concrete waste is assumed to be disposed in a landfill site, but that will not be the solution especially in the future, because of decreasing tendency of the site availability and natural resources. Concerning concrete recycling, demand for roadbeds and backfill tends to be less than the amount of dismantled concrete generated in a single rural site, and conventional recycled aggregate is limited of its use to non-structural concrete, because of its inferior quality to ordinary natural aggregate. Therefore, it is vital to develop high quality recycled aggregate for general uses of dismantled concrete. If recycled aggregate is available for high structural concrete, the dismantling concrete is recyclable as aggregate for industry including nuclear field. Authors developed techniques on high quality aggregate reclamation for large amount of concrete generated during NPP decommissioning. Concrete of NPP buildings has good features for recycling aggregate; large quantity of high quality aggregate from same origin, record keeping of the aggregate origin, and little impurities in dismantled concrete such as wood and plastics. The target of recycled aggregate in this development is to meet the quality criteria for NPP concrete as prescribed in JASS 5N 'Specification for Nuclear Power Facility Reinforced Concrete' and JASS 5 'Specification for Reinforced Concrete Work'. The target of recycled aggregate concrete is to be comparable performance with ordinary aggregate concrete. The high quality recycled aggregate production techniques are assumed to apply for recycling for large amount of non-contaminated concrete. These techniques can also be applied for slightly contaminated concrete dismantled from radiological control area (RCA), together with free release survey. In conclusion: a technology on dismantled concrete recycling for high quality aggregate was developed

  10. Promoting High Quality Teacher-Child Interactions: Examining the Role of Teachers' Depression, Perceptions of Children's Peer Relationships, and Contextual Factors

    Science.gov (United States)

    Granger, Kristen

    2017-01-01

    The overall goal of this dissertation was to examine teacher characteristics, teachers' beliefs, and contextual factors that may motivate teachers' decisions to engage in high quality teacher-child interactions. I use two complementary studies to meet this goal. These two studies provide insight into several aspects of early childhood teachers'…

  11. [Quality of life or life expectancy? Criteria and sources of information in the decision-making of patients undergoing aortic valve surgery].

    Science.gov (United States)

    Schmied, Wolfram; Barnick, Saskia; Heimann, Dierk; Schäfers, Hans-Joachim; Köllner, Volker

    2015-01-01

    Physicians are expected to involve patients adequately in the decision-making process prior to surgery. To this end, it is essential to have knowledge about the potential reasons for such a decision. In this study we investigated which information sources and decision criteria are important to patients prior to aortic valve surgery. A consecutive sample of 468 patients (70.1%m, aged 66.9±14.2 years) was examined 2 years after aortic valve replacement or reconstruction with a self-developed questionnaire. Preoperative discussion with a cardiologist or a cardiac surgeon was the information source patients used most frequently and felt to be the most helpful. The most important decision criterion was quality of life, followed by life expectancy and likelihood of reoperation. Two years postoperatively, 97.3% of the patients were satisfied with their decision. Preoperative counseling by a physician plays an essential role in the decision-making process prior to cardiac surgery. Patients want to be involved in decision-making, though they do not want to bear the full responsibility.

  12. [Faecal occult blood test for colorectal cancer screening: high quality for a good price].

    Science.gov (United States)

    van Veldhuizen, Harriët; Bonfrer, J M G Hans; Kuipers, Ernst J

    2013-01-01

    The Dutch National Institute for Public Health and the Environment (RIVM) awarded the immunochemical faecal occult blood test (IFOBT) to FOB Gold of Sentinel following a European call for tenders. The contract-awarding procedure included the application of quality knock-out criteria, which were met by two suppliers. The decisive factor was the best price/quality ratio. A recent review indicated that, at present, no single IFOBT is better than any other. The decision to opt for a test manufactured by a different supplier than was used in the previous screening pilots made it necessary to re-determine the cut-off value. This value has now been set (88 ng/ml) and is confirmed by a laboratory test. Colonoscopy-related capacity planning, as well as its diagnostic yield, depends on numerous factors; therefore, the RIVM is currently monitoring the referral percentage and number of adenomas detected and is collaborating on quality terms. Any necessary adjustments are to be made during the introduction of the screening test.

  13. Flexibility in collective decision-making by ant colonies: Tracking food across space and time

    International Nuclear Information System (INIS)

    Dussutour, Audrey; Nicolis, Stamatios C.

    2013-01-01

    Deciding which of many available resources to exploit is a problem faced by a range of decentralized biological systems. For example, ants are able to choose between food sources that vary in quality using a chemical trail. This communication system characterized by a strong positive feedback allows a rapid transfer of information and the selection of the best food source. This is true in static environment, where a single, unchanging solution exists. In dynamic environments however such recruitment often ‘lock’ groups into suboptimal decisions, preventing a response to changes in available resources. Here, we investigate decision-making in a dynamic environment for the greenhead ants (Rhytidoponera metallica) which use a non-chemical recruitment. To experimentally test our study species’ ability to adapt to changes in their foraging environment, we offered three feeders that changed in quality. At any given time, only one feeder provided high quality food, while the others provided low quality food. Every two hours, the quality of the feeders changed such that the previously high quality feeder became a low quality feeder, and vice versa. We showed that ants were able to track changes in food quality across space and time. By coupling behavioral observations to computer simulations, we demonstrate that selection of food sources relies uniquely on a retention effect of feeding individuals on newcomers without comparison between available opportunities. The elegance of these parsimonious foraging systems is that the collective decision arises from the perception of conspecifics without the need for a leader having a synoptic overall view of the situation and knowing all the available options

  14. Material Distortion of Economic Behaviour and Everyday Decision Quality

    DEFF Research Database (Denmark)

    Gidlöf, Kerstin; Wallin, Annika; Holmqvist, Kenneth

    2013-01-01

    just as often poor as good. If the proportion of bad purchase decisions based on misleading information is small enough, perhaps it might be better to direct the authors' attention to other ways of improving the decision environments that consumers encounter. In addition, the eye-tracking study...... provides some insight into how consumers sample information when making an in-store purchase decision. The present data show that consumers invested on average of less than 1 s to look at products. © 2013 Springer Science+Business Media New York....

  15. Decision making under uncertainty

    International Nuclear Information System (INIS)

    Cyert, R.M.

    1989-01-01

    This paper reports on ways of improving the reliability of products and systems in this country if we are to survive as a first-rate industrial power. The use of statistical techniques have, since the 1920s, been viewed as one of the methods for testing quality and estimating the level of quality in a universe of output. Statistical quality control is not relevant, generally, to improving systems in an industry like yours, but certainly the use of probability concepts is of significance. In addition, when it is recognized that part of the problem involves making decisions under uncertainty, it becomes clear that techniques such as sequential decision making and Bayesian analysis become major methodological approaches that must be utilized

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

    Science.gov (United States)

    Ballantine, R. Malcolm

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

  17. Effect of forage quality in faeces from different ruminant species fed high and low quality forage

    DEFF Research Database (Denmark)

    Jalali, A R; Nørgaard, P; Nielsen, M O

    2010-01-01

    Effect of forage quality in faeces from different ruminant species fed high and low quality forage......Effect of forage quality in faeces from different ruminant species fed high and low quality forage...

  18. 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…

  19. TOTAL QUALITY MANAGEMENT IN HIGH EDUCATION

    Directory of Open Access Journals (Sweden)

    Hasan SERİN, Alper AYTEKİN

    2009-01-01

    Full Text Available The approach of Total Quality Management (TQM has been even more common and most recently its use in high education has been discussed. Likewise the enterprises producing various products, universities have also inputs, processes, and outputs. Due to conditions of competition, universities have to improve the qualities of these inputs, processes, and outputs, according to satisfaction, demands, and expectations of internal and external customers. If the TQM has been implemented in the universities with a manner that aims for customer satisfaction (students, lecturers, public and private establishments, and families, supports constant development, ensures participatory approach, and encourages working in groups, it will provide universities with effectiveness, efficiency, dynamics, and economics. In this study, common problems of universities, definitions of quality and TQM in high education, customer concept at universities, and factors affecting the quality of education have been explained. Besides, in order TQM approach to be successfully implemented in the universities, various suggestions have been presented.

  20. When Quality Beats Quantity: Decision Theory, Drug Discovery, and the Reproducibility Crisis.

    Directory of Open Access Journals (Sweden)

    Jack W Scannell

    Full Text Available A striking contrast runs through the last 60 years of biopharmaceutical discovery, research, and development. Huge scientific and technological gains should have increased the quality of academic science and raised industrial R&D efficiency. However, academia faces a "reproducibility crisis"; inflation-adjusted industrial R&D costs per novel drug increased nearly 100 fold between 1950 and 2010; and drugs are more likely to fail in clinical development today than in the 1970s. The contrast is explicable only if powerful headwinds reversed the gains and/or if many "gains" have proved illusory. However, discussions of reproducibility and R&D productivity rarely address this point explicitly. The main objectives of the primary research in this paper are: (a to provide quantitatively and historically plausible explanations of the contrast; and (b identify factors to which R&D efficiency is sensitive. We present a quantitative decision-theoretic model of the R&D process. The model represents therapeutic candidates (e.g., putative drug targets, molecules in a screening library, etc. within a "measurement space", with candidates' positions determined by their performance on a variety of assays (e.g., binding affinity, toxicity, in vivo efficacy, etc. whose results correlate to a greater or lesser degree. We apply decision rules to segment the space, and assess the probability of correct R&D decisions. We find that when searching for rare positives (e.g., candidates that will successfully complete clinical development, changes in the predictive validity of screening and disease models that many people working in drug discovery would regard as small and/or unknowable (i.e., an 0.1 absolute change in correlation coefficient between model output and clinical outcomes in man can offset large (e.g., 10 fold, even 100 fold changes in models' brute-force efficiency. We also show how validity and reproducibility correlate across a population of simulated

  1. "Quality of prenatal and maternal care: bridging the know-do gap" (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan Africa.

    Science.gov (United States)

    Blank, Antje; Prytherch, Helen; Kaltschmidt, Jens; Krings, Andreas; Sukums, Felix; Mensah, Nathan; Zakane, Alphonse; Loukanova, Svetla; Gustafsson, Lars L; Sauerborn, Rainer; Haefeli, Walter E

    2013-04-10

    Despite strong efforts to improve maternal care, its quality remains deficient in many countries of Sub-Saharan Africa as persistently high maternal mortality rates testify. The QUALMAT study seeks to improve the performance and motivation of rural health workers and ultimately quality of primary maternal health care services in three African countries Burkina Faso, Ghana, and Tanzania. One major intervention is the introduction of a computerized Clinical Decision Support System (CDSS) for rural primary health care centers to be used by health care workers of different educational levels. A stand-alone, java-based software, able to run on any standard hardware, was developed based on assessment of the health care situation in the involved countries. The software scope was defined and the final software was programmed under consideration of test experiences. Knowledge for the decision support derived from the World Health Organization (WHO) guideline "Pregnancy, Childbirth, Postpartum and Newborn Care; A Guide for Essential Practice". The QUALMAT CDSS provides computerized guidance and clinical decision support for antenatal care, and care during delivery and up to 24 hours post delivery. The decision support is based on WHO guidelines and designed using three principles: (1) Guidance through routine actions in maternal and perinatal care, (2) integration of clinical data to detect situations of concern by algorithms, and (3) electronic tracking of peri- and postnatal activities. In addition, the tool facilitates patient management and is a source of training material. The implementation of the software, which is embedded in a set of interventions comprising the QUALMAT study, is subject to various research projects assessing and quantifying the impact of the CDSS on quality of care, the motivation of health care staff (users) and its health economic aspects. The software will also be assessed for its usability and acceptance, as well as for its influence on

  2. A Structured Approach to End-of-Life Decision Making Improves Quality of Care for Patients With Terminal Illness in a Teaching Hospital in Ghana.

    Science.gov (United States)

    Edwin, Ama Kyerewaa; Johnson McGee, Summer; Opare-Lokko, Edwina Addo; Gyakobo, Mawuli Kotope

    2016-03-01

    To determine whether a structured approach to end-of-life decision-making directed by a compassionate interdisciplinary team would improve the quality of care for patients with terminal illness in a teaching hospital in Ghana. A retrospective analysis was done for 20 patients who consented to participate in the structured approach to end-of-life decision-making. Twenty patients whose care did not follow the structured approach were selected as controls. Outcome measures were nociceptive pain control, completing relationships, and emotional response towards dying. These measures were statistically superior in the study group compared to the control group. A structured approach to end-of-life decision-making significantly improves the quality of care for patients with terminal illness in the domains of pain control, completing relationships and emotional responses towards dying. © The Author(s) 2014.

  3. Analysis of high-quality modes in open chaotic microcavities

    International Nuclear Information System (INIS)

    Fang, W.; Yamilov, A.; Cao, H.

    2005-01-01

    We present a numerical study of the high-quality modes in two-dimensional dielectric stadium microcavities. Although the classical ray mechanics is fully chaotic in a stadium billiard, all of the high-quality modes show a 'strong scar' around unstable periodic orbits. When the deformation (ratio of the length of the straight segments over the diameter of the half circles) is small, the high-quality modes correspond to whispering-gallery-type trajectories and their quality factors decrease monotonically with increasing deformation. At large deformation, each high-quality mode is associated with multiple unstable periodic orbits. Its quality factor changes nonmonotonically with the deformation, and there exists an optimal deformation for each mode at which its quality factor reaches a local maximum. This unusual behavior is attributed to the interference of waves propagating along different constituent orbits that could minimize light leakage out of the cavity

  4. Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making.

    Science.gov (United States)

    Schroy, Paul C; Mylvaganam, Shamini; Davidson, Peter

    2014-02-01

    Decision aids for colorectal cancer (CRC) screening have been shown to enable patients to identify a preferred screening option, but the extent to which such tools facilitate shared decision making (SDM) from the perspective of the provider is less well established. Our goal was to elicit provider feedback regarding the impact of a CRC screening decision aid on SDM in the primary care setting. Cross-sectional survey. Primary care providers participating in a clinical trial evaluating the impact of a novel CRC screening decision aid on SDM and adherence. Perceptions of the impact of the tool on decision-making and implementation issues. Twenty-nine of 42 (71%) eligible providers responded, including 27 internists and two nurse practitioners. The majority (>60%) felt that use of the tool complimented their usual approach, increased patient knowledge, helped patients identify a preferred screening option, improved the quality of decision making, saved time and increased patients' desire to get screened. Respondents were more neutral is their assessment of whether the tool improved the overall quality of the patient visit or patient satisfaction. Fewer than 50% felt that the tool would be easy to implement into their practices or that it would be widely used by their colleagues. Decision aids for CRC screening can improve the quality and efficiency of SDM from the provider perspective but future use is likely to depend on the extent to which barriers to implementation can be addressed. © 2011 John Wiley & Sons Ltd.

  5. VALDOR 2003. Values in Decisions on Risk. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Kjell (ed.) [Karinta-Konsult, Taeby (Sweden)

    2003-10-01

    Many decisions that may have an impact on human health and the environment are often controversial and are made in value-laden and emotionally charged circumstances. The decision-making context is not only determined by the factual basis provided by the experts, but also by stakeholder pressure groups, extensive media coverage and the value systems of the experts themselves. Value judgements are often embedded in the technical assessments much more than usually appreciated. Risk assessment gives good opportunities to analyse and discuss these problems. It attracts great attention in modern society and requires contributions from a intricate mixture of technical risk assessment, sociology, ethics and political science. This complexity leads to high demands on transparency in order to arrive at high quality decisions, as well as requirements on public insight and participation. This symposium addressed the role of experts, media and and regulators in complex decisions, as well as procedures that can enhance transparency. Special focus was given to biotechnology and nuclear waste management. The problems of risk communication in these areas such as a high degree of complexity, fragmentation in debates, mixing facts and values, mistrust in experts, etc are shared with many other fields. The proceedings comprise 63 contributions, 50 of which have been separately indexed.

  6. VALDOR 2003. Values in Decisions on Risk. Proceedings

    International Nuclear Information System (INIS)

    Andersson, Kjell

    2003-10-01

    Many decisions that may have an impact on human health and the environment are often controversial and are made in value-laden and emotionally charged circumstances. The decision-making context is not only determined by the factual basis provided by the experts, but also by stakeholder pressure groups, extensive media coverage and the value systems of the experts themselves. Value judgements are often embedded in the technical assessments much more than usually appreciated. Risk assessment gives good opportunities to analyse and discuss these problems. It attracts great attention in modern society and requires contributions from a intricate mixture of technical risk assessment, sociology, ethics and political science. This complexity leads to high demands on transparency in order to arrive at high quality decisions, as well as requirements on public insight and participation. This symposium addressed the role of experts, media and and regulators in complex decisions, as well as procedures that can enhance transparency. Special focus was given to biotechnology and nuclear waste management. The problems of risk communication in these areas such as a high degree of complexity, fragmentation in debates, mixing facts and values, mistrust in experts, etc are shared with many other fields. The proceedings comprise 63 contributions, 50 of which have been separately indexed

  7. Argumentative SOX Compliant and Quality Decision Support Intelligent Expert System over the Suppliers Selection Process

    Directory of Open Access Journals (Sweden)

    Jesus Angel Fernandez Canelas

    2013-01-01

    Full Text Available The objective of this paper is to define a decision support system over SOX (Sarbanes-Oxley Act compatibility and quality of the Suppliers Selection Process based on Artificial Intelligence and Argumentation Theory knowledge and techniques. The present SOX Law, in effect nowadays, was created to improve financial government control over US companies. This law is a factor standard out United States due to several factors like present globalization, expansion of US companies, or key influence of US stock exchange markets worldwide. This paper constitutes a novel approach to this kind of problems due to following elements: (1 it has an optimized structure to look for the solution, (2 it has a dynamic learning method to handle court and control gonvernment bodies decisions, (3 it uses fuzzy knowledge to improve its performance, and (4 it uses its past accumulated experience to let the system evolve far beyond its initial state.

  8. Structural factors affecting prosthodontic decision making in Japan

    Directory of Open Access Journals (Sweden)

    Noriyuki Wakabayashi

    2015-11-01

    Full Text Available Prosthodontic treatment strategies, prosthetic designs and materials, and treatment procedures are not determined solely by the diagnosis. We discuss the major effect of structural factors surrounding prosthodontic care on treatment decisions in Japan. These structural factors are related to the dentist, such as the dentist's education, postgraduate courses, and access to the latest research, and to the health care support system, including the social insurance system. Education content from schools of dentistry has clear effects on dentists’ treatment decisions, and the specific modalities taught depend highly on the school faculty. The use of research, especially clinical studies, in treatment decisions is currently limited. Regarding the health care support system factors, the public health insurance system has a strong effect on the actual prosthodontic treatments performed in Japan. To maintain the current piecework payment system, efforts should be encouraged to preclude both overtreatment and undertreatment. New perspectives on treatment decisions associated with technological advancement and changes in health care needs should be established to ensure that the Japanese population can enjoy high-quality prosthodontic treatment that meets international standards. The development of a clinical pathway and decision-making model that adheres to academic-based clinical guidelines and the insurance system will be necessary.

  9. 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 ...

  10. GIS and remote sensing components of a spatial decision system in support of sustainable forest management

    Energy Technology Data Exchange (ETDEWEB)

    St-Onge, B.A.; Waaub, J.P.; Alleaume, S.; Couture, M. [Quebec Univ., Dept. of Geography, Montreal, PQ (Canada)

    1999-05-01

    The development of a tool used in decision making processes in forest management was discussed with special focus on two critical aspects of the decision aid system which pertain to spatial information. These are: (1) the use of up-to-date precise information, and (2) the accessibility of this information. This paper focuses on two approaches designed to provide accessible high quality information to the users of the decision aid system: i.e. the development of high resolution remote sensing methods, and a GIS data warehouse accessible over the Internet. 4 refs., 2 figs.

  11. High beam quality and high energy short-pulse laser with MOPA

    Science.gov (United States)

    Jin, Quanwei; Pang, Yu; Jiang, JianFeng; Tan, Liang; Cui, Lingling; Wei, Bin; Sun, Yinhong; Tang, Chun

    2018-03-01

    A high energy, high beam quality short-pulse diode-pumped Nd:YAG master oscillator power-amplifier (MOPA) laser with two amplifier stages is demonstrated. The two-rod birefringence compensation was used as beam quality controlling methods, which presents a short-pulse energy of 40 mJ with a beam quality value of M2 = 1.2 at a repetition rate of 400Hz. The MOPA system delivers a short-pulse energy of 712.5 mJ with a pulse width of 12.4 ns.The method of spherical aberration compensation is improved the beam quality, a M2 factor of 2.3 and an optical-to-optical efficiency of 27.7% is obtained at the maximum laser out power.The laser obtained 1.4J out energy with polarization integration.

  12. Flexible Decision Support in Dynamic Interorganizational Networks

    NARCIS (Netherlands)

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

    2008-01-01

    textabstractAn effective Decision Support System (DSS) should help its users improve decision-making in complex, information-rich, environments. We present a feature gap analysis that shows that current decision support technologies lack important qualities for a new generation of agile business

  13. High quality-factor optical resonators

    International Nuclear Information System (INIS)

    Henriet, Rémi; Salzenstein, Patrice; Coillet, Aurélien; Saleh, Khaldoun; Chembo, Yanne K; Ristic, Davor; Ferrari, Maurizio; Mortier, Michel; Rasoloniaina, Alphonse; Dumeige, Yannick; Féron, Patrice; Cibiel, Gilles; Llopis, Olivier

    2014-01-01

    Various resonators are investigated for microwave photonic applications. Micro-sphere, disk and fiber ring resonators were designed, realized and characterized. Obtained quality factors are as high as Q = 10 10 . (paper)

  14. Data quality system using reference dictionaries and edit distance algorithms

    Science.gov (United States)

    Karbarz, Radosław; Mulawka, Jan

    2015-09-01

    The real art of management it is important to make smart decisions, what in most of the cases is not a trivial task. Those decisions may lead to determination of production level, funds allocation for investments etc. Most of the parameters in decision-making process such as: interest rate, goods value or exchange rate may change. It is well know that these parameters in the decision-making are based on the data contained in datamarts or data warehouse. However, if the information derived from the processed data sets is the basis for the most important management decisions, it is required that the data is accurate, complete and current. In order to achieve high quality data and to gain from them measurable business benefits, data quality system should be used. The article describes the approach to the problem, shows the algorithms in details and their usage. Finally the test results are provide. Test results show the best algorithms (in terms of quality and quantity) for different parameters and data distribution.

  15. Athena: Towards Decision-Centric Anticipatory Sensor Information Delivery

    Directory of Open Access Journals (Sweden)

    Jongdeog Lee

    2018-01-01

    Full Text Available The paper introduces a new direction in quality-of-service-aware networked sensing that designs communication protocols and scheduling policies for data delivery that are optimized specifically for decision needs. The work complements present decision monitoring and support tools and falls in the larger framework of decision-driven resource management. A hallmark of the new protocols is that they are aware of the inference structure used to arrive at decisions (from logical predicates, as well as the data (and data quality that need to be furnished to successfully evaluate the unknowns on which these decisions are based. Such protocols can therefore anticipate and deliver precisely the right data, at the right level of quality, from the right sources, at the right time, to enable valid and timely decisions at minimum cost to the underlying network. This paper presents the decision model used and the protocol design philosophy, reviews the key recent results and describes a novel system, called Athena, that is the first to embody the aforementioned data delivery paradigm. Evaluation results are presented that compare the performance of decision-centric anticipatory information delivery to several baselines, demonstrating its various advantages in terms of decision timeliness, validity and network resources used. The paper concludes with a discussion of remaining future challenges in this emerging area.

  16. Psychosocial and Quality of Life in Women Receiving the 21-Gene Recurrence Score Assay: The Impact of Decision Style in Women with Intermediate RS

    International Nuclear Information System (INIS)

    Sulayman, N.; Spellman, E.; Graves, K. D.; Peshkin, B. N.; Isaacs, C.; Schwartz, M. D.; O’Neill, S. C.

    2012-01-01

    Multigene assays such as the 21-gene recurrence score (RS) quantify risk for recurrence and potential benefit from chemotherapy in early-stage, ER+ breast cancers. Few studies have assessed the impact of testing on patient-reported outcomes such as cancer-related distress or quality of life. The few studies that have assessed these outcomes do not consider potential modifiers, such as the patients’ level of involvement in the treatment decision-making process. In the current study, 81 breast cancer patients who received the RS assay completed cross-sectional surveys. We used linear multiple regression to assess whether test result, decision-making role (passive versus shared/active), and their interaction contributed to current levels of distress, quality of life, and decisional conflict. There were no associations between these variables and test result or decision-making role. However, women who received an intermediate RS and took a passive role in their care reported higher-cancer-related distress and cancer worry and lower quality of life than those who took a shared or active role. These data should be confirmed in prospective samples, as these poorer outcomes could be amenable to intervention

  17. Psychosocial and Quality of Life in Women Receiving the 21-Gene Recurrence Score Assay: The Impact of Decision Style in Women with Intermediate RS

    Directory of Open Access Journals (Sweden)

    Nadiyah Sulayman

    2012-01-01

    Full Text Available Multigene assays such as the 21-gene recurrence score (RS quantify risk for recurrence and potential benefit from chemotherapy in early-stage, ER+ breast cancers. Few studies have assessed the impact of testing on patient-reported outcomes such as cancer-related distress or quality of life. The few studies that have assessed these outcomes do not consider potential modifiers, such as the patients’ level of involvement in the treatment decision-making process. In the current study, 81 breast cancer patients who received the RS assay completed cross-sectional surveys. We used linear multiple regression to assess whether test result, decision-making role (passive versus shared/active, and their interaction contributed to current levels of distress, quality of life, and decisional conflict. There were no associations between these variables and test result or decision-making role. However, women who received an intermediate RS and took a passive role in their care reported higher-cancer-related distress and cancer worry and lower quality of life than those who took a shared or active role. These data should be confirmed in prospective samples, as these poorer outcomes could be amenable to intervention.

  18. Strategic planning decisions in the high tech industry

    CERN Document Server

    Daim, Tugrul; Beyhan, Berna; Basoglu, Nuri

    2013-01-01

    The scale and complexity of research and practices of open innovation mandate a correspondingly sophisticated form of decision making. Strategic Planning Decisions brings together a number of tools that ease the decision process in technology companies, providing both conceptual frameworks and practical applications. Innovative approaches are presented such as an ontology-based model where all the relevant aspects of a potential technology are interrelated to provide a comprehensive and logically connected data pool for decision makers. Divided into two sections, Strategic Planning Decisions describe both strategic approaches using the decision tools, and tactical approaches. Some of these tools are expanded while some others are embedded in a model that will lay the ground for practical application. These include: ·         bibliometric analysis, ·         ontology, ·         roadmapping, ·         lead user, six sigma, and ·         multi-actor & multi-object...

  19. Boise, Idaho: Improving Air Quality through Alternative Fuels & Reduced Vehicular Travel (City Energy: From Data to Decisions)

    Energy Technology Data Exchange (ETDEWEB)

    Strategic Priorities and Impact Analysis Team, Office of Strategic Programs

    2017-11-01

    This fact sheet "Boise, Idaho: Improving Air Quality through Alternative Fuels & Reduced Vehicular Travel" explains how the City of Boise used data from the U.S. Department of Energy's Cities Leading through Energy Analysis and Planning (Cities-LEAP) and the State and Local Energy Data (SLED) programs to inform its city energy planning. It is one of ten fact sheets in the "City Energy: From Data to Decisions" series.

  20. Evaluation of the quality of patient information to support informed shared decision-making.

    Science.gov (United States)

    Godolphin, W; Towle, A; McKendry, R

    2001-12-01

    (a) To find out how much patient information material on display in family physicians' offices refers to management choices, and hence may be useful to support informed and shared decision-making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians. All print information available for patients and exchanged between physicians and patients was collected in a single complete day of the office practices of 21 family physicians. A published and validated instrument (DISCERN) was used to assess quality. Community office practices in the greater Vancouver area, British Columbia, Canada. The physicians were purposefully recruited by their association with the medical school Department of Family Practice, their interest in providing patients with print information and their representation of a range of practice types and location. The source of the pamphlets and these categories: available in the physicians' offices; exchanged between physician and patient; and produced with the explicit or apparent intent to support evidence-based patient choice. The quality of the print information to support ISDM, as measured by DISCERN and the ease of use and reliability of the DISCERN tool. Fewer than 50% of pamphlets available in these offices fulfilled our minimum criteria for ISDM (mentioned more than one management option). Offices varied widely in the proportion of pamphlets on display that supported ISDM and how particular the physician was in selecting materials. The DISCERN tool is quick, valid and reliable for the evaluation of patient information. The quality of patient information materials used in the consultation and available in these offices was below midpoint on the DISCERN score. Major deficiencies were with respect to the mention of choices, risks, effect of no treatment or uncertainty and reliability (source, evidence-base). Good quality

  1. Towards a high quality high school workforce: A longitudinal, demographic analysis of U.S. public school physics teachers

    Directory of Open Access Journals (Sweden)

    Gregory T. Rushton

    2017-10-01

    Full Text Available Efforts to improve the number and quality of the high school physics teaching workforce have taken several forms, including those sponsored by professional organizations. Using a series of large-scale teacher demographic data sets from the National Center for Education Statistics (NCES, this study sought to investigate trends in teacher quality at the national level in the two and a half decades between 1987 and 2012. Specifically, we investigated (i details about the degree backgrounds, main teaching assignments, and experience levels of those assigned to teach physics; (ii whether the proportion of those with certifications in physics as a fraction of the entire physics teaching workforce had changed; and (iii if workforce diversity (with respect to race and gender had changed over time. Our data indicate that trends in these domains have generally been positive, but still fall short of having a highly qualified physics teacher in each classroom. Additionally, the population of physics teachers has more novices and fewer veterans than it did 10 years ago, although veteran physics teachers are not as rare as those in other branches of high school STEM fields. We also analyzed trends in physics teacher race and gender diversity and found them to lag behind other STEM and non-STEM teacher communities. High school physics is still mostly taught by white males with backgrounds from outside of physics. Implications for future policy decisions at the local and national levels are discussed, including attending to the specific needs of degree-holding and non-degree-holding physics teachers separately and localizing teacher recruitment and preparation efforts in regional centers.

  2. Towards a high quality high school workforce: A longitudinal, demographic analysis of U.S. public school physics teachers

    Science.gov (United States)

    Rushton, Gregory T.; Rosengrant, David; Dewar, Andrew; Shah, Lisa; Ray, Herman E.; Sheppard, Keith; Watanabe, Lynn

    2017-12-01

    Efforts to improve the number and quality of the high school physics teaching workforce have taken several forms, including those sponsored by professional organizations. Using a series of large-scale teacher demographic data sets from the National Center for Education Statistics (NCES), this study sought to investigate trends in teacher quality at the national level in the two and a half decades between 1987 and 2012. Specifically, we investigated (i) details about the degree backgrounds, main teaching assignments, and experience levels of those assigned to teach physics; (ii) whether the proportion of those with certifications in physics as a fraction of the entire physics teaching workforce had changed; and (iii) if workforce diversity (with respect to race and gender) had changed over time. Our data indicate that trends in these domains have generally been positive, but still fall short of having a highly qualified physics teacher in each classroom. Additionally, the population of physics teachers has more novices and fewer veterans than it did 10 years ago, although veteran physics teachers are not as rare as those in other branches of high school STEM fields. We also analyzed trends in physics teacher race and gender diversity and found them to lag behind other STEM and non-STEM teacher communities. High school physics is still mostly taught by white males with backgrounds from outside of physics. Implications for future policy decisions at the local and national levels are discussed, including attending to the specific needs of degree-holding and non-degree-holding physics teachers separately and localizing teacher recruitment and preparation efforts in regional centers.

  3. Quality of online information on type 2 diabetes: a cross-sectional study.

    Science.gov (United States)

    Weymann, Nina; Härter, Martin; Dirmaier, Jörg

    2015-12-01

    Evidence-based health information is a prerequisite for patients with type 2 diabetes to engage in self-management and to make informed medical decisions. The Internet is an important source of health information. In the present study, we systematically assessed formal quality, quality of decision support and usability of German and English language websites on type 2 diabetes. The search term 'type 2 diabetes' was entered in the two most popular search engines. Descriptive data on website quality are presented. Additionally, associations between website quality and affiliation (commercial vs. non-commercial), presence of the HON code quality seal and website traffic were explored. Forty-six websites were included. Most websites provided basic information necessary for decision-making, while only one website also provided decision support. Websites with a HON code had significantly better formal quality than websites without HON code. We found a highly significant correlation between usability and website traffic and a significant correlation between formal quality and website traffic. Most websites do not provide sufficient information to support patients in medical decision-making. Our finding that usability and website traffic are tightly associated is consistent with previous research indicating that design is the most important cue for users assessing website credibility. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. High-quality cardiopulmonary resuscitation: current and future directions.

    Science.gov (United States)

    Abella, Benjamin S

    2016-06-01

    Cardiopulmonary resuscitation (CPR) represents the cornerstone of cardiac arrest resuscitation care. Prompt delivery of high-quality CPR can dramatically improve survival outcomes; however, the definitions of optimal CPR have evolved over several decades. The present review will discuss the metrics of CPR delivery, and the evidence supporting the importance of CPR quality to improve clinical outcomes. The introduction of new technologies to quantify metrics of CPR delivery has yielded important insights into CPR quality. Investigations using CPR recording devices have allowed the assessment of specific CPR performance parameters and their relative importance regarding return of spontaneous circulation and survival to hospital discharge. Additional work has suggested new opportunities to measure physiologic markers during CPR and potentially tailor CPR delivery to patient requirements. Through recent laboratory and clinical investigations, a more evidence-based definition of high-quality CPR continues to emerge. Exciting opportunities now exist to study quantitative metrics of CPR and potentially guide resuscitation care in a goal-directed fashion. Concepts of high-quality CPR have also informed new approaches to training and quality improvement efforts for cardiac arrest care.

