WorldWideScience

Sample records for professionals decision makers

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

    Science.gov (United States)

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

    2014-12-01

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

  2. Providing support to surrogate decision-makers for people living with dementia: Healthcare professional, organisational and community responsibilities.

    Science.gov (United States)

    Shanley, Christopher; Fetherstonhaugh, Deirdre; McAuliffe, Linda; Bauer, Michael; Beattie, Elizabeth

    2017-09-01

    The prevalence of dementia will continue to increase with the ageing of the population. Many people living with dementia will reach a stage where surrogate decision-makers-mostly family carers-will need to make a range of decisions on their behalf. The aim of this study was to learn from surrogate decision-makers how they can be most effectively supported in this role. The study employed a qualitative design using semi-structured face-to-face or telephone interviews with a purposive sample of 34 surrogate decision-makers of people living with dementia. Transcripts of participant interviews were reviewed using a thematic approach to analysis. Four main themes were identified from this analysis: needing greater community awareness of dementia and its impact; intervening early in cognitive decline; relying on health professionals for ongoing support; and seeking and using support from wherever is relevant for each person. Based on this analysis and a review of the literature, we propose a wholistic set of recommendations for the support of surrogate decision-makers. Healthcare professionals need to help family carers understand the likely trajectory of dementia, including the significance of surrogate decision-making. They can support the person living with dementia and their surrogates to undertake advance care planning and they can act as empathic guides during this process. Health and community care organisations need to provide a "key worker" model wherever possible so that the person living with dementia and their surrogate decision-maker do not have to seek support from multiple staff members or organisations. Carer support programmes can routinely include information and resources about surrogate decision-making. Community and government organisations can help people prepare for the possibility of becoming surrogate decision-makers by promoting a greater public awareness and understanding of both dementia and advance care planning. © 2017 John Wiley & Sons Ltd.

  3. Language Assessment Literacy as Professional Competence: The Case of Canadian Admissions Decision Makers

    Directory of Open Access Journals (Sweden)

    Beverly Baker

    2016-06-01

    Full Text Available Abstract This language assessment literacy project involves the collaboration of assessment professionals and admissions officers at higher education institutions across Canada. Following a survey with 20 institutions (Baker, Tsushima, & Wang, 2014, workshops were held at eight institutions across the country dealing with the use of language test scores in university admissions decision making. Recordings of these workshops were analyzed within the typology of workplace knowledge developed by Eraut and his colleagues (Eraut 1994, 2000, 2004a, 2004b; McKee & Eraut, 2012. In addition, participants commented on the usefulness of the workshop materials for their work responsibilities. Results provided insights into a the language assessment literacy (LAL base needed for these specific users, including both propositional and procedural components, and b the possibilities of conceptualizing LAL for these score users as a type of professional workplace competence. Résumé Ce projet de sensibilisation en évaluation linguistique a été effectué avec la collaboration de professionnels de l’évaluation et de responsables des admissions dans les établissements d’enseignement supérieur à travers le Canada. Suite à un sondage effectué auprès de 20 institutions (Baker, Tsushima et Wang, 2014, des ateliers ont été organisés dans huit établissements à travers le pays traitant de l’utilisation des résultats des tests de langue dans la prise des décisions d’admission. Les enregistrements de ces ateliers ont été analysés dans la typologie des connaissances en milieu de travail développé par Eraut et ses collègues (Eraut, 1994, 2000, 2004a, 2004b ; McKee et Eraut, 2012. Les participants ont formulé des observations sur l’utilité du matériel d’atelier pour leurs responsabilités professionnelles. Les résultats nous aident à mieux comprendre a les notions en évaluation de langues les plus pertinentes pour ces utilisateurs sp

  4. What Attracts Decision Makers' Attention?

    DEFF Research Database (Denmark)

    Bentzen, Eric; Christiansen, John K.; Varnes, Claus J.

    2011-01-01

    portfolio meetings. The study seeks to investigate how managers allocate their attention and the role of different factors for their attention. Observations also make it possible to compare prior research and expectations with the actual observed behavior of decision makers. Design....../methodology/approach – The present analysis draws on insights from previous research into decision making in product and portfolio management and studies on organizational decision making. The authors frame why the attention of decision makers is so critical in complex situations. Data for this study were collected through direct......Purpose – Managers' attention is a scarce resource in complex innovation settings. Prior research on the factors to which managers pay attention is mostly based on surveys. The present study aims to address the need for knowledge about the behavior of decision makers based on observations from...

  5. 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

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

    Science.gov (United States)

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

    2013-09-01

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

  7. The DEVELOP National Program: Building Dual Capacity in Decision Makers and Young Professionals Through NASA Earth Observations

    Science.gov (United States)

    Childs, L. M.; Rogers, L.; Favors, J.; Ruiz, M.

    2012-12-01

    Through the years, NASA has played a distinct/important/vital role in advancing Earth System Science to meet the challenges of environmental management and policy decision making. Within NASA's Earth Science Division's Applied Sciences' Program, the DEVELOP National Program seeks to extend NASA Earth Science for societal benefit. DEVELOP is a capacity building program providing young professionals and students the opportunity to utilize NASA Earth observations and model output to demonstrate practical applications of those resources to society. Under the guidance of science advisors, DEVELOP teams work in alignment with local, regional, national and international partner organizations to identify the widest array of practical uses for NASA data to enhance related management decisions. The program's structure facilitates a two-fold approach to capacity building by fostering an environment of scientific and professional development opportunities for young professionals and students, while also providing end-user organizations enhanced management and decision making tools for issues impacting their communities. With the competitive nature and growing societal role of science and technology in today's global workplace, DEVELOP is building capacity in the next generation of scientists and leaders by fostering a learning and growing environment where young professionals possess an increased understanding of teamwork, personal development, and scientific/professional development and NASA's Earth Observation System. DEVELOP young professionals are partnered with end user organizations to conduct 10 week feasibility studies that demonstrate the use of NASA Earth science data for enhanced decision making. As a result of the partnership, end user organizations are introduced to NASA Earth Science technologies and capabilities, new methods to augment current practices, hands-on training with practical applications of remote sensing and NASA Earth science, improved remote

  8. Cost Accounting for Decision Makers.

    Science.gov (United States)

    Kaneklides, Ann L.

    1985-01-01

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

  9. A scientist's guide to engaging decision makers

    Science.gov (United States)

    Vano, J. A.

    2015-12-01

    Being trained as a scientist provides many valuable tools needed to address society's most pressing environmental issues. It does not, however, provide training on one of the most critical for translating science into action: the ability to engage decision makers. Engagement means different things to different people and what is appropriate for one project might not be for another. However, recent reports have emphasized that for research to be most useful to decision making, engagement should happen at the beginning and throughout the research process. There are an increasing number of boundary organizations (e.g., NOAA's Regional Integrated Sciences and Assessment program, U.S. Department of the Interior's Climate Science Centers) where engagement is encouraged and rewarded, and scientists are learning, often through trial and error, how to effectively include decision makers (a.k.a. stakeholders, practitioners, resource managers) in their research process. This presentation highlights best practices and practices to avoid when scientists engage decision makers, a list compiled through the personal experiences of both scientists and decision makers and a literature review, and how this collective knowledge could be shared, such as through a recent session and role-playing exercise given at the Northwest Climate Science Center's Climate Boot Camp. These ideas are presented in an effort to facilitate conversations about how the science community (e.g., AGU researchers) can become better prepared for effective collaborations with decision makers that will ultimately result in more actionable science.

  10. 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".

  11. Learning a decision maker's utility function from (possibly) inconsistent behavior

    DEFF Research Database (Denmark)

    Nielsen, Thomas Dyhre; Jensen, Finn Verner

    2004-01-01

    When modeling a decision problem using the influence diagram framework, thequantitative part rests on two principal components: probabilities forrepresenting the decision maker's uncertainty about the domain andutilities for representing preferences. Over the last decade, several methodshave been...

  12. An Investigation into the Decision Makers's Risk Attitude Index ...

    African Journals Online (AJOL)

    Numerical computation reveals that for a benchmark problem, the decision maker's risk attitude index ranking method produces unrealistic results when the decision maker's attitude towards risk was neutral. However, a modified problem derived from the benchmark problem produced realistic results. The study shows that ...

  13. Criminal Liability of Political Decision-Makers in the Netherlands

    NARCIS (Netherlands)

    Geelhoed, Willem; Zimmermann, Frank

    2017-01-01

    Dutch criminal law does not provide for criminal liability for a political decision-maker who decides to build a bridge, if thereafter the project runs out of control or the bridge appears not to justify the funds spent on the project. This is most probably even the case if the decision-maker knew

  14. Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role.

    Science.gov (United States)

    Trees, April R; Ohs, Jennifer E; Murray, Meghan C

    2017-06-07

    End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker's role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making.

  15. Information processing by networks of quantum decision makers

    Science.gov (United States)

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

    2018-02-01

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

  16. Programmable DNA-mediated decision maker

    OpenAIRE

    Shu, Jian-Jun; Wang, Qi-Wen; Yong, Kian-Yan

    2017-01-01

    DNA-mediated computing is a novel technology that seeks to capitalize on the enormous informational capacity of DNA and has tremendous computational ability to compete with the current silicon-mediated computing, due to massive parallelism and unique characteristics inherent in DNA interaction. In this paper, the methodology of DNA-mediated computing is utilized to enrich decision theory, by demonstrating how a novel programmable DNA-mediated normative decision-making apparatus is able to cap...

  17. Knowledge and Innovation of Decision Makers

    Science.gov (United States)

    1982-07-01

    so, the participants were dissatisfied with some as- pects of decision and game theory in the context of complex processes. At this stage , TDS was...conversation between the analyst and the client is regarded as a means to the end of obtaining a decision theoretic model in orderly stages ; by eliciting a...the experimental methods of Piaget , in Switzerland, and the accompanying epis- temology are better known but tend to be diluted and, with few exceptions

  18. 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...

  19. Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role

    Directory of Open Access Journals (Sweden)

    April R. Trees

    2017-06-01

    Full Text Available End-of-life (EOL decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker’s role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making.

  20. Training Conservation Practitioners to be Better Decision Makers

    Directory of Open Access Journals (Sweden)

    Fred A. Johnson

    2015-06-01

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

  1. "Did I make the right decision?": The difficult and unpredictable journey of being a surrogate decision maker for a person living with dementia.

    Science.gov (United States)

    Fetherstonhaugh, Deirdre; McAuliffe, Linda; Shanley, Christopher; Bauer, Michael; Beattie, Elizabeth

    2017-01-01

    Many people living with dementia eventually lose the capacity to make their own decisions and will rely on another person - a surrogate decision maker - to make decisions on their behalf. It is important - especially with the increasing prevalence of dementia - that the role of surrogate decision maker is understood and supported. This qualitative study explored the experiences of 34 surrogate decision makers of persons living with dementia in Australia. Face-to-face and telephone interviews were conducted over six months in 2014. Five themes were identified: becoming the only - or main - surrogate decision maker; growing into the role of surrogate decision maker; dealing with the stress of making decisions; having to challenge healthcare professionals; and getting support - or not - from family members. An overarching construct tying the themes together is the description of the participants' experience as being on a difficult and unpredictable journey. Healthcare professionals can provide support by acting as empathic guides on this journey.

  2. African Researchers and Decision-Makers: Building Synergy for ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2009-01-01

    Jan 1, 2009 ... This short and accessible book is essential reading for anyone interested in … the importance of synergy between researchers and decision-makers in Africa and how this can contribute to development. It highlights the key constraints why research is not used in policy development but also presents ...

  3. Empowering Health Care Decision-makers to Achieve Regional ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Empowering Health Care Decision-makers to Achieve Regional Needs for Tobacco Control in Latin America ... This project builds on earlier work on the development and validation of an economic model to estimate the social, economic, and health burden of tobacco, together with the expected impact of tax increases in ...

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

    Science.gov (United States)

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

    2016-12-01

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

  5. The Decision-Makers' Forum on a new paradigm for nuclear energy -- Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Motloch, C.G.

    1998-09-14

    The Decision-Makers' Forum on a New Paradigm for Nuclear Energy was created in response to the challenge by Sen. Pete V. Domenici to begin, ``a new dialogue with serious discussion about the full range of nuclear technologies.'' Sponsored by the Senate Nuclear Issues Caucus, the Forum was organized and facilitated by the Idaho National Engineering and Environmental Laboratory. The participants were decision-makers and key staff from industry, government, the national laboratories, academia and professional societies. Overall, the Forum was designed to capture the ideas of a large number of decision-makers about the high priority actions recommended to help set a new national agenda for nuclear energy. The Forum recommended 10 priority actions toward this end.

  6. The Decision-Makers Forum on a new Paradigm for Nuclear Energy, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Motloch, Chester George

    1998-09-01

    The Decision-Makers' Forum on a New Paradigm for Nuclear Energy was created in response to the challenge by Sen. Pete V. Domenici to begin, "a new dialogue with serious discussion about the full range of nuclear technologies." Sponsored by the Senate Nuclear Issues Caucus, the Forum was organized and facilitated by the Idaho National Engineering and Environmental Laboratory. The participants were decision-makers and key staff from industry, government, the national laboratories, academia and professional societies. Overall, the Forum was designed to capture the ideas of a large number of decision-makers about the high priority actions recommended to help set a new national agenda for nuclear energy. The Forum recommended 10 priority actions toward this end.

  7. Strategic issues in information technology international implications for decision makers

    CERN Document Server

    Schütte, Hellmut

    1988-01-01

    Strategic Issues in Information Technology: International Implications for Decision Makers presents the significant development of information technology in the output of components, computers, and communication equipment and systems. This book discusses the integration of information technology into factories and offices to increase productivity.Organized into six parts encompassing 12 chapters, this book begins with an overview of the advancement towards an automated interpretation communication system to achieve real international communication. This text then examines the main determining

  8. Surrogate decision makers' responses to physicians' predictions of medical futility.

    Science.gov (United States)

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

    2009-07-01

    Although physicians sometimes use the futility rationale to limit the use of life-sustaining treatments, little is known about how surrogate decision makers view this rationale. We sought to determine the attitudes of surrogates of patients who are critically ill toward whether physicians can predict futility and whether these attitudes predict surrogates' willingness to discontinue life support when faced with predictions of futility. This multicenter, mixed qualitative and quantitative study took place at three hospitals in California from 2006 to 2007. We conducted semistructured interviews with surrogate decision makers for 50 patients who were critically ill and incapacitated that addressed their beliefs about medical futility and inductively developed an organizing framework to describe these beliefs. We used a hypothetical scenario with a modified time-trade-off design to examine the relationship between a patient's prognosis and a surrogate's willingness to withdraw life support. We used a mixed-effects regression model to examine the association between surrogates' attitudes about futility and their willingness to limit life support in the face of a very poor prognosis. Validation methods included the use and integration of multiple data sources, multidisciplinary analysis, and member checking. Sixty-four percent of surrogates (n = 32; 95% confidence interval [CI], 49 to 77%) expressed doubt about the accuracy of physicians' futility predictions, 32% of surrogates (n = 16; 95% CI, 20 to 47%) elected to continue life support with a decision makers. The nature of the doubt may have implications for responding to conflicts about futility in clinical practice.

  9. Category theoretic analysis of single-photon decision maker

    CERN Document Server

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

    2016-01-01

    Decision making is a vital function in the era of artificial intelligence; however, its physical realizations and their theoretical fundamentals are not yet known. In our former study [Sci. Rep. 5, 513253 (2015)], we demonstrated that single photons can be used to make decisions in uncertain, dynamically changing environments. The multi-armed bandit problem was successfully solved using the dual probabilistic and particle attributes of single photons. Herein, we present the category theoretic foundation of the single-photon-based decision making, including quantitative analysis that agrees well with the experimental results. The category theoretic model unveils complex interdependencies of the entities of the subject matter in the most simplified manner, including a dynamically changing environment. In particular, the octahedral structure in triangulated categories provides a clear understanding of the underlying mechanisms of the single-photon decision maker. This is the first demonstration of a category the...

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

    Science.gov (United States)

    Webb, E.

    2006-12-01

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

  11. Developing a competitive intelligence strategy framework supporting the competitive intelligence needs of a financial institution’s decision makers

    Directory of Open Access Journals (Sweden)

    Tanya du Plessis

    2016-07-01

    Full Text Available Background: For competitive intelligence (CI to have the greatest contribution to strategic management, CI professionals require an in-depth understanding of the CI needs of decision makers. CI professionals have to carefully plan how to best inform corporate decision-making.A strategy framework is a planning tool which can be used to explore ways to enhance an organisation’s strategic planning capabilities.Objective: To investigate the CI needs of a financial institution’s decision makers in order to develop a CI strategy framework. To present the strategy framework as a planning tool to CI professionals in the financial services industry as well as mapping the process of developing a planning tool, thereby enabling a financial institution’s CI capability to better meet the CI needs of decision makers.Method: The guiding paradigm of interpretivist research directed the research design of a single qualitative case study, using an inductive approach. Qualitative data analysis techniques were used, which included the use of numerical data, to develop a planning tool for CI professionals based on a thorough understanding of the CI needs of decision makers.Results: Decision makers place considerable value on CI in terms of its contribution to strategy development, decision-making, gaining advantage over competitors and enhancing the financial performance of the organisation. Relationships between concepts and patterns or trends that were identified and utilised to establish themes in the data resulted in a 12-point strategy framework.Conclusion: A financial institution’s CI capability can be enhanced to better meet the CI needs of the organisation’s decision makers when CI professionals carefully plan their approach of informing corporate decision-making. This paper presents a 12-point CI strategy framework as a planning tool for CI professionals.

  12. Developing a competitive intelligence strategy framework supporting the competitive intelligence needs of a financial institution’s decision makers

    Directory of Open Access Journals (Sweden)

    Tanya du Plessis

    2016-07-01

    Full Text Available Background: For competitive intelligence (CI to have the greatest contribution to strategic management, CI professionals require an in-depth understanding of the CI needs of decision makers. CI professionals have to carefully plan how to best inform corporate decision-making.A strategy framework is a planning tool which can be used to explore ways to enhance an organisation’s strategic planning capabilities. Objective: To investigate the CI needs of a financial institution’s decision makers in order to develop a CI strategy framework. To present the strategy framework as a planning tool to CI professionals in the financial services industry as well as mapping the process of developing a planning tool, thereby enabling a financial institution’s CI capability to better meet the CI needs of decision makers. Method: The guiding paradigm of interpretivist research directed the research design of a single qualitative case study, using an inductive approach. Qualitative data analysis techniques were used, which included the use of numerical data, to develop a planning tool for CI professionals based on a thorough understanding of the CI needs of decision makers. Results: Decision makers place considerable value on CI in terms of its contribution to strategy development, decision-making, gaining advantage over competitors and enhancing the financial performance of the organisation. Relationships between concepts and patterns or trends that were identified and utilised to establish themes in the data resulted in a 12-point strategy framework. Conclusion: A financial institution’s CI capability can be enhanced to better meet the CI needs of the organisation’s decision makers when CI professionals carefully plan their approach of informing corporate decision-making. This paper presents a 12-point CI strategy framework as a planning tool for CI professionals.

  13. Rural emergency care 360°: mobilising healthcare professionals, decision-makers, patients and citizens to improve rural emergency care in the province of Quebec, Canada: a qualitative study protocol.

    Science.gov (United States)

    Fleet, Richard; Dupuis, Gilles; Fortin, Jean-Paul; Gravel, Jocelyn; Ouimet, Mathieu; Poitras, Julien; Légaré, France

    2017-08-17

    -priority recommendations enabling decision-makers in emergency care to implement improvements in rural emergency care in Quebec. This protocol has been approved by the CSSS Alphonse-Desjardins research ethics committee (Project number: MP 2017-009). The qualitative material will be kept confidential and the data will be presented in a way that respects confidentiality. The dissemination plan for the study includes publications in scientific and professional journals. We will also use social media to disseminate our findings and activities such as communications in public conferences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Patients' perspectives of the substitute decision maker: who makes better decisions?

    Science.gov (United States)

    Mirzaei, Komeil; Milanifar, Alireza; Asghari, Fariba

    2011-09-01

    Substitute decision making on behalf of incapable patients is based on the ethical principle of 'respect for autonomy'. This study was conducted to assess patients' wishes and preferences in terms of a substitute decision maker and determinants of such preferences. The authors conducted a cross-sectional study and selected samples randomly from patients presenting at Farabi Eye Hospital clinics who were 18 years of age or older. Questionnaires were completed through interviews. 200 patients between the ages of 18 and 83 years were interviewed. About 52% (N=105) were men and 73% (N=77) were married. Among married patients, the spouse was chosen as the substitute decision maker in only 51% of cases. Single men preferred their father first in 36% (N=9) of cases, while single girls chose their father in 5.6% (N=1) of cases and their most prevalent choice was other unmentioned people (33.3%, N=6). Most patients (93.5%) wished to be asked about their substitute decision maker when hospitalised. The results of this study show that the people we usually consult for decisions concerning patient treatment are significantly different from the patients' preferred substitute decision makers. The authors suggest patients be allowed to choose their substitute decision maker while conscious.

  15. Climate Modeling and Analysis with Decision Makers in Mind

    Science.gov (United States)

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

    2016-12-01

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

  16. Introducing Complex Decision Models to the Decision Maker with Computer Software - The Profile Distance Method (PDM

    Directory of Open Access Journals (Sweden)

    Edward Bernroider

    2010-06-01

    Full Text Available In this paper we demonstrate how the profile distance method was transformed into a software environment enabling the decision maker to utilize a complex decision making tool without any advanced knowledge of the underlying mathematical and technical features. We present theoretical and technical aspects as well as contextual and usage related information from the viewpoint of the decision maker. Preliminary empirical results suggest that the developed software component is effective in terms of platform independence, usability and intuitive interface design. The data showed a good rating for usefulness, which, however, was targeted as the main goal for further development.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kihlgren Mona

    2007-04-01

    stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet.

  19. Health Impact Assessment: a useful tool for decision makers

    Directory of Open Access Journals (Sweden)

    Livia Turco

    2007-09-01

    Full Text Available Health Impact Assessment is defined as ‘the combination of procedures, methods and tools through which it is possible to evaluate a policy, a program or a development plan concerning possible effects on public health and their distribution in the general population’. In a constructive debate this definition points out some interesting observations: - health is not the result of health policies alone, but it is often defined by the attention given to it in other contexts; - health is however the result of policies and it therefore must deserve the attention of Decision Makers; - health must not be taken into consideration without taking into account an evaluation of its distribution and its determinants within a population. Particular attention must therefore be paid into inequalities; - following the Council of the European Union recent conclusions on Health in All Policies we have to consider that everyday environments such as day-care centers, schools,workplaces,neighborhoods and the commute between them have significant effects on health and that health, in turn, has an effect on the economy by enabling active and productive participation in working life. In the past 20 years huge progress has been achieved in the epidemiological contest to define risks. Nowadays, it is known that a low cultural level lowers the capacity to respond to prevention, that elevated pollution levels do represent a health risk, and that the scarce social relationships that elderly people have in our society have strong consequences on their health and their quality of life.

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

    Science.gov (United States)

    Denys Yemshanov; Frank H Koch; Mark Ducey

    2015-01-01

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

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

    Science.gov (United States)

    Woods, Jeffrey G.

    2012-01-01

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

  2. Understanding the determinants of health: key decision makers in Saskatchewan Health districts and Saskatchewan Health, 1998.

    Science.gov (United States)

    Kahan, B R; Goodstadt, M S

    1999-01-01

    This research inquiry used qualitative and quantitative methods to examine how key decision makers from Saskatchewan health districts and Saskatchewan Health understand the determinants of health. The inquiry was based on the premise that key decision makers' understanding of the determinants of health, and the consensus regarding these understandings, hinder or facilitate dialogue, choice of effective strategies, and achievement of health promotion goals. Interviews indicated variation in perspective and emphasis regarding how key decision makers understand the determinants of health. A survey of key decision makers found: 1) inconsistencies in respondents' understanding of the determinants of health, particularly between stated beliefs and priorities for actions; and 2) that the degree of consensus among decision makers was higher for stated beliefs and lower for choices of action. Results indicate a need for clarification and consensus-building processes concerning the determinants of health, as well as for clear policies that foster consistency between beliefs and actions and minimize inappropriate or undesirable differences in interpretations.

  3. Sustainable energy catalogue - for European decision-makers. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Gram, S.; Jacobsen, Soeren

    2006-10-15

    The Green paper - A European Strategy for Sustainable, Competitive and Secure Energy, 2006 states that Europe has a rising dependency on imported energy reserves, which are concentrated in a few countries. The Rising gas and oil prices along with demands on lower emissions of CO2 adds pressure on the need for a new energy future for Europe. EU has since 1990 planned to become world leader in the renewable energy field. Therefore the EU member states have agreed that by 2010 21% of the consumed electricity and 5,75% of the consumed gasoline and diesel should originate from renewable energy sources. If the EU countries are to reach their goals, a commitment on several levels to develop and install energy from sustainable energy sources is needed. The purpose of this catalogue is to offer planners and decision-makers in EU states an inspirational tool to be used during local or regional transition towards sustainable energy technologies. The catalogue can also be used by everyone else who needs an overview of the sustainable energy technologies and their current development level and future potential, among others educational use is relevant. The catalogue provides an introduction to the following technologies that are already or are estimated to become central to a development with renewable energy in EU: Technologies for wind energy, wave energy, geothermal energy, bioenergy, solar energy, hydropower and fuel cells. The catalogue also includes a section about energy systems, which also includes a part about technologies for efficient use of energy. The catalogue could have included a few other technologies as e.g. heating pumps, but due to the size of the catalogue a priority was necessary. The catalogue does not claim to give all answers or to be complete regarding all details about the individual technologies; even so it offers information, which cannot easily be looked up on the Internet. In the back of the catalogue, under 'References and links' there

  4. Which criteria considered in healthcare decisions? Insights from an international survey of policy and clinical decision makers

    NARCIS (Netherlands)

    Tanios, Nataly; Wagner, Monika; Tony, Michele; Baltussen, Rob; van Til, Janine Astrid; Rindress, Donna; Kind, Paul; Goetghebeur, Mireille M.

    2013-01-01

    Objectives: The aim of this study was to gather qualitative and quantitative data on criteria considered by healthcare decision makers. Methods: Using snowball sampling and an online questionnaire with forty-three criteria organized into ten clusters, decision makers were invited by an international

  5. Which criteria are considered in healthcare decisions? Insights from an international survey of policy and clinical decision makers

    NARCIS (Netherlands)

    Tanios, N.; Wagner, M.; Tony, M.; Baltussen, R.M.; Til, J. van; Rindress, D.; Kind, P.; Goetghebeur, M.M.; Decision, C. International T

    2013-01-01

    Objectives: The aim of this study was to gather qualitative and quantitative data on criteria considered by healthcare decision makers. Methods: Using snowball sampling and an online questionnaire with forty-three criteria organized into ten clusters, decision makers were invited by an international

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

    Science.gov (United States)

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

    2016-08-02

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

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

    Science.gov (United States)

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

    2011-08-03

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

  8. A Framework for Investigating Influence of Organizational Decision Makers on Data Mining Process Achievement

    Directory of Open Access Journals (Sweden)

    Hanieh Hajisafari

    2012-02-01

    Full Text Available Currently, few studies deal with evaluation of data mining plans in context of solvng organizational problems. A successful data miner is searching to solve a fully defined business problem. To make the data mining (DM results actionable, the data miner must explain them to the business insider. The interaction process between the business insiders and data miners is actually a knowledge-sharing process. In this study through representing a framwork, influence of organizational decision makers on data mining process and results investigated. By investigating research literature, the critical success factors of data mining plans was identified and the role of organizational decision makers in each step of data mining was investigated.‌ Then, the conceptual framework of influence of organizational decision makers on data mining process achievement was designed. By getting expert opinions, the proposed framework was analyzed and evantually designed the final framework of influence of organizational decision makers on data mining process achievement. Analysis of experts opinions showed that by knowledge sharing of data ming results with decision makers, "learning", "action or internalization" and "enforcing/unlearning" will become as critical success factors. Also, results of examining importance of decision makers' feedback on data mining steps showed that getting feedback from decision makers could have most influence on "knowledge extraction and representing model" step and least on "data cleaning and preprocessing" step.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    Beaudoin, Michael

    2016-01-01

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

  11. How Do Decision-Makers Become Library Media Advocates?

    Science.gov (United States)

    Hartzell, Gary

    2007-01-01

    In this article, the author describes his path to library advocacy. It resulted from several youthful experiences, favorable professional associations, and an unexpected invitation shortly after he left K-12 education for the university. The author believes that it is a good idea to get more librarians to consider going into administration.…

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

    Science.gov (United States)

    Griswold, John S.; Jarvis, William F.

    2013-01-01

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

  13. End-of-life decisions: a cross-national study of treatment preference discussions and surrogate decision-maker appointments.

    NARCIS (Netherlands)

    Evans, N.; Pasman, H.R.W.; Vega Alonso, T.; Block, L. van den; Miccinesi, G.; Viviane, V.C.; Donker, G.; Bertolissi, S.; Zurriaga, O.; Deliens, L.

    2013-01-01

    Aim: Making decisions in anticipation of possible future incapacity is part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment preference discussions and appointments of surrogate decision-makers in Italy,

  14. Information paradox of new product development: A case of decision-makers' focus of attention

    DEFF Research Database (Denmark)

    Jespersen, Kristina Risom

    . First, competitive behavior makes decision-makers apply logic of reassurances in their implementation of NPD activities. Second, the information processing competence of decision-makers is unbalanced as information increases uncertainty in the concrete decision-making situation.......Drawing on theory of bounded rationality and the attention-based view of the company, decision-makers' focus of attention is examined within the new product development process. Attention, defined as something which occupies individual consciousness, should be directed at selecting development...... activities and applying information resulting from these activities to go/no-go decision-making. Based on the information behavior of 42 development managers collected through a virtual role-play simulation of new product development, this research finds two information paradoxes of new product development...

  15. Decisions and caregiving: end of life among blacks from the perspective of informal caregivers and decision makers.

    Science.gov (United States)

    Conner, Norma E; Chase, Susan K

    2015-06-01

    This focus group study describes end-of-life caregiving and decision making among blacks from the perspective of the informal caregivers and decision makers. The Behavioral Model of Health Services Use framed the study. Five focus groups with a total of 53 informal caregivers/decision makers were conducted. A qualitative phenomenological approach was used for the data analysis. Findings are presented under the themes of end of life caregiving and decision making roles, dynamics and process, and beliefs and values. The common thread of care giving and decision-making within relationship and six subthemes were identified. Findings also suggest the need for support and inclusion of designated informal caregivers and decision-makers in the advance care planning process early in the disease trajectory. © The Author(s) 2014.

  16. The accuracy of surrogate decision makers: a systematic review.

    Science.gov (United States)

    Shalowitz, David I; Garrett-Mayer, Elizabeth; Wendler, David

    2006-03-13

    Clinicians currently rely on patient-designated and next-of-kin surrogates to make end-of-life treatment decisions for incapacitated patients. Surrogates are instructed to use the substituted judgment standard, which directs them to make the treatment decision that the patient would have made if he or she were capacitated. However, commentators have questioned the accuracy with which surrogates predict patients' treatment preferences. A systematic literature search was conducted using PubMed, the Cochrane Library, and manuscript references, to identify published studies that provide empirical data on how accurately surrogates predict patients' treatment preferences and on the efficacy of commonly proposed methods to improve surrogate accuracy. Two of us (D.I.S. and D.W.) reviewed all articles and extracted data on the hypothetical scenarios used to assess surrogate accuracy and the percentage of agreement between patients and surrogates. The search identified 16 eligible studies, involving 151 hypothetical scenarios and 2595 surrogate-patient pairs, which collectively analyzed 19 526 patient-surrogate paired responses. Overall, surrogates predicted patients' treatment preferences with 68% accuracy. Neither patient designation of surrogates nor prior discussion of patients' treatment preferences improved surrogates' predictive accuracy. Patient-designated and next-of-kin surrogates incorrectly predict patients' end-of-life treatment preferences in one third of cases. These data undermine the claim that reliance on surrogates is justified by their ability to predict incapacitated patients' treatment preferences. Future studies should assess whether other mechanisms might predict patients' end-of-life treatment preferences more accurately. Also, they should assess whether reliance on patient-designated and next-of-kin surrogates offers patients and/or their families benefits that are independent of the accuracy of surrogates' decisions.

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

    Science.gov (United States)

    Carone, Alessandro; Iorio, Luigi Di

    2013-01-01

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

  18. 49 CFR 1503.659 - Petition to reconsider or modify a final decision and order of the TSA decision maker on appeal.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

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

    2009-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Siriporn Pooripussarakul

    2016-08-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  3. 49 CFR 1515.11 - Review by administrative law judge and TSA Final Decision Maker.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Review by administrative law judge and TSA Final... Review by administrative law judge and TSA Final Decision Maker. (a) Scope. This section applies to the following applicants: (1) An applicant who seeks review of a decision by TSA denying a request for a waiver...

  4. Economics for assisting policy-makers to take decisions about new and endemic diseases.

    Science.gov (United States)

    Carpenter, T E

    2017-04-01

    Animal health policy-makers are frequently faced with making decisions concerning the control and exclusion of diseases in livestock and wildlife populations. Economics is one of the tools they have to aid their decision-making. It can enable them to make objective decisions based on the expected costs and benefits of their policy. In addition, economics can help them determine both the distribution impact and the indirect impact of their decisions. However, economics is only one of many tools available to policy-makers, who also need to consider non-economic outcomes in their decision-making process. While there are sophisticated epidemic and economic (epinomic) models that are available to help evaluate complex problems, these models typically require extensive data and well-trained analysts to run and interpret their results. In addition, effective communication between analysts and policy-makers is important to ensure that results are clearly conveyed to the policy-makers. This may be facilitated by early and continued discussions between these two potentially disparate groups. If successfully performed and communicated, economic analyses may present valuable information to policy-makers, enabling them to not only better understand the economic implications of their policy, but also to communicate the policy to relevant stakeholders, further ensuring their likelihood of participating in the planned policy and hence increasing its likelihood of success.

  5. 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

  6. Knowledge uptake by technical professionals and decision-makers ...

    African Journals Online (AJOL)

    With respect to context, the investigation established a simple preliminary framework which described the combination of political and technical disciplines in a unified approach, and the translation of this into the bureaucracy. On the evidence of the in-depth interviews, the contextual aspects of developmental water services ...

  7. Knowledge uptake by technical professionals and decision-makers ...

    African Journals Online (AJOL)

    2008-09-17

    Sep 17, 2008 ... While significant knowledge appears to be available on developmental water services (a term for service provision, to meet developmental objectives, with an emphasis on poor communities, in which a range of factors other than purely technical factors are addressed), there appears to be insufficient ...

  8. Decision-makers' Risk Perception in the Internationalisation of Small and Medium-Sized Firms

    DEFF Research Database (Denmark)

    Eduardsen, Jonas Strømfeldt; Marinova, Svetla Trifonova

    2016-01-01

    This study examines the risk perception of decision-makers in small and medium sized enterprises (SMEs) and the factors underlying these perceptions in the process of internationalization of their firms. While risk perception has been identified as a potential predictor variable...... in internationalisation research, very little work has been done exploring the factors and processes that shape decision-makers’ perception of risk. A qualitative interview-based approach was adopted by collecting data from thirty-two Danish SMEs operating in four different industries. Findings suggest that while risk...... awareness exists, decision-makers do not perceive internationalisation as risky behaviour. Findings highlight the importance of decision-makers’ background, including cognitive and psychological characteristics, such as self-efficacy and locus of control, and their experiences in explaining risk perceptions...

  9. Assessing conceptions of cost-benefit analysis among road safety decision-makers : misunderstandings or disputes?

    NARCIS (Netherlands)

    Veisten, K. Elvik, R. & Bax, C.

    2010-01-01

    Statements about economic cost—benefit analysis were assessed in a sample of European road safety decision-makers. These statements related to both principles of cost—benefit analysis and implications for applying the method to road safety projects. A procedure of information reference testing was

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

    Science.gov (United States)

    Bray, D.

    2012-12-01

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

  11. Researcher-decision-maker partnerships in health services research: Practical challenges, guiding principles

    Directory of Open Access Journals (Sweden)

    Hofmeyer Anne

    2012-08-01

    Full Text Available Abstract Background In health services research, there is a growing view that partnerships between researchers and decision-makers (i.e., collaborative research teams will enhance the effective translation and use of research results into policy and practice. For this reason, there is an increasing expectation by health research funding agencies that health system managers, policy-makers, practitioners and clinicians will be members of funded research teams. While this view has merit to improve the uptake of research findings, the practical challenges of building and sustaining collaborative research teams with members from both inside and outside the research setting requires consideration. A small body of literature has discussed issues that may arise when conducting research in one’s own setting; however, there is a lack of clear guidance to deal with practical challenges that may arise in research teams that include team members who have links with the organization/community being studied (i.e., are “insiders”. Discussion In this article, we discuss a researcher-decision-maker partnership that investigated practice in primary care networks in Alberta. Specifically, we report on processes to guide the role clarification of insider team members where research activities may pose potential risk to participants or the team members (e.g., access to raw data. Summary These guiding principles could provide a useful discussion point for researchers and decision-makers engaged in health services research.

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

    Science.gov (United States)

    Sohl, Terry L; Claggett, Peter R

    2013-11-15

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

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

    Science.gov (United States)

    Sohl, Terry L.; Claggett, Peter R.

    2013-01-01

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

  14. Methods for providing decision makers with optimal solutions for multiple objectives that change over time

    CSIR Research Space (South Africa)

    Greeff, M

    2010-09-01

    Full Text Available for providing decision makers with optimal solutions for multiple objectives that change over time M GREEFF CSIR Meraka Institute, PO Box 395, Pretoria, 0001, South Africa Email: mgreeff@csir.co.za – www.csir.co.za IntroductIon decision making... solution, but a set of optimal solutions, called the Pareto optimal front (PoF). When the objectives change over time, the problem is called a dynamic mooP (dmooP). this research focuses on finding the PoF for dmooPs, in order to provide the decision...

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

    Science.gov (United States)

    Fasbender, Ulrike; Wang, Mo

    2016-01-01

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

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

    Science.gov (United States)

    Kuraoka, Yumiko; Nakayama, Kazuhiro

    2017-06-28

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Werntoft, Elisabet; Edberg, Anna-Karin

    2009-10-01

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

  19. Climate science information needs among natural resource decision-makers in the Northwest US

    Directory of Open Access Journals (Sweden)

    Elizabeth Allen

    2017-01-01

    Full Text Available Managing water resources, air quality, forests, rangelands and agricultural systems in the context of climate change requires a new level of integrated knowledge. In order to articulate a role for university-based research teams as providers of climate services, this paper analyzes environmental change concerns and expectations about climate models among natural resources decision-makers in the Northwest US. Data were collected during a series of workshops organized by researchers from BioEarth, a regional earth systems modeling initiative. Eighty-three stakeholders from industry, government agencies and non-governmental organizations engaged with a team of academic researchers developing integrated biophysical and economic climate modeling tools. Analysis of transcripts of workshop discussions, surveys, and questionnaires reveals diverse attitudes among stakeholders about: 1 preferred modes of engaging in climate science research, 2 specific concerns and questions about climate change impacts, and 3 the most relevant and usable scope and scale of climate change impacts projections. Diverse concerns and information needs among natural resource decision-makers highlight the need for research teams to define clear and precise goals for stakeholder engagement. Utilizing the skills of research team members who have communication and extension expertise is pivotally important. We suggest impactful opportunities for research teams and natural resource decision-makers to interface and learn from one another. Effective approaches include structuring group discussions to identify gaps in existing climate change impacts information, explicitly considering changing policies, technologies and management practices, and exploring possible unintended consequences of decisions.

  20. Decision maker views on priority setting in the Vancouver Island Health Authority

    Directory of Open Access Journals (Sweden)

    Mitton Craig

    2008-07-01

    Full Text Available Abstract Background Decisions regarding the allocation of available resources are a source of growing dissatisfaction for healthcare decision-makers. This dissatisfaction has led to increased interest in research on evidence-based resource allocation processes. An emerging area of interest has been the empirical analysis of the characteristics of existing and desired priority setting processes from the perspective of decision-makers. Methods We conducted in-depth, face-to-face interviews with 18 senior managers and medical directors with the Vancouver Island Health Authority, an integrated health care provider in British Columbia responsible for a population of approximately 730,000. Interviews were transcribed and content-analyzed, and major themes and sub-themes were identified and reported. Results Respondents identified nine key features of a desirable priority setting process: inclusion of baseline assessment, use of best evidence, clarity, consistency, clear and measurable criteria, dissemination of information, fair representation, alignment with the strategic direction and evaluation of results. Existing priority setting processes were found to be lacking on most of these desired features. In addition, respondents identified and explicated several factors that influence resource allocation, including political considerations and organizational culture and capacity. Conclusion This study makes a contribution to a growing body of knowledge which provides the type of contextual evidence that is required if priority setting processes are to be used successfully by health care decision-makers.

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

    OpenAIRE

    Werntoft, Elisabet; Edberg, Anna-Karin

    2009-01-01

    OBJECTIVES: Prioritisation in healthcare is an issue of growing importance due to scarcity of resources. The aims of this study were firstly to describe decision makers' experience of prioritisation and their views concerning willingness to pay and how to finance healthcare costs. An additional aim was to compare the views of politicians and physicians. METHODS: The study was a cross-sectional study based on a questionnaire administered to 700 Swedish politicians and physicians. This was ...

  2. Design Thinking and the Development of Real Options for Decision-Makers

    Science.gov (United States)

    2011-11-16

    the given circumstances. This essay proposes integrating elements of design thinking into the Mission Analysis and COA Development steps of the JOPP...briefly to show how design thinking can be integrated into the planning process and how continuing that line of thinking into the COA Development step is...a natural and necessary extension to develop options. Finally, the essay will show how design thinking informs decision-makers of the competing

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

    Science.gov (United States)

    Stamarski, Cailin S; Son Hing, Leanne S

    2015-01-01

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

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

    OpenAIRE

    Kuraoka, Yumiko; Nakayama, Kazuhiro

    2017-01-01

    Background A tube feeding decision aid designed at the Ottawa Health Research Institute was specifically created for substitute decision-makers who must decide whether to allow placement of a percutaneous endoscopic gastrostomy (PEG) tube in a cognitively impaired older person. We developed a Japanese version and found that the decision aid promoted the decision-making process of substitute decision-makers to decrease decisional conflict and increase knowledge. However, the factors that influ...

  5. NPD gate decision criteria: A consequence of strategic orientation or decision-maker expertise

    DEFF Research Database (Denmark)

    Søndergaard, Helle Alsted; Jespersen, Kristina Risom

    criteria at the decision gates. Results from a sample of 132 NPD practitioners studied a simulated NPD process show that the importance of decision criteria is influenced by both the strategic orientation of the company and individual decision-making expertise. Especially the proactive and aggressive......All NPD projects are evaluated at some point of time during the course of the process. These evaluations require the use criteria for deciding whether to carry on or 'kill' the project. The focus of this paper is on the origin of decision criteria and what determines the prioritisation of various...... strategic orientations influence the prioritisation of decision criteria....

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

    Science.gov (United States)

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

    2017-10-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  8. Informing Health Policy Decision Makers: A Nebraska Scope of Practice Case Study.

    Science.gov (United States)

    Lazure, Linda L; Cramer, Mary E; Hoebelheinrich, Katherine A

    2016-05-01

    Medicare patients seeking care from nurse practitioners (NPs) increased 15-fold from 1998 to 2010, and a 2.5-fold patient increase was recorded in states that have eased the regulatory environment for NPs. It is increasingly important that state regulatory and licensing boards-charged with protecting the public through the assurance of a qualified health-care workforce-examine whether their state regulatory environment restricts or promotes public access to quality health care. This article presents a case study of a statutory scope of practice credentialing review process for NPs in Nebraska. It examines in depth what individuals involved in policy change processes found most useful for informed decision making. The methodology included observation of the process, review of submitted documents, and a survey to individuals involved in the decision-making process (n = 22/48). The study findings have application for those seeking scope of practice policy changes, with specific suggestions for how to better prepare themselves and present information in formats that are helpful to decision makers. Our results also shed new light on what specific evidence submitted during a scope of practice review process is most valued for promoting the understanding of decision makers to effect change. © The Author(s) 2016.

  9. An approach for Web service selection based on confidence level of decision maker.

    Science.gov (United States)

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

    2014-01-01

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

  10. The Experience of Surrogate Decision Makers on Being Approached for Consent for Patient Participation in Research. A Multicenter Study.

    Science.gov (United States)

    Burns, Karen E A; Prats, Clara Juando; Maione, Maria; Lanceta, Mary; Zubrinich, Celia; Jeffs, Lianne; Smith, Orla M

    2017-02-01

    Recruitment in critical care research differs from other contexts in important ways: patients lack decision-making capacity, uncertainty exists regarding patient prognosis, and critical illnesses are often associated with appreciable morbidity and mortality. We aimed to describe the experiences of surrogate decision makers (SDMs) in being approached for consent for critically ill patients to participate in research. A multicenter, qualitative study involving semistructured interviews with 26 SDMs, who provided or declined surrogate consent for research participation, at 5 Canadian centers nested within a multicenter observational study of research recruitment practices. Transcripts were reviewed by three qualitative researchers, and data were analyzed using grounded theory and a narrative critical analysis. SDMs were guided by an overarching desire for the patient to live. Surrogate research decision-making involved three sequential stages: (1) being approached; (2) reflecting on participation; and (3) making a decision. In stage 1, SDMs identified factors (their expectations, how they were approached, the attributes of the person approaching, and study risks and benefits) that characterized their consent encounter and affirmed a preference to be approached in person. If SDMs perceived the risk of participation to be too high or felt patients may not benefit from participation, they did not contemplate further. In stage 2, SDMs who knew the patient's wishes or had a deeper understanding of research prioritized the patient's wishes and the perceived benefits of participation. Without this information, SDMs prioritized obtaining more and better care for the patient, considered what was in their mutual best interests, and valued healthcare professional's knowledge. Trust in healthcare professionals was essential to proceeding further. In stage 3, SDMs considered six factors in rendering decisions. SDMs engaged in three sequential stages and considered six factors in

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

    Science.gov (United States)

    Coutoumanos, Vincent

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

  12. EDUCATION MANAGEMENT DECISION-MAKERS IN EUROPEAN PRE – UNIVERSITY EDUCATION

    Directory of Open Access Journals (Sweden)

    DUMITRAȘCU DANUȚ DUMITRU

    2012-12-01

    Full Text Available EDUCATION MANAGEMENT DECISION-MAKERS IN EUROPEAN PRE – UNIVERSITY EDUCATION Ana Tuºa, 1 Affiliation , “Lucian Blaga” University of Sibiu, Faculty of Economics, Department of management Claudiu Sorin Voinia 2 , Affiliation, “Lucian Blaga” University of Sibiu Faculty of Engineering, Department of Industrial Engineering Dãnuþ Dumitru Dumitraºcu 3 Affiliation, “Lucian Blaga” University of Sibiu, Faculty of Economics, Department of management The theme paper consists in a comparative analysis of European preuniveristary education decision makers. Decision makers in preuniversity education management remain the key issue in the political agenda of most European countries. The diversity of educational policies in each European country aims to increase school autonomy, in a way that allows comparison of their main elements of management. Scientific research carried out aimed both theoretical and practical terms: - comparative analysis of how the makers of European schools are responsible for the management practiced in the educational institution. - identification of the achievement of school autonomy. Lately, in terms of policy makers and school autonomy, schools have gone through many reforms. It was felt the need to improve the democratic management and the quality of the educational process. The analysis and the approaches differ in terms of pace of reform, scale transfer of authority and areas that apply. No approach can be chosen as the ideal one or more effective than others, because the contexts in which they were made are so diverse. However, as it moves along, educational policy makers can learn from the approaches and experiences of others. The methodology was based on: the study of scientific literature from the country and abroad, on the theory and practice regarding the decision in the management of school education activities. Comparative analysis was conducted based on questionnaires

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

    Science.gov (United States)

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

    2016-06-01

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

  14. Real-world data from the health decision maker perspective. What are we talking about?

    Directory of Open Access Journals (Sweden)

    Silvana Romio

    2013-09-01

    Full Text Available Healthcare decision-makers are increasingly developing policies that seek information on “real-world” data providing “evidence” to support and monitor changes in clinical practice or policy decisions. Many strategies may be evaluated in experimental circumstances, but this does rarely reflect clinical practice. Due to the current focus on information and computer technology to provide safer and more efficient healthcare delivery, the amount of electronic medical records and other electronic healthcare data is increasing exponentially, and these real-world data can be used for evidence generation. This review describes why and how healthcare/policy decision making could benefit from real-world data, it introduces methods to investigate real-world clinical practice, lists potentialities of routinely collected real-world data, reviews their availability in the word, and outlines future challenges in this field. 

