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Sample records for video decision aid

  1. Video-based patient decision aids: A scoping review.

    Science.gov (United States)

    Winston, Karin; Grendarova, Petra; Rabi, Doreen

    2017-10-18

    This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    NARCIS (Netherlands)

    Volandes, A.E.; Barry, M.J.; Wood, F.; Elwyn, G.

    2013-01-01

    Objective Decision support tools are increasingly using audio-visual materials. However, disagreement exists about the use of audio-visual materials as they may be subjective and biased. Methods This is a literature review of the major texts for documentary film studies to extrapolate issues of

  3. A Pilot Randomized Trial of a Video Patient Decision Aid to Facilitate Early Intervention Referrals From Primary Care.

    Science.gov (United States)

    Jimenez, Manuel E; DuRivage, Nathalie E; Bezpalko, Orysia; Suh, Andrew; Wade, Roy; Blum, Nathan J; Fiks, Alexander G

    2017-03-01

    Many young children identified with developmental concerns in pediatric settings do not receive early intervention (EI). We assessed the impact of a video decision aid and text message reminder on knowledge and attitudes regarding developmental delay and EI as well as referral completion. We conducted a pilot randomized controlled trial in an urban setting and enrolled 64 parent-child dyads referred to EI. Compared with controls, participants who received the intervention demonstrated increased knowledge regarding developmental delay and EI as well as more favorable attitudes in certain topics. Although we did not find a significant difference between arms in EI intake and evaluation, we found a pattern suggestive of increased intake and evaluation among participants with low health literacy in the intervention arm. Additional study is needed to identify strategies that improve the EI referral process for families and to understand the potential targeted role for decision aids and text messages.

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

    Science.gov (United States)

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

    2013-09-01

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

  5. Improving self-care for heart failure for seniors: the impact of video and written education and decision aids.

    Science.gov (United States)

    Veroff, David R; Sullivan, Lisa A; Shoptaw, E J; Venator, Benjamin; Ochoa-Arvelo, Tamara; Baxter, Jonathan R; Manocchia, Michael; Wennberg, David

    2012-02-01

    Heart failure poses a substantial burden on health care expenditures and quality of life; therefore, strategies to improve health behaviors for heart failure are essential. Highly effective medical decision aids can enable health improvements for people with heart failure. In this randomized controlled study, individuals with heart failure in a private Medicare plan were randomized into either an intervention or control group. Participants in the intervention group received basic program information and a simple fact sheet about heart failure, plus a medical decision aid, Living with Heart Failure DVD and booklet; patients randomized to the control group received the basic written materials only. The study was powered to detect a 5% difference in the primary outcome measure (daily weight monitoring). Participants were surveyed 4 weeks after outreach materials were mailed. There were 480 survey respondents: 246 in the intervention group; 234 in the control group. Intervention group respondents were significantly more likely to weigh themselves daily (P=0.05) than control group respondents (44% versus 38%). The intervention group was more likely than the control group to monitor fluid intake (47% versus 44%) and follow a low-sodium diet (83% versus 77%). Other health behavior differences were not statistically significant. The DVD decision aid increased levels of daily weight monitoring and other important health behaviors. Broad application of inexpensive behavior change interventions, such as a DVD/booklet program, should help to facilitate important, routine self-care behaviors for individuals with heart failure.

  6. Multicriteria methodology for decision aiding

    CERN Document Server

    Roy, Bernard

    1996-01-01

    This is the first comprehensive book to present, in English, the multicriteria methodology for decision aiding In the foreword the distinctive features and main ideas of the European School of MCDA are outlined The twelve chapters are essentially expository in nature, but scholarly in treatment Some questions, which are too often neglected in the literature on decision theory, such as how is a decision made, who are the actors, what is a decision aiding model, how to define the set of alternatives, are discussed Examples are used throughout the book to illustrate the various concepts Ways to model the consequences of each alternative and building criteria taking into account the inevitable imprecisions, uncertainties and indeterminations are described and illustrated The three classical operational approaches of MCDA synthesis in one criterion (including MAUT), synthesis by outranking relations, interactive local judgements, are studied This methodology tries to be a theoretical or intellectual framework dire...

  7. GPS-Aided Video Tracking

    Directory of Open Access Journals (Sweden)

    Udo Feuerhake

    2015-08-01

    Full Text Available Tracking moving objects is both challenging and important for a large variety of applications. Different technologies based on the global positioning system (GPS and video or radio data are used to obtain the trajectories of the observed objects. However, in some use cases, they fail to provide sufficiently accurate, complete and correct data at the same time. In this work we present an approach for fusing GPS- and video-based tracking in order to exploit their individual advantages. In this way we aim to combine the reliability of GPS tracking with the high geometric accuracy of camera detection. For the fusion of the movement data provided by the different devices we use a hidden Markov model (HMM formulation and the Viterbi algorithm to extract the most probable trajectories. In three experiments, we show that our approach is able to deal with challenging situations like occlusions or objects which are temporarily outside the monitored area. The results show the desired increase in terms of accuracy, completeness and correctness.

  8. Severe Weather Forecast Decision Aid

    Science.gov (United States)

    Bauman, William H., III; Wheeler, Mark M.; Short, David A.

    2005-01-01

    This report presents a 15-year climatological study of severe weather events and related severe weather atmospheric parameters. Data sources included local forecast rules, archived sounding data, Cloud-to-Ground Lightning Surveillance System (CGLSS) data, surface and upper air maps, and two severe weather event databases covering east-central Florida. The local forecast rules were used to set threat assessment thresholds for stability parameters that were derived from the sounding data. The severe weather events databases were used to identify days with reported severe weather and the CGLSS data was used to differentiate between lightning and non-lightning days. These data sets provided the foundation for analyzing the stability parameters and synoptic patterns that were used to develop an objective tool to aid in forecasting severe weather events. The period of record for the analysis was May - September, 1989 - 2003. The results indicate that there are certain synoptic patterns more prevalent on days with severe weather and some of the stability parameters are better predictors of severe weather days based on locally tuned threat values. The results also revealed the stability parameters that did not display any skill related to severe weather days. An interactive web-based Severe Weather Decision Aid was developed to assist the duty forecaster by providing a level of objective guidance based on the analysis of the stability parameters, CGLSS data, and synoptic-scale dynamics. The tool will be tested and evaluated during the 2005 warm season.

  9. Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions.

    Science.gov (United States)

    Ameling, Jessica M; Auguste, Priscilla; Ephraim, Patti L; Lewis-Boyer, LaPricia; DePasquale, Nicole; Greer, Raquel C; Crews, Deidra C; Powe, Neil R; Rabb, Hamid; Boulware, L Ebony

    2012-12-01

    Few educational resources have been developed to inform patients' renal replacement therapy (RRT) selection decisions. Patients progressing toward end stage renal disease (ESRD) must decide among multiple treatment options with varying characteristics. Complex information about treatments must be adequately conveyed to patients with different educational backgrounds and informational needs. Decisions about treatment options also require family input, as families often participate in patients' treatment and support patients' decisions. We describe the development, design, and preliminary evaluation of an informational, evidence-based, and patient-and family-centered decision aid for patients with ESRD and varying levels of health literacy, health numeracy, and cognitive function. We designed a decision aid comprising a complementary video and informational handbook. We based our development process on data previously obtained from qualitative focus groups and systematic literature reviews. We simultaneously developed the video and handbook in "stages." For the video, stages included (1) directed interviews with culturally appropriate patients and families and preliminary script development, (2) video production, and (3) screening the video with patients and their families. For the handbook, stages comprised (1) preliminary content design, (2) a mixed-methods pilot study among diverse patients to assess comprehension of handbook material, and (3) screening the handbook with patients and their families. The video and handbook both addressed potential benefits and trade-offs of treatment selections. The 50-minute video consisted of demographically diverse patients and their families describing their positive and negative experiences with selecting a treatment option. The video also incorporated health professionals' testimonials regarding various considerations that might influence patients' and families' treatment selections. The handbook was comprised of written

  10. Development of a decision aid to inform patients’ and families’ renal replacement therapy selection decisions

    Directory of Open Access Journals (Sweden)

    Ameling Jessica M

    2012-12-01

    Full Text Available Abstract Background Few educational resources have been developed to inform patients’ renal replacement therapy (RRT selection decisions. Patients progressing toward end stage renal disease (ESRD must decide among multiple treatment options with varying characteristics. Complex information about treatments must be adequately conveyed to patients with different educational backgrounds and informational needs. Decisions about treatment options also require family input, as families often participate in patients’ treatment and support patients’ decisions. We describe the development, design, and preliminary evaluation of an informational, evidence-based, and patient-and family-centered decision aid for patients with ESRD and varying levels of health literacy, health numeracy, and cognitive function. Methods We designed a decision aid comprising a complementary video and informational handbook. We based our development process on data previously obtained from qualitative focus groups and systematic literature reviews. We simultaneously developed the video and handbook in “stages.” For the video, stages included (1 directed interviews with culturally appropriate patients and families and preliminary script development, (2 video production, and (3 screening the video with patients and their families. For the handbook, stages comprised (1 preliminary content design, (2 a mixed-methods pilot study among diverse patients to assess comprehension of handbook material, and (3 screening the handbook with patients and their families. Results The video and handbook both addressed potential benefits and trade-offs of treatment selections. The 50-minute video consisted of demographically diverse patients and their families describing their positive and negative experiences with selecting a treatment option. The video also incorporated health professionals’ testimonials regarding various considerations that might influence patients’ and families

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

    Science.gov (United States)

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

    2015-06-01

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

  12. AIDS: Administrative Decisions and Constitutional Rights.

    Science.gov (United States)

    Greenlaw, Paul S.; Kohl, John P.

    1993-01-01

    Review of case law in educational administration, hospitals, correctional institutions, and the military shows that, when risk of AIDS transmission is high, courts will support public sector administrators' decisions. Low risk means such decisions as mandatory blood testing will usually be struck down. (SK)

  13. Improving treatment decisions from radiographs: effect of a decision aid

    NARCIS (Netherlands)

    Mileman, P.A.; van den Hout, W.B.

    2009-01-01

    Purpose: To test whether dental students’ accuracy of treatment decision making for dentine caries using radiographs improved after using a decision aid (DA). Methods: Dental students (n = 227) assessed the need for treatment for proximal surfaces of a test set of radiographs for a scenario patient.

  14. Helping the Visually Impaired Student with Electronic Video Visual Aids.

    Science.gov (United States)

    Visualtek, Inc., Santa Monica, CA.

    THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT: Video visual aids are Closed Circuit TV systems (CCTV's) which magnify print and enlarge it electronically upon a screen so partially sighted persons with some residual vision can read and write normal size print. These devices are in use around the world in homes, schools, industries and libraries,…

  15. Decision aid reliance: modeling the effects of decision aid reliability and pressures to perform on reliance behavior

    NARCIS (Netherlands)

    Gomaa, M.I.; Hunton, J.E.; Vaassen, E.H.J.; Carree, M.A.

    2011-01-01

    We investigate the effects of decision aid reliability and pressure to perform on decision aid reliance. A total of 403 students took part in a four (pressures to perform: one through four) by five (decision aid reliability: 50%, 60%, 70%, 80% and 90%) between-participants experiment. We test two

  16. Adaptive Peircean decision aid project summary assessments.

    Energy Technology Data Exchange (ETDEWEB)

    Senglaub, Michael E.

    2007-01-01

    This efforts objective was to identify and hybridize a suite of technologies enabling the development of predictive decision aids for use principally in combat environments but also in any complex information terrain. The technologies required included formal concept analysis for knowledge representation and information operations, Peircean reasoning to support hypothesis generation, Mill's's canons to begin defining information operators that support the first two technologies and co-evolutionary game theory to provide the environment/domain to assess predictions from the reasoning engines. The intended application domain is the IED problem because of its inherent evolutionary nature. While a fully functioning integrated algorithm was not achieved the hybridization and demonstration of the technologies was accomplished and demonstration of utility provided for a number of ancillary queries.

  17. 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.

  18. How does a German audience appraise an American decision aid on early stage breast cancer?

    Science.gov (United States)

    Albrecht, Karoline; Simon, Daniela; Buchholz, Angela; Reuter, Katrin; Frosch, Dominick; Seebauer, Laura; Härter, Martin

    2011-04-01

    To investigate how a German audience appraises an American video-based decision aid on early stage breast cancer for potential use in Germany. A German synchronized voice-over version was produced and subject to different focus groups with patients (n=9), health care providers (n=7) and German health care experts (n=15) using an individual questionnaire-based evaluation and a moderated group discussion. Research questions included a general appraisal of the decision aid and the exploration of adaptation needs for use in Germany. Descriptive statistics were calculated and the qualitative data were analyzed applying an inductive approach to categorize the statements. The general appraisal of the decision aid revealed positive results in all groups, especially with regard to comprehensible presentation of information and integration of patients' testimonials. However, cultural differences between the American decision aid and Germany were debated in all groups. Despite a high general interest and positive appraisal of the decision aid, the results of this study suggest that it cannot just be translated and used in another country. The decision aid needs further cultural adaptation and testing in an implementation study before it can be transferred to Germany. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. 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...

  20. Decision aids for patients facing health treatment or screening decisions: systematic review

    Science.gov (United States)

    O’Connor, Annette M; Rostom, Alaa; Fiset, Valerie; Tetroe, Jacqueline; Entwistle, Vikki; Llewellyn-Thomas, Hilary; Holmes-Rovner, Margaret; Barry, Michael; Jones, Jean

    1999-01-01

    Objective To conduct a systematic review of randomised trials of patient decision aids in improving decision making and outcomes. Design We included randomised trials of interventions providing structured, detailed, and specific information on treatment or screening options and outcomes to aid decision making. Two reviewers independently screened and extracted data on several evaluation criteria. Results were pooled by using weighted mean differences and relative risks. Results 17 studies met the inclusion criteria. Compared with the controls, decision aids produced higher knowledge scores (weighted mean difference=19/100, 95% confidence interval 14 to 25); lower decisional conflict scores (weighted mean difference=−0.3/5, −0.4 to −0.1); more active patient participation in decision making (relative risk = 2.27, 95% confidence interval 1.3 to 4); and no differences in anxiety, satisfaction with decisions (weighted mean difference=0.6/100, −3 to 4), or satisfaction with the decision making process (2/100,−3 to 7). Decision aids had a variable effect on decisions. When complex decision aids were compared with simpler versions, they were better at reducing decisional conflict, improved knowledge marginally, but did not affect satisfaction. Conclusions Decision aids improve knowledge, reduce decisional conflict, and stimulate patients to be more active in decision making without increasing their anxiety. Decision aids have little effect on satisfaction and a variable effect on decisions. The effects on outcomes of decisions (persistence with choice, quality of life) remain uncertain. PMID:10487995

  1. Decision aids to help older people make health decisions : A systematic review and meta-analysis

    NARCIS (Netherlands)

    van Weert, J.C.M.; van Munster, B.C.; Sanders, R.; Spijker, R.; Hooft, L.; Jansen, J.

    2016-01-01

    Background Decision aids have been overall successful in improving the quality of health decision making. However, it is unclear whether the impact of the results of using decision aids also apply to older people (aged 65+). We sought to systematically review randomized controlled trials (RCTs) and

  2. Decision aids to help older people make health decisions : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Van Weert, Julia C M; Van Munster, Barbara C.; Sanders, Remco; Spijker, René; Hooft, Lotty; Jansen, Jesse

    2016-01-01

    Background: Decision aids have been overall successful in improving the quality of health decision making. However, it is unclear whether the impact of the results of using decision aids also apply to older people (aged 65+). We sought to systematically review randomized controlled trials (RCTs) and

  3. Decision aids to help older people make health decisions : a systematic review and meta-analysis

    NARCIS (Netherlands)

    van Weert, Julia C. M.; van Munster, Barbara C.; Sanders, Remco; Spijker, Rene; Hooft, Lotty; Jansen, Jesse

    2016-01-01

    Background: Decision aids have been overall successful in improving the quality of health decision making. However, it is unclear whether the impact of the results of using decision aids also apply to older people (aged 65+). We sought to systematically review randomized controlled trials (RCTs) and

  4. 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.

  5. Geo-Spatial Tactical Decision Aid Systems: Fuzzy Logic for Supporting Decision Making

    National Research Council Canada - National Science Library

    Grasso, Raffaele; Giannecchini, Simone

    2006-01-01

    .... This paper describes a tactical decision aid system based on fuzzy logic reasoning for data fusion and on current Open Geospatial Consortium specifications for interoperability, data dissemination...

  6. Probabilistic Decision Based Block Partitioning for Future Video Coding

    KAUST Repository

    Wang, Zhao

    2017-11-29

    In the latest Joint Video Exploration Team development, the quadtree plus binary tree (QTBT) block partitioning structure has been proposed for future video coding. Compared to the traditional quadtree structure of High Efficiency Video Coding (HEVC) standard, QTBT provides more flexible patterns for splitting the blocks, which results in dramatically increased combinations of block partitions and high computational complexity. In view of this, a confidence interval based early termination (CIET) scheme is proposed for QTBT to identify the unnecessary partition modes in the sense of rate-distortion (RD) optimization. In particular, a RD model is established to predict the RD cost of each partition pattern without the full encoding process. Subsequently, the mode decision problem is casted into a probabilistic framework to select the final partition based on the confidence interval decision strategy. Experimental results show that the proposed CIET algorithm can speed up QTBT block partitioning structure by reducing 54.7% encoding time with only 1.12% increase in terms of bit rate. Moreover, the proposed scheme performs consistently well for the high resolution sequences, of which the video coding efficiency is crucial in real applications.