  5. Quality management manual for production of high quality cassava flour

    DEFF Research Database (Denmark)

    Dziedzoave, Nanam Tay; Abass, Adebayo Busura; Amoa-Awua, Wisdom K.

    The high quality cassava flour (HQCF) industry has just started to evolve in Africa and elsewhere. The sustainability of the growing industry, the profitability of small- and medium-scale enterprises (SMEs) that are active in the industry and good-health of consumers can best be guaranteed through...... the adoption of proper quality and food safety procedures. Cassava processing enterprises involved in the productionof HQCF must therefore be commited to the quality and food safety of the HQCF. They must have the right technology, appropriate processing machhinery, standard testing instruments...... and the necessary technical expertise. This quality manual was therefore developed to guide small- to medium-scale cassava in the design and implematation of Hazard Analysis Critical Control Point (HACCP) system and Good manufacturing Practices (GMP) plans for HQCF production. It describes the HQCF production...

  6. Deepening the quality of clinical reasoning and decision-making in rural hospital nursing practice.

    Science.gov (United States)

    Sedgwick, M G; Grigg, L; Dersch, S

    2014-01-01

    Rural acute care nursing requires an extensive breadth and depth of knowledge as well as the ability to quickly reason through problems in order to make sound clinical decisions. This reasoning often occurs within an environment that has minimal medical or ancillary support. Registered nurses (RN) new to rural nursing, and employers, have raised concerns about patient safety while new nurses make the transition into rural practice. In addition, feeling unprepared for the rigors of rural hospital nursing practice is a central issue influencing RN recruitment and retention. Understanding how rural RNs reason is a key element for identifying professional development needs and may support recruitment and retention of skilled rural nurses. The purpose of this study was to explore how rural RNs reason through clinical problems as well as to assess the quality of such reasoning. This study used a non-traditional approach for data collection. Fifteen rural acute care nurses with varying years of experience working in southern Alberta, Canada, were observed while they provided care to patients of varying acuity within a simulated rural setting. Following the simulation, semi-structured interviews were conducted using a substantive approach to critical thinking. Findings revealed that the ability to engage in deep clinical reasoning varied considerably among participants despite being given the same information under the same circumstances. Furthermore, the number of years of experience did not seem to be directly linked to the ability to engage in sound clinical reasoning. Novice nurses, however, did rely heavily on others in their decision making in order to ensure they were making the right decision. Hence, their relationships with other staff members influenced their ability to engage in clinical reasoning and decision making. In situations where the patient's condition was deteriorating quickly, regardless of years of experience, all of the participants depended on

  7. Quality related communication approaches for organic food

    OpenAIRE

    Bodini, Antonella; Richter, T.; Felder, R.

    2006-01-01

    As food quality becomes more complex, consumer s are tending to reduce their involvement in the food purchase decision- making process. Consequently, prices are becoming more significant as they represent an easy choice criterion when consumer s have less information about the differences between the product and process quality inherent in food items (including environmental or social issues). The organic food sector provides high, complex food quality profiles and has therefore been seriousl...

  8. A guide to calculating habitat-quality metrics to inform conservation of highly mobile species

    Science.gov (United States)

    Bieri, Joanna A.; Sample, Christine; Thogmartin, Wayne E.; Diffendorfer, James E.; Earl, Julia E.; Erickson, Richard A.; Federico, Paula; Flockhart, D. T. Tyler; Nicol, Sam; Semmens, Darius J.; Skraber, T.; Wiederholt, Ruscena; Mattsson, Brady J.

    2018-01-01

    Many metrics exist for quantifying the relative value of habitats and pathways used by highly mobile species. Properly selecting and applying such metrics requires substantial background in mathematics and understanding the relevant management arena. To address this multidimensional challenge, we demonstrate and compare three measurements of habitat quality: graph-, occupancy-, and demographic-based metrics. Each metric provides insights into system dynamics, at the expense of increasing amounts and complexity of data and models. Our descriptions and comparisons of diverse habitat-quality metrics provide means for practitioners to overcome the modeling challenges associated with management or conservation of such highly mobile species. Whereas previous guidance for applying habitat-quality metrics has been scattered in diversified tracks of literature, we have brought this information together into an approachable format including accessible descriptions and a modeling case study for a typical example that conservation professionals can adapt for their own decision contexts and focal populations.Considerations for Resource ManagersManagement objectives, proposed actions, data availability and quality, and model assumptions are all relevant considerations when applying and interpreting habitat-quality metrics.Graph-based metrics answer questions related to habitat centrality and connectivity, are suitable for populations with any movement pattern, quantify basic spatial and temporal patterns of occupancy and movement, and require the least data.Occupancy-based metrics answer questions about likelihood of persistence or colonization, are suitable for populations that undergo localized extinctions, quantify spatial and temporal patterns of occupancy and movement, and require a moderate amount of data.Demographic-based metrics answer questions about relative or absolute population size, are suitable for populations with any movement pattern, quantify demographic

  9. To kill a kangaroo: understanding the decision to pursue high-risk/high-gain resources.

    Science.gov (United States)

    Jones, James Holland; Bird, Rebecca Bliege; Bird, Douglas W

    2013-09-22

    In this paper, we attempt to understand hunter-gatherer foraging decisions about prey that vary in both the mean and variance of energy return using an expected utility framework. We show that for skewed distributions of energetic returns, the standard linear variance discounting (LVD) model for risk-sensitive foraging can produce quite misleading results. In addition to creating difficulties for the LVD model, the skewed distributions characteristic of hunting returns create challenges for estimating probability distribution functions required for expected utility. We present a solution using a two-component finite mixture model for foraging returns. We then use detailed foraging returns data based on focal follows of individual hunters in Western Australia hunting for high-risk/high-gain (hill kangaroo) and relatively low-risk/low-gain (sand monitor) prey. Using probability densities for the two resources estimated from the mixture models, combined with theoretically sensible utility curves characterized by diminishing marginal utility for the highest returns, we find that the expected utility of the sand monitors greatly exceeds that of kangaroos despite the fact that the mean energy return for kangaroos is nearly twice as large as that for sand monitors. We conclude that the decision to hunt hill kangaroos does not arise simply as part of an energetic utility-maximization strategy and that additional social, political or symbolic benefits must accrue to hunters of this highly variable prey.

  10. Evaluating the police service quality for handling traffic crash reporting

    DEFF Research Database (Denmark)

    Janstrup, Kira Hyldekær; Kaplan, Sigal; Barfod, Michael Bruhn

    2017-01-01

    at the police service quality for handling the reporting of traffic crashes. Design/methodology/approach This study introduces a novel approach to evaluate service quality that combines multi-criteria decision analysis (MCDA) with latent class analysis (LCA). Moreover, this study presents the design of a web....../value This study advances the knowledge about police service quality with a novel expert-based decision support tool based on SERVQUAL, MCDA and LCA, demonstrates its applicability in countries with a high-police service, and opportunities and barriers for increasing the crash reporting rate....... participated in the survey that yielded 86 complete responses. Findings The novel approach was successfully applied and its implementation demonstrated the usefulness of the tool even in countries with a high police service. Results showed that the participating stakeholders perceived human factors as more...

  11. The Impact of Food Quality Information Services on Food Supply Chain Pricing Decisions and Coordination Mechanisms Based on the O2O E-Commerce Mode

    Directory of Open Access Journals (Sweden)

    Xiaoqiu Yu

    2018-01-01

    Full Text Available This paper considers the price conflict problem between the online channel of a food processing factory and the offline channel of the food retailers in food supply chains by analyzing the pricing decisions and coordination mechanisms between the food processing factory and food retailers under the influence of a food quality information service. First, the Stackelberg game method and the Bertrand game method are used to optimize the pricing decisions with the goal of maximizing the profits of the food processing factory and retailer. The analysis shows that the food quality information service level is positively correlated with the price of the factory’s own channel, and the influence of the food quality information service level on the price of the food processing factory’s or the food retailer’s own channel is stronger than its influence on the price of a competitor’s channel. Second, the food supply chain members’ pricing decisions are analyzed using the case analysis method by considering practical problems in the food supply chain. The results indicate that the food processing factory should use the Stackelberg game to make pricing decisions. However, it is optimal for the food retailer to make pricing decisions under the Bertrand game, and the total profit of the food supply chain is optimized under centralized decision making. Finally, we use both the quantitative discount mechanism and the Stackelberg game method to analyze the profits obtained by the food processing factory and retailer. The results indicate that the food processing factory should implement a quantitative discount mechanism when the quantity discount coefficient is greater than 0.4, and the retailer should implement a quantity discount mechanism when the quantity discount coefficient is in the range of 0.25 to 0.4.

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

    Science.gov (United States)

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

    2011-12-01

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

  13. Multisensor satellite data for water quality analysis and water pollution risk assessment: decision making under deep uncertainty with fuzzy algorithm in framework of multimodel approach

    Science.gov (United States)

    Kostyuchenko, Yuriy V.; Sztoyka, Yulia; Kopachevsky, Ivan; Artemenko, Igor; Yuschenko, Maxim

    2017-10-01

    Multi-model approach for remote sensing data processing and interpretation is described. The problem of satellite data utilization in multi-modeling approach for socio-ecological risks assessment is formally defined. Observation, measurement and modeling data utilization method in the framework of multi-model approach is described. Methodology and models of risk assessment in framework of decision support approach are defined and described. Method of water quality assessment using satellite observation data is described. Method is based on analysis of spectral reflectance of aquifers. Spectral signatures of freshwater bodies and offshores are analyzed. Correlations between spectral reflectance, pollutions and selected water quality parameters are analyzed and quantified. Data of MODIS, MISR, AIRS and Landsat sensors received in 2002-2014 have been utilized verified by in-field spectrometry and lab measurements. Fuzzy logic based approach for decision support in field of water quality degradation risk is discussed. Decision on water quality category is making based on fuzzy algorithm using limited set of uncertain parameters. Data from satellite observations, field measurements and modeling is utilizing in the framework of the approach proposed. It is shown that this algorithm allows estimate water quality degradation rate and pollution risks. Problems of construction of spatial and temporal distribution of calculated parameters, as well as a problem of data regularization are discussed. Using proposed approach, maps of surface water pollution risk from point and diffuse sources are calculated and discussed.

  14. FUZZY DECISION MAKING MODEL FOR BYZANTINE AGREEMENT

    Directory of Open Access Journals (Sweden)

    S. MURUGAN

    2014-04-01

    Full Text Available Byzantine fault tolerance is of high importance in the distributed computing environment where malicious attacks and software errors are common. A Byzantine process sends arbitrary messages to every other process. An effective fuzzy decision making approach is proposed to eliminate the Byzantine behaviour of the services in the distributed environment. It is proposed to derive a fuzzy decision set in which the alternatives are ranked with grade of membership and based on that an appropriate decision can be arrived on the messages sent by the different services. A balanced decision is to be taken from the messages received across the services. To accomplish this, Hurwicz criterion is used to balance the optimistic and pessimistic views of the decision makers on different services. Grades of membership for the services are assessed using the non-functional Quality of Service parameters and have been estimated using fuzzy entropy measure which logically ranks the participant services. This approach for decision making is tested by varying the number of processes, varying the number of faulty services, varying the message values sent to different services and considering the variation in the views of the decision makers about the services. The experimental result shows that the decision reached is an enhanced one and in case of conflict, the proposed approach provides a concrete result, whereas decision taken using the Lamport’s algorithm is an arbitrary one.

  15. If it feels right, do it: Intuitive decision making in a sample of high-level sport coaches

    Directory of Open Access Journals (Sweden)

    Dave eCollins

    2016-04-01

    Full Text Available Comprehensive understanding and application of decision making is important for the professional practice and status of sports coaches. Accordingly, building on a strong work base exploring the use of professional judgement and decision making in sport, we report a preliminary investigation into uses of intuition by high-level coaches. Two contrasting groups of high-level coaches from adventure sports (n = 10 and rugby union (n = 8, were interviewed on their experiences of using intuitive and deliberative decision making styles, the source of these skills, and the interaction between the two. Participants reported similarly high levels of usage to other professions. Interaction between the two styles was apparent to varying degrees, while the role of experience was seen as an important precursor to greater intuitive practice and employment. Initially intuitive then deliberate decision making was a particular feature, offering participants an immediate check on the accuracy and validity of the decision. Integration of these data with the extant literature and implications for practice are discussed.

  16. "If It Feels Right, Do It": Intuitive Decision Making in a Sample of High-Level Sport Coaches.

    Science.gov (United States)

    Collins, Dave; Collins, Loel; Carson, Howie J

    2016-01-01

    Comprehensive understanding and application of decision making is important for the professional practice and status of sports coaches. Accordingly, building on a strong work base exploring the use of professional judgment and decision making (PJDM) in sport, we report a preliminary investigation into uses of intuition by high-level coaches. Two contrasting groups of high-level coaches from adventure sports (n = 10) and rugby union (n = 8), were interviewed on their experiences of using intuitive and deliberative decision making styles, the source of these skills, and the interaction between the two. Participants reported similarly high levels of usage to other professions. Interaction between the two styles was apparent to varying degrees, while the role of experience was seen as an important precursor to greater intuitive practice and employment. Initially intuitive then deliberate decision making was a particular feature, offering participants an immediate check on the accuracy and validity of the decision. Integration of these data with the extant literature and implications for practice are discussed.

  17. Knowledge Translation Strategies for Enhancing Nurses’ Evidence-Informed Decision Making: A Scoping Review

    OpenAIRE

    Yost, Jennifer; Thompson, David; Ganann, Rebecca; Aloweni, Fazila; Newman, Kristine; McKibbon, Ann; Dobbins, Maureen; Ciliska, Donna

    2014-01-01

    Background Nurses are increasingly expected to engage in evidence-informed decision making (EIDM); the use of research evidence with information about patient preferences, clinical context and resources, and their clinical expertise in decision making. Strategies for enhancing EIDM have been synthesized in high-quality systematic reviews, yet most relate to physicians or mixed disciplines. Existing reviews, specific to nursing, have not captured a broad range of strategies for promoting the k...

  18. Effective use of product quality information in food supply chain logistics

    OpenAIRE

    Rijpkema, W.A.

    2014-01-01

    Food supply chains have inherent characteristics, such as variability in product quality and quality decay, which put specific demands on logistics decision making. Furthermore, food supply chain organization and control has changed significantly in the past decades by factors such as scale intensification and globalization. In practice, these characteristics and developments frequently lead to supply chain problems, such as high levels of product waste, product quality problems, and high lo...

  19. Multivariate analysis of flow cytometric data using decision trees.

    Science.gov (United States)

    Simon, Svenja; Guthke, Reinhard; Kamradt, Thomas; Frey, Oliver

    2012-01-01

    Characterization of the response of the host immune system is important in understanding the bidirectional interactions between the host and microbial pathogens. For research on the host site, flow cytometry has become one of the major tools in immunology. Advances in technology and reagents allow now the simultaneous assessment of multiple markers on a single cell level generating multidimensional data sets that require multivariate statistical analysis. We explored the explanatory power of the supervised machine learning method called "induction of decision trees" in flow cytometric data. In order to examine whether the production of a certain cytokine is depended on other cytokines, datasets from intracellular staining for six cytokines with complex patterns of co-expression were analyzed by induction of decision trees. After weighting the data according to their class probabilities, we created a total of 13,392 different decision trees for each given cytokine with different parameter settings. For a more realistic estimation of the decision trees' quality, we used stratified fivefold cross validation and chose the "best" tree according to a combination of different quality criteria. While some of the decision trees reflected previously known co-expression patterns, we found that the expression of some cytokines was not only dependent on the co-expression of others per se, but was also dependent on the intensity of expression. Thus, for the first time we successfully used induction of decision trees for the analysis of high dimensional flow cytometric data and demonstrated the feasibility of this method to reveal structural patterns in such data sets.

  20. Quality Assurance Strategy for Existing Homes: Final Quality Management Primer for High Performing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Del Bianco, M.; Taggart, J.; Sikora, J.; Wood, A.

    2012-12-01

    This guide is designed to help Building America (BA) Teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

  1. Quality Assurance Strategy for Existing Homes. Final Quality Management Primer for High Performing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Del Bianco, M. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Taggart, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Sikora, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Wood, A. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States)

    2012-12-01

    This guide is designed to help Building America (BA) teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

  2. The STARTEC Decision Support Tool for Better Tradeoffs between Food Safety, Quality, Nutrition, and Costs in Production of Advanced Ready-to-Eat Foods.

    Science.gov (United States)

    Skjerdal, Taran; Gefferth, Andras; Spajic, Miroslav; Estanga, Edurne Gaston; de Cecare, Alessandra; Vitali, Silvia; Pasquali, Frederique; Bovo, Federica; Manfreda, Gerardo; Mancusi, Rocco; Trevisiani, Marcello; Tessema, Girum Tadesse; Fagereng, Tone; Moen, Lena Haugland; Lyshaug, Lars; Koidis, Anastasios; Delgado-Pando, Gonzalo; Stratakos, Alexandros Ch; Boeri, Marco; From, Cecilie; Syed, Hyat; Muccioli, Mirko; Mulazzani, Roberto; Halbert, Catherine

    2017-01-01

    A prototype decision support IT-tool for the food industry was developed in the STARTEC project. Typical processes and decision steps were mapped using real life production scenarios of participating food companies manufacturing complex ready-to-eat foods. Companies looked for a more integrated approach when making food safety decisions that would align with existing HACCP systems. The tool was designed with shelf life assessments and data on safety, quality, and costs, using a pasta salad meal as a case product. The process flow chart was used as starting point, with simulation options at each process step. Key parameters like pH, water activity, costs of ingredients and salaries, and default models for calculations of Listeria monocytogenes , quality scores, and vitamin C, were placed in an interactive database. Customization of the models and settings was possible on the user-interface. The simulation module outputs were provided as detailed curves or categorized as "good"; "sufficient"; or "corrective action needed" based on threshold limit values set by the user. Possible corrective actions were suggested by the system. The tool was tested and approved by end-users based on selected ready-to-eat food products. Compared to other decision support tools, the STARTEC-tool is product-specific and multidisciplinary and includes interpretation and targeted recommendations for end-users.

  3. Tactical decision making under stress (TADMUS) decision support system

    OpenAIRE

    Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.

    1996-01-01

    A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes and cognitive analysis of the decision making problems faced by Navy tactical officers in a shipboard Combat Information Center. Baseline testing in high intensity, peace keeping, littoral scenarios indicated...

  4. Applying Machine Learning and High Performance Computing to Water Quality Assessment and Prediction

    OpenAIRE

    Ruijian Zhang; Deren Li

    2017-01-01

    Water quality assessment and prediction is a more and more important issue. Traditional ways either take lots of time or they can only do assessments. In this research, by applying machine learning algorithm to a long period time of water attributes’ data; we can generate a decision tree so that it can predict the future day’s water quality in an easy and efficient way. The idea is to combine the traditional ways and the computer algorithms together. Using machine learning algorithms, the ass...

  5. A decision support system using combined-classifier for high-speed data stream in smart grid

    Science.gov (United States)

    Yang, Hang; Li, Peng; He, Zhian; Guo, Xiaobin; Fong, Simon; Chen, Huajun

    2016-11-01

    Large volume of high-speed streaming data is generated by big power grids continuously. In order to detect and avoid power grid failure, decision support systems (DSSs) are commonly adopted in power grid enterprises. Among all the decision-making algorithms, incremental decision tree is the most widely used one. In this paper, we propose a combined classifier that is a composite of a cache-based classifier (CBC) and a main tree classifier (MTC). We integrate this classifier into a stream processing engine on top of the DSS such that high-speed steaming data can be transformed into operational intelligence efficiently. Experimental results show that our proposed classifier can return more accurate answers than other existing ones.

  6. The Diffusion Decision Model: Theory and Data for Two-Choice Decision Tasks

    OpenAIRE

    Ratcliff, Roger; McKoon, Gail

    2008-01-01

    The diffusion decision model allows detailed explanations of behavior in two-choice discrimination tasks. In this article, the model is reviewed to show how it translates behavioral data—accuracy, mean response times, and response time distributions—into components of cognitive processing. Three experiments are used to illustrate experimental manipulations of three components: stimulus difficulty affects the quality of information on which a decision is based; instructions emphasizing either ...

  7. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    Science.gov (United States)

    Khader, A. I.; Rosenberg, D. E.; McKee, M.

    2013-05-01

    Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i) ignore the health risk of nitrate-contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome) is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs

  8. Factors Affecting Quality of Life at Different Intervals After Treatment of Localized Prostate Cancer: Unique Influence of Treatment Decision Making Satisfaction, Personality and Sexual Functioning.

    Science.gov (United States)

    Victorson, David E; Schuette, Stephanie; Schalet, Benjamin D; Kundu, Shilajit D; Helfand, Brian T; Novakovic, Kristian; Sufrin, Nathaniel; McGuire, Michael; Brendler, Charles

    2016-11-01

    Using patient reported outcomes measures we identified the most informative set of factors associated with quality of life in a large sample of men treated for localized prostate cancer. We examined relationships with quality of life using FACIT (Functional Assessment of Chronic Illness Therapy). We also hypothesized variables in a sample of men diagnosed with localized prostate cancer who represented different time points since treatment, including less than 12 months in 70, 1 to 3 years in 344, greater than 3 to 5 years in 291 and greater than 5 years in 97. Correlative measures included subscales of MAX-PC (Memorial Anxiety Scale for Prostate Cancer), short forms of PROMIS® and SOMS (Surgical Outcomes Measurement System), TDM-SATS (Treatment Decision-Making Satisfaction Scale) and subscales of the BFI (Big Five Inventory) of personality. Quality of life was significantly associated with hypothesized variables across different time cohorts. In regression models several factors accounted for most of the variability in quality of life scores depending on time since treatment, including 47%, 22%, 29% and 27% at less than 12 months, 1 to 3 years, greater than 3 to 5 years and greater than 5 years, respectively. Upon examining the unique contribution of these variables, treatment decision making satisfaction was the only variable to have a significant and unique contribution to quality of life across all 4 time cohorts (standardized coefficients 0.33, 0.27, 0.31 and 0.49, respectively, p personality style also had unique associations with quality of life (standardized coefficients 0.25 and -0.20, respectively). When considering the short-term and the longer term quality of life of a man after treatment for localized prostate cancer, our findings highlight the importance of treatment decision making satisfaction, erectile function and personality. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights

  9. Quality of Life Issues for Families Who Make the Decision to Use a Feeding Tube for Their Child with Disabilities.

    Science.gov (United States)

    Brotherson, Mary Jane; And Others

    1995-01-01

    Eight families deciding to use a feeding tube to meet the nutrition needs of their children with disabilities were interviewed over a two-year period. Family decision making in the context of quality of life was examined using a theoretical family systems model. Implications for future interventions are addressed. (Author/SW)

  10. Evidence informed decision making

    DEFF Research Database (Denmark)

    Sharma, Tarang; Choudhury, Moni; Kaur, Bindweep

    2015-01-01

    from the literature and a combined best practice checklist has been proposed. CONCLUSIONS: As decisions often need to be made in areas where there is a lack of published scientific evidence, CE is employed. Therefore to ensure its appropriateness the development of a validated CE data quality check......-list to assist decision makers is essential and further research in this area is a priority....

  11. A MODEL OF STUDENTS’ UNIVERSITY DECISION-MAKING BEHAVIOR

    OpenAIRE

    Ionela MANIU; George C. MANIU

    2014-01-01

    Over the last decade the higher education institutional framework suffered a major transformation:the increasing influence of market competition on academic life - “marketization”.Consequently, HEI attention is increasingly focused on attracting high quality (human) resources and students. Such context demands a deeper understanding of students’ decision making process for HEI. Literature on higher education management provides a large number of models, which attempt to provide a...

  12. Inequality in Preschool Quality? Community-Level Disparities in Access to High-Quality Learning Environments

    Science.gov (United States)

    Bassok, Daphna; Galdo, Eva

    2016-01-01

    In recent years, unequal access to high-quality preschool has emerged as a growing public policy concern. Because of data limitations, it is notoriously difficult to measure disparities in access to early learning opportunities across communities and particularly challenging to quantify gaps in access to "high-quality" programs. Research…

  13. Optimal core acquisition and remanufacturing policies under uncertain core quality fractions

    NARCIS (Netherlands)

    Teunter, R.H.; Flapper, S.D.P.

    2011-01-01

    Cores acquired by a remanufacturer are typically highly variable in quality. Even if the expected fractions of the various quality levels are known, then the exact fractions when acquiring cores are still uncertain. Our model incorporates this uncertainty in determining optimal acquisition decisions

  14. Low-quality birds do not display high-quality signals: The cysteine-pheomelanin mechanism of honesty

    Science.gov (United States)

    Galván, Ismael; Wakamatsu, Kazumasa; Camarero, Pablo R; Mateo, Rafael; Alonso-Alvarez, Carlos

    2015-01-01

    The mechanisms that make that the costs of producing high-quality signals are unaffordable to low-quality signalers are a current issue in animal communication. The size of the melanin-based bib of male house sparrows Passer domesticus honestly signals quality. We induced the development of new bibs while treating males with buthionine-sulfoximine (BSO), a substance that depletes the levels of the antioxidant glutathione (GSH) and the amino acid cysteine, two elements that switch melanogenesis from eumelanin to pheomelanin. Final bib size is negatively related to pheomelanin levels in the bib feathers. BSO reduced cysteine and GSH levels in all birds, but improved phenotypes (bibs larger than controls) were only expressed by high-quality birds (BSO birds with largest bibs initially). Negative associations between final bib size and cysteine levels in erythrocytes, and between pheomelanin and cysteine levels, were observed in high-quality birds only. These findings suggest that a mechanism uncoupling pheomelanin and cysteine levels may have evolved in low-quality birds to avoid producing bibs of size not corresponding to their quality and greater relative costs. Indeed, greater oxidative stress in cells was not observed in low-quality birds. This may represent the first mechanism maintaining signal honesty without producing greater relative costs on low-quality signalers. PMID:25330349

  15. Effects of child interview tactics on prospective jurors' decisions.

    Science.gov (United States)

    Johnson, Jonni L; Shelley, Alexandra E

    2014-01-01

    Although decisions in child sexual abuse (CSA) cases are influenced by many factors (e.g., child age, juror gender), case and trial characteristics (e.g., interview quality) can strongly influence legal outcomes. In the present study, 319 prospective jurors read about a CSA investigation in which the alleged victim was interviewed at a child advocacy center (CAC) or traditional police setting. The prospective jurors then provided legally relevant ratings (e.g., child credibility, interview quality, defendant guilt). Structural equation modeling techniques revealed that child credibility predicted greater confidence in guilt decisions and also mediated all associations with such decisions. Having fewer negative prior opinions and rating the interview as of better quality were associated with higher child credibility ratings. Mitigating factors (e.g., interview quality), as opposed to proxy indicators (e.g., participant gender), better predicted CSA case outcomes. Similar associations across groups (e.g., CAC interviews did not make child victims more or less credible) permit a tentative conclusion that CACs do not positively or negatively affect decisions made in hypothetical CSA cases. Ideas for future studies examining factors influencing decisions in CSA cases are discussed. Copyright © 2014 John Wiley & Sons, Ltd.

  16. Medical Decision-Making for Adults Who Lack Decision-Making Capacity and a Surrogate: State of the Science.

    Science.gov (United States)

    Kim, Hyejin; Song, Mi-Kyung

    2018-01-01

    Adults who lack decision-making capacity and a surrogate ("unbefriended" adults) are a vulnerable, voiceless population in health care. But little is known about this population, including how medical decisions are made for these individuals. This integrative review was to examine what is known about unbefriended adults and identify gaps in the literature. Six electronic databases were searched using 4 keywords: "unbefriended," "unrepresented patients," "adult orphans," and "incapacitated patients without surrogates." After screening, the final sample included 10 data-based articles for synthesis. Main findings include the following: (1) various terms were used to refer to adults who lack decision-making capacity and a surrogate; (2) the number of unbefriended adults was sizable and likely to grow; (3) approaches to medical decision-making for this population in health-care settings varied; and (4) professional guidelines and laws to address the issues related to this population were inconsistent. There have been no studies regarding the quality of medical decision-making and its outcomes for this population or societal impact. Extremely limited empirical data exist on unbefriended adults to develop strategies to improve how medical decisions are made for this population. There is an urgent need for research to examine the quality of medical decision-making and its outcomes for this vulnerable population.

  17. A Novel Group Decision-Making Method Based on Sensor Data and Fuzzy Information.

    Science.gov (United States)

    Bai, Yu-Ting; Zhang, Bai-Hai; Wang, Xiao-Yi; Jin, Xue-Bo; Xu, Ji-Ping; Su, Ting-Li; Wang, Zhao-Yang

    2016-10-28

    Algal bloom is a typical phenomenon of the eutrophication of rivers and lakes and makes the water dirty and smelly. It is a serious threat to water security and public health. Most scholars studying solutions for this pollution have studied the principles of remediation approaches, but few have studied the decision-making and selection of the approaches. Existing research uses simplex decision-making information which is highly subjective and uses little of the data from water quality sensors. To utilize these data and solve the rational decision-making problem, a novel group decision-making method is proposed using the sensor data with fuzzy evaluation information. Firstly, the optimal similarity aggregation model of group opinions is built based on the modified similarity measurement of Vague values. Secondly, the approaches' ability to improve the water quality indexes is expressed using Vague evaluation methods. Thirdly, the water quality sensor data are analyzed to match the features of the alternative approaches with grey relational degrees. This allows the best remediation approach to be selected to meet the current water status. Finally, the selection model is applied to the remediation of algal bloom in lakes. The results show this method's rationality and feasibility when using different data from different sources.

  18. A Novel Group Decision-Making Method Based on Sensor Data and Fuzzy Information

    Directory of Open Access Journals (Sweden)

    Yu-Ting Bai

    2016-10-01

    Full Text Available Algal bloom is a typical phenomenon of the eutrophication of rivers and lakes and makes the water dirty and smelly. It is a serious threat to water security and public health. Most scholars studying solutions for this pollution have studied the principles of remediation approaches, but few have studied the decision-making and selection of the approaches. Existing research uses simplex decision-making information which is highly subjective and uses little of the data from water quality sensors. To utilize these data and solve the rational decision-making problem, a novel group decision-making method is proposed using the sensor data with fuzzy evaluation information. Firstly, the optimal similarity aggregation model of group opinions is built based on the modified similarity measurement of Vague values. Secondly, the approaches’ ability to improve the water quality indexes is expressed using Vague evaluation methods. Thirdly, the water quality sensor data are analyzed to match the features of the alternative approaches with grey relational degrees. This allows the best remediation approach to be selected to meet the current water status. Finally, the selection model is applied to the remediation of algal bloom in lakes. The results show this method’s rationality and feasibility when using different data from different sources.

  19. Impacts of High Variable Renewable Energy Futures on Wholesale Electricity Prices, and on Electric-Sector Decision Making

    Energy Technology Data Exchange (ETDEWEB)

    Seel, Joachim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mills, Andrew D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wiser, Ryan H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Deb, Sidart [LCG Consulting, Los Altos, CA (United States); Asokkumar, Aarthi [LCG Consulting, Los Altos, CA (United States); Hassanzadeh, Mohammad [LCG Consulting, Los Altos, CA (United States); Aarabali, Amirsaman [LCG Consulting, Los Altos, CA (United States)

    2018-05-11

    Increasing penetrations of variable renewable energy (VRE) can affect wholesale electricity price patterns and make them meaningfully different from past, traditional price patterns. Many long-lasting decisions for supply- and demand-side electricity infrastructure and programs are based on historical observations or assume a business-as-usual future with low shares of VRE. Our motivating question is whether certain electric-sector decisions that are made based on assumptions reflecting low VRE levels will still achieve their intended objective in a high VRE future. We qualitatively describe how various decisions may change with higher shares of VRE and outline an analytical framework for quantitatively evaluating the impacts of VRE on long-lasting decisions. We then present results from detailed electricity market simulations with capacity expansion and unit commitment models for multiple regions of the U.S. for low and high VRE futures. We find a general decrease in average annual hourly wholesale energy prices with more VRE penetration, increased price volatility and frequency of very low-priced hours, and changing diurnal price patterns. Ancillary service prices rise substantially and peak net-load hours with high capacity value are shifted increasingly into the evening, particularly for high solar futures. While in this report we only highlight qualitatively the possible impact of these altered price patterns on other demand- and supply-side electric sector decisions, the core set of electricity market prices derived here provides a foundation for later planned quantitative evaluations of these decisions in low and high VRE futures.

  20. Decision Making in Action: Applying Research to Practice

    Science.gov (United States)

    Orasanu, Judith; Statler, Irving C. (Technical Monitor)

    1994-01-01

    The importance of decision-making to safety in complex, dynamic environments like mission control centers and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. A similar observation has been made in nuclear power plants. Yet laboratory research on decision making has not proven especially helpful in improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multidimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication

  1. Volunteer stream monitoring: Do the data quality and monitoring experience support increased community involvement in freshwater decision making?