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

    Science.gov (United States)

    Irwan; Gustientiedina; Sunarti; Desnelita, Yenny

    2017-12-01

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

  16. Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers

    Directory of Open Access Journals (Sweden)

    Stephen Bornstein

    2017-11-01

    Full Text Available Abstract Background The Contextualized Health Research Synthesis Program (CHRSP, developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. Methods As an integrated knowledge translation (KT method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies. Although it was developed in the Canadian province of Newfoundland and Labrador, the CHRSP methodology is adaptable to a variety of settings with distinctive features, such as those in rural, remote, and small-town locations. Results CHRSP has published 25 syntheses on priority topics chosen by the provincial healthcare system, including: Clinical and cost-effectiveness: telehealth, rural renal dialysis, point-of-care testing; Community-based health services: helping seniors age in place, supporting seniors with dementia, residential treatment centers for at-risk youth; Healthcare organization/service delivery: reducing acute-care length of stay, promoting flu vaccination among health workers, safe patient handling, age-friendly acute care; and Health promotion: diabetes prevention, promoting healthy dietary habits. These studies have been used by decision makers to inform local policy and practice decisions. Conclusions By asking the health

  17. Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers.

    Science.gov (United States)

    Bornstein, Stephen; Baker, Rochelle; Navarro, Pablo; Mackey, Sarah; Speed, David; Sullivan, Melissa

    2017-11-02

    The Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. As an integrated knowledge translation (KT) method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies. Although it was developed in the Canadian province of Newfoundland and Labrador, the CHRSP methodology is adaptable to a variety of settings with distinctive features, such as those in rural, remote, and small-town locations. CHRSP has published 25 syntheses on priority topics chosen by the provincial healthcare system, including: Clinical and cost-effectiveness: telehealth, rural renal dialysis, point-of-care testing; Community-based health services: helping seniors age in place, supporting seniors with dementia, residential treatment centers for at-risk youth; Healthcare organization/service delivery: reducing acute-care length of stay, promoting flu vaccination among health workers, safe patient handling, age-friendly acute care; and Health promotion: diabetes prevention, promoting healthy dietary habits. These studies have been used by decision makers to inform local policy and practice decisions. By asking the health system to identify its own priorities and to participate directly in

  18. Involving decision-makers in the transformation of results into urban sustainability policies

    Directory of Open Access Journals (Sweden)

    Eleni Feleki

    2016-06-01

    Full Text Available Mind mapping tools are used to stimulate thinking about sustainability and define its significance for urban planning. Such tools are based on keywords that are identified and structured through dialogue-based procedures. The approach can be used also for switching between highlighting sectorial aspects, such as territorial management and urban design, social and economic cohesion and cross-sectorial aspects, such as sustainable mobility and energy efficiency. This paper emphasizes a structured dialogue with desicion-makers at national, regional and local levels, aimed at identifying what decision-makers really need to decide and the key barriers to the implementation of existing urban sustainability tools. This study was organized in four discrete steps. Initially, what EU urban sustainability projects can deliver (studies, methodologies, tools, policies, etc. was identified. The deliverables were evaluated against certain criteria and categorized into cross-cutting aspects (territorial management and urban design, social and economic cohesion and sectorial aspects (sustainable mobility, energy efficiency. The structured dialogue was implemented in parallel with the evaluation of the deliverables in order to match them with decision-makers’ needs, priorities and expectations. The ultimate goal was to develop and make available an operational Decision Support System (DSS for public Authorities and urban planners, which combines their needs, priorities and expectations (structured dialogue results with existing deliverables, developed within the framework of EU projects that up to now have had a low transferability and applicability rate.

  19. Learning environment simulator: a tool for local decision makers and first responders

    Energy Technology Data Exchange (ETDEWEB)

    Leclaire, Rene J [Los Alamos National Laboratory; Hirsch, Gary B [CLE, INCORPORATED

    2009-01-01

    The National Infrastructure Simulation and Analysis Center (NISAC) has developed a prototype learning environment simulator (LES) based on the Critical Infrastructure Protection Decision Support System (CIPDSS) infrastructure and scenario models. The LES is designed to engage decision makers at the grass-roots level (local/city/state) to deepen their understanding of an evolving crisis, enhance their intuition and allow them to test their own strategies for events before they occur. An initial version is being developed, centered on a pandemic influenza outbreak and has been successfully tested with a group of hospital administrators and first responders. LES is not a predictive tool but rather a simulated environment allowing the user to experience the complexities of a crisis before it happens. Users can contrast various approaches to the crisis, competing with alternative strategies of their own or other participants. LES is designed to assist decision makers in making informed choices by functionally representing relevant scenarios before they occur, including impacts to critical infrastructures with their interdependencies, and estimating human health & safety and economic impacts. In this paper a brief overview of the underlying models are given followed by a description of the LES, its interface and usage and an overview of the experience testing LES with a group of hospital administrators and first responders. The paper concludes with a brief discussion of the work remaining to make LES operational.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  2. A Theory of Change for Capacity Building for the Use of Research Evidence by Decision Makers in Southern Africa

    Science.gov (United States)

    Stewart, Ruth

    2015-01-01

    The effective use of public policy to reduce poverty and inequality in southern Africa requires an increased use of research evidence to inform decision making. There is an absence of clear evidence as to how best to encourage evidence-informed decision making, and how to build capacity among decision makers in the use of research. This paper…

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2012-08-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

    Cortina, Carla; Boggia, Antonio

    2014-08-01

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

  8. End-of-Life Decisions: A Cross-National Study of Treatment Preference Discussions and Surrogate Decision-Maker Appointments

    Science.gov (United States)

    Evans, Natalie; Pasman, H. Roeline; Vega Alonso, Tomás; Van den Block, Lieve; Miccinesi, Guido; Van Casteren, Viviane; Donker, Gé; Bertolissi, Stefano; Zurriaga, Oscar; Deliens, Luc; Onwuteaka-Philipsen, Bregje; EUROIMPACT, on behalf of

    2013-01-01

    Background Making treatment decisions in anticipation of possible future incapacity is an important part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment discussions and patients’ appointment of surrogate decision-makers in Italy, Spain, Belgium and the Netherlands and examines associated factors. Methods A cross-sectional, retrospective survey was conducted with representative GP networks in four countries. GPs recorded the health and care characteristics in the last three months of life of 4,396 patients who died non-suddenly. Prevalences were estimated and logistic regressions were used to examine between country differences and country-specific associated patient and care factors. Results GP-patient discussion of treatment preferences occurred for 10%, 7%, 25% and 47% of Italian, Spanish, Belgian and of Dutch patients respectively. Furthermore, 6%, 5%, 16% and 29% of Italian, Spanish, Belgian and Dutch patients had a surrogate decision-maker. Despite some country-specific differences, previous GP-patient discussion of primary diagnosis, more frequent GP contact, GP provision of palliative care, the importance of palliative care as a treatment aim and place of death were positively associated with preference discussions or surrogate appointments. A diagnosis of dementia was negatively associated with preference discussions and surrogate appointments. Conclusions The study revealed a higher prevalence of treatment preference discussions and surrogate appointments in the two northern compared to the two southern European countries. Factors associated with preference discussions and surrogate appointments suggest that delaying diagnosis discussions impedes anticipatory planning, whereas early preference discussions, particularly for dementia patients, and the provision of palliative care encourage participation. PMID:23472122

  9. End-of-life decisions: a cross-national study of treatment preference discussions and surrogate decision-maker appointments.

    Directory of Open Access Journals (Sweden)

    Natalie Evans

    Full Text Available BACKGROUND: Making treatment decisions in anticipation of possible future incapacity is an important part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment discussions and patients' appointment of surrogate decision-makers in Italy, Spain, Belgium and the Netherlands and examines associated factors. METHODS: A cross-sectional, retrospective survey was conducted with representative GP networks in four countries. GPs recorded the health and care characteristics in the last three months of life of 4,396 patients who died non-suddenly. Prevalences were estimated and logistic regressions were used to examine between country differences and country-specific associated patient and care factors. RESULTS: GP-patient discussion of treatment preferences occurred for 10%, 7%, 25% and 47% of Italian, Spanish, Belgian and of Dutch patients respectively. Furthermore, 6%, 5%, 16% and 29% of Italian, Spanish, Belgian and Dutch patients had a surrogate decision-maker. Despite some country-specific differences, previous GP-patient discussion of primary diagnosis, more frequent GP contact, GP provision of palliative care, the importance of palliative care as a treatment aim and place of death were positively associated with preference discussions or surrogate appointments. A diagnosis of dementia was negatively associated with preference discussions and surrogate appointments. CONCLUSIONS: The study revealed a higher prevalence of treatment preference discussions and surrogate appointments in the two northern compared to the two southern European countries. Factors associated with preference discussions and surrogate appointments suggest that delaying diagnosis discussions impedes anticipatory planning, whereas early preference discussions, particularly for dementia patients, and the provision of palliative care encourage participation.

  10. Modelling of adaptation to climate change and decision-makers behaviours for the Veluwe forest area in the Netherlands

    NARCIS (Netherlands)

    Yousefpour, R.; Didion, M.P.; Jacobsen, J.B.; Meilby, H.; Hengeveld, G.M.; Schelhaas, M.; Thorsen, B.J.

    2015-01-01

    We apply Bayesian updating theory to model how decision-makers may gradually learn about climate change and make use of this information in making adaptive forest management decisions. We develop modelling steps to i) simulate observation of a multi-dimensional climate system, ii) apply updating

  11. Reproductive tourism in Argentina: clinic accreditation and its implications for consumers, health professionals and policy makers.

    Science.gov (United States)

    Smith, Elise; Behrmann, Jason; Martin, Carolina; Williams-Jones, Bryn

    2010-08-01

    A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include: the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given to more recent 'players' in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we examine the context-specific ethical and policy implications of private Argentinean fertility clinics that market reproductive services via the internet. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices.

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

    Science.gov (United States)

    Geller, G.; Nativi, S.

    2011-12-01

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

  13. Scaling up success to improve health: Towards a rapid assessment guide for decision makers

    Directory of Open Access Journals (Sweden)

    Jason Paltzer

    2015-01-01

    Full Text Available Introduction Evidence-based health interventions exist and are effectively implemented throughout resource-limited settings. The literature regarding scale-up strategies and frameworks is growing. The purpose of this paper is to identify and systematically document the variation in scale-up strategies to develop a rapid assessment tool for decision-makers looking to identify the most appropriate strategy for their organizational and environmental contexts. Methods A list of scale-up strategies and frameworks were identified through an in-depth literature review and conversations with scale-up and quality improvement leaders. The literature search included a broad range of terms that might be used interchangeably with scale-up of best practices. Terms included: implementation research, knowledge translation, translational research, quality improvement research, health systems improvement, scale-up, best practices, improvement collaborative, and community based research. Based on this research, 18 strategies and frameworks were identified, and nine met our inclusion criteria for scale-up of health-related strategies. We interviewed the key contact for four of the nine strategies to obtain additional information regarding the strategy’s scale-up components, targets, underlying theories, evaluation efforts, facilitating factors, and barriers. A comparative analysis of common elements and strategy characteristics was completed by two of the authors on the nine selected strategies. Key strategy characteristics and common factors that facilitate or hinder the strategy’s success in scaling up health-related interventions were identified. Results Common features of scale-up strategies include: 1 the development of context-specific evidence; 2 collaborative partnerships; 3 iterative processes; and 4 shared decision-making. Facilitating factors include strong leadership, community engagement, communication, government collaboration, and a focus on

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2013-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Stinton, David P [ORNL; McGervey, Joseph [SRA International, Inc.; Curran, Scott [ORNL

    2011-11-01

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

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

    Science.gov (United States)

    Marzocchi, Warner

    2013-04-01

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

  18. Brain-Computer Evolutionary Multi-Objective Optimization (BC-EMO): a genetic algorithm adapting to the decision maker

    OpenAIRE

    Battiti, Roberto; Passerini, Andrea

    2009-01-01

    The centrality of the decision maker (DM) is widely recognized in the Multiple Criteria Decision Making community. This translates into emphasis on seamless human-computer interaction, and adaptation of the solution technique to the knowledge which is progressively acquired from the DM. This paper adopts the methodology of Reactive Optimization(RO) for evolutionary interactive multi-objective optimization. RO follows to the paradigm of "learning while optimizing", through the use of online ma...

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

    Science.gov (United States)

    Stroup, Jay Walter

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Guzel, Pinar

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-09-01

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

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

    Science.gov (United States)

    Habib, Shahid; Nokra, Nada A.

    2004-02-01

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

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

    Science.gov (United States)

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

    2012-04-01

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

  5. The Statistical Value Chain - a Benchmarking Checklist for Decision Makers to Evaluate Decision Support Seen from a Statistical Point-Of-View

    OpenAIRE

    Herrmann, Ivan Tengbjerg; Henningsen, Geraldine; Wood, Christian D.; James I.R. Blake; Mortensen, Jørgen Birk; Spliid, Henrik

    2013-01-01

    When decisions are made, by decision makers (DMs) in private and public organizations the DMs are supported by analysts (ANs) who provide decision support to the DM. Therefore, the quality of decision support provided by the AN directly affects the quality of a DM’s decision. At present, many quantitative methods exist for evaluating uncertainty—for example, Monte Carlo simulation—and such methods work very well when the AN is in full control of the data collection and model-building processe...

  6. Modelling of adaptation to climate change and decision-makers behaviours for the Veluwe forest area in the Netherlands

    DEFF Research Database (Denmark)

    Yousefpour, Rasoul; Didion, Markus; Jacobsen, Jette Bredahl

    2015-01-01

    production as a measure of management performance. The results illustrate the benefits of updating beliefs to eventually utilize the positive effects and limit negative impacts of climate change on forest biomass production. We find that adaptive decision-making results in switching decisions over time......We apply Bayesian updating theory to model how decision-makers may gradually learn about climate change and make use of this information in making adaptive forest management decisions. We develop modelling steps to i) simulate observation of a multi-dimensional climate system, ii) apply updating...... and mostly differ from deterministic decisions ignoring any change in climate. Moreover, we find that the adaptation strategies are indispensable not only because of climate change but also because of the development of the forest biological system over time and the need to revisit decisions....

  7. Computerized clinical decision support systems for therapeutic drug monitoring and dosing: A decision-maker-researcher partnership systematic review

    Directory of Open Access Journals (Sweden)

    Weise-Kelly Lorraine

    2011-08-01

    Full Text Available Abstract Background Some drugs have a narrow therapeutic range and require monitoring and dose adjustments to optimize their efficacy and safety. Computerized clinical decision support systems (CCDSSs may improve the net benefit of these drugs. The objective of this review was to determine if CCDSSs improve processes of care or patient outcomes for therapeutic drug monitoring and dosing. Methods We conducted a decision-maker-researcher partnership systematic review. Studies from our previous review were included, and new studies were sought until January 2010 in MEDLINE, EMBASE, Evidence-Based Medicine Reviews, and Inspec databases. Randomized controlled trials assessing the effect of a CCDSS on process of care or patient outcomes were selected by pairs of independent reviewers. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results Thirty-three randomized controlled trials were identified, assessing the effect of a CCDSS on management of vitamin K antagonists (14, insulin (6, theophylline/aminophylline (4, aminoglycosides (3, digoxin (2, lidocaine (1, or as part of a multifaceted approach (3. Cluster randomization was rarely used (18% and CCDSSs were usually stand-alone systems (76% primarily used by physicians (85%. Overall, 18 of 30 studies (60% showed an improvement in the process of care and 4 of 19 (21% an improvement in patient outcomes. All evaluable studies assessing insulin dosing for glycaemic control showed an improvement. In meta-analysis, CCDSSs for vitamin K antagonist dosing significantly improved time in therapeutic range. Conclusions CCDSSs have potential for improving process of care for therapeutic drug monitoring and dosing, specifically insulin and vitamin K antagonist dosing. However, studies were small and generally of modest quality, and effects on patient outcomes were uncertain, with no convincing

  8. Urban Sustainability and Parking Areas in Naples: a Tool for Decision-Makers

    Directory of Open Access Journals (Sweden)

    Carmela Gargiulo

    2010-04-01

    Full Text Available The methodological target of this paper consists in setting up a supporting tool for the public decision-maker in individuating the areas for parking within urban territory. The construction of this tool is guided by criteria referring more to urban and regional planning choices than to transport ones and concerning mostly the integration among environmental safeguard, activities distribution and need for mobility. As matter of fact, the methodological route tends to join the morphologicalsettlement and environmental characteristics of the site with the demand for parking, which depends on the activities settled in the urban ambit of reference, considering them as keyelements in building compatible choices of city transformation either in the phase of localization, distribution and sizing of interventions or in the following phase of planning the building typology of parking equipments. This paper shares the position expressed in the report on sustainable European Cities, destined to the local authorities of any city in the states of the European Union, which belongs to those documents targeted to affect the development and implementation of innovating policies and actions for promoting a more sustainable urban Europe. Therefore, the paper is divided into three parts. The first part defines the algorithm showing the iter through which it is possible to define feasible and compatible solutions for envisaging localization, distribution and typology of the areas and spaces to be realized. The second part, through the real implementation in a particular case, the city of Naples, deals with the definition of further criteria that are time by time implemented according to the urban context of reference. The tird part deals with the application to Naples and individuates a specific typology of parking areas, as implementation of the worked out algorythm and of the abovesaid criteria. The central part of the paper deals, then, with defining a route

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

    Science.gov (United States)

    Madani, Kaveh

    2016-04-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  11. Market orientation in the mental models of decision-makers in two cross-border value chains: A pilot study using the laddering technique

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Trondsen, Torbjørn; Campos, Emilio Gonzalo

    in the mental models that can be related to actors? market orientation. In both value chains decision-makers have a fair degree of overlap in their views on what drives their business. There are also differences, between the chains, in what decision-makers believe are the major success factors. The pork chain...

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

    Science.gov (United States)

    2016-02-09

    in the crisis and overcame it, not with soaring rhetoric , but with bold actions, each of which shifted public opinion toward support of his policy...Jacobs, Lawrence R., and Robert Y. Shapiro. “Lyndon Johnson, Vietnam, and Public Opinion : Rethinking Realist Theory of Leadership.” Presidential ...1 AIR WAR COLLEGE AIR UNIVERSITY GAINING MOMENTUM: HOW MEDIA INFLUENCES PUBLIC OPINION TO PUSH CIVIL-MILITARY DECISION MAKERS INTO

  13. Low-frequency electrical and magnetic fields: The precautionary principle for national authorities. Guidance for decision-makers

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    This publication is intended as a support for making decisions on health hazards and electromagnetic fields. It is based on the strength of scientific findings hitherto, at the same time as technical and economic aspects of possible measures are considered in the light of limited community resources. The national authorities recommend a precautionary principle based primarily on non-discountable cancer risks. Similar principles should also be applied to other suspected effects on health. The guide offers supportive documentation to decision-makers` tasks with assessing what is reasonable in each individual case, balancing possible hazards against technical and economic considerations. 6 refs

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

    Science.gov (United States)

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

    2015-09-01

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

  15. [Requirements for and expectations of health technology assessment in Galicia (Spain). A qualitative study from the perspective of decision-makers and clinicians].

    Science.gov (United States)

    Varela-Lema, Leonor; Merino, Gerardo Atienza; García, Marisa López; Martínez, María Vidal; Triana, Elena Gervas; Mota, Teresa Cerdá

    2011-01-01

    To explore perceptions of the use of health technology assessment (HTA) in the Galician public health system, identify opinions on the usefulness of the products and services developed by the Galician Health Technology Assessment Agency (avalia-t), and determine the barriers and facilitators to the transfer of results to clinical practice. We performed a qualitative study based on in-depth semi-structured interviews of 20 intentionally selected experts (10 health care professionals and 10 hospital decision makers). The interviews were tape recorded and transcribed for inductive thematic analysis. Interest in HTA activities was high, but most informants considered these activities to be underused as a tool to aid decision making in clinical practice. A series of key factors was identified to guarantee HTA use: greater dissemination of HTA activities and availability of the results, increased involvement and communication among health care professionals in the selection and prioritization of relevant research, contextualization and adaptation of results to the local context, increased organizational support and greater financial resources. The present study allows end-userś opinions on the utility of the various products/services offered by HTA agencies to be contrasted in order to adapt HTA activity to their needs and requirements. The involvement of health care professionals in all HTA fields is perceived as one of the main lines of action for HTA agencies. Such involvement could be achieved by reinforcing personal contact and increasing feedback to collaborators. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  16. Product Life Cycle concept use and application by marketing decision-makers in small South African organisations

    Directory of Open Access Journals (Sweden)

    F. J. Herbst

    2003-12-01

    Full Text Available The purpose of the study was to test the underlying theory of the product life cycle concept with the primary objective of establishing what the use and practical value of the product life cycle concept is in making marketing decisions in small manufacturing and dealer organisations in Gauteng. The main focus was to test the ability of marketing decision-makers in these small organisations to associate their application and use of the product life cycle concept with Kotler's assumptions on marketing characteristics, described marketing objectives and proposed marketing strategies. A major finding was that small organisations tended to display a marketing knowledge level with the existing marketing theory. Another important conclusion of the study was that the current product life cycle concept theory needs to be broadened to include strategies on the expanded marketing mix. Apart from the different use and application by marketing decision-makers in small organisations in South Africa the product life cycle concept theory has potential as a strategic tool and a high likelihood for its future use as a marketing decision-making instrument.

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2012-11-01

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

  19. The Teacher as Decision-Maker: Connecting Self with the Practice of Teaching.

    Science.gov (United States)

    Manley-Casimir, Michael; Wassermann, Selma

    1989-01-01

    Describes a teacher education course which focused on study of critical incidents to analyze teachers' decision-making practices. A film which portrayed a teacher in decision-making crisis was viewed and later discussed in small groups. Teachers were asked to relate the film to personal experiences and to keep a journal during the course to…

  20. Is investing in apprentices related to decision-makers' altruism and their high time preference?

    NARCIS (Netherlands)

    Jansen, A.

    2016-01-01

    In this article, the relation between firms’ engagement in apprenticeship training and two important economic preferences, i.e. the decision maker’s altruism and time preference, is analyzed. Firstly, the relation between these two preferences and a firm’s decision to provide apprenticeship places

  1. A decision aid regarding long-term tube feeding targeting substitute decision makers for cognitively impaired older persons in Japan: a small-scale before-and-after study.

    Science.gov (United States)

    Kuraoka, Yumiko; Nakayama, Kazuhiro

    2014-02-05

    In Japan, there is no decision-making guide regarding long-term tube feeding that specifically targets individuals making decisions on behalf of cognitively impaired older persons (substitute decision makers). The objective of this study was to describe the development and evaluation of such a decision aid. In this before-and-after study, participants comprised substitute decision makers for 13 cognitively impaired inpatients aged 65 years and older who were being considered for placement of a percutaneous endoscopic gastrostomy tube in acute care hospitals and mixed-care hospitals in Japan. Questionnaires were used to compare substitute decision makers' knowledge, decisional conflict, and predisposition regarding feeding tube placement before and after exposure to a decision aid. The acceptability of the decision aid was also assessed. Paired t-tests were used to compare participants' knowledge and decisional conflict scores before and after using the decision aid. Substitute decision makers showed significantly increased knowledge (P substitute decision makers found the decision aid helpful and acceptable. The decision aid facilitated the decision-making process of substitute decision makers by decreasing decisional conflict and increasing knowledge.

  2. Healthcare professionals' and policy makers' views on implementing a clinical practice guideline of hypertension management: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Ping Yein Lee

    Full Text Available Most studies have reported barriers to guideline usage mainly from doctors' perspective; few have reported the perspective of other stakeholders. This study aimed to determine the views and barriers to adherence of a national clinical practice guideline (CPG on management of hypertension from the perspectives of policymakers, doctors and allied healthcare professionals.This study used a qualitative approach with purposive sampling. Seven in depth interviews and six focus group discussions were conducted with 35 healthcare professionals (policy makers, doctors, pharmacists and nurses at a teaching hospital in Kuala Lumpur, Malaysia, between February and June 2013. All interviews were audio-recorded, transcribed verbatim and checked. Thematic approach was used to analyse the data.Two main themes and three sub-themes emerged from this study. The main themes were (1 variation in the use of CPG and (2 barriers to adherence to CPG. The three sub-themes for barriers were issues inherent to the CPG, systems and policy that is not supportive of CPG use, and attitudes and behaviour of stakeholders. The main users of the CPG were the primary care doctors. Pharmacists only partially use the guidelines, while nurses and policy makers were not using the CPG at all. Participants had suggested few strategies to improve usage and adherence to CPG. First, update the CPG regularly and keep its content simple with specific sections for allied health workers. Second, use technology to facilitate CPG accessibility and provide protected time for implementation of CPG recommendations. Third, incorporate local CPG in professional training, link CPG adherence to key performance indicators and provide incentives for its use.Barriers to the use of CPG hypertension management span across all stakeholders. The development and implementation of CPG focused mainly on doctors with lack of involvement of other healthcare stakeholders. Guidelines should be made simple, current

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

    Science.gov (United States)

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

    2017-08-03

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

  4. "It's not just what the doctor tells me:" factors that influence surrogate decision-makers' perceptions of prognosis.

    Science.gov (United States)

    Boyd, Elizabeth A; Lo, Bernard; Evans, Leah R; Malvar, Grace; Apatira, Latifat; Luce, John M; White, Douglas B

    2010-05-01

    Physicians and surrogate decision-makers for seriously ill patients often have different views of patients' prognoses. We sought to understand what sources of knowledge surrogates rely on when estimating a patient's prognosis. Prospective, mixed-methods study using face-to-face, semistructured interviews with surrogate decision-makers. Four intensive care units at the University of California, San Francisco Medical Center in 2006 to 2007. Participants were 179 surrogate decision-makers for 142 incapacitated, critically ill patients at high risk for death. Less than 2% (3 of 179) of surrogates reported that their beliefs about the patients' prognoses hinged exclusively on prognostic information provided to them by physicians. The majority cited other factors in addition to physicians' predictions that also contributed to their beliefs about the patients' prognoses, including perceptions of the patient's individual strength of character and will to live; the patient's unique history of illness and survival; the surrogate's own observations of the patient's physical appearance; the surrogate's belief that their presence at the bedside may improve the prognosis; and the surrogate's optimism, intuition, and faith. For some surrogates, these other sources of knowledge superseded the importance of the physician's prognostication. However, most surrogates endeavored to balance their own knowledge of the patient with physicians' biomedical knowledge. Surrogates use diverse types of knowledge when estimating their loved ones' prognoses, including individualized attributes of the patient, such as their strength of character and life history, of which physicians may be unaware. Attention to these considerations may help clinicians identify and overcome disagreements about prognosis.

  5. An Application of Narrowing the Information Gap Between Data Providers and Decision Makers Through a Disaster Response Scenario

    Science.gov (United States)

    Lowther, R. P.; Brill, M.

    2008-12-01

    A scenario-based distributed information system for operationally building the Global Earth Observing System of Systems (GEOSS) is presented as part of Northrop Grumman's participation in the GEOSS ten- year Architecture Implementation Pilot plan. Northrop Grumman is responding to the application challenge of implementing GEOSS capabilities by adding several U.S. Global Earth Observing (USGEO) data providers through architecture development and multiple scenario demonstrations, one of which is Natural Disaster Response. The scenarios ensure responders collaborate with the Group on Earth Observations (GEO) Societal Benefit Area working groups and external agencies. A six-stage disaster cycle is executed for a major hurricane and flooding scenario on the Port of Houston that incorporates multiple user communities and demonstrates how communities of practice may be applied to extend information sharing in response to disasters. The scenario is user driven and uses products derived from existing earth observing systems. The enterprise model for this hurricane and flooding scenario depicts an end-to-end approach to executing disaster response management. The centrality of the community portal in creating a coordinated disaster response cannot be overstated. Northrop Grumman has reached interoperability agreements with multiple community data providers whose goal is to make their data and products accessible as "persistent exemplars" within GEOSS to global users and decision makers. As multiple GEO community members integrate their data and services into GEOSS, the whole of GEOSS becomes much more than the sum of its components; however, GEOSS must deliver high-value information easily understood by decision makers through smart source selection. When this occurs, and GEOSS becomes operational, the information gap will narrow between systems, providers, analysts, and decision makers.

  6. The Impact of Decision Makers' Constraints on the Outcome of Value of Information Analysis

    NARCIS (Netherlands)

    Koffijberg, Hendrik; Knies, Saskia; Janssen, Mart P.

    2017-01-01

    Background: When proven effective, decision making regarding reimbursement of new health technology typically involves ethical, social, legal, and health economic aspects and constraints. Nevertheless, when applying standard value of information (VOI) analysis, the value of collecting additional

  7. Heuristics: The good, the bad, and the biased. What value can bias have for decision makers?

    OpenAIRE

    Curley, Lee J.; Murray, Jennifer.; MacLean, Rory.

    2017-01-01

    This discussion paper will look at heuristics (rule of thumb techniques for decision making), (Tversky & Kahneman, 1974) and their potential value. Typically, heuristics have been viewed negatively (Gigerenzer & Goldstein, 1996), with research suggesting that heuristics bias how individuals think, which may create sub-optimal performance (Tversky & Kahneman, 1974). However, researchers, such as Gigerenzer and Goldstein (1996), have highlighted that a bias in decision making may not necessaril...

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

    Energy Technology Data Exchange (ETDEWEB)

    Webb, Erik Karl; Tidwell, Vincent Carroll

    2009-10-01

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

  9. Decision-maker's guide to wood fuel for small industrial energy users. Final report. [Includes glossary

    Energy Technology Data Exchange (ETDEWEB)

    Levi, M. P.; O& #x27; Grady, M. J.

    1980-02-01

    The technology and economics of various wood energy systems available to the small industrial and commercial energy user are considered. This book is designed to help a plant manager, engineer, or others in a decision-making role to become more familiar with wood fuel systems and make informed decisions about switching to wood as a fuel. The following subjects are discussed: wood combustion, pelletized wood, fuel storage, fuel handling and preparation, combustion equipment, retrofitting fossil-fueled boilers, cogeneration, pollution abatement, and economic considerations of wood fuel use. (MHR)

  10. A Conceptual Framework for Defense Acquisition Decision Makers: Giving the Schedule its Due

    Science.gov (United States)

    2014-01-01

    Principles from microeconomic theory and operations research can provide insight into acquisition decisions to produce military capabili- ties in an...Department Edmund Conrow (1995) developed an excellent microeconomic framework to investigate the incentives of buyers and sellers in the defense

  11. 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.

  12. The Impact of the Arab Decision-Makers on the Oil Market

    Science.gov (United States)

    1976-03-01

    model and the Snyder Decision-making modelo Their strategies will be analyzed as a form of deterrence proposed by Herman Kahn„ Areas of analysis will be...aggression unprofitable." J The oil weapon has all the desirable characteristics of a successful deterrent. It is cheap, non-accident prone, persuasive , 12

  13. Factors Influencing the Adoption of Cloud Storage by Information Technology Decision Makers

    Science.gov (United States)

    Wheelock, Michael D.

    2013-01-01

    This dissertation uses a survey methodology to determine the factors behind the decision to adopt cloud storage. The dependent variable in the study is the intent to adopt cloud storage. Four independent variables are utilized including need, security, cost-effectiveness and reliability. The survey includes a pilot test, field test and statistical…

  14. Decision Makers Calibrate Behavioral Persistence on the Basis of Time-Interval Experience

    Science.gov (United States)

    McGuire, Joseph T.; Kable, Joseph W.

    2012-01-01

    A central question in intertemporal decision making is why people reverse their own past choices. Someone who initially prefers a long-run outcome might fail to maintain that preference for long enough to see the outcome realized. Such behavior is usually understood as reflecting preference instability or self-control failure. However, if a…

  15. Prevalence of and Factors Related to Discordance About Prognosis Between Physicians and Surrogate Decision Makers of Critically Ill Patients.

    Science.gov (United States)

    White, Douglas B; Ernecoff, Natalie; Buddadhumaruk, Praewpannarai; Hong, Seoyeon; Weissfeld, Lisa; Curtis, J Randall; Luce, John M; Lo, Bernard

    2016-05-17

    Misperceptions about prognosis by individuals making decisions for incapacitated critically ill patients (surrogates) are common and often attributed to poor comprehension of medical information. To determine the prevalence of and factors related to physician-surrogate discordance about prognosis in intensive care units (ICUs). Mixed-methods study comprising quantitative surveys and qualitative interviews conducted in 4 ICUs at a major US medical center involving surrogate decision makers and physicians caring for patients at high risk of death from January 4, 2005, to July 10, 2009. Discordance about prognosis, defined as a difference between a physician's and a surrogate's prognostic estimates of at least 20%; misunderstandings by surrogates (defined as any difference between a physician's prognostic estimate and a surrogate's best guess of that estimate); differences in belief (any difference between a surrogate's actual estimate and their best guess of the physician's estimate). Two hundred twenty-nine surrogate decision makers (median age, 47 [interquartile range {IQR}, 35-56] years; 68% women) and 99 physicians were involved in the care of 174 critically ill patients (median age, 60 [IQR, 47-74] years; 44% women). Physician-surrogate discordance about prognosis occurred in 122 of 229 instances (53%; 95% CI, 46.8%-59.7%). In 65 instances (28%), discordance was related to both misunderstandings by surrogates and differences in belief about the patient's prognosis; 38 (17%) were related to misunderstandings by surrogates only; 7 (3%) were related to differences in belief only; and data were missing for 12. Seventy-five patients (43%) died. Surrogates' prognostic estimates were much more accurate than chance alone, but physicians' prognostic estimates were statistically significantly more accurate than surrogates' (C statistic, 0.83 vs 0.74; absolute difference, 0.094; 95% CI, 0.024-0.163; P = .008). Among 71 surrogates interviewed who had beliefs about the

  16. Critical care physicians’ approaches to negotiating with surrogate decision makers: a qualitative study

    Science.gov (United States)

    Brush, David R.; Brown, Crystal E.; Alexander, G. Caleb

    2013-01-01

    Objective To describe how critical care physicians manage conflicts with surrogates about withdrawing or withholding patients’ life support. Design Qualitative analysis of key informant interviews with critical care physicians during 2010. We transcribed interviews verbatim and used grounded theory to code and revise a taxonomy of themes and to identify illustrative quotes. Setting 3 academic medical centers, 1 academic-affiliated medical center and 4 private practice groups or private hospitals in a large Midwestern city Subjects 14 critical care physicians Measurements and main results Physicians reported tailoring their approach to address specific reasons for disagreement with surrogates. Five common approaches were identified: (1) building trust, (2) educating and informing, (3) providing surrogates more time, (4) adjusting surrogate and physician roles, and (5) highlighting specific values. When mistrust was an issue, physicians endeavored to build a more trusting relationship with the surrogate before re-addressing decision making. Physicians also reported correcting misunderstandings by providing targeted education, and some reported highlighting specific patient, surrogate, or physician values that they hoped would guide surrogates to agree with them. When surrogates struggled with decision making roles, physicians attempted to reinforce the concept of substituted judgment. Physicians noted that some surrogates needed time to “come to terms” with the patent’s illness before agreeing with physicians. Many physicians had witnessed colleagues negotiate in ways they found objectionable, such as providing misleading information, injecting their own values into the negotiation, or behaving unprofessionally towards surrogates. While some physicians viewed their efforts to encourage surrogates’ agreement as persuasive, others strongly denied persuading surrogates and described their actions as “guiding” or “negotiating.” Conclusions Physicians

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

    Science.gov (United States)

    Haynes, R Brian; Wilczynski, Nancy L

    2010-02-05

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

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

    Directory of Open Access Journals (Sweden)

    Wilczynski Nancy L

    2010-02-01

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

  19. Patient-reported outcomes in meta-analyses-part 2: methods for improving interpretability for decision-makers.

    Science.gov (United States)

    Johnston, Bradley C; Patrick, Donald L; Thorlund, Kristian; Busse, Jason W; da Costa, Bruno R; Schünemann, Holger J; Guyatt, Gordon H

    2013-12-21

    Systematic reviews and meta-analyses of randomized trials that include patient-reported outcomes (PROs) often provide crucial information for patients, clinicians and policy-makers facing challenging health care decisions. Based on emerging methods, guidance on improving the interpretability of meta-analysis of patient-reported outcomes, typically continuous in nature, is likely to enhance decision-making. The objective of this paper is to summarize approaches to enhancing the interpretability of pooled estimates of PROs in meta-analyses. When differences in PROs between groups are statistically significant, decision-makers must be able to interpret the magnitude of effect. This is challenging when, as is often the case, clinical trial investigators use different measurement instruments for the same construct within and between individual randomized trials. For such cases, in addition to pooling results as a standardized mean difference, we recommend that systematic review authors use other methods to present results such as relative (relative risk, odds ratio) or absolute (risk difference) dichotomized treatment effects, complimented by presentation in either: natural units (e.g. overall depression reduced by 2.4 points when measured on a 50-point Hamilton Rating Scale for Depression); minimal important difference units (e.g. where 1.0 unit represents the smallest difference in depression that patients, on average, perceive as important the depression score was 0.38 (95% CI 0.30 to 0.47) units less than the control group); or a ratio of means (e.g. where the mean in the treatment group is divided by the mean in the control group, the ratio of means is 1.27, representing a 27% relative reduction in the mean depression score).

  20. Reducing Energy Subsidies in China, India and Russia: Dilemmas for Decision Makers

    Directory of Open Access Journals (Sweden)

    Indra Overland

    2010-02-01

    Full Text Available This article examines and compares efforts to reduce energy subsidies in China, India and Russia. Despite dissimilarities in forms of governance, these three states have followed surprisingly similar patterns in reducing energy subsidies, characterised by two steps forward, one step back. Non-democratic governments and energy importers might be expected to be more likely to halt subsidies. In fact, the degree of democracy and status as net energy exporters or importers does not seem to significantly affect these countries’ capacity to reduce subsidies, as far as can be judged from the data in this article. Politicians in all three fear that taking unpopular decisions may provoke social unrest.

  1. A graphical, computer-based decision-support tool to help decision makers evaluate policy options relating to physical activity.

    Science.gov (United States)

    Yancey, Antronette K; Cole, Brian L; McCarthy, William J

    2010-09-01

    This pilot study builds on efforts to develop evaluation methods to compare and contrast potential strategies designed to increase population physical activity generally, and to reduce disparities in activity levels more specifically. The study presents a user-friendly, semi-quantitative decision-support tool of intermediate complexity that may better enable quick, flexible first-pass "ballpark" decision making by state and local health agencies instead of traditional evidence-based scientific reviews. The tool produces a summary score from ratings on 18 criteria, adjusted by fixed or variable weights to incorporate salient community contextual factors. Stair use, workplace activity breaks, and school construction siting are presented as samples. This first iteration of the decision-support tool is intended to be refined empirically by the experiences and policy outcomes of agencies adopting the innovation. This decision-support tool may expand the capacity of public health practitioners to conduct first-pass assessments of policy options for physical activity promotion in underserved communities. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Kadir Masood

    2007-01-01

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

  3. Transportation Energy Futures: Key Opportunities and Tools for Decision Makers (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2012-12-01

    The Transportation Energy Futures (TEF) project examines underexplored greenhouse gas-abatement and oil-savings opportunities by consolidating transportation energy knowledge, conducting advanced analysis, and exploring additional opportunities for sound strategic action. Led by NREL, in collaboration with Argonne National Laboratory, the project's primary goal is to provide analysis to accompany DOE-EERE's long-term transportation energy planning by addressing high-priority questions, informing domestic decisions about transportation energy strategies, priorities, and investments. Research and analysis were conducted with an eye toward short-term actions that support long-term energy goals The project looks beyond technology to examine each key question in the context of the marketplace, consumer behavior, industry capabilities, and infrastructure. This updated fact sheet includes a new section on initial project findings.

  4. Publicly available software tools for decision-makers during an emergent epidemic-Systematic evaluation of utility and usability.

    Science.gov (United States)

    Heslop, David James; Chughtai, Abrar Ahmad; Bui, Chau Minh; MacIntyre, C Raina

    2017-12-01

    Epidemics and emerging infectious diseases are becoming an increasing threat to global populations-challenging public health practitioners, decision makers and researchers to plan, prepare, identify and respond to outbreaks in near real-timeframes. The aim of this research is to evaluate the range of public domain and freely available software epidemic modelling tools. Twenty freely utilisable software tools underwent assessment of software usability, utility and key functionalities. Stochastic and agent based tools were found to be highly flexible, adaptable, had high utility and many features, but low usability. Deterministic tools were highly usable with average to good levels of utility. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  5. The CAULDRON game: Helping decision makers understand extreme weather event attribution

    Science.gov (United States)

    Walton, P.; Otto, F. E. L.

    2014-12-01

    There is a recognition from academics and stakeholders that climate science has a fundamental role to play in the decision making process, but too frequently there is still uncertainty about what, when, how and why to use it. Stakeholders suggest that it is because the science is presented in an inaccessible manner, while academics suggest it is because the stakeholders do not have the scientific knowledge to understand and apply the science appropriately. What is apparent is that stakeholders need support, and that there is an onus on academia to provide it. This support is even more important with recent developments in climate science, such as extreme weather event attribution. We are already seeing the impacts of extreme weather events around the world causing lost of life and damage to property and infrastructure with current research suggesting that these events could become more frequent and more intense. If this is to be the case then a better understanding of the science will be vital in developing robust adaptation and business planning. The use of games, role playing and simulations to aid learning has long been understood in education but less so as a tool to support stakeholder understanding of climate science. Providing a 'safe' space where participants can actively engage with concepts, ideas and often emotions, can lead to deep understanding that is not possible through more passive mechanisms such as papers and web sites. This paper reports on a game that was developed through a collaboration led by the Red Cross/Red Crescent, University of Oxford and University of Reading to help stakeholders understand the role of weather event attribution in the decision making process. The game has already been played successfully at a number of high profile events including COP 19 and the African Climate Conference. It has also been used with students as part of a postgraduate environmental management course. As well as describing the design principles of the

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    Eckermann, Simon; Willan, Andrew R

    2013-05-01

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

  8. GAIA - a generalizable, extensible structure for integrating games, models and social networking to support decision makers

    Science.gov (United States)

    Paxton, L. J.; Schaefer, R. K.; Nix, M.; Fountain, G. H.; Weiss, M.; Swartz, W. H.; Parker, C. L.; MacDonald, L.; Ihde, A. G.; Simpkins, S.; GAIA Team

    2011-12-01

    In this paper we describe the application of a proven methodology for modeling the complex social and economic interactions embodied in real-world decision making to water scarcity and water resources. We have developed a generalizable, extensible facility we call "GAIA" - Global Assimilation of Information for Action - and applied it to different problem sets. We describe the use of the "Green Country Model" and other gaming/simulation tools to address the impacts of climate and climate disruption issues at the intersection of science, economics, policy, and society. There is a long history in the Defense community of using what are known as strategic simulations or "wargames" to model the complex interactions between the environment, people, resources, infrastructure and the economy in a competitive environment. We describe in this paper, work that we have done on understanding how this heritage can be repurposed to help us explore how the complex interplay between climate disruption and our socio/political and economic structures will affect our future. Our focus here is on a fundamental and growing issue - water and water availability. We consider water and the role of "virtual water" in the system. Various "actors" are included in the simulations. While these simulations cannot definitively predict what will happen, they do illuminate non-linear feedbacks between, for example, treaty agreement, the environment, the economy, and the government. These simulations can be focused on the global, regional, or local environment. We note that these simulations are not "zero sum" games - there need not be a winner and a loser. They are, however, competitive influence games: they represent the tools that a nation, state, faction or group has at its disposal to influence policy (diplomacy), finances, industry (economy), infrastructure, information, etc to achieve their particular goals. As in the real world the problem is competitive - not everyone shares the same

  9. The ecological model web concept: A consultative infrastructure for researchers and decision makers using a Service Oriented Architecture

    Science.gov (United States)

    Geller, Gary

    2010-05-01

    Rapid climate and socioeconomic changes may be outrunning society's ability to understand, predict, and respond to change effectively. Decision makers such as natural resource managers want better information about what these changes will be and how the resources they are managing will be affected. Researchers want better understanding of the components and processes of ecological systems, how they interact, and how they respond to change. Nearly all these activities require computer models to make ecological forecasts that can address "what if" questions. However, despite many excellent models in ecology and related disciplines, there is no coordinated model system—that is, a model infrastructure--that researchers or decision makers can consult to gain insight on important ecological questions or help them make decisions. While this is partly due to the complexity of the science, to lack of critical observations, and other issues, limited access to and sharing of models and model outputs is a factor as well. An infrastructure that increased access to and sharing of models and model outputs would benefit researchers, decision makers of all kinds, and modelers. One path to such a "consultative infrastructure" for ecological forecasting is called the Model Web, a concept for an open-ended system of interoperable computer models and databases communicating using a Service Oriented Architectures (SOA). Initially, it could consist of a core of several models, perhaps made interoperable retroactively, and then it could grow gradually as new models or databases were added. Because some models provide basic information of use to many other models, such as simple physical parameters, these "keystone" models are of particular importance in a model web. In the long run, a model web would not be rigidly planned and built--instead, like the World Wide Web, it would grow largely organically, with limited central control, within a framework of broad goals and data exchange

  10. Psychological Peculiarities of Judge Professional Activity and Decision-Making

    Science.gov (United States)

    Uspanov, Zholdybai T.; Turabayeva, Dana S.