  7. A framework for explaining reliance on decision aids

    NARCIS (Netherlands)

    Dongen, C.J.G. van; Maanen, P.P. van

    2013-01-01

    This study presents a framework for understanding task and psychological factors affecting reliance on advice from decision aids. The framework describes how informational asymmetries in combination with rational, motivational and heuristic factors explain human reliance behavior. To test hypotheses

  8. JAVAMIX: A Tactical Decision Aid to Evaluate Minefield Clearance Plans

    National Research Council Canada - National Science Library

    Filho, Jose

    2001-01-01

    A Tactical Decision Aid (TDA) for mixed minefield clearance, JAVAMIX, was designed, developed and tested, The TDA uses a Monte Carlo Simulation and it is based on the Monte Carlo option of the TDA MIXER (Washburn, 1995...

  9. Decision Aids: the Effect of Labeling Options on Patient choices and Decision-Making

    Science.gov (United States)

    Dolan, James G.; Cherkasky, Olena A.; Chin, Nancy; Veazie, Peter J.

    2015-01-01

    Background Conscious and unconscious biases can influence how people interpret new information and make decisions. Current standards for creating decision aids, however, do not address this issue. Method Using a 2×2 factorial design we sent surveys to members of two Internet survey panels containing a decision scenario involving a choice between aspirin or a statin drug to lower risk of heart attack and a decision aid. Each aid presented identical information about reduction in heart attack risk and likelihood of a major side effect. They differed in whether the options were labeled and amount of decisional guidance: information only (a balance sheet) versus information plus values clarification (a multicriteria decision analysis). After using the decision aid, participants indicated their preferred medication. Those using a multicriteria decision aid also judged differences in the comparative outcome data provided for the two options and the relative importance of achieving benefits versus avoiding risks in making the decision. Results The study sample size is 536. Participants using decision aids with unlabeled options were more likely to choose a statin: 56% versus 25%, p < 0.001. The type of decision aid made no difference. This effect persists after adjusting for differences in survey company, age, gender, education level, health literacy, and numeracy. Participants using unlabeled decision aids were also more likely to interpret the data presented as favoring a statin with regard to both treatment benefits and risk of side effects (p ≤ 0.01). There were no significant differences in decision priorities (p=0.21). Conclusion Identifying the options in patient decision aids can influence patient preferences and change how they interpret comparative outcome data. PMID:26229084

  10. Decision Aids: The Effect of Labeling Options on Patient Choices and Decision Making.

    Science.gov (United States)

    Dolan, James G; Cherkasky, Olena A; Chin, Nancy; Veazie, Peter J

    2015-11-01

    Conscious and unconscious biases can influence how people interpret new information and make decisions. Current standards for creating decision aids, however, do not address this issue. Using a 2×2 factorial design, we developed surveys that contained a decision scenario (involving a choice between aspirin or a statin drug to lower risk of heart attack) and a decision aid. Each aid presented identical information about reduction in heart attack risk and likelihood of a major side effect. They differed in whether the options were labeled and the amount of decisional guidance: information only (a balance sheet) versus information plus values clarification (a multicriteria decision analysis). We sent the surveys to members of 2 Internet survey panels. After using the decision aid, participants indicated their preferred medication. Those using a multicriteria decision aid also judged differences in the comparative outcome data provided for the 2 options and the relative importance of achieving benefits versus avoiding risks in making the decision. The study sample size was 536. Participants using decision aids with unlabeled options were more likely to choose a statin: 56% versus 25% (P < 0.001). The type of decision aid made no difference. This effect persisted after adjustment for differences in survey company, age, gender, education level, health literacy, and numeracy. Participants using unlabeled decision aids were also more likely to interpret the data presented as favoring a statin with regard to both treatment benefits and risk of side effects (P ≤ 0.01). There were no significant differences in decision priorities (P = 0.21). Identifying the options in patient decision aids can influence patient preferences and change how they interpret comparative outcome data. © The Author(s) 2015.

  11. Text summarization as a decision support aid

    OpenAIRE

    Workman, T Elizabeth; Fiszman, Marcelo; Hurdle, John F

    2012-01-01

    Abstract Background PubMed data potentially can provide decision support information, but PubMed was not exclusively designed to be a point-of-care tool. Natural language processing applications that summarize PubMed citations hold promise for extracting decision support information. The objective of this study was to evaluate the efficiency of a text summarization application called Semantic MEDLINE, enhanced with a novel dynamic summarization method, in identifying decision support data. Me...

  12. A Review of Shared Decision-Making and Patient Decision Aids in Radiation Oncology.

    Science.gov (United States)

    Woodhouse, Kristina Demas; Tremont, Katie; Vachani, Anil; Schapira, Marilyn M; Vapiwala, Neha; Simone, Charles B; Berman, Abigail T

    2017-06-01

    Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.

  13. Feasibility of web-based decision aids in neurological patients

    NARCIS (Netherlands)

    van Til, Janine Astrid; Drossaert, Constance H.C.; Renzenbrink, Gerbert J.; Snoek, Govert J.; Dijkstra, Evelien; Stiggelbout, Anne M.; IJzerman, Maarten Joost

    2010-01-01

    Decision aids (DAs) may be helpful in improving patients' participation in medical decision-making. We investigated the potential for web-based DAs in a rehabilitation population. Two self-administered DAs focused on the treatment of acquired ankle-foot impairment in stroke and the treatment of

  14. Practical Aspects of a Visual Aid to Decision Making

    Science.gov (United States)

    Fisher, Z.; Bailey, R.; Willner, P.

    2012-01-01

    Background: Previous research has demonstrated that people with mild intellectual disabilities (ID) have difficulty in "weighing up" information, defined as integrating disparate items of information in order to reach a decision. However, this problem could be overcome by the use of a visual aid to decision making. In an earlier study,…

  15. Multicriteria decision aid/analysis in finance

    NARCIS (Netherlands)

    J. Spronk (Jaap); R.E. Steuer; C. Zopounidis

    2005-01-01

    textabstractMULTIPLE CRITERIA DECISION ANALYSIS: State of the Art Surveys is the most comprehensive work available to survey the state of the art in MCDA to date. Its 25 chapters are organized in eight parts and are written by 52 international leading experts. Each of these parts covers one of the

  16. Text summarization as a decision support aid

    Directory of Open Access Journals (Sweden)

    Workman T

    2012-05-01

    Full Text Available Abstract Background PubMed data potentially can provide decision support information, but PubMed was not exclusively designed to be a point-of-care tool. Natural language processing applications that summarize PubMed citations hold promise for extracting decision support information. The objective of this study was to evaluate the efficiency of a text summarization application called Semantic MEDLINE, enhanced with a novel dynamic summarization method, in identifying decision support data. Methods We downloaded PubMed citations addressing the prevention and drug treatment of four disease topics. We then processed the citations with Semantic MEDLINE, enhanced with the dynamic summarization method. We also processed the citations with a conventional summarization method, as well as with a baseline procedure. We evaluated the results using clinician-vetted reference standards built from recommendations in a commercial decision support product, DynaMed. Results For the drug treatment data, Semantic MEDLINE enhanced with dynamic summarization achieved average recall and precision scores of 0.848 and 0.377, while conventional summarization produced 0.583 average recall and 0.712 average precision, and the baseline method yielded average recall and precision values of 0.252 and 0.277. For the prevention data, Semantic MEDLINE enhanced with dynamic summarization achieved average recall and precision scores of 0.655 and 0.329. The baseline technique resulted in recall and precision scores of 0.269 and 0.247. No conventional Semantic MEDLINE method accommodating summarization for prevention exists. Conclusion Semantic MEDLINE with dynamic summarization outperformed conventional summarization in terms of recall, and outperformed the baseline method in both recall and precision. This new approach to text summarization demonstrates potential in identifying decision support data for multiple needs.

  17. Text summarization as a decision support aid.

    Science.gov (United States)

    Workman, T Elizabeth; Fiszman, Marcelo; Hurdle, John F

    2012-05-23

    PubMed data potentially can provide decision support information, but PubMed was not exclusively designed to be a point-of-care tool. Natural language processing applications that summarize PubMed citations hold promise for extracting decision support information. The objective of this study was to evaluate the efficiency of a text summarization application called Semantic MEDLINE, enhanced with a novel dynamic summarization method, in identifying decision support data. We downloaded PubMed citations addressing the prevention and drug treatment of four disease topics. We then processed the citations with Semantic MEDLINE, enhanced with the dynamic summarization method. We also processed the citations with a conventional summarization method, as well as with a baseline procedure. We evaluated the results using clinician-vetted reference standards built from recommendations in a commercial decision support product, DynaMed. For the drug treatment data, Semantic MEDLINE enhanced with dynamic summarization achieved average recall and precision scores of 0.848 and 0.377, while conventional summarization produced 0.583 average recall and 0.712 average precision, and the baseline method yielded average recall and precision values of 0.252 and 0.277. For the prevention data, Semantic MEDLINE enhanced with dynamic summarization achieved average recall and precision scores of 0.655 and 0.329. The baseline technique resulted in recall and precision scores of 0.269 and 0.247. No conventional Semantic MEDLINE method accommodating summarization for prevention exists. Semantic MEDLINE with dynamic summarization outperformed conventional summarization in terms of recall, and outperformed the baseline method in both recall and precision. This new approach to text summarization demonstrates potential in identifying decision support data for multiple needs.

  18. Translating Evidence to Facilitate Shared Decision Making: Development and Usability of a Consult Decision Aid Prototype.

    Science.gov (United States)

    Stacey, Dawn; Légaré, France; Lyddiatt, Anne; Giguere, Anik M C; Yoganathan, Manosila; Saarimaki, Anton; Pardo, Jordi Pardo; Rader, Tamara; Tugwell, Peter

    2016-12-01

    The purpose of this study was to translate evidence from Cochrane Reviews into a format that can be used to facilitate shared decision making during the consultation, namely patient decision aids. A systematic development process (a) established a stakeholder committee; (b) developed a prototype according to the International Patient Decision Aid Standards; (c) applied the prototype to a Cochrane Review and used an interview-guided survey to evaluate acceptability/usability; (d) created 12 consult decision aids; and (e) used a Delphi process to reach consensus on considerations for creating a consult decision aid. The 1-page prototype includes (a) a title specifying the decision; (b) information on the health condition, options, benefits/harms with probabilities; (c) an explicit values clarification exercise; and (d) questions to screen for decisional conflict. Hyperlinks provide additional information on definitions, probabilities presented graphically, and references. Fourteen Cochrane Consumer Network members and Cochrane Editorial Unit staff participated. Thirteen reported that it would help patient/clinician discussions and were willing to use and/or recommend it. Seven indicated the right amount of information, six not enough, and one too much. Changes to the prototype were more links to definitions, more white space, and details on GRADE evidence ratings. Creating 12 consult decision aids took about 4 h each. We identified ten considerations when selecting Cochrane Reviews for creating consult decision aids. Using a systematic process, we developed a consult decision aid prototype to be populated with evidence from Cochrane Reviews. It was acceptable and easy to apply. Future studies will evaluate implementation of consult decision aids.

  19. Collaborative Platforms Aid Emergency Decision Making

    Science.gov (United States)

    2013-01-01

    Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."

  20. Decision aid for women considering breast cancer screening

    DEFF Research Database (Denmark)

    Pasternack, Iris; Saalasti-Koskinen, Ulla; Mäkelä, Marjukka

    2011-01-01

    relevant content and format for the decision aid for breast cancer screening. Feedback from women was sought for the draft documents. RESULTS: A decision aid attached to the invitation letter for screening was considered the best way to ensure access to information. In addition, tailored letter templates...... for all phases of the screening program, a poster, and a public website were developed. Initial feedback from users (women, professionals, and service providers), was mainly positive. Six months after publishing, the implementation of the decision aid was still incomplete. CONCLUSIONS: Providing balanced...... information for women invited to breast cancer screening is demanding and requires careful planning. Professionals and service providers need to be engaged in the HTA process to ensure proper dissemination and implementation of the information. End user participation is essential in the formulation...

  1. An entertainment-education colorectal cancer screening decision aid for African American patients: A randomized controlled trial.

    Science.gov (United States)

    Hoffman, Aubri S; Lowenstein, Lisa M; Kamath, Geetanjali R; Housten, Ashley J; Leal, Viola B; Linder, Suzanne K; Jibaja-Weiss, Maria L; Raju, Gottumukkala S; Volk, Robert J

    2017-04-15

    Colorectal cancer screening rates for African American patients remain suboptimal. Patient decision aids designed with an entertainment-education approach have been shown to improve saliency and foster informed decision making. The purpose of this study was to assess whether an entertainment-education decision aid tailored for African American patients improved patients' decision making, attitudes, intentions, or colorectal cancer screening behavior. Eighty-nine participants were randomized to view 1) a patient decision aid video containing culturally tailored information about colorectal cancer screening options and theory-based support in decision making presented in an entertainment-education format or 2) an attention control video about hypertension that contained similarly detailed information. Participants met with their clinician and then completed follow-up questionnaires assessing their knowledge, decisional conflict, self-advocacy, attitudes, perceived social norms, and intentions. At 3 months, completion of screening was assessed by chart review. Viewing the culturally tailored decision aid significantly increased African American patients' knowledge of colorectal cancer screening recommendations and options. It also significantly reduced their decisional conflict and improved their self-advocacy. No significant differences were observed in participants' attitudes, norms, or intentions. At three months, 23% of all patients had completed a colonoscopy. Designing targeted, engaging patient decision aids for groups that receive suboptimal screening holds promise for improving patient decision making and self-advocacy. Additional research is warranted to investigate the effectiveness of such aids in clinical practices with suboptimal screening rates and on downstream behaviors (such as repeat testing). Cancer 2017;123:1401-1408. © 2016 American Cancer Society. © 2016 American Cancer Society.

  2. Using Video as Pedagogy for Globally Connected Learning about the HIV/AIDS Pandemic

    Science.gov (United States)

    Rowan, Diana; Kabwira, Davie; Mmatli, Tlamelo; Rankopo, Morena; Long, Dennis D.

    2012-01-01

    How might U.S. social work students' perceptions of HIV/AIDS differ from those of social work students in sub-Saharan Africa? Furthermore, what can students learn from hearing how students from other countries view them? Social work students in the United States, Botswana, and Malawi were video-recorded; they then viewed the videos of students at…

  3. Hierarchical outranking methods for multi-criteria decision aiding

    OpenAIRE

    Del Vasto Terrientes, Luis Miguel

    2015-01-01

    Multi-Criteria Decision Aiding (MCDA) methods support complex decision making involving multiple and conflictive criteria. MCDA distinguishes two main approaches to deal with this type of problems: utility-based and outranking methods, each with its own strengths and weaknesses. Outranking methods are based on social choice models combined with Artificial Intelligence techniques (such as the management of categorical data or uncertainty). They are recognized as providing tools for a realisti...

  4. The effect of patient narratives on information search in a web-based breast cancer decision aid: an eye-tracking study.

    Science.gov (United States)

    Shaffer, Victoria A; Owens, Justin; Zikmund-Fisher, Brian J

    2013-12-17

    Previous research has examined the impact of patient narratives on treatment choices, but to our knowledge, no study has examined the effect of narratives on information search. Further, no research has considered the relative impact of their format (text vs video) on health care decisions in a single study. Our goal was to examine the impact of video and text-based narratives on information search in a Web-based patient decision aid for early stage breast cancer. Fifty-six women were asked to imagine that they had been diagnosed with early stage breast cancer and needed to choose between two surgical treatments (lumpectomy with radiation or mastectomy). Participants were randomly assigned to view one of four versions of a Web decision aid. Two versions of the decision aid included videos of interviews with patients and physicians or videos of interviews with physicians only. To distinguish between the effect of narratives and the effect of videos, we created two text versions of the Web decision aid by replacing the patient and physician interviews with text transcripts of the videos. Participants could freely browse the Web decision aid until they developed a treatment preference. We recorded participants' eye movements using the Tobii 1750 eye-tracking system equipped with Tobii Studio software. A priori, we defined 24 areas of interest (AOIs) in the Web decision aid. These AOIs were either separate pages of the Web decision aid or sections within a single page covering different content. We used multilevel modeling to examine the effect of narrative presence, narrative format, and their interaction on information search. There was a significant main effect of condition, P=.02; participants viewing decision aids with patient narratives spent more time searching for information than participants viewing the decision aids without narratives. The main effect of format was not significant, P=.10. However, there was a significant condition by format interaction on

  5. 3D video bit rate adaptation decision taking using ambient illumination context

    Directory of Open Access Journals (Sweden)

    G. Nur Yilmaz

    2014-09-01

    Full Text Available 3-Dimensional (3D video adaptation decision taking is an open field in which not many researchers have carried out investigations yet compared to 3D video display, coding, etc. Moreover, utilizing ambient illumination as an environmental context for 3D video adaptation decision taking has particularly not been studied in literature to date. In this paper, a user perception model, which is based on determining perception characteristics of a user for a 3D video content viewed under a particular ambient illumination condition, is proposed. Using the proposed model, a 3D video bit rate adaptation decision taking technique is developed to determine the adapted bit rate for the 3D video content to maintain 3D video quality perception by considering the ambient illumination condition changes. Experimental results demonstrate that the proposed technique is capable of exploiting the changes in ambient illumination level to use network resources more efficiently without sacrificing the 3D video quality perception.