    Directory of Open Access Journals (Sweden)

    Richard G. Storey

    2016-12-01

    Full Text Available Recent freshwater policy reforms in New Zealand promote increased community involvement in freshwater decision making and management. Involving community members in scientific monitoring increases both their knowledge and their ability to discuss this knowledge with professionals, potentially increasing their influence in decision-making processes. However, these interactions rarely occur because, in particular, of perceptions that volunteer-collected data are unreliable. We assessed the agreement between volunteer (community group and local government (regional council data at nine stream sites across New Zealand. Over 18 months, community groups and regional council staff monitored, in parallel, a common set of water quality variables, physical habitat, periphyton and benthic macroinvertebrates that are routinely used by regional councils for statutory state of environment reporting. Community groups achieved close agreement (correlations ≥ 0.89, bias < 1% with regional councils for temperature, electrical conductivity, visual water clarity, and Escherichia coli. For dissolved oxygen, nitrate, and pH, correlations were weaker (0.2, 0.53, and 0.4, respectively. Volunteer assessments of physical habitat were as consistent over time as those of councils. For visual assessments of thick periphyton growths (% streambed cover, volunteers achieved a correlation of 0.93 and bias of 0.1% relative to councils. And for a macroinvertebrate biotic index that indicates water and habitat quality, correlation was 0.88, bias was < 5%, and the average difference was 12% of the index score. Volunteers showed increased awareness of local freshwaters, understanding of stream ecosystems, and attentiveness to local and national freshwater issues. Most volunteers had shared their knowledge and interest with others in their community. Most groups had developed relationships with their regional council, and some volunteers became more interested in engaging in

  2. Effect of Product Quality, Promotion, and Brand Image on Purchase Decision of Nike Sports Shoes (Case Study on S1 Fisip Undip Students)

    OpenAIRE

    Saputra, Denny; Waluyo, Handoyo Djoko; Listyorini, Sari

    2014-01-01

    Complex consumer needs all critical and followed increasingly competitive market competition lead to Nike Sports Shoes must to compete and also maintain their market consumer seized from its competitors. Consumers who take the decision to choose Nike Sports Shoes will consider various things before buying it. Consideration to make a decision consist of influenced the quality of the product, promotion, and brand image of Nike Sport Shoes. The problem in this research is Sports Shoes Nike fluct...

  3. Emblems of Quality in Higher Education. Developing and Sustaining High-Quality Programs.

    Science.gov (United States)

    Haworth, Jennifer Grant; Conrad, Clifton F.

    This book proposes an "engagement" theory of program quality to evaluate and improve higher education programs at all degree levels. Based on interviews with 781 participants in a national study of Masters degree programs, it focuses on the interactive roles of students, faculty, and administrators in developing high-quality programs…

  4. Modelling Financial-Accounting Decisions by Means of OLAP Tools

    Directory of Open Access Journals (Sweden)

    Diana Elena CODREAN

    2011-03-01

    Full Text Available At present, one can say that a company’s good running largely depends on the information quantity and quality it relies on when making decisions. The information needed to underlie decisions and be obtained due to the existence of a high-performing information system which makes it possible for the data to be shown quickly, synthetically and truly, also providing the opportunity for complex analyses and predictions. In such circumstances, computerized accounting systems, too, have grown their complexity by means of data analyzing information solutions such as OLAP and Data Mining which help perform a multidimensional analysis of financial-accounting data, potential frauds can be detected and data hidden information can be revealed, trends for certain indicators can be set up, therefore ensuring useful information to a company’s decision making.

  5. Modelling and Decision Support of Clinical Pathways

    Science.gov (United States)

    Gabriel, Roland; Lux, Thomas

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

  6. Motivated information processing and group decision-making : Effects of process accountability on information processing and decision quality

    NARCIS (Netherlands)

    Scholten, Lotte; van Knippenberg, Daan; Nijstad, Bernard A.; De Dreu, Carsten K. W.

    Integrating dual-process models [Chaiken, S., & Trope, Y. (Eds.). (1999). Dual-process theories in social psychology. NewYork: Guilford Press] with work on information sharing and group decision-making [Stasser, G., & Titus, W. (1985). Pooling of unshared information in group decision making: biased

  7. SU-E-J-155: Automatic Quantitative Decision Making Metric for 4DCT Image Quality

    Energy Technology Data Exchange (ETDEWEB)

    Kiely, J Blanco; Olszanski, A; Both, S; White, B [University of Pennsylvania, Philadelphia, PA (United States); Low, D [Deparment of Radiation Oncology, University of California Los Angeles, Los Angeles, CA (United States)

    2015-06-15

    Purpose: To develop a quantitative decision making metric for automatically detecting irregular breathing using a large patient population that received phase-sorted 4DCT. Methods: This study employed two patient cohorts. Cohort#1 contained 256 patients who received a phasesorted 4DCT. Cohort#2 contained 86 patients who received three weekly phase-sorted 4DCT scans. A previously published technique used a single abdominal surrogate to calculate the ratio of extreme inhalation tidal volume to normal inhalation tidal volume, referred to as the κ metric. Since a single surrogate is standard for phase-sorted 4DCT in radiation oncology clinical practice, tidal volume was not quantified. Without tidal volume, the absolute κ metric could not be determined, so a relative κ (κrel) metric was defined based on the measured surrogate amplitude instead of tidal volume. Receiver operator characteristic (ROC) curves were used to quantitatively determine the optimal cutoff value (jk) and efficiency cutoff value (τk) of κrel to automatically identify irregular breathing that would reduce the image quality of phase-sorted 4DCT. Discriminatory accuracy (area under the ROC curve) of κrel was calculated by a trapezoidal numeric integration technique. Results: The discriminatory accuracy of ?rel was found to be 0.746. The key values of jk and tk were calculated to be 1.45 and 1.72 respectively. For values of ?rel such that jk≤κrel≤τk, the decision to reacquire the 4DCT would be at the discretion of the physician. This accounted for only 11.9% of the patients in this study. The magnitude of κrel held consistent over 3 weeks for 73% of the patients in cohort#3. Conclusion: The decision making metric, ?rel, was shown to be an accurate classifier of irregular breathing patients in a large patient population. This work provided an automatic quantitative decision making metric to quickly and accurately assess the extent to which irregular breathing is occurring during phase

  8. SU-E-J-155: Automatic Quantitative Decision Making Metric for 4DCT Image Quality

    International Nuclear Information System (INIS)

    Kiely, J Blanco; Olszanski, A; Both, S; White, B; Low, D

    2015-01-01

    Purpose: To develop a quantitative decision making metric for automatically detecting irregular breathing using a large patient population that received phase-sorted 4DCT. Methods: This study employed two patient cohorts. Cohort#1 contained 256 patients who received a phasesorted 4DCT. Cohort#2 contained 86 patients who received three weekly phase-sorted 4DCT scans. A previously published technique used a single abdominal surrogate to calculate the ratio of extreme inhalation tidal volume to normal inhalation tidal volume, referred to as the κ metric. Since a single surrogate is standard for phase-sorted 4DCT in radiation oncology clinical practice, tidal volume was not quantified. Without tidal volume, the absolute κ metric could not be determined, so a relative κ (κrel) metric was defined based on the measured surrogate amplitude instead of tidal volume. Receiver operator characteristic (ROC) curves were used to quantitatively determine the optimal cutoff value (jk) and efficiency cutoff value (τk) of κrel to automatically identify irregular breathing that would reduce the image quality of phase-sorted 4DCT. Discriminatory accuracy (area under the ROC curve) of κrel was calculated by a trapezoidal numeric integration technique. Results: The discriminatory accuracy of ?rel was found to be 0.746. The key values of jk and tk were calculated to be 1.45 and 1.72 respectively. For values of ?rel such that jk≤κrel≤τk, the decision to reacquire the 4DCT would be at the discretion of the physician. This accounted for only 11.9% of the patients in this study. The magnitude of κrel held consistent over 3 weeks for 73% of the patients in cohort#3. Conclusion: The decision making metric, ?rel, was shown to be an accurate classifier of irregular breathing patients in a large patient population. This work provided an automatic quantitative decision making metric to quickly and accurately assess the extent to which irregular breathing is occurring during phase

  9. Integration of professional judgement and decision-making in high-level adventure sports coaching practice.

    Science.gov (United States)

    Collins, Loel; Collins, Dave

    2015-01-01

    This study examined the integration of professional judgement and decision-making processes in adventure sports coaching. The study utilised a thematic analysis approach to investigate the decision-making practices of a sample of high-level adventure sports coaches over a series of sessions. Results revealed that, in order to make judgements and decisions in practice, expert coaches employ a range of practical and pedagogic management strategies to create and opportunistically use time for decision-making. These approaches include span of control and time management strategies to facilitate the decision-making process regarding risk management, venue selection, aims, objectives, session content, and differentiation of the coaching process. The implication for coaches, coach education, and accreditation is the recognition and training of the approaches that "create time" for the judgements in practice, namely "creating space to think". The paper concludes by offering a template for a more expertise-focused progression in adventure sports coaching.

  10. Fuzzy Multicriteria Decision Analysis for Adaptive Watershed Management

    Science.gov (United States)

    Chang, N.

    2006-12-01

    The dramatic changes of societal complexity due to intensive interactions among agricultural, industrial, and municipal sectors have resulted in acute issues of water resources redistribution and water quality management in many river basins. Given the fact that integrated watershed management is more a political and societal than a technical challenge, there is a need for developing a compelling method leading to justify a water-based land use program in some critical regions. Adaptive watershed management is viewed as an indispensable tool nowadays for providing step-wise constructive decision support that is concerned with all related aspects of the water consumption cycle and those facilities affecting water quality and quantity temporally and spatially. Yet the greatest challenge that decision makers face today is to consider how to leverage ambiguity, paradox, and uncertainty to their competitive advantage of management policy quantitatively. This paper explores a fuzzy multicriteria evaluation method for water resources redistribution and subsequent water quality management with respect to a multipurpose channel-reservoir system--the Tseng- Wen River Basin, South Taiwan. Four fuzzy operators tailored for this fuzzy multicriteria decision analysis depict greater flexibility in representing the complexity of various possible trade-offs among management alternatives constrained by physical, economic, and technical factors essential for adaptive watershed management. The management strategies derived may enable decision makers to integrate a vast number of internal weirs, water intakes, reservoirs, drainage ditches, transfer pipelines, and wastewater treatment facilities within the basin and bring up the permitting issue for transboundary diversion from a neighboring river basin. Experience gained indicates that the use of different types of fuzzy operators is highly instructive, which also provide unique guidance collectively for achieving the overarching goals

  11. Young People's Decision-Making: The Importance of High Quality School-Based Careers Education, Information, Advice and Guidance

    Science.gov (United States)

    Haynes, Gill; McCrone, Tami; Wade, Pauline

    2013-01-01

    This paper explores the decision-making processes of young people aged 13-14?years in 30 consortia across England as they chose their options for Key Stage 4 at a time when a new qualification, the 14-19 Diploma, was being introduced. It draws on data collected as part of a longitudinal national study (January 2008-August 2011) of the introduction…

  12. Data quality and processing for decision making: divergence between corporate strategy and manufacturing processes

    Science.gov (United States)

    McNeil, Ronald D.; Miele, Renato; Shaul, Dennis

    2000-10-01

    Information technology is driving improvements in manufacturing systems. Results are higher productivity and quality. However, corporate strategy is driven by a number of factors and includes data and pressure from multiple stakeholders, which includes employees, managers, executives, stockholders, boards, suppliers and customers. It is also driven by information about competitors and emerging technology. Much information is based on processing of data and the resulting biases of the processors. Thus, stakeholders can base inputs on faulty perceptions, which are not reality based. Prior to processing, data used may be inaccurate. Sources of data and information may include demographic reports, statistical analyses, intelligence reports (e.g., marketing data), technology and primary data collection. The reliability and validity of data as well as the management of sources and information is critical element to strategy formulation. The paper explores data collection, processing and analyses from secondary and primary sources, information generation and report presentation for strategy formulation and contrast this with data and information utilized to drive internal process such as manufacturing. The hypothesis is that internal process, such as manufacturing, are subordinate to corporate strategies. The impact of possible divergence in quality of decisions at the corporate level on IT driven, quality-manufacturing processes based on measurable outcomes is significant. Recommendations for IT improvements at the corporate strategy level are given.

  13. [Patients' decision for aesthetic surgery].

    Science.gov (United States)

    Fansa, H; Haller, S

    2011-12-01

    Aesthetic surgery is a service which entails a high degree of trust. Service evaluation prior to provision is difficult for the patient. This leads to the question of how to manage the service successfully while still focusing on the medical needs. The decision to undergo an operation is not influenced by the operation itself, but by preoperative events which induce the patient to have the operation done. According to "buying decisions" for products or in service management, the decision for an aesthetic operation is extensive; the patient is highly involved and actively searching for information using different directed sources of information. The real "buying decision" consists of 5 phases: problem recognition, gathering of information, alternative education, purchase decision, and post purchase behaviour. A retrospective survey of 40 female patients who have already undergone an aesthetic operation assessed for problem recognition, which types of information were collected prior to the appointment with the surgeon, and why the patients have had the operation at our hospital. They were also asked how many alternative surgeons they had been seen before. Most of the patients had been thinking about undergoing an operation for several years. They mainly used the web for their research and were informed by other (non-aesthetic) physicians/general practitioners. Requested information was about the aesthetic results and possible problems and complications. Patients came based on web information and because of recommendations from other physicians. 60% of all interviewees did not see another surgeon and decided to have the operation because of positive patient-doctor communication and the surgeon's good reputation. Competence was considered to be the most important quality of the surgeon. However, the attribute was judged on subjective parameters. Environment, office rooms and staff were assessed as important but not very important. Costs of surgery were ranked second

  14. Long quantum channels for high-quality entanglement transfer

    International Nuclear Information System (INIS)

    Banchi, L; Apollaro, T J G; Cuccoli, A; Verrucchi, P; Vaia, R

    2011-01-01

    High-quality quantum-state and entanglement transfer can be achieved in an unmodulated spin bus operating in the ballistic regime, which occurs when the endpoint qubits A and B are nonperturbatively coupled to the chain by a suitable exchange interaction j 0 . Indeed, the transition amplitude characterizing the transfer quality exhibits a maximum for a finite optimal value j opt 0 (N), where N is the channel length. We show that j opt 0 (N) scales as N -1/6 for large N and that it ensures a high-quality entanglement transfer even in the limit of arbitrarily long channels, almost independently of the channel initialization. For instance, for any chain length the average quantum-state transmission fidelity exceeds 90% and decreases very little in a broad neighbourhood of j opt 0 (N). We emphasize that, taking the reverse point of view, should j 0 be experimentally constrained, high-quality transfer can still be obtained by adjusting the channel length to its optimal value. (paper)

  15. The STARTEC Decision Support Tool for Better Tradeoffs between Food Safety, Quality, Nutrition, and Costs in Production of Advanced Ready-to-Eat Foods

    Science.gov (United States)

    Gefferth, Andras; Spajic, Miroslav; Estanga, Edurne Gaston; Vitali, Silvia; Pasquali, Frederique; Bovo, Federica; Manfreda, Gerardo; Mancusi, Rocco; Tessema, Girum Tadesse; Fagereng, Tone; Moen, Lena Haugland; Lyshaug, Lars; Koidis, Anastasios; Delgado-Pando, Gonzalo; Stratakos, Alexandros Ch.; Boeri, Marco; From, Cecilie; Syed, Hyat; Muccioli, Mirko; Mulazzani, Roberto; Halbert, Catherine

    2017-01-01

    A prototype decision support IT-tool for the food industry was developed in the STARTEC project. Typical processes and decision steps were mapped using real life production scenarios of participating food companies manufacturing complex ready-to-eat foods. Companies looked for a more integrated approach when making food safety decisions that would align with existing HACCP systems. The tool was designed with shelf life assessments and data on safety, quality, and costs, using a pasta salad meal as a case product. The process flow chart was used as starting point, with simulation options at each process step. Key parameters like pH, water activity, costs of ingredients and salaries, and default models for calculations of Listeria monocytogenes, quality scores, and vitamin C, were placed in an interactive database. Customization of the models and settings was possible on the user-interface. The simulation module outputs were provided as detailed curves or categorized as “good”; “sufficient”; or “corrective action needed” based on threshold limit values set by the user. Possible corrective actions were suggested by the system. The tool was tested and approved by end-users based on selected ready-to-eat food products. Compared to other decision support tools, the STARTEC-tool is product-specific and multidisciplinary and includes interpretation and targeted recommendations for end-users. PMID:29457031

  16. The STARTEC Decision Support Tool for Better Tradeoffs between Food Safety, Quality, Nutrition, and Costs in Production of Advanced Ready-to-Eat Foods

    Directory of Open Access Journals (Sweden)

    Taran Skjerdal

    2017-01-01

    Full Text Available A prototype decision support IT-tool for the food industry was developed in the STARTEC project. Typical processes and decision steps were mapped using real life production scenarios of participating food companies manufacturing complex ready-to-eat foods. Companies looked for a more integrated approach when making food safety decisions that would align with existing HACCP systems. The tool was designed with shelf life assessments and data on safety, quality, and costs, using a pasta salad meal as a case product. The process flow chart was used as starting point, with simulation options at each process step. Key parameters like pH, water activity, costs of ingredients and salaries, and default models for calculations of Listeria monocytogenes, quality scores, and vitamin C, were placed in an interactive database. Customization of the models and settings was possible on the user-interface. The simulation module outputs were provided as detailed curves or categorized as “good”; “sufficient”; or “corrective action needed” based on threshold limit values set by the user. Possible corrective actions were suggested by the system. The tool was tested and approved by end-users based on selected ready-to-eat food products. Compared to other decision support tools, the STARTEC-tool is product-specific and multidisciplinary and includes interpretation and targeted recommendations for end-users.

  17. Risk management in facility transition and management decision making: Needs and opportunities

    International Nuclear Information System (INIS)

    Stillwell, W.; Seaver, D.; Keller, J.; Smith, D.; Weaver, D.; Sanders, T.; Thullen, P.

    1993-02-01

    An overall approach to risk management is described in this paper. Many of these concepts have been developed and applied as part of Hanford Mission Planning (HMP) (Hanford Mission Plan, 1992). At Hanford, HMP provides a mechanism for integrating planning across all the missions and programs of the site. This paper discusses the decision context within which EM must make and defend decisions, the types of decisions that are being and will need to be made in order to progress with the cleanup of the DOE complex, and the resulting need for risk management. Risk management, in turn, requires quality health and ecological risk information to make these decisions. Other types of information are also needed, but the risk information is typically the most important and the most difficult to obtain. The paper then describes a general technical approach to risk management, including particular methods for developing the high quality of human health and ecological risk information that will be needed to support risk management. We next turn to several special issues that make risk management more complex than many other decisions. We discuss these issues and offer some practical suggestions with respect to addressing them in the risk management framework. Finally, we conclude with some discussion of other opportunities for applying risk management

  18. Multiple Criteria Decision Analysis for Health Care Decision Making—An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; IJzerman, Maarten Joost

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading

  19. Identifying suitable substrates for high-quality graphene-based heterostructures

    Science.gov (United States)

    Banszerus, L.; Janssen, H.; Otto, M.; Epping, A.; Taniguchi, T.; Watanabe, K.; Beschoten, B.; Neumaier, D.; Stampfer, C.

    2017-06-01

    We report on a scanning confocal Raman spectroscopy study investigating the strain-uniformity and the overall strain and doping of high-quality chemical vapour deposited (CVD) graphene-based heterostuctures on a large number of different substrate materials, including hexagonal boron nitride (hBN), transition metal dichalcogenides, silicon, different oxides and nitrides, as well as polymers. By applying a hBN-assisted, contamination free, dry transfer process for CVD graphene, high-quality heterostructures with low doping densities and low strain variations are assembled. The Raman spectra of these pristine heterostructures are sensitive to substrate-induced doping and strain variations and are thus used to probe the suitability of the substrate material for potential high-quality graphene devices. We find that the flatness of the substrate material is a key figure for gaining, or preserving high-quality graphene.

  20. A systematic review of decision support needs of parents making child health decisions

    Science.gov (United States)

    Jackson, Cath; Cheater, Francine M.; Reid, Innes

    2008-01-01

    Abstract Objective  To identify the decision support needs of parents attempting to make an informed health decision on behalf of a child. Context  The first step towards implementing patient decision support is to assess patients’ information and decision‐making needs. Search strategy  A systematic search of key bibliographic databases for decision support studies was performed in 2005. Reference lists of relevant review articles and key authors were searched. Three relevant journals were hand searched. Inclusion criteria  Non‐intervention studies containing data on decision support needs of parents making child health decisions. Data extraction and synthesis  Data were extracted on study characteristics, decision focus and decision support needs. Studies were quality assessed using a pre‐defined set of criteria. Data synthesis used the UK Evidence for Policy and Practice Information and Co‐ordinating Centre approach. Main results  One‐hundred and forty nine studies were included across various child health decisions, settings and study designs. Thematic analysis of decision support needs indicated three key issues: (i) information (including suggestions about the content, delivery, source, timing); (ii) talking to others (including concerns about pressure from others); and (iii) feeling a sense of control over the process that could be influenced by emotionally charged decisions, the consultation process, and structural or service barriers. These were consistent across decision type, study design and whether or not the study focused on informed decision making. PMID:18816320

  1. An environmental fairness based optimisation model for the decision-support of joint control over the water quantity and quality of a river basin

    Science.gov (United States)

    Yu, Sen; He, Li; Lu, Hongwei

    2016-04-01

    This paper presented a new environmental fairness based optimisation model (EFOM) for the decision-support of water resources management and water pollution control at the watershed scale. The model integrated three prediction modules for water consumption and pollutant discharge (WCPD), environmental Gini coefficient (EGC) and water quality (WASP). The model is capable of optimizing the total discharge quantity in the whole basin and controlling units both spatially and temporally, and addressing the conflicts between environmental fairness and efficiency. The model was applied to the Songhua River basin, attempting to support decision-making of joint control over the water quantity and quality. Validation of the WASP module showed that the simulation agreed well with water quality monitoring values (2013) in the Harbin section. Results from the EFOM model also indicated that the water environment in the Harbin section would be improved significantly by effectively controlling the total pollution discharge. The identified optimal strategy obtained from the EFOM showed that the percentage of water in good quality reaches 72% in 2020, suggesting that the strategy would guarantee the planning goals of The China Action Plan for Water Pollution Control to be satisfied. Hence, the modelling under the consideration of environmental fairness can be a new attempt, which is beneficial to optimal joint control of water quantity and water quality at the watershed scale.

  2. Multivariate analysis of flow cytometric data using decision trees

    Directory of Open Access Journals (Sweden)

    Svenja eSimon

    2012-04-01

    Full Text Available Characterization of the response of the host immune system is important in understanding the bidirectional interactions between the host and microbial pathogens. For research on the host site, flow cytometry has become one of the major tools in immunology. Advances in technology and reagents allow now the simultaneous assessment of multiple markers on a single cell level generating multidimensional data sets that require multivariate statistical analysis. We explored the explanatory power of the supervised machine learning method called 'induction of decision trees' in flow cytometric data. In order to examine whether the production of a certain cytokine is depended on other cytokines, datasets from intracellular staining for six cytokines with complex patterns of co-expression were analyzed by induction of decision trees. After weighting the data according to their class probabilities, we created a total of 13,392 different decision trees for each given cytokine with different parameter settings. For a more realistic estimation of the decision trees's quality, we used stratified 5-fold cross-validation and chose the 'best' tree according to a combination of different quality criteria. While some of the decision trees reflected previously known co-expression patterns, we found that the expression of some cytokines was not only dependent on the co-expression of others per se, but was also dependent on the intensity of expression. Thus, for the first time we successfully used induction of decision trees for the analysis of high dimensional flow cytometric data and demonstrated the feasibility of this method to reveal structural patterns in such data sets.

  3. Shared decision-making in the paediatric field: a literature review and concept analysis.

    Science.gov (United States)

    Park, Eun Sook; Cho, In Young

    2017-09-13

    The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field. The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for child's health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising child's health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care. This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field. © 2017 Nordic College of Caring Science.

  4. Data Mining for Education Decision Support: A Review

    Directory of Open Access Journals (Sweden)

    Suhirman Suhirman

    2014-12-01

    Full Text Available Management of higher education must continue to evaluate on an ongoing basis in order to improve the quality of institutions. This will be able to do the necessary evaluation of various data, information, and knowledge of both internal and external institutions. They plan to use more efficiently the collected data, develop tools so that to collect and direct management information, in order to support managerial decision making. The collected data could be utilized to evaluate quality, perform analyses and diagnoses, evaluate dependability to the standards and practices of curricula and syllabi, and suggest alternatives in decision processes. Data minings to support decision making are well suited methods to provide decision support in the education environments, by generating and presenting relevant information and knowledge towards quality improvement of education processes. In educational domain, this information is very useful since it can be used as a base for investigating and enhancing the current educational standards and managements. In this paper, a review on data mining for academic decision support in education field is presented. The details of this paper will review on recent data mining in educational field and outlines future researches in educational data mining.

  5. Strategies to facilitate shared decision-making about pediatric oncology clinical trial enrollment: A systematic review.

    Science.gov (United States)

    Robertson, Eden G; Wakefield, Claire E; Signorelli, Christina; Cohn, Richard J; Patenaude, Andrea; Foster, Claire; Pettit, Tristan; Fardell, Joanna E

    2018-07-01

    We conducted a systematic review to identify the strategies that have been recommended in the literature to facilitate shared decision-making regarding enrolment in pediatric oncology clinical trials. We searched seven databases for peer-reviewed literature, published 1990-2017. Of 924 articles identified, 17 studies were eligible for the review. We assessed study quality using the 'Mixed-Methods Appraisal Tool'. We coded the results and discussions of papers line-by-line using nVivo software. We categorized strategies thematically. Five main themes emerged: 1) decision-making as a process, 2) individuality of the process; 3) information provision, 4) the role of communication, or 5) decision and psychosocial support. Families should have adequate time to make a decision. HCPs should elicit parents' and patients' preferences for level of information and decision involvement. Information should be clear and provided in multiple modalities. Articles also recommended providing training for healthcare professionals and access to psychosocial support for families. High quality, individually-tailored information, open communication and psychosocial support appear vital in supporting decision-making regarding enrollment in clinical trials. These data will usefully inform future decision-making interventions/tools to support families making clinical trial decisions. A solid evidence-base for effective strategies which facilitate shared decision-making is needed. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Decision-making for delivery location and quality of care among slum-dwellers: a qualitative study in Uttar Pradesh, India.

    Science.gov (United States)

    Sudhinaraset, May; Beyeler, Naomi; Barge, Sandhya; Diamond-Smith, Nadia

    2016-07-07

    In 2013, the Government of India launched the National Urban Health Mission (NUHM) in order to better address the health needs of urban populations, including the nearly 100 million living in slums. Maternal and neonatal health indicators remain poor in India. The objective of this study is to highlight the experiences of women, their husbands, and mothers-in-law related to maternal health services and delivery experiences. In total, we conducted 80 in-depth interviews, including 40 with recent mothers, 20 with their husbands, and 20 with their mothers-in-law. Purposeful sampling was conducted in order to obtain differences across delivery experiences (facility vs. home), followed by their family members. Major factors that influence decision-making about where to seek care included household dynamics and joint-decision-making with families, financial barriers, and perceived quality of care. Women perceived that private facilities were higher quality compared to public facilities, but also more expensive. Disrespectful care, bribes in the facility, and payment challenges were common in this population. A number of programmatic and policy recommendations are highlighted from this study. Future endeavors should include a greater focus on health education and public programs, including educating women on how to access programs, who is eligible, and how to obtain public funds. Families need to be educated on their rights and expectations in facilities. Future programs should consider the role of husbands and mothers-in-law in reproductive decision-making and support during deliveries. Triangulating information from multiple sources is important for future research efforts.

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

    Science.gov (United States)

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

    2017-12-01

    The stiff competition for water between agriculture and non-agricultural production sectors makes it necessary to have effective management of irrigation networks in farms. However, the process of selecting flow control structures in irrigation networks is highly complex and involves different levels of decision makers. In this paper, we apply multi-attribute decision making (MADM) methodology to develop a decision analysis (DA) framework for evaluating, ranking and selecting check and intake structures for irrigation canals. The DA framework consists of identifying relevant attributes for canal structures, developing a robust scoring system for alternatives, identifying a procedure for data quality control, and identifying a MADM model for the decision analysis. An application is illustrated through an analysis for automation purposes of the Qazvin irrigation network, one of the oldest and most complex irrigation networks in Iran. A survey questionnaire designed based on the decision framework was distributed to experts, managers, and operators of the Qazvin network and to experts from the Ministry of Power in Iran. Five check structures and four intake structures were evaluated. A decision matrix was generated from the average scores collected from the survey, and was subsequently solved using TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) method. To identify the most critical structure attributes for the selection process, optimal attribute weights were calculated using Entropy method. For check structures, results show that the duckbill weir is the preferred structure while the pivot weir is the least preferred. Use of the duckbill weir can potentially address the problem with existing Amil gates where manual intervention is required to regulate water levels during periods of flow extremes. For intake structures, the Neyrpic® gate and constant head orifice are the most and least preferred alternatives, respectively. Some advantages

  8. Framing decisions decision-making that accounts for irrationality, people and constraints

    CERN Document Server

    Frame, J Davidson

    2012-01-01

    The economic crisis of 2008-2009 was a transformational event: it demonstrated that smart people aren''t as smart as they and the public think. The crisis arose because a lot of highly educated people in high-impact positions- political power brokers, business leaders, and large segments of the general public-made a lot of bad decisions despite unprecedented access to data, highly sophisticated decision support systems, methodological advances in the decision sciences, and guidance from highly experienced experts. How could we get things so wrong? The answer, says J. Davidson Frame in Framing

  9. Testing an advanced satellite technique for dust detection as a decision support system for the air quality assessment

    Science.gov (United States)

    Falconieri, Alfredo; Filizzola, Carolina; Femiano, Rossella; Marchese, Francesco; Sannazzaro, Filomena; Pergola, Nicola; Tramutoli, Valerio; Di Muro, Ersilia; Divietri, Mariella; Crisci, Anna Maria; Lovallo, Michele; Mangiamele, Lucia; Vaccaro, Maria Pia; Palma, Achille

    2014-05-01

    In order to correctly apply the European directive for air quality (2008/50/CE), local Authorities are often requested to discriminate the possible origin (natural/anthropic) of anomalous concentration of pollutants in the air (art.20 Directive 2008/50/CE). In this framework, it's been focused on PM10 and PM2,5 concentrations and sources. In fact, depending on their origin, appropriate counter-measures can be taken devoted to prevent their production (e.g. by traffic restriction) or simply to reduce their impact on citizen health (e.g. information campaigns). In this context suitable satellite techniques can be used in order to identify natural sources (particularly Saharan dust, but also volcanic ash or forest fire smoke) that can be responsible of over-threshold concentration of PM10/2,5 in populated areas. In the framework of the NIBS (Networking and Internationalization of Basilicata Space Technologies) project, funded by the Basilicata Region within the ERDF 2007-2013 program, the School of Engineering of University of Basilicata, the Institute of Methodologies for Environmental Analysis of National Research Council (IMAA-CNR) and the Regional Agency for the Protection of the Environment of Basilicata Region (ARPAB) have started a collaboration devoted to assess the potential of the use of advanced satellite techniques for Saharan dust events identification to support ARPAB activities related to the application of the European directive for air quality (2008/50/CE) in Basilicata region. In such a joint activity, the Robust Satellite Technique (RST) approach has been assessed and tested as a decision support system for monitoring and evaluating air quality at local and regional level. In particular, RST-DUST products, derived by processing high temporal resolution data provided by SEVIRI (Spinning Enhanced Visible and Infrared Imager) sensor on board Meteosat Second Generation platforms, have been analysed together with PM10 measurements performed by the ground

  10. A conceptual model of the role of communication in surrogate decision making for hospitalized adults.

    Science.gov (United States)

    Torke, Alexia M; Petronio, Sandra; Sachs, Greg A; Helft, Paul R; Purnell, Christianna

    2012-04-01

    To build a conceptual model of the role of communication in decision making, based on literature from medicine, communication studies and medical ethics. We proposed a model and described each construct in detail. We review what is known about interpersonal and patient-physician communication, described literature about surrogate-clinician communication, and discussed implications for our developing model. The communication literature proposes two major elements of interpersonal communication: information processing and relationship building. These elements are composed of constructs such as information disclosure and emotional support that are likely to be relevant to decision making. We propose these elements of communication impact decision making, which in turn affects outcomes for both patients and surrogates. Decision making quality may also mediate the relationship between communication and outcomes. Although many elements of the model have been studied in relation to patient-clinician communication, there is limited data about surrogate decision making. There is evidence of high surrogate distress associated with decision making that may be alleviated by communication-focused interventions. More research is needed to test the relationships proposed in the model. Good communication with surrogates may improve both the quality of medical decisions and outcomes for the patient and surrogate. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Shared decision-making.

    Science.gov (United States)

    Godolphin, William

    2009-01-01

    Shared decision-making has been called the crux of patient-centred care and identified as a key part of change for improved quality and safety in healthcare. However, it rarely happens, is hard to do and is not taught - for many reasons. Talking with patients about options is not embedded in the attitudes or communication skills training of most healthcare professionals. Information tools such as patient decision aids, personal health records and the Internet will help to shift this state, as will policy that drives patient and public involvement in healthcare delivery and training.

  12. Decision Aid for Cigarette Smokers Scheduled for Elective Surgery.

    Science.gov (United States)

    Warner, David O; LeBlanc, Annie; Kadimpati, Sandeep; Vickers, Kristin S; Shi, Yu; Montori, Victor M

    2015-07-01

    Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery. In formative work, a decision aid was designed to facilitate patient-clinician discussion regarding three options: continue smoking, attempt a period of temporary abstinence, and attempt to quit smoking for good. A randomized, two-group pilot study was then conducted in smokers evaluated in preparation for elective surgery in a preoperative clinic to test the hypothesis that the decision aid would improve measures of decisional quality compared with usual care. The final decision aid consisted of three laminated cards. The front of each card included a colorful graphic describing each choice; the reverse including two to three pros and cons for each decision, a simple graphic illustrating the effects of smoking on the body, and a motivational phrase. In the randomized trial of 130 patients, the decision aid significantly (P < 0.05) improved measures of decisional quality and patient involvement in decision making (Cohen's d effect sizes of 0.76 and 1.20 for the Decisional Conflict Scale and Observing PatienT involvement In decisiON-making scale, respectively). However, the decision aid did not affect any aspect of perioperative smoking behavior, including the distribution of or adherence to choices. Although the use of a decision aid to facilitate clinician-patient discussions regarding tobacco use around the time of surgery substantially improved measures of decisional quality, it alone did not change perioperative tobacco use behavior.