    2016-01-01

    The article considers the psychological peculiarities of judge professional activity and decision-making, judge's mental set and requirements to ethical and moral requirements and quality. Moreover, this work offers original job analysis and competency model of judge professional activity. The authors have studied the problems concerning the…

  11. What Makes Institutional Long-Term Care the Most Appropriate Setting for People With Dementia? Exploring the Influence of Client Characteristics, Decision-Maker Attributes, and Country in 8 European Nations.

    Science.gov (United States)

    Tucker, Sue; Brand, Christian; Sutcliffe, Caroline; Challis, David; Saks, Kai; Verbeek, Hilde; Cabrera, Esther; Karlsson, Staffan; Leino-Kilpi, Helena; Stephan, Astrid; Soto, Maria E

    2016-05-01

    To explore the extent to which client characteristics, decision-maker attributes, and country influence judgments of institutional long-term care (ILTC) appropriateness for people with dementia. A total of 161 experts in dementia care from 8 European countries reviewed a series of 14 vignettes representing people with dementia on the cusp of ILTC admission and indicated the most appropriate setting in which to support each case in a simple discrete choice exercise: own home, very sheltered housing, residential home, or nursing home. At least 16 experts participated in each country (Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the United Kingdom). Descriptive statistics were used to characterize the experts and their placement preferences. Logistic regression modeling was used to explore the extent to which the sociodemographic and clinical characteristics of people with dementia, and the profession, workplace, and country of decision-makers were associated with ILTC recommendation. Client characteristics, decision-maker attributes, and country all seemed to play a part in influencing professionals' perceptions of the appropriateness of ILTC for people with dementia. Expert decision-makers were more likely to recommend ILTC for individuals who required help with mobility or had multiple care needs, and appeared to give more weight to carers' than clients' wishes. Community-based social workers were less likely than other professional groups to favor ILTC placement. Experts in Finland, Germany, and the United Kingdom were less likely to recommend ILTC than experts in France, the Netherlands, and Estonia; experts in Sweden and Spain took an intermediate position. This study provides new understanding of the factors that shape professionals' perceptions of ILTC appropriateness and highlights the need to construct multifaceted models of institutionalization when planning services for people with dementia. It also has several important clinical

  12. To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles.

    Science.gov (United States)

    Lee, Yew Kong; Lee, Ping Yein; Cheong, Ai Theng; Ng, Chirk Jenn; Abdullah, Khatijah Lim; Ong, Teng Aik; Razack, Azad Hassan Abdul

    2015-01-01

    To explore the views of Malaysian healthcare professionals (HCPs) on stakeholders' decision making roles in localized prostate cancer (PCa) treatment. Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. The participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients' decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient's treatment due to Malaysia's close-knit family culture. A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.

  13. To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles.

    Directory of Open Access Journals (Sweden)

    Yew Kong Lee

    Full Text Available To explore the views of Malaysian healthcare professionals (HCPs on stakeholders' decision making roles in localized prostate cancer (PCa treatment.Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.The participants comprised private urologists (n = 4, government urologists (n = 6, urology trainees (n = 6, government policy maker (n = 1 and oncologists (n = 3. HCP perceptions of the roles of the three parties involved (HCPs, patients, family included: HCP as the main decision maker, HCP as a guide to patients' decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient's treatment due to Malaysia's close-knit family culture.A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.

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

    Science.gov (United States)

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

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

  15. Energy policy and the opinion leaders and the decision makers in Finland. Energiapolitiikka ja vaikuttajat. Energiapolitiikan maeaeraeytymiseen vaikuttaneista tahoista Suomessa

    Energy Technology Data Exchange (ETDEWEB)

    Ruostesaari, I.

    1987-11-01

    The present study analyses the formation of Finland's energy policy using governmental structure and elite research as a frame of reference. The main object of this study is to outline the network structure of the opinion leaders and of the overall interaction around the energy question. In other words, the purpose is to analyse those organizations and persons who in recent years have most deeply influenced on the formation of energy policy and on its decision making processes. The present study is in three parts. In the first part (Chapters 3-4) the structure of the interaction around the energy question and the network structure of the opinion leaders and the decision makers is outlined using mainly formal criteria. Chapter 3 studies the extent of participation in the formation of the national energy policy. In other words, the question is what bodies have participated through committee system in the formation o the energy policy and to what extent. In Chapter 4 the interrelationships of the various energy organizations are described using the so called interlocking directors method. In short, the first main part of the study looks for those organizations and persons who through their official position have either participated in the forming of the energy policy or have influenced on it. The second main part tries to indicate to what extent the above mentioned organizations and persons have real influence on the energy policy. Here the expert method is used. Also the roles which mass media, research work, and informal communication play in the energy policy are analysed here. In the third main part the energy policy's top elite is defined on the basis of the previous analyses. At the end a pattern based on the subsystems has been outlined to clarify the mechanism by which Finland's energy policy is formed.

  16. Haitian and international responders' and decision-makers' perspectives regarding disability and the response to the 2010 Haiti earthquake

    Science.gov (United States)

    Hunt, Matthew R.; Chung, Ryoa; Durocher, Evelyne; Henrys, Jean Hugues

    2015-01-01

    Background Following disasters, persons with disabilities (PWD) are especially vulnerable to harm, yet they have commonly been excluded from disaster planning, and their needs have been poorly addressed during disaster relief. Following the 2010 Haiti earthquake, thousands of individuals experienced acute injuries. Many more individuals with preexisting disabilities experienced heightened vulnerability related to considerations including safety, access to services, and meeting basic needs. Objective The objective of this research was to better understand the perceptions of responders and decision-makers regarding disability and efforts to address the needs of PWD following the 2010 earthquake. Design We conducted a qualitative study using interpretive description methodology and semistructured interviews with 14 Haitian and 10 international participants who were involved in the earthquake response. Results Participants identified PWD as being among the most vulnerable individuals following the earthquake. Though some forms of disability received considerable attention in aid efforts, the needs of other PWD did not. Several factors were identified as challenges for efforts to address the needs of PWD including lack of coordination and information sharing, the involvement of multiple aid sectors, perceptions that this should be the responsibility of specialized organizations, and the need to prioritize limited resources. Participants also reported shifts in local social views related to disability following the earthquake. Conclusions Addressing the needs of PWD following a disaster is a crucial population health challenge and raises questions related to equity and responsibility for non-governmental organizations, governments, and local communities. PMID:26257047

  17. Haitian and international responders' and decision-makers' perspectives regarding disability and the response to the 2010 Haiti earthquake.

    Science.gov (United States)

    Hunt, Matthew R; Chung, Ryoa; Durocher, Evelyne; Henrys, Jean Hugues

    2015-01-01

    Following disasters, persons with disabilities (PWD) are especially vulnerable to harm, yet they have commonly been excluded from disaster planning, and their needs have been poorly addressed during disaster relief. Following the 2010 Haiti earthquake, thousands of individuals experienced acute injuries. Many more individuals with preexisting disabilities experienced heightened vulnerability related to considerations including safety, access to services, and meeting basic needs. The objective of this research was to better understand the perceptions of responders and decision-makers regarding disability and efforts to address the needs of PWD following the 2010 earthquake. We conducted a qualitative study using interpretive description methodology and semistructured interviews with 14 Haitian and 10 international participants who were involved in the earthquake response. Participants identified PWD as being among the most vulnerable individuals following the earthquake. Though some forms of disability received considerable attention in aid efforts, the needs of other PWD did not. Several factors were identified as challenges for efforts to address the needs of PWD including lack of coordination and information sharing, the involvement of multiple aid sectors, perceptions that this should be the responsibility of specialized organizations, and the need to prioritize limited resources. Participants also reported shifts in local social views related to disability following the earthquake. Addressing the needs of PWD following a disaster is a crucial population health challenge and raises questions related to equity and responsibility for non-governmental organizations, governments, and local communities.

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

    Science.gov (United States)

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

    2013-06-03

    Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers' knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer's costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of

  19. Multi-criteria decision analysis of breast cancer control in low- and middle- income countries: development of a rating tool for policy makers

    NARCIS (Netherlands)

    Venhorst, K.; Zelle, S.G.; Tromp, N.; Lauer, J.A.

    2014-01-01

    BACKGROUND: The objective of this study was to develop a rating tool for policy makers to prioritize breast cancer interventions in low- and middle- income countries (LMICs), based on a simple multi-criteria decision analysis (MCDA) approach. The definition and identification of criteria play a key

  20. Joint research project to develop a training course or nuclear policy decision makers and planners in developing countries between KAERI and IAEA

    Energy Technology Data Exchange (ETDEWEB)

    Lee, E. J.; Suh, I. S.; Lee, H. Y. and others

    2000-12-01

    KAERI developed training course curricula on nuclear power policy and planning for decision makers and planners in developing countries under the assistance of the IAEA. It was utilized two IAEA staff members and a Korean consultation group were utilized for the development of curricula. Curriculum consists of training objectives, training contents in modular basis, detailed contents of each training module, training setting, training duration, session hours, and entry requirements of audience. One is workshop on nuclear energy policy for high-level decision makers in developing countries. The other is training course on nuclear power planning and project management for middle level managers in developing countries. The textbook in English will be printed by the end of February in 2001. Developed curricula will be implemented for Vietnam high level nuclear decision makers, middle level managers in developing countries and north Korea nuclear high level decision makers in 2001. These training courses' curricula and textbook will be utilized as basic technical documents to promote the national nuclear bilateral technical cooperation programs with Morocco, Egypt, Bangladesh, Indonesia, Ukraine, etc.

  1. Application of a General Risk Management Model to Portfolio Optimization Problems with Elliptical Distributed Returns for Risk Neutral and Risk Averse Decision Makers

    NARCIS (Netherlands)

    B. Kaynar; S.I. Birbil (Ilker); J.B.G. Frenk (Hans)

    2007-01-01

    textabstractIn this paper portfolio problems with linear loss functions and multivariate elliptical distributed returns are studied. We consider two risk measures, Value-at-Risk and Conditional-Value-at-Risk, and two types of decision makers, risk neutral and risk averse. For Value-at-Risk, we show

  2. Decision making for health care professionals: use of decision trees within the community mental health setting.

    Science.gov (United States)

    Bonner, G

    2001-08-01

    To examine the application of the decision tree approach to collaborative clinical decision-making in mental health care in the United Kingdom (UK). While this approach to decision-making has been examined in the acute care setting, there is little published evidence of its use in clinical decision-making within the mental health setting. The complexities of dual diagnosis (schizophrenia and substance misuse in this case example) and the varied viewpoints of different professionals often hamper the decision-making process. This paper highlights how the approach was used successfully as a multiprofessional collaborative approach to decision-making in the context of British community mental health care. A selective review of the relevant literature and a case study application of the decision tree framework. The process of applying the decision tree framework to clinical decision-making in mental health practice can be time consuming and client inclusion within the process is not always appropriate. The approach offers a method of assigning numerical values to support complex multiprofessional decision-making as well as considering underpinning literature to inform the final decision. Use of the decision tree offers a common framework that can assist professionals to examine the options available to them in depth, while considering the complex variables that influence decision-making in collaborative mental health practice. Use of the decision tree warrants further consideration in mental health care in terms of practice and education.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    1975-08-01

    1959. b Schlaifer, R. Anais 2f decisions under uncertainitv. New York: McGraw-Hill, 1969. Schopenhauer , A. The art of controversy. In J. B. Saunders...Ed.), 7_11a s qf L u Schopenhauer , New York: Wiley Book Co., no date. Schrenk, L. P. Objective difficulty and input history in sequential decision

  5. Educational Programs for Intelligence Professionals.

    Science.gov (United States)

    Miller, Jerry P.

    1994-01-01

    Discusses the need for education programs for competitive intelligence professionals. Highlights include definitions of intelligence functions, focusing on business intelligence; information utilization by decision makers; information sources; competencies for intelligence professionals; and the development of formal education programs. (38…

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

    Science.gov (United States)

    2013-01-01

    Background Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. Methods An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers’ knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. Results The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer’s costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic

  7. Understanding Decision Making through Complexity in Professional Networks

    Directory of Open Access Journals (Sweden)

    Kon Shing Kenneth Chung

    2014-01-01

    Full Text Available The attitudes of general practitioners (GP play an influential role in their decision making about patient treatment and care. Considering the GP-patient encounter as a complex system, the interactions between the GP and their personal network of peers give rise to “aggregate complexity,” which in turn influences the GP’s decisions about patient treatment. This study models aggregate complexity and its influence in decision making in primary care through the use of social network metrics. Professional network and attitudinal data on decision making responsibility from 107 rural GPs were analysed. Social network measures of “density” and “inclusiveness” were used for computing the “interrelatedness” of components within such a “complex system.” The “number of components” and “degree of interrelatedness” were used to determine the complexity profiles, which was then used to associate with responsibility in decision making for each GP. GPs in simple profiles (i.e., with low components and interactions in contrast to those in nonsimple profiles, indicate a higher responsibility for the decisions they make in medical care. This study suggests that social networks-based complexity profiles are useful for understanding decision making in primary care as it accounts for the role of influence through the professional networks of GPs.

  8. Understanding and Addressing Vulnerability Following the 2010 Haiti Earthquake: Applying a Feminist Lens to Examine Perspectives of Haitian and Expatriate Health Care Providers and Decision-Makers.

    Science.gov (United States)

    Durocher, Evelyne; Chung, Ryoa; Rochon, Christiane; Hunt, Matthew

    2016-07-01

    Vulnerability is a central concept in humanitarian aid. Discussions of vulnerability in disaster response literature and guidelines for humanitarian aid range from considerations of a universal human vulnerability, to more nuanced examinations of how particular characteristics render individuals more or less at risk. Despite its frequent use, there is a lack of clarity about how vulnerability is conceptualized and how it informs operational priorities in humanitarian assistance. Guided by interpretive description methodology, we draw on the feminist taxonomy of vulnerability presented by Mackenzie, Rogers and Dodds (2014) to examine perspectives of 24 expatriate and Haitian decision-makers and health professionals interviewed between May 2012 and March 2013. The analysis explores concepts of vulnerability and equity in relation to the humanitarian response following the 2010 earthquake in Haiti. Participants' conceptualizations of vulnerability included consideration for inherent vulnerabilities related to individual characteristics (e.g. being a woman or disabled) and situational vulnerabilities related to particular circumstances such as having less access to health care resources or basic necessities. Participants recognized that vulnerabilities could be exacerbated by socio-political structures but felt ill-equipped to address these. The use of the taxonomy and a set of questions inspired by Hurst's (2008) approach to identifying and reducing vulnerability can guide the analysis of varied sources of vulnerability and open discussions about how and by whom vulnerabilities should be addressed in humanitarian responses. More research is required to inform how humanitarian responders could balance addressing acute vulnerability with consideration of systemic and pre-existing circumstances that underlie much of the vulnerability experienced following an acute disaster.

  9. Understanding and Addressing Vulnerability Following the 2010 Haiti Earthquake: Applying a Feminist Lens to Examine Perspectives of Haitian and Expatriate Health Care Providers and Decision-Makers

    Science.gov (United States)

    Chung, Ryoa; Rochon, Christiane; Hunt, Matthew

    2016-01-01

    Vulnerability is a central concept in humanitarian aid. Discussions of vulnerability in disaster response literature and guidelines for humanitarian aid range from considerations of a universal human vulnerability, to more nuanced examinations of how particular characteristics render individuals more or less at risk. Despite its frequent use, there is a lack of clarity about how vulnerability is conceptualized and how it informs operational priorities in humanitarian assistance. Guided by interpretive description methodology, we draw on the feminist taxonomy of vulnerability presented by Mackenzie, Rogers and Dodds (2014) to examine perspectives of 24 expatriate and Haitian decision-makers and health professionals interviewed between May 2012 and March 2013. The analysis explores concepts of vulnerability and equity in relation to the humanitarian response following the 2010 earthquake in Haiti. Participants’ conceptualizations of vulnerability included consideration for inherent vulnerabilities related to individual characteristics (e.g. being a woman or disabled) and situational vulnerabilities related to particular circumstances such as having less access to health care resources or basic necessities. Participants recognized that vulnerabilities could be exacerbated by socio-political structures but felt ill-equipped to address these. The use of the taxonomy and a set of questions inspired by Hurst’s (2008) approach to identifying and reducing vulnerability can guide the analysis of varied sources of vulnerability and open discussions about how and by whom vulnerabilities should be addressed in humanitarian responses. More research is required to inform how humanitarian responders could balance addressing acute vulnerability with consideration of systemic and pre-existing circumstances that underlie much of the vulnerability experienced following an acute disaster. PMID:27617037

  10. Exploring the experiences of substitute decision-makers with an exception to consent in a paediatric resuscitation randomised controlled trial: study protocol for a qualitative research study.

    Science.gov (United States)

    Parker, Melissa J; de Laat, Sonya; Schwartz, Lisa

    2016-09-13

    Prospective informed consent is required for most research involving human participants; however, this is impracticable under some circumstances. The Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS) outlines the requirements for research involving human participants in Canada. The need for an exception to consent (deferred consent) is recognised and endorsed in the TCPS for research in individual medical emergencies; however, little is known about substitute decision-maker (SDM) experiences. A paediatric resuscitation trial (SQUEEZE) (NCT01973907) using an exception to consent process began enrolling at McMaster Children's Hospital in January 2014. This qualitative research study aims to generate new knowledge on SDM experiences with the exception to consent process as implemented in a randomised controlled trial. The SDMs of children enrolled into the SQUEEZE pilot trial will be the sampling frame from which ethics study participants will be derived. Qualitative research study involving individual interviews and grounded theory methodology. SDMs for children enrolled into the SQUEEZE pilot trial. Up to 25 SDMs. Qualitative methodology: SDMs will be invited to participate in the qualitative ethics study. Interviews with consenting SDMs will be conducted in person or by telephone, taped and professionally transcribed. Participants will be encouraged to elaborate on their experience of being asked to consent after the fact and how this process occurred. Data gathering and analysis will be undertaken simultaneously. The investigators will collaborate in developing the coding scheme, and data will be coded using NVivo. Emerging themes will be identified. This research represents a rare opportunity to interview parents/guardians of critically ill children enrolled into a resuscitation trial without their knowledge or prior consent. Findings will inform implementation of the exception to consent process in the planned definitive SQUEEZE

  11. Marine Conservation: Effective Communication is Critical to Engaging the Public and Decision Makers in Sustaining our Seas

    Science.gov (United States)

    Crowder, L. B.

    2006-12-01

    Scientists are most comfortable talking to other scientists. But if we hope our science will be used to drive good policy decisions at the state or federal level, we have to be willing to leave the comfortable cloisters of science and venture out into a world where people speak different languages and have different perspectives. Early in my career, I had the good fortune to be involved in two research programs that were focused on basic science, but also proved to be relevant to management and policy. The first project involved modeling the bioenergetics of growth in salmonid fishes. The second modeled the population dynamics of a threatened marine species, loggerhead sea turtle. Somewhat to my surprise, both papers led to major policy changes and the models were actively employed by managers within a year of two of publication. The question for me then became whether this could be done deliberately. Since then I have had the opportunity to communicate with a wide variety of people from congressmen, to school children, to the public, and among professionals across disciplinary boundaries. Communication skills are critical for scientists to become influential in the policy arena. We have to listen to all people involved in the policymaking process AND we have to be able to communicate effectively with them. This requires a deep understanding of the science and a willingness to work hard on communicating the science clearly, concisely, and compellingly. Scientists can work to develop their own skills, but professional training helps. This can come via shortcourses, mentorships, or full university courses. At Duke Marine Lab, we initiated graduate course in Professional Writing that focuses upon writing for different audiences, including commercial fishermen, retirees, teenagers, scientists in different fields, politicians, and managers. This course has been widely endorsed by our graduates as one of the most important courses they attended; interviews and job offers

  12. Biodosimetry: Medicine, Science, and Systems to Support the Medical Decision-Maker Following a Large Scale Nuclear or Radiation Incident.

    Science.gov (United States)

    Coleman, C Norman; Koerner, John F

    2016-12-01

    The public health and medical response to a radiological or nuclear incident requires the capability to sort, assess, treat, triage and to ultimately discharge, refer or transport people to their next step in medical care. The size of the incident and scarcity of resources at the location of each medical decision point will determine how patients are triaged and treated. This will be a rapidly evolving situation impacting medical responders at regional, national and international levels. As capabilities, diagnostics and medical countermeasures improve, a dynamic system-based approach is needed to plan for and manage the incident, and to adapt effectively in real time. In that the concepts and terms can be unfamiliar and possibly confusing, resources and a concept of operations must be considered well in advance. An essential underlying tenet is that medical evaluation and care will be managed by healthcare professionals with biodosimetry assays providing critical supporting data. Published by Oxford University Press 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  13. Market assessment for active solar heating and cooling products. Category B: a survey of decision-makers in the HVAC marketplace. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-09-01

    A comprehensive evaluation of the market for solar heating and cooling products for new and retrofit markets is reported. The emphasis is on the analysis of solar knowledge among HVAC decision makers and a comprehensive evaluation of their solar attitudes and behavior. The data from each of the following sectors are described and analyzed: residential consumers, organizational and manufacturing buildings, HVAC engineers and architects, builders/developers, and commercial/institutional segments. (MHR)

  14. Integration of environmental and human health risk assessment for industries using hazardous materials: a quantitative multi criteria approach for environmental decision makers.

    Science.gov (United States)

    Topuz, E; Talinli, I; Aydin, E

    2011-02-01

    Environmental management, for which environmental and human health risk assessment is the first stage, is a requirement for industries both before construction and during operation in order to sustain improved quality of life in the ecosystem. Therefore, the aim of this study is to propose an approach that integrates environmental and human health risk assessment for industries using hazardous materials in order to support environmental decision makers with quantitative and directive results. Analytic hierarchy process and fuzzy logic are used as tools to handle problems caused by complexity of environment and uncertain data. When the proposed approach is implemented to a scenario, it was concluded that it is possible to define risk sources with their risk classes and related membership degrees in that classes which enable the decision maker to decide which risk source has priority. In addition, they can easily point out and rank the factors contributing those risk sources owing to priority weights of them. As a result, environmental decision makers can use this approach while they are developing management alternatives for unfounded and on-going industrial plants using hazardous materials. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Svensson, Per G.; Hancock, Meg G.; Hums, Mary A.

    2016-01-01

    Sport for Development and Peace (SDP) policy-makers and practitioners continue to offer ambitious claims regarding the potential role of sport-based programs for promoting social change. Yet, it is important to put sport under a critical lens in order to develop a more balanced and realistic understanding of the role of sport in society. Whether…

  16. Preparing future fisheries professionals to make good decisions

    Science.gov (United States)

    Colvin, Michael E.; Peterson, James T.

    2017-01-01

    Future fisheries professionals will face decision-making challenges in an increasingly complex field of fisheries management. Though fisheries students are well trained in the use of the scientific method to understand the natural world, they are rarely exposed to structured decision making (SDM) as part of an undergraduate or graduate education. Specifically, SDM encourages users (e.g., students, managers) to think critically and communicate the problem and then identify specific, measurable objectives as they relate to the problem. Next, users must think critically and creatively about management alternatives that can be used to meet the objectives—there must be more than one alternative or there is no decision to be made. Lastly, the management alternatives are evaluated with regard to how likely they are to succeed in terms of multiple, possibly completing, objectives, such as how stakeholder groups value outcomes of management actions versus monetary cost. We believe that exposure to SDM and its elements is an important part of preparing future fisheries professional to meet the challenges they may face. These challenges include reduced budgets, the growth of potentially competing natural resource interest groups, and stakeholder desire to be involved in management decisions affecting public trust resources, just to name a few.

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

    Science.gov (United States)

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

    2016-04-01

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

  18. Making makers make maker machines

    DEFF Research Database (Denmark)

    Hobye, Mads; Padfield, Nicolas; Pedersen, Michael Haldrup

    Fablab 2.0 is about enabling Fablabs as development platforms for new fabrication technologies. From this perspective, we have an obligation to become meta­reflective on our technology development ­ not just for immediate usability and transparency for users, but to push the frontiers of what...... is possible within the maker movement. In this paper we will explore selected cases of how Fablab RUC as a research Fablab develops new maker tools for students, researchers and entrepreneurs ­ and how they have become an important ingredient in staying vital for the overall discourse....

  19. A Hierarchical Analysis of Bridge Decision Makers ... The Role of New Technology Adoption in the Timber Bridge Market: Special Project

    Science.gov (United States)

    Robert L. Smith; Robert J. Bush; Daniel L. Schmoldt

    1995-01-01

    Bridge design engineers and local highway officials make bridge replacement decisions across the United States. The Analytical Hierarchy Process was used to characterize the bridge material selection decision of these individuals. State Department of Transportation engineers, private consulting engineers, and local highway officials were personally interviewed in...

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

    Science.gov (United States)

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

    2017-06-01

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

  1. Including values in evidence-based policy making for breast screening: An empirically grounded tool to assist expert decision makers.

    Science.gov (United States)

    Parker, Lisa

    2017-07-01

    Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions. The decision making tool provided here is intended to assist with this process. The tool is modified from more general frameworks that are intended to assist with ethical decision making in public health, and informed by data drawn from previous empirical studies on values amongst Australian breast screening experts. It provides a structured format for breast screening committees to consider and discuss the values of themselves and others, suggests relevant topics for further inquiry and highlights areas of need for future research into the values of the public. It enables committees to publicly explain and justify their decisions with reference to values, improving transparency and accountability. It is intended to act alongside practices that seek to accommodate the values of individual women in the informed decision making process for personal decision making about participation in breast screening. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. The emotionally intelligent decision maker: emotion-understanding ability reduces the effect of incidental anxiety on risk taking.

    Science.gov (United States)

    Yip, Jeremy A; Côté, Stéphane

    2013-01-01

    In two experiments, we examined how a core dimension of emotional intelligence, emotion-understanding ability, facilitates decision making. Individuals with higher levels of emotion-understanding ability can correctly identify which events caused their emotions and, in particular, whether their emotions stem from events that are unrelated to current decisions. We predicted that incidental feelings of anxiety, which are unrelated to current decisions, would reduce risk taking more strongly among individuals with lower rather than higher levels of emotion-understanding ability. The results of Experiment 1 confirmed this prediction. In Experiment 2, the effect of incidental anxiety on risk taking among participants with lower emotion-understanding ability, relative to participants with higher emotion-understanding ability, was eliminated when we informed participants about the source of their anxiety. This finding reveals that emotion-understanding ability guards against the biasing effects of incidental anxiety by helping individuals determine that such anxiety is irrelevant to current decisions.

  3. Learning to See the Opportunities in Crisis and Catastrophe: A Decision Makers Guide to the Issue-Attention Cycle

    Science.gov (United States)

    2015-09-01

    to defining the span (life cycle) of issue- attention . Second is by the public and thus polity’s reaction to the emergent problem.13 Compelling work...THE OPPORTUNITIES IN CRISIS AND CATASTROPHE: A DECISION MAKER’S GUIDE TO THE ISSUE- ATTENTION CYCLE by Christopher M. Kimrey September 2015...AND CATASTROPHE: A DECISION MAKER’S GUIDE TO THE ISSUE- ATTENTION CYCLE 5. FUNDING NUMBERS 6. AUTHOR(S) Kimrey, Christopher M. 7. PERFORMING

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

    Science.gov (United States)

    Alfonso, Leonardo

    2013-04-01

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

  5. Beyond the Academic Journal: Unfreezing Misconceptions About Mental Illness and Gun Violence Through Knowledge Translation to Decision-Makers.

    Science.gov (United States)

    Horwitz, Joshua; Grilley, Anna; Kennedy, Orla

    2015-06-01

    In a policy arena characterized by polarized debate, such as the consideration of legal interventions to prevent gun violence, research evidence is an important tool to inform decision-making processes. However, unless the evidence is communicated to stakeholders who can influence policy decisions, the research will often remain an academic exercise with little practical impact. The Educational Fund to Stop Violence's process of "unfreezing" individual perceptions and conventional interpretations of the relationship between mental illness and gun violence, forming a consensus, and translating this knowledge to stakeholders through state discussion forums is one way to inform policy change. The recent passage of gun violence prevention legislation in California provides an example of successfully closing the knowledge translation gap between research and decision-making processes. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Supporting decision makers in land use planning around chemical sites. Case study: expansion of an oil refinery.

    Science.gov (United States)

    Papazoglou, I A; Bonanos, G S; Nivolianitou, Z S; Duijm, N J; Rasmussen, B

    2000-01-07

    An approach for supporting decisions on land use around chemical sites - along with a software decision support system (DSS) - based on multi-criteria decision analysis (MCDA; and particularly on the establishment of the set of efficient solutions and letting the final selection depend on local procedures and value tradeoffs) is being illustrated through a case study where five alternative expansions of a refinery are considered along with the existing situation. Alternative land use plans are based on combinations of alternative uses of specific land cells coupled with alternative expansion options. Criteria for evaluating alternative land use plans are the potential loss of life (PLL), the noise levels and the economic benefit resulting for each specific land use plan.

  7. The Homeland Security Ecosystem: An Analysis of Hierarchical and Ecosystem Models and Their Influence on Decision Makers

    Science.gov (United States)

    2012-12-01

    specific areas of expertise to support the greater organization. In 8 Richard L. Daft ... Daft , Organization Theory and Design, 56. 11 Allison and Zelikow, Essence of Decision, 145. 12 David Alberts and Richard Hayes, Power to the Edge...coordinate actions; performance monitored; and feedback exchanged with leadership .17 In complex hierarchical organizations with many specialized functions

  8. District Decision-Makers' Considerations of Equity and Equality Related to Students' Opportunities to Learn Algebra

    Science.gov (United States)

    Herbel-Eisenmann, Beth A.; Keazer, Lindsay; Traynor, Anne

    2018-01-01

    Background/Context: In this article we explore equity issues related to school district decision-making about students' opportunities to learn algebra. We chose algebra because of the important role it plays in the U.S. as a gatekeeper to future academic success. Current research has not yet explored issues of equity in district-level…

  9. To notify or not to notify : Decision aid for policy makers on whether to make an infectious disease mandatorily notifiable

    NARCIS (Netherlands)

    Bijkerk, Paul; Fanoy, E. B.; Kardamanidis, K.; van der Plas, S. M.; te Wierik, M. J.; Kretzschmar, M. E.; Haringhuizen, G. B.; van Vliet, H. J.; van der Sande, M. A.

    2015-01-01

    Mandatory notification can be a useful tool to support infectious disease prevention and control. Guidelines are needed to help policymakers decide whether mandatory notification of an infectious disease is appropriate. We developed a decision aid, based on a range of criteria previously used in the

  10. Development of a resource modelling tool to support decision makers in pandemic influenza preparedness: The AsiaFluCap Simulator.

    Science.gov (United States)

    Stein, Mart Lambertus; Rudge, James W; Coker, Richard; van der Weijden, Charlie; Krumkamp, Ralf; Hanvoravongchai, Piya; Chavez, Irwin; Putthasri, Weerasak; Phommasack, Bounlay; Adisasmito, Wiku; Touch, Sok; Sat, Le Minh; Hsu, Yu-Chen; Kretzschmar, Mirjam; Timen, Aura

    2012-10-12

    Health care planning for pandemic influenza is a challenging task which requires predictive models by which the impact of different response strategies can be evaluated. However, current preparedness plans and simulations exercises, as well as freely available simulation models previously made for policy makers, do not explicitly address the availability of health care resources or determine the impact of shortages on public health. Nevertheless, the feasibility of health systems to implement response measures or interventions described in plans and trained in exercises depends on the available resource capacity. As part of the AsiaFluCap project, we developed a comprehensive and flexible resource modelling tool to support public health officials in understanding and preparing for surges in resource demand during future pandemics. The AsiaFluCap Simulator is a combination of a resource model containing 28 health care resources and an epidemiological model. The tool was built in MS Excel© and contains a user-friendly interface which allows users to select mild or severe pandemic scenarios, change resource parameters and run simulations for one or multiple regions. Besides epidemiological estimations, the simulator provides indications on resource gaps or surpluses, and the impact of shortages on public health for each selected region. It allows for a comparative analysis of the effects of resource availability and consequences of different strategies of resource use, which can provide guidance on resource prioritising and/or mobilisation. Simulation results are displayed in various tables and graphs, and can also be easily exported to GIS software to create maps for geographical analysis of the distribution of resources. The AsiaFluCap Simulator is freely available software (http://www.cdprg.org) which can be used by policy makers, policy advisors, donors and other stakeholders involved in preparedness for providing evidence based and illustrative information on

  11. Development of a resource modelling tool to support decision makers in pandemic influenza preparedness: The AsiaFluCap Simulator

    Directory of Open Access Journals (Sweden)

    Stein Mart

    2012-10-01

    Full Text Available Abstract Background Health care planning for pandemic influenza is a challenging task which requires predictive models by which the impact of different response strategies can be evaluated. However, current preparedness plans and simulations exercises, as well as freely available simulation models previously made for policy makers, do not explicitly address the availability of health care resources or determine the impact of shortages on public health. Nevertheless, the feasibility of health systems to implement response measures or interventions described in plans and trained in exercises depends on the available resource capacity. As part of the AsiaFluCap project, we developed a comprehensive and flexible resource modelling tool to support public health officials in understanding and preparing for surges in resource demand during future pandemics. Results The AsiaFluCap Simulator is a combination of a resource model containing 28 health care resources and an epidemiological model. The tool was built in MS Excel© and contains a user-friendly interface which allows users to select mild or severe pandemic scenarios, change resource parameters and run simulations for one or multiple regions. Besides epidemiological estimations, the simulator provides indications on resource gaps or surpluses, and the impact of shortages on public health for each selected region. It allows for a comparative analysis of the effects of resource availability and consequences of different strategies of resource use, which can provide guidance on resource prioritising and/or mobilisation. Simulation results are displayed in various tables and graphs, and can also be easily exported to GIS software to create maps for geographical analysis of the distribution of resources. Conclusions The AsiaFluCap Simulator is freely available software (http://www.cdprg.org which can be used by policy makers, policy advisors, donors and other stakeholders involved in preparedness for

  12. Three strategic water quality challenges that decision-makers need to know about and how the CSIR should respond

    CSIR Research Space (South Africa)

    Turton, A

    2008-11-01

    Full Text Available spatial maldistribution pattern to it (courtesy South African Institute of Civil Engineers, 2008). This suggests that the water quality crisis presented in this paper is more likely to occur unless a well designed and informed intervention takes place... them, then all of our efforts at solution- seeking will mount to naught (at least in my professional opinion). Driver No. 1: Dilution Capacity. The most important driver is the climate, and in particular our precipitation patterns. Map 1 shows...

  13. Human Capital - A Critical Look at Developing Better Acquisition Leaders and Decision-Makers Using the Power of Emotional Intelligence

    Science.gov (United States)

    2017-03-21

    Empathy Decision Making Leadership Drive Strength Time Mgt Commitment Ethic Assertion Self-Esteem Stress Mgt 10 EI Skills TOTAL TOTAL 19.12522361...Industry Week, Colin Powell was asked if leadership is recognizable. He replied, “The performance of the organization is the ultimate measure of a...elevate their Emotional Intelligence (EI). By being more self-aware of personal leadership strengths and weakness, program leaders will build, and

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

    Science.gov (United States)

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

    2014-01-01

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

  15. Risk communication and trust in decision-maker action: a case study of the Giant Mine Remediation Plan.

    Science.gov (United States)

    Jardine, Cynthia G; Banfield, Laura; Driedger, S Michelle; Furgal, Christopher M

    2013-01-01

    The development and implementation of a remediation plan for the residual arsenic trioxide stored at the former Giant Mine site in the Canadian Northwest Territories has raised important issues related to trust. Social and individual trust of those responsible for making decisions on risks is critically important in community judgements on risk and the acceptability of risk management decisions. Trust is known to be affected by value similarity and confidence in past performance, which serve as interacting sources of cooperation in acting toward a common goal. To explore the elements of trust associated with the development and implementation of the Giant Mine Remediation Plan. Semi-structured interviews were conducted with eight purposively selected key informants representing both various interested and affected parties and the two government proponents. Five primary issues related to trust were identified by the participants: (1) a historical legacy of mistrust between the community (particularly Aboriginal peoples) and government; (2) barriers to building trust with the federal government; (3) limited community input and control over the decision-making process; (4) the conflicted and confounded role of the government agencies being both proponent and regulator, and the resulting need for independent oversight; and (5) distrust of the government to commit to the perpetual care required for the remediation option selected. The dual-mode model of trust and confidence was shown to be a useful framework for understanding the pivotal role of trust in the development of the Giant Mine Remediation Plan. Failure to recognize issues of trust based on value dissimilarity and lack of confidence based on past performance have resulted in a lack of cooperation characterized by delayed remediation and a prolonged and expensive consultation process. Government recognition of the importance of trust to these issues will hopefully improve future communication and public

  16. The Statistical Value Chain - a Benchmarking Checklist for Decision Makers to Evaluate Decision Support Seen from a Statistical Point-Of-View

    DEFF Research Database (Denmark)

    Herrmann, Ivan Tengbjerg; Henningsen, Geraldine; Wood, Christian D.

    2013-01-01

    method that a DM can employ in order to evaluate the process of decision support from a statistical point-of-view. We call this approach the “Statistical Value Chain” (SVC): a consecutive benchmarking checklist with eight steps that can be used to evaluate decision support seen from a statistical point-of-view....

  17. A Perspective on Consumers 3.0: They Are Not Better Decision-Makers Than Previous Generations

    Directory of Open Access Journals (Sweden)

    Petr eHoudek

    2016-06-01

    Full Text Available This perspective article builds upon the theory of local thinking in interpretation and prediction of consumer behavior in a contemporary world of information overload. It is shown that even informed and socially and environmentally responsible consumers (consumers 3.0 exhibit selective recall, limited attention and bounded search in the perception and interpretation of price and quality of purchases. Their decisions fall into local cognitive frames, which specifically focus attention only on a narrow structure and content of the choice. The cognitive frames can be established by recent or regular purchases, but also extreme or primary purchase experiences. The article includes a short conceptual review of car, food, clothing, insurance, drugs, paintings and other product purchases showing that the local cognitive frames often lead to bad bargains across various sectors. The article presents several suggestions for future research.

  18. How seasonal forecast could help a decision maker: an example of climate service for water resource management

    Science.gov (United States)

    Viel, Christian; Beaulant, Anne-Lise; Soubeyroux, Jean-Michel; Céron, Jean-Pierre

    2016-04-01

    The FP7 project EUPORIAS was a great opportunity for the climate community to co-design with stakeholders some original and innovative climate services at seasonal time scales. In this framework, Météo-France proposed a prototype that aimed to provide to water resource managers some tailored information to better anticipate the coming season. It is based on a forecasting system, built on a refined hydrological suite, forced by a coupled seasonal forecast model. It particularly delivers probabilistic river flow prediction on river basins all over the French territory. This paper presents the work we have done with "EPTB Seine Grands Lacs" (EPTB SGL), an institutional stakeholder in charge of the management of 4 great reservoirs on the upper Seine Basin. First, we present the co-design phase, which means the translation of classical climate outputs into several indices, relevant to influence the stakeholder's decision making process (DMP). And second, we detail the evaluation of the impact of the forecast on the DMP. This evaluation is based on an experiment realised in collaboration with the stakeholder. Concretely EPTB SGL has replayed some past decisions, in three different contexts: without any forecast, with a forecast A and with a forecast B. One of forecast A and B really contained seasonal forecast, the other only contained random forecasts taken from past climate. This placebo experiment, realised in a blind test, allowed us to calculate promising skill scores of the DMP based on seasonal forecast in comparison to a classical approach based on climatology, and to EPTG SGL current practice.

  19. Stepping stones to significant market shares for renewables. The European forum for market players and decision makers in the renewable energy industry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    This invitation to a two-day European Forum for market players and decision makers in the renewable energy business lists the presentations made at the conference in 2007. The programme included contributions in the following areas: Policies and market deployment initiatives, market trends and experience - from support schemes to market experience, opportunities in a changing framework in Switzerland, instruments and infrastructure requirements - how to make the market work and supply and demand aspects of a growing market. The conference examined how renewable forms of energy can gain significant market shares and reach a quota of 50% renewables in 50 years. The first session examined policies and market deployment initiatives, the second market trends and experiences, the third opportunities for Switzerland in a changing framework. The second day featured sessions on instruments and infrastructure requirements as well as on supply and demand aspects in a growing market. The conference was complemented with four workshops.

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

    Science.gov (United States)

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

    2011-12-01

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

  1. The impact of scientific information on ecosystem management: making sense of the contextual gap between information providers and decision makers.

    Science.gov (United States)

    van Wyk, Ernita; Roux, Dirk J; Drackner, Mikael; McCool, Stephen F

    2008-05-01

    Scientific information is not always effectively incorporated into decision-making processes. This phenomenon seems to hold even when the information is aligned with an articulated need, is generated according to sound scientific procedures, and is packaged with end-user preferences in mind. We propose that contextual or cultural differences contribute significantly to the misalignment in communication between those who generate information and those who seek information for improved management of natural resources. The solution is to cultivate shared understanding, which in turn relies on acknowledgment and sharing of diverse values and attitudes. This constitutes a difficult challenge in a culturally diverse environment. Whereas cultural diversity represents wealth in experiences, knowledge and perspectives it can constrain the potential to develop the shared understandings necessary for effective integration of new information. This article illustrates how a lack of shared understanding among participants engaged in a resource-management process can produce and perpetuate divergent views of the world, to the extent that information and knowledge flows are ineffective and scientific information, even when requested, cannot be used effectively. Four themes were distilled from interviews with management and scientific staff of a natural resource-management agency in South Africa. The themes are used to illustrate how divergent views embedded in different cultures can discourage alignment of effort toward a common purpose. The article then presents a sense-making framework to illustrate the potential for developing shared understandings in a culturally diverse world.

  2. Are normal decision-makers sensitive to changes in value contrast under uncertainty? Evidence from the Iowa Gambling Task.

    Directory of Open Access Journals (Sweden)

    We-Kang Lee

    Full Text Available The Iowa Gambling Task (IGT developed by Bechara et al. in 1994 is used to diagnose patients with Ventromedial Medial Prefrontal Cortex (VMPFC lesions, and it has become a landmark in research on decision making. According to Bechara et al., the manipulation of progressive increments of monetary value can normalize the performance of patients with VMPFC lesions; thus, they developed a computerized version of the IGT. However, the empirical results showed that patients' performances did not improve as a result of this manipulation, which suggested that patients with VMPFC lesions performed myopically for future consequences. Using the original version of the IGT, some IGT studies have demonstrated that increments of monetary value significantly influence the performance of normal subjects in the IGT. However, other research has resulted in inconsistent findings. In this study, we used the computerized IGT (1X-IGT and manipulated the value contrast of progressive increments (i.e., by designing the 10X-IGT, which contained 10 times of progressive increment to investigate the influence of value contrast on the performance of normal subjects. The resulting empirical observations indicated that the value contrast (1X- vs. 10X-IGT of the progressive increment had no effect on the performance of normal subjects. This study also provides a discussion of the issue of value in IGT-related studies. Moreover, we found the "prominent deck B phenomenon" in both versions of the IGT, which indicated that the normal subjects were guided mostly by the gain-loss frequency, rather than by the monetary value contrast. In sum, the behavioral performance of normal subjects demonstrated a low correlation with changes in monetary value, even in the 10X-IGT.

  3. Perception and use of complementary and alternative medicine among children and adults with epilepsy: the importance of the decision makers.

    Directory of Open Access Journals (Sweden)

    Ali A Asadi-Pooya

    2014-02-01

    Full Text Available The aim of the current study was to assess the extent to which complementary and alternative medicine (CAM has been used in children and adults to treat seizures and to compare the perceptions and usage of CAM between adult patients who decides for themselves and adults who decide for their sick children.In this cross-sectional study, patients who have been treated for epilepsy for at least one year at the outpatient epilepsy clinic at the Shiraz University of Medical Sciences were interviewed from January 2012 through March 2012. The questionnaire collected specific information of CAM perceptions and usage among patients. Pearson Chi-Square and Student's t-test were used to compare variables among children group with adults group. Ninety-eight children (their caregivers and 158 adults (themselves participated. Adult patients (53% more frequently believed that CAM might be useful in treating seizures than adults with sick kids (35% (P = 0.0004. Herbal drugs, traditional medicine and exercise were more often considered as being helpful in treating seizures among adult patients compared to adults with sick children. CAM usage was not different among adult patients compared to adults with sick kids (P = 0.3. CAM is an option considered by many people with epilepsy to treat seizures. The individual who makes the decision as to use any of these unconventional treatment options is probably not different when it comes to self (the patient himself vs. non-self (the parents/care-givers, despite the observed difference that adult patients more frequently believed that CAM might be useful in treating seizures than adults with sick kids.

  4. Preaching What We Practice: Teaching Ethical Decision-Making to Computer Security Professionals

    Science.gov (United States)

    Fleischmann, Kenneth R.

    The biggest challenge facing computer security researchers and professionals is not learning how to make ethical decisions; rather it is learning how to recognize ethical decisions. All too often, technology development suffers from what Langdon Winner terms technological somnambulism - we sleepwalk through our technology design, following past precedents without a second thought, and fail to consider the perspectives of other stakeholders [1]. Computer security research and practice involves a number of opportunities for ethical decisions. For example, decisions about whether or not to automatically provide security updates involve tradeoffs related to caring versus user autonomy. Decisions about online voting include tradeoffs between convenience and security. Finally, decisions about routinely screening e-mails for spam involve tradeoffs of efficiency and privacy. It is critical that these and other decisions facing computer security researchers and professionals are confronted head on as value-laden design decisions, and that computer security researchers and professionals consider the perspectives of various stakeholders in making these decisions.

  5. Developmental changes in decision making under risk: The role of executive functions and reasoning abilities in 8- to 19-year-old decision makers.