  6. Do Visual Aids Really Matter? A Comparison of Student Evaluations before and after Embedding Visuals into Video Lectures

    Science.gov (United States)

    Fish, Kristine; Mun, Jungwon; A'Jontue, RoseAnn

    2016-01-01

    Educational webcasts or video lectures as a teaching tool and a form of visual aid have become widely used with the rising prevalence of online and blended courses and with the increase of web-based video materials. Thus, research pertaining to factors enhancing the effectiveness of video lectures, such as number of visual aids, is critical. This…

  7. The Use of Graphs as Decision Aids in Relation to Information Overload and Managerial Decision Quality.

    Science.gov (United States)

    Chan, Siu Y.

    2001-01-01

    Discussion of information overload focuses on a study of masters degree students at a Hong Kong university that investigated the effectiveness of graphs as decision aids to reduce adverse effects of information overload on decision quality. Results of a simulation of a business prediction task with a sample of business managers are presented.…

  8. Decision aiding in plastic surgery: a multicriteria analysis

    Directory of Open Access Journals (Sweden)

    Luiz Flávio Autran Monteiro Gomes

    2012-08-01

    Full Text Available The aim of this article is to present, through a real case, a practical way, based on Multicriteria Decision Aiding, to support decision making in Plastic Surgery. The case studied was a Caucasian woman of 36 years of age with mammarian hypertrophia with ptosis and abdominal lipodystrophy, making it necessary to select the most adequate techniques for the best aesthetic result. For this purpose, the multicriteria methods Even Swaps and PrOACT were used. Three plastic surgeons working in the city of Rio de Janeiro with equivalent professional experience were consulted as decision agents. In order to define the objectives to be achieved, the criteria relevant to the making of the decision and the alternatives which could be used were identified. Throughout this identification and in the later analysis the surgeons participated in the application of the methods, which contributed towards facilitating their acceptance of the multicriteria analysis in their decision making. It was confirmed, in this case study, that the use of Multicriteria Decision Aiding tends to make the medical decision more wide ranging and, above all, transparent. The plastic surgeons themselves validated the analysis, considering it fully consistent with their professional experience.

  9. Aiding Lay Decision Making Using a Cognitive Competencies Approach

    Science.gov (United States)

    Maule, A. J.; Maule, Simon

    2016-01-01

    Two prescriptive approaches have evolved to aid human decision making: just in time interventions that provide support as a decision is being made; and just in case interventions that educate people about future events that they may encounter so that they are better prepared to make an informed decision when these events occur. We review research on these two approaches developed in the context of supporting everyday decisions such as choosing an apartment, a financial product or a medical procedure. We argue that the lack of an underlying prescriptive theory has limited the development and evaluation of these interventions. We draw on recent descriptive research on the cognitive competencies that underpin human decision making to suggest new ways of interpreting how and why existing decision aids may be effective and suggest a different way of evaluating their effectiveness. We also briefly outline how our approach has the potential to develop new interventions to support everyday decision making and highlight the benefits of drawing on descriptive research when developing and evaluating interventions. PMID:26779052

  10. Culturally sensitive AIDS educational videos for African American audiences: effects of source, message, receiver, and context.

    Science.gov (United States)

    Herek, G M; Gillis, J R; Glunt, E K; Lewis, J; Welton, D; Capitanio, J P

    1998-10-01

    The importance of using culturally sensitive educational materials in HIV-related interventions with racial and ethnic minority groups is widely recognized. However, little empirical research has been conducted to assess the relative effectiveness of different techniques for creating culturally sensitive AIDS educational videos. Two field experiments with three samples of African American adults (N = 174, 173, and 143) were conducted to assess how source characteristics (race of communicator), message characteristics (multicultural message vs. culturally specific message), and audience characteristics (racial distrust and AIDS-related distrust) influence proximate (perceptions of the message's credibility and attractiveness) and distal (AIDS-related attitudes, beliefs, and behavioral intentions) output variables for AIDS educational videos. In Study 1, an AIDS video with a culturally specific message was rated as more credible, more attractive, and of higher quality than was a video with a multicultural message. The multicultural message was rated less favorably when delivered by a White announcer than when the announcer was Black. In Study 2, the same pattern was replicated with a second community sample and a campus-based sample. Study 2 also indicated that a multicultural message might be more effective if delivered in a culturally specific context, namely, after audience members watch a culturally specific video. Minimal changes were observed in distal outcome variables. It is argued that influencing proximate output variables is necessary, though not sufficient, for effecting long-term change in AIDS-related attitudes, beliefs, and behaviors.

  11. Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

    Science.gov (United States)

    Dhukaram, Anandhi Vivekanandan; Baber, Chris

    2015-06-01

    Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Advanced text and video analytics for proactive decision making

    Science.gov (United States)

    Bowman, Elizabeth K.; Turek, Matt; Tunison, Paul; Porter, Reed; Thomas, Steve; Gintautas, Vadas; Shargo, Peter; Lin, Jessica; Li, Qingzhe; Gao, Yifeng; Li, Xiaosheng; Mittu, Ranjeev; Rosé, Carolyn Penstein; Maki, Keith; Bogart, Chris; Choudhari, Samrihdi Shree

    2017-05-01

    Today's warfighters operate in a highly dynamic and uncertain world, and face many competing demands. Asymmetric warfare and the new focus on small, agile forces has altered the framework by which time critical information is digested and acted upon by decision makers. Finding and integrating decision-relevant information is increasingly difficult in data-dense environments. In this new information environment, agile data algorithms, machine learning software, and threat alert mechanisms must be developed to automatically create alerts and drive quick response. Yet these advanced technologies must be balanced with awareness of the underlying context to accurately interpret machine-processed indicators and warnings and recommendations. One promising approach to this challenge brings together information retrieval strategies from text, video, and imagery. In this paper, we describe a technology demonstration that represents two years of tri-service research seeking to meld text and video for enhanced content awareness. The demonstration used multisource data to find an intelligence solution to a problem using a common dataset. Three technology highlights from this effort include 1) Incorporation of external sources of context into imagery normalcy modeling and anomaly detection capabilities, 2) Automated discovery and monitoring of targeted users from social media text, regardless of language, and 3) The concurrent use of text and imagery to characterize behaviour using the concept of kinematic and text motifs to detect novel and anomalous patterns. Our demonstration provided a technology baseline for exploiting heterogeneous data sources to deliver timely and accurate synopses of data that contribute to a dynamic and comprehensive worldview.

  13. The Video Role Model as an Enterprise Teaching Aid

    Science.gov (United States)

    Robertson, Martyn; Collins, Amanda

    2003-01-01

    This article examines the need to develop a more enterprising approach to learning by adopting an experiential approach. It specifically examines the use of video case studies of entrepreneurial role models within an enterprise module at Leeds Metropolitan University. The exercise enables students to act as a consultant or counsellor and apply…

  14. Video research: documenting and learning from HIV and AIDS communication strategies for social change in Ghana

    OpenAIRE

    Decosas, Heiko

    2010-01-01

    The dynamic landscape of global communications continually presents new challenges for the design and analysis of media and communication within international development projects. This Masters project uses video and web technology to document, explore and extend the role of communication in a CIDA funded HIV and AIDS stigma reduction project in Ghana, West Africa. The project includes a documentary video entitled: The Challenge of Stigma, Reflections on community education as a pathway to ch...

  15. What information is used in treatment decision aids? A systematic review of the types of evidence populating health decision aids.

    Science.gov (United States)

    Clifford, Amanda M; Ryan, Jean; Walsh, Cathal; McCurtin, Arlene

    2017-02-23

    Patient decision aids (DAs) are support tools designed to provide patients with relevant information to help them make informed decisions about their healthcare. While DAs can be effective in improving patient knowledge and decision quality, it is unknown what types of information and evidence are used to populate such decision tools. Systematic methods were used to identify and appraise the relevant literature and patient DAs published between 2006 and 2015. Six databases (Academic Search Complete, AMED, CINAHL, Biomedical Reference Collection, General Sciences and MEDLINE) and reference list searching were used. Articles evaluating the effectiveness of the DAs were appraised using the Cochrane Risk of Bias tool. The content, quality and sources of evidence in the decision aids were evaluated using the IPDASi-SF and a novel classification system. Findings were synthesised and a narrative analysis was performed on the results. Thirteen studies representing ten DAs met the inclusion criteria. The IPDASI-SF score ranged from 9 to 16 indicating many of the studies met the majority of quality criteria. Sources of evidence were described but reports were sometimes generic or missing important information. The majority of DAs incorporated high quality research evidence including systematic reviews and meta-analyses. Patient and practice evidence was less commonly employed, with only a third of included DAs using these to populate decision aid content. The quality of practice and patient evidence ranged from high to low. Contextual factors were addressed across all DAs to varying degrees and covered a range of factors. This is an initial study examining the information and evidence used to populate DAs. While research evidence and contextual factors are well represented in included DAs, consideration should be given to incorporating high quality information representing all four pillars of evidence based practice when developing DAs. Further, patient and expert practice

  16. An evaluation by teachers of a decision aid for viewing bitewing radiographs

    NARCIS (Netherlands)

    Mileman, P.A.; van den Hout, W.B.

    2008-01-01

    Objectives: To evaluate a new decision aid to improve restorative treatment decision making for proximal caries from bitewing radiographs. Methods: Dental teachers involved in patient treatment and clinical caries diagnosis (n = 31) viewed a computerized decision aid. Whilst using the aid, measures

  17. The Effect of a Decision Aid on the Quality of Colorectal Cancer Screening Decisions

    Science.gov (United States)

    2012-03-29

    of polyps associated with colon cancer are believed to originate as benign adenomatous polyps, which take 7 to 15 years to develop into life ...iii Abstract Title of Dissertation: The Effect of a Decision Aid on the Quality of Colon Cancer Screening Decisions Cecilia Lee, Doctor of...Administration Preventive Medicine and Biometrics Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States. CRC

  18. Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid.

    NARCIS (Netherlands)

    Joseph-Williams, N.; Evans, R.; Edwards, A.; Newcombe, R.G.; Wright, P.; Grol, R.P.T.M.; Elwyn, G.

    2010-01-01

    BACKGROUND: Web-based decision aids are known to have an effect on knowledge, attitude, and behavior; important components of informed decision making. We know what decision aids achieve in randomized controlled trials (RCTs), but we still know very little about how they are used and how this

  19. Does the Use of a Decision Aid Improve Decision Making in Prosthetic Heart Valve Selection? A Multicenter Randomized Trial

    NARCIS (Netherlands)

    Korteland, Nelleke M.; Ahmed, Yunus; Koolbergen, David R.; Brouwer, Marjan; de Heer, Frederiek; Kluin, Jolanda; Bruggemans, Eline F.; Klautz, Robert J. M.; Stiggelbout, Anne M.; Bucx, Jeroen J. J.; Roos-Hesselink, Jolien W.; Polak, Peter; Markou, Thanasie; van den Broek, Inge; Ligthart, Rene; Bogers, Ad J. J. C.; Takkenberg, Johanna J. M.

    2017-01-01

    A Dutch online patient decision aid to support prosthetic heart valve selection was recently developed. A multicenter randomized controlled trial was conducted to assess whether use of the patient decision aid results in optimization of shared decision making in prosthetic heart valve selection. In

  20. Assessing Practitioners’ and Patients’ Needs Regarding Shared Decision-Making and Decision Aids

    Directory of Open Access Journals (Sweden)

    Michiel Hageman

    2016-04-01

    Full Text Available Background: As part of the process of developing a decision aid for carpal tunnel syndrome (CTS according to the Ottawa Decision Support Framework, we were interested in the level of ‘decisional conflict’ of hand surgeons and patients with CTS. This study addresses the null hypothesis that there is no difference between surgeon and patient decisional conflict with respect to test and treatment options for CTS. Secondary analyses assess the impact of patient and physician demographics and the strength of the patient-physician relationship on decisional conflict.   Methods: One-hundred-twenty-three observers of the Science of Variation Group (SOVG and 84 patients with carpal tunnel syndrome completed a survey regarding the Decisional Conflict Scale. Patients also filled out the Pain Self-efficacy Questionnaire (PSEQ and the Patient Doctor Relationship Questionnaire (PDRQ-9.   Results: On average, patients had significantly greater decision conflict and scored higher on most subscales of the decisional conflict scale than hand surgeons.Factors associated with greater decision conflict were specific hand surgeon, less self-efficacy (confidence that one can achieve one’s goals in spite of pain, and higher PDRQ (relationship between patient and doctor. Surgeons from Europe have--on average--significantly more decision conflict than surgeons in the United States of America.   Conclusions: Patients with CTS have more decision conflict than hand surgeons. Decision aids might help narrow this gap in decisional conflict.

  1. A qualitative study of physicians' perceptions of three decision aids.

    Science.gov (United States)

    Graham, Ian D; Logan, Jo; O'Connor, Annette; Weeks, Karen E; Aaron, Shawn; Cranney, Ann; Dales, Robert; Elmslie, Thomas; Hebert, Paul; Jolly, Elaine; Laupacis, Andreas; Mitchell, Susan; Tugwell, Peter

    2003-07-01

    The study objective was to investigate physicians' perceptions of three patient decision aids (DA). Semi-structured telephone interviews were conducted with 20 family physicians and 12 gynecologists about a DA for women considering long-term hormone replacement therapy; with 16 respirologists about a DA for the use of intubation and mechanical ventilation for patients with severe chronic obstructive pulmonary disease; and with 19 physicians (geriatricians, gastroenterologists, internists) about a DA for long-term placement of feeding tubes in the elderly. Participants were identified by a snowball sampling technique. The interviews were analyzed using standard qualitative methods. Most participants (81%) indicated some willingness to use the DAs. The characteristics of the DA viewed positively included it being: balanced, well organized, a useful tool, evidence-based, improves decision making process and multimedia. Some of the negative characteristics were stated as: too complex, the cost, the availability, only appropriate for certain groups of patients, and time consuming. The DAs were acceptable to most participants. Perceived positive and negative factors were similar for all DAs. Uptake of decision aids may be facilitated if physicians have an opportunity to examine and try them, and if they can have unfettered access to them for distribution purposes.

  2. Community Pharmacists' Perspectives of a Decision Aid for Managing Type 2 Diabetes in Ontario.

    Science.gov (United States)

    Verweel, Lee; Gionfriddo, Michael R; MacCallum, Lori; Dolovich, Lisa; Rosenberg-Yunger, Zahava R S

    2017-12-01

    Decision aids are tools designed to help patients make choices about their health care. We explored pharmacists' perceptions of an evidence-based diabetes decision aid developed by the Mayo Clinic, Diabetes Medication Choice (DMC). Using DMC as a reference, we aimed to explore pharmacists' perspectives on decision aids, their place in a community pharmacy setting and the implementing of a decision aid, such as DMC, in Ontario. We used semistructured interviews with a convenience sample of community pharmacists from Ontario. We applied a thematic analysis to the data. We conducted 16 interviews with pharmacists, of whom 9 were certified diabetes educators, and 10 were female. Three themes emerged from the data: pharmacists' knowledge and awareness of decision aids; pharmacists' perceptions of the DMC decision aids, and implementation of the DMC decision aids in Ontario pharmacies. Participants discussed their limited experience with and training in the use of decision aids. Although many participants agreed that the DMC decision aids may contribute to patient-centred care, all agreed that significant changes were needed to be made to implement this tool in practice. Pharmacists felt that the use of decision aids in community pharmacies in Ontario may improve patient-centred care. Modifications, however, are needed to improve the applicability to their context and fit into their workflow. Empirical data concerning the impact of decision aids in community pharmacy is needed. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  3. FIESTA: An operational decision aid for space network fault isolation

    Science.gov (United States)

    Lowe, Dawn; Quillin, Bob; Matteson, Nadine; Wilkinson, Bill; Miksell, Steve

    1987-01-01

    The Fault Tolerance Expert System for Tracking and Data Relay Satellite System (TDRSS) Applications (FIESTA) is a fault detection and fault diagnosis expert system being developed as a decision aid to support operations in the Network Control Center (NCC) for NASA's Space Network. The operational objectives which influenced FIESTA development are presented and an overview of the architecture used to achieve these goals are provided. The approach to the knowledge engineering effort and the methodology employed are also presented and illustrated with examples drawn from the FIESTA domain.