  13. Fast decision algorithms in low-power embedded processors for quality-of-service based connectivity of mobile sensors in heterogeneous wireless sensor networks.

    Science.gov (United States)

    Jaraíz-Simón, María D; Gómez-Pulido, Juan A; Vega-Rodríguez, Miguel A; Sánchez-Pérez, Juan M

    2012-01-01

    When a mobile wireless sensor is moving along heterogeneous wireless sensor networks, it can be under the coverage of more than one network many times. In these situations, the Vertical Handoff process can happen, where the mobile sensor decides to change its connection from a network to the best network among the available ones according to their quality of service characteristics. A fitness function is used for the handoff decision, being desirable to minimize it. This is an optimization problem which consists of the adjustment of a set of weights for the quality of service. Solving this problem efficiently is relevant to heterogeneous wireless sensor networks in many advanced applications. Numerous works can be found in the literature dealing with the vertical handoff decision, although they all suffer from the same shortfall: a non-comparable efficiency. Therefore, the aim of this work is twofold: first, to develop a fast decision algorithm that explores the entire space of possible combinations of weights, searching that one that minimizes the fitness function; and second, to design and implement a system on chip architecture based on reconfigurable hardware and embedded processors to achieve several goals necessary for competitive mobile terminals: good performance, low power consumption, low economic cost, and small area integration.

  14. [Association between psychosocial aspects of work and quality of life among motorcycle taxi drivers].

    Science.gov (United States)

    Teixeira, Jules Ramon Brito; Boery, Eduardo Nagib; Casotti, Cezar Augusto; Araújo, Tânia Maria de; Pereira, Rafael; Ribeiro, Ícaro José Santos; Rios, Marcela Andrade; Amorim, Camila Rego; Moreira, Ramon Missias; Boery, Rita Narriman Silva de Oliveira; Sales, Zenilda Nogueira

    2015-01-01

    This study aimed to evaluate the quality of life of motorcycle taxi drivers and the association with psychosocial characteristics of their work. This was a cross-sectional epidemiological study with a sample of 400 motorcycle taxi drivers in Jequié, Bahia State, Brazil. The study used a form containing demographic and socioeconomic data, WHO Quality of Life-Bref Questionnaire (WHOQOL-Bref), and the Job Content Questionnaire (JCQ). Motorcycle taxi drivers with greater decision-making control over their work showed better self-rated quality of life in the psychological domain; those with high psychological demands presented better self-rated quality of life in the social relations and environmental domains; those with high strain and active work showed better self-rated quality of life in the social and environmental domains. The psychosocial work environment and especially decision-making autonomy were thus important determinants of self-rated quality of life in this group of motorcycle taxi drivers.

  15. 36 CFR 907.14 - Corporation decision making procedures.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Corporation decision making procedures. 907.14 Section 907.14 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION ENVIRONMENTAL QUALITY § 907.14 Corporation decision making procedures. To ensure that at major decision making points all relevant...

  16. Data Warehousing and Data Quality for a Spatial Decision Support System

    National Research Council Canada - National Science Library

    Dill, Robert

    1997-01-01

    .... The Army Reserve Installation Evaluation System (ARIES) integrates a GIS mapping engine and a decision model solver in a flexible environment that leverages operational legacy database information for decision-making...

  17. Should I go with my gut? Investigating the benefits of emotion-focused decision making.

    Science.gov (United States)

    Mikels, Joseph A; Maglio, Sam J; Reed, Andrew E; Kaplowitz, Lee J

    2011-08-01

    Deliberative decision strategies have historically been considered the surest path to sound decisions; however, recent evidence and theory suggest that affective strategies may be equally as effective. In four experiments we examined conditions under which affective versus deliberative decision strategies might result in higher decision quality. While consciously focusing on feelings versus details, participants made choices that varied in complexity, in extent of subsequent conscious deliberation allowed, and in domain. Results indicate that focusing on feelings versus details led to superior objective and subjective decision quality for complex decisions. However, when using a feeling-focused approach, subsequent deliberation after encoding resulted in reduced choice quality. These results suggest that affective decision strategies may be more effective relative to deliberative strategies for certain complex decisions. 2011 APA, all rights reserved

  18. Multiple Criteria Decision Analysis for Health Care Decision Making—Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Marsh, Kevin; IJzerman, Maarten Joost; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading

  19. WHY FUZZY QUALITY?

    Directory of Open Access Journals (Sweden)

    Abbas Parchami

    2016-09-01

    Full Text Available Such as other statistical problems, we may confront with uncertain and fuzzy concepts in quality control. One particular case in process capability analysis is a situation in which specification limits are two fuzzy sets. In such a uncertain and vague environment, the produced product is not qualified with a two-valued Boolean view, but to some degree depending on the decision-maker strictness and the quality level of the produced product. This matter can be cause to a rational decision-making on the quality of the production line. First, a comprehensive approach is presented in this paper for modeling the fuzzy quality concept. Then, motivations and advantages of applying this flexible approach instead of using classical quality are mentioned.

  20. Influence of acute stress on decision outcomes and heuristics.

    Science.gov (United States)

    Hepler, Teri J; Kovacs, Attila J

    2017-03-01

    The purpose of this study was to examine the take-the-first (TTF) heuristic and decision outcomes in sports under conditions of no, mental, and physical stress. Participants (N.=68) performed 8 video decision-making trials under each of 3 stress conditions: no stress (counting backwards), mental stress (mental serial subtraction), and physical stress (running on treadmill at 13 RPE). Prior to each decision-making trial, participants were exposed to 30 seconds of stress. The decision-making task required participants to watch a video depicting an offensive situation in basketball and then decide what the player with the ball should do next. No differences were found between the 3 stress conditions on TTF frequency, number of options generated, quality of first generated option, or final decision quality. However, participants performing under conditions of no stress and physical stress generated their first option and made their final decision faster than they did when making decisions under mental stress. Overall, results suggest that mental stress impairs decision speed and that TTF is an ecologically rationale heuristic in dynamic, time-pressured situations.

  1. Health Informatics Can Avoid Committing Symbolic Violence by Recognizing and Supporting Generic Decision-making Competencies

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

    2015-01-01

    'Symbolic violence' is committed, however well-intentionally, by the imposition of particular conceptualizations of what information, in what form and quality, is needed in order to make an 'informed choice' and hence - by questionable segue - a high quality decision. The social and cultural forms...... experienced by individuals at any and all levels of general literacy. It leads many to adopt the same range of avoidant and other undesirable strategies within healthcare situations observed in those of low basic literacy. The alternative response we propose exploits the alternative generic decision literacy...... which comes in the form of the ability to access and use the decision-relevant resources provided for many consumer services and products on comparison websites and magazines. The methodology is the simple form of multi-criteria analysis in which the products' ratings on multiple criteria are combined...

  2. Analyzing The Effect Of Marketing Mix, Service Quality And Brand Equity On Consumer Buying Decision In Indomaret Manado

    OpenAIRE

    Tumewu, Ferdinand J; Mongdong, Vilanri G

    2015-01-01

    Nowadays retail industry has been growing quite fast supported by the consumer behavior that has begun to shift from traditional to modern retail market. APRINDO predicted that the growth would be around 10% by 2015. Indomaret franchise is the pioneer in Indonesia. The objective of this research is to identify the effect of marketing mix, service quality and brand equity on consumer buying decision. In this research, the population refers to the consumer of Indomaret Manado with cluster sampl...

  3. Evaluating the quality and use of economic data in decisions about essential medicines.

    Science.gov (United States)

    Moucheraud, Corrina; Wirtz, Veronika J; Reich, Michael R

    2015-10-01

    To evaluate the quality of economic data provided in applications to the World Health Organization (WHO) Model List of Essential Medicines and to evaluate the role of these data in decision-making by the expert committee that considers the applications. We analysed applications submitted to the WHO Expert Committee on the Selection and Use of Essential Medicines between 2002 and 2013. The completeness of data on the price and cost-effectiveness of medicines was extracted from application documents and coded using a four-point scale. We recorded whether or not the expert committee discussed economic information and the outcomes of each application. Associations between the completeness of economic data and application outcomes were assessed using χ 2 tests. The expert committee received 134 applications. Only eight applications (6%) included complete price data and economic evaluation data. Many applicants omitted or misinterpreted the economic evaluation section of the application form. Despite the lack of economic data, all applications were reviewed by the committee. There was no significant association between the completeness of economic information and application outcomes. The expert committee tried to address information gaps in applications by further review and analysis of data related to the application. The World Health Organization should revise the instructions to applicants on economic data requirements; develop new mechanisms to assist applicants in completing the application process; and define methods for the use of economic data in decision-making.

  4. Renewable Energy Data, Analysis, and Decisions: A Guide for Practitioners

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Sarah L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Lopez, Anthony J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Watson, Andrea C [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Grue, Nicholas W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Leisch, Jennifer E. [United States Agency for International Development (USAID)

    2018-03-16

    High-quality renewable energy resource data and other geographic information system (GIS) data are essential for the transition to a clean energy economy that prioritizes local resources, improves resiliency, creates jobs, and promotes energy independence. This guide is intended to support policymakers and planners, as well as technical experts, consultants, and academics in incorporating improved data and analysis into renewable energy decision-making.

  5. Risk-averse decision-making for civil infrastructure exposed to low-probability, high-consequence events

    International Nuclear Information System (INIS)

    Cha, Eun Jeong; Ellingwood, Bruce R.

    2012-01-01

    Quantitative analysis and assessment of risk to civil infrastructure has two components: probability of a potentially damaging event and consequence of damage, measured in terms of financial or human losses. Decision models that have been utilized during the past three decades take into account the probabilistic component rationally, but address decision-maker attitudes toward consequences and risk only to a limited degree. The application of models reflecting these attitudes to decisions involving low-probability, high-consequence events that may impact civil infrastructure requires a fundamental understanding of risk acceptance attitudes and how they affect individual and group choices. In particular, the phenomenon of risk aversion may be a significant factor in decisions for civil infrastructure exposed to low-probability events with severe consequences, such as earthquakes, hurricanes or floods. This paper utilizes cumulative prospect theory to investigate the role and characteristics of risk-aversion in assurance of structural safety.

  6. Ergonomics and risk management in high risk organizations: nuclear power plant operator decision making

    International Nuclear Information System (INIS)

    Carvalho, Paulo Victor Rodrigues de

    2003-08-01

    Nuclear power plants are high hazard environments where emergency situations can have devastating effects. The operator crew has the ultimate responsibility to control the energy production process with safety. The outcome of a crisis is consequently dependent on the crew's judgement, decision making and situation awareness. In such way we should know how operators make their decisions in order to develop safety strategies. The aim of this thesis is to examine the cognitive processes through which operators make decisions when dealing with micro incidents during their actual work, and to determine whether they use a naturalistic or normative decision making strategy. That is, do they try to recognize the micro incident as familiar and base decisions on condition-action rules (naturalistic), or do they need to concurrently compare and contrast options before selecting the best possible (normative). The method employed for data collection was the Cognitive Task Analysis (CTA) and Ergonomic Work Analysis (EWA). The main findings of this thesis were that decision making is primarily based on naturalistic strategies, such as condition-action rules and recognition. In new situations rules are created ad hoc. These rules appear derived from experience and training rather than from Standard Operating Procedures and contrast normative competence standards used by nuclear industry. (author)

  7. Quality Assurance in Defense Adjudication Workshop for Defining and Assessing Quality

    National Research Council Canada - National Science Library

    Carney, Ralph

    2003-01-01

    ...) can adopt to assure the quality of adjudication decisions. Subject matter experts identified adjudication customers, products and services, and customer expectations and defined adjudication quality...

  8. Quality Assurance in Defense Adjudication: Workshop for Defining and Assessing Quality

    National Research Council Canada - National Science Library

    Carney, Ralph

    2002-01-01

    ...) can adopt to assure the quality of adjudication decisions. Subject matter experts identified adjudication customers, products and services, and customer expectations and defined adjudication quality...

  9. Applying STOPP Guidelines in Primary Care Through Electronic Medical Record Decision Support: Randomized Control Trial Highlighting the Importance of Data Quality.

    Science.gov (United States)

    Price, Morgan; Davies, Iryna; Rusk, Raymond; Lesperance, Mary; Weber, Jens

    2017-06-15

    Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly. We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non-academic) primary care practices. We conducted a mixed-method, pragmatic, cluster, randomized control trial in research naïve primary care practices. Phase 1: In the randomized controlled trial, 40 fully automated STOPP rules were implemented as EMR alerts during a 16-week intervention period. The control group did not receive the 40 STOPP rules (but received other alerts). Participants were recruited through the OSCAR EMR user group mailing list and in person at user group meetings. Results were assessed by querying EMR data PIPs. EMR data quality probes were included. Phase 2: physicians were invited to participate in 1-hour semi-structured interviews to discuss the results. In the EMR, 40 STOPP rules were successfully implemented. Phase 1: A total of 28 physicians from 8 practices were recruited (16 in intervention and 12 in control groups). The calculated PIP rate was 2.6% (138/5308) (control) and 4.11% (768/18,668) (intervention) at baseline. No change in PIPs was observed through the intervention (P=.80). Data quality probes generally showed low use of problem list and medication list. Phase 2: A total of 5 physicians participated. All the participants felt that they were aware of the alerts but commented on workflow and presentation challenges. The calculated PIP rate was markedly less than the expected rate found in literature (2.6% and 4.0% vs 20% in literature). Data quality probes highlighted issues related to completeness of data in areas of the EMR used for PIP reporting and by the decision support such as problem and medication lists. Users also highlighted areas for better integration of STOPP guidelines with

  10. The effect of the quality of vital sign recording on clinical decision making in a regional acute care trauma ward.

    Science.gov (United States)

    Keene, Claire M; Kong, Victor Y; Clarke, Damian L; Brysiewicz, Petra

    2017-10-01

    Recording vital signs is important in the hospital setting and the quality of this documentation influences clinical decision making. The Modified Early Warning Score (MEWS) uses vital signs to categorise the severity of a patient's physiological derangement and illustrates the clinical impact of vital signs in detecting patient deterioration and making management decisions. This descriptive study measured the quality of vital sign recordings in an acute care trauma setting, and used the MEWS to determine the impact the documentation quality had on the detection of physiological derangements and thus, clinical decision making. Vital signs recorded by the nursing staff of all trauma patients in the acute care trauma wards at a regional hospital in South Africa were collected from January 2013 to February 2013. Investigator-measured values taken within 2 hours of the routine observations and baseline patient information were also recorded. A MEWS for each patient was calculated from the routine and investigator-measured observations. Basic descriptive statistics were performed using EXCEL. The details of 181 newly admitted patients were collected. Completion of recordings was 81% for heart rate, 88% for respiratory rate, 98% for blood pressure, 92% for temperature and 41% for GCS. The recorded heart rate was positively correlated with the investigator's measurement (Pearson's correlation coefficient of 0.76); while the respiratory rate did not correlate (Pearson's correlation coefficient of 0.02). In 59% of patients the recorded respiratory rate (RR) was exactly 20 breaths per minute and 27% had a recorded RR of exactly 15. Seven percent of patients had aberrant Glasgow Coma Scale readings above the maximum value of 15. The average MEWS was 2 for both the recorded (MEWS(R)) and investigator (MEWS(I)) vitals, with the range of MEWS(R) 0-7 and MEWS(I) 0-9. Analysis showed 59% of the MEWS(R) underestimated the physiological derangement (scores were lower than the MEWS

  11. Physicians' intentions and use of three patient decision aids

    Science.gov (United States)

    Graham, Ian D; Logan, Jo; Bennett, Carol L; Presseau, Justin; O'Connor, Annette M; Mitchell, Susan L; Tetroe, Jacqueline M; Cranney, Ann; Hebert, Paul; Aaron, Shawn D

    2007-01-01

    Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270) returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80%) also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians (<60%) felt the decision aid would improve the quality of patient visits or be easily implemented into practice and very few (27%) felt that the decision aid would save time. Physicians' intentions to use the decision aid were related to their comfort with offering it to patients, the decision aid topic, and the perceived ease of implementing it into practice. While 54% of the surveyed physicians indicated they would use the decision aid, less than a third followed through with this

  12. Decision makers, scientists and the public as stakeholders: the connection between traffic intervention policy and air quality in a local context.

    Science.gov (United States)

    Weiand, L.; von Schneidemesser, E.; Schmitz, S.; Niehoff, N.

    2017-12-01

    Urban mobility is a key issue to make cities more inclusive, safer, and more environmentally friendly. To ensure a sustainable future, local policy should, among other actions, aim to improve access to sustainable transport systems and enhance mobility opportunities, while at the same time addressing critical environmental and health targets. In order to assess whether these objectives are met, measures should be informed and evaluated from a social and environmental perspective. Citizens' opinions and the acceptance of environmental policies are crucial to successful implementation of urban mobility measures. The complexity of urban air quality issues require transparent decision-making processes that are grounded in evidence-based research and embrace local knowledge. From this basis, our research group and the city council collaborated to assess a new policy action intended to address environmental and health targets. This talk will present the results from the assessment of this new policy, that was implemented in large part to alleviate air quality exceedances, from the perspective of public acceptability of the measure and the approach taken by the city council to implement the measure. Parallel to assessing the effect of this policy on the recorded levels of air pollution and traffic counts, we conducted a social survey to examine public opinions of this measure, as well as the link between air quality awareness and mobility decisions. 4661 responses were collected over a one month period. Survey participants were those most affected by the traffic measure, including commuters and local residents. The results show that there is an overall low acceptance rate of the measure (8%) as well as low concern for air quality (2,90 - where 1 = not concerned and 6 = very concerned). We also found that there is a negative relationship between air quality rating and air quality concern. A similar approach was taken to understand climate change concern, which will be

  13. Health-related quality of life in children with high-functioning autism.

    Science.gov (United States)

    Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A; Wood-Dauphinee, Sharon; Kehayia, Eva

    2015-01-01

    The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of life of children. A cross-sectional study of children with high-functioning autism (n = 30) and peers (n = 31) was conducted using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Children with high-functioning autism had significantly poorer health-related quality of life than peers whether reported by themselves (p children and parental scores suggested variance in points of view. This study specifically investigated health-related quality of life in children with high-functioning autism as compared to a sample of peers, from the child's perspective. It strengthens earlier findings that children with high-functioning autism experience poorer health-related quality of life than those without this disorder and points to the importance of clinicians working with families to identify areas in a child's life that promote or hinder their sense of well-being. © The Author(s) 2013.

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

    Science.gov (United States)

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

    2017-04-01

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

  15. Application of a simulation model of water quality in the improvement of high basin of Rio Negro - Antioquia

    International Nuclear Information System (INIS)

    Molina Perez, Francisco; Wills Toro, Alvaro; Ramirez Cardona, Juan F

    1995-01-01

    The present article consigns the application of a model of water quality: QUAL2E, of the high basin of the Rio Negro in the East Antioquia. The system Rio Negro was divided in 16 homogeneous tracts, in which 15 seating capacity stations and sampling were located, this way 5 in the Rio Negro and 10 in the main flowing gulches. In the period October of 1993 to May of 1994, they were carried out 10 samplings of quality of the water, coupling this way, the basic data for the hydrological scenarios of summer, intermission and winter. Later on it was carried out the calibration of the pattern for the summer and the validation for winter; the parameters were refined especially suspended solids, dissolved oxygen and DBO5. The use of the pattern allows carrying out the prospective for the quality of the water in the region facilitating a better one taking of decisions in the related with the use of the resource and actions of prevention and control

  16. Public Reporting of Hospital-Level Cancer Surgical Volumes in California: An Opportunity to Inform Decision Making and Improve Quality.

    Science.gov (United States)

    Clarke, Christina A; Asch, Steven M; Baker, Laurence; Bilimoria, Karl; Dudley, R Adams; Fong, Niya; Holliday-Hanson, Merry L; Hopkins, David S P; Imholz, Elizabeth M; Malin, Jennifer; Moy, Lisa; O'Sullivan, Maryann; Parker, Joseph P; Saigal, Christopher S; Spurlock, Bruce; Teleki, Stephanie; Zingmond, David; Lang, Lance

    2016-10-01

    Most patients, providers, and payers make decisions about cancer hospitals without any objective data regarding quality or outcomes. We developed two online resources allowing users to search and compare timely data regarding hospital cancer surgery volumes. Hospital cancer surgery volumes for all California hospitals were calculated using ICD-9 coded hospital discharge summary data. Cancer surgeries included (bladder, brain, breast, colon, esophagus, liver, lung, pancreas, prostate, rectum, and stomach) were selected on the basis of a rigorous literature review to confirm sufficient evidence of a positive association between volume and mortality. The literature could not identify threshold numbers of surgeries associated with better or worse outcomes. A multidisciplinary working group oversaw the project and ensured sound methodology. In California in 2014, about 60% of surgeries were performed at top-quintile-volume hospitals, but the per-hospital median numbers of surgeries for esophageal, pancreatic, stomach, liver, or bladder cancer surgeries were four or fewer. At least 670 patients received cancer surgery at hospitals that performed only one or two surgeries for a particular cancer type; 72% of those patients lived within 50 miles of a top-quintile-volume hospital. There is clear potential for more readily available information about hospital volumes to help patient, providers, and payers choose cancer surgery hospitals. Our successful public reporting of hospital volumes in California represents an important first step toward making publicly available even more provider-specific data regarding cancer care quality, costs, and outcomes, so those data can inform decision-making and encourage quality improvement.

  17. Cognitive processes in anesthesiology decision making.

    Science.gov (United States)

    Stiegler, Marjorie Podraza; Tung, Avery

    2014-01-01

    The quality and safety of health care are under increasing scrutiny. Recent studies suggest that medical errors, practice variability, and guideline noncompliance are common, and that cognitive error contributes significantly to delayed or incorrect diagnoses. These observations have increased interest in understanding decision-making psychology.Many nonrational (i.e., not purely based in statistics) cognitive factors influence medical decisions and may lead to error. The most well-studied include heuristics, preferences for certainty, overconfidence, affective (emotional) influences, memory distortions, bias, and social forces such as fairness or blame.Although the extent to which such cognitive processes play a role in anesthesia practice is unknown, anesthesia care frequently requires rapid, complex decisions that are most susceptible to decision errors. This review will examine current theories of human decision behavior, identify effects of nonrational cognitive processes on decision making, describe characteristic anesthesia decisions in this context, and suggest strategies to improve decision making.

  18. A Primer on Bayesian Decision Analysis With an Application to a Kidney Transplant Decision.

    Science.gov (United States)

    Neapolitan, Richard; Jiang, Xia; Ladner, Daniela P; Kaplan, Bruce

    2016-03-01

    A clinical decision support system (CDSS) is a computer program, which is designed to assist health care professionals with decision making tasks. A well-developed CDSS weighs the benefits of therapy versus the cost in terms of loss of quality of life and financial loss and recommends the decision that can be expected to provide maximum overall benefit. This article provides an introduction to developing CDSSs using Bayesian networks, such CDSS can help with the often complex decisions involving transplants. First, we review Bayes theorem in the context of medical decision making. Then, we introduce Bayesian networks, which can model probabilistic relationships among many related variables and are based on Bayes theorem. Next, we discuss influence diagrams, which are Bayesian networks augmented with decision and value nodes and which can be used to develop CDSSs that are able to recommend decisions that maximize the expected utility of the predicted outcomes to the patient. By way of comparison, we examine the benefit and challenges of using the Kidney Donor Risk Index as the sole decision tool. Finally, we develop a schema for an influence diagram that models generalized kidney transplant decisions and show how the influence diagram approach can provide the clinician and the potential transplant recipient with a valuable decision support tool.

  19. High School Students' Career Decision-Making Pattern across Parenting Styles and Parental Attachment Levels

    Science.gov (United States)

    Cenkseven-Onder, Fulya; Kirdok, Oguzhan; Isik, Erkan

    2010-01-01

    Introduction: The purpose of this research was to investigate career decision among high school students regarding to their parenting styles (authoritative, authoritarian, indulgent, and neglectful) and parental attachment levels. Method: With this purpose, 382 (200 females; 182 males) Turkish high school students aged 14-18 completed Career…

  20. Image Quality in High-resolution and High-cadence Solar Imaging

    Science.gov (United States)

    Denker, C.; Dineva, E.; Balthasar, H.; Verma, M.; Kuckein, C.; Diercke, A.; González Manrique, S. J.

    2018-03-01

    Broad-band imaging and even imaging with a moderate bandpass (about 1 nm) provides a photon-rich environment, where frame selection (lucky imaging) becomes a helpful tool in image restoration, allowing us to perform a cost-benefit analysis on how to design observing sequences for imaging with high spatial resolution in combination with real-time correction provided by an adaptive optics (AO) system. This study presents high-cadence (160 Hz) G-band and blue continuum image sequences obtained with the High-resolution Fast Imager (HiFI) at the 1.5-meter GREGOR solar telescope, where the speckle-masking technique is used to restore images with nearly diffraction-limited resolution. The HiFI employs two synchronized large-format and high-cadence sCMOS detectors. The median filter gradient similarity (MFGS) image-quality metric is applied, among others, to AO-corrected image sequences of a pore and a small sunspot observed on 2017 June 4 and 5. A small region of interest, which was selected for fast-imaging performance, covered these contrast-rich features and their neighborhood, which were part of Active Region NOAA 12661. Modifications of the MFGS algorithm uncover the field- and structure-dependency of this image-quality metric. However, MFGS still remains a good choice for determining image quality without a priori knowledge, which is an important characteristic when classifying the huge number of high-resolution images contained in data archives. In addition, this investigation demonstrates that a fast cadence and millisecond exposure times are still insufficient to reach the coherence time of daytime seeing. Nonetheless, the analysis shows that data acquisition rates exceeding 50 Hz are required to capture a substantial fraction of the best seeing moments, significantly boosting the performance of post-facto image restoration.

  1. High-frequency oscillations in distributed neural networks reveal the dynamics of human decision making

    Directory of Open Access Journals (Sweden)

    Adrian G Guggisberg

    2008-03-01

    Full Text Available We examine the relative timing of numerous brain regions involved in human decisions that are based on external criteria, learned information, personal preferences, or unconstrained internal considerations. Using magnetoencephalography (MEG and advanced signal analysis techniques, we were able to non-invasively reconstruct oscillations of distributed neural networks in the high-gamma frequency band (60–150 Hz. The time course of the observed neural activity suggested that two-alternative forced choice tasks are processed in four overlapping stages: processing of sensory input, option evaluation, intention formation, and action execution. Visual areas are activated fi rst, and show recurring activations throughout the entire decision process. The temporo-occipital junction and the intraparietal sulcus are active during evaluation of external values of the options, 250–500 ms after stimulus presentation. Simultaneously, personal preference is mediated by cortical midline structures. Subsequently, the posterior parietal and superior occipital cortices appear to encode intention, with different subregions being responsible for different types of choice. The cerebellum and inferior parietal cortex are recruited for internal generation of decisions and actions, when all options have the same value. Action execution was accompanied by activation peaks in the contralateral motor cortex. These results suggest that high-gamma oscillations as recorded by MEG allow a reliable reconstruction of decision processes with excellent spatiotemporal resolution.

  2. Use of the long-term quality of life assessment in the decision to indicate surgery in patients with chronic rhinosinusitis.

    Science.gov (United States)

    Marambaia, Pablo Pinillos; Lima, Manuela Garcia; Macario, Hélder; Gomes, Amaury de Machado; Gomes, Leonado Marques; Marambaia, Melina Pinillos; Santos, Otávio Marambaia Dos

    2018-04-22

    Quality-of-life questionnaires have been used to support decision-making in patients with chronic rhinosinusitis in the past decade. The choice of treatment in practice, however, also considers the patient's decision. To assess the long-term quality of life of patients with chronic rhinosinusitis who decided to avoid surgery. This is a prospective longitudinal study with a group of patients with chronic rhinosinusitis, with and without indication for surgery, with application of the questionnaire SNOT-22 in two periods: between 2011 and 2012 and between June and August 2016, via email. Data were collected from 42 patients, of which 13 presented indications for surgery and 29 were not indicated for surgery. The average quality of life score was 42.1 (±16.4) in the group with an indication for surgery and 40.6 (±23.4) in the group without this indication, p=0.84. All the patients were assessed by a single doctor with blinding in relation to the initial score. No differences were detected between the groups. The impact of the chronic rhinosinusitis was reduced even among the patients with the indication for surgery. Both groups scored over 40. This study can help predict the impact of the chronic rhinosinusitis over time and better adjust expectations with non-surgical treatment. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  3. Statistical Framework for Recreational Water Quality Criteria and Monitoring

    DEFF Research Database (Denmark)

    Halekoh, Ulrich

    2008-01-01

    recreational governmental authorities controlling water quality. The book opens with a historical account of water quality criteria in the USA between 1922 and 2003. Five chapters are related to sampling strategies and decision rules. Chapter 2 discusses the dependence of decision-making rules on short...... modeling exploiting additional information like meteorological data can support the decision process as shown in Chapter 10. The question of which information to extract from water sample analyses is closely related to the task of risk assessment for human health. Beach-water quality is often measured......Administrators of recreational waters face the basic tasks of surveillance of water quality and decisions on beach closure in case of unacceptable quality. Monitoring and subsequent decisions are based on sampled water probes and fundamental questions are which type of data to extract from...

  4. Strategic decision analysis applied to borehole seismology

    International Nuclear Information System (INIS)

    Menke, M.M.; Paulsson, B.N.P.

    1994-01-01

    Strategic Decision Analysis (SDA) is the evolving body of knowledge on how to achieve high quality in the decision that shapes an organization's future. SDA comprises philosophy, process concepts, methodology, and tools for making good decisions. It specifically incorporates many concepts and tools from economic evaluation and risk analysis. Chevron Petroleum Technology Company (CPTC) has applied SDA to evaluate and prioritize a number of its most important and most uncertain R and D projects, including borehole seismology. Before SDA, there were significant issues and concerns about the value to CPTC of continuing to work on borehole seismology. The SDA process created a cross-functional team of experts to structure and evaluate this project. A credible economic model was developed, discrete risks and continuous uncertainties were assessed, and an extensive sensitivity analysis was performed. The results, even applied to a very restricted drilling program for a few years, were good enough to demonstrate the value of continuing the project. This paper explains the SDA philosophy concepts, and process and demonstrates the methodology and tools using the borehole seismology project example. SDA is useful in the upstream industry not just in the R and D/technology decisions, but also in major exploration and production decisions. Since a major challenge for upstream companies today is to create and realize value, the SDA approach should have a very broad applicability

  5. Integrating Water Quality and River Rehabilitation Management - A Decision-Analytical Perspective

    Science.gov (United States)

    Reichert, P.; Langhans, S.; Lienert, J.; Schuwirth, N.

    2009-04-01

    Integrative river management involves difficult decisions about alternative measures to improve their ecological state. For this reason, it seems useful to apply knowledge from the decision sciences to support river management. We discuss how decision-analytical elements can be employed for designing an integrated river management procedure. An important aspect of this procedure is to clearly separate scientific predictions of the consequences of alternatives from objectives to be achieved by river management. The key elements of the suggested procedure are (i) the quantitative elicitation of the objectives from different stakeholder groups, (ii) the compilation of the current scientific knowledge about the consequences of the effects resulting from suggested measures in the form of a probabilistic mathematical model, and (iii) the use of these predictions and valuations to prioritize alternatives, to uncover conflicting objectives, to support the design of better alternatives, and to improve the transparency of communication about the chosen management strategy. The development of this procedure led to insights regarding necessary steps to be taken for rational decision-making in river management, to guidelines about the use of decision-analytical techniques for performing these steps, but also to new insights about the application of decision-analytical techniques in general. In particular, the consideration of the spatial distribution of the effects of measures and the potential added value of connected rehabilitated river reaches leads to favoring measures that have a positive effect beyond a single river reach. As these effects only propagate within the river network, this results in a river basin oriented management concept as a consequence of a rational decision support procedure, rather than as an a priori management paradigm. There are also limitations to the support that can be expected from the decision-analytical perspective. It will not provide the

  6. The integrated system of research quality (quality of the research and research quality

    Directory of Open Access Journals (Sweden)

    M. V. Yurasova

    2014-01-01

    Full Text Available The necessity of the use of research for decision-making on the information received, are considered typical examples of the use of integrated systems research in the practice of the organization, approaches and assess the quality of research and study quality as a subject of study.

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

    Science.gov (United States)

    Hedlund; Ilgen; Hollenbeck

    1998-10-01

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

  8. Small decisions with big impact on data analytics

    Directory of Open Access Journals (Sweden)

    Jana Diesner

    2015-11-01

    Full Text Available Big social data have enabled new opportunities for evaluating the applicability of social science theories that were formulated decades ago and were often based on small- to medium-sized samples. Big Data coupled with powerful computing has the potential to replace the statistical practice of sampling and estimating effects by measuring phenomena based on full populations. Preparing these data for analysis and conducting analytics involves a plethora of decisions, some of which are already embedded in previously collected data and built tools. These decisions refer to the recording, indexing and representation of data and the settings for analysis methods. While these choices can have tremendous impact on research outcomes, they are not often obvious, not considered or not being made explicit. Consequently, our awareness and understanding of the impact of these decisions on analysis results and derived implications are highly underdeveloped. This might be attributable to occasional high levels of over-confidence in computational solutions as well as the possible yet questionable assumption that Big Data can wash out minor data quality issues, among other reasons. This article provides examples for how to address this issue. It argues that checking, ensuring and validating the quality of big social data and related auxiliary material is a key ingredient for empowering users to gain reliable insights from their work. Scrutinizing data for accuracy issues, systematically fixing them and diligently documenting these processes can have another positive side effect: Closely interacting with the data, thereby forcing ourselves to understand their idiosyncrasies and patterns, can help us to move from being able to precisely model and formally describe effects in society to also understand and explain them.

  9. Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses

    Science.gov (United States)

    Krömker, Dörthe; Meguerditchian, Ari N; Tamblyn, Robyn

    2016-01-01

    Background Patient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids. Objective The first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making. Methods Relevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making. Results Of 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however

  10. Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses.