    Science.gov (United States)

    Schiebener, Johannes; García-Arias, María; García-Villamisar, Domingo; Cabanyes-Truffino, Javier; Brand, Matthias

    2015-01-01

    Previous studies have shown that children and adolescents often tend toward risky decisions despite explicit knowledge about the potential negative consequences. This phenomenon has been suggested to be associated with the immaturity of brain areas involved in cognitive control functions. Particularly, "frontal lobe functions," such as executive functions and reasoning, mature until young adulthood and are thought to be involved in age-related changes in decision making under explicit risk conditions. We investigated 112 participants, aged 8-19 years, with a frequently used task assessing decisions under risk, the Game of Dice Task (GDT). Additionally, we administered the Modified Card Sorting Test assessing executive functioning (categorization, cognitive flexibility, and strategy maintenance) as well as the Ravens Progressive Matrices assessing reasoning. The results showed that risk taking in the GDT decreased with increasing age and this effect was not moderated by reasoning but by executive functions: Particularly, young persons with weak executive functioning showed very risky decision making. Thus, the individual maturation of executive functions, associated with areas in the prefrontal cortex, seems to be an important factor in young peoples' behavior in risky decision-making situations.

  6. Husbands as decision-makers in relation to family size: East-West regional differentials in Turkey.

    Science.gov (United States)

    Kulu, I

    1990-01-01

    Fertility studies usually gather information from women only. This sex-bias present in the research fails to take into account the contribution that men make in forming fertility patterns. This study examines the role of Turkish husbands in the decision-making regarding family size and the use of family planning methods. The historic and cultural background in Turkey is based upon a male-dominant structure. This dominant role of men is present on individual, family, community, and national levels. The differences between the Eastern and Western regions, in regard to socio-economic factors is fully explored. The data used in this study comes from a 1988 national health survey. Three questionnaires were applied in 6,552 households in 5 regions. One questionnaire was for the household, one for ever-married women, and one for ever-married men. This paper focuses on the data generated by the husband's questionnaires (a sub-sample of 2,264 respondents). Several factors are identified that maintain an authoritarian, male-dominated system. These factors include type of marriage, arranged marriages, the payment of bride-price, and participation in the labor force. Both men in the East and West expect their wives to fulfill a traditional sex-role. Women are expected to be wives and mothers, and to obey their husbands. Most men do not approve of married women working outside of the home. Traditional values continue to shape the style of relating between men and women in both regions, despite the modernization that has taken place in the West. "Higher socioeconomic development does not necessarily imply the automatic acquisition of modern values." The author does establish that practices that subjugate women are more prevalent and are deeply rooted in the East. In keeping with the cultural practices of the society, male attitudes and values strongly influence family planning practices. One-fourth of the women in a national survey stated that the reason they did not use a

  7. How can continuing professional development better promote shared decision-making? Perspectives from an international collaboration

    Directory of Open Access Journals (Sweden)

    Labrecque Michel

    2011-07-01

    Full Text Available Abstract Background Shared decision-making is not widely implemented in healthcare. We aimed to set a research agenda about promoting shared decision-making through continuing professional development. Methods Thirty-six participants met for two days. Results Participants suggested ways to improve an environmental scan that had inventoried 53 shared decision-making training programs from 14 countries. Their proposed research agenda included reaching an international consensus on shared decision-making competencies and creating a framework for accrediting continuing professional development initiatives in shared decision-making. Conclusions Variability in shared decision-making training programs showcases the need for quality assurance frameworks.

  8. Interventions for improving the adoption of shared decision making by healthcare professionals.

    Science.gov (United States)

    Légaré, France; Ratté, Stéphane; Stacey, Dawn; Kryworuchko, Jennifer; Gravel, Karine; Graham, Ian D; Turcotte, Stéphane

    2010-05-12

    Shared decision making (SDM) is a process by which a healthcare choice is made jointly by the practitioner and the patient and is said to be the crux of patient-centred care. Policy makers perceive SDM as desirable because of its potential to a) reduce overuse of options not clearly associated with benefits for all (e.g., prostate cancer screening); b) enhance the use of options clearly associated with benefits for the vast majority (e.g., cardiovascular risk factor management); c) reduce unwarranted healthcare practice variations; d) foster the sustainability of the healthcare system; and e) promote the right of patients to be involved in decisions concerning their health. Despite this potential, SDM has not yet been widely adopted in clinical practice. To determine the effectiveness of interventions to improve healthcare professionals' adoption of SDM. We searched the following electronic databases up to 18 March 2009: Cochrane Library (1970-), MEDLINE (1966-), EMBASE (1976-), CINAHL (1982-) and PsycINFO (1965-). We found additional studies by reviewing a) the bibliographies of studies and reviews found in the electronic databases; b) the clinicaltrials.gov registry; and c) proceedings of the International Shared Decision Making Conference and the conferences of the Society for Medical Decision Making. We included all languages of publication. We included randomised controlled trials (RCTs) or well-designed quasi-experimental studies (controlled clinical trials, controlled before and after studies, and interrupted time series analyses) that evaluated any type of intervention that aimed to improve healthcare professionals' adoption of shared decision making. We defined adoption as the extent to which healthcare professionals intended to or actually engaged in SDM in clinical practice or/and used interventions known to facilitate SDM. We deemed studies eligible if the primary outcomes were evaluated with an objective measure of the adoption of SDM by healthcare

  9. The Use of Operational Short and Long Lead-time Hydrologic Forecasts by Water Resources Decision Makers in the Ohio River Valley

    Science.gov (United States)

    Adams, T. E.

    2012-12-01

    The need for hydroclimatic forecasts for water resources systems operations is significant and is clearly growing. Hydroclimatic forecasts consist of two components: first, forecasts of hydrometeorological forcings used to drive hydrologic models and, second, the resulting streamflow and stage forecasts or derivative quantities, such as reservoir inflow volumes or time above (or below) some threshold value. These forecast range from hourly to annual lead-times and include both deterministic and probabilistic formats. In the Ohio River Valley, forecasts are made available by the NOAA/NWS Ohio River Forecast Center to decision makers. These include the general public, local and state emergency managers and other officials, federal agencies, utilities, the navigation industry, and agricultural sector, and others. Hydrologic forecasts are utilized by end-users for widely varying purposes including flood warning and mitigation, reservoir management, and decision making for construction projects, to name a few. This paper will illustrate the range of NWS hydrologic streamflow and stage products that are made publicly available and how some of the forecasts are used during drought or low-flow periods and during episodes of flooding. The methodologies used to generate hydroclimatic forecasts and the complexities found in large-scale operational systems and their impact on forecast robustness will also be discussed.

  10. A Review of Contemporary Ethical Decision-Making Models for Mental Health Professionals

    Science.gov (United States)

    Francis, Perry C.

    2015-01-01

    Mental health professionals are faced with increasingly complex ethical decisions that are impacted by culture, personal and professional values, and the contexts in which they and their clients inhabit. This article presents the reasons for developing and implementing multiple ethical decision making models and reviews four models that address…

  11. Professionalizing the Nation's Cybersecurity Workforce?: Criteria for Decision-Making

    Science.gov (United States)

    National Academies Press, 2013

    2013-01-01

    "Professionalizing the Nation's Cybersecurity Workforce? Criteria for Decision-Making" considers approaches to increasing the professionalization of the nation's cybersecurity workforce. This report examines workforce requirements for cybersecurity and the segments and job functions in which professionalization is most needed;…

  12. Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site.

    Science.gov (United States)

    Sockolow, P S; Weiner, J P; Bowles, K H; Abbott, P; Lehmann, H P

    2011-01-01

    Provide evidence-based advise to "Program of All-inclusive Care for the Elderly" (PACE) decision makers considering implementing an electronic health record (EHR) system, drawing on the results of a mixed methods study to examine: (1) the diffusion of an EHR among clinicians documenting direct patient care in a PACE day care site, (2) the impact of the use of the EHR on the satisfaction levels of clinicians, and (3) the impact of the use of the EHR on patient functional outcomes. Embedded mixed methods design with a post-test design quantitative experiment and concurrent qualitative component. Quantitative methods included: (1) the EHR audit log used to determine the frequency and timing during the week of clinicians' usage of the system; (2) a 22-item clinician satisfaction survey; and (3) a 16-item patient functional outcome questionnaire related to locomotion, mobility, personal hygiene, dressing, feeding as well the use of adaptive devices. Qualitative methods included observations and open-ended, semi-structured follow-up interviews. Qualitative data was merged with the quantitative data by comparing the findings along themes. The setting was a PACE utilizing an EHR in Philadelphia: PACE manages the care of nursing-home eligible members to enable them to avoid nursing home admission and reside in their homes. Participants were 39 clinicians on the multi-disciplinary teams caring for the elders and 338 PACE members. Clinicians did not use the system as intended, which may help to explain why the benefits related to clinical processes and patient outcomes as expected for an EHR were not reflected in the results. Clinicians were satisfied with the EHR, although there was a non-significant decline between 11 and 17 months post implementation of the EHR. There was no significant difference in patient functional outcome the two time periods. However, the sample size of 48 was too small to allow any conclusive statements to be made. Interpretation of findings

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

    Directory of Open Access Journals (Sweden)

    Martin Douglas K

    2005-01-01

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

  14. Multi-criteria decision analysis of breast cancer control in low- and middle- income countries: development of a rating tool for policy makers.

    Science.gov (United States)

    Venhorst, Kristie; Zelle, Sten G; Tromp, Noor; Lauer, Jeremy A

    2014-01-01

    The objective of this study was to develop a rating tool for policy makers to prioritize breast cancer interventions in low- and middle- income countries (LMICs), based on a simple multi-criteria decision analysis (MCDA) approach. The definition and identification of criteria play a key role in MCDA, and our rating tool could be used as part of a broader priority setting exercise in a local setting. This tool may contribute to a more transparent priority-setting process and fairer decision-making in future breast cancer policy development. First, an expert panel (n = 5) discussed key considerations for tool development. A literature review followed to inventory all relevant criteria and construct an initial set of criteria. A Delphi study was then performed and questionnaires used to discuss a final list of criteria with clear definitions and potential scoring scales. For this Delphi study, multiple breast cancer policy and priority-setting experts from different LMICs were selected and invited by the World Health Organization. Fifteen international experts participated in all three Delphi rounds to assess and evaluate each criterion. This study resulted in a preliminary rating tool for assessing breast cancer interventions in LMICs. The tool consists of 10 carefully crafted criteria (effectiveness, quality of the evidence, magnitude of individual health impact, acceptability, cost-effectiveness, technical complexity, affordability, safety, geographical coverage, and accessibility), with clear definitions and potential scoring scales. This study describes the development of a rating tool to assess breast cancer interventions in LMICs. Our tool can offer supporting knowledge for the use or development of rating tools as part of a broader (MCDA based) priority setting exercise in local settings. Further steps for improving the tool are proposed and should lead to its useful adoption in LMICs.

  15. A qualitative study of professional and client perspectives on information flows and decision aid use

    Science.gov (United States)

    2012-01-01

    Background This paper explores the meanings given by a diverse range of stakeholders to a decision aid aimed at helping carers of people in early to moderate stages of dementia (PWD) to select community based respite services. Decision aids aim to empower clients to share decision making with health professionals. However, the match between health professionals' perspectives on decision support needs and their clients' perspective is an important and often unstudied aspect of decision aid use. Methods A secondary analysis was undertaken of qualitative data collected as part of a larger study. The data included twelve interviews with carers of people with dementia, three interviews with expert advisors, and three focus groups with health professionals. A theoretical analysis was conducted, drawing on theories of 'positioning' and professional identity. Results Health professionals are seen to hold varying attitudes and beliefs about carers' decision support needs, and these appeared to be grounded in the professional identity of each group. These attitudes and beliefs shaped their attitudes towards decision aids, the information they believed should be offered to dementia carers, and the timing of its offering. Some groups understood carers as needing to be protected from realistic information and consequently saw a need to filter information to carer clients. Conclusion Health professionals' beliefs may cause them to restrict information flows, which can limit carers' ability to make decisions, and limit health services' ability to improve partnering and shared decision making. In an era where information is freely available to those with the resources to access it, we question whether health professionals should filter information. PMID:22458734

  16. Trust in medical decision-making concerning older people: the views of key professionals in the Dutch health care practice.

    Science.gov (United States)

    Ubachs-Moust, Josy; Houtepen, Rob; Van der Weijden, Trudy; ter Meulen, Ruud; Vos, Rein

    2010-11-01

    This article deals with the issue of public trust in decisions made by individual physicians, concerning older people, as perceived by various key professionals. While trust is a basic element in our health care service, it is at the same time a difficult phenomenon to conceptualize. This article tries to contribute to a better understanding of what trust in medical practice entails and what are the necessary conditions for a society to put trust in the medical profession. The focus is on care for older people under the condition of scarcity in health care resources. Our study has a qualitative design consisting of semi-structured in-depth interviews with 24 key professionals focusing on decision-makers and those in line of professionally organizing or influencing the decision-making process. We found roughly three categories of trust: distrust; trust; and qualified trust. In each category we found different reasons to give or withhold trust and different views on how far the discretionary power of doctors should go. We recommend promoting trust by addressing the criteria or limits brought forward in the qualified trust category. The preconditions as identified in the qualified trust section provide the boundaries and marking points between which physicians have to move regarding the care for older people. The qualifications provide us insight in where and how to invest in trust under these and under different circumstances. An important conclusion is that trust is never finished: trust needs to be gained and negotiated in a continuous process of action and interaction.

  17. How Deep is the Critical Zone: A Scientific Question with Potential Impact For Decision-makers in Areas of Shale-Gas Development and Hydraulic Fracturing

    Science.gov (United States)

    Brantley, S. L.

    2014-12-01

    Citizens living in areas of shale-gas development such as the Marcellus gas play in Pennsylvania and surrounding states are cognizant of the possibility that drilling and production of natural gas -- including hydraulic fracturing -- may have environmental impacts on their water. The Critical Zone is defined as the zone from vegetation canopy to the lower limits of groundwater. This definition is nebulous in terms of the lower limit, and yet, defining the bottom of the Critical Zone is important if citizens are to embrace shale-gas development. This is because, although no peer-reviewed study has been presented that documents a case where hydraulic fracturing or formation fluids have migrated upwards from fracturing depths to drinking water resources, a few cases of such leakage have been alleged. On the other hand, many cases of methane migration into aquifers have been documented to occur and some have been attributed to shale-gas development. The Critical Zone science community has a role to play in understanding such contamination problems, how they unfold, and how they should be ameliorated. For example, one big effort of the Critical Zone science community is to promote sharing of data describing the environment. This data effort has been extended to provide data for citizens to understand water quality by a team known as the Shale Network. As scientists learn to publish data online, these efforts must also be made accessible to non-scientists. As citizens access the data, the demand for data will grow and all branches of government will eventually respond by providing more accessible data that will help the public and policy-makers make decisions.

  18. Regional decision-makers as potential users of Extreme Weather Event Attribution - Case studies from the German Baltic Sea coast and the Greater Paris area

    Directory of Open Access Journals (Sweden)

    Maria Schwab

    2017-12-01

    Full Text Available Extreme Event Attribution has raised increasing attention in climate science in the last years. It means to judge the extent to which certain weather-related extreme events have changed due to human influences on climate with probabilistic statements. Extreme Event Attribution is often anticipated to spur more than just scientific ambition. It is able to provide answers to a commonly asked questions after extreme events, namely, ‘can we blame it on climate change’ and is assumed to support decision-making of various actors engaged in climate change mitigation and adaptation. More in-depth research is widely lacking about who these actors are; in which context they can make use of it; and what requirements they have, to be able to actually apply Extreme Event Attribution. We have therefore addressed these questions with two empirical case studies looking at regional decision-makers who deal with storm surge risks in the German Baltic Sea region and heat waves in the Greater Paris area. Stakeholder interviews and workshops reveal that fields of application and requirements are diverse, difficult to explicitly identify, and often clearly associated with stakeholders' specific mandate, the hazard background, and the regional socio-economic setting. Among the considered stakeholders in the Baltic Sea region, Extreme Event Attribution is perceived to be most useful to awareness-raising, in particular for climate change mitigation. They emphasised the importance of receiving understandable information - and that, rather later, but with smaller uncertainties than faster, but with higher uncertainties. In the Paris case, we typically talked to people engaged in adaptation with expertise in terms of climate science, but narrowly defined mandates which is typical for the Paris-centred political system with highly specialised public experts. The interviewees claimed that Extreme Event Attribution is most useful to political leverage and public

  19. Application of Contemporary Literature to Enhance Interpersonal Skills and Ethical Decision Making in Professional Selling Coursework

    Science.gov (United States)

    Kimball, Bob

    2007-01-01

    Educators and marketing professionals agree that course-work must address interpersonal communication skills and ethical decision making in addition to traditional business functions and skills. This article describes an innovative approach to teaching the professional selling course in which students enhance their competency in these areas…

  20. Patient and professional accuracy of recalled treatment decisions in out-patient consultations

    DEFF Research Database (Denmark)

    Skinner, T. C.; Barnard, K.; Cradock, S.

    2007-01-01

    Aims: To test the assumption that professional recall of consultation decisions is valid and more accurate than patient recall of consultation decisions. Methods: One hundred and thirty-four consultations between diabetes specialist nurses and diabetes specialist dietitians in an adult out-patien...

  1. Analysis of variable involved in decision-making ethics of professional accounting

    Directory of Open Access Journals (Sweden)

    Alexandre André Feil

    2016-05-01

    Full Text Available The central objective of this study is to identify and analyze the intervening variables that influence ethical decision making of accounting professionals, in a region in the state of Rio Grande do Sul, Brazil. The methodology is quantitative and descriptive exploratory. The technical procedures include the use of questionnaires with response linked to Likert scale, comprising a sample unit of 122 professional accounting, and analysis occurs through non-parametric statistics, such as logistic regression and Spearman correlation. The results reveal that the accounting professionals who agree fully with the importance of the Counter Code of Professional Ethics (CEPC as a guide to conduct 59% and stick to it in decision making in 63.9%. The logistic regression model predicted that professionals meet the CEPC and do not meet respectively with a certainty of 87.5% and 100%. The attitudes towards CEPC these accounting professionals can be explained by the importance and use this as a guide of conduct, with a 95.5% prediction sure. The intervening variables that were significant at 0.01 and 0.05 in the CEPC compliance relating to religiosity, relevance and assistance that the code provides the professional conduct. It follows that the ethical decision making of the accounting professional is influenced by their religion and relevance and assistance that the CEPC provides for this professional.

  2. Computerised decision support systems for healthcare professionals: an interpretative review.

    Science.gov (United States)

    Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz

    2012-01-01

    Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may

  3. Ethics Training and Workplace Ethical Decisions of MBA Professionals

    Science.gov (United States)

    Romious, Tamar S.; Thompson, Randall; Thompson, Elizabeth

    2016-01-01

    We recruited 15 MBA professionals in the St. Louis, Missouri metropolitan area to explore experiences and perceptions of classroom ethics training and ethical experiences in the workplace. Telephone interviews were conducted using open-ended questions to collect data that were uploaded to NVivo 10 for qualitative analysis. As a result of the data…

  4. Budget-makers and health care systems.

    Science.gov (United States)

    White, Joseph

    2013-10-01

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

  5. Computerised decision support systems for healthcare professionals: an interpretative review

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2013-03-01

    Full Text Available Purpose Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.Methods We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997–2010. The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.Results Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.Conclusions Whilst the potential of clinical decision support systems in improving, in particular

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

    Science.gov (United States)

    Venkat, Arvind; Becker, Julianna

    2014-01-01

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

  7. Ensemble-based analysis of Front Range severe convection on 6-7 June 2012: Forecast uncertainty and communication of weather information to Front Range decision-makers

    Science.gov (United States)

    Vincente, Vanessa

    -allowing ensemble also showed greater skill in forecasting heavy precipitation amounts in the vicinity of where they were observed during the most active convective period, particularly near urbanized areas. A total of 9 Front Range EMs were interviewed to research how they understood hazardous weather information, and how their perception of forecast uncertainty would influence their decision making following a heavy rain event. Many of the EMs use situational awareness and past experiences with major weather events to guide their emergency planning. They also highly valued their relationship with the National Weather Service to improve their understanding of weather forecasts and ask questions about the uncertainties. Most of the EMs perceived forecast uncertainty in terms of probability and with the understanding that forecasting the weather is an imprecise science. The greater the likelihood of occurrence (implied by a higher probability of precipitation) showed greater confidence in the forecast that an event was likely to happen. Five probabilistic forecast products were generated from the convection-allowing ensemble output to generate a hypothetical warm season heavy rain event scenario. Responses varied between the EMs in which products they found most practical or least useful. Most EMs believed that there was a high probability for flooding, as illustrated by the degree of forecasted precipitation intensity. Most confirmed perceiving uncertainty in the different forecast representations, sharing the idea that there is an inherent uncertainty that follows modeled forecasts. The long-term goal of this research is to develop and add reliable probabilistic forecast products to the "toolbox" of decision-makers to help them better assess hazardous weather information and improve warning notifications and response.

  8. Decision making by parents and healthcare professionals when considering continued care for pediatric patients with cancer.

    Science.gov (United States)

    Hinds, P S; Oakes, L; Furman, W; Foppiano, P; Olson, M S; Quargnenti, A; Gattuso, J; Powell, B; Srivastava, D K; Jayawardene, D; Sandlund, J T; Strong, C

    1997-10-01

    To better define the treatment-related decisions considered most difficult by parents of pediatric patients with cancer and the factors that influenced their final decisions. Retrospective-descriptive design. Pediatric oncology institution in the mid-southern region on the United States. 39 parents representing 37 of 83 eligible families, 16 attending physicians, three nurses, and two chaplains. Parent participants responded by telephone to six open-ended interview questions and a 15-item questionnaire about factors that were important when making the decision to continue care. Healthcare professionals were interviewed face-to-face. Most difficult treatment-related decisions; factors influencing decision making. Parents reported 15 types of difficult decisions, the majority of which were made late in the course of treatment. Deciding between a phase I drug study or no further treatment (n = 14), maintaining or withdrawing life support (n = 11), and giving more chemotherapy or giving no further treatment (n = 8) were the most frequently reported difficult decisions. Parents rated "recommendations received from healthcare professionals" as the questionnaire factor most important in their decision making, and healthcare professionals rated "discussion with the family of the patient" as the most important factor. Parents of children or adolescents with cancer and their healthcare providers face difficult treatment-related decisions, many of which occur late in the course of treatment. Parents and healthcare professionals cite similar factors in their decision making but differ in their ratings of the factors' importance. For parents, the information and recommendations they receive from healthcare professionals figure most frequently and most importantly in their decision making. For healthcare professionals, the certainty that the patient will not get better and discussions with the patient's family figure most importantly in their decision making. Once parents

  9. Decision-making around antithrombotics for stroke prevention in atrial fibrillation: the health professionals' views.

    Science.gov (United States)

    Wang, Yishen; Bajorek, Beata

    2016-08-01

    Background For stroke prevention in patients with atrial fibrillation (AF), the decision-making around antithrombotic therapy has been complicated by older age, multiple comorbidities, polypharmacy and the different pharmacological properties of warfarin and the nonvitamin K antagonist oral anticoagulants (NOACs). The complexity of decision-making has been associated with a reluctance by health professionals to use antithrombotic therapy, leading to poor clinical outcomes. In order to improve stroke prevention in patients with AF, the contemporary perspectives of health professionals on the decision-making around antithrombotic therapy needs exploration. Objective To elicit emerging themes describing health professionals' perspectives on the decision-making around antithrombotic therapy for stroke prevention in patients with AF. Setting Sydney metropolitan area of New South Wales, Australia. Method A qualitative study based on face-to-face interviews was conducted from August to October 2014. Seven pharmacists, seven specialists, six general practitioners and six nurses practising in the Sydney metropolitan area and managing antithrombotic therapy for AF were interviewed until theme saturation was achieved in each subgroup. Interview transcripts were analysed using manual inductive coding. Main outcome measure Emerging themes describing health professionals' perspectives on the decision-making around antithrombotic therapy for stroke prevention in patients with AF. Results Three overarching themes emerged. (1) Comprehensive assessment is necessary for decision-making but is not always implemented. Health professionals mostly focused on stroke risk assessment, not on the bleeding risk and medication safety issues. (2) Health professionals from different disciplines have different preferences for antithrombotic therapies. Although the majority of health professionals considered warfarin as the first-line therapy, NOACs were preferred by neurologists and

  10. Memento of decision makers: the national organizations involved in the mastery of greenhouse gas emissions; Memento des decideurs: les collectivites territoriales engagees dans la maitrise des emissions de gaz a effet de serre

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-07-01

    In front of the risks linked with the increase of the greenhouse gas emissions in the atmosphere, the decision makers must take into consideration first, the scientific advice of climatic change experts, and second, the considerable inertia of the climatic system. Thus, any action implemented so far will have an impact all along the 21. century and later whatever the future human activities. The aim of this memento is to sensibilize the decision makers about the possible consequences of their choice in terms of volume of greenhouse gases and of medium- and long-term evolution: 1 - stakes, role of local decision-makers (greenhouse effect and climatic change, France's international commitment, stakes, liabilities of local decision makers, decentralization laws, local plans of fight against greenhouse effect, public information and dialogue); 2 - urbanism and transports (urban displacements, alternatives to individual cars, collective transportation systems, parking, inter-region transports, goods transport, local urbanization plan, localization of activities, vehicle fleets of local authorities, companies transportation plans); 3 - buildings (energy conservation and consumption in municipal and social buildings, high environmental quality approach, management of maintenance and exploitation contracts, choice of building materials and space heating systems, air-conditioning and space cooling, mastery of power demand, recreational, cultural, school and public health buildings, insulation of buildings); 4 - energy utilities, production and distribution (public lighting, water treatment, municipal wastes, use of renewable energies, cogeneration, district heating networks, power distribution in rural areas: mastery of consumptions and decentralized production, wood-fuel and biomass valorization); 5 - other possible domains of action (tourism, agriculture, forestry and by-products, north-south solidarity with new partnerships). (J.S.)

  11. Professional autonomy in 21st century healthcare: Nurses' accounts of clinical decision-making

    DEFF Research Database (Denmark)

    Traynor, Michael; Boland, Maggie; Buus, Niels

    2010-01-01

    profession for reasons including history, gender and a traditional subservience to medicine. This paper reports on a focus group study of UK nurses participating in post-qualifying professional development in 2008. Three groups of nurses in different specialist areas comprised a total of 26 participants....... The study uses accounts of decision-making to gain insight into contemporary professional nursing. The study also aims to explore the usefulness of a theory of professional work set out by Jamous and Peloille (1970). The analysis draws on notions of interpretive repertoires and elements of narrative...... analysis. We identified two interpretive repertoires: 'clinical judgement' which was used to describe the different grounds for making judgements; and 'decision-making' which was used to describe organisational circumstances influencing decision-making. Jamous and Peloille's theory proved useful...

  12. Health Care Professional Factors Influencing Shared Medical Decision Making in Korea

    Directory of Open Access Journals (Sweden)

    Kae-Hwa Jo

    2015-11-01

    Full Text Available Till date, the medical decision-making process in Korea has followed the paternalist model, relying on the instructions of physicians. However, in recent years, shared decision making at the end-of-life between physicians and nurses is now emphasized in Korea. The purpose of this study was conducted to explore how health care professionals’ characteristics, attitude toward dignified dying, and moral sensitivity affect their shared medical decision making. The design was descriptive survey. This study was undertaken in two university hospitals in two metropolitan cities, South Korea. The participants were 344 nurses and 80 physicians who work at university hospitals selected by convenience sampling method. Data were collected from January 10 through March 20, 2014 using the Dignified Dying Scale, Moral Sensitivity Scale, and Shared Medical Decision-Making Scale. Shared medical decision making, attitude toward dignified dying, moral sensitivity, age, and working experience had a significant correlation with each other. The factors affecting shared medical decision making of Korean health care professionals were moral sensitivity and attitude toward dignified dying. These variables explained 22.4% of the shared medical decision making. Moral sensitivity and a positive attitude toward dignified dying should be promoted among health care professionals as a part of an educational program for shared medical decision making.

  13. Cultural change and environmentalism: a cross-national approach of mass publics and decision makers Mudança cultural e ambientalismo: uma abordagem transnacional sobre opinião pública e agentes decisórios

    Directory of Open Access Journals (Sweden)

    Peter Ester

    2004-12-01

    Full Text Available The main focus of this study - the Global Environmental Survey (GOES - is the impact of cultural influences on environmental attitudes. GOES examines the cultural impact from a basic cross-national perspective, investigating the impact of cultural change and value shifts on environmental concern, attitudes, and behavior in both Western and non-Western societies. This study provides cross-national insights in how mass publics and decision makers in both developed and developing countries frame environmental problems and solutions. In addition, the project has shown how leading environmental decision makers and opinion leaders assess the environmental beliefs and attitudes of the public. Apparently, citizens are not yet ready to translate pro-environmental concerns into acceptance of far-reaching environmental policy measures. Citizens in both developed and developing countries seem to prefer voluntary lifestyle changes. Moving from environmental concern via policy support to actual (reported environmental behavior, we can conclude that persistent pro-environmental behavior does not describe citizens' environmental involvement and commitment. Our data indicate that environmentally relevant behaviors (e.g., transportation, energy use, recycling, household purchases, political activism do not form a consistent and coherent pattern. Practice of one type of ecologically conscious behavior does not predict engagement in another. It is not that people reserve a distinctive spot in their mental software for judging the environmental impact of habitual behaviors. Their mental mapping probably consists of manifold decisional heuristics, including comfort, health, safety, price, efficiency, effectiveness, and social responsibility, which are likely to be hierarchically ordered and in competition with environmental heuristics. A focus on specific behaviors, though, reveals that citizens may be deeply involved in "green" behavior. This is related in part to

  14. Team dynamics, decision making, and attitudes toward multidisciplinary cancer meetings: health professionals' perspectives.

    Science.gov (United States)

    Devitt, Bianca; Philip, Jennifer; McLachlan, Sue-Anne

    2010-11-01

    Multidisciplinary cancer care is a standard feature of high quality care. In many centers, the multidisciplinary meeting (MDM) is an integral component. A qualitative study was performed to explore health professionals' attitudes towards this model of care, the decision making processes, and dynamics among team members. A series of focus groups was conducted with health professionals who attend MDMs at our institution. Focus groups followed a semistructured format with open-ended questions. A thematic analysis was performed. Four focus groups were held, attended by 23 participants including allied health professionals, specialist nurses, medical oncologists, and surgeons. All participants believed the primary objective of the MDM was to develop an individualized treatment plan. Several other key themes emerged. The MDM provided opportunities to improve communication, efficiency, and education as well as enhance professional relationships. Medical information was prioritized ahead of psychosocial details, with allied health professionals describing difficulty contributing to MDM discussion. Patient attendance at MDMs was opposed by health professionals because of concerns about the patient's ability to cope with the information discussed and the effect their presence would have on the dynamics of the decision-making process. Health professionals endorse MDMs as a useful tool in treating patients with cancer. Within this forum, both opportunities and constrains exist, with many benefits extending beyond the meeting itself into other clinical areas. Further study is warranted to establish an evidence base to ensure that both the possibilities and the limitations of this model of care are fully understood.

  15. Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task

    Science.gov (United States)

    Laureiro-Martínez, Daniella; Canessa, Nicola; Brusoni, Stefano; Zollo, Maurizio; Hare, Todd; Alemanno, Federica; Cappa, Stefano F.

    2014-01-01

    An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time). We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea) and managers (who are constantly involved in making strategic decisions but have no venture experience) engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex (FPC) previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making. PMID:24478664

  16. Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task

    Directory of Open Access Journals (Sweden)

    Daniella eLaureiro-Martínez

    2014-01-01

    Full Text Available An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time. We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea and managers (who are constantly involved in making strategic decisions but have no venture experience engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making.

  17. Barriers to the participation of people with psychosocial disability in mental health policy development in South Africa: a qualitative study of perspectives of policy makers, professionals, religious leaders and academics.

    Science.gov (United States)

    Kleintjes, Sharon; Lund, Crick; Swartz, Leslie

    2013-03-11

    This paper outlines stakeholder views on environmental barriers that prevent people who live with psychosocial disability from participating in mental health policy development in South Africa. Fifty-six semi-structured interviews with national, provincial and local South African mental health stakeholders were conducted between August 2006 and August 2009. Respondents included public sector policy makers, professional regulatory council representatives, and representatives from non-profit organisations (NPOs), disabled people's organisations (DPOs), mental health interest groups, religious organisations, professional associations, universities and research institutions. Respondents identified three main environmental barriers to participation in policy development: (a) stigmatization and low priority of mental health, (b) poverty, and (c) ineffective recovery and community supports. A number of attitudes, practices and structures undermine the equal participation of South Africans with psychosocial disability in society. A human rights paradigm and multi-system approach is required to enable full social engagement by people with psychosocial disability, including their involvement in policy development.

  18. The Relationship Between the Clinical Orientation of Substance Abuse Professionals and Their Clinical Decisions

    Science.gov (United States)

    Toriello, Paul J.; Leierer, Stephen J.

    2005-01-01

    In this study, the authors examined the relationship between the clinical orientations of substance abuse professionals (SAPs) and their clinical decisions. Cluster analysis grouped a sample of 245 SAPs on two clinical orientations that differed in their relative endorsement of traditional versus contemporary substance abuse counseling processes…

  19. 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.

  20. Decision in the pedagogical professional practice and the abduction’s function

    Directory of Open Access Journals (Sweden)

    Franco Blezza

    2014-01-01

    Full Text Available The aim of this short contribution is to present a summary of the decision problem within the profession of the pedagogist, and the fundamental role of the abduction  (’απαγωγή, retroduction process in its proper context, in professional practice of the pedagogist, as in all professional practice involving the social and professional pedagogy. Pedagogy is a field for reflection, application and commitment or engagement to education. Moreover, pedagogy is establishing itself as a profession, the profession of the pedagogist (not of the educator, who is a different figure, in the socio-health, intellectual, cultural and aid profession field, even in spite of heavy delays and failures of the Italian laws and the resistance of professional groups related but already recognized both by law and by society. The so-called “pedagogical interlocution” is a paradigmatic form of the professional pedagogical practice. Decision in professional pedagogy, properly speaking, must be reached by the interlocutor(s, who must debate and develop it, with the aid of the professional pedagogist. Abduction is not a valid syllogism: it concerns a possible example of a general case or of a rule, whose the actual pertinence to this general case or this rule is mediated by the professional or expert assumptions. The professional approach of the pedagogist, from methodological point of view, is casuistic (case based and situational as a form of aid given to the person, alternative and other than to the statistical-operational methodology that addresses rather to populations composed of individuals. Cases of general interest in professional pedagogy can be labeled as “casuistries” or “case study” categories. A good collection of casuistries - case study categories is provided by Erich Fromm, concerning the problems of family education; and by Viktor E. Frankl in his search for sense, Lebenssinn or λόγος. A further range of examples of categories

  1. FAmily CEntered (FACE) advance care planning: Study design and methods for a patient-centered communication and decision-making intervention for patients with HIV/AIDS and their surrogate decision-makers.

    Science.gov (United States)

    Kimmel, Allison L; Wang, Jichuan; Scott, Rachel K; Briggs, Linda; Lyon, Maureen E

    2015-07-01

    Although the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a chronic illness, disease-specific advance care planning has not yet been evaluated for the palliative care needs of adults with HIV/AIDS. This prospective, longitudinal, randomized, two-arm controlled clinical trial aims to test the efficacy of FAmily CEntered advance care planning among adults living with AIDS and/or HIV with co-morbidities on congruence in treatment preferences, healthcare utilization, and quality of life. The FAmily CEntered intervention arm is two face-to-face sessions with a trained, certified facilitator: Session 1) Disease-Specific Advance Care Planning Respecting Choices Interview; Session 2) Completion of advance directive. The Healthy Living Control arm is: Session 1) Developmental/Relationship History; Session 2) Nutrition. Follow-up data will be collected at 3, 6, 12, and 18 months post-intervention. A total of 288 patient/surrogate dyads will be enrolled from five hospital-based, out-patient clinics in Washington, District of Columbia. Participants will be HIV positive and ≥ 21 years of age; surrogates will be ≥ 18 years of age. Exclusion criteria are homicidality, suicidality, psychosis, and impaired cognitive functioning. We hypothesize that this intervention will enhance patient-centered communication with a surrogate decision-maker about end of life treatment preferences over time, enhance patient quality of life and decrease health care utilization. We further hypothesize that this intervention will decrease health disparities for Blacks in completion of advance directives. If proposed aims are achieved, the benefits of palliative care, particularly increased treatment preferences about end-of-life care and enhanced quality of life, will be extended to people living with AIDS. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Assisted Reproduction: What factors interfere in the professional's decisions? Are single women an issue?

    Directory of Open Access Journals (Sweden)

    Tarlatzis Basil C

    2011-05-01

    Full Text Available Abstract Background With the development of medical technology, many countries around the world have been implementing ethical guidelines and laws regarding Medically Assisted Reproduction (MAR. A physician's reproductive decisions are not solely based on technical criteria but are also influenced by society values. Therefore, the aim of this study was to analyze the factors prioritized by MAR professionals when deciding on whether to accept to perform assisted reproduction and to show any existing cultural differences. Methods Cross-sectional study involving 224 healthcare professionals working with assisted reproduction in Brazil, Italy, Germany and Greece. Instrument used for data collection: a questionnaire, followed by the description of four special MAR cases (a single woman, a lesbian couple, an HIV discordant couple and gender selection which included case-specific questions regarding the professionals' decision on whether to perform the requested procedure as well as the following factors: socio-demographic variables, moral and legal values as well as the technical aspects which influence decision-making. Results Only the case involving a single woman who wishes to have a child (without the intention of having a partner in the future demonstrated significant differences. Therefore, the study was driven towards the results of this case specifically. The analyses we performed demonstrated that professionals holding a Master's Degree, those younger in age, female professionals, those having worked for less time in reproduction, those in private clinics and Brazilian health professionals all had a greater tendency to perform the procedure in that case. A multivariate analysis demonstrated that the reasons for the professional's decision to perform the procedure were the woman's right to gestate and the duty of MAR professionals to help her. The professionals who decided not to perform the procedure identified the woman's marital status and

  3. Assisted Reproduction: What factors interfere in the professional's decisions? Are single women an issue?

    Science.gov (United States)

    2011-01-01

    Background With the development of medical technology, many countries around the world have been implementing ethical guidelines and laws regarding Medically Assisted Reproduction (MAR). A physician's reproductive decisions are not solely based on technical criteria but are also influenced by society values. Therefore, the aim of this study was to analyze the factors prioritized by MAR professionals when deciding on whether to accept to perform assisted reproduction and to show any existing cultural differences. Methods Cross-sectional study involving 224 healthcare professionals working with assisted reproduction in Brazil, Italy, Germany and Greece. Instrument used for data collection: a questionnaire, followed by the description of four special MAR cases (a single woman, a lesbian couple, an HIV discordant couple and gender selection) which included case-specific questions regarding the professionals' decision on whether to perform the requested procedure as well as the following factors: socio-demographic variables, moral and legal values as well as the technical aspects which influence decision-making. Results Only the case involving a single woman who wishes to have a child (without the intention of having a partner in the future) demonstrated significant differences. Therefore, the study was driven towards the results of this case specifically. The analyses we performed demonstrated that professionals holding a Master's Degree, those younger in age, female professionals, those having worked for less time in reproduction, those in private clinics and Brazilian health professionals all had a greater tendency to perform the procedure in that case. A multivariate analysis demonstrated that the reasons for the professional's decision to perform the procedure were the woman's right to gestate and the duty of MAR professionals to help her. The professionals who decided not to perform the procedure identified the woman's marital status and the child's right to a

  4. Health professionals' decision-making in wound management: a grounded theory.

    Science.gov (United States)

    Gillespie, Brigid M; Chaboyer, Wendy; St John, Winsome; Morley, Nicola; Nieuwenhoven, Paul

    2015-06-01

    To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice. With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area. A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice. Interviews were conducted with 20 multi-disciplinary participants from nursing, surgery, infection control and wound care who worked at a metropolitan hospital in Australia. Data were collected during 2012-2013. Constant comparative analysis underpinned by Strauss and Corbin's framework was used to identify clinical decision-making processes. The core category was 'balancing practice-based knowledge with evidence-based knowledge'. Participants' clinical practice and actions embedded the following processes: 'utilizing the best available information', 'using a consistent approach in wound assessment' and 'using a multidisciplinary approach'. The substantive theory explains how practice and evidence knowledge was balanced and the variation in use of intuitive practice-based knowledge versus evidence-based knowledge. Participants considered patients' needs and preferences, costs, outcomes, technologies, others' expertise and established practices. Participants' decision-making tended to be more heavily weighted towards intuitive practice-based processes. These findings offer a better understanding of the processes used by health professionals' in their decision-making in wound care. Such an understanding may inform the development of evidence-based interventions that lead to better patient outcomes. © 2014 John Wiley & Sons Ltd.

  5. Opinions of decision-makers on the liberalization of abortion laws in Mexico Opiniones de tomadores de decisiones sobre la liberalización de la ley del aborto en México

    Directory of Open Access Journals (Sweden)

    Marieke G van Dijk

    2007-12-01

    Full Text Available OBJECTIVE: In the last decade, important advances were made in the struggle for reproductive rights in Mexico. The goal of this study was to discover the opinions of decision-makers about the grounds for legal abortion as well as to explore their perceptions about further liberalization of abortion laws countrywide. MATERIAL AND METHODS: In-depth interviews were conducted with eight prominent decision-makers working in governmental health, law and social institutions as well as representatives of political parties. RESULTS: Six decision-makers favored a further liberalization of abortion laws. They proposed several strategies to move forward with liberalization. Two decision-makers were against abortion under all circumstances. CONCLUSIONS: Three factors seem to play a key role in the liberalization of abortion: a liberal party governing at the state level, a favorable public opinion and the pressure of NGOs promoting reproductive rights. A state-by-state approach seems more effective for generating changes in abortion laws.OBJETIVO: En la última década se realizaron avances importantes en la lucha por los derechos reproductivos en México. El objetivo del estudio fue conocer las opiniones de tomadores de decisiones (TD sobre las causales para un aborto legal, así como explorar sus percepciones sobre la liberalización de las leyes en todo el país. MATERIAL Y MÉTODOS: Se realizaron entrevistas a profundidad con ocho TD de instituciones gubernamentales de asuntos sociales, legales y de salud, así como representantes de partidos políticos. RESULTADOS: Seis entrevistados favorecieron la liberalización de las leyes y propusieron varias estrategias para realizarla. Dos entrevistados estuvieron en contra del aborto bajo cualquier circunstancia. CONCLUSIONES: En la liberalización del aborto, tres factores parecen tener un papel relevante: un partido liberal gobernando estatalmente, una opinión pública favorable y la presión de ONG que

  6. Occupational asthma caused by samba (Triplochiton scleroxylon) wood dust in a professional maker of wooden models of airplanes: a case study.

    Science.gov (United States)

    Krawczyk-Szulc, Patrycja; Wiszniewska, Marta; Pałczyński, Cezary; Nowakowska-Świrta, Ewa; Kozak, Anna; Walusiak-Skorupa, Jolanta

    2014-06-01

    Wood dust is a known occupational allergen that may induce, in exposed workers, respiratory diseases including asthma and allergic rhinitis. Samba (obeche, Triplochiton scleroxylon) is a tropical tree, which grows in West Africa, therefore, Polish workers are rarely exposed to it. This paper describes a case of occupational asthma caused by samba wood dust. The patient with suspicion of occupational asthma due to wood dust was examined at the Department of Occupational Diseases and Clinical Toxicology in the Nofer Institute of Occupational Medicine. Clinical evaluation included: analysis of occupational history, skin prick tests (SPT) to common and occupational allergens, determination of serum specific IgE to occupational allergens, serial spirometry measurements, metacholine challenge test and specific inhalation challenge test with samba dust SPT and specific serum IgE assessment revealed sensitization to common and occupational allergens including samba. Spirometry measurements showed mild obstruction. Metacholine challenge test revealed a high level of bronchial hyperactivity. Specific inhalation challenge test was positive and cellular changes in nasal lavage and induced sputum confirmed allergic reaction to samba. IgE mediated allergy to samba wood dust was confirmed. This case report presents the first documented occupational asthma and rhinitis due to samba wood dust in wooden airplanes model maker in Poland.

  7. INFORMATION MODELLING OF PROCESS OF ADOPTION OF ADMINISTRATIVE DECISIONS AT THE ORGANIZATION OF PROFESSIONAL DEVELOPMENT OF THE PERSONNEL

    Directory of Open Access Journals (Sweden)

    Yaroslav E. Prokushev

    2015-01-01

    Full Text Available The article is devoted to a problem of theorganization of professional developmentof personnel. The article is consideringtwo interconnected tasks. The fi rst task is: estimation of degree of need of professional development of the specifi c worker. The second task is: choice of the programof professional development. Functionalinformation models of procedures ofadoption of administrative decisions withinthese tasks are developed.

  8. Moral Hypocrisy on the Basis of Construal Level: To Be a Utilitarian Personal Decision Maker or to Be a Moral Advisor?

    Science.gov (United States)

    Xiao, Wei; Wu, Qing; Yang, Qun; Zhou, Liang; Jiang, Yuan; Zhang, Jiaxi; Miao, Danmin; Peng, Jiaxi

    2015-01-01

    Background People encounter various moral issues that involve making decisions for others by giving advice. Objective This study investigated the characteristics of providing suggestions for oneself versus providing suggestions for others in ethical decision-making and the differences between them based on Construal Level Theory (CLT). Methods A total of 768 undergraduate students from three universities in China were randomly assigned to eight groups on the basis of a grid of two Construal Levels (self or others) by two different numbers of people saved (5 people or 15 people) by two problem situations (trolley problem vs. footbridge problem). The investigation examined participants’ decisions to opt to take action or refrain from action that would have the consequence of saving more people. Results The main effects of Construal Level (F1, 752 = 6.46, p = .011), saving number (F1, 752 = 35.81, p dilemmas. PMID:25689521

  9. Moral hypocrisy on the basis of construal level: to be a utilitarian personal decision maker or to be a moral advisor?

    Directory of Open Access Journals (Sweden)

    Wei Xiao

    Full Text Available People encounter various moral issues that involve making decisions for others by giving advice.This study investigated the characteristics of providing suggestions for oneself versus providing suggestions for others in ethical decision-making and the differences between them based on Construal Level Theory (CLT.A total of 768 undergraduate students from three universities in China were randomly assigned to eight groups on the basis of a grid of two Construal Levels (self or others by two different numbers of people saved (5 people or 15 people by two problem situations (trolley problem vs. footbridge problem. The investigation examined participants' decisions to opt to take action or refrain from action that would have the consequence of saving more people.The main effects of Construal Level (F1, 752 = 6.46, p = .011, saving number (F1, 752 = 35.81, p < .001, and problem situation type (F1, 752 = 330.55, p < .001 were all significant. The interaction of the problem situation and saving number (F1, 752 = 1.01, p = .31, and social distance and saving number (F1, 752 = 0.85, p = .36, and interaction of the three independent factors (F1, 752 = 0.47, p = .49 were not significant. However, the interaction of social distance and problem situation (F1, 752 = 9.46, p = .002 was significant. Results indicated the participants utilized a component of utilitarian reasoning in the decision-making, and their behaviors appeared more utilitarian at low Construal Levels (CLs compared to high.CLs, saving numbers, and problem situation significantly affected moral decision-making and exhibited significant interaction. Making decisions for oneself (low-construal rather than giving advice to others (high-construal was one important factor that determined whether the people were utilitarian or not. Utilitarian considerations are more relevant in impersonal dilemmas.