  4. The use of video-based patient education for shared decision-making in the treatment of prostate cancer.

    Science.gov (United States)

    Gomella, L G; Albertsen, P C; Benson, M C; Forman, J D; Soloway, M S

    2000-08-01

    Increased consumerism, patient empowerment, and autonomy are creating a health care revolution. In recent years, the public has become better informed and more sophisticated. An extraordinary amount of treatment advice from books, the media, and the Internet is available to patients today, although much of it is confusing or conflicting. Consequently, the traditional, paternalistic doctor-patient relationship is yielding to a more consumerist one. The new dynamic is based on a participatory ethic and a change in the balance of power. This shared decision-making creates a true partnership between professionals and patients, in which each contributes equally to decisions about treatment or care. Evidence suggests that in diseases such as prostate cancer, where there may be a number of appropriate treatment options for a particular patient, shared decision-making may lead to improved clinical and quality-of-life outcomes. This article explores the evolving relationship between the physician and patient, the pros and cons of shared decision-making, and the use of video technology in the clinical setting. The authors review the use of medical decision aids, including a video-based educational program called CHOICES, in the treatment of prostate cancer and other diseases.

  5. Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making

    National Research Council Canada - National Science Library

    Liu, Shuyan; Schad, Daniel J; Kuschpel, Maxim S; Rapp, Michael A; Heinz, Andreas

    2016-01-01

    .... We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess...

  6. Can people find patient decision aids on the Internet?

    Science.gov (United States)

    Morris, Debra; Drake, Elizabeth; Saarimaki, Anton; Bennett, Carol; O'Connor, Annette

    2008-12-01

    To determine if people could find patient decision aids (PtDAs) on the Internet using the most popular general search engines. We chose five medical conditions for which English language PtDAs were available from at least three different developers. The search engines used were: Google (www.google.com), Yahoo! (www.yahoo.com), and MSN (www.msn.com). For each condition and search engine we ran six searches using a combination of search terms. We coded all non-sponsored Web pages that were linked from the first page of the search results. Most first page results linked to informational Web pages about the condition, only 16% linked to PtDAs. PtDAs were more readily found for the breast cancer surgery decision (our searches found seven of the nine developers). The searches using Yahoo and Google search engines were more likely to find PtDAs. The following combination of search terms: condition, treatment, decision (e.g. breast cancer surgery decision) was most successful across all search engines (29%). While some terms and search engines were more successful, few resulted in direct links to PtDAs. Finding PtDAs would be improved with use of standardized labelling, providing patients with specific Web site addresses or access to an independent PtDA clearinghouse.

  7. Decision Aids Can Support Cancer Clinical Trials Decisions: Results of a Randomized Trial.

    Science.gov (United States)

    Politi, Mary C; Kuzemchak, Marie D; Kaphingst, Kimberly A; Perkins, Hannah; Liu, Jingxia; Byrne, Margaret M

    2016-12-01

    Cancer patients often do not make informed decisions regarding clinical trial participation. This study evaluated whether a web-based decision aid (DA) could support trial decisions compared with our cancer center's website. Adults diagnosed with cancer in the past 6 months who had not previously participated in a cancer clinical trial were eligible. Participants were randomized to view the DA or our cancer center's website (enhanced usual care [UC]). Controlling for whether participants had heard of cancer clinical trials and educational attainment, multivariable linear regression examined group on knowledge, self-efficacy for finding trial information, decisional conflict (values clarity and uncertainty), intent to participate, decision readiness, and trial perceptions. Two hundred patients (86%) consented between May 2014 and April 2015. One hundred were randomized to each group. Surveys were completed by 87 in the DA group and 90 in the UC group. DA group participants reported clearer values regarding trial participation than UC group participants reported (least squares [LS] mean = 15.8 vs. 32, p trial participation among cancer patients facing this preference-sensitive choice. Although better informing patients before trial participation could improve retention, more work is needed to examine DA impact on enrollment and retention. This paper describes evidence regarding a decision tool to support patients' decisions about trial participation. By improving knowledge, helping patients clarify preferences for participation, and facilitating conversations about trials, decision aids could lead to decisions about participation that better match patients' preferences, promoting patient-centered care and the ethical conduct of clinical research. ©AlphaMed Press.

  8. Does training with 3D videos improve decision-making in team invasion sports?

    Science.gov (United States)

    Hohmann, Tanja; Obelöer, Hilke; Schlapkohl, Nele; Raab, Markus

    2016-01-01

    We examined the effectiveness of video-based decision training in national youth handball teams. Extending previous research, we tested in Study 1 whether a three-dimensional (3D) video training group would outperform a two-dimensional (2D) group. In Study 2, a 3D training group was compared to a control group and a group trained with a traditional tactic board. In both studies, training duration was 6 weeks. Performance was measured in a pre- to post-retention design. The tests consisted of a decision-making task measuring quality of decisions (first and best option) and decision time (time for first and best option). The results of Study 1 showed learning effects and revealed that the 3D video group made faster first-option choices than the 2D group, but differences in the quality of options were not pronounced. The results of Study 2 revealed learning effects for both training groups compared to the control group, and faster choices in the 3D group compared to both other groups. Together, the results show that 3D video training is the most useful tool for improving choices in handball, but only in reference to decision time and not decision quality. We discuss the usefulness of a 3D video tool for training of decision-making skills outside the laboratory or gym.

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

    Directory of Open Access Journals (Sweden)

    Glyn Elwyn

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

  10. Is Video Podcast Supplementation as a Learning Aid Beneficial to Dental Students?

    Science.gov (United States)

    Kalludi, Shivananda; Punja, Dhiren; Rao, Raghavendra; Dhar, Murali

    2015-12-01

    Podcasting has recently emerged as an important information technology tool for health professionals. Podcasts can be viewed online or downloaded to a user computer or a handheld multimedia device like a portable MP3 player, smart phone and tablet device. The principal advantage of the podcast is that the presentation of information need not be linked with any particular time or location. Since students are familiar with newer technology tools and may be using it on a regular basis, video podcast could serve as a convenient tool for students to help remember both conceptual and factual information. The purpose of this study was to assess the attitude of first year dental students towards video podcast supplementation and to assess the efficacy of video podcast as a teaching aid in comparison to text book reading. First year dental students were recruited for this study. A didactic lecture class was conducted for the students (n=100). The students were then randomly divided into two groups. Students present in group A (n=46) underwent a video podcast session followed by a multiple choice question test. This was followed by student feedback to assess the usefulness of video podcast. Students belonging to group B (n=54) had a study session for 20 minutes followed by the MCQ test. Students then underwent the video podcast session followed by feedback to assess the utility of video podcast. Mann-Whitney U test was applied to compare the difference in the median MCQ score between the two groups. The findings revealed a significant gain in the median MCQ score in the intervention group (group A) when compared to control group (Group B). In the feedback form, 89% of students agreed that the video podcast might be useful as it would enable them to view slides and hear the lectures repeatedly. Students who underwent the video podcast session performed significantly better in the MCQ test compared to students who underwent text book reading alone. This demonstrates an

  11. Reduction in uptake of PSA tests following decision aids: systematic review of current aids and their evaluations.

    NARCIS (Netherlands)

    Evans, R.; Edwards, A.; Brett, J.; Bradburn, M.; Watson, E.; Austoker, J.; Elwyn, G.

    2005-01-01

    A man's decision to have a prostate-specific antigen (PSA) test should be an informed one. We undertook a systematic review to identify and appraise PSA decision aids and evaluations. We searched 15 electronic databases and hand-searched key journals. We also contacted key authors and organisations.

  12. Development and application of culturally appropriate decision aids for smoking cessation in Korea: a pragmatic clustered randomization crossover trial

    Directory of Open Access Journals (Sweden)

    Lee JE

    2016-09-01

    Full Text Available Ji Eun Lee,1 Dong Wook Shin,1–3 Beomseok Suh,1 Sohyun Chun,4 You-Seon Nam,3 Belong Cho1,2 1Department of Family Medicine, Health Promotion Center, 2Laboratory of Health Promotion and Health Behavior, Biomedical Research Institute, Seoul National University Hospital, 3JW Lee Center for Global Medicine, Seoul National University College of Medicine, 4International Health Services, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea Introduction: In Asian countries, reluctance to seek pharmacological intervention is a major barrier for smoking cessation. Culturally appropriate decision aids are expected to help people in the decision making for the use of smoking cessation medication. Objective: The aim of this study was to develop a culturally tailored decision aid for smoking cessation and evaluate its effect on the use of smoking cessation medication. Patients and methods: A 7-minute video on smoking cessation information and options was developed. Physicians were randomized into intervention and control groups. The decision aid was provided to patients in the intervention group, and they watched it, while those in the control group were provided usual medical care for smoking cessation. The primary outcome was the proportion of smokers who were prescribed smoking cessation medication within 1 month after consultation. The secondary outcomes were abstinence rate and use of smoking cessation medication within 6 months. A logistic regression analysis was used to assess the effect of the decision aid on the outcomes. Results: In total, 414 current smokers (intervention group: 195; control group: 219 were enrolled. The mean age of the participants was 48.2 years, and 381 subjects (92% were males. In total, 11.8% of the participants in the intervention group and 10.5% in the control group were prescribed smoking cessation medications within 1 month. The odds ratio was 1.02 (95% CI: 0.40–2.63 after

  13. Computerized Aid Improves Safety Decision Process for Survivors of Intimate Partner Violence

    Science.gov (United States)

    Glass, Nancy; Eden, Karen B.; Bloom, Tina; Perrin, Nancy

    2010-01-01

    A computerized safety decision aid was developed and tested with Spanish or English-speaking abused women in shelters or domestic violence (DV) support groups (n = 90). The decision aid provides feedback about risk for lethal violence, options for safety, assistance with setting priorities for safety, and a safety plan personalized to the user.…

  14. arriba-lib: evaluation of an electronic library of decision aids in primary care physicians

    Directory of Open Access Journals (Sweden)

    Hirsch Oliver

    2012-06-01

    Full Text Available Abstract Background The successful implementation of decision aids in clinical practice initially depends on how clinicians perceive them. Relatively little is known about the acceptance of decision aids by physicians and factors influencing the implementation of decision aids from their point of view. Our electronic library of decision aids (arriba-lib is to be used within the encounter and has a modular structure containing evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. The aim of our study was to evaluate the acceptance of arriba-lib in primary care physicians. Methods We conducted an evaluation study in which 29 primary care physicians included 192 patients. The physician questionnaire contained information on which module was used, how extensive steps of the shared decision making process were discussed, who made the decision, and a subjective appraisal of consultation length. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Results Only a minority of consultations (8.9% was considered to be unacceptably extended. In 90.6% of consultations, physicians said that a decision could be made. A shared decision was perceived by physicians in 57.1% of consultations. Physicians said that a decision was more likely to be made when therapeutic options were discussed “detailed”. Prior experience with decision aids was not a critical variable for implementation within our sample of primary care physicians. Conclusions Our study showed that it might be feasible to apply our electronic library of decision aids (arriba-lib in the primary care context. Evidence-based decision aids offer support for physicians in the management of medical information. Future studies should monitor the long-term adoption of

  15. Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers.

    Science.gov (United States)

    Trevena, Lyndal J; Zikmund-Fisher, Brian J; Edwards, Adrian; Gaissmaier, Wolfgang; Galesic, Mirta; Han, Paul K J; King, John; Lawson, Margaret L; Linder, Suzanne K; Lipkus, Isaac; Ozanne, Elissa; Peters, Ellen; Timmermans, Danielle; Woloshin, Steven

    2013-01-01

    Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients' risk perception and leads to better informed decision making. This paper summarises current "best practices" in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a "state of the art" summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid "1 in x" formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. A substantial and rapidly expanding evidence base exists for risk

  16. A procurement decision model for a video rental store - A case study

    Directory of Open Access Journals (Sweden)

    BJ Kok

    2007-12-01

    Full Text Available A procurement decision model for a video rental store is presented in this paper. The model is based on inventory management, but many classical inventory management principles are inappropriate since the commodities (movie titles are removed from, and after a certain time period, returned to inventory. The commodities also have a decaying demand in general; hence the video rental store owner (the decision maker is required to procure new titles periodically. The question addressed in this paper is how to determine which movie titles to acquire, and how many copies of each in order to best maximise profit. An approximated demand function is presented, and attributes of movie titles in inventory are used to classify candidate movie titles and predict their future demand. This allows the decision maker to select the most profitable candidate items from a list, whilst remaining within a predetermined budget. The procurement decision model is evaluated by means of predicting the expected turnover using the procurement decision model solution, and then comparing it to the turnover achieved using the procurement strategy followed by the store owner. The model is not prescriptive - the decision maker may still utilise his/her experience to acquire new movie titles. The procurement decision model, however, does assist the decision making process by presenting a point of departure from which procurement decisions may be made.

  17. The perspectives of Iranian physicians and patients towards patient decision aids: a qualitative study.

    Science.gov (United States)

    Rashidian, Hamideh; Nedjat, Saharnaz; Majdzadeh, Reza; Gholami, Jaleh; Haghjou, Leila; Abdollahi, Bahar Sadeghi; Davatchi, Fereydoun; Rashidian, Arash

    2013-09-25

    Patient preference is one of the main components of clinical decision making, therefore leading to the development of patient decision aids. The goal of this study was to describe physicians' and patients' viewpoints on the barriers and limitations of using patient decision aids in Iran, their proposed solutions, and, the benefits of using these tools. This qualitative study was conducted in 2011 in Iran by holding in-depth interviews with 14 physicians and 8 arthritis patient. Interviewees were selected through purposeful and maximum variation sampling. As an example, a patient decision aid on the treatment of knee arthritis was developed upon literature reviews and gathering expert opinion, and was presented at the time of interview. Thematic analysis was conducted to analyze the data by using the OpenCode software. The results were summarized into three categories and ten codes. The extracted categories were the perceived benefits of using the tools, as well as the patient-related and physician-related barriers in using decision aids. The following barriers in using patient decision aids were identified in this study: lack of patients and physicians' trainings in shared decision making, lack of specialist per capita, low treatment tariffs and lack of an exact evaluation system for patient participation in decision making. No doubt these barriers demand the health authorities' special attention. Hence, despite patients and physicians' inclination toward using patient decision aids, these problems have hindered the practical usage of these tools in Iran--as a developing country.

  18. A procurement decision model for a video rental store — A case study

    African Journals Online (AJOL)

    inappropriate since the commodities (movie titles) are removed from, and after a certain time period, returned to inventory. The commodities also have a decaying demand in general; hence the video rental store owner (the decision maker) is required to procure new titles periodically. The question addressed in this paper is ...

  19. A procurement decision model for a video rental store — A case study

    African Journals Online (AJOL)

    eral; hence the video rental store owner (the decision maker) is required to procure new titles periodically. The question addressed in this paper is how to determine which movie titles to acquire, and how many copies of each in order to best maximise profit. An approx- imated demand function is presented, and attributes of ...

  20. Computer aided decision support system for cervical cancer classification

    Science.gov (United States)

    Rahmadwati, Rahmadwati; Naghdy, Golshah; Ros, Montserrat; Todd, Catherine

    2012-10-01

    Conventional analysis of a cervical histology image, such a pap smear or a biopsy sample, is performed by an expert pathologist manually. This involves inspecting the sample for cellular level abnormalities and determining the spread of the abnormalities. Cancer is graded based on the spread of the abnormal cells. This is a tedious, subjective and time-consuming process with considerable variations in diagnosis between the experts. This paper presents a computer aided decision support system (CADSS) tool to help the pathologists in their examination of the cervical cancer biopsies. The main aim of the proposed CADSS system is to identify abnormalities and quantify cancer grading in a systematic and repeatable manner. The paper proposes three different methods which presents and compares the results using 475 images of cervical biopsies which include normal, three stages of pre cancer, and malignant cases. This paper will explore various components of an effective CADSS; image acquisition, pre-processing, segmentation, feature extraction, classification, grading and disease identification. Cervical histological images are captured using a digital microscope. The images are captured in sufficient resolution to retain enough information for effective classification. Histology images of cervical biopsies consist of three major sections; background, stroma and squamous epithelium. Most diagnostic information are contained within the epithelium region. This paper will present two levels of segmentations; global (macro) and local (micro). At the global level the squamous epithelium is separated from the background and stroma. At the local or cellular level, the nuclei and cytoplasm are segmented for further analysis. Image features that influence the pathologists' decision during the analysis and classification of a cervical biopsy are the nuclei's shape and spread; the ratio of the areas of nuclei and cytoplasm as well as the texture and spread of the abnormalities

  1. A generic tool for development of decision aids based on clinical practice guidelines.

    NARCIS (Netherlands)

    Raats, C.J.; Veenendaal, H van; Versluijs, M.M.; Burgers, J.S.