    Science.gov (United States)

    Syrowatka, Ania; Krömker, Dörthe; Meguerditchian, Ari N; Tamblyn, Robyn

    2016-01-26

    Patient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids. The first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making. Relevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making. Of 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however, some features performed better than

  11. Conceptual framework of knowledge management for ethical decision-making support in neonatal intensive care.

    Science.gov (United States)

    Frize, Monique; Yang, Lan; Walker, Robin C; O'Connor, Annette M

    2005-06-01

    This research is built on the belief that artificial intelligence estimations need to be integrated into clinical social context to create value for health-care decisions. In sophisticated neonatal intensive care units (NICUs), decisions to continue or discontinue aggressive treatment are an integral part of clinical practice. High-quality evidence supports clinical decision-making, and a decision-aid tool based on specific outcome information for individual NICU patients will provide significant support for parents and caregivers in making difficult "ethical" treatment decisions. In our approach, information on a newborn patient's likely outcomes is integrated with the physician's interpretation and parents' perspectives into codified knowledge. Context-sensitive content adaptation delivers personalized and customized information to a variety of users, from physicians to parents. The system provides structuralized knowledge translation and exchange between all participants in the decision, facilitating collaborative decision-making that involves parents at every stage on whether to initiate, continue, limit, or terminate intensive care for their infant.

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

    Science.gov (United States)

    Gillespie, Mary

    2010-11-01

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

  13. The cycle of intellingence production as support organizacional decision making

    Directory of Open Access Journals (Sweden)

    Ismael Cristofer Baierle

    2011-12-01

    Full Text Available Many authors claim that to cope with rapid changes in social and productive environments, and especially for responding quickly to customer demands and / or users in an organization, information is needed and its management. Decision-making processes also take into account only the past experiences, and this model no longer meets the precepts of today's corporate world, considering the speed with which the market and competition are in search of improvement. Centered on the concepts of Competitive Intelligence and Artificial Intelligence, this article aims to show the importance of information processing, focusing on the processes of decision making and provide a model for their organization and storage. The findings point to the use of intelligent systems, contributing to improved decision-making process and seeking to obtain answers with high quality standards relating to market demand.

  14. Analytical quality, performance indices and laboratory service

    DEFF Research Database (Denmark)

    Hilden, Jørgen; Magid, Erik

    1999-01-01

    analytical error, bias, cost effectiveness, decision-making, laboratory techniques and procedures, mass screening, models, statistical, quality control......analytical error, bias, cost effectiveness, decision-making, laboratory techniques and procedures, mass screening, models, statistical, quality control...

  15. How Decisions Can Be Organized - and Why It Matters

    DEFF Research Database (Denmark)

    Christensen, Michael; Knudsen, Thorbjørn

    2013-01-01

    of organization be it social, political, or economic. Can we add another employee somewhere in the decision process to increase economic performance? Can we add or eliminate a channel of communication to raise the quality of decisions? What level of skill is worth paying for when we hire a decision maker...

  16. Ethical decision making in clinical practice.

    Science.gov (United States)

    Fowler, M D

    1989-12-01

    Contemporary nursing ethics education focuses on the use of an analytical model of ethical decision making for both its process and its content. Perhaps this is the case because it bears some resemblance to the nursing process, which is taught in a similar fashion. Thus, a deductivist method of ethical decision making fits within the same general schema of the hypotheticodeductive method of decision making that is taught for nursing diagnosis. Ethics requires that nurses respect persons, inform patients and secure their consent, not inflict harm, preserve the patient's quality of life, prevent harm and remove harmful conditions, do good for patients, and minimize risk to themselves. These are among the norms of obligation that guide ethical analysis and judgment in nursing practice and are the substance of the analytical model of ethical decision making. Nursing's ethics has established high ideals and strong demands for nurses. These are demands which nurses have met and ideals which have often been realized. Whatever the strength of our science, nursing is an inherently moral endeavor and is only as strong as its commitment to its ethical obligations and values. Between the grinding edges of the forces that affect it, nursing must establish its priorities among the aspects of its environment that it attempts to control. Ethics must be chief among those priorities.

  17. Quality specifications for the extra-analytical phase of laboratory testing: Reference intervals and decision limits.

    Science.gov (United States)

    Ceriotti, Ferruccio

    2017-07-01

    Reference intervals and decision limits are a critical part of the clinical laboratory report. The evaluation of their correct use represents a tool to verify the post analytical quality. Four elements are identified as indicators. 1. The use of decision limits for lipids and glycated hemoglobin. 2. The use, whenever possible, of common reference values. 3. The presence of gender-related reference intervals for at least the following common serum measurands (besides obviously the fertility relate hormones): alkaline phosphatase (ALP), alanine aminotransferase (ALT), creatine kinase (CK), creatinine, gamma-glutamyl transferase (GGT), IgM, ferritin, iron, transferrin, urate, red blood cells (RBC), hemoglobin (Hb) and hematocrit (Hct). 4. The presence of age-related reference intervals. The problem of specific reference intervals for elderly people is discussed, but their use is not recommended; on the contrary it is necessary the presence of pediatric age-related reference intervals at least for the following common serum measurands: ALP, amylase, creatinine, inorganic phosphate, lactate dehydrogenase, aspartate aminotransferase, urate, insulin like growth factor 1, white blood cells, RBC, Hb, Hct, alfa-fetoprotein and fertility related hormones. The lack of such reference intervals may imply significant risks for the patients. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study.

    Science.gov (United States)

    Torke, Alexia M; Callahan, Christopher M; Sachs, Greg A; Wocial, Lucia D; Helft, Paul R; Monahan, Patrick O; Slaven, James E; Montz, Kianna; Burke, Emily S; Inger, Lev

    2018-03-01

    Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient's hospitalization. To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults. Observational study at three hospitals in a Midwest metropolitan area. Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study. Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4-6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems). The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate-severe anxiety); 29% reported depression, (14.0% moderate-severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = -0.30, p = 0.003) and higher decision quality (β = -0.44, p post-traumatic stress (β = 0.23, p = 0.022) but also higher satisfaction (β = 0

  19. Complex Decision Making Theory and Practice

    CERN Document Server

    Qudrat-Ullah, Hassan; Spector, J Michael

    2007-01-01

    The increasingly complex environment of today's world, characterized by technological innovation and global communication, generates myriads of possible and actual interactions while limited physical and intellectual resources severely impinge on decision makers, be it in the public or private domains. At the core of the decision-making process is the need for quality information that allows the decision maker to better assess the impact of decisions in terms of outcomes, nonlinear feedback processes and time delays on the performance of the complex system invoked. This volume is a timely review on the principles underlying complex decision making, the handling of uncertainties in dynamic envrionments and of the various modeling approaches used. The book consists of five parts, each composed of several chapters: I: Complex Decision Making: Concepts, Theories and Empirical Evidence II: Tools and Techniques for Decision Making in Complex Environments and Systems III: System Dynamics and Agent-Based Modeling IV:...

  20. The effect of high-fidelity patient simulation on the critical thinking and clinical decision-making skills of new graduate nurses.

    Science.gov (United States)

    Maneval, Rhonda; Fowler, Kimberly A; Kays, John A; Boyd, Tiffany M; Shuey, Jennifer; Harne-Britner, Sarah; Mastrine, Cynthia

    2012-03-01

    This study was conducted to determine whether the addition of high-fidelity patient simulation to new nurse orientation enhanced critical thinking and clinical decision-making skills. A pretest-posttest design was used to assess critical thinking and clinical decision-making skills in two groups of graduate nurses. Compared with the control group, the high-fidelity patient simulation group did not show significant improvement in mean critical thinking or clinical decision-making scores. When mean scores were analyzed, both groups showed an increase in critical thinking scores from pretest to posttest, with the high-fidelity patient simulation group showing greater gains in overall scores. However, neither group showed a statistically significant increase in mean test scores. The effect of high-fidelity patient simulation on critical thinking and clinical decision-making skills remains unclear. Copyright 2012, SLACK Incorporated.

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

    Science.gov (United States)

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

    2011-06-01

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

  2. Making difficult decisions: the role of quality of care in choosing a nursing home.

    Science.gov (United States)

    Pesis-Katz, Irena; Phelps, Charles E; Temkin-Greener, Helena; Spector, William D; Veazie, Peter; Mukamel, Dana B

    2013-05-01

    We investigated how quality of care affects choosing a nursing home. We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model. In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size. In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers.

  3. Complementary Cognitive Capabilities, Economic Decision-Making, and Aging

    OpenAIRE

    Li, Ye; Baldassi, Martine; Johnson, Eric J.; Weber, Elke U.

    2013-01-01

    Fluid intelligence decreases with age, yet evidence about age declines in decision-making quality is mixed: Depending on the study, older adults make worse, equally good, or even better decisions than younger adults. We propose a potential explanation for this puzzle, namely that age differences in decision performance result from the interplay between two sets of cognitive capabilities that impact decision making, one in which older adults fare worse (i.e., fluid intelligence) and one in whi...

  4. Real-World Solutions for Developing High-Quality PHP Frameworks and Applications

    CERN Document Server

    Bergmann, Sebastian

    2011-01-01

    Learn to develop high-quality applications and frameworks in PHP Packed with in-depth information and step-by-step guidance, this book escorts you through the process of creating, maintaining and extending sustainable software of high quality with PHP. World-renowned PHP experts present real-world case studies for developing high-quality applications and frameworks in PHP that can easily be adapted to changing business requirements. . They offer different approaches to solving  typical development and quality assurance problems that every developer needs to know and master.Details the process

  5. Integrity Model Application: A Quality Support System for Decision-makers on Water Quality Assessment and Improvement

    Science.gov (United States)

    Mirauda, D.; Ostoich, M.; Di Maria, F.; Benacchio, S.; Saccardo, I.

    2018-03-01

    In this paper, a mathematical model has been applied to a river in North-East Italy to describe vulnerability scenarios due to environmental pollution phenomena. Such model, based on the influence diagrams theory, allowed identifying the extremely critical factors, such as wastewater discharges, drainage of diffuse pollution from agriculture and climate changes, which might affect the water quality of the river. The obtained results underlined how the water quality conditions have improved thanks to the continuous controls on the territory, following the application of Water Framework Directive 2000/60/EC. Nevertheless, some fluvial stretches did not reach the “good ecological status” by 2015, because of the increasing population in urban areas recorded in the last years and the high presence of tourists during the summer months, not balanced by a treatment plants upgrade.

  6. Analytical approaches to quality assurance and quality control in rangeland monitoring data

    Science.gov (United States)

    Producing quality data to support land management decisions is the goal of every rangeland monitoring program. However, the results of quality assurance (QA) and quality control (QC) efforts to improve data quality are rarely reported. The purpose of QA and QC is to prevent and describe non-sampling...

  7. Assessing the Hydrologic Performance of the EPA's Nonpoint Source Water Quality Assessment Decision Support Tool Using North American Land Data Assimilation System (Products)

    Science.gov (United States)

    Lee, S.; Ni-Meister, W.; Toll, D.; Nigro, J.; Guiterrez-Magness, A.; Engman, T.

    2010-01-01

    The accuracy of streamflow predictions in the EPA's BASINS (Better Assessment Science Integrating Point and Nonpoint Sources) decision support tool is affected by the sparse meteorological data contained in BASINS. The North American Land Data Assimilation System (NLDAS) data with high spatial and temporal resolutions provide an alternative to the NOAA National Climatic Data Center (NCDC)'s station data. This study assessed the improvement of streamflow prediction of the Hydrological Simulation Program-FORTRAN (HSPF) model contained within BASINS using the NLDAS 118 degree hourly precipitation and evapotranspiration estimates in seven watersheds of the Chesapeake Bay region. Our results demonstrated consistent improvements of daily streamflow predictions in five of the seven watersheds when NLDAS precipitation and evapotranspiration data was incorporated into BASINS. The improvement of using the NLDAS data is significant when watershed's meteorological station is either far away or not in a similar climatic region. When the station is nearby, using the NLDAS data produces similar results. The correlation coefficients of the analyses using the NLDAS data were greater than 0.8, the Nash-Sutcliffe (NS) model fit efficiency greater than 0.6, and the error in the water balance was less than 5%. Our analyses also showed that the streamflow improvements were mainly contributed by the NLDAS's precipitation data and that the improvement from using NLDAS's evapotranspiration data was not significant; partially due to the constraints of current BASINS-HSPF settings. However, NLDAS's evapotranspiration data did improve the baseflow prediction. This study demonstrates the NLDAS data has the potential to improve stream flow predictions, thus aid the water quality assessment in the EPA nonpoint water quality assessment decision tool.

  8. Visual analytics in medical education: impacting analytical reasoning and decision making for quality improvement.

    Science.gov (United States)

    Vaitsis, Christos; Nilsson, Gunnar; Zary, Nabil

    2015-01-01

    The medical curriculum is the main tool representing the entire undergraduate medical education. Due to its complexity and multilayered structure it is of limited use to teachers in medical education for quality improvement purposes. In this study we evaluated three visualizations of curriculum data from a pilot course, using teachers from an undergraduate medical program and applying visual analytics methods. We found that visual analytics can be used to positively impacting analytical reasoning and decision making in medical education through the realization of variables capable to enhance human perception and cognition on complex curriculum data. The positive results derived from our evaluation of a medical curriculum and in a small scale, signify the need to expand this method to an entire medical curriculum. As our approach sustains low levels of complexity it opens a new promising direction in medical education informatics research.

  9. Error affect inoculation for a complex decision-making task.

    Science.gov (United States)

    Tabernero, Carmen; Wood, Robert E

    2009-05-01

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

  10. Elements of an environmental decision support system for seasonal wetland salt management in a river basin subjected to water quality regulation

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, N.W.T.

    2009-06-01

    Seasonally managed wetlands in the Grasslands Basin on the west-side of California's San Joaquin Valley provide food and shelter for migratory wildfowl during winter months and sport for waterfowl hunters during the annual duck season. Surface water supply to these wetlands contain salt which, when drained to the San Joaquin River during the annual drawdown period, can negatively impact water quality and cause concern to downstream agricultural riparian water diverters. Recent environmental regulation, limiting discharges salinity to the San Joaquin River and primarily targeting agricultural non-point sources, now also targets return flows from seasonally managed wetlands. Real-time water quality management has been advocated as a means of continuously matching salt loads discharged from agricultural, wetland and municipal operations to the assimilative capacity of the San Joaquin River. Past attempts to build environmental monitoring and decision support systems (EDSS's) to implement this concept have enjoyed limited success for reasons that are discussed in this paper. These reasons are discussed in the context of more general challenges facing the successful implementation of a comprehensive environmental monitoring, modelling and decision support system for the San Joaquin River Basin.

  11. Improving decision speed, accuracy and group cohesion through early information gathering in house-hunting ants.

    Science.gov (United States)

    Stroeymeyt, Nathalie; Giurfa, Martin; Franks, Nigel R

    2010-09-29

    Successful collective decision-making depends on groups of animals being able to make accurate choices while maintaining group cohesion. However, increasing accuracy and/or cohesion usually decreases decision speed and vice-versa. Such trade-offs are widespread in animal decision-making and result in various decision-making strategies that emphasize either speed or accuracy, depending on the context. Speed-accuracy trade-offs have been the object of many theoretical investigations, but these studies did not consider the possible effects of previous experience and/or knowledge of individuals on such trade-offs. In this study, we investigated how previous knowledge of their environment may affect emigration speed, nest choice and colony cohesion in emigrations of the house-hunting ant Temnothorax albipennis, a collective decision-making process subject to a classical speed-accuracy trade-off. Colonies allowed to explore a high quality nest site for one week before they were forced to emigrate found that nest and accepted it faster than emigrating naïve colonies. This resulted in increased speed in single choice emigrations and higher colony cohesion in binary choice emigrations. Additionally, colonies allowed to explore both high and low quality nest sites for one week prior to emigration remained more cohesive, made more accurate decisions and emigrated faster than emigrating naïve colonies. These results show that colonies gather and store information about available nest sites while their nest is still intact, and later retrieve and use this information when they need to emigrate. This improves colony performance. Early gathering of information for later use is therefore an effective strategy allowing T. albipennis colonies to improve simultaneously all aspects of the decision-making process--i.e. speed, accuracy and cohesion--and partly circumvent the speed-accuracy trade-off classically observed during emigrations. These findings should be taken into account

  12. Patent Assessment Quality

    DEFF Research Database (Denmark)

    Burke, Paul F.; Reitzig, Markus

    2006-01-01

    The increasing number of patent applications worldwide and the extension of patenting to the areas of software and business methods have triggered a debate on "patent quality". While patent quality may have various dimensions, this paper argues that consistency in the decision making on the side...... of the patent office is one important dimension, particularly in new patenting areas (emerging technologies). In order to understand whether patent offices appear capable of providing consistent assessments of a patent's technological quality in such novel industries from the beginning, we study the concordance...... of the European Patent Office's (EPO's) granting and opoposition decisions for individual patents. We use the historical example of biotech patens filed between 1978 until 1986, the early stage of the industry. Our results indicate that the EPO shows systematically different assessments of technological quality...

  13. Blueprint for action: steps toward a high-quality, high-value maternity care system.

    Science.gov (United States)

    Angood, Peter B; Armstrong, Elizabeth Mitchell; Ashton, Diane; Burstin, Helen; Corry, Maureen P; Delbanco, Suzanne F; Fildes, Barbara; Fox, Daniel M; Gluck, Paul A; Gullo, Sue Leavitt; Howes, Joanne; Jolivet, R Rima; Laube, Douglas W; Lynne, Donna; Main, Elliott; Markus, Anne Rossier; Mayberry, Linda; Mitchell, Lynn V; Ness, Debra L; Nuzum, Rachel; Quinlan, Jeffrey D; Sakala, Carol; Salganicoff, Alina

    2010-01-01

    Childbirth Connection hosted a 90th Anniversary national policy symposium, Transforming Maternity Care: A High Value Proposition, on April 3, 2009, in Washington, DC. Over 100 leaders from across the range of stakeholder perspectives were actively engaged in the symposium work to improve the quality and value of U.S. maternity care through broad system improvement. A multi-disciplinary symposium steering committee guided the strategy from its inception and contributed to every phase of the project. The "Blueprint for Action: Steps Toward a High Quality, High Value Maternity Care System", issued by the Transforming Maternity Care Symposium Steering Committee, answers the fundamental question, "Who needs to do what, to, for, and with whom to improve the quality of maternity care over the next five years?" Five stakeholder workgroups collaborated to propose actionable strategies in 11 critical focus areas for moving expeditiously toward the realization of the long term "2020 Vision for a High Quality, High Value Maternity Care System", also published in this issue. Following the symposium these workgroup reports and recommendations were synthesized into the current blueprint. For each critical focus area, the "Blueprint for Action" presents a brief problem statement, a set of system goals for improvement in that area, and major recommendations with proposed action steps to achieve them. This process created a clear sightline to action that if enacted could improve the structure, process, experiences of care, and outcomes of the maternity care system in ways that when anchored in the culture can indeed transform maternity care. Copyright 2010 Jacobs Institute of Women

  14. Physicians' intentions and use of three patient decision aids

    Directory of Open Access Journals (Sweden)

    Mitchell Susan L

    2007-07-01

    Full Text Available Abstract Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270 returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80% also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians ( Conclusion Despite strong support for the format, content, and quality of patient decision aids, and physicians' stated intentions to adopt them into clinical practice, most did not use them within three months of completing the survey. There is a wide gap between intention and behaviour. Further research is required to study the determinants of this intention-behaviour gap and to develop interventions aimed at barriers to physicians' use of decision aids.

  15. Data-Driven Markov Decision Process Approximations for Personalized Hypertension Treatment Planning

    Directory of Open Access Journals (Sweden)

    Greggory J. Schell PhD

    2016-10-01

    Full Text Available Background: Markov decision process (MDP models are powerful tools. They enable the derivation of optimal treatment policies but may incur long computational times and generate decision rules that are challenging to interpret by physicians. Methods: In an effort to improve usability and interpretability, we examined whether Poisson regression can approximate optimal hypertension treatment policies derived by an MDP for maximizing a patient’s expected discounted quality-adjusted life years. Results: We found that our Poisson approximation to the optimal treatment policy matched the optimal policy in 99% of cases. This high accuracy translates to nearly identical health outcomes for patients. Furthermore, the Poisson approximation results in 104 additional quality-adjusted life years per 1000 patients compared to the Seventh Joint National Committee’s treatment guidelines for hypertension. The comparative health performance of the Poisson approximation was robust to the cardiovascular disease risk calculator used and calculator calibration error. Limitations: Our results are based on Markov chain modeling. Conclusions: Poisson model approximation for blood pressure treatment planning has high fidelity to optimal MDP treatment policies, which can improve usability and enhance transparency of more personalized treatment policies.

  16. A Collaborator's Reputation Can Bias Decisions and Anxiety under Uncertainty.

    Science.gov (United States)

    Qi, Song; Footer, Owen; Camerer, Colin F; Mobbs, Dean

    2018-02-28

    Informational social influence theory posits that under conditions of uncertainty, we are inclined to look to others for advice. This leaves us remarkably vulnerable to being influenced by others' opinions or advice. Rational agents, however, do not blindly seek and act on arbitrary information, but often consider the quality of its source before committing to a course of action. Here, we ask the question of whether a collaborator's reputation can increase their social influence and, in turn, bias perception and anxiety under changing levels of uncertainty. Human male and female participants were asked to provide estimations of dot direction using the random dot motion (RDM) perceptual discrimination task and were paired with transient collaborators of high or low reputation whom provided their own estimations. The RDM varied in degrees of uncertainty and joint performance accuracy was linked to risk of an electric shock. Despite providing identical information, we show that collaborating with a high reputation compared with a low reputation partner, led to significantly more conformity during the RDM task for uncertain perceptual decisions. Consequently, high reputation partners decreased the subjects' anxiety during the anticipatory shock periods. fMRI data showed that parametric changes in conformity resulted in increased activity in the ventromedial PFC, whereas dissent was associated with increased in activity in the dorsal anterior cingulate cortex (dACC). Furthermore, the dACC and insula, regions involved in anticipatory pain, were significantly more active when collaborating with a low reputation partner. These results suggest that information about reputation can influence both cognitive and affective processes and in turn alter the neural circuits that underlie decision-making and emotion. SIGNIFICANCE STATEMENT Humans look to others for advice when making decisions under uncertainty. Rational agents, however, do not blindly seek information, but often

  17. Improved learning in U.S. history and decision competence with decision-focused curriculum.

    Directory of Open Access Journals (Sweden)

    David Jacobson

    Full Text Available Decision making is rarely taught in high school, even though improved decision skills could benefit young people facing life-shaping decisions. While decision competence has been shown to correlate with better life outcomes, few interventions designed to improve decision skills have been evaluated with rigorous quantitative measures. A randomized study showed that integrating decision making into U.S. history instruction improved students' history knowledge and decision-making competence, compared to traditional history instruction. Thus, integrating decision training enhanced academic performance and improved an important, general life skill associated with improved life outcomes.

  18. Decision analysis with cumulative prospect theory.

    Science.gov (United States)

    Bayoumi, A M; Redelmeier, D A

    2000-01-01

    Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

  19. Consumer Decision-Making of Older People: A 45-Year Review.

    Science.gov (United States)

    Hettich, Dominik; Hattula, Stefan; Bornemann, Torsten

    2017-03-15

    Aging is one of the key future challenges for global life. Of particular interest is the consumption-related decision-making of older people, as its better understanding would enable the effective influence of behavior, which would help to secure the economic well-being and ensure a better quality of life for this population. This article explores the respective literature and identifies gaps for future research. We conducted a holistic review of peer-reviewed literature that examined the decision-making of older consumers. Using a structured approach based on the consumer decision process model, we present the findings of 45 years of research (a total of 42 articles) and identify further research areas. The review reveals that the literature on older consumers' decision-making is fragmented, and that the findings are mixed. In particular, results on the role of emotions are controversial. While emotions have been shown to be better controlled by older individuals, emotions are also found to be highly influential in commercial advertisements. Similarly, the literature contains a lively debate on the relevance of price, service and store quality, and provider choice. These results call for a more holistic view of the decision-making of older consumers, and the review highlights numerous opportunities for future research. For instance, little is known about how older consumers deal with need recognition and the reasons they search for particular information. Moreover, understanding is lacking with respect to online purchase and feedback behavior. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Decision making in midwifery: rationality and intuition.

    Science.gov (United States)

    Steinhauer, Suyai

    2015-04-01

    Decision making in midwifery is a complex process that shapes and underpins clinical practice and determines, to a large extent, the quality of care. Effective decision making and professional accountability are central to clinical governance, and being able.to justify all decisions is a professional and legal requirement. At the same time, there is an emphasis in midwifery on shared decision making, and keeping women at the centre of their care, and research reveals that feelings of choice, control and autonomy are central to a positive birth experience. However the extent to which decisions are really shared and care truly woman-centred is debatable and affected by environment and culture. Using a case study of a decision made in clinical practice around amniotomy, this article explores the role of the intuitive thinking system in midwifery decision making, and highlights the importance of involving women in the decision making process.

  1. Exploring stop-go decision zones at rural high-speed intersections with flashing green signal and insufficient yellow time in China.

    Science.gov (United States)

    Tang, Keshuang; Xu, Yanqing; Wang, Fen; Oguchi, Takashi

    2016-10-01

    The objective of this study is to empirically analyze and model the stop-go decision behavior of drivers at rural high-speed intersections in China, where a flashing green signal of 3s followed by a yellow signal of 3s is commonly applied to end a green phase. 1, 186 high-resolution vehicle trajectories were collected at four typical high-speed intersection approaches in Shanghai and used for the identification of actual stop-go decision zones and the modeling of stop-go decision behavior. Results indicate that the presence of flashing green significantly changed the theoretical decision zones based on the conventional Dilemma Zone theory. The actual stop-go decision zones at the study intersections were thus formulated and identified based on the empirical data. Binary Logistic model and Fuzzy Logic model were then developed to further explore the impacts of flashing green on the stop-go behavior of drivers. It was found that the Fuzzy Logic model could produce comparably good estimation results as compared to the traditional Binary Logistic models. The findings of this study could contribute the development of effective dilemma zone protection strategies, the improvement of stop-go decision model embedded in the microscopic traffic simulation software and the proper design of signal change and clearance intervals at high-speed intersections in China. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. A Mashup Application to Support Complex Decision Making for Retail Consumers

    OpenAIRE

    Steven Walczak; Deborah L. Kellogg; Dawn G. Gregg

    2010-01-01

    Purchase processes often require complex decision making and consumers frequently use Web information sources to support these decisions. However, increasing amounts of information can make finding appropriate information problematic. This information overload, coupled with decision complexity, can increase time required to make a decision and reduce decision quality. This creates a need for tools that support these decision-making processes. Online tools that bring together data and partial ...

  3. Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

    Science.gov (United States)

    Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

    2014-09-01

    Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

  4. A Decision-Making Model for Deterring Food Vendors from Selling Harmless Low-Quality Foods as High-Quality Foods to Consumers

    Directory of Open Access Journals (Sweden)

    Po-Yu Chen

    2017-01-01

    Full Text Available For certain types of foods, food vendors often label low-quality foods that are harmless to human health as foods of excellent quality and sell these falsely labeled products to consumers. Because this type of food poses no harm to human health, when public health units discover their act of false labeling or food adulteration, vendors are only penalized with a fine rather than having them assume criminal liability. Upon discovering vendors act of falsely labeling food, public health units typically punish the involved parties according to the extent of false labeling. Such static protective measure is ineffective. Instead, the extent of punishment should be based not only on the extent of false labeling, but also on the frequency of food sampling as well as the number of samples obtained for food inspections. Only through this dynamic approach can food adulteration or false labeling be effectively prevented. Adopting the standpoint of the public sector in food safety management, this study developed a mathematical model that facilitates discussion on the aforementioned problems. Furthermore, we discussed how the supply-demand environmental factors of the food market are influenced by the administrative means that the public health units have used to prevent food false labeling.

  5. Adoption and impact of high quality bambara flour (HQBF ...

    African Journals Online (AJOL)

    Adoption and impact of high quality bambara flour (HQBF) technology in the ... consumer acceptability/quality of products, credit, availability of raw materials, and ... as a result of 12.5 per cent increase in demand for bambara-based products.

  6. Development of a high-quality cut-off wall using electrophoresis

    International Nuclear Information System (INIS)

    Kawachi, T.; Murahashi, H.

    1991-01-01

    Techniques to build a high-quality cut-off wall have been developed for storage facilities of low-level radioactive waste (LLW) as an emergency measures to prevent leakages. The cut-off wall is highly impermeable, nucleid-adsorptive and have long-term durability. Electrophoresis is used to form impermeable membrane of bentonite as main features of the cut-off wall. First of all, laboratory tests have been conducted to study ways of building barriers on site and to collect data on the barriers properties. Afterwards, on-site construction tests of a high-quality cut-off wall have been carried out. In this paper, we describe the process and results on the studies of the high-quality cut-off wall using electrophoresis

  7. Timing of high-quality child care and cognitive, language, and preacademic development.

    Science.gov (United States)

    Li, Weilin; Farkas, George; Duncan, Greg J; Burchinal, Margaret R; Vandell, Deborah Lowe

    2013-08-01

    The effects of high- versus low-quality child care during 2 developmental periods (infant-toddlerhood and preschool) were examined using data from the National Institute of Child Health and Human Development Study of Early Child Care. Propensity score matching was used to account for differences in families who used different combinations of child care quality during the 2 developmental periods. Findings indicated that cognitive, language, and preacademic skills prior to school entry were highest among children who experienced high-quality care in both the infant-toddler and preschool periods, somewhat lower among children who experienced high-quality child care during only 1 of these periods, and lowest among children who experienced low-quality care during both periods. Irrespective of the care received during infancy-toddlerhood, high-quality preschool care was related to better language and preacademic outcomes at the end of the preschool period; high-quality infant-toddler care, irrespective of preschool care, was related to better memory skills at the end of the preschool period. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  8. Health-Related Quality of Life in Children with High-Functioning Autism

    Science.gov (United States)

    Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A.; Wood-Dauphinee, Sharon; Kehayia, Eva

    2015-01-01

    The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of…

  9. High quality digital holographic reconstruction on analog film

    Science.gov (United States)

    Nelsen, B.; Hartmann, P.

    2017-05-01

    High quality real-time digital holographic reconstruction, i.e. at 30 Hz frame rates, has been at the forefront of research and has been hailed as the holy grail of display systems. While these efforts have produced a fascinating array of computer algorithms and technology, many applications of reconstructing high quality digital holograms do not require such high frame rates. In fact, applications such as 3D holographic lithography even require a stationary mask. Typical devices used for digital hologram reconstruction are based on spatial-light-modulator technology and this technology is great for reconstructing arbitrary holograms on the fly; however, it lacks the high spatial resolution achievable by its analog counterpart, holographic film. Analog holographic film is therefore the method of choice for reconstructing highquality static holograms. The challenge lies in taking a static, high-quality digitally calculated hologram and effectively writing it to holographic film. We have developed a theoretical system based on a tunable phase plate, an intensity adjustable high-coherence laser and a slip-stick based piezo rotation stage to effectively produce a digitally calculated hologram on analog film. The configuration reproduces the individual components, both the amplitude and phase, of the hologram in the Fourier domain. These Fourier components are then individually written on the holographic film after interfering with a reference beam. The system is analogous to writing angularly multiplexed plane waves with individual component phase control.

  10. Intelligent decision making in quality management theory and applications

    CERN Document Server

    Yanık, Seda

    2016-01-01

      This book presents recently developed intelligent techniques with applications and theory in the area of quality management. The involved applications of intelligence include techniques such as fuzzy sets, neural networks, genetic algorithms, etc. The book consists of classical quality management topics dealing with intelligent techniques for solving the complex quality management problems. The book will serve as an excellent reference for quality managers, researchers, lecturers and postgraduate students in this area. The authors of the chapters are well-known researchers in the area of quality management.  .

  11. THE MAKING OF DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Leonardo Yuji Tamura

    2016-04-01

    Full Text Available Quantum Electronics was a Brazilian startup in the 1990's that was acquired by an American equity fund in 2012. They are currently the largest manufacturer of vehicle tracking and infotainment systems. The company was founded by three college friends, who are currently executives at the company: Camilo Santos, Pedro Barbosa and Luana Correa. Edward Hutter was sent by the equity fund to take over the company’s finances, but is having trouble making organizational decisions with his colleagues. As a consultant, I was called to help them improve their decision making process and project prioritization. I adapted and deployed our firm's methodology, but, in the end, its adequacy is shown to be very much in question. The author of this case study intends to explore how actual organizational decisions rely on different decision models and their assumptions, .as well as demonstrate that a decision model is neither absolutely good nor bad as its quality is context dependent.

  12. Offering online recommendations with minimum customer input through conjoint-based decision aids

    NARCIS (Netherlands)

    De Bruyn, Arnaud; Liechty, John C.; Huizingh, Eelko K. R. E.; Lilien, Gary L.

    2008-01-01

    In their purchase decisions, online customers seek to improve decision quality while limiting search efforts. In practice, many merchants have understood the importance of helping customers in the decision-making process and provide online decision aids to their visitors. In this paper, we show how

  13. Environmental sensor networks and continuous data quality assurance to manage salinity within a highly regulated river basin

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, N.W.T.; Ortega, R.; Holm, L.

    2010-01-05

    This paper describes a new approach to environmental decision support for salinity management in the San Joaquin Basin of California that focuses on web-based data sharing using YSI Econet technology and continuous data quality management using a novel software tool, Aquarius.