  10. The influence of health care professional characteristics on pain management decisions.

    Science.gov (United States)

    Bartley, Emily J; Boissoneault, Jeff; Vargovich, Alison M; Wandner, Laura D; Hirsh, Adam T; Lok, Benjamin C; Heft, Marc W; Robinson, Michael E

    2015-01-01

    Evidence suggests that patient characteristics such as sex, race, and age influence the pain management decisions of health care providers. Although this signifies that patient demographics may be important determinants of health care decisions, pain-related care also may be impacted by the personal characteristics of the health care practitioner. However, the extent to which health care provider characteristics affect pain management decisions is unclear, underscoring the need for further research in this area. A total of 154 health care providers (77 physicians, 77 dentists) viewed video vignettes of virtual human (VH) patients varying in sex, race, and age. Practitioners provided computerized ratings of VH patients' pain intensity and unpleasantness, and also reported their willingness to prescribe non-opioid and opioid analgesics for each patient. Practitioner sex, race, age, and duration of professional experience were included as predictors to determine their impact on pain management decisions. When assessing and treating pain, practitioner sex, race, age, and duration of experience were all significantly associated with pain management decisions. Further, the role of these characteristics differed across VH patient sex, race, and age. These findings suggest that pain assessment and treatment decisions may be impacted by the health care providers' demographic characteristics, effects which may contribute to pain management disparities. Future research is warranted to determine whether findings replicate in other health care disciplines and medical conditions, and identify other practitioner characteristics (e.g., culture) that may affect pain management decisions. Wiley Periodicals, Inc.

  11. Pennsylvania's private woodland owners--a study of the characteristics, attitudes,and actions of an important group of decision-makers

    Science.gov (United States)

    David N. Larsen; David A. Gansner; David A. Gansner

    1972-01-01

    An expanding megalopolitan population is going to look to forest lands in the Northeast for a greater supply of commodities and services. Will they find what they are looking for? The answer to this question depends greatly on the attitudes and actions of woodland owners. They control the resource, and their decisions will determine its use.

  12. What's on a decision makers mind? - Identifying barriers in information flows between actors in integrated water management using mental model mapping. Poster.

    NARCIS (Netherlands)

    Kolkman, Rien; van Os, A.G.; Geurts, Petrus A.T.M.; van der Veen, A.

    2004-01-01

    This research studies the relation between mental models and the decision process outcome, in the specific case of the Zwolle storm surge barrier. Differences in mental models between stakeholders will result in different lines of argumentation leading to different solution alternatives. The final

  13. The Use of land evaluation information by land use planners and decision-makers; a case study in Santa Catarina, Brazil

    NARCIS (Netherlands)

    Bacic, I.L.Z.; Rossiter, D.G.; Bregt, A.K.

    2003-01-01

    Land evaluation is the prediction of land performance over time under specific uses, to guide strategic land use decisions. Modern land evaluation has a 30 year history, yet the results have often been disappointing. Land users and planners have been reported to ignore land evaluations, perhaps

  14. Professionals' decision-making about out-of-home placements following instances of child abuse.

    Science.gov (United States)

    Britner, Preston A; Mossler, Daniel G

    2002-04-01

    The goal of this research was to study how different groups of child welfare professionals prioritize and use information to make placement decisions following instances of child abuse. A total of 90 juvenile court judges and guardians ad litem, Court Appointed Special Advocates (CASA), social workers, and mental health professionals responded to a detailed questionnaire describing four case studies of child physical abuse in which a parent was the perpetrator, the child was either 2 years or 6 years of age, and the abuse was either first time or chronic. Participants rated the impact of specific pieces of information regarding child, family, and system-level characteristics on their decision-making process. Analyses of reactions to these vignettes demonstrate that professional groups use different kinds of information when making decisions about foster care placements. Social workers and mental health providers rely on information about the severity and pattern of abuse and on information about services offered in the past and parental responses to those services. Judges and guardians ad litem rely more heavily on information about the likelihood of a reoccurrence of abuse and the child's ability to recount the abuse, whereas CASA volunteers rely on information about the stability of the family. Professional group membership, rather than factors such as age or ethnicity of the child or chronicity of abuse, accounts for different patterns of prioritizing and using information when making decisions about whether a child should remain in the home or be placed in foster care. The implications for community-based training and intervention efforts are discussed.

  15. The effect of professional identity on comprehensiveness in strategic decision making: physician executives in the Canadian health care context.

    Science.gov (United States)

    Karmali, Shazia

    2012-01-01

    This paper explores differences in decision-making approaches between physician executives and nonphysician executives in a managerial setting. Fredrickson and Mitchell's (1984) conceptualization of the construct of comprehensiveness in strategic decision making is the central construct of this paper. Theories of professional identity, socialization, and institutional/dominant logics are applied to illustrate their impact on strategic decision-making approaches of physician and nonphysician executives. This paper proposes that high-status professionals, specifically physicians, occupying senior management roles are likely to approach decision making in a way that is consistent with their professional identity, and by extension, that departments led by physician executives are less likely to exhibit comprehensiveness in strategic decision-making processes than departments led by nonphysician executives. This paper provides conceptual evidence that physicians and nonphysicians approach management differently, and introduces the utility of comprehensiveness as a construct for strategic decision making in the context of health care management.

  16. A study to enhance medical students’ professional decision-making, using teaching interventions on common medications

    Directory of Open Access Journals (Sweden)

    Jane Wilcock

    2015-06-01

    Full Text Available Aim: To create sustained improvements in medical students’ critical thinking skills through short teaching interventions in pharmacology. Method: The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination. Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed. Results: Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies. Conclusion: Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training.

  17. Career Decision-Making Self-Efficacy and Professional Commitment Among Master Nursing Students.

    Science.gov (United States)

    Wang, Jingxia; Guo, Rui; Liu, Minhui; Zhang, Xiaofei; Ren, Lu; Sun, Mei; Tang, Siyuan

    2018-03-01

    Developing countries face a shortage of nurses with higher education, such as those with a master's degree. However, few studies have investigated the interaction between career decision and professional commitment (PC) of nursing students, especially for postgraduates. This study performed correlation analysis for career decision-making self-efficacy (CDMSE) and PC of 545 nursing postgraduate students from nursing schools at 19 universities or colleges throughout mainland China, who came from different regions, and possessed different years of study and different types of degrees as well as part-time job experiences. Data reliability and validity were confirmed for both Career Decision-Making Self-Efficacy Scale for university students (CDMSE-R) and Professional Commitment Questionnaire (PCQ). We found positive correlations between factors of PC and CDMSE. The score of CDMSE was different between regions, degree types, grades, and part-time job experiences. According to our results, we suggest nursing education or career advisory services should promote the PC of nursing students according to factors of their CDMSE scores.

  18. Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study

    Directory of Open Access Journals (Sweden)

    Jack Susan M

    2011-11-01

    Full Text Available Abstract Background Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. Methods A descriptive qualitative study was conducted to explore: 1 the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2 how decision makers at different levels report using research evidence; and 3 factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Results Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. Conclusions There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence

  19. Antecedents and Consequences of Medical Students' Moral Decision Making during Professionalism Dilemmas.

    Science.gov (United States)

    Monrouxe, Lynn; Shaw, Malissa; Rees, Charlotte

    2017-06-01

    Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students' action (or inaction) runs counter to their perceived moral values-often due to organizational constraints or power hierarchies-they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance). We suggest how medical educators can support students' understandings of ethical dilemmas and facilitate their habits of enacting professionalism: by modeling appropriate resistance behaviors. © 2017 American Medical Association. All Rights Reserved.

  20. Implementing clinical decision support for primary care professionals – the process

    DEFF Research Database (Denmark)

    Kortteisto, Tiina; Komulainen, Jorma; Kunnamo, Ilkka

    2012-01-01

    the implementation. The actual use was measured by means of a questionnaire and statistical data. The implementation process consisted of three successive training rounds and lasted for 18 months. After 12 months the reported actual use of the eCDS functions was diverse. The study indicates that successful......We describe the process of putting into practice a computer-based clinical decision support (eCDS) service integrated in the electronic patient record, and the actual use of eCDS after one year in a primary care organization with 48 health care professionals. Multiple methods were used to support...

  1. Factors considered in end-of-life care decision making by health care professionals.

    Science.gov (United States)

    Foo, Wei Ting; Zheng, Yiliang; Kwee, Ann K; Yang, Grace M; Krishna, Lalit

    2013-06-01

    To explore the importance of factors influencing the end-of-life care decision making of health care professionals (HCPs) in Singapore. This cross-sectional survey encompassed facets of patient, family, and HCP-related care considerations. In total, 187 questionnaires were distributed to physicians and nurses and had a response rate of 78.6%. The respondents rated patients' wishes (96.6%), their clinical symptoms (93.9%), and patients' beliefs (91.1%) very high. In all, 94.6% of the HCPs would respect a competent patient's wishes over the family's wishes when goals conflict. However, 59.9% of HCPs would abide by the family's wishes when the patient loses capacity even if the patient's previously expressed wishes are known. End-of-life care decision making by HCPs appears largely patient centered, although familial determination still wields significant influence with implications for advance care planning.

  2. Relationships Between Clinical Decision-Making Patterns and Self-Efficacy and Nursing Professionalism in Korean Pediatric Nurses.

    Science.gov (United States)

    Choi, Miyoung; Kim, Jisoo

    2015-01-01

    As pediatric nurses must make decisions on a regular basis when caring for hospitalized children, clinical decision-making abilities are necessary in this profession. In the present study, we explored clinical decision-making patterns and their association with self-efficacy and nursing professionalism in pediatric nurses. We surveyed 173 pediatric nurses and analyzed the relationships between their clinical decision-making patterns and self-efficacy and nursing professionalism. Factor analysis identified 5 clinical decision-making patterns: patient-family-nurse collaborative (PNC), individual patient-oriented (IP), nurse model-oriented (NM), pattern-oriented intuitive (PI), and nursing knowledge-oriented (NK). The most frequently observed clinical decision-making pattern was the PNC. The self-efficacy and nursing professionalism were found to be higher in pediatric nurses using the IP and NM, and were lower for those using the PNC. Thus, the present results suggest that pediatric nurses' clinical decision-making patterns are influenced by nursing professionalism and self-efficacy. Therefore, intervention programs focusing on these variables might improve clinical decision-making in pediatric nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. The Foci of In-Action Professional Judgement and Decision-Making in High-Level Adventure Sports Coaching Practice

    Science.gov (United States)

    Collins, Loel; Collins, Dave

    2017-01-01

    This article continues a theme of previous investigations by the authors and examines the focus of in-action reflection as a component of professional judgement and decision-making (PJDM) processes in high-level adventure sports coaching. We utilised a thematic analysis approach to investigate the decision-making practices of a sample of…

  4. Etude statistique des brevets: un nouvel outil d'aide à la décision Patent Statistics: a New Tool for Decision Makers

    Directory of Open Access Journals (Sweden)

    Moureau M.

    2006-11-01

    . Such analyses then fall within the scope of decision-making tools, since they bring to light a certain interpretation of the past and can be used for forecasts in the future.

  5. "Good idea but not feasible" – the views of decision makers and stakeholders towards strategies for better palliative care in Germany: a representative survey

    Directory of Open Access Journals (Sweden)

    Schneider Nils

    2009-07-01

    Full Text Available Abstract Background Statements on potential measures to improve palliative care in Germany predominantly reflect the points of view of experts from specialized palliative care organizations. By contrast, relatively little is known about the views of representatives of organizations and institutions that do not explicitly specialize in palliative care, but are involved to a relevant extent in the decision-making and policy-making processes. Therefore, for the first time in Germany, we carried out a representative study of the attitudes of a broad range of different stakeholders acting at the national or state level of the health care system. Methods 442 organizations and institutions were included and grouped as follows: patient organizations, nursing organizations, medical associations, specialized palliative care organizations, political institutions, health insurance funds and others. Using a standardized questionnaire, the participants were asked to rate their agreement with the World Health Organization's definition of palliative care (five-point scale: 1 = completely agree, 5 = completely disagree and to evaluate 18 pre-selected improvement measures with regard to their general meaningfulness and the feasibility of their introduction into the German health care system (two-point scale: 1 = good, 2 = poor. Results The response rate was 67%. Overall, the acceptance of the aims of palliative care in the WHO definition was strong. However, the level of agreement among health insurance funds' representatives was significantly less than that among representatives of the palliative care organizations. All the improvement measures selected for evaluation were rated significantly higher in respect of their meaningfulness than of their feasibility in Germany. In detail, the meaningfulness of 16 measures was evaluated positively (70–100% participants chose the answer "good"; for six of these measures feasibility was evaluated negatively (0–30

  6. Valuing structured professional judgment: predictive validity, decision-making, and the clinical-actuarial conflict.

    Science.gov (United States)

    Falzer, Paul R

    2013-01-01

    Structured professional judgment (SPJ) has received considerable attention as an alternative to unstructured clinical judgment and actuarial assessment, and as a means of resolving their ongoing conflict. However, predictive validity studies have typically relied on receiver operating characteristic (ROC) analysis, the same technique commonly used to validate actuarial assessment tools. This paper presents SPJ as distinct from both unstructured clinical judgment and actuarial assessment. A key distinguishing feature of SPJ is the contribution of modifiable factors, either dynamic or protective, to summary risk ratings. With modifiable factors, the summary rating scheme serves as a prognostic model rather than a classification procedure. However, prognostic models require more extensive and thorough predictive validity testing than can be provided by ROC analysis. It is proposed that validation should include calibration and reclassification techniques, as well as additional measures of discrimination. Several techniques and measures are described and illustrated. The paper concludes by tracing the limitations of ROC analysis to its philosophical foundation and its origin as a statistical theory of decision-making. This foundation inhibits the performance of crucial tasks, such as determining the sufficiency of a risk assessment and examining the evidentiary value of statistical findings. The paper closes by noting a current effort to establish a viable and complementary relationship between SPJ and decision-making theory. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Professional judgement and decision-making in adventure sports coaching: the role of interaction.

    Science.gov (United States)

    Collins, Loel; Collins, Dave

    2016-01-01

    This qualitative study presents the view that coaching practice places demands on the coach's adaptability and flexibility. These requirements for being adaptive and flexible are met through a careful process of professional judgement and decision-making based on context-appropriate bodies of knowledge. Adventure sports coaches were selected for study on the basis that adventure sports create a hyper-dynamic environment in which these features can be examined. Thematic analysis revealed that coaches were generally well informed and practised with respect to the technical aspects of their sporting disciplines. Less positively, however, they often relied on ad hoc contextualisation of generalised theories of coaching practice to respond to the hyper-dynamic environments encountered in adventure sports. We propose that coaching practice reflects the demands of the environment, individual learning needs of the students and the task at hand. Together, these factors outwardly resemble a constraints-led approach but, we suggest, actually reflect manipulation of these parameters from a cognitive rather than an ecological perspective. This process is facilitated by a refined judgement and decision-making process, sophisticated epistemology and an explicit interaction of coaching components.

  8. CaseMaker

    DEFF Research Database (Denmark)

    Ørngreen, Rikke

    2004-01-01

    Experience with case teaching, both at the Copenhagen Business School and also on a more large scale world basis, shows that students often do not carry out the kind of high level analysis of a case, which the case teaching paradigm claim it can encourage. Also, as the worlds of digital, multimedia...... and web-based educational environments emerge, case teachers want to use more than just paper-based cases, but have found that developing multimedia web cases is not a trivial matter. CaseMaker is an e-Learning environment, which supports: 1) Teachers in the development of cases. 2) Students in individual...... and collaborative analysis of cases. The system is currently under development and this paper reports on our first analysis and design phases, discussing the many possibilities and problems of case-based e-Learning....

  9. The role of discretion in recreation decision-making by resource professionals in the USDA Forest Service

    Science.gov (United States)

    Teressa Trusty; Lee K. Cerveny

    2012-01-01

    This paper explores opportunities for administrative discretion in decision-making for natural resource management. We carried out an exploratory study in the USDA Forest Service to understand factors affecting administrative actions related to recreation use in riparian areas. We conducted semi-structured interviews with 27 resource professionals from a national...

  10. The Power of Empowerment: Mediating the Relationship between Teachers' Participation in Decision Making and Their Professional Commitment

    Science.gov (United States)

    Bogler, Ronit

    2005-01-01

    This study examines the mediating effect of teacher empowerment on the relationship between teachers' participation in decision making and their professional commitment. The data were collected through quantitative questionnaires from a sample of 983 teachers in 25 junior high schools and 27 high schools in Israel. Hierarchical regression analyses…

  11. Healthcare professionals' and mothers' perceptions of factors that influence decisions to breastfeed or formula feed infants: a comparative study.

    Science.gov (United States)

    Brown, Amy; Raynor, Peter; Lee, Michelle

    2011-09-01

    This article is a report of a study comparing healthcare professionals' and mothers' perceptions of factors that influence the decision to breastfeed or formula feed an infant. The World Health Organisation recommends that mothers should breastfeed exclusively for the first 6 months of age and then continue to do so alongside complementary foods for the first 2 years and beyond. However, levels of breastfeeding in the United Kingdom are below the recommended targets. Low levels of actual or perceived professional support and understanding are associated with formula use. Twenty professionals working closely with mothers of young infants completed a semi-structured interview exploring the reasons they believed mothers chose to use formula milk. Twenty-three mothers with an infant aged 6-12 months also reflected on their experiences of milk feeding. The data were collected during 2007-2008. Professionals described a range of influences on maternal decisions to breastfeed or formula feed including lack of knowledge, support and help with difficulties. These were strongly echoed in the reasons mothers gave for formula use, suggesting clear professional understanding of the challenges relating to breastfeeding. Although keen to give further support, professionals raised issues of lack of time and resources to support mothers. Contrary to maternal beliefs of poor professional understanding, professionals had a clear perception of influences affecting early milk feeding choice. Further resources and recognition are needed for healthcare professionals working with new mothers to enable them to offer increased support, with the aim of increasing breastfeeding duration. © 2011 Blackwell Publishing Ltd.

  12. Differences in multiple-target visual search performance between non-professional and professional searchers due to decision-making criteria.

    Science.gov (United States)

    Biggs, Adam T; Mitroff, Stephen R

    2015-11-01

    Professional visual searches, such as those conducted by airport security personnel, often demand highly accurate performance. As many factors can hinder accuracy, it is critical to understand the potential influences. Here, we examined how explicit decision-making criteria might affect multiple-target search performance. Non-professional searchers (college undergraduates) and professional searchers (airport security officers) classified trials as 'safe' or 'dangerous', in one of two conditions. Those in the 'one = dangerous' condition classified trials as dangerous if they found one or two targets, and those in the 'one = safe' condition only classified trials as dangerous if they found two targets. The data suggest an important role of context that may be mediated by experience; non-professional searchers were more likely to miss a second target in the one = dangerous condition (i.e., when finding a second found target did not change the classification), whereas professional searchers were more likely to miss a second in the one = safe condition. © 2014 The British Psychological Society.

  13. Shaping parents: impact of contrasting professional counseling on parents' decision making for children with disorders of sex development.

    Science.gov (United States)

    Streuli, Jürg C; Vayena, Effy; Cavicchia-Balmer, Yvonne; Huber, Johannes

    2013-08-01

    The management of disorders or differences of sex development (DSD) remains complex, especially with respect to parents' decision for or against early genitoplasty. Most parents still tend to disfavor postponing surgery until the child is old enough to provide consent. To identify the determinants of parental decisions for or against early sex assignment surgery in DSD children, and in particular to assess the influence of contrasting behavior of health-care professionals and the information they dispense. Preliminary data analysis from a focus group identified two broad approaches to counseling information. Two six-minute counseling videos were produced on this basis: one medicalized, by an endocrinologist, the other demedicalized, by a psychologist. Third-year medical students (N = 89) were randomized to watch either video as prospective parents and report its impact on their decision in a self-administered questionnaire. Statistical analysis of questionnaire responses regarding decisions for or against surgery, including self-assessed impact of potential determinants. Thirty-eight of eighty-nine "parents" (43%) chose early surgery for "their" child, including 27/41 "parents" (66%) shown the medicalized video vs. 11/48 (23%) shown the demedicalized video (P parents" perceived their personal attitudes on a four-point Likert scale as the main influence on their decision although their "attitude" was significantly shaped by the video. Parental decisions concerning early sex assignment surgery for DSD children depend on the health professional counseling received, to a degree of which neither parents nor professionals appear fully aware. In the absence of conclusive data for or against early surgery, there is a danger of medicalized or demedicalized parentalism resulting in irreversible and inadequately grounded decisions, regardless of the consensus statement of 2005 and the subsequent call for multidisciplinary management. © 2013 International Society for

  14. The role of discretion in recreation decision-making by resource professionals in the USDA Forest Service.

    Science.gov (United States)

    Trusty, Teressa; Cerveny, Lee K

    2012-09-30

    This paper explores opportunities for administrative discretion in decision-making for natural resource management. We carried out an exploratory study in the USDA Forest Service to understand factors affecting administrative actions related to recreation use in riparian areas. We conducted semi-structured interviews with 27 resource professionals from a national forest in the northwest region of the United States. Questions focused on professional judgments about recreation in riparian areas, administrative actions related to management of these activities, and the potential for personal values to influence decisions. We analyzed the transcribed interviews using Atlas.ti, coding the data for salient themes. In this paper, we discuss perceptions of resource professionals about the potential for personal values to influence administrative actions and decisions. We highlight four distinct realms in the planning process where expanded discretionary capacity exists and values may emerge. Finally, we suggest ways to reduce the potential influence of value-based judgments in decision-making. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Programming of a refinery from the perspective of the decision makers: trade-offs analysis for corporate and technical guidelines; A programacao de uma refinaria sob a otica do decisor: uma analise dos trade-offs diante das orientacoes tecnicas e corporativas

    Energy Technology Data Exchange (ETDEWEB)

    Spiegel, Thais; Caulliraux, Heitor Mansur; Proenca, Adriano [Coordenacao dos Programas de Pos-Graduacao de Engenharia (COPPE/UFRJ), RJ (Brazil)

    2012-07-01

    Refineries usually gather a set of activities that shape how complex and dynamic it is. Adding to the complexity of the refining process, there is also a great freedom in the refinery operations, multiple arrangements possible to convert certain oil in derivatives. In this context, this article focuses on decision-making processes that lead refineries of an integrated oil company in their day to day. As decision-making, the text refers to a process that always brings a kind of conflict resolution, in which contradictory goals have to be negotiated and reconciled. The object of analysis is inserted in hierarchical decision-making processes, ie a process of disintegration, which begins with a comprehensive assessment, and then divides the decision in elements smaller and more defined, so that they are interdependent. The output at an aggregate level shall be the input in the next detailed level. In each level of the hierarchical, decision-making is the result of a problem, presented in a given context to a decision maker. Decision maker will be the responsible for the direction of the refinery production to which it is allocated. The programmer of each refinery is general guidelines that should be considered, albeit non-explicit or non-configurable, in some cases these take the form of technical criteria and in other situations derived from the business. From these, this article presents a critical and analytical in the face of dilemmas that emerge in front of decision makers search for converging a production schedule that meets both the criteria set. (author)

  16. The Durban World Congress Ethics Round Table IV: health care professional end-of-life decision making.

    Science.gov (United States)

    Joynt, Gavin M; Lipman, Jeffrey; Hartog, Christiane; Guidet, Bertrand; Paruk, Fathima; Feldman, Charles; Kissoon, Niranjan; Sprung, Charles L

    2015-04-01

    When terminal illness exists, it is common clinical practice worldwide to withhold (WH) or withdraw (WD) life-sustaining treatments. Systematic documentation of professional opinion and perceived practice similarities and differences may allow recommendations to be developed. Speakers from invited faculty of the World Federation of Societies of Intensive and Critical Care Medicine Congress that took place in Durban (2013), with an interest in ethics, were approached to participate in an ethics round table. Key domains of health care professional end-of-life decision making were defined, explored by discussion, and then questions related to current practice and opinion developed and subsequently answered by round-table participants to establish the presence or absence of agreement. Agreement was established for the desirability for early goal-of-care discussions and discussions between health care professionals to establish health care provider consensus and confirmation of the grounds for WH/WD, before holding formal WH/WD discussions with patients/surrogates. Nurse and other health care professional involvement were common in most but not all countries/regions. Principles and practical triggers for initiating discussions on WH/WD, such as multiorgan failure, predicted short-term survival, and predicted poor neurologic outcome, were identified. There was majority agreement for many but not all statements describing health care professional end-of-life decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Using Research to Inform Fledgling Professional Development Schools: Data-Driven Decision Making

    Science.gov (United States)

    Damore, Sharon J.; Kapustka, Katherine

    2007-01-01

    The Urban Professional Development School (PDS) Network represents a group of professional educators from a large, urban university and six public and private schools in the same metropolitan area committed to providing progressive models of professional development for teachers across the lifespan. This paper demonstrates how participants in this…

  18. Engaging in patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis: the views of health professionals

    Directory of Open Access Journals (Sweden)

    Hogden A

    2012-09-01

    Full Text Available Anne Hogden,1 David Greenfield,1 Peter Nugus,1 Matthew C Kiernan21Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, 2Prince of Wales Clinical School, University of New South Wales, and Neuroscience Research Australia, Sydney, New South Wales, AustraliaBackground: The aim of this study was to explore clinician perspectives on patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis (ALS, in an attempt to identify factors influencing decision-making.Methods: Thirty-two health professionals from two specialized multidisciplinary ALS clinics participated in individual and group interviews. Participants came from allied health, medical, and nursing backgrounds. Interviews were audio recorded, and the transcripts were analyzed thematically.Results: Respondents identified barriers and facilitators to optimal timing and quality of decision-making. Barriers related to the patient and the health system. Patient barriers included difficulties accepting the diagnosis, information sources, and the patient-carer relationship. System barriers were timing of diagnosis and symptom management services, access to ALS-specific resources, and interprofessional communication. Facilitators were teamwork approaches, supported by effective communication and evidence-based information.Conclusion: Patient-centered and collaborative decision-making is influenced by a range of factors that inhibit the delivery of optimal care. Decision-making relies on a fine balance between timing of information and service provision, and the readiness of patients to receive them. Health system restrictions impacted on optimal timing, and patients coming to terms with their condition. Clinicians valued proactive decision-making to prepare patients and families for inevitable change. The findings indicate disparity between patient choices and clinician perceptions of evidence, knowledge, and

  19. Adoption of clinical decision support systems in a developing country: Antecedents and outcomes of physician's threat to perceived professional autonomy.

    Science.gov (United States)

    Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh; Nezakati, Hossein

    2015-08-01

    The basic objective of this research is to study the antecedents and outcomes of professional autonomy which is a central construct that affects physicians' intention to adopt clinical decision support systems (CDSS). The antecedents are physicians' attitude toward knowledge sharing and interactivity perception (about CDSS) and the outcomes are performance expectancy and intention to adopt CDSS. Besides, we include (1) the antecedents of attitude toward knowledge sharing-subjective norms, social factors and OCB (helping behavior) and (2) roles of physicians' involvement in decision making, computer self-efficacy and effort expectancy in our framework. Data from a stratified sample of 335 Malaysian physicians working in 12 public and private hospitals in Malaysia were collected to test the hypotheses using Structural Equation Modeling (SEM). The important findings of our research are: (1) factors such as perceived threat to professional autonomy, performance expectancy, and physicians' involvement in making decision about CDSS have significant impact on physicians' intention to adopt CDSS; (2) physicians' attitude toward knowledge sharing, interactivity perception and computer self-efficacy of physicians play a crucial role in influencing their perceived threat to professional autonomy; and (3) social network, shared goals and OCB (helping behavior) impact physicians' attitude toward knowledge sharing. The findings provide a comprehensive understanding of the factors that influence physicians' intention to adopt CDSS in a developing country. The results can help hospital managers manage CDSS implementation in an effective manner. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Beginning RPG Maker VX Ace

    CERN Document Server

    Perez, Darrin

    2014-01-01

    Beginning RPG Maker VX Ace takes you through the process of using the RPG Maker VX Ace game development engine to create your very own role playing game. The book has been designed with the complete beginner in mind who has little to no experience with the engine. Tutorials and exercises will take you from installing the software to putting the final touches upon your first project. Game design can be quite a daunting challenge, as it generally involves a large amount of programming know-how on top of having to plan everything out that makes a good game what it is. RPG Maker VX Ace

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

    Science.gov (United States)

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

    2012-01-01

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

  2. Most Important Factors for the Implementation of Shared Decision Making in Sciatica Care: Ranking among Professionals and Patients

    Science.gov (United States)

    Hofstede, Stefanie N.; van Bodegom-Vos, Leti; Wentink, Manon M.; Vleggeert-Lankamp, Carmen L. A.; Vliet Vlieland, Thea P. M.; de Mheen, Perla J. Marang-van

    2014-01-01

    Introduction Due to the increasing specialization of medical professionals, patients are treated by multiple disciplines. To ensure that delivered care is patient-centered, it is crucial that professionals and the patient together decide on treatment (shared decision making (SDM)). However, it is not known how SDM should be integrated in multidisciplinary practice. This study determines the most important factors for SDM implementation in sciatica care, as it is known that a prior inventory of factors is crucial to develop a successful implementation strategy. Methods 246 professionals (general practitioners, physical therapists, neurologists, neurosurgeons, orthopedic surgeons) (30% response) and 155 patients (96% response) responded to an internet-based survey. Respondents ranked barriers and facilitators identified in previous interviews, on their importance using Maximum Difference Scaling. Feeding back the personal top 5 most important factors, each respondent indicated whether these factors were barriers or facilitators. Hierarchical Bayes estimation was used to estimate the relative importance (RI) of each factor. Results Professionals assigned the highest importance to: quality of professional-patient relationship (RI 4.87; CI 4.75–4.99); importance of quick recovery of patient (RI 4.83; CI 4.69–4.97); and knowledge about treatment options (RI 6.64; CI 4.53–4.74), which were reported as barrier and facilitator. Professionals working in primary care had a different ranking than those working in hospital care. Patients assigned the highest importance to: correct diagnosis by professionals (barrier, RI 8.19; CI 7.99–8.38); information provision about treatment options and potential harm and benefits (RI 7.87; CI 7.65–8.08); and explanation of the professional about the care trajectory (RI 7.16; CI 6.94–7.38), which were reported as barrier and facilitator. Conclusions Knowledge, information provision and a good relationship are the most important

  3. Most important factors for the implementation of shared decision making in sciatica care: ranking among professionals and patients.

    Directory of Open Access Journals (Sweden)

    Stefanie N Hofstede

    Full Text Available INTRODUCTION: Due to the increasing specialization of medical professionals, patients are treated by multiple disciplines. To ensure that delivered care is patient-centered, it is crucial that professionals and the patient together decide on treatment (shared decision making (SDM. However, it is not known how SDM should be integrated in multidisciplinary practice. This study determines the most important factors for SDM implementation in sciatica care, as it is known that a prior inventory of factors is crucial to develop a successful implementation strategy. METHODS: 246 professionals (general practitioners, physical therapists, neurologists, neurosurgeons, orthopedic surgeons (30% response and 155 patients (96% response responded to an internet-based survey. Respondents ranked barriers and facilitators identified in previous interviews, on their importance using Maximum Difference Scaling. Feeding back the personal top 5 most important factors, each respondent indicated whether these factors were barriers or facilitators. Hierarchical Bayes estimation was used to estimate the relative importance (RI of each factor. RESULTS: Professionals assigned the highest importance to: quality of professional-patient relationship (RI 4.87; CI 4.75-4.99; importance of quick recovery of patient (RI 4.83; CI 4.69-4.97; and knowledge about treatment options (RI 6.64; CI 4.53-4.74, which were reported as barrier and facilitator. Professionals working in primary care had a different ranking than those working in hospital care. Patients assigned the highest importance to: correct diagnosis by professionals (barrier, RI 8.19; CI 7.99-8.38; information provision about treatment options and potential harm and benefits (RI 7.87; CI 7.65-8.08; and explanation of the professional about the care trajectory (RI 7.16; CI 6.94-7.38, which were reported as barrier and facilitator. CONCLUSIONS: Knowledge, information provision and a good relationship are the most important

  4. Most important factors for the implementation of shared decision making in sciatica care: ranking among professionals and patients.

    Science.gov (United States)

    Hofstede, Stefanie N; van Bodegom-Vos, Leti; Wentink, Manon M; Vleggeert-Lankamp, Carmen L A; Vliet Vlieland, Thea P M; Marang-van de Mheen, Perla J

    2014-01-01

    Due to the increasing specialization of medical professionals, patients are treated by multiple disciplines. To ensure that delivered care is patient-centered, it is crucial that professionals and the patient together decide on treatment (shared decision making (SDM)). However, it is not known how SDM should be integrated in multidisciplinary practice. This study determines the most important factors for SDM implementation in sciatica care, as it is known that a prior inventory of factors is crucial to develop a successful implementation strategy. 246 professionals (general practitioners, physical therapists, neurologists, neurosurgeons, orthopedic surgeons) (30% response) and 155 patients (96% response) responded to an internet-based survey. Respondents ranked barriers and facilitators identified in previous interviews, on their importance using Maximum Difference Scaling. Feeding back the personal top 5 most important factors, each respondent indicated whether these factors were barriers or facilitators. Hierarchical Bayes estimation was used to estimate the relative importance (RI) of each factor. Professionals assigned the highest importance to: quality of professional-patient relationship (RI 4.87; CI 4.75-4.99); importance of quick recovery of patient (RI 4.83; CI 4.69-4.97); and knowledge about treatment options (RI 6.64; CI 4.53-4.74), which were reported as barrier and facilitator. Professionals working in primary care had a different ranking than those working in hospital care. Patients assigned the highest importance to: correct diagnosis by professionals (barrier, RI 8.19; CI 7.99-8.38); information provision about treatment options and potential harm and benefits (RI 7.87; CI 7.65-8.08); and explanation of the professional about the care trajectory (RI 7.16; CI 6.94-7.38), which were reported as barrier and facilitator. Knowledge, information provision and a good relationship are the most important conditions for SDM perceived by both patients and

  5. Evaluative Decision-Making for High-Quality Professional Development: Cultivating an Evaluative Stance

    Science.gov (United States)

    Sumsion, Jennifer; Lunn Brownlee, Joanne; Ryan, Sharon; Walsh, Kerryann; Farrell, Ann; Irvine, Susan; Mulhearn, Gerry; Berthelsen, Donna

    2015-01-01

    Unprecedented policy attention to early childhood education internationally has highlighted the crucial need for a skilled early years workforce. Consequently, professional development of early years educators has become a global policy imperative. At the same time, many maintain that professional development research has reached an impasse. In…

  6. Demandas y expectativas de la evaluación de tecnologías sanitarias en Galicia: Análisis cualitativo desde la perspectiva de decisores y clínicos Requirements for and expectations of health technology assessment in Galicia (Spain: A qualitative study from the perspective of decision-makers and clinicians

    Directory of Open Access Journals (Sweden)

    Leonor Varela-Lema

    2011-12-01

    in the Galician public health system, identify opinions on the usefulness of the products and services developed by the Galician Health Technology Assessment Agency (avalia-t, and determine the barriers and facilitators to the transfer of results to clinical practice. Method: We performed a qualitative study based on in-depth semi-structured interviews of 20 intentionally selected experts (10 health care professionals and 10 hospital decision makers. The interviews were tape recorded and transcribed for inductive thematic analysis. Results: Interest in HTA activities was high, but most informants considered these activities to be underused as a tool to aid decision making in clinical practice. A series of key factors was identified to guarantee HTA use: greater dissemination of HTA activities and availability of the results, increased involvement and communication among health care professionals in the selection and prioritization of relevant research, contextualization and adaptation of results to the local context, increased organizational support and greater financial resources. Conclusions: The present study allows end-users´ opinions on the utility of the various products/services offered by HTA agencies to be contrasted in order to adapt HTA activity to their needs and requirements. The involvement of health care professionals in all HTA fields is perceived as one of the main lines of action for HTA agencies. Such involvement could be achieved by reinforcing personal contact and increasing feedback to collaborators.

  7. Principles of Classroom Management: A Professional Decision-Making Model, 7th Edition

    Science.gov (United States)

    Levin, James; Nolan, James F.

    2014-01-01

    This text takes a decision-making model approach to classroom management. It provides teachers with a very practical system to influence students to choose to behave productively and to strive for academic success. This widely used text presents an array of decision-making options that guide teachers in developing positive, pro-social classroom…

  8. A Case Study of Human Resource Development Professionals' Decision Making in Vendor Selection for Employee Development: A Degrees-of-Freedom Analysis

    Science.gov (United States)

    Cathcart, Stephen Michael

    2016-01-01

    This mixed method study examines HRD professionals' decision-making processes when making an organizational purchase of training. The study uses a case approach with a degrees of freedom analysis. The data to analyze will examine how HRD professionals in manufacturing select outside vendors human resource development programs for training,…

  9. Validating a conceptual model for an inter-professional approach to shared decision making: a mixed methods study

    Science.gov (United States)

    Légaré, France; Stacey, Dawn; Gagnon, Susie; Dunn, Sandy; Pluye, Pierre; Frosch, Dominick; Kryworuchko, Jennifer; Elwyn, Glyn; Gagnon, Marie-Pierre; Graham, Ian D

    2011-01-01

    Rationale, aims and objectives Following increased interest in having inter-professional (IP) health care teams engage patients in decision making, we developed a conceptual model for an IP approach to shared decision making (SDM) in primary care. We assessed the validity of the model with stakeholders in Canada. Methods In 15 individual interviews and 7 group interviews with 79 stakeholders, we asked them to: (1) propose changes to the IP-SDM model; (2) identify barriers and facilitators to the model's implementation in clinical practice; and (3) assess the model using a theory appraisal questionnaire. We performed a thematic analysis of the transcripts and a descriptive analysis of the questionnaires. Results Stakeholders suggested placing the patient at its centre; extending the concept of family to include significant others; clarifying outcomes; highlighting the concept of time; merging the micro, meso and macro levels in one figure; and recognizing the influence of the environment and emotions. The most common barriers identified were time constraints, insufficient resources and an imbalance of power among health professionals. The most common facilitators were education and training in inter-professionalism and SDM, motivation to achieve an IP approach to SDM, and mutual knowledge and understanding of disciplinary roles. Most stakeholders considered that the concepts and relationships between the concepts were clear and rated the model as logical, testable, having clear schematic representation, and being relevant to inter-professional collaboration, SDM and primary care. Conclusions Stakeholders validated the new IP-SDM model for primary care settings and proposed few modifications. Future research should assess if the model helps implement SDM in IP clinical practice. PMID:20695950

  10. Maternal bodies and medicines: a commentary on risk and decision-making of pregnant and breastfeeding women and health professionals.

    Science.gov (United States)

    McDonald, Karalyn; Amir, Lisa H; Davey, Mary-Ann

    2011-11-25

    The perceived risk/benefit balance of prescribed and over-the-counter (OTC) medicine, as well as complementary therapies, will significantly impact on an individual's decision-making to use medicine. For women who are pregnant or breastfeeding, this weighing of risks and benefits becomes immensely more complex because they are considering the effect on two bodies rather than one. Indeed the balance may lie in opposite directions for the mother and baby/fetus. The aim of this paper is to generate a discussion that focuses on the complexity around risk, responsibility and decision-making of medicine use by pregnant and breastfeeding women. We will also consider the competing discourses that pregnant and breastfeeding women encounter when making decisions about medicine. Women rely not only on biomedical information and the expert knowledge of their health care professionals but on their own experiences and cultural understandings as well. When making decisions about medicines, pregnant and breastfeeding women are influenced by their families, partners and their cultural societal norms and expectations. Pregnant and breastfeeding women are influenced by a number of competing discourses. "Good" mothers should manage and avoid any risks, thereby protecting their babies from harm and put their children's needs before their own - they should not allow toxins to enter the body. On the other hand, "responsible" women take and act on medical advice - they should take the medicine as directed by their health professional. This is the inherent conflict in medicine use for maternal bodies. The increased complexity involved when one body's actions impact the body of another - as in the pregnant and lactating body - has received little acknowledgment. We consider possibilities for future research and methodologies. We argue that considering the complexity of issues for maternal bodies can improve our understanding of risk and public health education.

  11. Situating School District Resource Decision Making in Policy Context

    Science.gov (United States)

    Spain, Angeline K.

    2016-01-01

    Decentralization and deregulation policies assume that local educational leaders make better resource decisions than state policy makers do. Conceptual models drawn from organizational theory, however, offer competing predictions about how district central office administrators are likely to leverage their professional expertise in devolved…

  12. MakerBot projects blueprints

    CERN Document Server

    Larson, Joseph

    2013-01-01

    MakerBot Projects Blueprints is a project-based book, with each chapter taking you through the creation of an awesome stand-alone project. MakerBot Project Blueprints is for anyone with an interest in the 3D printing revolution and the slightest bit of computer skills. Whether you own a 3D printer or not you can design for them. All it takes is Blender, a free 3D modeling tool, this book and a little creativity and someday you'll be able to hold something you designed in the computer in your hands.

  13. FileMaker Pro 9

    CERN Document Server

    Coffey, Geoff

    2007-01-01

    FileMaker Pro 9: The Missing Manual is the clear, thorough and accessible guide to the latest version of this popular desktop database program. FileMaker Pro lets you do almost anything with the information you give it. You can print corporate reports, plan your retirement, or run a small country -- if you know what you're doing. This book helps non-technical folks like you get in, get your database built, and get the results you need. Pronto.The new edition gives novices and experienced users the scoop on versions 8.5 and 9. It offers complete coverage of timesaving new features such as the Q

  14. Professional Development for International Teachers: Examining TPACK and Technology Integration Decision Making

    Science.gov (United States)

    Dalal, Medha; Archambault, Leanna; Shelton, Catharyn

    2017-01-01

    This mixed-methods study explored the impacts of a semester-long technology professional development for secondary school international teachers from developing nations around the world. We used (a) a survey approach to examine international teachers' perceived technology integration abilities using the technological pedagogical content knowledge…

  15. Program Directors' Perceptions of Professional Bachelor's Athletic Training Student Decisions to Persist and Depart

    Science.gov (United States)

    Bowman, Thomas G.; Hertel, Jay; Mazerolle, Stephanie M.; Dodge, Thomas M.; Wathington, Heather D.

    2016-01-01

    Context: Recent literature has focused on reasons for athletic training student persistence and departure. However, accredited professional bachelor's athletic training program (ATP) directors' opinions regarding student retention have yet to be studied, to our knowledge. Objective: To determine reasons for athletic training student persistence…

  16. Supporting decision making in cross-border regions: a health technology assessment tool for hospitals.

    Science.gov (United States)

    Knies, Saskia; Lombardi, Gloria; Commers, Matt; Dauben, Hans-Peter; Evers, Silvia; Michelsen, Kai; Oortwijn, Wija; Opara, Chibuzo; Brand, Helmut

    2013-01-01

    The aim of this study was to develop an health technology assessment (HTA) decision tool to support the decision-making process on health technologies for hospital decision makers in cross-border regions. Several methods were used to collect information necessary to develop the cross-border mini-HTA decision tool. The literature was inventoried on HTA in border regions and local settings and the use of HTA by local decision makers. Semi-structured interviews with hospital decision makers in cross-border regions were also performed. Based on group discussion of the resulting information, it was decided to use the Danish mini-HTA guideline as a starting point for development of the decision tool. After finishing the first version of the decision tool it was tested in two pilot studies. Some questions in the Danish mini-HTA guideline were not relevant. Other questions needed rephrasing and questions about cross-border situations were added. The pilots showed several missing topics, including legal questions and reimbursement issues. The final decision tool consists of three sections: a general section, a section for hospitals not cooperating cross-border and a section for hospitals that are cooperating with hospitals across a national or regional border. Based on our literature search, this may be the first cross-border mini-HTA decision tool. The decision tool will be of help for healthcare professionals and decision makers in border settings who would like to use HTA evidence to support their decision-making process.

  17. Decision technologies and the independent professional: the future's challenge to learning and leadership.

    Science.gov (United States)

    Dowie, J

    2001-12-01

    Most references to "leadership" and "learning" as sources of quality improvement in medical care reflect an implicit commitment to the decision technology of "clinical judgement". All attempts to sustain this waning decision technology by clinical guidelines, care pathways, "evidence based practice", problem based curricula, and other stratagems only increase the gap between what is expected of doctors in today's clinical situation and what is humanly possible, hence the morale, stress, and health problems they are increasingly experiencing. Clinical guidance programmes based on decision analysis represent the coming decision technology, and proactive adaptation will produce independent doctors who can deliver excellent evidence based and preference driven care while concentrating on the human aspects of the therapeutic relation, having been relieved of the unbearable burdens of knowledge and information processing currently laid on them. History is full of examples of the incumbents of dominant technologies preferring to die than to adapt, and medicine needs both learning and leadership if it is to avoid repeating this mistake.

  18. Patient and health care professional decision-making to commence and withdraw from renal dialysis: a systematic review of qualitative research.