    2008-01-01

    OBJECTIVE: Patient involvement in medical decision making has been suggested to contribute to patients' satisfaction and better patient outcomes. Decision aids are particularly useful for preference-sensitive decisions. Ideally, these should be based on up-to-date evidence-based guidelines. The

  2. Distributed training, testing, and decision aids within one solution

    Science.gov (United States)

    Strini, Robert A.; Strini, Keith

    2002-07-01

    Military air operations in the European theater require U.S. and NATO participants to send various mission experts to 10 Combined Air Operations Centers (CAOCs). Little or no training occurs prior to their arrival for tours of duty ranging between 90 days to 3 years. When training does occur, there is little assessment of its effectiveness in raising CAOC mission readiness. A comprehensive training management system has been developed that utilizes traditional and web based distance-learning methods for providing instruction and task practice as well as distributed simulation to provide mission rehearsal training opportunities on demand for the C2 warrior. This system incorporates new technologies, such as voice interaction and virtual tutors, and a Learning Management System (LMS) that tracks trainee progress from academic learning through procedural practice and mission training exercises. Supervisors can monitor their subordinate's progress through synchronous or asynchronous methods. Embedded within this system are virtual tutors, which provide automated performance measurement as well as tutoring. The training system offers a true time management savings for current instructors and training providers that today must perform On the Job Training (OJT) duties before, during and after each event. Many units do not have the resources to support OJT and are forced to maintain an overlap of several days to minimally maintain unit readiness. One CAOC Commander affected by this paradigm has advocated supporting a beta version of this system to test its ability to offer training on-demand and track the progress of its personnel and unit readiness. If successful, aircrew simulation devices can be connected through either Distributed Interactive Simulation or High Level Architecture methods to provide a DMT-C2 air operations training environment in Europe. This paper presents an approach to establishing a training, testing and decision aid capability and means to assess

  3. The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse

    DEFF Research Database (Denmark)

    Hulbæk, Mette; Primdahl, Jette; Nielsen, Jesper Bo

    The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse.......The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse....

  4. Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making.

    Science.gov (United States)

    Liu, Shuyan; Schad, Daniel J; Kuschpel, Maxim S; Rapp, Michael A; Heinz, Andreas

    2016-01-01

    Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.

  5. Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making.

    Directory of Open Access Journals (Sweden)

    Shuyan Liu

    Full Text Available Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.

  6. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas.

    Science.gov (United States)

    Hoffman, Aubri S; Volk, Robert J; Saarimaki, Anton; Stirling, Christine; Li, Linda C; Härter, Martin; Kamath, Geetanjali R; Llewellyn-Thomas, Hilary

    2013-01-01

    In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension-the delivery of patient decision aids on the Internet-is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. As of 2012, the updated theoretical rationale and emerging evidence suggest potential benefits to delivering patient decision aids on the Internet. However, additional research is needed to identify best practices and quality metrics for Internet-based development, evaluation, and dissemination, particularly in the areas of interactivity, multimedia components, socially-generated information, and implementation strategies.

  7. Can patient decision aids help people make good decisions about participating in clinical trials? A study protocol

    Directory of Open Access Journals (Sweden)

    Fergusson Dean A

    2008-07-01

    Full Text Available Abstract Background Evidence shows that the standard process for obtaining informed consent in clinical trials can be inadequate, with study participants frequently not understanding even basic information fundamental to giving informed consent. Patient decision aids are effective decision support tools originally designed to help patients make difficult treatment or screening decisions. We propose that incorporating decision aids into the informed consent process will improve the extent to which participants make decisions that are informed and consistent with their preferences. A mixed methods study will test this proposal. Methods Phase one of this project will involve assessment of a stratified random sample of 50 consent documents from recently completed investigator-initiated clinical trials, according to existing standards for supporting good decision making. Phase two will involve interviews of a purposive sample of 50 trial participants (10 participants from each of five different clinical areas about their experience of the informed consent process, and how it could be improved. In phase three, we will convert consent forms for two completed clinical trials into decision aids and pilot test these new tools using a user-centered design approach, an iterative development process commonly employed in computer usability literature. In phase four, we will conduct a pilot observational study comparing the new tools to standard consent forms, with potential recruits to two hypothetical clinical trials. Outcomes will include knowledge of key aspects of the decision, knowledge of the probabilities of different outcomes, decisional conflict, the hypothetical participation decision, and qualitative impressions of the experience. Discussion This work will provide initial evidence about whether a patient decision aid can improve the informed consent process. The larger goal of this work is to examine whether study recruitment can be improved from

  8. Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid.

    Science.gov (United States)

    Joseph-Williams, Natalie; Evans, Rhodri; Edwards, Adrian; Newcombe, Robert G; Wright, Patricia; Grol, Richard; Elwyn, Glyn

    2010-05-26

    Web-based decision aids are known to have an effect on knowledge, attitude, and behavior; important components of informed decision making. We know what decision aids achieve in randomized controlled trials (RCTs), but we still know very little about how they are used and how this relates to the informed decision making outcome measures. To examine men's use of an online decision aid for prostate cancer screening using website transaction log files (web-logs), and to examine associations between usage and components of informed decision making. We conducted an observational web-log analysis of users of an online decision aid, Prosdex. Men between 50 and 75 years of age were recruited for an associated RCT from 26 general practices across South Wales, United Kingdom. Men allocated to one arm of the RCT were included in the current study. Time and usage data were derived from website log files. Components of informed decision making were measured by an online questionnaire. Available for analysis were 82 web-logs. Overall, there was large variation in the use of Prosdex. The mean total time spent on the site was 20 minutes. The mean number of pages accessed was 32 (SD 21) out of a possible 60 pages. Significant associations were found between increased usage and increased knowledge (Spearman rank correlation [rho] = 0.69, P limitation in mind. We recommend that web-log analysis should be an integral part of online decision aid development and analysis. ISRCTN48473735; http://www.controlled-trials.com/ISRCTN48473735 (Archived by WebCite at http://www.webcitation.org/5pqeF89tS).

  9. A Generic Approach to the Development of Tactical Decision Aids

    NARCIS (Netherlands)

    Neef, R.M.; Brake, G. te

    2005-01-01

    Military tactics require efficient and effective decision making in unclear, complex and dynamic environments. Tactical decision-makers need to make the right choices based on large amounts of data from various sources with varying reliability and often under severe time-pressure. Therefore decision

  10. Decision support aids with anthropomorphic characteristics influence trust and performance in younger and older adults.

    Science.gov (United States)

    Pak, Richard; Fink, Nicole; Price, Margaux; Bass, Brock; Sturre, Lindsay

    2012-01-01

    This study examined the use of deliberately anthropomorphic automation on younger and older adults' trust, dependence and performance on a diabetes decision-making task. Research with anthropomorphic interface agents has shown mixed effects in judgments of preferences but has rarely examined effects on performance. Meanwhile, research in automation has shown some forms of anthropomorphism (e.g. etiquette) have effects on trust and dependence on automation. Participants answered diabetes questions with no-aid, a non-anthropomorphic aid or an anthropomorphised aid. Trust and dependence in the aid was measured. A minimally anthropomorphic aide primarily affected younger adults' trust in the aid. Dependence, however, for both age groups was influenced by the anthropomorphic aid. Automation that deliberately embodies person-like characteristics can influence trust and dependence on reasonably reliable automation. However, further research is necessary to better understand the specific aspects of the aid that affect different age groups. Automation that embodies human-like characteristics may be useful in situations where there is under-utilisation of reasonably reliable aids by enhancing trust and dependence in that aid. Practitioner Summary: The design of decision-support aids on consumer devices (e.g. smartphones) may influence the level of trust that users place in that system and their amount of use. This study is the first step in articulating how the design of aids may influence user's trust and use of such systems.

  11. Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers

    Science.gov (United States)

    2013-01-01

    Background Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients’ risk perception and leads to better informed decision making. This paper summarises current “best practices” in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. Method An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a “state of the art” summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. Results The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid “1 in x” formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. Conclusion A substantial and

  12. Patient decision aids in routine maternity care: Benefits, barriers, and new opportunities.

    Science.gov (United States)

    Stevens, Gabrielle; Thompson, Rachel; Watson, Bernadette; Miller, Yvette D

    2016-02-01

    Participation in decision-making, supported by comprehensive and quality information provision, is increasingly emphasised as a priority for women in maternity care. Patient decision aids are tools that can offer women greater access to information and guidance to participate in maternity care decision-making. Relative to their evaluation in controlled settings, the implementation of patient decision aids in routine maternity care has received little attention and our understanding of which approaches may be effective is limited. This paper critically discusses the application of patient decision aids in routine maternity care and explores viable solutions for promoting their successful uptake. A range of patient decision aids have been developed for use within maternity care, and controlled trials have highlighted their positive impact on the decision-making process for women. Nevertheless, evidence of successful patient decision aid implementation in real world health care settings is lacking due to practical and ideological barriers that exist. Patient-directed social marketing campaigns are a relatively novel approach to patient decision aid delivery that may facilitate their adoption in maternity care, at least in the short-term, by overcoming common implementation barriers. Social marketing may also be particularly well suited to maternity care, given the unique characteristics of this health context. The potential of social marketing campaigns to facilitate patient decision aid adoption in maternity care highlights the need for pragmatic trials to evaluate their effectiveness. Identifying which sub-groups of women are more or less likely to respond to these strategies will further direct implementation. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  13. A Framework For Design Of Operator Planning/Decision Aids: Expert Systems Approach

    Science.gov (United States)

    Yufik, Yan M.; Sheridan, Thomas B.

    1984-06-01

    This paper suggests an approach to modeling reactor control planning and decision-making which serves as a framework for the design of computer based decision aids. The suggested approach combines two distinct theoretical concepts. The first uses a probabilistic graph to characterize the operator's "internal model" of the system behavior; the second invokes the idea of implicit utility maximization as a generic computational heuristic operating on the graph. The model is used to derive some basic design principles of decision aids that might complement operator decision processes in planning control operations.

  14. Effectiveness of decision aids on smoking cessation in adult patients: a systematic review protocol.

    Science.gov (United States)

    Moyo, Fernea; Archibald, Ella; Slyer, Jason T

    2017-12-01

    The objective of this review is to determine the effectiveness of the use of decision aids in a shared decision-making encounter between any healthcare provider and adult patients who smoke, compared to standard education on smoking cessation, in any healthcare setting.Specifically, the review questions are: What is the effectiveness of the use of decision aids in a shared decision-making encounter in any healthcare setting between the healthcare provider and adult patients who smoke compared to standard education, based on the patient's.

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

    Data.gov (United States)

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

  16. Evaluation of Tactical Decision Aid Programs for Prediction of Field Performance of IR Sensors

    National Research Council Canada - National Science Library

    Goksin, Celalettin

    2000-01-01

    .... Army's ACQUIRE and the infrared module of the Navy/Air Force Tactical Decision Aid (TDA), WinEOTDA. Differences in the modeling of underlying physical principles, input parameters, and treatments are analyzed...

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

    Science.gov (United States)

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

    2016-01-26

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

  18. Use of a patient decision aid for prenatal screening for Down syndrome: what do pregnant women say?

    NARCIS (Netherlands)

    Portocarrero, M.E.; Giguere, A.M.; Lepine, J.; Garvelink, M.M.; Robitaille, H.; Delanoe, A.; Levesque, I.; Wilson, B.J.; Rousseau, F.; Legare, F.

    2017-01-01

    BACKGROUND: Patient decision aids (PtDAs) help people make difficult, values-sensitive decisions. Prenatal screening for assessing the risk of genetic conditions in the fetus is one such decision and patient decision aids are rarely used in this clinical context. We sought to identify factors

  19. Personalised Multi-Criterial Online Decision Support for Siblings Considering Stem Cell Donation: An Interactive Aid.

    Science.gov (United States)

    Kaltoft, Mette Kjer; Salkeld, Glenn; Dowie, Jack

    2016-01-01

    Person-centred decision support combines the best available information on the considerations that matter to the individual, with the importance the person attaches to those considerations. Nurses and other health professionals can benefit from being able to draw on this support within a clinical conversation. A case study and storyline on four siblings facing a transplant coordinator's call to donate stem cells to their brother [1] is 'translated' and used to demonstrate how an interactive multi-criteria aid can be developed for each within a conversational mode. The personalized dialogue and decision aid are accessible online for interaction. Each sibling's decision exemplifies the communication including physical and psychosocial complexities within any decision cascade from call-to-test and to donate, if compatible. A shared template can embrace the informational and ethical aspects of a decision. By interactive decision support within a clinical conversation, each stakeholder can gain a personalised opinion, as well as increased generic health decision literacy [2].

  20. Commander's Decision Aid for Predictive Battlespace Awareness (CDA4PBA)

    National Research Council Canada - National Science Library

    Calhoun, Christopher S; Fitzhugh, Elisabeth W; Klinger, David W

    2006-01-01

    ...), was to develop and demonstrate human-centered decision-making technologies to improve processes, performance, tools, and training to support a commander's predictive battlespace awareness ability...

  1. Do choosing wisely tools meet criteria for patient decision aids? A descriptive analysis of patient materials.

    Science.gov (United States)

    Légaré, France; Hébert, Jessica; Goh, Larissa; Lewis, Krystina B; Leiva Portocarrero, Maria Ester; Robitaille, Hubert; Stacey, Dawn

    2016-08-26

    Choosing Wisely is a remarkable physician-led campaign to reduce unnecessary or harmful health services. Some of the literature identifies Choosing Wisely as a shared decision-making approach. We evaluated the patient materials developed by Choosing Wisely Canada to determine whether they meet the criteria for shared decision-making tools known as patient decision aids. Descriptive analysis of all Choosing Wisely Canada patient materials. In May 2015, we selected all Choosing Wisely Canada patient materials from its official website. Four team members independently extracted characteristics of the English materials using the International Patient Decision Aid Standards (IPDAS) modified 16-item minimum criteria for qualifying and certifying patient decision aids. The research team discussed discrepancies between data extractors and reached a consensus. Descriptive analysis was conducted. Of the 24 patient materials assessed, 12 were about treatments, 11 were about screening and 1 was about prevention. The median score for patient materials using IPDAS criteria was 10/16 (range: 8-11) for screening topics and 6/12 (range: 6-9) for prevention and treatment topics. Commonly missed criteria were stating the decision (21/24 did not), providing balanced information on option benefits/harms (24/24 did not), citing evidence (24/24 did not) and updating policy (24/24 did not). Out of 24 patient materials, only 2 met the 6 IPDAS criteria to qualify as patient decision aids, and neither of these 2 met the 6 certifying criteria. Patient materials developed by Choosing Wisely Canada do not meet the IPDAS minimal qualifying or certifying criteria for patient decision aids. Modifications to the Choosing Wisely Canada patient materials would help to ensure that they qualify as patient decision aids and thus as more effective shared decision-making tools. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  2. Decision aids for respite service choices by carers of people with dementia: development and pilot RCT

    Science.gov (United States)

    2012-01-01

    Background Decision aids are often used to assist individuals confronted with a diagnosis of a serious illness to make decisions about treatment options. However, they are rarely utilised to help those with chronic or age related conditions to make decisions about care services. Decision aids should also be useful for carers of people with decreased decisional capacity. These carers' choices must balance health outcomes for themselves and for salient others with relational and value-based concerns, while relying on information from health professionals. This paper reports on a study that both developed and pilot tested a decision aid aimed at assisting carers to make evaluative judgements of community services, particularly respite care. Methods A mixed method sequential study, involving qualitative development and a pilot randomised controlled trial, was conducted in Tasmania, Australia. We undertook 13 semi-structured interviews and three focus groups to inform the development of the decision aid. For the randomised control trial we randomly assigned 31 carers of people with dementia to either receive the service decision aid at the start or end of the study. The primary outcome was measured by comparing the difference in carer burden between the two groups three months after the intervention group received the decision aid. Pilot data was collected from carers using interviewer-administered questionnaires at the commencement of the project, two weeks and 12 weeks later. Results The qualitative data strongly suggest that the intervention provides carers with needed decision support. Most carers felt that the decision aid was useful. The trial data demonstrated that, using the mean change between baseline and three month follow-up, the intervention group had less increase in burden, a decrease in decisional conflict and increased knowledge compared to control group participants. Conclusions While these results must be interpreted with caution due to the small

  3. Decision aids for respite service choices by carers of people with dementia: development and pilot RCT

    Directory of Open Access Journals (Sweden)

    Stirling Christine

    2012-03-01

    Full Text Available Abstract Background Decision aids are often used to assist individuals confronted with a diagnosis of a serious illness to make decisions about treatment options. However, they are rarely utilised to help those with chronic or age related conditions to make decisions about care services. Decision aids should also be useful for carers of people with decreased decisional capacity. These carers' choices must balance health outcomes for themselves and for salient others with relational and value-based concerns, while relying on information from health professionals. This paper reports on a study that both developed and pilot tested a decision aid aimed at assisting carers to make evaluative judgements of community services, particularly respite care. Methods A mixed method sequential study, involving qualitative development and a pilot randomised controlled trial, was conducted in Tasmania, Australia. We undertook 13 semi-structured interviews and three focus groups to inform the development of the decision aid. For the randomised control trial we randomly assigned 31 carers of people with dementia to either receive the service decision aid at the start or end of the study. The primary outcome was measured by comparing the difference in carer burden between the two groups three months after the intervention group received the decision aid. Pilot data was collected from carers using interviewer-administered questionnaires at the commencement of the project, two weeks and 12 weeks later. Results The qualitative data strongly suggest that the intervention provides carers with needed decision support. Most carers felt that the decision aid was useful. The trial data demonstrated that, using the mean change between baseline and three month follow-up, the intervention group had less increase in burden, a decrease in decisional conflict and increased knowledge compared to control group participants. Conclusions While these results must be interpreted with

  4. Development of a patient decision aid for the treatment of localised prostate cancer: a participatory design approach.