  14. Data quality objectives

    Energy Technology Data Exchange (ETDEWEB)

    Haeberer, F. [Environmental Protection Agency, Washington, DC (United States)

    1993-12-31

    The U.S. Environmental Protection Agency (EPA) spends about $500 million annually in collecting environmental data for scientific research and regulatory decision making. In addition, the regulated community may spend as much as ten times more each year in responding to EPA compliance requirements. Among the EPA and the regulated community there are several important common concerns: both want to make informed decisions using the right type, quality, and quantity of data. Collecting new data is very resource intensive to all parties. Neither EPA nor the regulated community can afford to collect more or {open_quotes}better{close_quotes} data than are really needed; the Data Quality Objectives (DQO) process is a systematic planning tool for ensuring that the right data will be collected for arriving at a decision within the desired confidence constraints. Using the DQO process to plan environmental data collections can help improve their effectiveness and efficiency, and enhance the defensibility of the decisions for which the data are used.

  15. Data quality objectives

    International Nuclear Information System (INIS)

    Haeberer, F.

    1993-01-01

    The U.S. Environmental Protection Agency (EPA) spends about $500 million annually in collecting environmental data for scientific research and regulatory decision making. In addition, the regulated community may spend as much as ten times more each year in responding to EPA compliance requirements. Among the EPA and the regulated community there are several important common concerns: both want to make informed decisions using the right type, quality, and quantity of data. Collecting new data is very resource intensive to all parties. Neither EPA nor the regulated community can afford to collect more or open-quotes betterclose quotes data than are really needed; the Data Quality Objectives (DQO) process is a systematic planning tool for ensuring that the right data will be collected for arriving at a decision within the desired confidence constraints. Using the DQO process to plan environmental data collections can help improve their effectiveness and efficiency, and enhance the defensibility of the decisions for which the data are used

  16. A conceptual competitive intelligence quality assurance model

    Directory of Open Access Journals (Sweden)

    Tshilidzi Eric Nenzhelele

    2015-12-01

    Full Text Available Competitive Intelligence (CI improves the quality of product and service, decision-making and it improves quality of life. However, it has been established that decision makers are not happy about the quality of CI. This is because enterprises fail in quality assurance of CI. It has been concluded that most enterprises are clueless concerning CI quality assurance. Studies that previously attempted to resolve CI quality problem were limited in scope and focused too much on the quality of information than the overall CI quality. The purpose of this study is to propose a conceptual CI quality assurance model which will help in quality assurance of CI. The research was qualitative in nature and used content analysis.

  17. Investigation of effective decision criteria for multiobjective optimization in IMRT.

    Science.gov (United States)

    Holdsworth, Clay; Stewart, Robert D; Kim, Minsun; Liao, Jay; Phillips, Mark H

    2011-06-01

    To investigate how using different sets of decision criteria impacts the quality of intensity modulated radiation therapy (IMRT) plans obtained by multiobjective optimization. A multiobjective optimization evolutionary algorithm (MOEA) was used to produce sets of IMRT plans. The MOEA consisted of two interacting algorithms: (i) a deterministic inverse planning optimization of beamlet intensities that minimizes a weighted sum of quadratic penalty objectives to generate IMRT plans and (ii) an evolutionary algorithm that selects the superior IMRT plans using decision criteria and uses those plans to determine the new weights and penalty objectives of each new plan. Plans resulting from the deterministic algorithm were evaluated by the evolutionary algorithm using a set of decision criteria for both targets and organs at risk (OARs). Decision criteria used included variation in the target dose distribution, mean dose, maximum dose, generalized equivalent uniform dose (gEUD), an equivalent uniform dose (EUD(alpha,beta) formula derived from the linear-quadratic survival model, and points on dose volume histograms (DVHs). In order to quantatively compare results from trials using different decision criteria, a neutral set of comparison metrics was used. For each set of decision criteria investigated, IMRT plans were calculated for four different cases: two simple prostate cases, one complex prostate Case, and one complex head and neck Case. When smaller numbers of decision criteria, more descriptive decision criteria, or less anti-correlated decision criteria were used to characterize plan quality during multiobjective optimization, dose to OARs and target dose variation were reduced in the final population of plans. Mean OAR dose and gEUD (a = 4) decision criteria were comparable. Using maximum dose decision criteria for OARs near targets resulted in inferior populations that focused solely on low target variance at the expense of high OAR dose. Target dose range, (D

  18. Application of Domain Knowledge to Software Quality Assurance

    Science.gov (United States)

    Wild, Christian W.

    1997-01-01

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

  19. Reversible inactivation of the lateral hypothalamus reversed high reward choices in cost-benefit decision-making in rats.

    Science.gov (United States)

    Karimi, Sara; Mesdaghinia, Azam; Farzinpour, Zahra; Hamidi, Gholamali; Haghparast, Abbas

    2017-11-01

    The Lateral hypothalamus (LH) is an important component of the networks underlying the control of feeding and other motivated behaviors. Cost-benefit decision-making is mediated largely by the prefrontal cortex (PFC) which strongly innervates the LH. Therefore, in the current study, we conducted a series of experiments to elucidate the role of the perifornical area of the lateral hypothalamus (PeF-LH) in effort and/or delay-based decision-making. We trained different groups of rats in a delay-based and/or an effort-based form of cost-benefit T-maze decision- making task in which they could either choose to pay the cost to obtain a high reward in one arm or could obtain a low reward in the other arm with no cost. During test days, the rats received local injections of either vehicle or lidocaine4% (0.5 μl/side), in the PeF-LH. In an effort-based decision task, PeF-LH inactivation led to decrease in high reward choice. Similarly, in a delay-based decision task animals' preference changed to a low but immediately available reward. This was not caused by a spatial memory or motor deficit. PeF-LH inactivation modified decision behavior. The results imply that PeF-LH is important for allowing the animal to pay a cost to acquire greater rewards. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    McCaughey, Deirdre; Bruning, Nealia S

    2010-05-26

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

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

    Directory of Open Access Journals (Sweden)

    Bruning Nealia S

    2010-05-01

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

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

    Science.gov (United States)

    2010-01-01

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

  3. Repeatability and reproducibility of decisions by latent fingerprint examiners.

    Directory of Open Access Journals (Sweden)

    Bradford T Ulery

    Full Text Available The interpretation of forensic fingerprint evidence relies on the expertise of latent print examiners. We tested latent print examiners on the extent to which they reached consistent decisions. This study assessed intra-examiner repeatability by retesting 72 examiners on comparisons of latent and exemplar fingerprints, after an interval of approximately seven months; each examiner was reassigned 25 image pairs for comparison, out of total pool of 744 image pairs. We compare these repeatability results with reproducibility (inter-examiner results derived from our previous study. Examiners repeated 89.1% of their individualization decisions, and 90.1% of their exclusion decisions; most of the changed decisions resulted in inconclusive decisions. Repeatability of comparison decisions (individualization, exclusion, inconclusive was 90.0% for mated pairs, and 85.9% for nonmated pairs. Repeatability and reproducibility were notably lower for comparisons assessed by the examiners as "difficult" than for "easy" or "moderate" comparisons, indicating that examiners' assessments of difficulty may be useful for quality assurance. No false positive errors were repeated (n = 4; 30% of false negative errors were repeated. One percent of latent value decisions were completely reversed (no value even for exclusion vs. of value for individualization. Most of the inter- and intra-examiner variability concerned whether the examiners considered the information available to be sufficient to reach a conclusion; this variability was concentrated on specific image pairs such that repeatability and reproducibility were very high on some comparisons and very low on others. Much of the variability appears to be due to making categorical decisions in borderline cases.

  4. Fault Isolation for Shipboard Decision Support

    DEFF Research Database (Denmark)

    Lajic, Zoran; Blanke, Mogens; Nielsen, Ulrik Dam

    2010-01-01

    Fault detection and fault isolation for in-service decision support systems for marine surface vehicles will be presented in this paper. The stochastic wave elevation and the associated ship responses are modeled in the frequency domain. The paper takes as an example fault isolation of a containe......Fault detection and fault isolation for in-service decision support systems for marine surface vehicles will be presented in this paper. The stochastic wave elevation and the associated ship responses are modeled in the frequency domain. The paper takes as an example fault isolation...... to the quality of decisions given to navigators....

  5. PROBLEMATIC FEATURES OF THE POLITICAL DECISION MAKERS

    Directory of Open Access Journals (Sweden)

    Aleksey Sergeevih Voynov

    2014-11-01

    Full Text Available Purpose: identify the most important features in the process of making political decisions that affect the effectiveness of problem-solving situationsScientific novelty: as a result of the analysis identified the problematic features of major importance for the efficiency of the development and adoption of the most rational solution to a problem situation.Results: the analysis of the most significant features affecting the quality of decisions among them the interest of the person making decisions in the search for causes of the problem situation; decisions from the influence of the immediate environment; populism in decision making, creating a visibility problem-solving; decision making based on personal emotional factor face decision-makers; the perception of the population face decision-makers in relation to the current problem situation and possible ways of its resolution.Defined facts influencing the process of political decision-making such as: corruption, the struggle for influence on the process of political decision-making, lack of qualified specialists, staff shortage, including arose as the result of substitution of notions of "succession" to "nepotism".

  6. Amotivation and the Occupational Decision: An Investigation of Australian Senior High School Students

    Science.gov (United States)

    Jung, Jae Yup; McCormick, John

    2010-01-01

    This exploratory study investigated the occupational decision-related processes of senior high school students, in terms of the extent to which they may be amotivated in choosing a future occupation. Data were gathered using a newly developed questionnaire, which was largely adapted from a number of psychometrically proven instruments, and…

  7. The Treatment of cardiovascular Risk in Primary care using Electronic Decision supOrt (TORPEDO) study-intervention development and protocol for a cluster randomised, controlled trial of an electronic decision support and quality improvement intervention in Australian primary healthcare.

    Science.gov (United States)

    Peiris, David; Usherwood, Tim; Panaretto, Katie; Harris, Mark; Hunt, Jenny; Patel, Bindu; Zwar, Nicholas; Redfern, Julie; Macmahon, Stephen; Colagiuri, Stephen; Hayman, Noel; Patel, Anushka

    2012-01-01

    Large gaps exist in the implementation of guideline recommendations for cardiovascular disease (CVD) risk management. Electronic decision support (EDS) systems are promising interventions to close these gaps but few have undergone clinical trial evaluation in Australia. We have developed HealthTracker, a multifaceted EDS and quality improvement intervention to improve the management of CVD risk. It is hypothesised that the use of HealthTracker over a 12-month period will result in: (1) an increased proportion of patients receiving guideline-indicated measurements of CVD risk factors and (2) an increased proportion of patients at high risk will receive guideline-indicated prescriptions for lowering their CVD risk. Sixty health services (40 general practices and 20 Aboriginal Community Controlled Health Services (ACCHSs) will be randomised in a 1:1 allocation to receive either the intervention package or continue with usual care, stratified by service type, size and participation in existing quality improvement initiatives. The intervention consists of point-of-care decision support; a risk communication interface; a clinical audit tool to assess performance on CVD-related indicators; a quality improvement component comprising peer-ranked data feedback and support to develop strategies to improve performance. The control arm will continue with usual care without access to these intervention components. Quantitative data will be derived from cross-sectional samples at baseline and end of study via automated data extraction. Detailed process and economic evaluations will also be conducted. The general practice component of the study is approved by the University of Sydney Human Research Ethics Committee (HREC) and the ACCHS component is approved by the Aboriginal Health and Medical Research Council HREC. Formal agreements with each of the participating sites have been signed. In addition to the usual scientific forums, results will be disseminated via newsletters

  8. [Value-based cancer care. From traditional evidence-based decision making to balanced decision making within frameworks of shared values].

    Science.gov (United States)

    Palazzo, Salvatore; Filice, Aldo; Mastroianni, Candida; Biamonte, Rosalbino; Conforti, Serafino; Liguori, Virginia; Turano, Salvatore; De Simone, Rosanna; Rovito, Antonio; Manfredi, Caterina; Minardi, Stefano; Vilardo, Emmanuelle; Loizzo, Monica; Oriolo, Carmela

    2016-04-01

    Clinical decision making in oncology is based so far on the evidence of efficacy from high-quality clinical research. Data collection and analysis from experimental studies provide valuable insight into response rates and progression-free or overall survival. Data processing generates valuable information for medical professionals involved in cancer patient care, enabling them to make objective and unbiased choices. The increased attention of many scientific associations toward a more rational resource consumption in clinical decision making is mirrored in the Choosing Wisely campaign against the overuse or misuse of exams and procedures of little or no benefit for the patient. This cultural movement has been actively promoting care solutions based on the concept of "value". As a result, the value-based decision-making process for cancer care should not be dissociated from economic sustainability and from ethics of the affordability, also given the growing average cost of the most recent cancer drugs. In support of this orientation, the National Comprehensive Cancer Network (NCCN) has developed innovative and "complex" guidelines based on values, defined as "evidence blocks", with the aim of assisting the medical community in making overall sustainable choices.

  9. Socioeconomic assessment guidance report: Determining the effects of amenity characteristics on business location decisions

    International Nuclear Information System (INIS)

    Allison, T.

    1993-02-01

    Evaluating perception-based impacts of hazardous waste facilities has become an increasingly important part of socioeconomic impact assessments in recent years. One area of discussion has been the potential effect of risk perceptions on business location decision making. This report evaluates the importance of environmental amenities (broadly defined to include natural, cultural, and recreational features; environmental quality; and other indexes of quality of life) with respect to decisions on locating both manufacturing and business service activities. It discusses the major theoretical and empirical issues that arise in attempting to determine the effects of environmental amenities on the location choices for businesses and business activities. This discussion is followed by a survey of major findings from the academic literature and a review of research by the state of Nevada. A number of recommendations for further research are also provided to help the US Department of Energy's Office of Civilian Radioactive Waste Management better understand the importance of perception-based impacts in business location decision making and estimate the scale of socioeconomic impacts that would result from siting a high-level waste repository in Nevada

  10. Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.

    Science.gov (United States)

    Oczkowski, Simon J W; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-04-09

    % CI -0.5, -0.15, p communication tools may improve documentation of EOL decision making and may result in lower resource use. The supporting evidence is low to very low in quality. Further high-quality randomized studies of simple communication interventions are needed to determine whether structured, rather than ad hoc, approaches to end-of-life decision-making improve patient-level, family-level, and system-level outcomes. PROSPERO CRD42014012913.

  11. Prediction of bread-making quality using size exclusion high ...

    African Journals Online (AJOL)

    Variation in the distribution of protein molecular weight in wheat (Triticum aestivum), influences breadmaking quality of wheat cultivars, resulting in either poor or good bread. The objective of this study was to predict breadmaking quality of wheat cultivars using size exclusion high performance liquid chromatography.

  12. An integrative review of health-related quality of life in patients with critical limb ischaemia.

    Science.gov (United States)

    Monaro, Susan; West, Sandra; Gullick, Janice

    2017-10-01

    To examine the domains and the domain-specific characteristics within a peripheral arterial disease health-related quality of life framework for their usefulness in defining critical limb ischaemia health-related quality of life. Critical Limb Ischaemia presents a highly individualised set of personal and health circumstances. Treatment options include conservative management, revascularisation or amputation. However, the links between treatment decisions and quality of life require further investigation. The framework for this integrative review was the peripheral arterial disease-specific health-related quality of life domains identified by Treat-Jacobson et al. The literature expanded and refined Treat-Jacobson's framework by modifying the characteristics to better describe health-related quality of life in critical limb ischaemia. Given that critical limb ischaemia is a highly individualised situation with powerful health-related quality of life implications, further research focusing on patient and family-centred decision-making relating to therapeutic options and advanced care planning is required. A critical limb ischaemia-specific, health-related quality of life tool is required to capture both the unique characteristics of this disorder, and the outcomes for active or conservative care among this complex group of patients. © 2016 John Wiley & Sons Ltd.

  13. Development and validation of a shared decision-making instrument for health-related quality of life one year after total hip replacement based on quality registries data.

    Science.gov (United States)

    Nemes, Szilard; Rolfson, Ola; Garellick, Göran

    2018-02-01

    Clinicians considering improvements in health-related quality of life (HRQoL) after total hip replacement (THR) must account for multiple pieces of information. Evidence-based decisions are important to best assess the effect of THR on HRQoL. This work aims at constructing a shared decision-making tool that helps clinicians assessing the future benefits of THR by offering predictions of 1-year postoperative HRQoL of THR patients. We used data from the Swedish Hip Arthroplasty Register. Data from 2008 were used as training set and data from 2009 to 2012 as validation set. We adopted two approaches. First, we assumed a continuous distribution for the EQ-5D index and modelled the postoperative EQ-5D index with regression models. Second, we modelled the five dimensions of the EQ-5D and weighted together the predictions using the UK Time Trade-Off value set. As predictors, we used preoperative EQ-5D dimensions and the EQ-5D index, EQ visual analogue scale, visual analogue scale pain, Charnley classification, age, gender, body mass index, American Society of Anesthesiologists, surgical approach and prosthesis type. Additionally, the tested algorithms were combined in a single predictive tool by stacking. Best predictive power was obtained by the multivariate adaptive regression splines (R 2  = 0.158). However, this was not significantly better than the predictive power of linear regressions (R 2  = 0.157). The stacked model had a predictive power of 17%. Successful implementation of a shared decision-making tool that can aid clinicians and patients in understanding expected improvement in HRQoL following THR would require higher predictive power than we achieved. For a shared decision-making tool to succeed, further variables, such as socioeconomics, need to be considered. © 2016 John Wiley & Sons, Ltd.

  14. Exome sequencing generates high quality data in non-target regions

    Directory of Open Access Journals (Sweden)

    Guo Yan

    2012-05-01

    Full Text Available Abstract Background Exome sequencing using next-generation sequencing technologies is a cost efficient approach to selectively sequencing coding regions of human genome for detection of disease variants. A significant amount of DNA fragments from the capture process fall outside target regions, and sequence data for positions outside target regions have been mostly ignored after alignment. Result We performed whole exome sequencing on 22 subjects using Agilent SureSelect capture reagent and 6 subjects using Illumina TrueSeq capture reagent. We also downloaded sequencing data for 6 subjects from the 1000 Genomes Project Pilot 3 study. Using these data, we examined the quality of SNPs detected outside target regions by computing consistency rate with genotypes obtained from SNP chips or the Hapmap database, transition-transversion (Ti/Tv ratio, and percentage of SNPs inside dbSNP. For all three platforms, we obtained high-quality SNPs outside target regions, and some far from target regions. In our Agilent SureSelect data, we obtained 84,049 high-quality SNPs outside target regions compared to 65,231 SNPs inside target regions (a 129% increase. For our Illumina TrueSeq data, we obtained 222,171 high-quality SNPs outside target regions compared to 95,818 SNPs inside target regions (a 232% increase. For the data from the 1000 Genomes Project, we obtained 7,139 high-quality SNPs outside target regions compared to 1,548 SNPs inside target regions (a 461% increase. Conclusions These results demonstrate that a significant amount of high quality genotypes outside target regions can be obtained from exome sequencing data. These data should not be ignored in genetic epidemiology studies.

  15. Peer effects in decision-making: Evidence from corporate investment

    Directory of Open Access Journals (Sweden)

    Shenglan Chen

    2017-06-01

    Full Text Available We show that peer effects influence corporate investment decisions. Using a sample of China’s listed firms from 1999 to 2012, we show that a one standard deviation increase in peer firms’ investments is associated with a 4% increase in firm i’s investments. We further identify the mechanisms, conditions and economic consequences of peer effects in firms’ investment decisions. We find that peer effects are more pronounced when firms have information advantages and the information disclosure quality of peer firms is higher, or if they face more fierce competition. When firms are industry followers, are young or have financial constraints, they are highly sensitive to their peers firms. We also quantify the economic consequences generated by peer effects, which can increase firm performance in future periods.

  16. Decision-making in Sport under Mental and Physical Stress

    Directory of Open Access Journals (Sweden)

    Teri J. Hepler

    2015-10-01

    Full Text Available Background: Successful decision-making in sport requires good decisions to be made quickly, but little is understood about the decision process under stress. Objective: The purpose of this study was to compare decision outcomes and the Take the First (TTF heuristic under conditions of mental, physical, and no stress.  Method:  Participants (N=112 were divided into 3 stress groups:  mental stress (mental serial subtraction, physical stress (running on treadmill at 60-70% of maximum effort, and no stress (counting backwards by 1. Participants were exposed to 30 seconds of stress and then watched a video depicting an offensive situation in basketball requiring them to decide what the player with the ball should do next. Each participant performed 10 trials of the video decision-making task.  Results: No differences were found between the 3 stress groups on decision quality, TTF frequency, number of options generated, or quality of first generated option.  However, participants in the no stress and physical stress conditions were faster in generating their first option and making their final decision as compared to the mental stress group.  Conclusion: Overall, results suggest that mental stress impairs decision speed and that TTF is an ecologically rationale heuristic in dynamic, time-pressured situations.  Keywords: Take the first, Heuristic, Pressure, Cognitive performance

  17. A Laboratory Simulation of Parental Investment Decisions: The Role of Future Reproductive Opportunities and Quality of Offspring in Determining Levels of Parental Investment

    Directory of Open Access Journals (Sweden)

    Stefanie L. Turner

    2006-01-01

    Full Text Available Hagen's Defection Hypothesis (2002 predicts that a mother's age and the quality of her offspring are critical factors in determining her investment in her newborn. We tested this hypothesis using hamster races in which 113 college student participants received a hamster (“offspring” and 10 poker chips (“resources” to “invest” into the hamster based on information about the quality of the hamster and about the possibility of future races. Subjects invested the most in low quality offspring when they expected to run only one race and the least in low quality offspring when they expected more racing opportunities in the future. Offspring quality affected investment differently depending on the presence or absence of future investment opportunities and the sex of the subject. Overall, the results supported Hagen's model of parental investment and also suggest that parental investment may be explained by conscious as well as unconscious decision-making.

  18. Key factors for a high-quality VR experience

    Science.gov (United States)

    Champel, Mary-Luc; Doré, Renaud; Mollet, Nicolas

    2017-09-01

    For many years, Virtual Reality has been presented as a promising technology that could deliver a truly new experience to users. The media and entertainment industry is now investigating the possibility to offer a video-based VR 360 experience. Nevertheless, there is a substantial risk that VR 360 could have the same fate as 3DTV if it cannot offer more than just being the next fad. The present paper aims at presenting the various quality factors required for a high-quality VR experience. More specifically, this paper will focus on the main three VR quality pillars: visual, audio and immersion.

  19. Identifying Non-Sustainable Courses of Action: A Prerequisite for Decision-Making in Education for Sustainable Development

    Science.gov (United States)

    Gresch, Helge; Bögeholz, Susanne

    2013-04-01

    Students are faced with a multitude of decisions as consumers and in societal debates. Because of the scarcity of resources, the destruction of ecosystems and social injustice in a globalized world, it is vital that students are able to identify non-sustainable courses of action when involved in decision-making. The application of decision-making strategies is one approach to enhancing the quality of decisions. Options that do not meet ecological, social or economic standards should be excluded using non-compensatory strategies whereas other tasks may require a complete trade-off of all the evidence, following a compensatory approach. To enhance decision-making competence, a computer-based intervention study was conducted that focused on the use of decision-making strategies. While the results of the summative evaluation are reported by Gresch et al. (International Journal of Science Education, 2011), in-depth analyses of process-related data collected during the information processing are presented in this paper to reveal insights into the mechanisms of the intervention. The quality of high school students' ( n = 120) metadecision skills when selecting a decision-making strategy was investigated using qualitative content analyses combined with inferential statistics. The results reveal that the students offered elaborate reflections on the sustainability of options. However, the characteristics that were declared non-sustainable differed among the students because societal norms and personal values were intertwined. One implication for education for sustainable development is that students are capable of reflecting on decision-making tasks and on corresponding favorable decision-making strategies at a metadecision level. From these results, we offer suggestions for improving learning environments and constructing test instruments for decision-making competence.

  20. Swedish Consumers’ Perception of Food Quality and Sustainability in Relation to Organic Food Production

    Science.gov (United States)

    Gebresenbet, Girma

    2018-01-01

    Consumers’ demand for locally produced and organic foods has increased in Sweden. This paper presents the results obtained from the analysis of data acquired from 100 consumers in Sweden who participated in an online survey during March to June 2016. The objective was to identify consumers’ demand in relation to organic food and sustainable food production, and to understand how the consumers evaluate food quality and make buying decisions. Qualitative descriptions, descriptive statistics and Pearson’s Chi-square test (with alpha value of p production method is more sustainable than conventional methods. Female consumers have more positive attitudes than men towards organic food. However, age difference, household size and income level do not significantly influence the consumers’ perception of sustainable food production concepts. Regionality, sustainable methods of production and organic production are the most important parameters to characterize the food as high quality and make buying decisions. On the other hand, product uniformity, appearance, and price were found to be relatively less important parameters. Food buying decisions and food quality were found to be highly related with Pearson’s correlation coefficient of r = 0.99. PMID:29614785

  1. Sleep quality and its relationship with quality of life among high-risk pregnant women (gestational diabetes and hypertension).

    Science.gov (United States)

    Saadati, Fatemeh; Sehhatiei Shafaei, Fahimeh; Mirghafourvand, Mozhgan

    2018-01-01

    Sleep is one of the most basic human requirements. This research aims at determining the status of sleep quality and its relationship with quality of life among high-risk pregnant women in Tabriz, Iran, in 2015. This research was a sectional study done on 364 qualified women in 28-36 weeks of pregnancy suffering from mild preeclampsia and gestational diabetes. The sampling was done as convenience. Personal-social-midwifery questionnaire, Pittsburg sleep quality, and quality of life in pregnancy (QOL-ORAV) were used for gathering data. Multivariate linear regression model was used for determining the relationship between sleep quality and its subsets with quality of life and controlling confounders. In the current study, the prevalence of sleep disturbance was 96.4%. Mean (SD) of the total score of sleep quality was 10.1 (4.1) and the total score of quality of life was 61.7 (17.3). According to Pearson's correlation test, there was statistically significant relationship between quality of life and sleep quality and all its subsets except sleep duration and use of sleep medication (p quality of life. The findings of current research show that sleep quality is low among high-risk pregnant women and quality of life is medium. So, it is necessary that required training is given by health cares for improving sleep quality and quality of life to mothers.

  2. 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.

  3. Teachers' Grading Decision Making

    Science.gov (United States)

    Isnawati, Ida; Saukah, Ali

    2017-01-01

    This study investigated teachers' grading decision making, focusing on their beliefs underlying their grading decision making, their grading practices and assessment types, and factors they considered in grading decision making. Two teachers from two junior high schools applying different curriculum policies in grade reporting in Indonesian…

  4. Quality assurance in research and development

    International Nuclear Information System (INIS)

    Laslett, G.F.; Waker, C.H.

    1990-01-01

    It is propounded that, given high status for the Research and Development (R and D) activity of the comapny or site, ''freeing'' the scientists and engineers involved at the innovative decision-taking point helps quality. Effort and money to raise the latter may be best spent in ensuring better calibre, background and training of them, making more meaningful the teamwork across the supplier/customer interfaces, and avoiding risk of misunderstanding of the use to be made of the outcome of the R and D endeavour. But the staff's conscience towards quality, hand in hand with safety, must be constantly stimulated. (author)

  5. Time Is Money: The Decision Making of Smartphone High Users in Gain and Loss Intertemporal Choice.

    Science.gov (United States)

    Tang, Zixuan; Zhang, Huijun; Yan, An; Qu, Chen

    2017-01-01

    Nowadays the smartphone plays an important role in our lives. While it brings us convenience and efficiency, its overuse can cause problems. Although a great number of studies have demonstrated that people affected by substance abuse, pathological gambling, and internet addiction disorder have lower self-control than average, scarcely any study has investigated the decision making of smartphone high users by using a behavioral paradigm. The present study employed an intertemporal task, the Smartphone Addiction Inventory (SPAI) and the Barratt Impulsiveness Scale 11th version (BIS-11) to explore the decision control of smartphone high users in a sample of 125 college students. Participants were divided into three groups according to their SPAI scores. The upper third (69 or higher), middle third (from 61 to 68) and lower third (60 or lower) of scores were defined as high smartphone users, medium users and low users, respectively. We compared the percentage of small immediate reward/penalty choices in different conditions between the three groups. Relative to the low users group, high users and medium users were more inclined to request an immediate monetary reward. Moreover, for the two dimensions of time and money in intertemporal choice, high users and medium users showed a bias in intertemporal choice task among most of the time points and value magnitude compared to low users. These findings demonstrated that smartphone overuse was associated with problematic decision-making, a pattern similar to that seen in persons affected by a variety of addictions.

  6. Next Generation High Quality Videoconferencing Service for the LHC

    CERN Multimedia

    CERN. Geneva

    2012-01-01

    In recent times, we have witnessed an explosion of video initiatives in the industry worldwide. Several advancements in video technology are currently improving the way we interact and collaborate. These advancements are forcing tendencies and overall experiences: any device in any network can be used to collaborate, in most cases with an overall high quality. To cope with this technology progresses, CERN IT Department has taken the leading role to establish strategies and directions to improve the user experience in remote dispersed meetings and remote collaboration at large in the worldwide LHC communities. Due to the high rate of dispersion in the LHC user communities, these are critically dependent of videoconferencing technology, with a need of robustness and high quality for the best possible user experience. We will present an analysis of the factors that influenced the technical and strategic choices to improve the reliability, efficiency and overall quality of the LHC remote sessions. In particular, ...

  7. IMPROVING THE QUALITY OF THE DECISION MAKING BY USING BUSINESS INTELLIGENCE SOLUTIONS

    Directory of Open Access Journals (Sweden)

    MARIA Dan Stefan

    2009-05-01

    Full Text Available On the basis of the decision making stands information, as one of the main elements that determine the evolution of our-days society. As a consequence, data analysis tends to become a priority in the activity of an organization for decision making. The di

  8. Application Of Decision Tree Approach To Student Selection Model- A Case Study

    Science.gov (United States)

    Harwati; Sudiya, Amby

    2016-01-01

    The main purpose of the institution is to provide quality education to the students and to improve the quality of managerial decisions. One of the ways to improve the quality of students is to arrange the selection of new students with a more selective. This research takes the case in the selection of new students at Islamic University of Indonesia, Yogyakarta, Indonesia. One of the university's selection is through filtering administrative selection based on the records of prospective students at the high school without paper testing. Currently, that kind of selection does not yet has a standard model and criteria. Selection is only done by comparing candidate application file, so the subjectivity of assessment is very possible to happen because of the lack standard criteria that can differentiate the quality of students from one another. By applying data mining techniques classification, can be built a model selection for new students which includes criteria to certain standards such as the area of origin, the status of the school, the average value and so on. These criteria are determined by using rules that appear based on the classification of the academic achievement (GPA) of the students in previous years who entered the university through the same way. The decision tree method with C4.5 algorithm is used here. The results show that students are given priority for admission is that meet the following criteria: came from the island of Java, public school, majoring in science, an average value above 75, and have at least one achievement during their study in high school.

  9. A comparative analysis of risk and quality

    DEFF Research Database (Denmark)

    Lynette, Jennifer Elyse

    2017-01-01

    Within the field of emergency management and fire response, risk and quality are conceptualized to some degree in every response effort. Quality is viewed as a relatively new concept within the field of emergency management and fire response. Whereas, within this same field the concept of risk is....... This understanding can serve to facilitate more informed and effective decision making that incorporates both risk and quality before, during, and after emergency events....... independently, decision making and judgement processes have the potential to be positively impacted by furthering research and developing a deeper understanding of these constructs. By understanding risk management principles and combining that with a quality systems approach, decision making can be improved......Within the field of emergency management and fire response, risk and quality are conceptualized to some degree in every response effort. Quality is viewed as a relatively new concept within the field of emergency management and fire response. Whereas, within this same field the concept of risk...

  10. The effects of scientific literacy on participation to political decision making

    Directory of Open Access Journals (Sweden)

    Süerdem Ahmet

    2016-01-01

    Full Text Available The low levels of scientific literacy among the general public in a society where technology penetrates all aspects of everyday life creates major citizenship problems. One of the main goals of education is increasing the civic scientific literacy of the citizens besides preparing students for science based vocations. Well educated human capital stock is important for informed decision making as well as the development of research and development activities. The quality of policy decisions is highly dependent on the level of interest, information and attitudes towards S&T. Making conscious decisions about S&T related developments is substantial for democratic participation of the public to policy making. Increasing complexity of science and technology related issues creates a gap between expert and citizen knowledge. Scientific literacy decreases this gap in terms of creating a knowledgeable approach to the controversies around scientific issues. The aim of this study is to make an operational model for explaining how civic scientific literacy affects public understanding of science and these in turn influence participation to political decision making. We analyse the effects of scientific literacy and other public understanding of science variables on participation to political decision making.

  11. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Science.gov (United States)

    McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

    2015-01-01

    Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (pmobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  12. Towards Sustainability: Effective Operations Strategies, Quality Management and Operational Excellence in Banking

    Directory of Open Access Journals (Sweden)

    Vesna Tornjanski

    2017-02-01

    Full Text Available This paper sets out to extend and deepen the understanding the ways toward economic sustainability through efficient and effective growth operations strategies, quality management and operational excellence in banking. In this study we define new quality management practices based on developed conceptual architecture of digital platform for operations function in banking. Additionally, we employ decision making framework consisted of two parts: introduction of new operations services using Total Unduplicated Reach and Frequency (TURF statistical analysis and segregation of core from actual and augmented operations services utilizing Analytic Network Process (ANP method based on BOCR model. Proposed quality management practices were used for the first time in this paper for particular purposes and have the high potential to impact the excellence in banking business. The study can contribute to operations management, quality management, innovation management, IT management, business process management and decision making in service organizations.