    Science.gov (United States)

    Hussain, Jamilla A; Flemming, Kate; Murtagh, Fliss E M; Johnson, Miriam J

    2015-07-07

    To ensure that decisions to start and stop dialysis in ESRD are shared, the factors that affect patients and health care professionals in making such decisions must be understood. This systematic review sought to explore how and why different factors mediate the choices about dialysis treatment. MEDLINE, Embase, CINAHL, and PsychINFO were searched for qualitative studies of factors that affect patients' or health care professionals' decisions to commence or withdraw from dialysis. A thematic synthesis was conducted. Of 494 articles screened, 12 studies (conducted from 1985 to 2014) were included. These involved 206 patients (most receiving hemodialysis) and 64 health care professionals (age ranges: patients, 26-93 years; professionals, 26-61 years). For commencing dialysis, patients based their choice on "gut instinct," as well as deliberating over the effect of treatment on quality of life and survival. How individuals coped with decision-making was influential: Some tried to take control of the problem of progressive renal failure, whereas others focused on controlling their emotions. Health care professionals weighed biomedical factors and were led by an instinct to prolong life. Both patients and health care professionals described feeling powerless. With regard to dialysis withdrawal, only after prolonged periods on dialysis were the realities of life on dialysis fully appreciated and past choices questioned. By this stage, however, patients were physically dependent on treatment. As was seen with commencing dialysis, individuals coped with treatment withdrawal in a problem- or emotion-controlling way. Families struggled to differentiate between choosing versus allowing death. Health care teams avoided and queried discussions regarding dialysis withdrawal. Patients, however, missed the dialogue they experienced during predialysis education. Decision-making in ESRD is complex and dynamic and evolves over time and toward death. The factors at work are

  19. İzmirde Kurulu Bir Plastik İşletmesinde Karar Vericinin Optimal Hedeflere Odaklanmasında Toplamsal Model Tabanlı Bulanık Hedef Programlama (An Additive Model Based Fuzzy Goal Programming Allows Decision Makers to Focus On Optimal Goals in A Plastic Factory Which Is Established in Izmir

    Directory of Open Access Journals (Sweden)

    Ahmet AKDENİZ

    2010-07-01

    Full Text Available As known; goal programming, which is a type of multi-objective programming that its priority is satisfaction and based on optimization, allows decision maker to design an optimal system. Hence; a solution set provides simultaneous satisfactory is determined. Fuzzy goal programming model is analyzed in two different forms with respect to objective preemptive priority structure. In the first form, an importance level of preferences is specified quantitatively. In the second form, preference priority is added to model as linguistic information.In fuzzy goal programming; additive model which is adapted to mentioned two forms is developed by Tiwari, Dharmar and Rao (1987. Goal programming based on more satisfaction instead of optimization. Thus, using of fuzzy logic in this area is appealing. Goal programming approaches based on fuzzy logic is developed by the time of progress and every approach is aimed at getting better models. A model that allows preemptive priority in fuzzy goal programming in order to reach maximum membership and makes its solution to one structural problem is developed by Chen and Tsai (2001. Additive model which is proposed by Chen and Tsai allows for making desired success of level for every fuzzy goal by a decision maker. Thus, relative importance of these goals is stated clearly. In this paper, additive model used in fuzzy goal programming applied to plastic factory which is established in Izmir. The relationship between goals of production planning chief and model outputs is evaluated and presented.

  20. Enhanced decision support for policy makers using a web interface to health-economic models - Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

    NARCIS (Netherlands)

    Hubben, G.A.A.; Bos, J.M.; Glynn, D.M.; van der Ende, A.; van Alphen, L.; Postma, M.J.

    2007-01-01

    We have developed a web-based user-interface (web interface) to enhance the usefulness of health-economic evaluations to support decision making (http://pcv.healtheconomics.nl). It allows the user to interact with a health-economic model to evaluate predefined and customized scenarios and perform

  1. Assessment of the Influence of Demographic and Professional Characteristics on Health Care Providers' Pain Management Decisions Using Virtual Humans.

    Science.gov (United States)

    Boissoneault, Jeff; Mundt, Jennifer M; Bartley, Emily J; Wandner, Laura D; Hirsh, Adam T; Robinson, Michael E

    2016-05-01

    Disparities in health care associated with patients' gender, race, and age are well documented. Previous studies using virtual human (VH) technology have demonstrated that provider characteristics may play an important role in pain management decisions. However, these studies have largely emphasized group differences. The aims of this study were to examine dentists' and physicians' use of VH characteristics when making clinical judgments (i.e., cue use) and to identify provider characteristics associated with the magnitude of the impact of these cues (β-weights). Providers (N=152; 76 physicians, 76 dentists) viewed video vignettes of VH patients varying in gender (male/female), race (white/black), and age (younger/older). Participants rated VH patients' pain intensity and unpleasantness and then rated their own likelihood of administering non-opioid and opioid analgesics. Compared to physicians, dentists had significantly lower β-weights associated with VH age cues for all ratings (p0.69). These effects varied by provider race and gender. For pain intensity, professional differences were present only among non-white providers. White providers had greater β-weights than non-white providers for pain unpleasantness but only among men. Provider differences regarding the use of VH age cues in non-opioid analgesic administration were present among all providers except non-white males. These findings highlight the interaction of patient and provider factors in driving clinical decision making. Although profession was related to use of VH age cues in pain-related clinical judgments, this relationship was modified by providers' personal characteristics. Additional research is needed to understand what aspects of professional training or practice may account for differences between physicians and dentists and what forms of continuing education may help to mitigate the disparities.

  2. Shared decision-making behaviours in health professionals: a systematic review of studies based on the Theory of Planned Behaviour.

    Science.gov (United States)

    Thompson-Leduc, Philippe; Clayman, Marla L; Turcotte, Stéphane; Légaré, France

    2015-10-01

    Shared decision making (SDM) requires health professionals to change their practice. Socio-cognitive theories, such as the Theory of Planned Behaviour (TPB), provide the needed theoretical underpinnings for designing behaviour change interventions. We systematically reviewed studies that used the TPB to assess SDM behaviours in health professionals to explore how theory is being used to explain influences on SDM intentions and/or behaviours, and which construct is identified as most influential. We searched PsycINFO, MEDLINE, EMBASE, CINAHL, Index to theses, Proquest dissertations and Current Contents for all years up to April 2012. We included all studies in French or English that used the TPB and related socio-cognitive theories to assess SDM behavioural intentions or behaviours in health professionals. We used Makoul & Clayman's integrative SDM model to identify SDM behaviours. We extracted study characteristics, nature of the socio-cognitive theory, SDM behaviour, and theory-based determinants of the SDM behavioural intention or behaviour. We computed simple frequency counts. Of 12,388 titles, we assessed 136 full-text articles for eligibility. We kept 20 eligible studies, all published in English between 1996 and 2012. Studies were conducted in Canada (n = 8), the USA (n = 6), the Netherlands (n = 3), the United Kingdom (n = 2) and Australia (n = 1). The determinant most frequently and significantly associated with intention was the subjective norm (n = 15/21 analyses). There was great variance in the way socio-cognitive theories predicted SDM intention and/or behaviour, but frequency of significance indicated that subjective norm was most influential. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  3. Design-to-fabricate: maker hardware requires maker software.

    Science.gov (United States)

    Schmidt, Ryan; Ratto, Matt

    2013-01-01

    As a result of consumer-level 3D printers' increasing availability and affordability, the audience for 3D-design tools has grown considerably. However, current tools are ill-suited for these users. They have steep learning curves and don't take into account that the end goal is a physical object, not a digital model. A new class of "maker"-level design tools is needed to accompany this new commodity hardware. However, recent examples of such tools achieve accessibility primarily by constraining functionality. In contrast, the meshmixer project is building tools that provide accessibility and expressive power by leveraging recent computer graphics research in geometry processing. The project members have had positive experiences with several 3D-design-to-print workshops and are exploring several design-to-fabricate problems. This article is part of a special issue on 3D printing.

  4. Care as a mutual endeavour : experiences of a multiple sclerosis patient and her healthcare professionals

    NARCIS (Netherlands)

    Oeseburg, B.; Abma, T.A.

    2006-01-01

    In Dutch healthcare policy patients are seen as informed, autonomous experts and active decision makers with control over their illness and care. Healthcare professionals are expected to operate as providers of information. The purpose of this article is to argue that the consumerist approach of the

  5. Functioning assessment vs. conventional medical assessment : a comparative study on health professionals' clinical decision-making and the fit with patient's own perspective of health

    NARCIS (Netherlands)

    Stallinga, Hillegonda A.; Roodbol, Petrie F.; Annema, Coby; Jansen, Gerard J.; Wynia, Klaske

    Aims and objectives. To compare a functioning assessment based on the International Classification of Functioning, Disability and Health (ICF) with a conventional medical assessment, in terms of their respective consequences for health professionals' clinical decision-making and the fit with

  6. The Effects of an Online Data-Based Decisions Professional Development for In-Service Teachers of Students with Significant Disability

    Science.gov (United States)

    Jimenez, Bree A.; Mims, Pamela J.; Baker, Josh

    2016-01-01

    With the increase in the use of online professional development resources, especially for rural educators, this study evaluated the effects of online training modules on in-service teachers' ability to collect and use instructional progress monitoring data to make instructional decisions for students with significant disability (i.e., moderate to…

  7. The Influence of Lived Experience with Addiction and Recovery on Practice-Related Decisions among Professionals Working in Addiction Agencies Serving Women

    Science.gov (United States)

    Novotna, Gabriela; Dobbins, Maureen; Jack, Susan M.; Sword, Wendy; Niccols, Alison; Brooks, Sandy; Henderson, Joanna

    2013-01-01

    Aims: The study objectives were to: (1) understand the value attributed to the lived experience of addiction and recovery among professionals working in addiction agencies serving women in Canada and (2) describe how lived experience influence practice-related decision-making. Methods: A descriptive qualitative study was conducted with a…

  8. Making the Connection between Environmental Science and Decision Making

    Science.gov (United States)

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

    2011-12-01

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

  9. Can scientists and policy makers work together?

    OpenAIRE

    Choi, B.; Pang, T.; Lin, V.; Puska, P.; Sherman, G.; Goddard, M.; Ackland, M.; Sainsbury, P.; Stachenko, S.; Morrison, H.; Clottey, C.

    2005-01-01

    This paper addresses a fundamental question in evidence based policy making—can scientists and policy makers work together? It first provides a scenario outlining the different mentalities and imperatives of scientists and policy makers, and then discusses various issues and solutions relating to whether and how scientists and policy makers can work together. Scientists and policy makers have different goals, attitudes toward information, languages, perception of time, and career paths. Impor...

  10. Comparative analysis of nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks: a discussion paper.

    Science.gov (United States)

    Kennedy, Catriona; O'Reilly, Pauline; Fealy, Gerard; Casey, Mary; Brady, Anne-Marie; McNamara, Martin; Prizeman, Geraldine; Rohde, Daniela; Hegarty, Josephine

    2015-08-01

    To review, discuss and compare nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks. Scope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society. Discussion paper. Twelve scope of practice and associated decision-making frameworks (January 2000-March 2014). Two main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice. Nursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decision-making provides a very public statement about the status of nursing in a given jurisdiction. © 2015 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Struzik, E.

    2009-12-01

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

  12. Guidance for patients considering direct-to-consumer genetic testing and health professionals involved in their care: development of a practical decision tool.

    Science.gov (United States)

    Jackson, Leigh; Goldsmith, Lesley; Skirton, Heather

    2014-06-01

    Direct-to-consumer (DTC) genetic tests are available online, but there is little practical guidance for health professionals and consumers concerning their use. Work to produce such guidance was initially informed by three systematic reviews assessing the evidence on views and experiences of users and health professionals and policies of professional and bioethics organizations. The evidence suggested that consumers' motivations include general curiosity, improving their general health, ascertaining the risk of a particular condition or planning for future children. However, health professionals and bioethics organizations expressed concerns about potential harms resulting from these tests. Using this evidence, we constructed a list of topics to be included in proposed guidelines. Using an expert group technique, we aimed to develop guidance for (i) potential consumers and (ii) health professionals approached by patients considering or having undertaken such tests. We considered it important to involve a wide range of participants with relevant experience. Accordingly, researchers and clinicians based in four countries were invited to a 2-day workshop in August 2012. Following an iterative process, we decided to produce clinically relevant and pragmatic guidance in the form of a decision support tool for use in primary care. By utilizing both the relevant literature and the experience of the expert group, we identified seven key underlying reasons that might prompt individuals to consider DTC testing. We considered primary care physicians as the most likely health professionals from whom individuals would seek advice. Based on the outcomes of the workshop, we developed a decision support tool encompassing varied clinical scenarios. Health professionals and patients are guided through a pathway that includes relevant actions and information on the appropriateness of the test. This tool will be freely accessible to health professionals and patients online. © The

  13. Barriers to optimizing investments in the built environment to reduce youth obesity: policy-maker perspectives.

    Science.gov (United States)

    Grant, Jill L; MacKay, Kathryn C; Manuel, Patricia M; McHugh, Tara-Leigh F

    2010-01-01

    To identify factors which limit the ability of local governments to make appropriate investments in the built environment to promote youth health and reduce obesity outcomes in Atlantic Canada. Policy-makers and professionals participated in focus groups to discuss the receptiveness of local governments to introducing health considerations into decision-making. Seven facilitated focus groups involved 44 participants from Atlantic Canada. Thematic discourse analysis of the meeting transcripts identified systemic barriers to creating a built environment that fosters health for youth aged 12-15 years. Participants consistently identified four categories of barriers. Financial barriers limit the capacities of local government to build, maintain and operate appropriate facilities. Legacy issues mean that communities inherit a built environment designed to facilitate car use, with inadequate zoning authority to control fast food outlets, and without the means to determine where schools are built or how they are used. Governance barriers derive from government departments with distinct and competing mandates, with a professional structure that privileges engineering, and with funding programs that encourage competition between municipalities. Cultural factors and values affect outcomes: people have adapted to car-oriented living; poverty reduces options for many families; parental fears limit children's mobility; youth receive limited priority in built environment investments. Participants indicated that health issues have increasing profile within local government, making this an opportune time to discuss strategies for optimizing investments in the built environment. The focus group method can foster mutual learning among professionals within government in ways that could advance health promotion.

  14. Evaluation of an online training for improving self-reported evidence-based decision-making skills in cancer control among public health professionals.

    Science.gov (United States)

    Morshed, A B; Ballew, P; Elliott, M B; Haire-Joshu, D; Kreuter, M W; Brownson, R C

    2017-11-01

    The purpose of this evaluation was to assess the effect of the online evidence-based cancer control (EBCC) training on improving the self-reported evidence-based decision-making (EBDM) skills in cancer control among Nebraska public health professionals. Cross-sectional group comparison. Previously developed EBDM measures were administered via online surveys to 201 public health professionals at baseline (comparison group) and 123 professionals who took part in the training. Respondents rated the importance of and their skill level in 18 EBCC skills. Differences were examined using analysis of variance models adjusted for gender, age, years at agency, and years in position, and stratified by respondent educational attainment. Among professionals without an advanced degree, training participants reported higher overall skill scores (P = .016) than the baseline non-participant group, primarily driven by differences in the partnerships and collaboration and evaluation domains. No differences in importance ratings were observed. Among professionals with advanced degrees, there were no differences in skill scores and small differences in importance scores in the expected direction (P self-reported EBDM skills among public health professionals without an advanced degree, though a gap remained between the self-reported skills and the perceived importance of the skills. Further research on training content and modalities for professionals with higher educational attainment and baseline skill scores is needed. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Professional Responsibility, Consensus, and Conflict: A Survey of Physician Decisions for the Chronically Critically Ill in Neonatal and Pediatric Intensive Care Units.

    Science.gov (United States)

    Shapiro, Miriam C; Donohue, Pamela K; Kudchadkar, Sapna R; Hutton, Nancy; Boss, Renee D

    2017-09-01

    To describe neonatologist and pediatric intensivist attitudes and practices relevant to high-stakes decisions for children with chronic critical illness, with particular attention to physician perception of professional duty to seek treatment team consensus and to disclose team conflict. Self-administered online survey. U.S. neonatal ICUs and PICUs. Neonatologists and pediatric intensivists. None. We received 652 responses (333 neonatologists, denominator unknown; 319 of 1,290 pediatric intensivists). When asked about guiding a decision for tracheostomy in a chronically critically ill infant, only 41.7% of physicians indicated professional responsibility to seek a consensus decision, but 73.3% reported, in practice, that they would seek consensus and make a consensus-based recommendation; the second most common practice (15.5%) was to defer to families without making recommendations. When presented with conflict among the treatment team, 63% of physicians indicated a responsibility to be transparent about the decision-making process and reported matching practices. Neonatologists more frequently reported a responsibility to give decision making fully over to families; intensivists were more likely to seek out consensus among the treatment team. ICU physicians do not agree about their responsibilities when approaching difficult decisions for chronically critically ill children. Although most physicians feel a professional responsibility to provide personal recommendations or defer to families, most physicians report offering consensus recommendations. Nearly all physicians embrace a sense of responsibility to disclose disagreement to families. More research is needed to understand physician responsibilities for making recommendations in the care of chronically critically ill children.

  16. DECISIONS, METHODS AND TECHNIQUES RELATED TO DECISION SUPPORT SYSTEMS (DSS

    Directory of Open Access Journals (Sweden)

    Boghean Florin

    2015-07-01

    Full Text Available Generalised uncertainty, a phenomenon that today’s managers are facing as part of their professional experience, makes it impossible to anticipate the way the business environment will evolve or what will be the consequences of the decisions they plan to implement. Any decision making process within the company entails the simultaneous presence of a number of economic, technical, juridical, human and managerial variables. The development and the approval of a decision is the result of decision making activities developed by the decision maker and sometimes by a decision support team or/and a decision support system (DSS. These aspects related to specific applications of decision support systems in risk management will be approached in this research paper. Decisions in general and management decisions in particular are associated with numerous risks, due to their complexity and increasing contextual orientation. In each business entity, there are concerns with the implementation of risk management in order to improve the likelihood of meeting objectives, the trust of the parties involved, increase the operational safety and security as well as the protection of the environment, minimise losses, improve organisational resilience in order to diminish the negative impact on the organisation and provide a solid foundation for decision making. Since any business entity is considered to be a wealth generator, the analysis of their performance should not be restricted to financial efficiency alone, but will also encompass their economic efficiency as well. The type of research developed in this paper entails different dimensions: conceptual, methodological, as well as empirical testing. Subsequently, the conducted research entails a methodological side, since the conducted activities have resulted in the presentation of a simulation model that is useful in decision making processes on the capital market. The research conducted in the present paper

  17. SUPPORT OF ADOPTION OF ADMINISTRATIVE DECISIONS WHEN CARRYING OUT PROCEDURE OF THE CHOICE OF THE PLACE OF PASSING OF PROFESSIONAL DEVELOPMENT OF THE PERSONNEL

    Directory of Open Access Journals (Sweden)

    Yaroslav E. Prokushev

    2015-01-01

    Full Text Available The article is devoted to a problem ofsupport of decision-making for a choiceof the program of passing of professionaldevelopment of the personal. The scope of the work is the sphere of theoreticaland applied questions of human resourcemanagement. The procedure of a choice of the program of professional development of the personal taking into accountthe available needs for its training isoffered.

  18. Space between the borders? Perceptions of professionals on the participation in decision-making of young people in coercive care

    NARCIS (Netherlands)

    Ten Brummelaar, Mijntje D.C.; Knorth, Erik J.; Post, Wendy J.; Harder, Annemiek T.; Kalverboer, Margrite E.

    2016-01-01

    The participation of young people in care and treatment decisions is regarded as an essential element in effective decision-making and care. Although care and treatment in juvenile justice facilities is, in the first instance, based on a coercive placement (i.e. nonparticipatory decision-making), it

  19. Evaluating Ethical Responsibility in Inverse Decision Support

    Directory of Open Access Journals (Sweden)

    Ahmad M. Kabil

    2012-01-01

    Full Text Available Decision makers have considerable autonomy on how they make decisions and what type of support they receive. This situation places the DSS analyst in a different relationship with the client than his colleagues who support regular MIS applications. This paper addresses an ethical dilemma in “Inverse Decision Support,” when the analyst supports a decision maker who requires justification for a preconceived selection that does not correspond to the best option that resulted from the professional resolution of the problem. An extended application of the AHP model is proposed for evaluating the ethical responsibility in selecting a suboptimal alternative. The extended application is consistent with the Inverse Decision Theory that is used extensively in medical decision making. A survey of decision analysts is used to assess their perspective of using the proposed extended application. The results show that 80% of the respondents felt that the proposed extended application is useful in business practices. 14% of them expanded the usability of the extended application to academic teaching of the ethics theory. The extended application is considered more usable in a country with a higher Transparency International Corruption Perceptions Index (TICPI than in a country with a lower one.

  20. Learning to Program with Game Maker

    Science.gov (United States)

    Johnson, Claire

    2017-01-01

    "Game Maker" is widely used in UK secondary schools, yet under-researched in that context. This paper presents the findings of a qualitative case study that explores how authoring computer games using "Game Maker" can support the learning of basic programming concepts in a mainstream UK secondary setting. The research draws on…

  1. Does the market maker stabilize the market?

    NARCIS (Netherlands)

    Zhu, M.; Chiarella, C.; He, X.Z.; Wang, D.

    2009-01-01

    The market maker plays an important role in price formation, but his/her behavior and stabilizing impact on the market are relatively unclear, in particular in speculative markets. This paper develops a financial market model that examines the impact on market stability of the market maker, who acts

  2. Market orientation in the mental models of decision-makers

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Trondsen, Torbjørn; Campos, Emilio Gonzalo

    2010-01-01

    : Norwegian salmon exported to Japan and Danish pork exported to Japan. The analysis of the mental models centers on potential overlap and linkages between actors in the value chain, including elements in the mental models that may relate to the actors' market orientation. Findings: In both value chains...... relations between chain partners. Research limitations/implications: While confirming prior results regarding the role of competitive pressure, end-user heterogeneity/dynamism, regulations, and trade associations, the results also generate new insights into the possible role of relational governance...

  3. Exploring the Importance of Information Superiority to the Decision Maker

    Science.gov (United States)

    2008-06-01

    the plots. They all have roughly the same shape, but a significant color change occurs between one and two sensors, indicating a significant jump in...0.35 0.4 Number of Red Units I m p r o v e d % D e c r e a s e 1 Sensor 2 Sensors 3 Sensors 4 Sensors 5 Sensors 6 Sesnors 7 Sensors 8 Sensors 9

  4. Toolkit for local decision makers aims to strengthen environmental sustainability

    CSIR Research Space (South Africa)

    Murambadoro, M

    2011-11-01

    Full Text Available Members of the South African Risk and Vulnerability Atlas were involved in a meeting aimed at the development of a toolkit towards improved integration of climate change into local government's integrated development planning (IDP) process....

  5. Bridging the gap among healthcare workers and decision-makers ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    income countries has been slow. ... They will integrate the tool into the existing Health Management Information System (HMIS) in Tanzania, generate evidence on how a gender and equity perspective can be integrated in the routine assessment of ...

  6. African Researchers and Decision-Makers: Building Synergy for ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    1 janv. 2009 ... Further, research is very often designed and carried out without regard for its potential users or beneficiaries. How should research agendas be ... La protection sociale et les collectivités vulnérables en Afrique de l'Est - retombées sur le bien-être des ménages. Les mécanismes de protection sociale ...

  7. Developing Tomorrow's Decision-Makers: Opportunities for Biotechnology Education Research

    Science.gov (United States)

    Hilton, Annette; Nichols, Kim; Kanasa, Harry

    2011-01-01

    Globally, science curricula have been described as outdated, and students perceive school science as lacking in relevance. Declines in senior secondary and tertiary student participation in science indicate an urgent need for change if we are to sustain future scientific research and development, and perhaps more importantly, to equip students…

  8. The Roles of Decision Makers in Special Operations

    Science.gov (United States)

    2016-12-01

    Organization SAS Special Air Service SOF Special Operation Forces Spetsnaz Russian Special Forces Unit The Unit Sayeret Matkal UN United Nations...operation forces, Spetsnaz , carried out a rescue operation by pumping an unknown chemical gas into the theater’s ventilation system then entering the...Special Forces, Spetsnaz , conducted a rescue operation to end the siege that cost hundreds of hostages’ lives. Though a few articles have been

  9. Professional judgement and decision-making in the planning process of high-level adventure sports coaching practice

    OpenAIRE

    Collins, L.; Collins, D

    2016-01-01

    This investigation examined the planning and decision-making processes in adventure sports coaching. We utilised a thematic analysis approach to investigate the planning decision-making practices of a sample of high-level adventure sports coaches over a series of sessions. The investigation discovered that, in planning coaching activity, high-level adventure sports coaches draw on their epistemological values and domain-specific expertise, employ a synergy of classic and naturalistic decision...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

  12. Thermodynamic analysis of a solar coffee maker

    Energy Technology Data Exchange (ETDEWEB)

    Sosa-Montemayor, F.; Jaramillo, O.A. [Centro de Investigacion en Energia, Universidad Nacional Autonoma de Mexico, Privada Xochicalco S/N, Temixco, Morelos CP 62580 (Mexico); del Rio, J.A. [Centro Morelense de Innovacion y Tranferencia Tecnologica, CCyTEM, Camino Temixco a Emiliano Zapata, Km 0.3, Colonia Emiliano Zapata, Morelos CP 62760 (Mexico)

    2009-09-15

    In this paper we present a novel solar concentrating application, a coffee brewing system using a satellite TV mini-Dish concentrator coupled to a stovetop espresso coffee maker. We present a theoretical model for the thermal behavior of the water in the lower chamber of the coffee maker. We validate the model obtaining good agreement with the experimental results. Our findings indicate that the coffee brewing system works, it takes 30-50 min to complete its task. The model and our practical experience encourage us to improve the concentration device in order to obtain a useful solar coffee maker, using the theoretical model as a safe guide to achieve this. (author)

  13. Pups in the Shark Tank: how marine studies graduates influence Washington's policy makers

    Science.gov (United States)

    Sutton, A. J.; Conathan, M.; English, C. A.; Mace, A.; Meyer, J. J.

    2011-12-01

    Since established in 1979, nearly 900 graduate students have been awarded a John A. Knauss Sea Grant Marine Policy Fellowship. Named after former Administrator of the National Oceanic and Atmospheric Administration (NOAA), Dean of Oceanography at University of Rhode Island, and one of the founders of Sea Grant, this annual fellowship places post-graduate degree students in offices within the executive and legislative branches of government to work on ocean policy issues in Washington, DC. Fellows serve as professional staff within their offices and work on a wide range of tasks including advising agency and Congressional leadership on marine science and policy issues, synthesizing scientific information for use in a decision making context, and overseeing enactment of legislation. Alumni are now infused into every level of the ocean world and play prominent roles in national and international marine policy development, acting in various venues ranging from NGO leaders to Congressional staff, academia to natural resource agency decision-makers. In fact, NOAA's current Chief of Staff is a former Knauss fellow. Here we describe this unique educational experience, lessons learned navigating ocean and climate issues at the science-policy interface, and how early career policy fellowships strengthen and catalyze the link between science and policy in a world where such connections are increasingly important.

  14. Perspectives of patients, families, and health care professionals on decision-making about dialysis modality--the good, the bad, and the misunderstandings!

    Science.gov (United States)

    Griva, Konstadina; Li, Zhi Hui; Lai, Alden Yuanhong; Choong, Meng Chan; Foo, Marjorie Wai Yin

    2013-01-01

    This study explored the factors influencing decision-making about dialysis modality, integrating the perspectives of patients, their families, and health care professionals within an Asian population. The study further sought to understand the low penetration rate of peritoneal dialysis (PD) in Singapore. ♢ A sample of 59 participants comprising pre-dialysis patients, dialysis patients, caregivers, and health care professionals (HCPs) participated in semi-structured interviews to explore the decision-making process and their views about various dialysis modalities. Data were thematically analyzed using NVivo9 (QSR International, Doncaster, Australia) to explore barriers to and facilitators of various dialysis modalities and decisional support needs. ♢ Fear of infection, daily commitment to PD, and misperceptions of PD emerged as barriers to PD. Side effects, distance to dialysis centers, and fear of needling and pain were barriers to hemodialysis (HD). The experiences of other patients, communicated informally or opportunistically, influenced the preferences and choices of patients and family members for a dialysis modality. Patients and families value input from HCPs and yet express strong needs to discuss subjective experiences of life on dialysis (PD or HD) with other patients before making a decision about dialysis modality. ♢ Pre-dialysis education should expand its focus on the family as the unit of care and should provide opportunities for interaction with dialysis patients and for peer-led learning. Barriers to PD, especially misperceptions and misunderstandings, can be targeted to improve PD uptake.

  15. Perspectives of Patients, Families, and Health Care Professionals on Decision-Making About Dialysis Modality—The Good, the Bad, and the Misunderstandings!

    Science.gov (United States)

    Griva, Konstadina; Li, Zhi Hui; Lai, Alden Yuanhong; Choong, Meng Chan; Foo, Marjorie Wai Yin

    2013-01-01

    ♦ Objectives: This study explored the factors influencing decision-making about dialysis modality, integrating the perspectives of patients, their families, and health care professionals within an Asian population. The study further sought to understand the low penetration rate of peritoneal dialysis (PD) in Singapore. ♦ Methods: A sample of 59 participants comprising pre-dialysis patients, dialysis patients, caregivers, and health care professionals (HCPs) participated in semi-structured interviews to explore the decision-making process and their views about various dialysis modalities. Data were thematically analyzed using NVivo9 (QSR International, Doncaster, Australia) to explore barriers to and facilitators of various dialysis modalities and decisional support needs. ♦ Results: Fear of infection, daily commitment to PD, and misperceptions of PD emerged as barriers to PD. Side effects, distance to dialysis centers, and fear of needling and pain were barriers to hemodialysis (HD). The experiences of other patients, communicated informally or opportunistically, influenced the preferences and choices of patients and family members for a dialysis modality. Patients and families value input from HCPs and yet express strong needs to discuss subjective experiences of life on dialysis (PD or HD) with other patients before making a decision about dialysis modality. ♦ Conclusions: Pre-dialysis education should expand its focus on the family as the unit of care and should provide opportunities for interaction with dialysis patients and for peer-led learning. Barriers to PD, especially misperceptions and misunderstandings, can be targeted to improve PD uptake. PMID:23123668

  16. Difficult decisions: An interpretative phenomenological analysis study of healthcare professionals' perceptions of oxygen therapy in palliative care.

    Science.gov (United States)

    Kelly, Carol Ann; O'Brien, Mary R

    2015-12-01

    The role of oxygen therapy to palliate dyspnoea is controversial. Without a clear evidence base oxygen is commonly prescribed, sometimes to the detriment of patients. This use of oxygen appears to be an entrenched culture, the roots of which remain obscure. To explore healthcare professionals' perceptions of oxygen therapy in palliative care. Interpretative phenomenological analysis study utilising semi-structured interviews to explore beliefs and behaviours of healthcare professionals regarding palliative oxygen therapy. Data were recorded, transcribed and analysed using interpretative phenomenological analysis. A total of 34 healthcare professionals, including doctors, nurses, pharmacists and paramedics in the United Kingdom, who were involved in prescribing, or administering, oxygen therapy to palliate dyspnoea. Most healthcare professionals in this study were well informed about oxygen therapy; all recognised the role of oxygen in palliative care setting as important. The overarching theme of compassion identified sub-themes of 'comfort', 'do anything and everything' and 'family benefit'. However, the use of oxygen in the palliative care setting was not without its dilemmas, as additional sub-themes of 'controversy', 'doubt' and 'dependency' illustrated. Findings suggest that oxygen therapy in palliative care poses an on-going dilemma for healthcare professionals striving to provide optimum care. It seems patients and families often expect and welcome oxygen, but the perception of oxygen as a solution to dyspnoea can conflict with healthcare professionals' own doubt and experiences. There appears to be an emotional cost associated with this dilemma and the choices that need to be made. © The Author(s) 2015.

  17. Simulation Models of Human Decision-Making Processes

    Directory of Open Access Journals (Sweden)

    Nina RIZUN

    2014-10-01

    Full Text Available The main purpose of the paper is presentation of the new concept of human decision-making process modeling via using the analogy with Automatic Control Theory. From the author's point of view this concept allows to develop and improve the theory of decision-making in terms of the study and classification of specificity of the human intellectual processes in different conditions. It was proved that the main distinguishing feature between the Heuristic / Intuitive and Rational Decision-Making Models is the presence of so-called phenomenon of "enrichment" of the input information with human propensity, hobbies, tendencies, expectations, axioms and judgments, presumptions or bias and their justification. In order to obtain additional knowledge about the basic intellectual processes as well as the possibility of modeling the decision results in various parameters characterizing the decision-maker, the complex of the simulation models was developed. These models are based on the assumptions that:  basic intellectual processes of the Rational Decision-Making Model can be adequately simulated and identified by the transient processes of the proportional-integral-derivative controller; basic intellectual processes of the Bounded Rationality and Intuitive Models can be adequately simulated and identified by the transient processes of the nonlinear elements.The taxonomy of the most typical automatic control theory elements and their compliance with certain decision-making models with a point of view of decision-making process specificity and decision-maker behavior during a certain time of professional activity was obtained.

  18. The factors influencing young mothers' infant feeding decisions: the views of healthcare professionals and voluntary workers on the role of the baby's maternal grandmother.

    Science.gov (United States)

    Bernie, Kate

    2014-04-01

    Increasing rates of exclusive breastfeeding for the first 6 months of life is important to ensure that infants achieve "optimal growth, development, and health" and could generate over £40 million in annual savings for the National Health Service. Interventions targeting young mothers are recommended because of low breastfeeding rates. Women's mothers have been identified as potential influences on whether women choose to breastfeed. This study explored health, social, and voluntary care professionals' perceptions of young mothers' attitudes to breastfeeding and the role of maternal grandmothers. Semistructured interviews were conducted with nine professionals working with young mothers. Thematic analysis was used to interpret data and identify key themes. Professionals felt that prevalent attitudes among young mothers who bottle fed were that breastfeeding is embarrassing, deviant from the social norm, and detrimental to their social life and relationships but that women understand the health benefits. Grandmothers were identified as important influences on some women, and, in particular, concerns were raised that grandmothers sometimes undermined intentions to breastfeed by offering to bottle feed infants. However, potential problems with involving grandmothers in breastfeeding promotion strategies were identified, and more pressing issues were raised, particularly inadequate postnatal support for young mothers. Professionals recognize grandmothers as an important influence and source of support for many mothers but identified other priorities for interventions, particularly improving the level of support in postnatal care. Their ultimate focus is to build positive relationships with women and empower them to make informed decisions.

  19. Intention to adopt clinical decision support systems in a developing country: effect of Physician’s perceived professional autonomy, involvement and belief: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Sambasivan Murali

    2012-12-01

    Full Text Available Abstract Background Computer-based clinical decision support systems (CDSS are regarded as a key element to enhance decision-making in a healthcare environment to improve the quality of medical care delivery. The concern of having new CDSS unused is still one of the biggest issues in developing countries for the developers and implementers of clinical IT systems. The main objectives of this study are to determine whether (1 the physician’s perceived professional autonomy, (2 involvement in the decision to implement CDSS and (3 the belief that CDSS will improve job performance increase the intention to adopt CDSS. Four hypotheses were formulated and tested. Methods A questionnaire-based survey conducted between July 2010 and December 2010. The study was conducted in seven public and five private hospitals in Kuala Lumpur, Malaysia. Before contacting the hospitals, necessary permission was obtained from the Ministry of Health, Malaysia and the questionnaire was vetted by the ethics committee of the ministry. Physicians working in 12 hospitals from 10 different specialties participated in the study. The sampling method used was stratified random sampling and the physicians were stratified based on the specialty. A total of 450 physicians were selected using a random number generator. Each of these physicians was given a questionnaire and out of 450 questionnaires, 335 (response rate – 74% were returned and 309 (69% were deemed usable. Results The hypotheses were tested using Structural Equation Modeling (SEM. Salient results are: (1 Physicians’ perceived threat to professional autonomy lowers the intention to use CDSS (p Conclusion The proposed model with the three main constructs (physician’s professional characteristic, involvement and belief explains 47% of the variance in the intention to use CDSS. This is significantly higher than the models addressed so far. The results will have a major impact in implementing CDSS in developing

  20. Optimising Transport Decision Making using Customised Decision Models and Decision Conferences

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn

    The subject of this Ph.D. thesis entitled “Optimising Transport Decision Making using Customised Decision Models and Decision Conferences” is multi-criteria decision analysis (MCDA) and decision support in the context of transport infrastructure assessments. Despite the fact that large amounts...... identification to the possible decision making. The process makes use of a preliminary problem structuring phase, and an intervention phase featuring the concept of a decision conference where decision-makers and multiple stakeholders have the possibility of interacting with the decision support model...... depends to a high degree on subjective preferences stated by the decision-makers as the methodology deals with impacts (or criteria) that are difficult to quantify or assign with a monetary value. As a result of this an examination process is proposed that can guide the decision-makers through...

  1. Continuous Decision Support

    Science.gov (United States)

    2015-12-24

    Decision trees [15, 39, 40] are another widely used tool in this situation and providing a decision maker with an optimal chronological sequence of...problem, or a decision analysis perspective that applies decision trees or multi-criteria methods to rank alternatives. In any case, there is an implicit...the inherent uncertainty of a decision problem in which the field of alternatives is unknown, and it is not surprising that even an educated estimate of

  2. Decisions, Decisions!

    Science.gov (United States)

    McFadden, F. Lee

    1975-01-01

    A self-instructional program on decision making was used in conjunction with workshops to introduce the staff of an instructional materials company to the decision tree process as they used it to study their own film production problem. (Author/MS)

  3. Integrating Cognitive Mapping Analysis into Multi-Criteria Decision Aiding

    OpenAIRE

    Kpoumié, Amidou; Damart, Sébastien; Tsoukiàs, Alexis

    2017-01-01

    Multi-criteria decision aiding (MCDA) is a process implying two distinctive actors (the client and the analyst) which aims at providing transparent and coherent support for complex decision situations, taking into account values of decision makers involved in a specific decision context. The theoretical framework of MCDA traditionally addresses problems involving a single decision maker. However, MCDA ought to investigate the case where the decision maker is made up of groups of individuals w...

  4. Experienced EFL Teachers' Professional Practical Knowledge, Reasoning and Classroom Decision Making in Egypt: Views from the Inside Out

    Science.gov (United States)

    Abdelhafez, Ahmed

    2014-01-01

    This study aimed to investigate the areas that constituted the professional practical knowledge of experienced English as a Foreign Language teachers in Egypt and how their knowledge informed their classroom practice. Quantitative and qualitative data were collected from 236 preparatory and secondary school teachers in 38 schools through…

  5. Does the market maker stabilize the market?

    Science.gov (United States)

    Zhu, Mei; Chiarella, Carl; He, Xue-Zhong; Wang, Duo

    2009-08-01

    The market maker plays an important role in price formation, but his/her behavior and stabilizing impact on the market are relatively unclear, in particular in speculative markets. This paper develops a financial market model that examines the impact on market stability of the market maker, who acts as both a liquidity provider and an active investor in a market consisting of two types of boundedly rational speculative investors-the fundamentalists and trend followers. We show that the market maker does not necessarily stabilize the market when he/she actively manages the inventory to maximize profits, and that rather the market maker’s impact depends on the behavior of the speculators. Numerical simulations show that the model is able to generate outcomes for asset returns and market inventories that are consistent with empirical findings.

  6. Playing a role – but which one ? : how public service motivation and professionalism affect decision-making in dilemma situations

    NARCIS (Netherlands)

    Schott, Carina

    2015-01-01

    Individuals who work in the public sector see themselves confronted with conflicting values, contradictory demands, and the need to serve an at times difficult to define ‘public interest’. This book contributes to our understanding of what drives public service professionals’ decision-making in

  7. End of life care and decision making: Opinions and experiences of the general public, bereaved relatives, and professionals

    NARCIS (Netherlands)

    N.J.H. Raijmakers (Natasja)

    2013-01-01

    textabstractEnd-of-life care aims to improve quality of life of patients and their relatives facing problems associated with life-threatening illness in the last days of life. End-of-life decision-making is an important aspect of end-of-life care that can have a significant impact on the process of

  8. Development and usability testing of a web-based decision support for users and health professionals in psychiatric services.

    Science.gov (United States)

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

    2017-09-01

    Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Ethical decision making: the person in the process.

    Science.gov (United States)

    Mattison, M

    2000-05-01

    Ethical decisions made by social workers are shaped by the decision maker and the process used to resolve ethical dilemmas. Although systematic guidelines for resolving ethical dilemmas offer social workers a logical approach to the decision-making sequence, it is inevitable that discretionary judgments will condition the ultimate choice of action. Social workers are influenced by professional roles, practice experiences, individualized perspectives, personal preferences, motivations, and attitudes. Through reflective self-awareness social workers can recognize their value preferences and be alert to the ways in which these values unknowingly influence the resolution of ethical dilemmas. Understanding which values or ethical principles were given priority from among competing alternatives can inform social workers about their value patterning. This article challenges social workers to view current ethical decisions as linked to other ethical decisions they have made in the past or will make in the future. An approach to developing keener insight into value patterning is presented.

  10. Becoming Language Professionals: Identity Work and Pedagogical Decisions by Secondary School L2 Teachers of Spanish and French

    OpenAIRE

    Heidenfeldt, William Allen

    2015-01-01

    This dissertation examines the ways in which three focal high school teachers of second language (L2) French and Spanish in California construct and enact their professional identities as multilingual subjects with diverse linguistic repertoires. By drawing from multiple disciplines, including sociolinguistics, psychology, and education, I examine how social and biographical factors influence language learning and teaching and also how language instructors participate in the construction of t...

  11. A Multidisciplinary Research Agenda for Understanding Vaccine-Related Decisions

    Directory of Open Access Journals (Sweden)

    Nick Sevdalis

    2013-07-01

    Full Text Available There is increasingly broad global recognition of the need to better understand determinants of vaccine acceptance. Fifteen social science, communication, health, and medical professionals (the “Motors of Trust in Vaccination” (MOTIV think tank explored factors relating to vaccination decision-making as a step to building a multidisciplinary research agenda. One hundred and forty seven factors impacting decisions made by consumers, professionals, and policy makers on vaccine acceptance, delay, or refusal were identified and grouped into three major categories: cognition and decision-making; groups and social norms; and communication and engagement. These factors should help frame a multidisciplinary research agenda to build an evidence base on the determinants of vaccine acceptance to inform the development of interventions and vaccination policies.

  12. Engaging in patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis: the views of health professionals

    OpenAIRE

    Hogden A; Greenfield D; Nugus P; Kiernan MC

    2012-01-01

    Anne Hogden,1 David Greenfield,1 Peter Nugus,1 Matthew C Kiernan21Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, 2Prince of Wales Clinical School, University of New South Wales, and Neuroscience Research Australia, Sydney, New South Wales, AustraliaBackground: The aim of this study was to explore clinician perspectives on patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis (ALS), in an attempt ...

  13. Ethical Behavior and Ajzen’s Theory of Planned Behavior Applied to the Decision to Obtain Professional Credentials

    Science.gov (United States)

    2015-03-26

    present a five-step process for making an ethical decision ( Velasquez , Moberg, Meyer, Shanks, McLean, DeCosse, Andre, and Hanson, 2009). This...reasoned action and the theory of planned behavior. Journal of Business Ethics , 17, 1825. Civil engineering body of knowledge for the 21st century...philosophies. Journal of Business Ethics , 11(5), 461. Forsyth, D. R. (2014a). Ethics position questionnaire. Retrieved from https

  14. Evaluation of the Monroe Slurry Maker.

    Science.gov (United States)

    2009-05-01

    In early February, 2009, the Maine Department of Transportation (MaineDOT) installed a Monroe Slurry : Maker on one of its 2009 Volvo Wheelers (see Photos 1 and 2). This truck was equipped with a : Henderson Utility Body. An 18 gallon per minute spoo...

  15. Nordsøen Movie Maker

    DEFF Research Database (Denmark)

    2013-01-01

    oplevelser med legesyge sæler, susende hvirvelstrømme og gigantiske klumpfisk. Nordsøen Movie Maker giver filmen et ekstra virtuelt lag, og via augmented reality bliver der tilføjet seje og morsomme, animerede specialeffekter. 1) Download app’en 2) Find et moviespot ved ekspeditionsposterne i Nordsøen...

  16. Understanding frailty: a qualitative study of European healthcare policy-makers' approaches to frailty screening and management.

    Science.gov (United States)

    Gwyther, Holly; Shaw, Rachel; Jaime Dauden, Eva-Amparo; D'Avanzo, Barbara; Kurpas, Donata; Bujnowska-Fedak, Maria; Kujawa, Tomasz; Marcucci, Maura; Cano, Antonio; Holland, Carol

    2018-01-13

    To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views. Thematic analysis of semistructured qualitative interviews. European healthcare policy departments. Seven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role. Seven themes were identified. Our findings reveal a 'knowledge gap', around frailty and awareness of the malleability of frailty, which has resulted in restricted ownership of frailty by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a culture shift in care with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed barriers to a culture shift, indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The cultural acceptance of an integrated care system theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in signposting adult care , the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that screening for frailty could be an effective tool for frailty management. There is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the

  17. Effect of training, education, professional experience, and need for cognition on accuracy of exposure assessment decision-making.

    Science.gov (United States)

    Vadali, Monika; Ramachandran, Gurumurthy; Banerjee, Sudipto

    2012-04-01

    Results are presented from a study that investigated the effect of characteristics of occupational hygienists relating to educational and professional experience and task-specific experience on the accuracy of occupational exposure judgments. A total of 49 occupational hygienists from six companies participated in the study and 22 tasks were evaluated. Participating companies provided monitoring data on specific tasks. Information on nine educational and professional experience determinants (e.g. educational background, years of occupational hygiene and exposure assessment experience, professional certifications, statistical training and experience, and the 'need for cognition (NFC)', which is a measure of an individual's motivation for thinking) and four task-specific determinants was also collected from each occupational hygienist. Hygienists had a wide range of educational and professional backgrounds for tasks across a range of industries with different workplace and task characteristics. The American Industrial Hygiene Association exposure assessment strategy was used to make exposure judgments on the probability of the 95th percentile of the underlying exposure distribution being located in one of four exposure categories relative to the occupational exposure limit. After reviewing all available job/task/chemical information, hygienists were asked to provide their judgment in probabilistic terms. Both qualitative (judgments without monitoring data) and quantitative judgments (judgments with monitoring data) were recorded. Ninety-three qualitative judgments and 2142 quantitative judgments were obtained. Data interpretation training, with simple rules of thumb for estimating the 95th percentiles of lognormal distributions, was provided to all hygienists. A data interpretation test (DIT) was also administered and judgments were elicited before and after training. General linear models and cumulative logit models were used to analyze the relationship between

  18. Identifying and enhancing risk thresholds in the detection of elder financial abuse: a signal detection analysis of professionals' decision making.