    Science.gov (United States)

    Al-Itejawi, Hoda H M; van Uden-Kraan, Cornelia F; Vis, André N; Nieuwenhuijzen, Jakko A; Hofstee, Myrna J A; van Moorselaar, Reindert Jeroen A; Verdonck-de Leeuw, Irma M

    2016-04-01

    To develop a patient decision aid and to prepare an overview of requirements for implementation. We developed a decision aid that fits the preferences of patients and health care professionals to ensure adequate uptake in clinical practice. A participatory design approach was used to acquire insight into preferences regarding the content and design of a decision aid and into barriers and aspects of the decision aid that facilitate implementation in clinical practice. Three focus group interviews with patients, their partners and health care professionals were conducted. A prototype of the decision aid was developed and presented to patients (n = 14) and health care professionals (n = 13) in semi-structured interviews. Patients (n = 5) participated in a usability study. Data were analysed by two independent coders. Health care professionals considered medical information on treatments and side effects as the most important aspect to be included in the decision aid. Patients also focused on nonmedical considerations, such as location. Both expected the decision aid to support patients in making a treatment choice. According to health care professionals, the oncology nurse was the most suitable to discuss the decision aid with patients, while some patients preferred to discuss the patient decision aid with the urologist. The main barrier to implementation of the decision aid was said to be the expectation that it is time and money consuming, while the incorporation of the decision aid into clinical guidelines and basing the content on these guidelines, would promote implementation. By using a participatory design approach a patient decision aid was designed to meet patients' and health care professionals' needs. Insight was also gained on requirements for implementation. Wide-scale implementation of decision aids is desirable. An overview is provided of requirements for implementation to successfully incorporate a decision aid into clinical practice. © 2016 John

  5. Adaptive mode decision with residual motion compensation for distributed video coding

    DEFF Research Database (Denmark)

    Luong, Huynh Van; Forchhammer, Søren; Slowack, Jurgen

    2013-01-01

    Distributed video coding (DVC) is a coding paradigm that entails low complexity encoding by exploiting the source statistics at the decoder. To improve the DVC coding efficiency, this paper proposes a novel adaptive technique for mode decision to control and take advantage of skip mode and intra...... mode in DVC. The adaptive mode decision is not only based on quality of key frames but also the rate of Wyner-Ziv (WZ) frames. To improve noise distribution estimation for a more accurate mode decision, a residual motion compensation is proposed to estimate a current noise residue based on a previously...... decoded frame. The experimental results show that the proposed adaptive mode decision DVC significantly improves the rate distortion performance without increasing the encoding complexity. For a GOP size of 2 on the set of test sequences, the average bitrate saving of the proposed codec is 35.5% on WZ...

  6. Adaptive mode decision with residual motion compensation for distributed video coding

    DEFF Research Database (Denmark)

    Luong, Huynh Van; Forchhammer, Søren; Slowack, Jurgen

    2015-01-01

    Distributed video coding (DVC) is a coding paradigm that entails low complexity encoding by exploiting the source statistics at the decoder. To improve the DVC coding efficiency, this paper proposes a novel adaptive technique for mode decision to control and take advantage of skip mode and intra...... mode in DVC. The adaptive mode decision is not only based on quality of key frames but also the rate of Wyner-Ziv (WZ) frames. To improve noise distribution estimation for a more accurate mode decision, a residual motion compensation is proposed to estimate a current noise residue based on a previously...... decoded frame. The experimental results show that the proposed adaptive mode decision DVC significantly improves the rate distortion performance without increasing the encoding complexity. For a GOP size of 2 on the set of test sequences, the average bitrate saving of the proposed codec is 35.5% on WZ...

  7. Development of a decision aid for cardiopulmonary resuscitation and invasive mechanical ventilation in the intensive care unit employing user-centered design and a wiki platform for rapid prototyping.

    Science.gov (United States)

    Plaisance, Ariane; Witteman, Holly O; LeBlanc, Annie; Kryworuchko, Jennifer; Heyland, Daren Keith; Ebell, Mark H; Blair, Louisa; Tapp, Diane; Dupuis, Audrey; Lavoie-Bérard, Carole-Anne; McGinn, Carrie Anna; Légaré, France; Archambault, Patrick Michel

    2018-01-01

    decision aid. A video version of the decision aid could clarify its purpose.

  8. A Model of Submarine Emergency Decisionmaking and Decision Aiding

    Science.gov (United States)

    1986-10-01

    even in the absence of psychological effects. In particular, the question may be addressed: with how high an error rate may the aid operate and still...Rationality," Ajiiigm 0 Vl1, No.6, pp. 703-709. [9] Levis, A.H. arid K.L. Boettcher (1983j). "Decisionmaking Organizacions with Acyclical Informafion

  9. How does AIDS illness affect women's residential decisions ...

    African Journals Online (AJOL)

    Women attempt to balance their children's nurturing, in the short and long term, with care of the self. Their efforts do not always succeed and can incur high costs to their wellbeing and relationships with their children. Keywords: care, HIV/AIDS, households, kinship, motherhood, moving house, poverty, social anthropology, ...

  10. A quantitative method for evaluating alternatives. [aid to decision making

    Science.gov (United States)

    Forthofer, M. J.

    1981-01-01

    When faced with choosing between alternatives, people tend to use a number of criteria (often subjective, rather than objective) to decide which is the best alternative for them given their unique situation. The subjectivity inherent in the decision-making process can be reduced by the definition and use of a quantitative method for evaluating alternatives. This type of method can help decision makers achieve degree of uniformity and completeness in the evaluation process, as well as an increased sensitivity to the factors involved. Additional side-effects are better documentation and visibility of the rationale behind the resulting decisions. General guidelines for defining a quantitative method are presented and a particular method (called 'hierarchical weighted average') is defined and applied to the evaluation of design alternatives for a hypothetical computer system capability.

  11. Improving decision making about clinical trial participation - a randomised controlled trial of a decision aid for women considering participation in the IBIS-II breast cancer prevention trial

    National Research Council Canada - National Science Library

    Juraskova, I; Butow, P; Bonner, C; Bell, M L; Smith, A B; Seccombe, M; Boyle, F; Reaby, L; Cuzick, J; Forbes, J F

    2014-01-01

    .... This study investigated whether decision aids (DAs) can reduce decisional difficulties among women considering participation in the International Breast Cancer Intervention Study-II (IBIS-II) trial...

  12. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    Science.gov (United States)

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  13. Effect of patient decision aid was influenced by presurgical evaluation among patients with osteoarthritis of the knee.

    Science.gov (United States)

    Boland, Laura; Taljaard, Monica; Dervin, Geoffrey; Trenaman, Logan; Tugwell, Peter; Pomey, Marie-Pascale; Stacey, Dawn

    2018-02-01

    Decision aids help patients make total joint arthroplasty decisions, but presurgical evaluation might influence the effects of a decision aid. We compared the effects of a decision aid among patients considering total knee arthroplasty at 2 surgical screening clinics with different evaluation processes. We performed a subgroup analysis of a randomized controlled trial. Patients were recruited from 2 surgical screening clinics: an academic clinic providing 20-minute physician consultations and a community clinic providing 45-minute physiotherapist/nurse consultations with education. We compared the effects of decision quality, decisional conflict and surgery rate using Cochran-Mantel-Haenszel χ2 tests and the Breslow-Day test. We evaluated 242 patients: 123 from the academic clinic (61 who used the decision aid and 62 controls) and 119 from the community clinic (59 who used the decision aid and 60 controls). Results suggested a between-site difference in the effect of the decision aid on the patients' decision quality (p = 0.09): at the academic site, patients who used the decision aid were more likely to make better-quality decisions than controls (54% v. 35%, p = 0.044), but not at the community site (47% v. 51%, p = 0.71). Fewer patients who used decision aids at the academic site than at the community site experienced decisional conflict (p = 0.007) (33% v. 52%, p = 0.05 at the academic site and 40% v. 24%, p = 0.08 at the community site). The effect of the decision aid on surgery rates did not differ between sites (p = 0.65). The decision aid had a greater effect at the academic site than at the community site, which provided longer consultations with more verbal education. Hence, decision aids might be of greater value when more extensive total knee arthroplasty presurgical assessment and counselling are either impractical or unavailable.

  14. SOFTWARE PROCESS ASSESSMENT AND IMPROVEMENT USING MULTICRITERIA DECISION AIDING - CONSTRUCTIVIST

    Directory of Open Access Journals (Sweden)

    Leonardo Ensslin

    2012-12-01

    Full Text Available Software process improvement and software process assessment have received special attention since the 1980s. Some models have been created, but these models rest on a normative approach, where the decision-maker’s participation in a software organization is limited to understanding which process is more relevant to each organization. The proposal of this work is to present the MCDA-C as a constructivist methodology for software process improvement and assessment. The methodology makes it possible to visualize the criteria that must be taken into account according to the decision-makers’ values in the process improvement actions, making it possible to rank actions in the light of specific organizational needs. This process helped the manager of the company studied to focus on and prioritize process improvement actions. This paper offers an empirical understanding of the application of performance evaluation to software process improvement and identifies complementary tools to the normative models presented today.

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

    National Research Council Canada - National Science Library

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

    2015-01-01

    ...) can help healthcare providers support women in this decision. Using an environmental scan, we aimed to identify publicly available DAs focusing on prenatal screening/diagnosis for Down syndrome that provide effective support for decision making...

  16. 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

  17. Decision trees and integrated features for computer aided mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Kegelmeyer, W.P. Jr.; Groshong, B.; Allmen, M.; Woods, K.

    1997-02-01

    Breast cancer is a serious problem, which in the United States causes 43,000 deaths a year, eventually striking 1 in 9 women. Early detection is the only effective countermeasure, and mass mammography screening is the only reliable means for early detection. Mass screening has many shortcomings which could be addressed by a computer-aided mammographic screening system. Accordingly, we have applied the pattern recognition methods developed in earlier investigations of speculated lesions in mammograms to the detection of microcalcifications and circumscribed masses, generating new, more rigorous and uniform methods for the detection of both those signs. We have also improved the pattern recognition methods themselves, through the development of a new approach to combinations of multiple classifiers.

  18. Supporting Shared Decision-making for Children's Complex Behavioral Problems: Development and User Testing of an Option Grid™ Decision Aid.

    Science.gov (United States)

    Barnett, Erin R; Boucher, Elizabeth A; Daviss, William B; Elwyn, Glyn

    2018-01-01

    There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid. Researchers included information about a carefully chosen number of psychosocial and pharmacological treatment options, using descriptions based on the best available evidence. Using semi-structured qualitative interviews (n = 18), we conducted user testing with four parents and four clinical prescribers and field testing with four parents, four clinical prescribers, and two clinic administrators. The researchers coded and synthesized the interview responses using mixed inductive and deductive methods. Parents, clinicians, and administrators felt the Option Grid had significant value, although they reported that additional training and other support would be required in order to successfully implement the Option Grid and achieve shared decision-making in clinical practice.

  19. Comparing the effect of a decision aid plus patient navigation with usual care on colorectal cancer screening completion in vulnerable populations: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Brenner, Alison T; Getrich, Christina M; Pignone, Michael; Rhyne, Robert L; Hoffman, Richard M; McWilliams, Andrew; de Hernandez, Brisa Urquieta; Weaver, Mark A; Tapp, Hazel; Harbi, Khalil; Reuland, Daniel

    2014-07-08

    Screening can reduce colorectal cancer (CRC) incidence and mortality. However, screening is underutilized in vulnerable patient populations, particularly among Latinos. Patient-directed decision aids can increase CRC screening knowledge, self-efficacy, and intent; however, their effect on actual screening test completion tends to be modest. This is probably because decision aids do not address some of the patient-specific barriers that prevent successful completion of CRC screening in these populations. These individual barriers might be addressed though patient navigation interventions. This study will test a combined decision aid and patient navigator intervention on screening completion in diverse populations of vulnerable primary care patients. We will conduct a multisite, randomized controlled trial with patient-level randomization. Planned enrollment is 300 patients aged 50 to 75 years at average CRC risk presenting for appointments at two primary clinics in North Carolina and New Mexico. Intervention participants will view a video decision aid immediately before the clinic visit. The 14 to 16 minute video presents information about fecal occult blood tests and colonoscopy and will be viewed on a portable computer tablet in English or Spanish. Clinic-based patient navigators are bilingual and bicultural and will provide both face-to-face and telephone-based navigation. Control participants will view an unrelated food safety video and receive usual care. The primary outcome is completion of a CRC screening test at six months. Planned subgroup analyses include examining intervention effectiveness in Latinos, who will be oversampled. Secondarily, the trial will evaluate the intervention effects on knowledge of CRC screening, self-efficacy, intent, and patient-provider communication. The study will also examine whether patient ethnicity, acculturation, language preference, or health insurance status moderate the intervention effect on CRC screening. This

  20. User-centered design and the development of patient decision aids: protocol for a systematic review.

    Science.gov (United States)

    Witteman, Holly O; Dansokho, Selma Chipenda; Colquhoun, Heather; Coulter, Angela; Dugas, Michèle; Fagerlin, Angela; Giguere, Anik Mc; Glouberman, Sholom; Haslett, Lynne; Hoffman, Aubri; Ivers, Noah; Légaré, France; Légaré, Jean; Levin, Carrie; Lopez, Karli; Montori, Victor M; Provencher, Thierry; Renaud, Jean-Sébastien; Sparling, Kerri; Stacey, Dawn; Vaisson, Gratianne; Volk, Robert J; Witteman, William

    2015-01-26

    Providing patient-centered care requires that patients partner in their personal health-care decisions to the full extent desired. Patient decision aids facilitate processes of shared decision-making between patients and their clinicians by presenting relevant scientific information in balanced, understandable ways, helping clarify patients' goals, and guiding decision-making processes. Although international standards stipulate that patients and clinicians should be involved in decision aid development, little is known about how such involvement currently occurs, let alone best practices. This systematic review consisting of three interlinked subreviews seeks to describe current practices of user involvement in the development of patient decision aids, compare these to practices of user-centered design, and identify promising strategies. A research team that includes patient and clinician representatives, decision aid developers, and systematic review method experts will guide this review according to the Cochrane Handbook and PRISMA reporting guidelines. A medical librarian will hand search key references and use a peer-reviewed search strategy to search MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, the ACM library, IEEE Xplore, and Google Scholar. We will identify articles across all languages and years describing the development or evaluation of a patient decision aid, or the application of user-centered design or human-centered design to tools intended for patient use. Two independent reviewers will assess article eligibility and extract data into a matrix using a structured pilot-tested form based on a conceptual framework of user-centered design. We will synthesize evidence to describe how research teams have included users in their development process and compare these practices to user-centered design methods. If data permit, we will develop a measure of the user-centeredness of development processes and identify practices that are likely

  1. Medical decision-making, adherence and quality of life in people living with HIV/AIDS

    OpenAIRE

    Kremer, Heidemarie

    2004-01-01

    Introduction: The purpose of this study is to describe the decision about antiretroviral therapy (ART) from the perspective of people living with HIV/AIDS (PWHA) and to develop models to reduce decisional conflict and to optimize the quality of life in PWHA. Methods: 79 HIV+ people who had been offered ART by their physicians participated. In the qualitative part of this study, interviews on reasons and sources of information for decision-making and patient-physician relationship were eva...

  2. A multi-criteria decision aid methodology to design electric vehicles public charging networks

    OpenAIRE

    João Raposo; Ana Rodrigues; Carlos Silva; Tomaz Dentinho

    2015-01-01

    This article presents a new multi-criteria decision aid methodology, dynamic-PROMETHEE, here used to design electric vehicle charging networks. In applying this methodology to a Portuguese city, results suggest that it is effective in designing electric vehicle charging networks, generating time and policy based scenarios, considering offer and demand and the city’s urban structure. Dynamic-PROMETHE adds to the already known PROMETHEE’s characteristics other useful features, such as decision ...

  3. INTEGRATED TECHNOLOGY ROADMAPPING TOOL TO AID THE DECISION-MAKING OF R&D INVESTMENTS

    OpenAIRE

    HUSAM ARMAN; NABIL GINDY; MOHAMMAD KABLI; SHIRLEY CAVIN

    2014-01-01

    The technology planning activity that leads to an effective R&D portfolio must involve decisions that are taken under a considerable degree of uncertainty. In this paper, we describe an integrated technology planning approach with the focus on the use of technology roadmapping concept in a systematic process, using dedicated and customized software which utilizes integer linear programming (ILP) tools, to aid decision-makers in selecting the optimum portfolio of R&D projects in the manufactur...

  4. Augmenting communication and decision making in the intensive care unit with a cardiopulmonary resuscitation video decision support tool: a temporal intervention study.