  13. Optimization of nitridation conditions for high quality inter-polysilicon dielectric layers

    NARCIS (Netherlands)

    Klootwijk, J.H.; Bergveld, H.J.; van Kranenburg, H.; Woerlee, P.H.; Wallinga, Hans

    1996-01-01

    Nitridation of deposited high temperature oxides (HTO) was studied to form high quality inter-polysilicon dielectric layers for embedded non volatile memories. Good quality dielectric layers were obtained earlier by using an optimized deposition of polysilicon and by performing a post-dielectric

  14. The Effect of High-Impact Writing on Decision Making Within a Public Sector Bureaucracy.

    Science.gov (United States)

    Suchan, Jim

    1998-01-01

    Finds that respondents (working in a medium-sized federal government agency) reading high-impact reports did not make significantly better decisions than those reading bureaucratic reports. Shows that context factors (perceived work roles, job design, organizational structure, report genre expectations, and organizational language norms) caused…

  15. Water Quality Analysis Simulation

    Science.gov (United States)

    The Water Quality analysis simulation Program, an enhancement of the original WASP. This model helps users interpret and predict water quality responses to natural phenomena and man-made pollution for variious pollution management decisions.

  16. eHealth Literacy and Intervention Tailoring Impacts the Acceptability of a HIV/STI Testing Intervention and Sexual Decision Making Among Young Gay and Bisexual Men.

    Science.gov (United States)

    Horvath, Keith J; Bauermeister, José A

    2017-02-01

    We assessed whether young men who have sex with men's acceptability with the online Get Connected! intervention and subsequent sexual health decision making were influenced by their baseline eHealth literacy (high vs. low competency) and intervention tailoring (tailored or nontailored intervention condition). Compared to the high eHealth literacy/tailored intervention group: (1) those in the low eHealth literacy/tailored intervention condition and participants in the nontailored intervention condition (regardless of eHealth literacy score) reported lower intervention information quality scores; and (2) those in the low eHealth literacy/nontailored intervention group reported lower intervention system quality scores and that the intervention had less influence on their sexual health decision making. Future similar intervention research should consider how eHealth literacy might influence participants' abilities to navigate intervention content and integrate it into their sexual decision making.

  17. Producing high-quality slash pine seeds

    Science.gov (United States)

    James Barnett; Sue Varela

    2003-01-01

    Slash pine is a desirable species. It serves many purposes and is well adapted to poorly drained flatwoods and seasonally flooded areas along the lower Coastal Plain of the Southeastern US. The use of high-quality seeds has been shown to produce uniform seedlings for outplanting, which is key to silvicultural success along the Coastal Plain and elsewhere. We present...

  18. Decision-making in product portfolios of pharmaceutical research and development--managing streams of innovation in highly regulated markets.

    Science.gov (United States)

    Jekunen, Antti

    2014-01-01

    Decision-making is a core function of any drug development firm. Developing drugs demands a firm to be highly innovative, while at the same time the activity is strictly regulated. Successful drug development offers the right to apply for a long-term patent that confers exclusive marketing rights. This article addresses the issue of what constitutes an adequate portfolio of drugs for a drug development firm and how it might be managed successfully. The paper investigates decision-making in the industry and specifically in the development of oncology drugs from various perspectives: the need for decisions, their timing, decision-making at the project level, the optimal portfolio, tools for portfolio analysis, the evaluation of patents, and finally the importance of the drug portfolio. Drug development decisions as important organizational elements should get more emphasis, and decisions in drug portfolio using modern decision-making methods should be used more widely than what currently happens. Structured, informed decisions would help avoiding late terminations of drugs in Phase III development. An improved research and development pipeline and drug portfolio management are the major elements in the general strategy targeting success.

  19. Licensing Surrogate Decision-Makers.

    Science.gov (United States)

    Rosoff, Philip M

    2017-06-01

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

  20. A Probabilistic Decision-Making Scoring System for Quality and Safety Management in Aloreña de Málaga Table Olive Processing

    Directory of Open Access Journals (Sweden)

    Miguel Á. Ruiz Bellido

    2017-11-01

    Full Text Available Table olives are one of the most representatives and consumed fermented vegetables in Mediterranean countries. However, there is an evident lack of standardization of production processes and HACCP systems thus implying the need of establishing decision-making tools allowing their commercialization and shelf-life extension. The present work aims at developing a decision-making scoring system by means of a probabilistic assessment to standardize production process of Aloreña de Málaga table olives based on the identification of potential hazards or deficiencies in hygienic processes for the subsequent implementation of corrective measures. A total of 658 microbiological and physico-chemical data were collected over three consecutive olive campaigns (2014–2016 to measure the variability and relative importance of each elaboration step on total hygienic quality and product safety. Three representative companies were visited to collect samples from food-contact surfaces, olive fruits, brines, air environment, olive dressings, water tanks, and finished/packaged products. A probabilistic assessment was done based on the establishment of Performance Hygiene and Safety Scores (PHSS 0–100% through a standardized system for evaluating product acceptability. The mean value of the global PHSS for the Aloreña de Málaga table olives processing (PHHSFTOT was 64.82% (90th CI: 52.78–76.39% indicating the high variability among facilities in the evaluated processing steps on final product quality and safety. Washing and cracking, and selection and addition of olive dressings were detected as the most deficient ones in relation to PHSSFi values (p < 0.05 (mean = 53.02 and 56.62%, respectively. The relative contribution of each processing step was quantified by different experts (n = 25 from the Aloreña de Málaga table olive sector through a weighted PHSS (PHSSw. The mean value of PHSSw was 65.53% (90th CI: 53.12–77.52%. The final processing steps

  1. Resolving future fire management conflicts using multicriteria decision making.

    Science.gov (United States)

    Driscoll, Don A; Bode, Michael; Bradstock, Ross A; Keith, David A; Penman, Trent D; Price, Owen F

    2016-02-01

    Management strategies to reduce the risks to human life and property from wildfire commonly involve burning native vegetation. However, planned burning can conflict with other societal objectives such as human health and biodiversity conservation. These conflicts are likely to intensify as fire regimes change under future climates and as growing human populations encroach farther into fire-prone ecosystems. Decisions about managing fire risks are therefore complex and warrant more sophisticated approaches than are typically used. We applied a multicriteria decision making approach (MCDA) with the potential to improve fire management outcomes to the case of a highly populated, biodiverse, and flammable wildland-urban interface. We considered the effects of 22 planned burning options on 8 objectives: house protection, maximizing water quality, minimizing carbon emissions and impacts on human health, and minimizing declines of 5 distinct species types. The MCDA identified a small number of management options (burning forest adjacent to houses) that performed well for most objectives, but not for one species type (arboreal mammal) or for water quality. Although MCDA made the conflict between objectives explicit, resolution of the problem depended on the weighting assigned to each objective. Additive weighting of criteria traded off the arboreal mammal and water quality objectives for other objectives. Multiplicative weighting identified scenarios that avoided poor outcomes for any objective, which is important for avoiding potentially irreversible biodiversity losses. To distinguish reliably among management options, future work should focus on reducing uncertainty in outcomes across a range of objectives. Considering management actions that have more predictable outcomes than landscape fuel management will be important. We found that, where data were adequate, an MCDA can support decision making in the complex and often conflicted area of fire management. © 2015

  2. Breeding and maintaining high-quality insects

    DEFF Research Database (Denmark)

    Jensen, Kim; Kristensen, Torsten Nygård; Heckmann, Lars-Henrik

    2017-01-01

    Insects have a large potential for sustainably enhancing global food and feed production, and commercial insect production is a rising industry of high economic value. Insects suitable for production typically have fast growth, short generation time, efficient nutrient utilization, high...... reproductive potential, and thrive at high density. Insects may cost-efficiently convert agricultural and industrial food by-products into valuable protein once the technology is finetuned. However, since insect mass production is a new industry, the technology needed to efficiently farm these animals is still...... in a starting phase. Here, we discuss the challenges and precautions that need to be considered when breeding and maintaining high-quality insect populations for food and feed. This involves techniques typically used in domestic animal breeding programs including maintaining genetically healthy populations...

  3. Real-time decision support and information gathering system for financial domain

    Science.gov (United States)

    Tseng, Chiu-Che; Gmytrasiewicz, Piotr J.

    2006-05-01

    The challenge of the investment domain is that a large amount of diverse information can be potentially relevant to an investment decision, and that, frequently, the decisions have to be made in a timely manner. This presents the potential for better decision support, but poses the challenge of building a decision support agent that gathers information from different sources and incorporates it for timely decision support. These problems motivate us to investigate ways in which the investors can be equipped with a flexible real-time decision support system to be practical in time-critical situations. The flexible real-time decision support system considers a tradeoff between decision quality and computation cost. For this purpose, we propose a system that uses the object oriented Bayesian knowledge base (OOBKB) design to create a decision model at the most suitable level of detail to guide the information gathering activities, and to produce an investment recommendation within a reasonable length of time. The decision models our system uses are implemented as influence diagrams. We validate our system with experiments in a simplified investment domain. The experiments show that our system produces a quality recommendation under different urgency situations. The contribution of our system is that it provides the flexible decision recommendation for an investor under time constraints in a complex environment.

  4. High Quality Virtual Reality for Architectural Exhibitions

    DEFF Research Database (Denmark)

    Kreutzberg, Anette

    2016-01-01

    This paper will summarise the findings from creating and implementing a visually high quality Virtual Reality (VR) experiment as part of an international architecture exhibition. It was the aim to represent the architectural spatial qualities as well as the atmosphere created from combining natural...... and artificial lighting in a prominent not yet built project. The outcome is twofold: Findings concerning the integration of VR in an exhibition space and findings concerning the experience of the virtual space itself. In the exhibition, an important aspect was the unmanned exhibition space, requiring the VR...... experience to be self-explanatory. Observations of different visitor reactions to the unmanned VR experience compared with visitor reactions at guided tours with personal instructions are evaluated. Data on perception of realism, spatial quality and light in the VR model were collected with qualitative...

  5. Decision-Making in Patients with Hyperthyroidism: A Neuropsychological Study.

    Science.gov (United States)

    Yuan, Lili; Tian, Yanghua; Zhang, Fangfang; Ma, Huijuan; Chen, Xingui; Dai, Fang; Wang, Kai

    2015-01-01

    Cognitive and behavioral impairments are common in patients with abnormal thyroid function; these impairments cause a reduction in their quality of life. The current study investigates the decision making performance in patients with hyperthyroidism to explore the possible mechanism of their cognitive and behavioral impairments. Thirty-eight patients with hyperthyroidism and forty healthy control subjects were recruited to perform the Iowa Gambling Task (IGT), which assessed decision making under ambiguous conditions. Patients with hyperthyroidism had a higher score on the Zung Self-Rating Anxiety Scale (Z-SAS), and exhibited poorer executive function and IGT performance than did healthy control subjects. The patients preferred to choose decks with a high immediate reward, despite a higher future punishment, and were not capable of effectively using feedback information from previous choices. No clinical characteristics were associated with the total net score of the IGT in the current study. Patients with hyperthyroidism had decision-making impairment under ambiguous conditions. The deficits may result from frontal cortex and limbic system metabolic disorders and dopamine dysfunction.

  6. Decision-Making in Patients with Hyperthyroidism: A Neuropsychological Study

    Science.gov (United States)

    Zhang, Fangfang; Ma, Huijuan; Chen, Xingui; Dai, Fang; Wang, Kai

    2015-01-01

    Introduction Cognitive and behavioral impairments are common in patients with abnormal thyroid function; these impairments cause a reduction in their quality of life. The current study investigates the decision making performance in patients with hyperthyroidism to explore the possible mechanism of their cognitive and behavioral impairments. Methods Thirty-eight patients with hyperthyroidism and forty healthy control subjects were recruited to perform the Iowa Gambling Task (IGT), which assessed decision making under ambiguous conditions. Results Patients with hyperthyroidism had a higher score on the Zung Self-Rating Anxiety Scale (Z-SAS), and exhibited poorer executive function and IGT performance than did healthy control subjects. The patients preferred to choose decks with a high immediate reward, despite a higher future punishment, and were not capable of effectively using feedback information from previous choices. No clinical characteristics were associated with the total net score of the IGT in the current study. Conclusions Patients with hyperthyroidism had decision-making impairment under ambiguous conditions. The deficits may result from frontal cortex and limbic system metabolic disorders and dopamine dysfunction. PMID:26090955

  7. [Transparency in public health decision-making].

    Science.gov (United States)

    García-Altés, Anna; Argimon, Josep M

    2016-11-01

    Improving the quality and transparency of governmental healthcare decision-making has an impact on the health of the population through policies, organisational management and clinical practice. Moreover, the comparison between healthcare centres and the transparent feedback of results to professionals and to the wider public contribute directly to improved results. The "Results Centre" of the Catalan healthcare system measures and disseminates the results achieved by the different healthcare centres in order to facilitate a shared decision-making process, thereby enhancing the quality of healthcare provided to the population of Catalonia (Spain). This is a pioneering initiative in Spain and is aligned with the most advanced countries in terms of policies of transparency and accountability. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Measuring earnings quality: Evidence from New Zealand

    Directory of Open Access Journals (Sweden)

    Muhammad Nurul Houqe

    2011-01-01

    Full Text Available We utilize two basic approaches to measure the quality of earnings which control two different dimensions of earnings management. The research design is structured primary on the basis of calculating two different measures of the quality of earnings on the industry level and on the company level. We calculate earnings quality for New Zealand public firms from the OSIRIS (http://www.osiris.com database for 2004-2007. This research concludes that various stakeholders should apply more than one measure for the quality of earning in order to have strong evidence about the level of quality before taking any corrective action or making any decision related to that company. If one company is having low quality of earning according to one technique and high quality of earnings according to another, the stakeholders cannot have a final conclusion about that company and they need more investigations and analysis to assess the quality of earnings

  9. [Shared decision-making in medical practice--patient-centred communication skills].

    Science.gov (United States)

    van Staveren, Remke

    2011-01-01

    Most patients (70%) want to participate actively in important healthcare decisions, the rest (30%) prefer the doctor to make the decision for them. Shared decision-making provides more patient satisfaction, a better quality of life and contributes to a better doctor-patient relationship. Patients making their own decision generally make a well considered and medically sensible choice. In shared decision-making the doctor asks many open questions, gives and requests much information, asks if the patient wishes to participate in the decision-making and explicitly takes into account patient circumstances and preferences. Shared decision-making should remain an individual choice and should not become a new dogma.

  10. The influence of the NPD architecture on NPD decision-making in high and low technology markets

    DEFF Research Database (Denmark)

    Jespersen, Kristina Risom

    on the market. Therefore the paper investigates the influence of a stage-gate structure and cross-functional teamwork on the go/no-go decision-making within the phases of the development process for different market conditions. Data is collected with an Internet survey questionnaire from 43 large companies...... and controlling the decision-making in the NPD process thereby reducing the risk of new products failing on the market. Research finds that the structure of the new product development process and a high interaction between organizational units when developing new products enhance the likelihood of success...... on high and low technology market producing consumer products. Results reveal that the survival of product ideas within the NPD process is significant different for companies in high and low technology markets, but that the stage-gate structure of the new product development process is of less importance...

  11. A simple threshold rule is sufficient to explain sophisticated collective decision-making.

    Directory of Open Access Journals (Sweden)

    Elva J H Robinson

    Full Text Available Decision-making animals can use slow-but-accurate strategies, such as making multiple comparisons, or opt for simpler, faster strategies to find a 'good enough' option. Social animals make collective decisions about many group behaviours including foraging and migration. The key to the collective choice lies with individual behaviour. We present a case study of a collective decision-making process (house-hunting ants, Temnothorax albipennis, in which a previously proposed decision strategy involved both quality-dependent hesitancy and direct comparisons of nests by scouts. An alternative possible decision strategy is that scouting ants use a very simple quality-dependent threshold rule to decide whether to recruit nest-mates to a new site or search for alternatives. We use analytical and simulation modelling to demonstrate that this simple rule is sufficient to explain empirical patterns from three studies of collective decision-making in ants, and can account parsimoniously for apparent comparison by individuals and apparent hesitancy (recruitment latency effects, when available nests differ strongly in quality. This highlights the need to carefully design experiments to detect individual comparison. We present empirical data strongly suggesting that best-of-n comparison is not used by individual ants, although individual sequential comparisons are not ruled out. However, by using a simple threshold rule, decision-making groups are able to effectively compare options, without relying on any form of direct comparison of alternatives by individuals. This parsimonious mechanism could promote collective rationality in group decision-making.

  12. A simple threshold rule is sufficient to explain sophisticated collective decision-making.

    Science.gov (United States)

    Robinson, Elva J H; Franks, Nigel R; Ellis, Samuel; Okuda, Saki; Marshall, James A R

    2011-01-01

    Decision-making animals can use slow-but-accurate strategies, such as making multiple comparisons, or opt for simpler, faster strategies to find a 'good enough' option. Social animals make collective decisions about many group behaviours including foraging and migration. The key to the collective choice lies with individual behaviour. We present a case study of a collective decision-making process (house-hunting ants, Temnothorax albipennis), in which a previously proposed decision strategy involved both quality-dependent hesitancy and direct comparisons of nests by scouts. An alternative possible decision strategy is that scouting ants use a very simple quality-dependent threshold rule to decide whether to recruit nest-mates to a new site or search for alternatives. We use analytical and simulation modelling to demonstrate that this simple rule is sufficient to explain empirical patterns from three studies of collective decision-making in ants, and can account parsimoniously for apparent comparison by individuals and apparent hesitancy (recruitment latency) effects, when available nests differ strongly in quality. This highlights the need to carefully design experiments to detect individual comparison. We present empirical data strongly suggesting that best-of-n comparison is not used by individual ants, although individual sequential comparisons are not ruled out. However, by using a simple threshold rule, decision-making groups are able to effectively compare options, without relying on any form of direct comparison of alternatives by individuals. This parsimonious mechanism could promote collective rationality in group decision-making.

  13. A Comparison of the Decision Quality of Group Decisions Made in a Face-to-Face Environment with Decisions Made Using a Distributed Group Decision Support System

    National Research Council Canada - National Science Library

    Cullen, Hope

    1997-01-01

    The Air Force is increasingly turning to a team approach for decision making. When team members are geographically separated it can be expensive for them to meet in a traditional face to face setting...

  14. Use of Integrative Oncology, Involvement in Decision-Making, and Breast Cancer Survivor Health-Related Quality of Life in the First 5 Years Postdiagnosis.

    Science.gov (United States)

    Andersen, M Robyn; Sweet, Erin; Hager, Shelly; Gaul, Marcia; Dowd, Fred; Standish, Leanna J

    2018-03-01

    This study sought to describe changes in the health-related quality of life (HRQOL) of women who do and do not seek naturopathic oncology (NO) complementary and alternative medicine (CAM) care during and immediately after breast cancer treatment, and to explore the predictive role of NO CAM care, demographic characteristics, and involvement in decision-making on HRQOL in breast cancer survivors. Matched cohorts of breast cancer survivors who did and did not choose to supplement their breast cancer treatment with NO care within 2 years of diagnosis participated. NO users were identified through naturopathic doctors' clinics and usual care (UC) controls with similar prognosis were identified through a cancer registry. The registry provided information about all participants' age, race, ethnicity, marital status, stage of cancer at time of diagnosis, date of diagnosis, and use of conventional medical treatments (surgery, chemotherapy, radiation, and endocrine therapy). Data of participants' self-reported involvement in decision-making and HRQOL were collected at study enrollment and at 6-month follow-up. At 6-month follow-up, the NO patients reported significantly more involvement in decision-making about care and better general health than did UC patients ( P decision-making about cancer treatment was associated with better role-physical, role-emotional, and social-functional well-being ( P decision-making about cancer treatment may be associated with better HRQOL in breast cancer survivors.

  15. Story quality management

    International Nuclear Information System (INIS)

    1976-12-01

    This book is written to explain quality management using stories, which have each story about quality management. The titles of stories are way to tell the meaning in mind, mom, house wife's meal costs a great deal, good bye digestive medicine, beans cooked in soy sauce, wedding and space rocket, each story is used to give descriptions of quality management like procedure and decision for division of labor, quality guaranteed and histogram.

  16. Preanalytical quality improvement : in quality we trust

    OpenAIRE

    Lippi, Giuseppe; Becan-McBride, Kathleen; Behulova, Darina; Bowen, Raffick A.; Church, Stephen; Delanghe, Joris; Grankvist, Kjell; Kitchen, Steve; Nybo, Mads; Nauck, Matthias; Nikolac, Nora; Palicka, Vladimir; Plebani, Mario; Sandberg, Sverre; Simundic, Ana-Maria

    2013-01-01

    Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and qu...

  17. NATIONAL AND INTERNATIONAL PERSPECTIVES ON THE QUALITY OF ACCOUNTING INFORMATION38

    OpenAIRE

    Assist. Alina Rusu

    2012-01-01

    The primary objective of general purpose financial reporting is to provide high-quality financial information about the reporting entity, useful for economic decision making. Qualitative characteristics of financial statements are the basic attributes that make sense of usefulness of accounting information. In the normalization and accounting doctrine, criteria for defining the concept of quality of accounting information are not identical, their selection and ranking being different. Our res...

  18. Barriers to data quality resulting from the process of coding health information to administrative data: a qualitative study.

    Science.gov (United States)

    Lucyk, Kelsey; Tang, Karen; Quan, Hude

    2017-11-22

    Administrative health data are increasingly used for research and surveillance to inform decision-making because of its large sample sizes, geographic coverage, comprehensivity, and possibility for longitudinal follow-up. Within Canadian provinces, individuals are assigned unique personal health numbers that allow for linkage of administrative health records in that jurisdiction. It is therefore necessary to ensure that these data are of high quality, and that chart information is accurately coded to meet this end. Our objective is to explore the potential barriers that exist for high quality data coding through qualitative inquiry into the roles and responsibilities of medical chart coders. We conducted semi-structured interviews with 28 medical chart coders from Alberta, Canada. We used thematic analysis and open-coded each transcript to understand the process of administrative health data generation and identify barriers to its quality. The process of generating administrative health data is highly complex and involves a diverse workforce. As such, there are multiple points in this process that introduce challenges for high quality data. For coders, the main barriers to data quality occurred around chart documentation, variability in the interpretation of chart information, and high quota expectations. This study illustrates the complex nature of barriers to high quality coding, in the context of administrative data generation. The findings from this study may be of use to data users, researchers, and decision-makers who wish to better understand the limitations of their data or pursue interventions to improve data quality.

  19. Improving decision speed, accuracy and group cohesion through early information gathering in house-hunting ants.

    Directory of Open Access Journals (Sweden)

    Nathalie Stroeymeyt

    Full Text Available BACKGROUND: Successful collective decision-making depends on groups of animals being able to make accurate choices while maintaining group cohesion. However, increasing accuracy and/or cohesion usually decreases decision speed and vice-versa. Such trade-offs are widespread in animal decision-making and result in various decision-making strategies that emphasize either speed or accuracy, depending on the context. Speed-accuracy trade-offs have been the object of many theoretical investigations, but these studies did not consider the possible effects of previous experience and/or knowledge of individuals on such trade-offs. In this study, we investigated how previous knowledge of their environment may affect emigration speed, nest choice and colony cohesion in emigrations of the house-hunting ant Temnothorax albipennis, a collective decision-making process subject to a classical speed-accuracy trade-off. METHODOLOGY/PRINCIPAL FINDINGS: Colonies allowed to explore a high quality nest site for one week before they were forced to emigrate found that nest and accepted it faster than emigrating naïve colonies. This resulted in increased speed in single choice emigrations and higher colony cohesion in binary choice emigrations. Additionally, colonies allowed to explore both high and low quality nest sites for one week prior to emigration remained more cohesive, made more accurate decisions and emigrated faster than emigrating naïve colonies. CONCLUSIONS/SIGNIFICANCE: These results show that colonies gather and store information about available nest sites while their nest is still intact, and later retrieve and use this information when they need to emigrate. This improves colony performance. Early gathering of information for later use is therefore an effective strategy allowing T. albipennis colonies to improve simultaneously all aspects of the decision-making process--i.e. speed, accuracy and cohesion--and partly circumvent the speed-accuracy trade

  20. Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation

    Science.gov (United States)

    Cox, Christopher E.; Lewis, Carmen L.; Hanson, Laura C.; Hough, Catherine L.; Kahn, Jeremy M.; White, Douglas B.; Song, Mi-Kyung; Tulsky, James A.; Carson, Shannon S.

    2013-01-01

    Objective Shared decision making is inadequate in intensive care units (ICUs). Decision aids can improve decision making quality, though their role in an ICU setting is unclear. We aimed to develop and pilot test a decision aid for shared decision makers of patients undergoing prolonged mechanical ventilation. Setting ICUs at three medical centers. Subjects 53 surrogate decision makers and 58 physicians. Design and interventions We developed the decision aid using defined methodological guidelines. After an iterative revision process, formative cognitive testing was performed among surrogate-physician dyads. Next, we compared the decision aid to usual care control in a prospective, before/after design study. Measurements and main results Primary outcomes were physician-surrogate discordance for expected patient survival, comprehension of relevant medical information, and the quality of communication. Compared to control, the intervention group had lower surrogate-physician discordance (7 [10] vs 43 [21]), greater comprehension (11.4 [0.7] vs 6.1 [3.7]), and improved quality of communication (8.7 [1.3] vs 8.4 [1.3]) (all ppost-intervention. Hospital costs were lower in the intervention group ($110,609 vs $178,618; p=0.044); mortality did not differ by group (38% vs 50%, p=0.95). 94% of surrogates and 100% of physicians reported that the decision aid was useful in decision making. Conclusion We developed a prolonged mechanical ventilation decision aid that is feasible, acceptable, and associated with both improved decision making quality and less resource utilization. Further evaluation using a randomized controlled trial design is needed to evaluate the decision aid's effect on long-term patient and surrogate outcomes. PMID:22635048

  1. The Application of Recognition-Primed Decision Theory to Decisions Made in an Outdoor Education Context

    Science.gov (United States)

    Boyes, Mike; Potter, Tom

    2015-01-01

    This research examined the decisions that highly experienced outdoor leaders made on backpacking expeditions conducted by a tertiary institution in the Southern Alps of New Zealand. The purpose of the research was to document decision problems and explore them as Recognition-Primed Decisions (RPD) within naturalistic decision making (NDM)…

  2. Influence of Price and Quality to Customer Satisfaction: Neuromarketing Approach

    Directory of Open Access Journals (Sweden)

    Aurimas Dapkevičius

    2011-04-01

    Full Text Available The purpose of this article is to analyze literature and find out empirical evidence on product price and quality influence on customer satisfaction through neuromarketing approach. Customers’ satisfaction on their purchase is a significant factor that leads business to success. In recent times, customer satisfaction has gained new attention within the context of the paradigm shift from transactional marketing to relationship marketing. Even it is agreed in the literature that price and quality has high effect on customer satisfaction; still there is little empirical evidence exploring this relation. Almost nothing is known about the human neural mechanisms through which it affects the decisions made by individuals. So, in this article there are reviewed two neuromarketing study cases as neuromarketing provides qualitatively different information, ostensibly better quality comparing to that obtained by traditional methods. The whole article reveals that price and quality is an important factor for customer satisfaction which leads to marketing managers’ decisions complexity nowadays as markets are becoming more and more complex and overloaded.Article in English

  3. Can high psychological job demands, low decision latitude, and high job strain predict disability pensions? A 12-year follow-up of middle-aged Swedish workers.

    Science.gov (United States)

    Canivet, Catarina; Choi, BongKyoo; Karasek, Robert; Moghaddassi, Mahnaz; Staland-Nyman, Carin; Östergren, Per-Olof

    2013-04-01

    The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period. We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register. Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04-2.0) and 1.7 in women (95 % CI, 1.3-2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women. High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile.

  4. The conceptual definition of a crisis management decision support system CMDSS

    Energy Technology Data Exchange (ETDEWEB)

    Schenker-Wicki, A G.M.

    1990-01-01

    The Institute for Automation and Operations Research at the University of Fribourg has been charged by the Swiss government to design a concept for a Crisis Management Decision Support System CMDSS to evaluate acceptable countermeasures to reduce ingestion dose after an accidental release of radioactivity and to implement a prototype. The study is divided in two parts. In the first part all the necessary modules and techniques for efficient decision making, based on the most recent developments in decision theory, as well as the necessary structuring of the decision making process are discussed, while in the second part the plausibility of the evaluated system is tested using a case study. For the time being no empirical research has been carried out. The decision making concept presented in this book comprehends decision making on two different levels, a technical and a political one. The division of decision power corresponds to the Swiss legal prescriptions for accidental release of radioactivity. To guarantee decisions of high quality, as many countermeasures as possible have to be presented to the decision makers. Due to the difficulty of evaluating all the possible countermeasures an expert-system is provided for the decision makers to generate the space of alternatives. The use of an expert-system should further help to reduce systematically the huge amount of information which is characteristic in crises situations. To support the comparison and ranking of the different alternatives a multi-criteria approach, the PROMETHEE method, which is based upon outranking relationships, is used. Due to the complexity of the decision making process, its poorly defined mathematical context and the unwillingness of the decision makers to use a method which requires defined substitution rates, decision methods based on utility theory will not be applied in this study. (Abstract Truncated)

  5. Implementing shared decision making in routine mental health care.

    Science.gov (United States)

    Slade, Mike

    2017-06-01

    Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non-maleficence. It is argued that SDM is "polyvalent", a sociological concept which describes an idea commanding superficial but not deep agreement between disparate stakeholders. Implementing SDM in routine mental health services is as much a cultural as a technical problem. Three challenges are identified: creating widespread access to high-quality decision support tools; integrating SDM with other recovery-supporting interventions; and responding to cultural changes as patients develop the normal expectations of citizenship. Two approaches which may inform responses in the mental health system to these cultural changes - social marketing and the hospitality industry - are identified. © 2017 World Psychiatric Association.

  6. Application of multicriteria decision making methods to air quality in the microenvironments of residential houses in Brisbane, Australia.

    Science.gov (United States)

    Ayoko, Godwin A; Morawska, Lidia; Kokot, Serge; Gilbert, Dale

    2004-05-01

    This paper reports the first application of the multicriteria decision making methods, PROMETHEE and GAIA, to indoor and outdoor air quality data. Fourteen residential houses in a suburb of Brisbane, Australia were investigated for 21 air quality-influencing criteria, which included the characteristics of the houses as well as the concentrations of volatile organic compounds, fungi, bacteria, submicrometer, and supermicrometer particles in their indoor and outdoor air samples. Ranking information necessary to select one house in preference to all others and to assess the parameters influencing the differentiation of the houses was found with the aid of PROMETHEE and GAIA. There was no correlation between the rank order of each house and the health complaints of its occupants. Patterns in GAIA plots show that indoor air quality in these houses is strongly dependent on the characteristics of the houses (construction material, distance of the house from a major road, and the presence of an in-built garage). Marked similarities were observed in the patterns obtained when GAIA and factor analysis were applied to the data. This underscores the potential of PROMETHEE and GAIA to provide information that can assist source apportionment and elucidation of effective remedial measures for indoor air pollution.

  7. [Shared decision-making based on equal information. Patient guidelines as a tool for patient counseling].

    Science.gov (United States)

    Sänger, Sylvia; Kopp, Ina; Englert, Gerhard; Brunsmann, Frank; Quadder, Bernd; Ollenschläger, Günter

    2007-06-15

    In discussions on the quality of cross-sectorial health-care services high importance is attributed to patient education and patient counseling, with guideline-based patient information being considered a crucial tool. Guideline-based patient information is supposed to serve patients as a decision-making basis and, in addition, to also support the implementation of the guidelines themselves. The article highlights how patient guidelines for National Disease Management Guidelines in Germany--within the scope of patient education and patient counseling--may provide a uniform information platform for physicians and patients aiming to promote shared decision-making. The authors will also address the issue which contents should be included in patient guidelines in order to meet these requirements and which measures are required to review their quality. The present paper continues the series of articles on the Program for German National Disease Management Guidelines.

  8. How decision analysis can further nanoinformatics.

    Science.gov (United States)

    Bates, Matthew E; Larkin, Sabrina; Keisler, Jeffrey M; Linkov, Igor

    2015-01-01

    The increase in nanomaterial research has resulted in increased nanomaterial data. The next challenge is to meaningfully integrate and interpret these data for better and more efficient decisions. Due to the complex nature of nanomaterials, rapid changes in technology, and disunified testing and data publishing strategies, information regarding material properties is often illusive, uncertain, and/or of varying quality, which limits the ability of researchers and regulatory agencies to process and use the data. The vision of nanoinformatics is to address this problem by identifying the information necessary to support specific decisions (a top-down approach) and collecting and visualizing these relevant data (a bottom-up approach). Current nanoinformatics efforts, however, have yet to efficiently focus data acquisition efforts on the research most relevant for bridging specific nanomaterial data gaps. Collecting unnecessary data and visualizing irrelevant information are expensive activities that overwhelm decision makers. We propose that the decision analytic techniques of multicriteria decision analysis (MCDA), value of information (VOI), weight of evidence (WOE), and portfolio decision analysis (PDA) can bridge the gap from current data collection and visualization efforts to present information relevant to specific decision needs. Decision analytic and Bayesian models could be a natural extension of mechanistic and statistical models for nanoinformatics practitioners to master in solving complex nanotechnology challenges.

  9. Analyzing Decision Logs to Understand Decision Making in Serious Crime Investigations.

    Science.gov (United States)

    Dando, Coral J; Ormerod, Thomas C

    2017-12-01

    Objective To study decision making by detectives when investigating serious crime through the examination of decision logs to explore hypothesis generation and evidence selection. Background Decision logs are used to record and justify decisions made during serious crime investigations. The complexity of investigative decision making is well documented, as are the errors associated with miscarriages of justice and inquests. The use of decision logs has not been the subject of an empirical investigation, yet they offer an important window into the nature of investigative decision making in dynamic, time-critical environments. Method A sample of decision logs from British police forces was analyzed qualitatively and quantitatively to explore hypothesis generation and evidence selection by police detectives. Results Analyses revealed diversity in documentation of decisions that did not correlate with case type and identified significant limitations of the decision log approach to supporting investigative decision making. Differences emerged between experienced and less experienced officers' decision log records in exploration of alternative hypotheses, generation of hypotheses, and sources of evidential inquiry opened over phase of investigation. Conclusion The practical use of decision logs is highly constrained by their format and context of use. Despite this, decision log records suggest that experienced detectives display strategic decision making to avoid confirmation and satisficing, which affect less experienced detectives. Application Potential applications of this research include both training in case documentation and the development of new decision log media that encourage detectives, irrespective of experience, to generate multiple hypotheses and optimize the timely selection of evidence to test them.