    Science.gov (United States)

    Harries, Priscilla; Yang, Huiqin; Davies, Miranda; Gilhooly, Mary; Gilhooly, Kenneth; Thompson, Carl

    2014-12-30

    Financial abuse of elders is an under acknowledged problem and professionals' judgements contribute to both the prevalence of abuse and the ability to prevent and intervene. In the absence of a definitive "gold standard" for the judgement, it is desirable to try and bring novice professionals' judgemental risk thresholds to the level of competent professionals as quickly and effectively as possible. This study aimed to test if a training intervention was able to bring novices' risk thresholds for financial abuse in line with expert opinion. A signal detection analysis, within a randomised controlled trial of an educational intervention, was undertaken to examine the effect on the ability of novices to efficiently detect financial abuse. Novices (n = 154) and experts (n = 33) judged "certainty of risk" across 43 scenarios; whether a scenario constituted a case of financial abuse or not was a function of expert opinion. Novices (n = 154) were randomised to receive either an on-line educational intervention to improve financial abuse detection (n = 78) or a control group (no on-line educational intervention, n = 76). Both groups examined 28 scenarios of abuse (11 "signal" scenarios of risk and 17 "noise" scenarios of no risk). After the intervention group had received the on-line training, both groups then examined 15 further scenarios (5 "signal" and 10 "noise" scenarios). Experts were more certain than the novices, pre (Mean 70.61 vs. 58.04) and post intervention (Mean 70.84 vs. 63.04); and more consistent. The intervention group (mean 64.64) were more certain of abuse post-intervention than the control group (mean 61.41, p = 0.02). Signal detection analysis of sensitivity (A´) and bias (C) revealed that this was due to the intervention shifting the novices' tendency towards saying "at risk" (C post intervention -.34) and away from their pre intervention levels of bias (C-.12). Receiver operating curves revealed more efficient judgments in the

  19. Turkey's Educational Policies in Central Asia and Caucasia: Perceptions of Policy Makers and Experts

    Science.gov (United States)

    Akcali, Pinar; Engin-Demir, Cennet

    2012-01-01

    The purpose of this study is to analyze the educational policies of Turkey in Central Asia and Caucasia in the post-Soviet era in terms of their successes and failures as perceived by some of the relevant professional policy makers in this field as well as experts from various think-tank institutions in Turkey who are interested in the region.…

  20. A meta-analysis of gender stereotypes and bias in experimental simulations of employment decision making.

    Science.gov (United States)

    Koch, Amanda J; D'Mello, Susan D; Sackett, Paul R

    2015-01-01

    Gender bias continues to be a concern in many work settings, leading researchers to identify factors that influence workplace decisions. In this study we examine several of these factors, using an organizing framework of sex distribution within jobs (including male- and female-dominated jobs as well as sex-balanced, or integrated, jobs). We conducted random effects meta-analyses including 136 independent effect sizes from experimental studies (N = 22,348) and examined the effects of decision-maker gender, amount and content of information available to the decision maker, type of evaluation, and motivation to make careful decisions on gender bias in organizational decisions. We also examined study characteristics such as type of participant, publication year, and study design. Our findings revealed that men were preferred for male-dominated jobs (i.e., gender-role congruity bias), whereas no strong preference for either gender was found for female-dominated or integrated jobs. Second, male raters exhibited greater gender-role congruity bias than did female raters for male-dominated jobs. Third, gender-role congruity bias did not consistently decrease when decision makers were provided with additional information about those they were rating, but gender-role congruity bias was reduced when information clearly indicated high competence of those being evaluated. Fourth, gender-role congruity bias did not differ between decisions that required comparisons among ratees and decisions made about individual ratees. Fifth, decision makers who were motivated to make careful decisions tended to exhibit less gender-role congruity bias for male-dominated jobs. Finally, for male-dominated jobs, experienced professionals showed smaller gender-role congruity bias than did undergraduates or working adults. (c) 2015 APA, all rights reserved.

  1. Professional Values Among Female Nursing Students in Saudi Arabia.

    Science.gov (United States)

    Allari, Rabia S; Ismaile, Samantha; Househ, Mowafa

    2017-01-01

    Professional values are essential to nursing practice because they guide standards for working, provide a structure for evaluating behavior, and influence decisions making. The purpose of this study is to explore the perception of Saudi female nursing students on professional values and to assess the correlation between their perception of professional values in relation to their year of academic studies. We used a cross-sectional descriptive study where a survey was administered to 150 Saudi female nurses living in Riyadh. Results show that Saudi female nurses have a high perception of professional values relating to confidentiality, privacy, moral and legal rights, health and safety, and the work environment. Whereas Saudi nursing students have a low perception for participating in professional nursing activities, utilizing research in practice, peer review, public policy, and engaging in on-going self-evaluation. There was positive correlation between different professional values and academic years. The highest correlations were for the items related to caring and trust more than activism because nursing students at higher academic levels viewed the relationship with patients as more important than advancing health care systems through public policy, research, and professional organizations. In conclusion, nursing program administrators should put emphasis on improving the development of professional values through a role modeling approach to promote activism and professional values through the arrangement of meetings, exchange forums, and conferences with other nurses, managers, policy makers, innovators, and researchers within the nursing field.

  2. Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

    Science.gov (United States)

    Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

    2018-01-01

    Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

  3. Professional responsibility and decision-making in the context of a disease-focused model of nursing care: The difficulties experienced by Spanish nurses.

    Science.gov (United States)

    Rodrigo, Olga; Caïs, Jordi; Monforte-Royo, Cristina

    2017-10-01

    When, in 1977, nurse education in Spain was transferred to universities a more patient-centred, the Anglo-American philosophy of care was introduced into a context in which nurses had traditionally prioritised their technical skills. This paper examines the characteristics of the nurse's professional role in Spain, where the model of nursing practice has historically placed them in a position akin to that of physician assistants. The study design was qualitative and used the method of analytic induction. Participants were selected by means of theoretical sampling and then underwent in-depth interviews. The resulting material was analysed using an approach based on the principles of grounded theory. Strategies were applied to ensure the credibility, transferability, dependability and confirmability of the findings. The main conclusion is that nurses in Spain continue to work within a disease-focused model of care, making it difficult for them to take responsibility for decision-making. © 2017 John Wiley & Sons Ltd.

  4. Integrated decision-making in response to weapons of mass destruction incidents: development and initial evaluation of a course for healthcare professionals.

    Science.gov (United States)

    Pryor, Erica; Heck, Emily; Norman, Linda; Weiner, Betsy; Mathews, Rick; Black, James; Terndrup, Thomas

    2006-01-01

    Standardized, validated training programs for teaching administrative decision-making to healthcare professionals responding to weapons of mass destruction (WMD) incidents have not been available. Therefore, a multidisciplinary team designed, developed, and offered a four-day, functional exercise, competency-based course at a national training center. This report provides a description of the development and initial evaluation of the course in changing participants' perceptions of their capabilities to respond to WMD events. Course participants were healthcare professionals, including physicians, nurses, emergency medical services administrators, hospital administrators, and public health officials. Each course included three modified tabletop and/or real-time functional exercises. A total of 441 participants attended one of the eight course offerings between March and August 2003. An intervention group only, pre-post design was used to evaluate change in perceived capabilities related to administrative decision-making for WMD incidents. Paired evaluation data were available on 339 participants (81.9%). Self-ratings for each of 21 capability statements were compared before and after the course. A 19-item total scale score for each participant was calculated from the pre-course and post-course evaluations. Paired t-tests on pre- and post-course total scores were conducted separately for each course. There was consistent improvement in self-rated capabilities after course completion for all 21 capability statements. Paired t-tests of pre- and post-course total scale scores indicated a significant increase in mean ratings for each course (all p < 0.001). The tabletop/real-time-exercise format was effective in increasing healthcare administrators' self-rated capabilities related to WMD disaster management and response. Integrating the competencies into training interventions designed for a specific target audience and deploying them into an interactive learning

  5. Evaluation by policy makers of a procedure to describe perceived landscape openness.

    Science.gov (United States)

    Weitkamp, Gerd; Van den Berg, Agnes E; Bregt, Arnold K; Van Lammeren, Ron J A

    2012-03-01

    In the last decade policy makers have increasingly recognized the need to include people's perceptions in methods for describing landscape quality. At the same time, a third wave of Geographic Information Systems (GIS) has become available that make it technically possible to model landscape quality in a realistic manner. However, as there is often a mismatch between science and policy, it remains unclear to what extent perception-based models developed by scientists can be useful to policy makers. The aim of the present study was to evaluate the usefulness to policy making of a GIS-based procedure for describing perceived landscape openness. To this end, a workshop was organized which was attended by eight Dutch policy makers who acted as representatives of their province (region). The Group Decision Room (GDR) technique was used to elicit the policy makers' evaluations of the procedure in an anonymous and reliable manner. The procedure was presented to the policy makers using cases from their own province, which they assessed using a mixture of qualitative and quantitative methods. The results show that policy makers rated the procedure as being highly relevant to policy making, scientifically credible, usable by policy makers and feasible to implement in the policy making process. They especially appreciated the flexibility and transparency of the procedure. The policy makers concluded that the procedure would be of most value for monitoring landscape changes and for analysing impacts on landscape openness in land use scenario studies. However, they requested guidelines for proper implementation of the various options in the procedure. In general, the current study shows that explicit and transparent evaluation of the usefulness of GIS-based tools can aid integration at the science-policy interface and help to ensure that both scientists and policy makers are informed of interrelated options and requirements. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Quantitative Decision Making.

    Science.gov (United States)

    Baldwin, Grover H.

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

  7. Games and Platform Decisions

    DEFF Research Database (Denmark)

    Hansen, Poul H. Kyvsgård; Mikkola, Juliana Hsuan

    2007-01-01

    is the application of on-line games in order to provide training for decision makers and in order to generate overview over the implications of platform decisions. However, games have to be placed in a context with other methods and we argue that a mixture of games, workshops, and simulations can provide improved...

  8. Decision making and imperfection

    CERN Document Server

    Karny, Miroslav; Wolpert, David

    2013-01-01

    Decision making (DM) is ubiquitous in both natural and artificial systems. The decisions made often differ from those recommended by the axiomatically well-grounded normative Bayesian decision theory, in a large part due to limited cognitive and computational resources of decision makers (either artificial units or humans). This state of a airs is often described by saying that decision makers are imperfect and exhibit bounded rationality. The neglected influence of emotional state and personality traits is an additional reason why normative theory fails to model human DM process.   The book is a joint effort of the top researchers from different disciplines to identify sources of imperfection and ways how to decrease discrepancies between the prescriptive theory and real-life DM. The contributions consider:   ·          how a crowd of imperfect decision makers outperforms experts' decisions;   ·          how to decrease decision makers' imperfection by reducing knowledge available;   ...

  9. Dual Criteria Decisions

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten Igel

    2014-01-01

    The most popular models of decision making use a single criterion to evaluate projects or lotteries. However, decision makers may actually consider multiple criteria when evaluating projects. We consider a dual criteria model from psychology. This model integrates the familiar tradeoffs between...

  10. The path of least resistance? Jurisdictions, responsibility and professional asymmetries in pharmacists' accounts of antibiotic decisions in hospitals.

    Science.gov (United States)

    Broom, Alex; Broom, Jennifer; Kirby, Emma; Scambler, Graham

    2015-12-01

    The misuse of antibiotics has become a major public health problem given the global threat of multi-resistant organisms and an anticipated 'antimicrobial perfect storm' within the next few decades. Despite recent attempts by health service providers to optimise antibiotic usage, widespread inappropriate use of antibiotics continues in hospitals internationally. In this study, drawing on qualitative interviews with Australian pharmacists, we explore how they engage in antibiotic decisions in the hospital environment. We develop a sociological understanding of pharmacy as situated within evolving interprofessional power relations, inflected by an emerging milieu whereby antibiotic optimisation is organisationally desired but interprofessionally constrained. We argue that the case of antibiotics articulates important interprofessional asymmetries, positioning pharmacists as delimited negotiators within the context of medical prescribing power. We conclude that jurisdictional uncertainties, and the resultant interprofessional dynamics between pharmacy and medicine, are vital delimiting factors in the emerging role of pharmacists as 'antimicrobial stewards' in the hospital environment. Moreover, we argue that a nuanced understanding of the character of interprofessional negotiations is key to improving the use of antibiotics within and beyond the hospital. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Maximizing Consensus in Portfolio Selection in Multicriteria Group Decision Making

    NARCIS (Netherlands)

    Michael, Emmerich T. M.; Deutz, A.H.; Li, L.; Asep, Maulana A.; Yevseyeva, I.

    2016-01-01

    This paper deals with a scenario of decision making where a moderator selects a (sub)set (aka portfolio) of decision alternatives from a larger set. The larger the number of decision makers who agree on a solution in the portfolio the more successful the moderator is. We assume that decision makers

  12. Manipulating decision making of typical agents

    CERN Document Server

    Yukalov, V I

    2014-01-01

    We investigate how the choice of decision makers can be varied under the presence of risk and uncertainty. Our analysis is based on the approach we have previously applied to individual decision makers, which we now generalize to the case of decision makers that are members of a society. The approach employs the mathematical techniques that are common in quantum theory, justifying our naming as Quantum Decision Theory. However, we do not assume that decision makers are quantum objects. The techniques of quantum theory are needed only for defining the prospect probabilities taking into account such hidden variables as behavioral biases and other subconscious feelings. The approach describes an agent's choice as a probabilistic event occurring with a probability that is the sum of a utility factor and of an attraction factor. The attraction factor embodies subjective and unconscious dimensions in the mind of the decision maker. We show that the typical aggregate amplitude of the attraction factor is $1/4$, and ...

  13. [Occupational asthma in a structure nail maker].

    Science.gov (United States)

    Hannu, Timo; Tuppurainen, Matti; Kauppi, Paula; Alanko, Kristina; Henriks-Eckerman, Maj-Len; Sauni, Riitta

    2009-01-01

    Chemicals that may cause allergy are being used in structure nails. In this case report two structure nail makers are described, who were diagnosed with occupational asthma in clinical studies. The studies included an inhalational exposure simulating the work. The causative agents of occupational asthma are apparently the acrylate compounds contained in the chemicals; use of these compounds has previously been linked with allergic contact dermatitis and asthma. Since the making of structure nails involves health risks, such work requires appropriate premises and personal protection.

  14. Engineering of Rocking Nut Maker Tools

    Directory of Open Access Journals (Sweden)

    Sulharman

    2016-02-01

    Full Text Available There had been mechanically conducted an engineering of Rocking Nut Maker Tools for rocking nut small industry. The objective is to engineer a maker tool for rocking nut which can work with the assistance of motor without using manpower, thus it will increase the production of rocking nut. Making method on rocking nut maker tool includes: (1 Designing tool; (2 tool making; (3 Tool testing. According to the result of engineering tool, there were obtained: frame for tray that was made from angle iron: the height was 450 mm, the length was 1500 mm, and the width was 500 mm width, while the thickness was 3 mm. The tray was made from aluminium with 60 mm height, 1485 mm length, 485 mm width and 3 mm plate thickness. The motor had the power capacity of ½ HP, single phase and 1400 rpm while gearbox was 1:10. The wheels were made from iron with the diameter of 60 mm and the thickness of 20 mm. There are 4 wheels which were installed under the tray. Popper mechanism was made from iron that included iron plate with the diameter of 210 mm, the thickness of 7 mm and iron bar with the diameter of 15 mm and the length of 220 mm. This was equipped with speed variable. The result from tools performance could increase the production capacity by 400%; the bumpy texture on peanut surface could attach more strongly, the storage capacity increased for 6 months, while the production only lasted for 3 months if it was by manual. The capacity of rocking nut maker was 45 kg/day; it was only 7.5 kg/day by manual. The average time consumed for rocking nut making was 1.5 hours/ processing, while by manual was 3 hours/ processing. The rocking speed was 89-99rpm. This was an economical technology, by using this engineered tool, the production capacity per month was increased by 750 kg or equivalent with Rp. 47,250,000.- and by using this tool, there was an increase in profit of Rp. 13,450/ kg while by manual was only Rp 2,250/ kg. On the other side, the production cost by

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

    Science.gov (United States)

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

  16. Eli Hecksher as a Portrait Maker

    Directory of Open Access Journals (Sweden)

    Benny Carlson

    2017-04-01

    Full Text Available Eli Heckscher was not only author of extensive investigations into economic history. He was also skillful in depicting phenomena in small format in encyclopædias, journals and newspapers. This article presents Heckscher as portrait maker of economic scholars. In these portraits—what he emphasized, what he praised, what he criticized—one can discern the stance of the portrait maker himself. Overall, his portraits are permeated by admiration of sharp theoretical analyses and massive economic historical investigations. He admires the founding fathers of political economy, Adam Smith and David Ricardo, stresses continuity in the development of economic thought, praises humble innovators like David Davidson, Knut Wicksell and Alfred Marshall and denounces (what he perceives as pretentious innovators like Gustav Cassel and John Maynard Keynes. He is critical towards economists who attempt to break out of the classical and neoclassical tradition, especially representatives of the German historical school, and what he judges to be a new type of mercantilism, represented by Bertil Ohlin and Keynes. At the same time he appreciates voluminous and solid investigations into economic history, even if performed without theoretical beacons, by scholars like William Cunningham, William Ashley, John Clapham, Marc Bloch, Richard Ehrenberg and Werner Sombart.

  17. Where Did You Come From? Where Will You Go? Human Evolutionary Biology Education and American Students' Academic Interests and Achievements, Professional Goals, and Socioscientific Decision-making

    Science.gov (United States)

    Schrein, Caitlin M.

    In the United States, there is a national agenda to increase the number of qualified science, technology, engineering, and maths (STEM) professionals and a movement to promote science literacy among the general public. This project explores the association between formal human evolutionary biology education (HEB) and high school science class enrollment, academic achievement, interest in a STEM degree program, motivation to pursue a STEM career, and socioscientific decision-making for a sample of students enrolled full-time at Arizona State University. Given a lack of a priori knowledge of these relationships, the Grounded Theory Method was used and was the foundation for a mixed-methods analysis involving qualitative and quantitative data from one-on-one interviews, focus groups, questionnaires, and an online survey. Theory development and hypothesis generation were based on data from 44 students. The survey instrument, developed to test the hypotheses, was completed by 486 undergraduates, age 18--22, who graduated from U.S. public high schools. The results showed that higher exposure to HEB was correlated with greater high school science class enrollment, particularly for advanced biological science classes, and that, for some students, HEB exposure may have influenced their enrollment, because the students found the content interesting and relevant. The results also suggested that students with higher K--12 HEB exposure felt more prepared for undergraduate science coursework. There was a positive correlation between HEB exposure and interest in a STEM degree and an indirect relationship between higher HEB exposure and motivation to pursue a STEM career. Regarding a number of socioscientific issues, including but not limited to climate change, homosexuality, and stem cell research, students' behaviors and decision-making more closely reflected a scientific viewpoint---or less-closely aligned to a religion-based perspective---when students had greater HEB exposure

  18. How Firms Make Boundary Decisions

    DEFF Research Database (Denmark)

    Dobrajska, Magdalena; Billinger, Stephan; Becker, Markus

    2014-01-01

    We report findings from an analysis of 234 firm boundary decisions that a manufacturing firm has made during a 10 year period. Extensive interviews with all major decision makers located both at the headquarters and subsidiaries allow us to examine (a) who was involved in each boundary decision...

  19. A study of professional mobility in a large corporation through cognitive mapping

    Directory of Open Access Journals (Sweden)

    Luiz Flávio Autran Monteiro Gomes

    2010-08-01

    Full Text Available Decisions which are made by executives in large corporations regarding professional mobility cause changes to both their personal and professional lives. This research was carried out with the aim of creating the structuring of a professional mobility problem through the use of a decision support tool, the cognitive mapping. Through the use of this tool, a decision making structure for professional mobility was developed, taking into consideration some important aspects of this process. The cognitive mapping proposed here was a problem structuring tool which leads decision makers to a greater understanding of the problem, giving them support towards good decision making in professional mobility. Through the research carried out it was possible to identify the principal factors which lead these professionals to a professional mobility decision which is as coherent and consistent as possible with the subjective aspects of their professional reality.As decisões com relação à mobilidade profissional tomadas por executivos em grandes corporações causam mudanças em suas vidas pessoais e profissionais. A presente pesquisa foi desenvolvida com o objetivo de estruturar o problema da mobilidade profissional através de uma ferramenta de suporte à decisão: o mapa cognitivo. Esta ferramenta promove uma maior compreensão do problema pelos tomadores de decisão. Através da pesquisa desenvolvida foi possível identificar os principais fatores que levaram os profissionais a tomar a decisão de mobilidade de forma o mais coerente e consistente com os aspectos subjetivos de sua realidade profissional.

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

    Science.gov (United States)

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

    2010-10-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  2. Statins: antimicrobial resistance breakers or makers?

    Directory of Open Access Journals (Sweden)

    Humphrey H.T. Ko

    2017-10-01

    Full Text Available Introduction The repurposing of non-antibiotic drugs as adjuvant antibiotics may help break antimicrobial resistance (AMR. Statins are commonly prescribed worldwide to lower cholesterol. They also possess qualities of AMR “breakers”, namely direct antibacterial activity, synergism with antibiotics, and ability to stimulate the host immune system. However, statins’ role as AMR breakers may be limited. Their current extensive use for cardiovascular protection might result in selective pressures for resistance, ironically causing statins to be AMR “makers” instead. This review examines statins’ potential as AMR breakers, probable AMR makers, and identifies knowledge gaps in a statin-bacteria-human-environment continuum. The most suitable statin for repurposing is identified, and a mechanism of antibacterial action is postulated based on structure-activity relationship analysis. Methods A literature search using keywords “statin” or “statins” combined with “minimum inhibitory concentration” (MIC was performed in six databases on 7th April 2017. After screening 793 abstracts, 16 relevant studies were identified. Unrelated studies on drug interactions; antifungal or antiviral properties of statins; and antibacterial properties of mevastatin, cerivastatin, antibiotics, or natural products were excluded. Studies involving only statins currently registered for human use were included. Results Against Gram-positive bacteria, simvastatin generally exerted the greatest antibacterial activity (lowest MIC compared to atorvastatin, rosuvastatin, and fluvastatin. Against Gram-negative bacteria, atorvastatin generally exhibited similar or slightly better activity compared to simvastatin, but both were more potent than rosuvastatin and fluvastatin. Discussion Statins may serve as AMR breakers by working synergistically with existing topical antibiotics, attenuating virulence factors, boosting human immunity, or aiding in wound healing. It

  3. Problem-Based Learning in Entry-Level Athletic Training Professional-Education Programs: A Model for Developing Critical-Thinking and Decision-Making Skills

    Science.gov (United States)

    Heinrichs, Kristinn I.

    2002-01-01

    Objective: To establish the underlying theory and benefits and describe the implementation of a problem-based learning curriculum. Data Sources: I searched MEDLINE, SPORT Discus, and nursing, evidence-based medicine, and educational psychology databases from 1987 through 2002 using the terms problem-based learning, physical therapy, nursing, and medicine. Data Synthesis: In the problem-based learning process, students encounter a problem, bring to it their preconceived understanding (accurate or not), learn to identify what they need to learn to better understand the problem, engage in self-directed study, and begin to resolve the problem. Problem-based learning has its origins in medical education but is widely used in K–12 education, social sciences, health professions education, law, business administration, engineering, and aviation. An entry-level master of science degree program in athletic training based on problem-based learning and integrated clinical education is described. Conclusions/Recommendations: Problem-based learning curricula, if implemented correctly, can facilitate the entry-level athletic training student's professional development into that of a life-long learner who bases clinical decisions and procedures on the best available evidence. PMID:12937544

  4. Problem-Based Learning in Entry-Level Athletic Training Professional-Education Programs: A Model for Developing Critical-Thinking and Decision-Making Skills.

    Science.gov (United States)

    Heinrichs, Kristinn I

    2002-12-01

    OBJECTIVE: To establish the underlying theory and benefits and describe the implementation of a problem-based learning curriculum. DATA SOURCES: I searched MEDLINE, SPORT Discus, and nursing, evidence-based medicine, and educational psychology databases from 1987 through 2002 using the terms problem-based learning, physical therapy, nursing, and medicine. DATA SYNTHESIS: In the problem-based learning process, students encounter a problem, bring to it their preconceived understanding (accurate or not), learn to identify what they need to learn to better understand the problem, engage in self-directed study, and begin to resolve the problem. Problem-based learning has its origins in medical education but is widely used in K-12 education, social sciences, health professions education, law, business administration, engineering, and aviation. An entry-level master of science degree program in athletic training based on problem-based learning and integrated clinical education is described. CONCLUSIONS/RECOMMENDATIONS: Problem-based learning curricula, if implemented correctly, can facilitate the entry-level athletic training student's professional development into that of a life-long learner who bases clinical decisions and procedures on the best available evidence.

  5. The complex clinical issues involved in an athlete's decision to retire from collision sport due to multiple concussions: a case study of a professional athlete

    Directory of Open Access Journals (Sweden)

    Andrew eGardner

    2013-09-01

    Full Text Available The issue of retirement from athletic participation due to repetitive concussive injuries remains controversial. The complexity of providing recommendations to elite athletes is highlighted by the prospect that offering inappropriate advice may foreseeably lead to engagement in a medico-legal challenge. Currently no evidenced-based, scientifically validated guidelines for forming the basis of such a decision exist. The current paper discusses the complexities of this challenge in addition to presenting a case study of a professional athlete. A number of central issues to consider when discussing athlete retirement revolve around the player’s medical and concussion histories, the current clinical profile, the athlete’s long-term life goals and understanding of the potential long-terms risks. Ensuring that thorough investigations of all possible differential diagnosis, that may explain the presenting symptoms, are conducted is also essential. Discussion pertaining to recommendations for guiding the clinical approach to the retirement issue for athletes with a history of multiple concussions is presented.

  6. 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

  7. Getting research to the policy table: a qualitative study with public health researchers on engaging with policy makers.

    Science.gov (United States)

    Otten, Jennifer J; Dodson, Elizabeth A; Fleischhacker, Sheila; Siddiqi, Sameer; Quinn, Emilee L

    2015-04-30

    Little attention has been given to how researchers can best provide evidence to policy makers so that it informs policy making. The objectives of this study were to increase understanding about the current state of public health nutrition and obesity researcher practices, beliefs, barriers, and facilitators to communicating and engaging with policy makers, and to identify best practices and suggest improvements. Eighteen semistructured interviews were conducted from 2011 to 2013 with public health nutrition and obesity researchers who were highly involved in communicating research to policy makers. Interviews were transcribed verbatim, coded, and analyzed to identify common themes. Study participants described wide variation in practices for communicating and engaging with policy makers and had mixed beliefs about whether and when researchers should engage. Besides a lack of formal policy communication training, barriers noted were promotion and tenure processes and a professional culture that does not value communicating and engaging with policy makers. Study participants cited facilitators to engaging with policy makers as ranging from the individual level (eg, desire to make a difference, relationships with collaborators) to the institutional level (eg, training/mentorship support, institutional recognition). Other facilitators identified were research- and funding-driven. Promising strategies suggested to improve policy engagement were more formal training, better use of intermediaries, and learning how to cultivate relationships with policy makers. Study findings provide insights into the challenges that will need to be overcome and the strategies that might be tried to improve communication and engagement between public health researchers and policy makers.

  8. Makers over speerpunten: opvattingen van makers en uitvoerend kunstenaars over de speerpuntenbrief Auteursrecht 20©20

    NARCIS (Netherlands)

    Weda, J.N.T.; Poort, J.P.; Akker, I.

    2011-01-01

    In dit artikel vergelijken de auteurs de Speerpuntenbrief Auteursrecht 20©20 met de uitkomsten van een enquête onder vierenhalf duizend makers en uitvoerend kunstenaars. De meeste onderdelen van de brief kunnen op hun instemming rekenen. Maar op de punten waar de brief zich liberaler toont, zijn

  9. To Make Good Decision: A Group DSS for Multiple Criteria Alternative Rank and Selection

    OpenAIRE

    Chen-Shu Wang; Heng-Li Yang; Shiang-Lin Lin

    2015-01-01

    Decision making is a recursive process and usually involves multiple decision criteria. However, such multiple criteria decision making may have a problem in which partial decision criteria may conflict with each other. An information technology, such as the decision support system (DSS) and group DSS (GDSS), emerges to assist decision maker for decision-making process. Both the DSS and GDSS should integrate with a symmetrical approach to assist decision maker to take all decision criteria in...

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

    Science.gov (United States)

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

    2011-01-01

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

  11. An Integrated Model for Optimization Oriented Decision Aiding and Rule Based Decision Making in Fuzzy Environment

    Directory of Open Access Journals (Sweden)

    A. Yousefli

    2014-01-01

    Full Text Available In this paper a fuzzy decision aid system is developed base on new concepts that presented in the field of fuzzy decision making in fuzzy environment (FDMFE. This framework aids decision makers to understand different circumstances of an uncertain problem that may occur in the future. Also, to keep decision maker from the optimization problem complexities, a decision support system, which can be replaced by optimization problem, is presented to make optimum or near optimum decisions without solving optimization problem directly. An application of the developed decision aid model and the decision support system is presented in the field of inventory models.

  12. Working with children in end-of-life decision making.

    Science.gov (United States)

    Whitty-Rogers, Joanne; Alex, Marion; MacDonald, Cathy; Pierrynowski Gallant, Donna; Austin, Wendy

    2009-11-01

    Traditionally, physicians and parents made decisions about children's health care based on western practices. More recently, with legal and ethical development of informed consent and recognition for decision making, children are becoming active participants in their care. The extent to which this is happening is however blurred by lack of clarity about what children - of diverse levels of cognitive development - are capable of understanding. Moreover, when there are multiple surrogate decision makers, parental and professional conflict can arise concerning children's 'best interest'. Giving children a voice and offering choice promotes their dignity and quality of life. Nevertheless, it also presents with many challenges. Case studies using pseudonyms and changed situational identities are used in this article to illuminate the complexity of ethical challenges facing nurses in end-of-life care with children and families.

  13. A Benchmark Usability Study of the Tactical Decision Making Under Stress Decision Support System

    National Research Council Canada - National Science Library

    Schmorrow, Dylan

    1998-01-01

    This study evaluates the usability of a U.S. Navy Decision Support System (DSS). The DSS was developed to enhance the performance of tactical decision makers within a Navy Combat Information Center...

  14. Excluded-Mean-Variance Neural Decision Analyzer for Qualitative Group Decision Making

    Directory of Open Access Journals (Sweden)

    Ki-Young Song

    2012-01-01

    Full Text Available Many qualitative group decisions in professional fields such as law, engineering, economics, psychology, and medicine that appear to be crisp and certain are in reality shrouded in fuzziness as a result of uncertain environments and the nature of human cognition within which the group decisions are made. In this paper we introduce an innovative approach to group decision making in uncertain situations by using a mean-variance neural approach. The key idea of this proposed approach is to compute the excluded mean of individual evaluations and weight it by applying a variance influence function (VIF; this process of weighting the excluded mean by VIF provides an improved result in the group decision making. In this paper, a case study with the proposed excluded-mean-variance approach is also presented. The results of this case study indicate that this proposed approach can improve the effectiveness of qualitative decision making by providing the decision maker with a new cognitive tool to assist in the reasoning process.

  15. An Introduction to Solar Decision-Making Tools

    Energy Technology Data Exchange (ETDEWEB)

    Mow, Benjamin [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-12

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

  16. Strategic control and interests, its effects on decision outcomes

    NARCIS (Netherlands)

    Stokman, FN; Stokman, JV

    1995-01-01

    In political systems and large organizations, ultimate decision makers are usually just a small subset of all actors in the social system. To arrive at acceptable decisions, decision makers have to take into account the preferences of other actors in the system. Typically preferences of more

  17. Cardinal priority ranking based decision making for economic ...

    African Journals Online (AJOL)

    To access the indifference band, interaction with the decision maker is obtained via cardinal priority ranking (CPR) of the objectives. The cardinal priority ranking is constructed in the functional space and then transformed into the decision space, so the cardinal priority ranking of objectives relate the decision maker's ...

  18. A mapping of design decision-making

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp; Andreasen, Mogens Myrup

    2004-01-01

    . The model is based on four observations: the engineering designers do not see a neat string of distinct and explicitly made decisions, there are several decision-makers during design, a design decision is not made at a distinct moment in time, and the decision object is evolving in time and changing...

  19. Aggregated systems model for nuclear safeguards decisions

    Energy Technology Data Exchange (ETDEWEB)

    1979-03-01

    This report summarizes a general analytical tool designed to assist nuclear safeguards decision-makers. The approach is based on decision analysis--a quantitative procedure for evaluating complex decision alternatives with uncertain outcomes. The report describes the general analytical approach in the context of safeguards decisions at a hypothetical nuclear fuel reprocessing plant.

  20. Sistem Penunjang Keputusan Pemilihan Sekolah Luar Biasa Dengan Metode Fuzzy Multiple Criteria Decision Making

    OpenAIRE

    Ferdy, Ferdy; Trisnawarman, Dedy; Rusdi, Zyad

    2016-01-01

    Decision support system has many methods that can be used by decision makers. one of the methods is fuzzy multiple criteria decision making (FMCDM) this method will help decision makers to make the final decision with regard to multiple criteria decision alternatives. This final task will be to apply the decision support system with fuzzy multiple criteria decision making to determine the selection of special schools.

  1. Managing Climate Policy Information Facilitating Knowledge Transfer to Policy Makers

    Directory of Open Access Journals (Sweden)

    Charikleia Karakosta

    2016-06-01

    Full Text Available In the challenging context of intense negotiations and radical developments in the field of climate policy, informing stakeholders about opportunities and pathways and about scientific insights and warnings is important to help create positive dynamics. Policy makers need digestible information to design good policies, and understand their options and the possible impacts of these options. They need access to well-structured knowledge, as well as appropriate techniques to manage information and data. However, available information is often difficult to access, not in the right format and of limited use to stakeholders. The range of knowledge needs identified has to be effectively addressed by providing interested parties with suitable, to-the-point information, covering the identified gaps. This is the main aim of this article that proposes the design and development of a climate policy database, which contains all the resources that can cover the identified knowledge gaps. The resources are derived from a broad range of existing reports, research and climate policy decisions at different levels. The goal is to render climate policy associated stakeholders able to extract key policy conclusions. The added value of this database was verified by users and stakeholders that generally argued that the climate policy database facilitates solid understanding of climate policy implications and fosters collaborative knowledge exchange in the field.

  2. 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

  3. Students Communicate their Professional Passion through Pecha Kucha

    DEFF Research Database (Denmark)

    Ringby, Betina

    for creativity, innovation and enterprise. Questions we cared about were: How to make students think creatively and innovatively? How to make students communicate their professional passion? Method A student-centered experiential approach was used to support and encourage students to form an innovative...... and enterprising behavior. Ability to communicate and present ideas and proposals for patients/clients, colleagues/partners and decision-makers is essential for students today. Pecha Kucha 20x20 is a globally used presentation format. 20 images are presented, each for 20 seconds and you talk along to the images....... Pecha Kucha was implemented in our curriculum as a learning activity in a 10-week course concerning health promotion and prevention. Each student was ‘forced’ to reflect on their own special professional interest, create an innovative presentation and finally communicate their passion. An online...

  4. Arguing to motivate decisions

    NARCIS (Netherlands)

    van der Weide, T.L.

    2011-01-01

    Decision makers often have to make difficult trade-offs in situations where multiple aspects matter that are different by nature. For example, in a crisis scenario with a big fire in a factory, trade-offs may have to be made between the safety of the victims and personnel, and the effects on the

  5. Understanding older women's decision making and coping in the context of breast cancer treatment.

    Science.gov (United States)

    Lifford, Kate J; Witt, Jana; Burton, Maria; Collins, Karen; Caldon, Lisa; Edwards, Adrian; Reed, Malcolm; Wyld, Lynda; Brain, Kate

    2015-06-10

    Primary endocrine therapy (PET) is a recognised alternative to surgery followed by endocrine therapy for a subset of older, frailer women with breast cancer. Choice of treatment is preference-sensitive and may require decision support. Older patients are often conceptualised as passive decision-makers. The present study used the Coping in Deliberation (CODE) framework to gain insight into decision making and coping processes in a group of older women who have faced breast cancer treatment decisions, and to inform the development of a decision support intervention (DSI). Semi-structured interviews were carried out with older women who had been offered a choice of PET or surgery from five UK hospital clinics. Women's information and support needs, their breast cancer diagnosis and treatment decisions were explored. A secondary analysis of these interviews was conducted using the CODE framework to examine women's appraisals of health threat and coping throughout the deliberation process. Interviews with 35 women aged 75-98 years were analysed. Appraisals of breast cancer and treatment options were sometimes only partial, with most women forming a preference for treatment relatively quickly. However, a number of considerations which women made throughout the deliberation process were identified, including: past experiences of cancer and its treatment; scope for choice; risks, benefits and consequences of treatment; instincts about treatment choice; and healthcare professionals' recommendations. Women also described various strategies to cope with breast cancer and their treatment decisions. These included seeking information, obtaining practical and emotional support from healthcare professionals, friends and relatives, and relying on personal faith. Based on these findings, key questions were identified that women may ask during deliberation. Many older women with breast cancer may be considered involved rather than passive decision-makers, and may benefit from DSIs

  6. Professional competencies in health promotion and public health: what is common and what is specific? Review of the European debate and perspectives for professional development.

    Science.gov (United States)

    Mereu, Alessandra; Sotgiu, Alessandra; Buja, Alessandra; Casuccio, Alessandra; Cecconi, Rosaria; Fabiani, Leila; Guberti, Emilia; Lorini, Chiara; Minelli, Liliana; Pocetta, Giancarlo; Contu, Paolo

    2015-01-01

    According to the Nairobi Call to Action, the growth of practitioners' skills can be favoured by setting accreditation standards and by reorienting professional competencies of current and future health workers. This will make it possible to develop a critical mass of competent practitioners, foster training, and increase visibility of the professional field. Through a review of the literature, the authors offer an overview of competency-based strategies for professional development in health promotion. The main research questions discussed were as follows: Is there a shared definition of public health?; Is there a shared definition of health promotion?; Who are the main stakeholders for public health and health promotion in Europe?; What is the meaning of professional competencies in education and practice for public health and health promotion?; Is there a shared system of professional core competencies in public health and health promotion?;What is common and what is specific between the two systems of professional competencies?; Is it useful and feasible to create specific strategies of professional development for public health and health promotion? A transformative use of competencies makes it possible to inform students, professionals, employers, and political decision-makers about what is expected from a specific profession and its values.

  7. Platform decisions supported by gaming

    DEFF Research Database (Denmark)

    Hansen, Poul H. Kyvsgård; Mikkola, Juliana Hsuan

    2007-01-01

    is the application of on-line games in order to provide training for decision makers and in order to generate overview over the implications of platform decisions. However, games have to be placed in a context with other methods and we argue that a mixture of games, workshops, and simulations can provide improved...

  8. [The role of information in public health decision-making].

    Science.gov (United States)

    Cecchi, Catherine

    2008-01-01

    Public health, prevention, health education and health promotion are inseparable from the concepts of information and communication. Information should respond as much as possible to the needs of professionals, decision-makers, and consumers who are more and more concerned and conscious of its importance in light of "information overload", various dissemination channels and the multiplicity of its sources. There are numerous issues at stake ranging from comprehension, to the validation of health information, health education, health promotion, prevention, decision-making, as well as issues related to knowledge and power. Irrespective of the type of choice to be made, the need for information, knowledge, and know-how is inseparable from that of other tools or regulatory measures required for decision-making. Information is the same as competence, epidemiological and population data, health data, scientific opinion, and expert conferences--all are needed to assist in decision-making. Based on the principle of precaution, information must increasingly take into account the rejection of a society which often reasons on the basis of a presumption of zero-risk, in an idealistic manner, and which also excludes the possibility of new risks. The consumer positions himself as the regulator of decisions, specifically those with regard to the notion of acceptable level of risk. All of the actors involved in the health system are or become at one moment or another public health decision-makers. Their decision might be based either on an analytical approach, or on an intuitive approach. Although the act of decision-making is the least visible part of public health policy, it is certainly the driving force. This process should integrate the perspective of all of the relevant players, including consumers, who are currently situated more and more frequently at the heart of the health system. Public health decision-making is conducted as a function of political, strategic and

  9. Difficulties in Surgical Decision Making and Associated Factors Among Elective Surgical Patients in Taiwan.

    Science.gov (United States)

    Lin, Mei-Ling; Chen, Ching-Huey

    2017-12-01

    Respect for the autonomy of patients is essential in life-threatening medical decisions such as surgery. Even if a patient has the competency to make decisions, many obstacles exist that may influence his or her willingness to participate in the surgical decision-making process. The aim of this study was to explore the perceived difficulties in surgical decision making and related factors among elective surgical patients. This was a cross-sectional correlational study. A convenience sampling method was used to recruit patients from a medical center in southern Taiwan. Patients who had received elective surgery, were older than 20 years old, and were competent to make medical decisions were invited to participate. A structured questionnaire was developed by the researchers to collect demographic data, decision patterns, and perceived difficulties in surgical decision making. Acceptable validity and reliability of the questionnaire were confirmed before data collection. Over 80% of the participants made the surgical decision by themselves or in collaboration with their family or physician. Less than 15% expected to make the surgical decision by themselves. Illness-related suffering was the greatest difficulty that participants faced. The patients who tended toward passive decision making faced greater difficulties in the dimensions of "do not understand information," "physician's lack of concern," and "difficulty in freely communicating with the physician" than their active decision-making peers. Male participants reported having more difficulty in communicating with their physician than their female peers. Age, education, and marital status were not significantly associated with perceived difficulties in surgical decision making. Family participation in the medical decision-making process is expected by most patients. Although less than 20% of the participants in this study were categorized as passive decision makers, this group reported more difficulties than the

  10. Difficulties in Surgical Decision Making and Associated Factors Among Elective Surgical Patients in Taiwan.

    Science.gov (United States)

    Lin, Mei-Ling; Chen, Ching-Huey

    2017-06-01

    Respect for the autonomy of patients is essential in life-threatening medical decisions such as surgery. Even if a patient has the competency to make decisions, many obstacles exist that may influence his or her willingness to participate in the surgical decision-making process. The aim of this study was to explore the perceived difficulties in surgical decision making and related factors among elective surgical patients. This was a cross-sectional correlational study. A convenience sampling method was used to recruit patients from a medical center in southern Taiwan. Patients who had received elective surgery, were older than 20 years old, and were competent to make medical decisions were invited to participate. A structured questionnaire was developed by the researchers to collect demographic data, decision patterns, and perceived difficulties in surgical decision making. Acceptable validity and reliability of the questionnaire were confirmed before data collection. Over 80% of the participants made the surgical decision by themselves or in collaboration with their family or physician. Less than 15% expected to make the surgical decision by themselves. Illness-related suffering was the greatest difficulty that participants faced. The patients who tended toward passive decision making faced greater difficulties in the dimensions of "do not understand information," "physician's lack of concern," and "difficulty in freely communicating with the physician" than their active decision-making peers. Male participants reported having more difficulty in communicating with their physician than their female peers. Age, education, and marital status were not significantly associated with perceived difficulties in surgical decision making. Family participation in the medical decision-making process is expected by most patients. Although less than 20% of the participants in this study were categorized as passive decision makers, this group reported more difficulties than the

  11. Canadian policy makers' views on pharmaceutical reimbursement contracts involving confidential discounts from drug manufacturers.

    Science.gov (United States)

    Morgan, Steven G; Thomson, Paige A; Daw, Jamie R; Friesen, Melissa K

    2013-10-01

    Pharmaceutical policy makers are increasingly negotiating reimbursement contracts that include confidential price terms that may be affected by drug utilization volumes, patterns, or outcomes. Though such contracts may offer a variety of benefits, including the ability to tie payment to the actual performance of a product, they may also create potential policy challenges. Through telephone interviews about this type of contract, we studied the views of officials in nine of ten Canadian provinces. Use of reimbursement contracts involving confidential discounts is new in Canada and ideas about power and equity emerged as cross-cutting themes in our interviews. Though confidential rebates can lower prices and thereby increase coverage of new medicines, several policy makers felt they had little power in the decision to negotiate rebates. Study participants explained that the recent rise in the use of rebates had been driven by manufacturers' pricing tactics and precedent set by other jurisdictions. Several policy makers expressed concerns that confidential rebates could result in inter-jurisdictional inequities in drug pricing and coverage. Policy makers also noted un-insured and under-insured patients must pay inflated "list prices" even if rebates are negotiated by drug plans. The establishment of policies for disciplined negotiations, inter-jurisdictional cooperation, and provision of drug coverage for all citizens are potential solutions to the challenges created by this new pharmaceutical pricing paradigm. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. Use of Scientific Information Sources by Policy Makers in the ...

    African Journals Online (AJOL)

    This study investigated how policy makers in Nigerian public agencies that have mandates for policy making and implementation in the science and technology sector access and use information sources in their activities. A questionnaire was used to collect data from 121 of the policy makers to find out the sources and ...

  13. Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

    Science.gov (United States)

    Clarke, Gemma; Galbraith, Sarah; Woodward, Jeremy; Holland, Anthony; Barclay, Stephen

    2015-06-11

    Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of 'who decides' cannot be fully answered. There is a potential for anonymity of multiple decision-makers

  14. Agreeing on Robust Decisions : New Processes for Decision Making under Deep Uncertainty

    OpenAIRE

    Hallegatte, Stephane; Brown, Casey; Gill, Stuart; Lempert, Robert; Kalra, Nidhi; Fozzard, Adrian; Shah, Ankur

    2014-01-01

    Investment decision making is already difficult for any diverse group of actors with different priorities and views. But the presence of deep uncertainties linked to climate change and other future conditions further challenges decision making by questioning the robustness of all purportedly optimal solutions. While decision makers can continue to use the decision metrics they have used in the ...

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

    Science.gov (United States)

    Landmesser, John Andrew

    2014-01-01

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

  16. DECISION TREES – A PERSPECTIVE OF ELECTRONIC DECISIONAL SUPPORT

    OpenAIRE

    Nicolae Marginean; Janetta Sirbu; Dan Racovitan

    2010-01-01

    Without substitute decision-maker, decision support system, through their components,can facilitate the work of decision-maker by providing useful clues to solving problems andidentifying opportunities. Choosing an optimal solution in case of complex decision makingprocesses, with a degree of uncertainty, involving a series of interdependent decisions, performed inseveral periods of time, can be achieved using decision trees. Suggestive and simple propertiespropel decision trees among the too...

  17. Building a Decision Support Tool for Adaptation to Extreme Heat

    Science.gov (United States)

    Steinberg, N.

    2016-12-01

    Human vulnerability to extreme heat can be a difficult measure to assess and effectively "operationalize" for key decision-makers. Existing heat alerts are sensitive to scale and context, often leaving public officials with insufficient forecast data, lack of coherent guidance, and an absence of tools that can accurately represent local heat-health risks. While local forecast data and extreme weather outlooks continue to improve, stakeholders are asking for decision support about interoperability and appropriate interventions to reduce heat-health risks for vulnerable populations. This presentation will discuss the information needs determined by public health officials in California with funding from California's Fourth Climate Change Assessment. Findings from a user needs assessment will be followed by a discussion of methods for communicating heat vulnerability and developing user-centric tools that can help public health professionals and planners prepare their communities for extreme heat.

  18. How can we synthesize qualitative and quantitative evidence for healthcare policy-makers and managers?

    Science.gov (United States)

    Pope, Catherine; Mays, Nicholas; Popay, Jennie

    2006-01-01

    Interest in synthesizing the findings of qualitative and quantitative evidence is increasing in response to the complex questions being asked by healthcare managers and policy-makers. There is a wealth of evidence available from many sources--both formal research and non-research based (e.g., expert opinion, stakeholder, and user views). Synthesis offers the opportunity to integrate diverse forms of evidence into a whole. We categorize the current approaches to the synthesis of qualitative and quantitative evidence into four broad groups: narrative, qualitative, quantitative, and Bayesian. Many of the methods for synthesis are emergent; some have been used to integrate primary data; few have a long history of application to healthcare. In the healthcare context, synthesis methods are less well developed than methods such as systematic review. Nonetheless, synthesis has the potential to provide knowledge and decision support to healthcare policy-makers and managers.