    Science.gov (United States)

    McCannon, Jessica B; O'Donnell, Walter J; Thompson, B Taylor; El-Jawahri, Areej; Chang, Yuchiao; Ananian, Lillian; Bajwa, Ednan K; Currier, Paul F; Parikh, Mihir; Temel, Jennifer S; Cooper, Zara; Wiener, Renda Soylemez; Volandes, Angelo E

    2012-12-01

    Effective communication between intensive care unit (ICU) providers and families is crucial given the complexity of decisions made regarding goals of therapy. Using video images to supplement medical discussions is an innovative process to standardize and improve communication. In this six-month, quasi-experimental, pre-post intervention study we investigated the impact of a cardiopulmonary resuscitation (CPR) video decision support tool upon knowledge about CPR among surrogate decision makers for critically ill adults. We interviewed surrogate decision makers for patients aged 50 and over, using a structured questionnaire that included a four-question CPR knowledge assessment similar to those used in previous studies. Surrogates in the post-intervention arm viewed a three-minute video decision support tool about CPR before completing the knowledge assessment and completed questions about perceived value of the video. We recruited 23 surrogates during the first three months (pre-intervention arm) and 27 surrogates during the latter three months of the study (post-intervention arm). Surrogates viewing the video had more knowledge about CPR (p=0.008); average scores were 2.0 (SD 1.1) and 2.9 (SD 1.2) (out of a total of 4) in pre-intervention and post-intervention arms. Surrogates who viewed the video were comfortable with its content (81% very) and 81% would recommend the video. CPR preferences for patients at the time of ICU discharge/death were distributed as follows: pre-intervention: full code 78%, DNR 22%; post-intervention: full code 59%, DNR 41% (p=0.23).

  5. Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers

    NARCIS (Netherlands)

    Trevena, L.J.; Zikmund-Fisher, B.J.; Edwards, A.; Gaissmaier, W.; Galesic, M.; Han, P.K.J.; King, J.; Lawson, M.L.; Linder, S.K.; Lipkus, I.; Ozanne, E.; Peters, E.; Timmermans, D.R.M.; Woloshin, S.

    2013-01-01

    Background: Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients' risk perception and leads to better informed decision

  6. Which Cooperative Ownership Model Performs Better? A Financial-Decision Aid Approach

    NARCIS (Netherlands)

    Kalogeras, N.; Pennings, J.M.E.; Benos, T.; Doumpos, M.

    2013-01-01

    In this article the financial/ownership structures of agribusiness cooperatives are analyzed to examine whether new cooperative models perform better than the more traditional ones. The assessment procedure introduces a new financial decision-aid approach, which is based on data-analysis techniques

  7. A novel classification method for aid decision of traditional Chinese patent medicines for stroke treatment.

    Science.gov (United States)

    Zhao, Yufeng; Liu, Bo; He, Liyun; Bai, Wenjing; Yu, Xueyun; Cao, Xinyu; Luo, Lin; Rong, Peijing; Zhao, Yuxue; Li, Guozheng; Liu, Baoyan

    2017-09-01

    Traditional Chinese patent medicines are widely used to treat stroke because it has good efficacy in the clinical environment. However, because of the lack of knowledge on traditional Chinese patent medicines, many Western physicians, who are accountable for the majority of clinical prescriptions for such medicine, are confused with the use of traditional Chinese patent medicines. Therefore, the aid-decision method is critical and necessary to help Western physicians rationally use traditional Chinese patent medicines. In this paper, Manifold Ranking is employed to develop the aid-decision model of traditional Chinese patent medicines for stroke treatment. First, 115 stroke patients from three hospitals are recruited in the cross-sectional survey. Simultaneously, traditional Chinese physicians determine the traditional Chinese patent medicines appropriate for each patient. Second, particular indicators are explored to characterize the population feature of traditional Chinese patent medicines for stroke treatment. Moreover, these particular indicators can be easily obtained byWestern physicians and are feasible for widespread clinical application in the future. Third, the aid-decision model of traditional Chinese patent medicines for stroke treatment is constructed based on Manifold Ranking. Experimental results reveal that traditional Chinese patent medicines can be differentiated. Moreover, the proposed model can obtain high accuracy of aid decision.

  8. A study of a Dutch online decision aid for parents of children with ADHD

    NARCIS (Netherlands)

    Ossebaard, Hans Cornelis; van Gemert-Pijnen, Julia E.W.C.; Sorbi, Marjolijn J.; Seydel, E.R.

    2010-01-01

    During a three-month study period, visitors to an online decision aid (DA) for attention deficit hyperactivity disorder (ADHD) were invited to complete an online questionnaire before and after working through the DA. Some 75,000 unique visitors found their way to the page on DAs, although fewer than

  9. Decision-aid design factors in connection with HF communication and emitter location disciplines

    Science.gov (United States)

    Goodman, John M.

    1989-09-01

    The advance of microcomputer technology, the growing sophistication of specified propagation models, and the expanding ability to sense the medium and apply that knowledge in real time is leading to an improvement in the prediction of system performance for tactical users. The maturation of artificial intelligence disciplines should provide the user of advanced C3I decision aids an ability to manage the plethora of information more effectively. Critical aspects of the process of developing useful and cost-effective decision aids are identified with emphasis upon the HF medium which is strongly propagation-limited and controlled by variable and often unpredictable phenomena. A major factor in this field of activity is the evolution of self-adaptive system architecture incorporating imbedded Real Time Channel Evaluation (RTCE). In this context, the decision aid is a process which is operationally transparent to the the user but could be user-defined. A key to the development of an adaptive resource management capability is the integration of a set of tools or decision aids which direct the system to compensate for pathological effects by adjustment of system parameters. The approach is ultimately limited by the accuracy with which the ionosphere or the HF channel may be specified. The accepted specification accuracy will determine the design approaches to be followed.

  10. Biomedical Informatics for Computer-Aided Decision Support Systems: A Survey

    Science.gov (United States)

    Belle, Ashwin; Kon, Mark A.; Najarian, Kayvan

    2013-01-01

    The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest. PMID:23431259

  11. Clinical decision aids for chest pain in the emergency department: identifying low-risk patients

    Directory of Open Access Journals (Sweden)

    Alley W

    2015-11-01

    Full Text Available William Alley, Simon A Mahler Department of Emergency Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA Abstract: Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS. However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients and better direct the workup and care given, many decision aids have been developed. While each may have merit in certain clinical settings, the most useful aid in the emergency department is one that finds all cases of ACS while also identifying a substantial subset of patients at low risk who can be discharged without stress testing or coronary angiography. This review describes several of the chest pain decision aids developed and studied through the recent past, starting with the thrombolysis in myocardial infarction (TIMI risk score and Global Registry of Acute Coronary Events (GRACE scores, which were developed as prognostic aids for patients already diagnosed with ACS, then subsequently validated in the undifferentiated chest pain population. Asia-Pacific Evaluation of Chest Pain Trial (ASPECT; Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins (ADAPT; North American Chest Pain Rule (NACPR; and History, Electrocardiogram, Age, Risk factors, Troponin (HEART score have been developed exclusively for use in the undifferentiated chest pain population as well, with improved performance compared to their predecessors. This review describes the relative merits and limitations of these decision aids so that providers can determine which tool fits the needs of their clinical practice setting. Keywords: chest pain, decision aid, risk score, acute coronary syndrome

  12. Teaching Basic First-Aid Skills against Home Accidents to Children with Autism through Video Modeling

    Science.gov (United States)

    Ergenekon, Yasemin

    2012-01-01

    It is known that children with DD can learn first-aid skills and use whenever needed. Applying first-aid skills was taught to three inclusion students with autism through "first-aid skills training package". In the study multiple probe design with probe trials across behaviors was used. The findings indicated that first-aid skills…

  13. An Integrated Decision-Making Model for Categorizing Weather Products and Decision Aids

    Science.gov (United States)

    Elgin, Peter D.; Thomas, Rickey P.

    2004-01-01

    The National Airspace System s capacity will experience considerable growth in the next few decades. Weather adversely affects safe air travel. The FAA and NASA are working to develop new technologies that display weather information to support situation awareness and optimize pilot decision-making in avoiding hazardous weather. Understanding situation awareness and naturalistic decision-making is an important step in achieving this goal. Information representation and situation time stress greatly influence attentional resource allocation and working memory capacity, potentially obstructing accurate situation awareness assessments. Three naturalistic decision-making theories were integrated to provide an understanding of the levels of decision making incorporated in three operational situations and two conditions. The task characteristics associated with each phase of flight govern the level of situation awareness attained and the decision making processes utilized. Weather product s attributes and situation task characteristics combine to classify weather products according to the decision-making processes best supported. In addition, a graphical interface is described that affords intuitive selection of the appropriate weather product relative to the pilot s current flight situation.

  14. Cultural targeting and tailoring of shared decision making technology: a theoretical framework for improving the effectiveness of patient decision aids in culturally diverse groups.

    Science.gov (United States)

    Alden, Dana L; Friend, John; Schapira, Marilyn; Stiggelbout, Anne

    2014-03-01

    Patient decision aids are known to positively impact outcomes critical to shared decision making (SDM), such as gist knowledge and decision preparedness. However, research on the potential improvement of these and other important outcomes through cultural targeting and tailoring of decision aids is very limited. This is the case despite extensive evidence supporting use of cultural targeting and tailoring to improve the effectiveness of health communications. Building on prominent psychological theory, we propose a two-stage framework incorporating cultural concepts into the design process for screening and treatment decision aids. The first phase recommends use of cultural constructs, such as collectivism and individualism, to differentially target patients whose cultures are known to vary on these dimensions. Decision aid targeting is operationalized through use of symbols and values that appeal to members of the given culture. Content dimensions within decision aids that appear particularly appropriate for targeting include surface level visual characteristics, language, beliefs, attitudes and values. The second phase of the framework is based on evidence that individuals vary in terms of how strongly cultural norms influence their approach to problem solving and decision making. In particular, the framework hypothesizes that differences in terms of access to cultural mindsets (e.g., access to interdependent versus independent self) can be measured up front and used to tailor decision aids. Thus, the second phase in the framework emphasizes the importance of not only targeting decision aid content, but also tailoring the information to the individual based on measurement of how strongly he/she is connected to dominant cultural mindsets. Overall, the framework provides a theory-based guide for researchers and practitioners who are interested in using cultural targeting and tailoring to develop and test decision aids that move beyond a "one-size fits all" approach

  15. Equilibrium Decision Method for Earthquake First-Aid Medicine Allocation Based on Demand Information Updating

    Directory of Open Access Journals (Sweden)

    Yong Ye

    2017-01-01

    Full Text Available The allocation of rescue resources after an earthquake has become a popular research topic in the field of emergency management. The allocation of first-aid medicine for earthquake rescue has stronger time sensitivity than that of general rescue materials. This study focuses on the problem of first-aid medicine allocation in earthquake response. First, we consider the incompleteness and renewal of decision information in an emergency environment, as well as the balance between the risk of decision error and delay. Second, we propose an equilibrium decision method for the allocation of first-aid medicine in earthquake rescue based on information update. This method attempts to realize a fair allocation to all disaster places and minimize total transport time loss. Third, a simulation analysis is performed in which the proposed method is applied to the first-aid medicine allocation problem in the Wenchuan earthquake response. Results show that the method can be used to create a good allocation plan in an earthquake rescue situation.

  16. Show Me My Health Plans: Using a Decision Aid to Improve Decisions in the Federal Health Insurance Marketplace.

    Science.gov (United States)

    Politi, Mary C; Kuzemchak, Marie D; Liu, Jingxia; Barker, Abigail R; Peters, Ellen; Ubel, Peter A; Kaphingst, Kimberly A; McBride, Timothy; Kreuter, Matthew W; Shacham, Enbal; Philpott, Sydney E

    2016-07-01

    Since the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. We designed and evaluated a decision aid, Show Me My Health Plans (SMHP), that provides education, preference assessment, and an annual out-of-pocket cost calculator with plan recommendations produced by a tailored, risk-adjusted algorithm incorporating age, gender, and health status. We evaluated whether SMHP compared to HealthCare.gov improved health insurance decision quality and the match between plan choice, needs, and preferences among 328 Missourians enrolling in the marketplace. Participants who used SMHP had higher health insurance knowledge (LS-Mean = 78 vs. 62; P < 0.001), decision self-efficacy (LS-Mean = 83 vs. 75; P < 0.002), confidence in their choice (LS-Mean = 3.5 vs. 2.9; P < 0.001), and improved health insurance literacy (odds ratio = 2.52, P <0.001) compared to participants using HealthCare.gov. Those using SMHP were 10.3 times more likely to select a silver- or gold-tier plan (P < 0.0001). SMHP can improve health insurance decision quality and the odds that consumers select an insurance plan with coverage likely needed to meet their health needs. This study represents a unique context through which to apply principles of decision support to improve health insurance choices.

  17. Visual Aids for Multimodal Treatment Options to Support Decision Making of Patients with Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Hofmann Sabine

    2012-10-01

    Full Text Available Abstract Background A variety of multimodal treatment options are available for colorectal cancer and many patients want to be involved in decisions about their therapies. However, their desire for autonomy is limited by lack of disease-specific knowledge. Visual aids may be helpful tools to present complex data in an easy-to-understand, graphic form to lay persons. The aim of the present study was to evaluate the treatment preferences of healthy persons and patients using visual aids depicting multimodal treatment options for colorectal cancer. Methods We designed visual aids for treatment scenarios based on four key studies concerning multimodal treatment of colorectal cancer. The visual aids were composed of diagrams depicting outcome parameters and side effects of two treatment options. They were presented to healthy persons (n = 265 and to patients with colorectal cancer (n = 102. Results Most patients and healthy persons could make immediate decisions after seeing the diagrams (range: 88% – 100%. Patients (79% chose the intensive-treatment option in the scenario with a clear survival benefit. In scenarios without survival benefit, all groups clearly preferred the milder treatment option (range: 78% - 90%. No preference was seen in the scenario depicting equally intense treatment options with different timing (neoadjuvant vs. adjuvant but without survival benefit. Conclusions Healthy persons’ and patients’ decisions using visual aids seem to be influenced by quality-of-life aspects rather than recurrence rates especially in situations without survival benefit. In the future visual aids may help to improve the management of patients with colorectal cancer.

  18. Evidence-based patient choice: a prostate cancer decision aid in plain language

    Directory of Open Access Journals (Sweden)

    Ohene-Frempong Janet

    2005-06-01

    Full Text Available Abstract Background Decision aids (DA to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and discussions with doctors in men newly diagnosed with prostate cancer. Methods Document development steps included preparing an evidence-based DA in standard medical parlance, iteratively translating it to emphasize shared decision making and plain language in three formats (booklet, Internet, and audio-tape. Scientific review of medical content was integrated with expert health literacy review of document structure and design. Formative evaluation methods included focus groups (n = 4 and survey of a new sample of men newly diagnosed with prostate cancer (n = 60, compared with historical controls (n = 184. Results A transparent description of the development process and design elements is reported. Formative evaluation among newly diagnosed prostate cancer patients found the DA to be clear and useful in reaching a decision. Newly diagnosed patients reported more discussions with doctors about treatment options, and showed increases in knowledge of side effects of radiation therapy. Conclusion The plain language DA presenting medical evidence in text and numerical formats appears acceptable and useful in decision-making about localized prostate cancer treatment. Further testing should evaluate the impact of all three media on decisions made and quality of life in the survivorship period, especially among very low literacy men.

  19. Decision Aids for Multiple-Decision Disease Management as Affected by Weather Input Errors

    Science.gov (United States)

    Many disease management decision support systems (DSS) rely, exclusively or in part, on weather inputs to calculate an indicator for disease hazard. Error in the weather inputs, typically due to forecasting, interpolation or estimation from off-site sources, may affect model calculations and manage...

  20. Efficient biprediction decision scheme for fast high efficiency video coding encoding

    Science.gov (United States)

    Park, Sang-hyo; Lee, Seung-ho; Jang, Euee S.; Jun, Dongsan; Kang, Jung-Won

    2016-11-01

    An efficient biprediction decision scheme of high efficiency video coding (HEVC) is proposed for fast-encoding applications. For low-delay video applications, bidirectional prediction can be used to increase compression performance efficiently with previous reference frames. However, at the same time, the computational complexity of the HEVC encoder is significantly increased due to the additional biprediction search. Although a some research has attempted to reduce this complexity, whether the prediction is strongly related to both motion complexity and prediction modes in a coding unit has not yet been investigated. A method that avoids most compression-inefficient search points is proposed so that the computational complexity of the motion estimation process can be dramatically decreased. To determine if biprediction is critical, the proposed method exploits the stochastic correlation of the context of prediction units (PUs): the direction of a PU and the accuracy of a motion vector. Through experimental results, the proposed method showed that the time complexity of biprediction can be reduced to 30% on average, outperforming existing methods in view of encoding time, number of function calls, and memory access.