  10. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  11. Qualidade de vida e medidas de utilidade: parâmetros clínicos para as tomadas de decisão em saúde Quality of life and utility measures: clinical parameters for decision-making in health

    Directory of Open Access Journals (Sweden)

    Alessandro Gonçalves Campolina

    2006-02-01

    Full Text Available In recent decades, the international scientific community has become increasingly interested in the concept of quality of life. One of the most important implications of the focus on quality of life is a shift from "cure" to "a guarantee of a better life" as a health care goal, as well as the inclusion of individuals' preferences for certain health states in the decision-making process associated with treatments, diagnostic strategies, and health spending. This is especially important as the prevalence of chronic diseases increases as a result of the aging of the population. This piece describes the main concepts and applications related to this new health paradigm, including quality of life itself, utility measures, quality-adjusted life years (QALYs, and health decision analysis.

  12. Parental Decision-Making Preferences in Neonatal Intensive Care.

    Science.gov (United States)

    Weiss, Elliott Mark; Barg, Frances K; Cook, Noah; Black, Emily; Joffe, Steven

    2016-12-01

    To explore how characteristics of medical decisions influence parents' preferences for control over decisions for their seriously ill infants. In qualitative interviews, parents of infants in the neonatal intensive care unit (NICU) were asked to consider all medical decisions they could recall, and were prompted with decisions commonly encountered in the NICU. For each decision, parents were asked detailed questions about who made each decision, whom they would have preferred to make the decision, and why. Using standard qualitative methods, responses were coded and organized such that decision-level characteristics could be analyzed according to preferred decision-making role. Parents identified 2 factors that were associated with a preference to delegate decisions to the medical team (high degree of urgency, high level of required medical expertise) and 4 factors associated with a preference to retain parental control (high perceived risk, high personal experience with the decision, involvement of foreign bodily fluids, and similarity to decisions that they perceived as part of the normal parental role). Characteristics of decisions influence preferences for control over medical decisions among parents of patients in the NICU. These insights may guide improvements in physician-parent communication and consent. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Integration study of high quality teaching resources in universities

    Directory of Open Access Journals (Sweden)

    Honglu Liu

    2012-12-01

    Full Text Available Purpose: The development level and quality of education depend on the merits and efficiency in the use of teaching resources, especially in the case of obvious contradiction between the demand and supply of teaching resources. So to integrate teaching resources, improve the efficiency in the use of high quality teaching resources, and take the road of content development to enhance the competitiveness of education has become very important and urgent.Design/methodology/approach: On the basis of analysis on the teaching resources of universities and the problems they faced, this paper introduced the basic concepts of cloud storage, and built the integration architecture of high quality teaching resources in universities based on the cloud storage.Findings and Originality/value: The HDFS-based cloud storage proposed in this paper is a dynamically adjustable and Internet-based storage solution, and the users can access storage targets using the network through a common and easy-to-use protocol and application programming interfaces. This new technology is useful for end users benefits. With the continuous development and improvement of cloud storage, it will necessarily result in more and more applications in the institutions of higher learning and education network.Originality/value: This paper introduced the cloud storage into the integration of high quality teaching resources in universities first and as a new form of service, it can be a good solution.

  14. Using Decision Analysis to Understand the Indications for Unilateral Hand Transplantation

    Science.gov (United States)

    McClelland, Brett; Novak, Christine B.; Hanna, Steven; McCabe, Steven J.

    2016-01-01

    Background: Upper extremity transplantation has been performed to improve quality of life, the benefit which must be traded off for the risk created by life-long immunosuppression. We believe the process of decision analysis is well suited to improve our understanding of these trade-offs. Method: We created a decision tree to include a branch point to illustrate the expected recovery of useful function in the transplant, using the best estimates for utility and probability that exist. Results: Our model revealed that when the probability of achieving a good result, graded as Chen level one or two is greater than 73%, transplantation is preferred over no transplantation. The decision is sensitive to the probability of major complications and the utility of a transplanted limb with minimal function. Conclusions: The results of this analysis show that under some circumstances given a high probability of satisfactory functional recovery, unilateral hand transplantation can be justified. PMID:28149213

  15. Group Decisions in Value Management

    Directory of Open Access Journals (Sweden)

    Christiono Utomo

    2015-04-01

    Full Text Available This research deals with a technique to expedite group decision making during the selection of technical solutions for value management process. Selection of a solution from a set of alternatives is facilitated by evaluating using multicriteria decision making techniques. During the process, every possible solution is rated on criteria of function and cost. Function deals more with quality than with quantity, and cost can be calculated based on the theoretical time value of money. Decision-making techniques based on satisfying games are applied to determine the relative function and cost of solutions and hence their relative value. The functions were determined by function analysis system technique. Analytical hierarchy process was applied to decision making and life-cycle cost analysis were used to calculate cost. Cooperative decision making was shown to consist of identifying agreement options, analyzing, and forming coalitions. The objective was attained using the satisfying game model as a basis for two main preferences. The model will improve the value of decision regarding design. It further emphasizes the importance of performance evaluation in the design process and value analysis. The result of the implementation, when applied to the selection of a building wall system, demonstrates a process of selecting the most valuable technical solution as the best-fit option for all decision makers. This work is relevant to group decision making and negotiation, as it aims to provide a framework to support negotiation in design activity.

  16. [Shared medical decision making in gynaecology].

    Science.gov (United States)

    This, P; Panel, P

    2010-02-01

    When two options or more can be chosen in medical care, the final decision implies two steps: facts analysis, and patient evaluation of preferences. Shared Medical Decision-Making is a rational conceptual frame that can be used in such cases. In this paper, we describe the concept, its practical modalities, and the questions raised by its use. In gynaecology, many medical situations involve "sensitive preferences choice": for example, contraceptive choice, menorrhagia treatment, and approach of menopause. Some tools from the "Shared Medical Decision Making" concept are useful to structure medical consultations, to convey information, and to reveal patients preferences. Decision aid are used in clinical research settings, but some of them may also be easily used in usual practice, and help physicians to improve both quality and traceability of the decisional process. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  17. Policy Implications for Continuous Employment Decisions of High School Principals: An Alternative Methodological Approach for Using High-Stakes Testing Outcomes

    Science.gov (United States)

    Young, I. Phillip; Fawcett, Paul

    2013-01-01

    Several teacher models exist for using high-stakes testing outcomes to make continuous employment decisions for principals. These models are reviewed, and specific flaws are noted if these models are retrofitted for principals. To address these flaws, a different methodology is proposed on the basis of actual field data. Specially addressed are…

  18. Decision making in urological surgery.

    Science.gov (United States)

    Abboudi, Hamid; Ahmed, Kamran; Normahani, Pasha; Abboudi, May; Kirby, Roger; Challacombe, Ben; Khan, Mohammed Shamim; Dasgupta, Prokar

    2012-06-01

    Non-technical skills are important behavioural aspects that a urologist must be fully competent at to minimise harm to patients. The majority of surgical errors are now known to be due to errors in judgment and decision making as opposed to the technical aspects of the craft. The authors reviewed the published literature regarding decision-making theory and in practice related to urology as well as the current tools available to assess decision-making skills. Limitations include limited number of studies, and the available studies are of low quality. Decision making is the psychological process of choosing between alternative courses of action. In the surgical environment, this can often be a complex balance of benefit and risk within a variable time frame and dynamic setting. In recent years, the emphasis of new surgical curriculums has shifted towards non-technical surgical skills; however, the assessment tools in place are far from objective, reliable and valid. Surgical simulators and video-assisted questionnaires are useful methods for appraisal of trainees. Well-designed, robust and validated tools need to be implemented in training and assessment of decision-making skills in urology. Patient safety can only be ensured when safe and effective decisions are made.

  19. Robust stochastic fuzzy possibilistic programming for environmental decision making under uncertainty

    International Nuclear Information System (INIS)

    Zhang, Xiaodong; Huang, Guo H.; Nie, Xianghui

    2009-01-01

    Nonpoint source (NPS) water pollution is one of serious environmental issues, especially within an agricultural system. This study aims to propose a robust chance-constrained fuzzy possibilistic programming (RCFPP) model for water quality management within an agricultural system, where solutions for farming area, manure/fertilizer application amount, and livestock husbandry size under different scenarios are obtained and interpreted. Through improving upon the existing fuzzy possibilistic programming, fuzzy robust programming and chance-constrained programming approaches, the RCFPP can effectively reflect the complex system features under uncertainty, where implications of water quality/quantity restrictions for achieving regional economic development objectives are studied. By delimiting the uncertain decision space through dimensional enlargement of the original fuzzy constraints, the RCFPP enhances the robustness of the optimization processes and resulting solutions. The results of the case study indicate that useful information can be obtained through the proposed RCFPP model for providing feasible decision schemes for different agricultural activities under different scenarios (combinations of different p-necessity and p i levels). A p-necessity level represents the certainty or necessity degree of the imprecise objective function, while a p i level means the probabilities at which the constraints will be violated. A desire to acquire high agricultural income would decrease the certainty degree of the event that maximization of the objective be satisfied, and potentially violate water management standards; willingness to accept low agricultural income will run into the risk of potential system failure. The decision variables under combined p-necessity and p i levels were useful for the decision makers to justify and/or adjust the decision schemes for the agricultural activities through incorporation of their implicit knowledge. The results also suggest that

  20. Socioeconomic assessment guidance report: Determining the effects of amenity characteristics on business location decisions

    Energy Technology Data Exchange (ETDEWEB)

    Allison, T.

    1993-02-01

    Evaluating perception-based impacts of hazardous waste facilities has become an increasingly important part of socioeconomic impact assessments in recent years. One area of discussion has been the potential effect of risk perceptions on business location decision making. This report evaluates the importance of environmental amenities (broadly defined to include natural, cultural, and recreational features; environmental quality; and other indexes of quality of life) with respect to decisions on locating both manufacturing and business service activities. It discusses the major theoretical and empirical issues that arise in attempting to determine the effects of environmental amenities on the location choices for businesses and business activities. This discussion is followed by a survey of major findings from the academic literature and a review of research by the state of Nevada. A number of recommendations for further research are also provided to help the US Department of Energy`s Office of Civilian Radioactive Waste Management better understand the importance of perception-based impacts in business location decision making and estimate the scale of socioeconomic impacts that would result from siting a high-level waste repository in Nevada.

  1. Integrating ecosystem-service tradeoffs into land-use decisions.

    Science.gov (United States)

    Goldstein, Joshua H; Caldarone, Giorgio; Duarte, Thomas Kaeo; Ennaanay, Driss; Hannahs, Neil; Mendoza, Guillermo; Polasky, Stephen; Wolny, Stacie; Daily, Gretchen C

    2012-05-08

    Recent high-profile efforts have called for integrating ecosystem-service values into important societal decisions, but there are few demonstrations of this approach in practice. We quantified ecosystem-service values to help the largest private landowner in Hawaii, Kamehameha Schools, design a land-use development plan that balances multiple private and public values on its North Shore land holdings (Island of O'ahu) of ∼10,600 ha. We used the InVEST software tool to evaluate the environmental and financial implications of seven planning scenarios encompassing contrasting land-use combinations including biofuel feedstocks, food crops, forestry, livestock, and residential development. All scenarios had positive financial return relative to the status quo of negative return. However, tradeoffs existed between carbon storage and water quality as well as between environmental improvement and financial return. Based on this analysis and community input, Kamehameha Schools is implementing a plan to support diversified agriculture and forestry. This plan generates a positive financial return ($10.9 million) and improved carbon storage (0.5% increase relative to status quo) with negative relative effects on water quality (15.4% increase in potential nitrogen export relative to status quo). The effects on water quality could be mitigated partially (reduced to a 4.9% increase in potential nitrogen export) by establishing vegetation buffers on agricultural fields. This plan contributes to policy goals for climate change mitigation, food security, and diversifying rural economic opportunities. More broadly, our approach illustrates how information can help guide local land-use decisions that involve tradeoffs between private and public interests.

  2. Is Shared Decision Making for End-of-Life Decisions Associated With Better Outcomes as Compared to Other Forms of Decision Making? A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Negin Hajizadeh MD, MPH

    2016-07-01

    Full Text Available Background: Whether shared decision making (SDM has been evaluated for end-of-life (EOL decisions as compared to other forms of decision making has not been studied. Purpose: To summarize the evidence on SDM being associated with better outcomes for EOL decision making, as compared to other forms of decision making. Data Sources: PubMed, Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and CINAHL databases were searched through April 2014. Study Selection: Studies were selected that evaluated SDM, compared to any other decision making style, for an EOL decision. Data Extraction: Components of SDM tested, comparators to SDM, EOL decision being assessed, and outcomes measured. Data Synthesis: Seven studies met the inclusion criteria (three experimental and four observational studies. Results were analyzed using narrative synthesis. All three experimental studies compared SDM interventions to usual care. The four observational studies compared SDM to doctor-controlled decision making, or reported the correlation between level of SDM and outcomes. Components of SDM specified in each study differed widely, but the component most frequently included was presenting information on the risks/benefits of treatment choices (five of seven studies. The outcome most frequently measured was communication, although with different measurement tools. Other outcomes included decisional conflict, trust, satisfaction, and “quality of dying.” Limitations: We could not analyze the strength of evidence for a given outcome due to heterogeneity in the outcomes reported and measurement tools. Conclusions: There is insufficient evidence supporting SDM being associated with improved outcomes for EOL decisions as opposed to other forms of decision making. Future studies should describe which components of SDM are being tested, outline the comparator decision making style, and use validated tools to measure outcomes.

  3. Legal argumentation and judicial decision making: Empirical evidence from Ecuador

    Directory of Open Access Journals (Sweden)

    José Luis Castro-Montero

    2018-05-01

    Full Text Available Legal scholars often analyze argumentation from a formal perspective, mostly applied to judicial decision making. This article presents an alternative approach, as it empirically evaluates the quality of petitioners’ legal argumentation within the context of abstract constitutional review proceedings. The quality of legal argumentation is herein defined as the ability of the petitioner to (i identify the challenged norm and the potentially infringed constitutional norm, (ii present clear and coherent arguments, and (iii justify its arguments upon legal sources, such as jurisprudential precedents or legal doctrine. Original data on forty lawsuits presented before the Ecuadorian Constitutional Court between 2008 and 2016 is used to test whether legal argumentation determines the outcome of a decision. A novel measure of the overall quality of argumentation and strength of cases brought before the Ecuadorian Constitutional Court by both public and private parties is also developed in the form of an expert survey. The main findings suggest that plaintiffs’ legal argumentation quality does not determine the outcome of the final decision of the Ecuadorian Constitutional Court, but rather the type of plaintiff (public or private does.

  4. Swedish Consumers’ Perception of Food Quality and Sustainability in Relation to Organic Food Production

    Directory of Open Access Journals (Sweden)

    Techane Bosona

    2018-04-01

    Full Text Available Consumers’ demand for locally produced and organic foods has increased in Sweden. This paper presents the results obtained from the analysis of data acquired from 100 consumers in Sweden who participated in an online survey during March to June 2016. The objective was to identify consumers’ demand in relation to organic food and sustainable food production, and to understand how the consumers evaluate food quality and make buying decisions. Qualitative descriptions, descriptive statistics and Pearson’s Chi-square test (with alpha value of p < 0.05 as level of significance, and Pearson’s correlation coefficient were used for analysis. About 72% of participants have the perception that organic food production method is more sustainable than conventional methods. Female consumers have more positive attitudes than men towards organic food. However, age difference, household size and income level do not significantly influence the consumers’ perception of sustainable food production concepts. Regionality, sustainable methods of production and organic production are the most important parameters to characterize the food as high quality and make buying decisions. On the other hand, product uniformity, appearance, and price were found to be relatively less important parameters. Food buying decisions and food quality were found to be highly related with Pearson’s correlation coefficient of r = 0.99.

  5. Strategic Wholesale Pricing and Commonality Strategy in a Supply Chain with Quality Segmentation

    Directory of Open Access Journals (Sweden)

    Tiantian Xu

    2015-01-01

    Full Text Available We develop two game models of a one-supplier and one-manufacturer supply chain to investigate the supplier’s strategic wholesale pricing decision and the manufacturer’s commonality strategy. The manufacturer has three commonality strategies for the high-end and low-end products: common high-quality component, common low-quality component, and dedicated components. We consider both wholesale price first scenario and commonality strategy first scenario. Under the wholesale price first scenario, we identify the range of each commonality strategy and find that (i the common low-quality component strategy is harmful to the supplier; (ii if the quality of low-quality component and the unit production cost of high-quality component are sufficiently low, the supplier induces the common high-quality component strategy by strategically decreasing the unit wholesale price of high-quality component, while if they are sufficiently high, the supplier induces the dedicated components strategy by increasing the unit wholesale price of high-quality component and decreasing that of low-quality one. Under the commonality strategy first scenario, the common low-quality component strategy may exist. By comparing the two scenarios, we find that (i if the unit production cost of low-quality component is medium, the equilibrium outcomes under both scenarios are identical; (ii there exists a first-mover advantage for the two players.

  6. PROBLEMATIC FEATURES OF THE POLITICAL DECISION MAKERS

    OpenAIRE

    Aleksey Sergeevih Voynov

    2014-01-01

    Purpose: identify the most important features in the process of making political decisions that affect the effectiveness of problem-solving situationsScientific novelty: as a result of the analysis identified the problematic features of major importance for the efficiency of the development and adoption of the most rational solution to a problem situation.Results: the analysis of the most significant features affecting the quality of decisions among them the interest of the person making deci...

  7. Acceptance of shared decision making with reference to an electronic library of decision aids (arriba-lib) and its association to decision making in patients: an evaluation study.

    Science.gov (United States)

    Hirsch, Oliver; Keller, Heidemarie; Krones, Tanja; Donner-Banzhoff, Norbert

    2011-07-07

    Decision aids based on the philosophy of shared decision making are designed to help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes. A patient decision aid can be regarded as a complex intervention because it consists of several presumably relevant components. Decision aids have rarely been field tested to assess patients' and physicians' attitudes towards them. It is also unclear what effect decision aids have on the adherence to chosen options. The electronic library of decision aids (arriba-lib) to be used within the clinical encounter has a modular structure and contains evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. We conducted an evaluation study in which 29 primary care physicians included 192 patients. After the consultation, patients filled in questionnaires and were interviewed via telephone two months later. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Patients were highly satisfied with arriba-lib and the process of shared decision making. Two-thirds of patients reached in the telephone interview wanted to be counselled again with arriba-lib. There was a high congruence between preferred and perceived decision making. Of those patients reached in the telephone interview, 80.7% said that they implemented the decision, independent of gender and education. Elderly patients were more likely to say that they implemented the decision. Shared decision making with our multi-modular electronic library of decision aids (arriba-lib) was accepted by a high number of patients. It has positive associations to general aspects of decision making in patients. It can be used for patient groups with a wide range of individual

  8. EXPERT-ANALITICAL MONITORING OF LEARNING PROCESS QUALITY IN HIGH SCHOOL

    Directory of Open Access Journals (Sweden)

    T. M. Korotun

    2010-10-01

    Full Text Available The technological model is proposed for monitoring process of learning process quality in high school compliant with current European and home standards. The mathematical methods are elaborated for diverse activities as to learning process objects quality determination unified support. They self-consistently combine: automatic expert evaluation with Bayesian net and Value tree models; Delphi technique enhancement; best practices for education quality assessment. Quality estimates’ consistency index is introduced for their choice and acceptability analysis. Its permanent increasing over monitoring stages is guaranteed. The tools for these stages’ automatic support are described.

  9. Democracy and Environmental Integration in Decision-Making

    DEFF Research Database (Denmark)

    Figueroa, Maria

    This dissertation presents an evaluation of the democratic qualities of decision-making processes for large transport infrastructure projects in two Scandinavian countries: Denmark and Sweden. The study uncovers criteria from aggregative and deliberative theories of democracy to create a qualitat......This dissertation presents an evaluation of the democratic qualities of decision-making processes for large transport infrastructure projects in two Scandinavian countries: Denmark and Sweden. The study uncovers criteria from aggregative and deliberative theories of democracy to create...... exemplify points of democratic strength and fragility in the decision processes. A robust system of participatory procedures exists, in both countries, as part of the planning tradition or as part of the legally mandatory environmental assessment procedures. This robust system shows fragility for government...... discourses to the state. While the role of civil society in deliberation is crucial, the study accepts that not all that goes on in civil society is conducive either to more democracy or greater environmental integration. The relevant discussion is then how to deal with differences that may have...

  10. Combined microfluidization and ultrasonication: a synergistic protocol for high-efficient processing of SWCNT dispersions with high quality

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Sida, E-mail: s.luo@buaa.edu.cn [Beihang University, School of Mechanical Engineering and Automation (China); Liu, Tao, E-mail: tliu@fsu.edu [Florida State University, High-Performance Materials Institute (United States); Wang, Yong; Li, Liuhe [Beihang University, School of Mechanical Engineering and Automation (China); Wang, Guantao; Luo, Yun [China University of Geosciences, Center of Safety Research, School of Engineering and Technology (China)

    2016-08-15

    High-efficient and large-scale production of high-quality CNT dispersions is necessary for meeting the future needs to develop various CNT-based electronic devices. Herein, we have designed novel processing protocols by combining conventional ultrasonication process with a new microfluidization technique to produce high-quality SWCNT dispersions with improved processing efficiency. To judge the quality of SWCNT dispersions, one critical factor is the degree of exfoliation, which could be quantified by both geometrical dimension of the exfoliated nanotubes and percentage of individual tubes in a given dispersion. In this paper, the synergistic effect of the combined protocols was systematically investigated through evaluating SWCNT dispersions with newly developed characterization techniques, namely preparative ultracentrifuge method (PUM) and simultaneous Raman scattering and photoluminescence spectroscopy (SRSPL). The results of both techniques draw similar conclusions that as compared with either of the processes operated separately, a low-pass microfluidization followed by a reasonable duration of ultrasonication could substantially improve the processing efficiency to produce high-quality SWCNT dispersions with averaged particle length and diameter as small as ~600 and ~2 nm, respectively.Graphical abstract.

  11. Decision-making in product portfolios of pharmaceutical research and development – managing streams of innovation in highly regulated markets

    Science.gov (United States)

    Jekunen, Antti

    2014-01-01

    Decision-making is a core function of any drug development firm. Developing drugs demands a firm to be highly innovative, while at the same time the activity is strictly regulated. Successful drug development offers the right to apply for a long-term patent that confers exclusive marketing rights. This article addresses the issue of what constitutes an adequate portfolio of drugs for a drug development firm and how it might be managed successfully. The paper investigates decision-making in the industry and specifically in the development of oncology drugs from various perspectives: the need for decisions, their timing, decision-making at the project level, the optimal portfolio, tools for portfolio analysis, the evaluation of patents, and finally the importance of the drug portfolio. Drug development decisions as important organizational elements should get more emphasis, and decisions in drug portfolio using modern decision-making methods should be used more widely than what currently happens. Structured, informed decisions would help avoiding late terminations of drugs in Phase III development. An improved research and development pipeline and drug portfolio management are the major elements in the general strategy targeting success. PMID:25364229

  12. Participatory Risk Assessment for Environmental Decision-Making

    International Nuclear Information System (INIS)

    Homan, Jacqueline; Petts, Judith

    2001-01-01

    Recent research, discussion and practice in the role environmental decision-making as an integral part of a democratic society have resulted in legislation, policy and guidance that encourage, and indeed may require, greater participation. The focus of this research paper is to explore these participatory ideas in the context of environmental risk assessment. Participation methods have generic application. However, the importance of fitting method to purpose requires that different contexts and issues relative to the objectives be addressed. In relation to environmental risk assessment these issues include: the complexity of risk issues per se; the inherent uncertainty that dominates any risk assessment; the quantitative nature of many risk assessments and the difficulty of dealing with low probability-high consequence outconies; the possibility of controversy in relation to decisions involving risk and thus the careful attention needed to the process and identification of participants; the traditional role and culture of experts in risk decisions and the challenge of reconciling this with the role of lay knowledge and the potential for the public to act as quality assurers in the risk decision process; the tendency for people to need reassurance when confronted with risk, even during a participation process; the need to acknowledge the public's ability to deal with complex technical issues and the need for information and data to respond to their questions, and the fact that 'risk' per se will often not be the only issue of public concern. The contributions to the risk debate from the social sciences are having considerable influence on the practice of environmental decision-making. Calls for increased stakeholder involvement in risk decisions are requiring greater access to and engagement with environmental risk assessments. Mechanisms for this level of involvement, however, are not well defined. For these aspirational calls to be realised in practice, decision

  13. Participatory Risk Assessment for Environmental Decision-Making

    Energy Technology Data Exchange (ETDEWEB)

    Homan, Jacqueline; Petts, Judith [Univ. of Birmingham (United Kingdom). Centre for Environmental Research and Training; Pollard, Simon; Twigger-Ross, Clare [National Centre for Risk Analysis and Options Appraisal, London (United Kingdom)

    2001-07-01

    Recent research, discussion and practice in the role environmental decision-making as an integral part of a democratic society have resulted in legislation, policy and guidance that encourage, and indeed may require, greater participation. The focus of this research paper is to explore these participatory ideas in the context of environmental risk assessment. Participation methods have generic application. However, the importance of fitting method to purpose requires that different contexts and issues relative to the objectives be addressed. In relation to environmental risk assessment these issues include: the complexity of risk issues per se; the inherent uncertainty that dominates any risk assessment; the quantitative nature of many risk assessments and the difficulty of dealing with low probability-high consequence outconies; the possibility of controversy in relation to decisions involving risk and thus the careful attention needed to the process and identification of participants; the traditional role and culture of experts in risk decisions and the challenge of reconciling this with the role of lay knowledge and the potential for the public to act as quality assurers in the risk decision process; the tendency for people to need reassurance when confronted with risk, even during a participation process; the need to acknowledge the public's ability to deal with complex technical issues and the need for information and data to respond to their questions, and the fact that 'risk' per se will often not be the only issue of public concern. The contributions to the risk debate from the social sciences are having considerable influence on the practice of environmental decision-making. Calls for increased stakeholder involvement in risk decisions are requiring greater access to and engagement with environmental risk assessments. Mechanisms for this level of involvement, however, are not well defined. For these aspirational calls to be realised in

  14. Automatic identification of high impact articles in PubMed to support clinical decision making.

    Science.gov (United States)

    Bian, Jiantao; Morid, Mohammad Amin; Jonnalagadda, Siddhartha; Luo, Gang; Del Fiol, Guilherme

    2017-09-01

    The practice of evidence-based medicine involves integrating the latest best available evidence into patient care decisions. Yet, critical barriers exist for clinicians' retrieval of evidence that is relevant for a particular patient from primary sources such as randomized controlled trials and meta-analyses. To help address those barriers, we investigated machine learning algorithms that find clinical studies with high clinical impact from PubMed®. Our machine learning algorithms use a variety of features including bibliometric features (e.g., citation count), social media attention, journal impact factors, and citation metadata. The algorithms were developed and evaluated with a gold standard composed of 502 high impact clinical studies that are referenced in 11 clinical evidence-based guidelines on the treatment of various diseases. We tested the following hypotheses: (1) our high impact classifier outperforms a state-of-the-art classifier based on citation metadata and citation terms, and PubMed's® relevance sort algorithm; and (2) the performance of our high impact classifier does not decrease significantly after removing proprietary features such as citation count. The mean top 20 precision of our high impact classifier was 34% versus 11% for the state-of-the-art classifier and 4% for PubMed's® relevance sort (p=0.009); and the performance of our high impact classifier did not decrease significantly after removing proprietary features (mean top 20 precision=34% vs. 36%; p=0.085). The high impact classifier, using features such as bibliometrics, social media attention and MEDLINE® metadata, outperformed previous approaches and is a promising alternative to identifying high impact studies for clinical decision support. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. DECIDE: a Decision Support Tool to Facilitate Parents' Choices Regarding Genome-Wide Sequencing.

    Science.gov (United States)

    Birch, Patricia; Adam, S; Bansback, N; Coe, R R; Hicklin, J; Lehman, A; Li, K C; Friedman, J M

    2016-12-01

    We describe the rationale, development, and usability testing for an integrated e-learning tool and decision aid for parents facing decisions about genome-wide sequencing (GWS) for their children with a suspected genetic condition. The online tool, DECIDE, is designed to provide decision-support and to promote high quality decisions about undergoing GWS with or without return of optional incidental finding results. DECIDE works by integrating educational material with decision aids. Users may tailor their learning by controlling both the amount of information and its format - text and diagrams and/or short videos. The decision aid guides users to weigh the importance of various relevant factors in their own lives and circumstances. After considering the pros and cons of GWS and return of incidental findings, DECIDE summarizes the user's responses and apparent preferred choices. In a usability study of 16 parents who had already chosen GWS after conventional genetic counselling, all participants found DECIDE to be helpful. Many would have been satisfied to use it alone to guide their GWS decisions, but most would prefer to have the option of consulting a health care professional as well to aid their decision. Further testing is necessary to establish the effectiveness of using DECIDE as an adjunct to or instead of conventional pre-test genetic counselling for clinical genome-wide sequencing.

  16. Decision-making in product portfolios of pharmaceutical research and development – managing streams of innovation in highly regulated markets

    Directory of Open Access Journals (Sweden)

    Jekunen A

    2014-10-01

    Full Text Available Antti Jekunen Vaasa Oncology Clinic, Vaasa, Finland Abstract: Decision-making is a core function of any drug development firm. Developing drugs demands a firm to be highly innovative, while at the same time the activity is strictly regulated. Successful drug development offers the right to apply for a long-term patent that confers exclusive marketing rights. This article addresses the issue of what constitutes an adequate portfolio of drugs for a drug development firm and how it might be managed successfully. The paper investigates decision-making in the industry and specifically in the development of oncology drugs from various perspectives: the need for decisions, their timing, decision-making at the project level, the optimal portfolio, tools for portfolio analysis, the evaluation of patents, and finally the importance of the drug portfolio. Drug development decisions as important organizational elements should get more emphasis, and decisions in drug portfolio using modern decision-making methods should be used more widely than what currently happens. Structured, informed decisions would help avoiding late terminations of drugs in Phase III development. An improved research and development pipeline and drug portfolio management are the major elements in the general strategy targeting success. Keywords: decision-making, drug development, clinical oncology, product management, pipeline, portfolio, portfolio analysis, company organization

  17. The Influence of Acculturation and Enculturation on Mexican American High School Students' Decision to Apply to College

    Science.gov (United States)

    Castillo, Linda G.; Lopez-Arenas, Araceli; Saldivar, Isaac M.

    2010-01-01

    This study examined the influence of acculturation, enculturation, parental education level, financial concerns, and gender on 106 Mexican American high school students' decisions to apply to college. Results indicated that acculturation and female gender were significant predictors. Implications for interventions with Latino high school students…

  18. 77 FR 54909 - Clean Water Act: Availability of List Decisions

    Science.gov (United States)

    2012-09-06

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9724-6] Clean Water Act: Availability of List Decisions... notice announces EPA's decision to identify certain water quality limited waters and the associated pollutant to be listed pursuant to the Clean Water Act Section 303(d)(2) on New York's list of impaired...

  19. Application of uncertainty and sensitivity analysis to the air quality SHERPA modelling tool

    Science.gov (United States)

    Pisoni, E.; Albrecht, D.; Mara, T. A.; Rosati, R.; Tarantola, S.; Thunis, P.

    2018-06-01

    Air quality has significantly improved in Europe over the past few decades. Nonetheless we still find high concentrations in measurements mainly in specific regions or cities. This dimensional shift, from EU-wide to hot-spot exceedances, calls for a novel approach to regional air quality management (to complement EU-wide existing policies). The SHERPA (Screening for High Emission Reduction Potentials on Air quality) modelling tool was developed in this context. It provides an additional tool to be used in support to regional/local decision makers responsible for the design of air quality plans. It is therefore important to evaluate the quality of the SHERPA model, and its behavior in the face of various kinds of uncertainty. Uncertainty and sensitivity analysis techniques can be used for this purpose. They both reveal the links between assumptions and forecasts, help in-model simplification and may highlight unexpected relationships between inputs and outputs. Thus, a policy steered SHERPA module - predicting air quality improvement linked to emission reduction scenarios - was evaluated by means of (1) uncertainty analysis (UA) to quantify uncertainty in the model output, and (2) by sensitivity analysis (SA) to identify the most influential input sources of this uncertainty. The results of this study provide relevant information about the key variables driving the SHERPA output uncertainty, and advise policy-makers and modellers where to place their efforts for an improved decision-making process.

  20. Dynamics of individual perceptual decisions

    Science.gov (United States)

    Clark, Torin K.; Lu, Yue M.; Karmali, Faisal

    2015-01-01

    Perceptual decision making is fundamental to a broad range of fields including neurophysiology, economics, medicine, advertising, law, etc. Although recent findings have yielded major advances in our understanding of perceptual decision making, decision making as a function of time and frequency (i.e., decision-making dynamics) is not well understood. To limit the review length, we focus most of this review on human findings. Animal findings, which are extensively reviewed elsewhere, are included when beneficial or necessary. We attempt to put these various findings and data sets, which can appear to be unrelated in the absence of a formal dynamic analysis, into context using published models. Specifically, by adding appropriate dynamic mechanisms (e.g., high-pass filters) to existing models, it appears that a number of otherwise seemingly disparate findings from the literature might be explained. One hypothesis that arises through this dynamic analysis is that decision making includes phasic (high pass) neural mechanisms, an evidence accumulator and/or some sort of midtrial decision-making mechanism (e.g., peak detector and/or decision boundary). PMID:26467513