  19. Optimal Offering and Operating Strategy for a Large Wind-Storage System as a Price Maker

    DEFF Research Database (Denmark)

    Ding, Huajie; Pinson, Pierre; Hu, Zechun

    2017-01-01

    and real-time operation policies to maximize their overall profit. As participants with large capacity in electricity markets can influence cleared prices by strategic offering, a large scaled WFESS is assumed to be a price maker in day-ahead markets. Correspondingly, the strategy considers influence......Wind farms and energy storage systems are playing increasingly more important roles in power systems, which makes their offering non-negligible in some markets. From the perspective of wind farm-energy storage systems (WF-ESS), this paper proposes an integrated strategy of day-ahead offering...... of offering quantity on cleared day-ahead prices, and adopts linear decision rules as the real time control strategy. These allow enhancing overall profits from both day-ahead and balancing markets. The integrated price-maker strategy is formulated as a stochastic programming problem, where uncertainty...

  20. Decision-Making under Stress and Its Implications for Managerial Decision-Making: A Review of Literature

    OpenAIRE

    Nuray Atsan

    2016-01-01

    We examine the main theoretical models of decision making under stress and the effects of decision stress on decision making process to provide a deeper understanding of the decision making phenomenon. The literature review reveals that stress can have an impact on each stage of the decision-making process. The review also finds that decision makers could enhance their decision-making performance and prevent potential decision failures by means of adapting certain coping strategies.

  1. FileMaker Pro 11 The Missing Manual

    CERN Document Server

    Prosser, Susan

    2010-01-01

    This hands-on, friendly guide shows you how to harness FileMaker's power to make your information work for you. With a few mouse clicks, the FileMaker Pro 11 database helps you create and print corporate reports, manage a mailing list, or run your entire business. FileMaker Pro 11: The Missing Manual helps you get started, build your database, and produce results, whether you're running a business, pursuing a hobby, or planning your retirement. It's a thorough, accessible guide for new, non-technical users, as well as those with more experience. Start up: Get your first database up and runnin

  2. The Role of Natural Resource Professionals in Addressing Climate Change

    Directory of Open Access Journals (Sweden)

    Shorna B. Allred

    2016-08-01

    Full Text Available Natural resource professionals, ranging from forest managers and educators to floodplain managers, play a critical role in implementing and conducting outreach with regards to climate mitigation and adaptation appropriate to local and regional scales. Natural resource professionals can also pave the way by adopting actions that serve as demonstrations of efforts to mitigate greenhouse gas emissions or adapt natural systems for the future. A web survey of 1488 natural resource professionals across New York State (NYS was conducted to assess their attitudes toward climate change, views toward climate change mitigation and adaptation priorities, actions taken to address climate change, and barriers faced as they relate to their professional responsibilities. The majority of natural resource professionals believe that climate change is happening, but there was slightly less agreement about human causes of climate change. Most natural resource professionals (69% see evidence of how climate change is impacting natural resources in NYS, but few (17% believed that there was sufficient information about how to address climate impacts at the local level. Nearly 60% of natural resources professionals undertook climate mitigation or adaptation actions in their work. Prominent influencing factors for action were proactive leadership and local impacts. Barriers to taking action on climate change were a lack of human and financial resources, the nature of costs relative to benefits, and lack of perceived threat. As managers and educators responsible for local water, land, and wildlife resources, natural resource professionals witness changes resulting from climate change first-hand. This paper will be useful to decision-makers at state and federal government levels regarding policies, incentives, and guidance that can be created with the goal of promoting a sound natural resource strategy in support of climate change readiness.

  3. Decision Topology Assessment in Engineering Design Under Uncertainity

    Science.gov (United States)

    2014-01-01

    giving responses to lottery questions. To alleviate some of the roadblocks to successful implementation of DA in design, the authors recently proposed...1. Provides ranking of alternatives involving multiple attributes. 2. Answers lottery questions. 3. Provides single attribute utility...maker. Method 2: Decision maker answers lottery questions Lottery questions are used to elicit the decision maker’s preferences over

  4. SYSTEM SAFETY IN LPG FIRED FURNACE - A MULTI CRITERIA DECISION MAKING TECHNIQUE

    National Research Council Canada - National Science Library

    S Georgekutty Mangalathu; N Siva Shanmugam; K Sankaranarayanasamy; T Ramesh; K Muthukumar

    2012-01-01

    ...). Analytical Hierarchy Process is a multi-criteria decision making technique, which breaks down a decision making problem in to a hierarchical structure, through which decision makers can bring...

  5. Assessment of policy makers' individual and organizational capacity ...

    African Journals Online (AJOL)

    Assessment of policy makers' individual and organizational capacity to acquire, assess, adapt and apply research evidence for maternal and child health policy making in Nigeria: a cross-sectional quantitative survey.

  6. Satisfaction with treatment decision-making and treatment regret among Latinas and non-Latina whites with DCIS

    Science.gov (United States)

    López, Mónica E.; Kaplan, Celia P.; Nápoles, Anna M.; Hwang, E. Shelly; Livaudais, Jennifer C.; Karliner, Leah S.

    2013-01-01

    Objective To examine differences in treatment decision-making participation, satisfaction, and regret among Latinas and non-Latina whites with DCIS. Methods Survey of Latina and non-Latina white women diagnosed with DCIS. We assessed women’s preferences for involvement in decision-making, primary treatment decision maker, and participatory decision-making. We examined primary outcomes of satisfaction with treatment decision-making and treatment regret by ethnic-language group. Results Among 745 participants (349 Latinas, 396 white) Spanish-speaking Latinas (SSL) had the highest mean preference for involvement in decision-making score and the lowest mean participatory decision-making score and were more likely to defer their final treatment decision to their physicians than English-speaking Latinas or whites (26%, 13%, 18%, pdecision-making (OR 0.4; CI 95%, 0.2-0.8) and expressed more regret than whites (OR 6.2; CI 95%, 3.0-12.4). More participatory decision-making increased the odds of satisfaction (OR 1.5; CI 95%, 1.3-1.8) and decreased the odds of treatment regret (OR 0.8; CI 95%, 0.7-1.0), independent of ethnicity-language. Conclusion Language barriers impede the establishment of decision-making partnerships between Latinas and their physicians, and result in less satisfaction with the decision-making process and more treatment regret. Practice Implications Use of professional interpreters may address communication-related disparities for these women. PMID:24207116

  7. Trouble makers : Laura Poitras and the problem of dissent

    OpenAIRE

    Danchev, Alex

    2015-01-01

    This review article considers three works by the distinguished documentary film-maker Laura Poitras: My country, my country (2006); The oath (2010); and the recently released Citizenfour (2014), focusing on the whistle-blower Edward Snowden. Poitras describes these works as a trilogy about American power after 9/11, but they are also about disobedience and resistance, or the problem of dissent. The article argues for the significance (and the virtue) of Poitras's project, as film maker and tr...

  8. Where Did You Come From? Where Will You Go? Human Evolutionary Biology Education and American Students' Academic Interests and Achievements, Professional Goals, and Socioscientific Decision-Making

    Science.gov (United States)

    Schrein, Caitlin M.

    2014-01-01

    In the United States, there is a national agenda to increase the number of qualified science, technology, engineering, and maths (STEM) professionals and a movement to promote science literacy among the general public. This project explores the association between formal human evolutionary biology education (HEB) and high school science class…

  9. Master's Program Module "Environmental Issues--Decision Making Experience" as Precondition for Implementation of Education for Sustainable Development for Professional Training of Teachers

    Science.gov (United States)

    Vinokurova, Natalia Fedorovna; Martilova, Natalia Viktorovna; Krivdina, Irina Yurievna; Badin, Mikhail Mikhailovich; Efimova, Olga Evgenyevna

    2016-01-01

    The article discusses current issues related to the implementation of the UNESCO roadmap implementing Global action programme on education for sustainable development. In the context of increasing the professional level of pedagogical workers is a priority area in the implementation of education for sustainable development. Therefore, we believe…

  10. Occupational Biographical Decisions of U.S. Nursing Professionals for Doing a PhD.--Consequences for the Education in Nursing Science in Germany

    Science.gov (United States)

    Seltrecht, Astrid

    2016-01-01

    In Germany, nursing science has been developing since the early 1990s. Since then it is possible for nursing professionals (partly with, partly without prior 3-year vocational training) to do a bachelor's or master's degree in nursing science at universities of applied sciences. However, to do a Ph.D. they need to change to a university as in…

  11. The decision of out-of-home placement in residential care after parental neglect: Empirically testing a psychosocial model.

    Science.gov (United States)

    Rodrigues, Leonor; Calheiros, Manuela; Pereira, Cícero

    2015-11-01

    Out-of-home placement decisions in residential care are complex, ambiguous and full of uncertainty, especially in cases of parental neglect. Literature on this topic is so far unable to understand and demonstrate the source of errors involved in those decisions and still fails to focus on professional's decision making process. Therefore, this work intends to test a socio-psychological model of decision-making that is a more integrated, dualistic and ecological version of the Theory of Planned Behavior's model. It describes the process through which the decision maker takes into account personal, contextual and social factors of the Decision-Making Ecology in the definition of his/her decision threshold. One hundred and ninety-five professionals from different Children and Youth Protection Units, throughout the Portuguese territory, participated in this online study. After reading a vignette of a (psychological and physical) neglect case toward a one-year-old child, participants were presented with a group of questions that measured worker's assessment of risk, intention, attitude, subjective norm, behavior control and beliefs toward residential care placement decision, as well as worker's behavior experience, emotions and family/child-related-values involved in that decision. A set of structural equation modeling analyses have proven the good fit of the proposed model. The intention to propose a residential care placement decision was determined by cognitive, social, affective, value-laden and experience variables and the perceived risk. Altogether our model explained 61% of professional's decision toward a parental neglect case. The theoretical and practical implications of these results are discussed, namely the importance of raising awareness about the existence of these biased psychosocial determinants. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. An Ontology-driven Framework for Supporting Complex Decision Process

    OpenAIRE

    Chai, Junyi; Liu, James N. K.

    2011-01-01

    The study proposes a framework of ONTOlogy-based Group Decision Support System (ONTOGDSS) for decision process which exhibits the complex structure of decision-problem and decision-group. It is capable of reducing the complexity of problem structure and group relations. The system allows decision makers to participate in group decision-making through the web environment, via the ontology relation. It facilitates the management of decision process as a whole, from criteria generation, alternat...

  13. Mental Disorders and Decision-Making Capacity: What Is the Role of Law?

    Science.gov (United States)

    Rommelaere, Claire

    2015-03-01

    When a patient appears to have a mental disorder, doubts may arise about his or her decision-making capacity. Health professionals must then assess the patient's capacity in order to make sure of the validity of his or her consent or refusal. Incapacity has indeed legal consequences, as law provides for the appointment of a surrogate decision-maker in case of incapacity. With Belgian law as a point of departure, this contribution is aiming at identifying the role of law in capacity assessment itself, prior to the decision about (in)capacity. In order to protect the patient's rights and to support the task of those carrying out the assessment, law should provide for a global definition of decigion-making capacity and for a frame-procedure guiding this assessment. In my opinion, it is possible for law to contribute to the complex task of capacity assessment without interfering embarrassingly with healthcare practice.

  14. Professional Ethics and Organizational Commitment Among the Education Department Staff of Tabriz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Ali Imani

    2017-06-01

    Full Text Available Background: Concepts such as organizational commitment and employees’ and managers’ ethics provide decision-makers and policy makers with potentially useful information which can result in increasing organizational efficiency and effectiveness. This study aimed to explore the relationship between professional ethics and organizational commitment among the staff working in the education departments of Tabriz University of Medical Sciences. Methods: This cross-sectional study was conducted in 2015. The study population consisted of all staff working as educational experts in the education departments of Tabriz University of Medical Sciences (N = 65. Data collection instruments used in this study were two standard questionnaires on professional ethics and organizational commitment. SPSS software version 21 was used to analyze the data. Results: According to the results, mean scores obtained for professional ethics and organizational commitment were (91.57± 9.13 (95% CI, 89.23-93.91 and (64.89 ± 10.37 (95% CI, 62.2367.54, respectively. A significant relationship was observed between professional ethics and organizational commitment among the educational experts working in Tabriz University of Medical Sciences (correlation coefficient = 0.405 (P = 0.001 (at 95% confidence level. Furthermore, there was a significant relationship between professional ethics and work experience (P = 0.043. The highest level of professional ethics observed was associated with those participants having a work experience of ranging from 6 to 10 years. Individuals with fulltime employment scored the highest in organizational commitment. Conclusion: Educational experts possessed a high level of professional ethics. The finding provides the grounds for promoting organizational commitment, which will lead to higher levels of organizational effectiveness.

  15. Graduate Enrollment Decisions of Undergraduate Science and Engineering Majors: A Survey of GRE Test Takers. GRE Board Professional Report No. 85-01P.

    Science.gov (United States)

    Grandy, Jerilee

    To understand better the factors involved in students' decisions to pursue graduate study in the natural sciences, mathematics, and engineering (NSME), this study surveyed a stratified sample of 1,651 NSME majors who took the Graduate Record Examination General Test in December 1990, planning to enroll in graduate school. The survey asked for…

  16. Professional midwifery in Guatemala: A qualitative exploration of perceptions, attitudes and expectations among stakeholders.

    Science.gov (United States)

    Summer, Anna; Guendelman, Sylvia; Kestler, Edgar; Walker, Dilys

    2017-07-01

    Despite recommendations that women give birth with a skilled birth attendant (SBA), 70% of births in Guatemala occur outside health facilities with informally trained traditional birth attendants (TBAs). To increase SBA in rural, indigenous communities, a professional midwifery school accredited by the government is scheduled to open in 2017. Drawing from Filby's model on barriers to the successful integration of professional midwifery into health systems, this paper aims to identify threats - and facilitators-toward professional midwifery's re-introduction in Guatemala. To elucidate perceptions, attitudes and expectations towards professional midwifery, qualitative, in-depth interviews were conducted with 32 physicians, nurses, and TBAs in six health centers and with key decision makers and professional midwives (PMs) in Guatemala City. We conducted open and axial coding in Atlas.ti and performed normative comparisons of participants' attitudes, perceptions, and expectations with the National Vision for professional midwifery and relative comparisons within and across disciplinary subgroups. Unprompted, physicians, nurses and TBAs were unable to correctly define professional midwifery. Yet, when professional midwifery was defined for them, they expressed willingness to work with PMs, seeing them as a needed human resource, instrumental in providing intercultural care and strengthening facility relationships with TBAs. Some stakeholders anticipated resistance toward PMs due to provider turf issues. Notable differences in expectations among all groups included ideas for supervision of and by the PMs and the PM's role in monitoring women and conducting births in communities alongside TBAs. Facilitators to professional midwifery's success include national political will, stakeholders' uniformity of vision, and the potential for improved intercultural care. Barriers are mostly professional in nature, including impediments to autonomous practice by PMs, hierarchical

  17. Decision story strategy: a practical approach for teaching decision making.

    Science.gov (United States)

    Smith, D L; Hamrick, M H; Anspaugh, D J

    1981-12-01

    Teachers are usually very enthusiastic in their evaluations of decision stories. Decision Story Strategies offer a change of pace, promote student involvement and stimulate creative thinking, problem solving and everpresent creative teaching-learning opportunities. The real-life problems presented within the structure of a decision story provide meaningful learning opportunities for students. Students begin to think in a broader perspective when considering other points of view and information sources. The Decision Story Strategy used with the Decision-Making Model provides a powerful tool for health educators to develop skills for making and evaluating decisions in an interesting and meaningful context. It may not be a panacea for all health educators, but is an effective strategy for the teacher concerned with developing independent decision makers. Most importantly, students are provided opportunities to solve their present problems as well as develop decision-making skills for the future.

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

    Science.gov (United States)

    Erskine, Michael A.

    2013-01-01

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

  19. Maker Cultures and the Prospects for Technological Action.

    Science.gov (United States)

    Nascimento, Susana; Pólvora, Alexandre

    2016-07-07

    Supported by easier and cheaper access to tools and expanding communities, maker cultures are pointing towards the ideas of (almost) everyone designing, creating, producing and distributing renewed, new and improved products, machines, things or artefacts. A careful analysis of the assumptions and challenges of maker cultures emphasizes the relevance of what may be called technological action, that is, active and critical interventions regarding the purposes and applications of technologies within ordinary lives, thus countering the deterministic trends of current directions of technology. In such transformative potential, we will explore a set of elements what is and could be technological action through snapshots of maker cultures based on the empirical research conducted in three particular contexts: the Fab Lab Network, Maker Media core outputs and initiatives such as Maker Faires, and the Open Source Hardware Association (OSHWA). Elements such as control and empowerment through material engagement, openness and sharing, and social, cultural, political and ethical values of the common good in topics such as diversity, sustainability and transparency, are critically analysed.

  20. Intuition in strategic decision making:implications for strategic decision effectiveness

    OpenAIRE

    Shepherd, Neil G.; Rudd, John M.

    2012-01-01

    Intuition can produce effective strategic decisions because of its speed and ability to solve less-structured problems. Despite this, there are only a very small number of empirical studies that have examined intuition in the strategic decision-making process. We examine the relationship between the use of intuition in the strategic decision-making process, and strategic decision effectiveness. We propose that the expertise of the decision-maker, environmental dynamism and the characteristics...

  1. Bridging the gap between science and decision making.

    Science.gov (United States)

    von Winterfeldt, Detlof

    2013-08-20

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

  2. Do probabilistic forecasts lead to better decisions?

    Directory of Open Access Journals (Sweden)

    M. H. Ramos

    2013-06-01

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

  3. A qualitative study exploring the difficulties influencing decision making at the end of life for people with dementia.

    Science.gov (United States)

    Lamahewa, Kethakie; Mathew, Rammya; Iliffe, Steve; Wilcock, Jane; Manthorpe, Jill; Sampson, Elizabeth L; Davies, Nathan

    2017-06-22

    Dementia is a progressive neurodegenerative condition characterized by declining functional and cognitive abilities. The quality of end of life care for people with dementia in the UK can be poor. Several difficult decisions may arise at the end of life, relating to the care of the person with dementia, for example management of comorbidities. To explore difficulties in decision making for practitioners and family carers at the end of life for people with dementia. Qualitative methodology using focus groups and semi-structured interviews and thematic analysis methods. Former (n=4) and current (n=6) family carers of people with experience of end of life care for a person with dementia were recruited from an English dementia voluntary group in 2015. A further 24 health and care professionals were purposively sampled to include a broad range of expertise and experience in dementia end of life care. Four key themes were identified as follows: challenges of delivering coherent care in dynamic systems; uncertainty amongst decision makers; internal and external conflict amongst decision makers; and a lack of preparedness for the end of life. Overarching difficulties such as poor communication, uncertainty and conflict about the needs of the person with dementia as well as the decision maker's own role can characterize decision making at the end of life. This study suggests that decision making at the end of life for people with dementia has the potential to be improved. More planning earlier in the course of dementia with an on-going approach to conversation may increase preparedness and family carers' expectations of end of life. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  4. Improving knowledge and changing behavior towards guideline based decisions in diabetes care: a controlled intervention study of a team-based learning approach for continuous professional development of physicians

    Directory of Open Access Journals (Sweden)

    Kühne-Eversmann Lisa

    2013-01-01

    Full Text Available Abstract Background Continuing Professional Development (CPD courses should ideally improve a physician’s knowledge and change their professional behavior in daily practice towards a best clinical practice reference model and guideline adherence. Interactive methods such as team-based learning and case-based learning, as compared to lectures, can impart sustainable knowledge and lead to high satisfaction among participants. We designed an interactive case-based CPD-seminar on diabetes care using a team-based learning approach to evaluate whether it leads to an improvement of short-term knowledge and changing of behavior towards guideline based decisions and how this learning approach is perceived by participants. Methods Questionnaires and an electronic voting system were used to evaluate motivation, acceptance and knowledge of voluntary participants. Furthermore, we analyzed data on index diagnostic tests and referrals of patients with diabetes of participating physicians over a period of six months before and after the course in comparison with a matched control group in a quasi-experimental design. Results Participants (n=103 rated the interactivity and team-based discussions as the main reasons for enhanced learning. They also expected that the course would change their professional behavior. Participants scored a mean of 43.9% right answers before and 62.6% after the course (p Conclusions Our team-based learning CPD-approach was highly accepted and resulted in an increase of short-term knowledge. It significantly increased the referral to diabetes specialists in daily practice whereas all other key professional behavior indicators did change but not significantly.

  5. Managing risk during care transitions when approaching end of life: A qualitative study of patients? and health care professionals? decision making

    OpenAIRE

    Coombs, Maureen A; Parker, Roses; de Vries, Kay

    2016-01-01

    Background: Increasing importance is being placed on the coordination of services at the end of life. Aim: To describe decision-making processes that influence transitions in care when approaching the end of life. Design: Qualitative study using field observations and longitudinal semi-structured interviews. Setting/participants: Field observations were undertaken in three sites: a residential care home, a medical assessment unit and a general medical unit in New Zealand. The Supportive and P...

  6. Cautious OWA and Evidential Reasoning for Decision Making under Uncertainty

    OpenAIRE

    Jean-Marc Tacnet; Jean Dezert

    2011-01-01

    To make a decision under certainty, multicriteria decision methods aims to choose, rank or sort alternatives on the basis of quantitative or qualitative criteria and preferences expressed by the decision-makers. However, decision is often done under uncertainty: choosing alternatives can have different consequences depending on the external context (or state of the word).

  7. Decision-Making Rationales among Quebec VET Student Aged 25 and Older

    Directory of Open Access Journals (Sweden)

    Louis Cournoyer

    2017-11-01

    Full Text Available Each year, a large number of students aged 25 years and over take part in vocational and education training (VET programs in the Province of Quebec, Canada. The life experiences of many of these adults are marked by complex psychosocial and professional events, which may have influenced their career decision-making processes. This paper aimed to identify key rationales guiding the decisions of adults aged 25 years and older to return to education based on a thematic analysis of 30 semi-structured interviews with students enrolled in a VET program. The analysis focused on two theoretical axes: one biographical and the other interactionist. The first involved personal life courses and professional projects undertaken by the student in the past. The second examined tensions and conflicts between context forces and adjustment strategies adopted by the student. The results revealed five decision-making rationales that characterized the vast majority of the students’ experiences: 1 get out of a socioprofessional and economic slump; 2 know yourself better, personally and socially; 3 value the concrete and the practical; 4 take advantage of supporting conditions; and 5 reconcile proximity and the known. The relevance and implications of these findings for professionals and decision makers in vocational training are discussed.

  8. 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.

  9. Decision aiding techniques for site remediation

    Energy Technology Data Exchange (ETDEWEB)

    Van de Walle, B.

    1996-09-18

    Decision making problems in the nuclear domain are known for their complexity since they usually involve a wide range of technical, social, and political considerations. Site restoration is a typical example of a complex nuclear decision problem, and more and more decision makers realize that they need new tools to assist in the decision making process. This paper reports on multi-criteria decision analysis, a powerful tool for handling complex decisions involving multiple criteria. The motivation to use multi-criteria decision analysis in the domain of site restoration is illustrated. New developments and challenges in this field are addressed.

  10. Professional Microsoft PowerPivot for Excel and SharePoint With Microsoft Office 2010 and SQL Server Gemini

    CERN Document Server

    Harinath, Sivakumar; Lee, Denny Guang-Yeu

    2010-01-01

    SQL Server "Gemini" brings the power of Microsoft's business intelligence tools to the desktop. Self-service business intelligence today augments traditional BI methods, allowing faster response time and greater flexibility. If you're a business decision-maker who uses Microsoft Office or an IT professional responsible for deploying and managing your organization's business intelligence systems, this guide will help you make the most of SQL Server 2008 "Gemini". Featuring insights and tips from the team that built the product, it offers a head start on mastering the feature

  11. Students Communicate their Professional Passion through Pecha Kucha

    DEFF Research Database (Denmark)

    Ringby, Betina

    learning process, and that their experience with Pecha Kucha as a creative and innovative presentation form would be a useful tool in their future studies and/or practical working life. The process of creating and presenting a Pecha Kucha contributed to an increasing awareness among students to see...... for creativity, innovation and enterprise. Questions we cared about were: How to make students think creatively and innovatively? How to make students communicate their professional passion? Method A student-centered experiential approach was used to support and encourage students to form an innovative...... and enterprising behavior. Ability to communicate and present ideas and proposals for patients/clients, colleagues/partners and decision-makers is essential for students today. Pecha Kucha 20x20 is a globally used presentation format. 20 images are presented, each for 20 seconds and you talk along to the images...

  12. Redes de Producción y Diseminación de Información sobre Educación en América Latina y el Caribe: su Utilidad para Tomadores de Decisión. Networks of Production and Dissemination of Information on Education in Latin America and the Caribbean: Their Usefulness for Decision Makers

    Directory of Open Access Journals (Sweden)

    Francisco Téllez

    2008-07-01

    Full Text Available This article presents the results of a study that explored the formal and informal information networks operating in Latin America and the Caribbean, and estimated their utility for educational policymaking processes. To achieve this goal the following procedures were undertaken: first, a search for information networks in the region was conducted; second, an analysis matrix for information networks intended to reveal their main characteristics (origin, members, information resources provided, types of information offered and topics for which information is provided, among others was made; and third, interviews to key informants about the utility of these networks to design educational policies in the region were conducted. The main conclusions of the study were: a most of the information related to educational policy that circulates through information networks in Latin America and the Caribbean is not useful for policymaking processes; b the networks that offer analytic abstracts of research and policy experiences, and propose policy solutions for policy problems in a non-technical language increase the possibility of information use by policymakers; c informal networks, where consultants, advisors, or colleagues communicate orally to policymakers relevant information about the characteristics of successful policy initiatives in specific contexts, seem to have more impact than formal networks on policy development; and d the utility of information networks for educational policy decisions is related to their ability to communicate, in a clear and straightforward way, the main results of policy researches and experiences. Este artículo presenta los resultados de un estudio que exploró las distintas redes de información formales y no formales que existen en América Latina y el Caribe, estimando su utilidad para el diseño de políticas educativas. Para lograr lo anterior, se llevaron a cabo los siguientes procedimientos: primero, se elabor

  13. Design of Absorbing Wave Maker based on Digital Filters

    DEFF Research Database (Denmark)

    Christensen, Morten; Frigaard, Peter

    An absorbing wave maker operated by means of on-line signals from digital FIR filters is presented. Surface elevations are measured in two positions in front of the wave maker. The reflected wave train is seperated by the sum of the incident and reflected wave trains by means of digital filtering...... and subsequent superposition of the measured surface elevations. The motion of the wave paddle required to absorb reflected waves is determined and added to the original wave paddle control signal. Irregular wave tests involving test structures with different degrees of reflection show that excellent absorption...

  14. Exploring the potential implementation of a tool to enhance shared decision making (SDM) in mental health services in the United Kingdom: a qualitative exploration of the views of service users, carers and professionals.

    Science.gov (United States)

    Brooks, Helen; Harris, Kamelia; Bee, Penny; Lovell, Karina; Rogers, Anne; Drake, Richard

    2017-01-01

    As a response to evidence that mental health service users and carers expect greater involvement in decisions about antipsychotic medication choice and prescribing, shared decision-making (SDM) has increasingly come to be viewed as an essential element of person-centred care and practice. However, this aspiration has yet to be realised in practice, as service users and carers continue to feel alienated from healthcare services. Existing understanding of the factors affecting the use of tools to support SDM is limited to inter-individual influences and wider factors affecting potential implementation are underexplored. To explore the potential use of a tool designed to enhance collaborative antipsychotic prescribing from the perspectives of secondary care mental health service users, carers and professionals. We conducted a qualitative study (semi-structured interviews and focus groups) using a convenience sample of 33 participants (10 mental health service users, 10 carers and 13 professionals) involved in antipsychotic prescribing in one Trust in the North of England. Participants were asked about the potential implementation of a tool to support SDM within secondary mental health services. Framework analysis incorporating the use of constant comparative method was used to analyse the data. The study identified a divergence in the views of service users and professionals, including a previously undocumented tendency for stakeholder groups to blame each other for potential implementation failure. This dissonance was shaped by meso and macro level influences relating to paternalism, legislative frameworks, accountability and lack of resources. Participants did not identify any macro level (policy or structural) facilitators to the use of the tool highlighting the negative impact of mental health contexts. Our study indicated that inter-individual factors are likely to be most important to implementation, given their potential to transcend meso and macro level

  15. Transparency in decision-making processes governing hazardous activities

    DEFF Research Database (Denmark)

    Rasmussen, B.; Jensen, K.K.; Sandøe, P.

    2007-01-01

    Transparent decisions are decisions in which the decision maker clearly presents to others the normative and factual premises behind the conclusions and explains the reasoning leading from these premises to the conclusion. Transparency thus involves uncovering, describing, documenting and communi......Transparent decisions are decisions in which the decision maker clearly presents to others the normative and factual premises behind the conclusions and explains the reasoning leading from these premises to the conclusion. Transparency thus involves uncovering, describing, documenting....... Transparency in this sense demands new efforts from the authorities and scientific advisors....

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

    Science.gov (United States)

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

    2015-12-01

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

  17. Creativity Assessment in the Context of Maker-Based Projects

    Science.gov (United States)

    Lille, Benjamin; Romero, Margarida

    2017-01-01

    Creativity is a key competence in 21st century education. Among the active learning pedagogies which aims to develop creativity, learning by making is an emerging approach in which the students are engaged in the co-creation of a shared artefact. In this study, we aim to analyse the creativity competency through a maker-based projects.…

  18. Biosimilar Makers Hope Court Starts 6-Month Wait Sooner.

    Science.gov (United States)

    Silverman, Ed

    2017-03-01

    The dispute centers on dueling interpretations of the Biologics Price Competition and Innovation Act, which says a company seeking to sell a biosimilar must give the maker of the brand-name biologic at least a 180-day notice before selling its drug.

  19. The Virtual Workplace Ethnography: Positioning Student Writers as Knowledge Makers

    Science.gov (United States)

    Sommers, Jeff

    2015-01-01

    The Virtual Workplace Ethnography is a first-year composition assignment that positions students as knowledge makers by requiring them to apply a theoretical lens ("Working Knowledge") to a video representation of a workplace. The lens provides multiple terms for analysis of workplace behaviors in context, providing a scaffolding for…

  20. The Promise of the Maker Movement for Education

    Science.gov (United States)

    Martin, Lee

    2015-01-01

    The Maker Movement is a community of hobbyists, tinkerers, engineers, hackers, and artists who creatively design and build projects for both playful and useful ends. There is growing interest among educators in bringing making into K-12 education to enhance opportunities to engage in the practices of engineering, specifically, and STEM more…

  1. SMILE Maker : a web-based tool for problem solving

    NARCIS (Netherlands)

    Stoyanov, S.; Aroyo, L.M.; Kommers, Petrus A.M.; Ivanov, Ivan

    1999-01-01

    This paper focuses on the purposes, theoretical model, and functionality of the SMILE (Solution Mapping Intelligent Learning Environment) Maker--a World Wide Web-based problem-solving tool. From an instructional design point of view, an attempt to establish a balance between

  2. Information source exploitation/exploration and NPD decision-making

    DEFF Research Database (Denmark)

    Jespersen, Kristina Risom

    of gate decision-making and information sources was developed across five generic stages (idea, concept, design, test, and commercialization). Our data was generated with a participatory agent-based simulation of NPD gate decision-points in the development process. The sample consists of 134 managers from......The purpose of this study is to examine how the exploration/exploitation continuum is applied by decision-makers in new product gate decision-making. Specifically, we analyze at gate decision-points how the evaluation of a new product project is affected by the information source exploitation....../exploration search behavior of decision-makers. In addition, overexploitation and overexploration in new product development decision-making is investigated through mediating effects of perceived information usefulness and applied performance criteria by decision-makers at gates. To this end a conceptual model...

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

    Directory of Open Access Journals (Sweden)

    Michael Christensen

    2013-12-01

    Full Text Available Recent theoretical advances allow organizational designers and managers to better understand how decision processes can be improved. These advances allow managers to address a number of critical questions about the structure and process of decision making, issues that are relevant for any kind 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? Is it a good idea to push decision makers beyond their current capacity if doing so increases their error rate by five percent? Where does the injection of inexperienced decision makers hurt the least? We describe an organizational design approach that provides answers to such questions, and we offer specific guidelines that managers can use to improve decision making in their organizations.

  4. Professionalism and nonprofit organizations.

    Science.gov (United States)

    Majone, G

    1984-01-01

    Many professionals prefer to work in nonprofit organizations, rather than in either for-profit or bureaucratic organizations. This preference suggests that nonprofits may be successful in reducing the tension between professional principles and institutional requirements. Professionals in for-profit organizations must submit to the control of a manager who is motivated to overrule them whenever their decisions come into conflict with the goal of profit maximization. Bureaucratic organizations stress predictability of results and adherence to rules as the overriding criteria of evaluation and control. This paper argues that nonprofits are on the whole superior from the point of view of professional ideology and practice. Thus, given a commitment to the values of professionalism, the preference for the nonprofit form becomes understandable, even without the usual assumptions about income-maximizing behavior.

  5. 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:...

  6. Decision analysis: a primer and application to pain-related studies.

    Science.gov (United States)

    Kim, Jaewhan; Nelson, Richard; Biskupiak, Joseph

    2008-01-01

    Decision analysis is a quantitative approach to decision making under uncertainty that explicitly states all relevant components of the decision, including statement of the problem, identification of the perspective of the decision maker, alternative courses of action and their consequences, and a model that illustrates the decision-making process. Decision trees and Markov models are used to provide a simplified version of complex clinical problems to help decision makers understand the risks and benefits of several clinical options. This article provides an introduction to decision analysis by describing the construction of decision trees and Markov models and employing examples from the recent literature.

  7. Family involvement in medical decision-making: Perceptions of nursing and psychology students.

    Science.gov (United States)

    Itzhaki, Michal; Hildesheimer, Galya; Barnoy, Sivia; Katz, Michael

    2016-05-01

    Family members often rely on health care professionals to guide and support them through the decision-making process. Although family involvement in medical decisions should be included in the preservice curriculum for the health care professions, perceptions of students in caring professions on family involvement in medical decision-making have not yet been examined. To examine the perceptions of nursing and psychology students on family involvement in medical decision-making for seriously ill patients. A descriptive cross-sectional design was used. First year undergraduate nursing and psychology students studying for their Bachelor of Arts degree were recruited. Perceptions were assessed with a questionnaire constructed based on the Multi-Attribute Utility Theory (MAUT), which examines decision-maker preferences. The questionnaire consisted of two parts referring to the respondent once as the patient and then as the family caregiver. Questionnaires were completed by 116 nursing students and 156 psychology students. Most were of the opinion that family involvement in decision-making is appropriate, especially when the patient is incapable of making decisions. Nursing students were more inclined than psychology students to think that financial, emotional, and value-based considerations should be part of the family's involvement in decision-making. Both groups of students perceived the emotional consideration as most acceptable, whereas the financial consideration was considered the least acceptable. Nursing and psychology students perceive family involvement in medical decision-making as appropriate. In order to train students to support families in the process of decision-making, further research should examine Shared Decision-Making (SDM) programs, which involve patient and clinician collaboration in health care decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Decision strategy research: system analysis

    Energy Technology Data Exchange (ETDEWEB)

    Carle, B

    2000-07-01

    The objective of SCK-CEN's R and D programme on decision strategies is (1) to develop theories, methods and software tools which help decision makers shape, analyse and understand their decisions; (2) to study group processes in decision making; (3) to apply theories, methods and tools in a context related to nuclear emergency preparedness and more generally to support in a context dealing with ionising radiation; (4) to increase SCK-CEN's knowledge on general emergency preparedness and to introduce SCK-CEN staff to computer supported decision techniques. Ongoing R and D has two components: (1) the study of the use of information and knowledge transfer in group decision processes, and more specific studying important factors when computers are used as information source and communication tool; and (2) the study of preference modelling individually and during group decision processes. Principal achievements in 1999 are described.

  9. Customised DSS and decision conferences

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn; Leleur, Steen

    2009-01-01

    with a multi-criteria decision analysis (MCDA) featuring the REMBRANDT and the swing weights techniques. The approach is presented based on a case study, which concerns the interaction between stakeholders and decision-makers at a decision conference which was set up for the appraisal of proposals...... for the alignment of a high-speed railway line in Sweden. Keyword: Decision Conference, Decision Support Systems, Multi-criteria Decision Analysis, REMBRANDT, Swing Weights...... for appraisals of large transport infrastructure projects. The paper exemplifies how the process at a decision conference can be effectively supported by a DSS customised using appropriate techniques for the specific task in hand. In this respect a conventional cost-benefit analysis (CBA) is combined...

  10. Efficiency and equity considerations in the preferences of health policy-makers in Israel.

    Science.gov (United States)

    Shmueli, Amir; Golan, Ofra; Paolucci, Francesco; Mentzakis, Emmanouil

    2017-01-01

    considerations by health policy-makers. The study explored the trade-off between efficiency and equity considerations in the preferences of health policy-makers in Israel. The way these declarative preferences have been expressed in actual policy decisions remains to be explored.

  11. Donation of surplus frozen embryos for stem cell research or fertility treatment-should medical professionals and healthcare institutions be allowed to exercise undue influence on the informed decision of their former patients?

    Science.gov (United States)

    Heng, Boon Chin

    2006-01-01

    The increasing availability of clinical assisted reproduction has led to an accumulated surplus of frozen embryos within fertility clinics worldwide. Couples that have attained success in clinical assisted reproduction, and have no further desire to reproduce; are often faced with an agonizing dilemma on what to do with their surplus frozen embryos-whether to simply discard them, or donate either for scientific research or to other infertile couples. There is a risk that persons or institutions directly involved in procuring donated embryos will prioritize their own interests over the informed choice of the patient to donate either for scientific research or to other infertile couples. Very often, formerly infertile couples who have attained reproductive success feel an overwhelming sense of gratitude to the fertility doctor handling their treatment. Hence, there is a risk of medical professionals exercising undue influence on their former patients, to sway the final decision to their preferred outcome. In the private practice setting, the preferred outcome would likely be donation for the treatment of other infertile couples; whilst in the case of medical professionals affiliated with research or academic institutions, the preferred outcome would likely be donation for stem cell research.

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

    Science.gov (United States)

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

    2014-05-01

    students, at an early stage of their professional life, to multidisciplinary collaborations and real-world problems involving decisions under uncertainty. An opinion survey conducted before and after the workshop enabled us to observe changes in participants' perspectives on what information and tools should be exchanged between researchers and decision-makers to better address uncertainty. Responses demonstrated a marked shift from a pre-workshop vertical conceptualizations of researcher—user group interaction to a post-workshop horizontal mode: in the former, researchers were portrayed as bestowing data-based products to decision-makers, while in the latter, both sets of actors engaged in institutionalized dialogues and frequent communication, exchanging their needs, expertise, and personnel. In addition to the survey, we will draw on examples from the course evaluation to illustrate the strengths and weaknesses of our approach. By doing so, we seek to encourage the organization of similar events by other universities, with the mid-term goal to improve future dialogue. From a pedagogical perspective, introducing students to these ideas at a very early stage in their research careers is an ideal opportunity to establish new modes of communication with an interdisciplinary perspective and strengthen dialogue between climate researchers, decision-makers and user groups.

  13. "Because I want to be informed, to be part of the decision-making": Patients' insights on informed consent practices by healthcare professionals in South Africa.

    Science.gov (United States)

    Chima, S C

    2015-12-01

    Informed consent (IC) is a legally enforceable right in South Africa based on constitutionally protected rights to bodily integrity and well-being. In terms of the law, patients cannot be involved in medical treatment or research without IC. Healthcare providers must inform patients about diagnosis, risks, benefits, treatment options, and right of refusal in a language patients understand based their literacy level. This study reports an empirical study on patients' perceptions of IC as practiced by doctors and nurses in South Africa. A cross-sectional study, using a bilingual semi-structured questionnaire was conducted among patients attending randomly selected public hospitals in eThekwini Metropolitan Municipality (Durban), KwaZulu-Natal province. Competent patients or legal surrogates were eligible for inclusion. IC was obtained from all participants. Four hundred and four participants completed questionnaires of which 68% were female. The median age of participants was 35 years (range 11-91 years). Most respondents spoke IsiZulu (55%), were single (56%), unemployed (66%), and with secondary school education (69%). Patients were generally informed about the diagnosis (81%), risks (57%), and benefits of treatment (61%). Few were informed about treatment options (41%), recommended treatment (28%), and right of refusal (25%). IC was obtained verbally in 73% of cases. Patients favored disclosure of all material risks (78%) and few consulted surrogates before decision-making (76%). There was an association between participant's age and knowledge of the age of consent (P = 0.005). Most patients were satisfied with information disclosed (91%) and did not feel coerced. Some were afraid to ask questions for fear of losing free treatment (8%). This study reveals that South African patients are aware of the right to IC, but many were vulnerable due to indigence. Barriers to IC include poverty, language, and low educational level. South African patients prefer disclosure

  14. Professional formation of young teacher

    Directory of Open Access Journals (Sweden)

    Едуард Тіберійович Соломка

    2015-11-01

    Full Text Available The article discusses some aspects of professional training of young teachers for vocational and educational activities.The psychological analysis of professional and educational activities of young teachers is conducted. Productive way of developing the ability to solve educational problems can be reflexive training of young teachers, which ensures them study the basics of designing specific educational decisions and organizes active interaction of beginners in the search of productive pedagogical decisions

  15. The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand.

    Science.gov (United States)

    Teerawattananon, Yot; Russell, Steve

    2008-09-26

    This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC) for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Twenty six out of 36 (72%) respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC) in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17%) whose decisions were influenced by economic evaluation evidence. This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions.

  16. Delivering on Equity: Implications for Decision-Makers. Issue Brief #1

    Science.gov (United States)

    Stonemeier, Jennifer; Trader, Barb; Richards, Curtis; Blank, Rolf; East, Bill; Toson, Amy

    2013-01-01

    The SWIFT Center will demonstrate how schools can be transformed to provide inclusive educational opportunities for all students. The SWIFT Center will address the key American goal of equal educational opportunity by assisting schools to reorganize in ways that enable them to fully deliver on inclusive, general education for all…

  17. Software project estimation the fundamentals for providing high quality information to decision makers

    CERN Document Server

    Abran, Alain

    2015-01-01

    Software projects are often late and over-budget and this leads to major problems for software customers. Clearly, there is a serious issue in estimating a realistic, software project budget. Furthermore, generic estimation models cannot be trusted to provide credible estimates for projects as complex as software projects. This book presents a number of examples using data collected over the years from various organizations building software. It also presents an overview of the non-for-profit organization, which collects data on software projects, the International Software Benchmarking Stan

  18. Laboratory Information Management Systems for Forensic Laboratories: A White Paper for Directors and Decision Makers

    Energy Technology Data Exchange (ETDEWEB)

    Anthony Hendrickson; Brian Mennecke; Kevin Scheibe; Anthony Townsend

    2005-10-01

    Modern, forensics laboratories need Laboratory Information Management Systems (LIMS) implementations that allow the lab to track evidentiary items through their examination lifecycle and also serve all pertinent laboratory personnel. The research presented here presents LIMS core requirements as viewed by respondents serving in different forensic laboratory capacities as well as different forensic laboratory environments. A product-development methodology was employed to evaluate the relative value of the key features that constitute a LIMS, in order to develop a set of relative values for these features and the specifics of their implementation. In addition to the results of the product development analysis, this paper also provides an extensive review of LIMS and provides an overview of the preparation and planning process for the successful upgrade or implementation of a LIMS. Analysis of the data indicate that the relative value of LIMS components are viewed differently depending upon respondents' job roles (i.e., evidence technicians, scientists, and lab management), as well as by laboratory size. Specifically, the data show that: (1) Evidence technicians place the most value on chain of evidence capabilities and on chain of custody tracking; (2) Scientists generally place greatest value on report writing and generation, and on tracking daughter evidence that develops during their analyses; (3) Lab. Managers place the greatest value on chain of custody, daughter evidence, and not surprisingly, management reporting capabilities; and (4) Lab size affects LIMS preference in that, while all labs place daughter evidence tracking, chain of custody, and management and analyst report generation as their top three priorities, the order of this prioritization is size dependent.

  19. Using conjoint analysis to develop a system to score research engagement actions by health decision makers.

    Science.gov (United States)

    Makkar, Steve R; Williamson, Anna; Turner, Tari; Redman, Sally; Louviere, Jordan

    2015-04-26

    Effective use of research to inform policymaking can be strengthened by policymakers undertaking various research engagement actions (e.g., accessing, appraising, and applying research). Consequently, we developed a thorough measurement and scoring tool to assess whether and how policymakers undertook research engagement actions in the development of a policy document. This scoring tool breaks down each research engagement action into its key 'subactions' like a checklist. The primary aim was to develop the scoring tool further so that it assigned appropriate scores to each subaction based on its effectiveness for achieving evidence-informed policymaking. To establish the relative effectiveness of these subactions, we conducted a conjoint analysis, which was used to elicit the opinions and preferences of knowledge translation experts. Fifty-four knowledge translation experts were recruited to undertake six choice surveys. Respondents were exposed to combinations of research engagement subactions called 'profiles', and rated on a 1-9 scale whether each profile represented a limited (1-3), moderate (4-6), or extensive (7-9) example of each research engagement action. Generalised estimating equations were used to analyse respondents' choice data, where a utility coefficient was calculated for each subaction. A large utility coefficient indicates that a subaction was influential in guiding experts' ratings of extensive engagement with research. The calculated utilities were used as the points assigned to the subactions in the scoring system. The following subactions yielded the largest utilities and were regarded as the most important components of engaging with research: searching academic literature databases, obtaining systematic reviews and peer-reviewed research, appraising relevance by verifying its applicability to the policy context, appraising quality by evaluating the validity of the method and conclusions, engaging in thorough collaborations with researchers, and undertaking formal research projects to inform the policy in question. We have generated an empirically-derived and context-sensitive method of measuring and scoring the extent to which policymakers engaged with research to inform policy development. The scoring system can be used by organisations to quantify staff research engagement actions and thus provide them with insights into what types of training, systems, and tools might improve their staff's research use capacity.

  20. Potential for the adoption of probabilistic risk assessments by end-users and decision-makers

    DEFF Research Database (Denmark)

    Frewer, Lynn J.; Fischer, Arnout R. H.; van den Brink, Paul J.

    2008-01-01

    -user and regulatory uptake has not been, to date, extensive. A case study, utilizing the Theory of Planned Behavior, was conducted in order to identify potential determinants of end-user adoption of probabilistic risk assessments associated with the ecotoxicological impact of pesticides. Seventy potential end...