  1. VIDEO DENOISING USING SWITCHING ADAPTIVE DECISION BASED ALGORITHM WITH ROBUST MOTION ESTIMATION TECHNIQUE

    Directory of Open Access Journals (Sweden)

    V. Jayaraj

    2010-08-01

    Full Text Available A Non-linear adaptive decision based algorithm with robust motion estimation technique is proposed for removal of impulse noise, Gaussian noise and mixed noise (impulse and Gaussian with edge and fine detail preservation in images and videos. The algorithm includes detection of corrupted pixels and the estimation of values for replacing the corrupted pixels. The main advantage of the proposed algorithm is that an appropriate filter is used for replacing the corrupted pixel based on the estimation of the noise variance present in the filtering window. This leads to reduced blurring and better fine detail preservation even at the high mixed noise density. It performs both spatial and temporal filtering for removal of the noises in the filter window of the videos. The Improved Cross Diamond Search Motion Estimation technique uses Least Median Square as a cost function, which shows improved performance than other motion estimation techniques with existing cost functions. The results show that the proposed algorithm outperforms the other algorithms in the visual point of view and in Peak Signal to Noise Ratio, Mean Square Error and Image Enhancement Factor.

  2. Dynamic Request Routing for Online Video-on-Demand Service: A Markov Decision Process Approach

    Directory of Open Access Journals (Sweden)

    Jianxiong Wan

    2014-01-01

    Full Text Available We investigate the request routing problem in the CDN-based Video-on-Demand system. We model the system as a controlled queueing system including a dispatcher and several edge servers. The system is formulated as a Markov decision process (MDP. Since the MDP formulation suffers from the so-called “the curse of dimensionality” problem, we then develop a greedy heuristic algorithm, which is simple and can be implemented online, to approximately solve the MDP model. However, we do not know how far it deviates from the optimal solution. To address this problem, we further aggregate the state space of the original MDP model and use the bounded-parameter MDP (BMDP to reformulate the system. This allows us to obtain a suboptimal solution with a known performance bound. The effectiveness of two approaches is evaluated in a simulation study.

  3. Healthcare4VideoStorm: Making Smart Decisions Based on Storm Metrics.

    Science.gov (United States)

    Zhang, Weishan; Duan, Pengcheng; Chen, Xiufeng; Lu, Qinghua

    2016-04-23

    Storm-based stream processing is widely used for real-time large-scale distributed processing. Knowing the run-time status and ensuring performance is critical to providing expected dependability for some applications, e.g., continuous video processing for security surveillance. The existing scheduling strategies' granularity is too coarse to have good performance, and mainly considers network resources without computing resources while scheduling. In this paper, we propose Healthcare4Storm, a framework that finds Storm insights based on Storm metrics to gain knowledge from the health status of an application, finally ending up with smart scheduling decisions. It takes into account both network and computing resources and conducts scheduling at a fine-grained level using tuples instead of topologies. The comprehensive evaluation shows that the proposed framework has good performance and can improve the dependability of the Storm-based applications.

  4. Healthcare4VideoStorm: Making Smart Decisions Based on Storm Metrics

    Directory of Open Access Journals (Sweden)

    Weishan Zhang

    2016-04-01

    Full Text Available Storm-based stream processing is widely used for real-time large-scale distributed processing. Knowing the run-time status and ensuring performance is critical to providing expected dependability for some applications, e.g., continuous video processing for security surveillance. The existing scheduling strategies’ granularity is too coarse to have good performance, and mainly considers network resources without computing resources while scheduling. In this paper, we propose Healthcare4Storm, a framework that finds Storm insights based on Storm metrics to gain knowledge from the health status of an application, finally ending up with smart scheduling decisions. It takes into account both network and computing resources and conducts scheduling at a fine-grained level using tuples instead of topologies. The comprehensive evaluation shows that the proposed framework has good performance and can improve the dependability of the Storm-based applications.

  5. Coaching patients in the use of decision and communication aids: RE-AIM evaluation of a patient support program.

    Science.gov (United States)

    Belkora, Jeff; Volz, Shelley; Loth, Meredith; Teng, Alexandra; Zarin-Pass, Margot; Moore, Dan; Esserman, Laura

    2015-05-28

    Decision aids educate patients about treatment options and outcomes. Communication aids include question lists, consultation summaries, and audio-recordings. In efficacy studies, decision aids increased patient knowledge, while communication aids increased patient question-asking and information recall. Starting in 2004, we trained successive cohorts of post-baccalaureate, pre-medical interns to coach patients in the use of decision and communication aids at our university-based breast cancer clinic. From July 2005 through June 2012, we used the RE-AIM framework to measure Reach, Effectiveness, Adoption, Implementation and Maintenance of our interventions. 1. Reach: Over the study period, our program sent a total of 5,153 decision aids and directly administered 2,004 communication aids. In the most recent program year (2012), out of 1,524 eligible patient appointments, we successfully contacted 1,212 (80%); coached 1,110 (73%) in the self-administered use of decision and communication aids; sent 958 (63%) decision aids; and directly administered communication aids for 419 (27%) patients. In a 2010 survey, coached patients reported self-administering one or more communication aids in 81% of visits 2. Effectiveness: In our pre-post comparisons, decision aids were associated with increased patient knowledge and decreased decisional conflict. Communication aids were associated with increased self-efficacy and number of questions; and with high ratings of patient preparedness and satisfaction 3. Adoption: Among visitors sent decision aids, 82% of survey respondents reviewed some or all; among those administered communication aids, 86% reviewed one or more after the visit 4. Through continuous quality adaptations, we increased the proportion of available staff time used for patient support (i.e. exploitation of workforce capacity) from 29% in 2005 to 84% in 2012 5. Maintenance: The main barrier to sustainability was the cost of paid intern labor. We addressed this by

  6. Entertainment education for informed breast cancer treatment decisions in low-literate women: development and initial evaluation of a patient decision aid.

    Science.gov (United States)

    Jibaja-Weiss, Maria L; Volk, Robert J; Granch, Thomas S; Nefe, Nancy E; Spann, Stephen J; Aoki, Noriaki; Robinson, Emily K; Freidman, Lois C; Beck, J Robert

    2006-01-01

    We report on the development and initial evaluation of a novel computerized decision support system (CDSS) that utilizes concepts from entertainment education (edutainment) to assist low-literate, multiethnic women in making initial surgical treatment decisions. We randomly assigned 51 patients diagnosed with early stage breast cancer to use the decision aid. Patients who viewed the CDSS improved their knowledge of breast cancer treatment; found the application easy to use and understand, informative, and enjoyable; and were less worried about treatment. The system clearly reached its intended objectives to create a usable decision aid for low-literate, novice computer users.

  7. Consumer Decision Making in Online Shopping Environments: The Effects of Interactive Decision Aids

    OpenAIRE

    Gerald Häubl; Valerie Trifts

    2000-01-01

    Despite the explosive growth of electronic commerce and the rapidly increasing number of consumers who use interactive media (such as the World Wide Web) for prepurchase information search and online shopping, very little is known about how consumers make purchase decisions in such settings. A unique characteristic of online shopping environments is that they allow vendors to create retail interfaces with highly interactive features. One desirable form of interactivity from a consumer perspec...

  8. Video-based training to improve perceptual-cognitive decision-making performance of Australian football umpires.

    Science.gov (United States)

    Larkin, Paul; Mesagno, Christopher; Berry, Jason; Spittle, Michael; Harvey, Jack

    2017-03-04

    Decision-making is a central component of the in-game performance of Australian football umpires; however, current umpire training focuses largely on physiological development with decision-making skills development conducted via explicit lecture-style meetings with limited practice devoted to making actual decisions. Therefore, this study investigated the efficacy of a video-based training programme, aimed to provide a greater amount of contextualised visual experiences without explicit instruction, to improve decision-making skills of umpires. Australian football umpires (n = 52) were recruited from metropolitan and regional Division 1 competitions. Participants were randomly assigned to an intervention or control group and classified according to previous umpire game experience (i.e., experienced; less experienced). The intervention group completed a 12-week video-based decision-making training programme, with decision-making performance assessed at pre-training, and 1-week retention and 3-week retention periods. The control group did not complete any video-based training. Results indicated a significant Group (intervention; Control) × Test interaction (F(1, 100) = 3.98; P = 0.02, partial ῆ(2) = 0.074), with follow-up pairwise comparisons indicating significant within-group differences over time for the intervention group. In addition, decision-making performance of the less experienced umpires in the intervention group significantly improved (F(2, 40) = 5.03, P = 0.01, partial ῆ(2) = 0.201). Thus, video-based training programmes may be a viable adjunct to current training programmes to hasten decision-making development, especially for less experienced umpires.

  9. An exploration of decision aid effectiveness: the impact of promoting affective vs. deliberative processing on a health-related decision.

    Science.gov (United States)

    Davis, Esther L; McCaffery, Kirsten; Mullan, Barbara; Juraskova, Ilona

    2015-12-01

    Decision aids (DAs) are non-directive communication tools that help patients make value-consistent health-care decisions. However, most DAs have been developed without an explicit theoretical framework, resulting in a lack of understanding of how DAs achieve outcomes. To investigate the effect of promoting affective vs. deliberative processing on DA effectiveness based on dual-process theory. One hundred and forty-eight female university students participated in a randomized controlled experiment with three conditions: emotion-focused, information-focused and control. Preference-value consistency, knowledge, decisional conflict and satisfaction were compared across the conditions using planned contrast analyses. The intervention comprised two different DAs and instructional manipulations. The emotion-focused condition received a modified DA with affective content and instructions to induce an affective reaction. The information-focused and control conditions received the same DA without the affective content. The information-focused condition received additional instructions to induce deliberative processing. Controlling for the experiment-wise error rate at P affective processing may hinder value-consistent decision making, while deliberative processing may enhance decisional satisfaction. This investigation of the effect of affective and deliberative processes in DA-supported decision making has implications for the design and use of DAs. DA effectiveness may be enhanced by incorporating a simple instruction to focus on the details of the information. © 2014 John Wiley & Sons Ltd.

  10. Clinical decision aids for chest pain in the emergency department: identifying low-risk patients

    Science.gov (United States)

    Alley, William; Mahler, Simon A

    2015-01-01

    Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS). However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients and better direct the workup and care given, many decision aids have been developed. While each may have merit in certain clinical settings, the most useful aid in the emergency department is one that finds all cases of ACS while also identifying a substantial subset of patients at low risk who can be discharged without stress testing or coronary angiography. This review describes several of the chest pain decision aids developed and studied through the recent past, starting with the thrombolysis in myocardial infarction (TIMI) risk score and Global Registry of Acute Coronary Events (GRACE) scores, which were developed as prognostic aids for patients already diagnosed with ACS, then subsequently validated in the undifferentiated chest pain population. Asia-Pacific Evaluation of Chest Pain Trial (ASPECT); Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins (ADAPT); North American Chest Pain Rule (NACPR); and History, Electrocardiogram, Age, Risk factors, Troponin (HEART) score have been developed exclusively for use in the undifferentiated chest pain population as well, with improved performance compared to their predecessors. This review describes the relative merits and limitations of these decision aids so that providers can determine which tool fits the needs of their clinical practice setting. PMID:27147894

  11. Climatological Data Option in My Weather Impacts Decision Aid (MyWIDA) Overview

    Science.gov (United States)

    2017-07-18

    a rules-based tactical decision aid, provides weather effects on weapon systems by coupling weather forecast data with system-specific environmental...day o Global grids o Pressure level o 2.5 ° by 2.5 ° • Higher Fidelity Data with Weather Research and Forecasting (WRF) Model Run The WRF...TES Threshold Evaluation Service WSDL Web Services Description Language XML eXtensible Markup Language WRF Weather Research and Forecasting

  12. Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes

    Science.gov (United States)

    Clarinval, Caroline; Biller-Andorno, Nikola

    2014-01-01

    Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575

  13. [The effects of case-based learning using video on clinical decision making and learning motivation in undergraduate nursing students].

    Science.gov (United States)

    Yoo, Moon-Sook; Park, Jin-Hee; Lee, Si-Ra

    2010-12-01

    The purpose of this study was to examine the effects of case-base learning (CBL) using video on clinical decision-making and learning motivation. This research was conducted between June 2009 and April 2010 as a nonequivalent control group non-synchronized design. The study population was 44 third year nursing students who enrolled in a college of nursing, A University in Korea. The nursing students were divided into the CBL and the control group. The intervention was the CBL with three cases using video. The controls attended a traditional live lecture on the same topics. With questionnaires objective clinical decision-making, subjective clinical decision-making, and learning motivation were measured before the intervention, and 10 weeks after the intervention. Significant group differences were observed in clinical decision-making and learning motivation. The post-test scores of clinical decision-making in the CBL group were statistically higher than the control group. Learning motivation was also significantly higher in the CBL group than in the control group. These results indicate that CBL using video is effective in enhancing clinical decision-making and motivating students to learn by encouraging self-directed learning and creating more interest and curiosity in learning.

  14. Using image processing technology combined with decision tree algorithm in laryngeal video stroboscope automatic identification of common vocal fold diseases.

    Science.gov (United States)

    Jeffrey Kuo, Chung-Feng; Wang, Po-Chun; Chu, Yueng-Hsiang; Wang, Hsing-Won; Lai, Chun-Yu

    2013-10-01

    This study used the actual laryngeal video stroboscope videos taken by physicians in clinical practice as the samples for experimental analysis. The samples were dynamic vocal fold videos. Image processing technology was used to automatically capture the image of the largest glottal area from the video to obtain the physiological data of the vocal folds. In this study, an automatic vocal fold disease identification system was designed, which can obtain the physiological parameters for normal vocal folds, vocal paralysis and vocal nodules from image processing according to the pathological features. The decision tree algorithm was used as the classifier of the vocal fold diseases. The identification rate was 92.6%, and the identification rate with an image recognition improvement processing procedure after classification can be improved to 98.7%. Hence, the proposed system has value in clinical practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Multi-criteria decision analysis for setting priorities on HIV/AIDS interventions in Thailand.

    Science.gov (United States)

    Youngkong, Sitaporn; Teerawattananon, Yot; Tantivess, Sripen; Baltussen, Rob

    2012-02-17

    A wide range of preventive, treatment, and care programs for HIV/AIDS are currently available and some of them have been implemented in Thailand. Policy makers are now facing challenges on how the scarce resources for HIV/AIDS control can be spent more wisely. Although effectiveness and cost-effectiveness information is useful for guiding policy decisions, empirical evidence indicates the importance of other criteria, such as equity and the characteristics of the target population, also play important roles in priority setting. This study aims to experiment with the use of multi-criteria decision analysis (MCDA) to prioritise interventions in HIV/AIDS control in Thailand. We used MCDA to rank 40 HIV/AIDS interventions on the basis of the priority setting criteria put forward by three groups of stakeholders including policy makers, people living with HIV/AIDs (PLWHA), and village health volunteers (VHVs). MCDA incorporated an explicit component of deliberation to let stakeholders reflect on the rank ordering, and adapt where necessary. Upon deliberation, policy makers expressed a preference for programs that target high risk groups such as men who have sex with men, injecting drug users, and female sex workers. The VHVs preferred interventions that target the youth or the general population, and gave lower priority to programs that target high risk groups. PLWHA gave all interventions the same priority. The rank order correlation between the priorities as expressed before and after deliberation was 37% among the policy makers and 46% among the VHVs. This study documented the feasibility of MCDA to prioritize HIV/AIDS interventions in Thailand, and has shown the usefulness of a deliberative process as an integrated component of MCDA. MCDA holds potential to contribute to a more transparent and accountable priority setting process, and further application of this approach in the prioritisation of health interventions is warranted.

  16. Studying complex decision making in natural settings: using a head-mounted video camera to study competitive orienteering.

    Science.gov (United States)

    Omodei, M M; McLennan, J

    1994-12-01

    Head-mounted video recording is described as a potentially powerful method for studying decision making in natural settings. Most alternative data-collection procedures are intrusive and disruptive of the decision-making processes involved while conventional video-recording procedures are either impractical or impossible. As a severe test of the robustness of the methodology we studied the decision making of 6 experienced orienteers who carried a head-mounted light-weight video camera as they navigated, running as fast as possible, around a set of control points in a forest. Use of the Wilcoxon matched-pairs signed-ranks test indicated that compared with free recall, video-assisted recall evoked (a) significantly greater experiential immersion in the recall, (b) significantly more specific recollections of navigation-related thoughts and feelings, (c) significantly more realizations of map and terrain features and aspects of running speed which were not noticed at the time of actual competition, and (d) significantly greater insight into specific navigational errors and the intrusion of distracting thoughts into the decision-making process. Potential applications of the technique in (a) the environments of emergency services, (b) therapeutic contexts, (c) education and training, and (d) sports psychology are discussed.

  17. Decisional equipoise is not decisional conflict: avoiding the false clarity bias in the evaluation of decision aids and Shared Decision Making processes

    DEFF Research Database (Denmark)

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

    2014-01-01

    these criteria weights with the best available evidence on the performance of the two options (have or not have a PSA test) on each criterion, produced a personalised expected value score for each option on a 0 to 1 scale. The Absolute Difference (AD) between the two option scores for each individual......Purposes: To question the use of criteria related to decisional ‘sureness’ in evaluating decision aids and Shared Decision Making processes,- as occurs in the Decisional Conflict Scale (items 10-12) and its reduced form SURE (item 1) - on the ground that decisional equipoise is a legitimate outcome...... that should not affect an evaluation of decision quality or decision support. To investigate the empirical extent of equipoise in a decision aid trial and explore the relationship between degree of equipoise and decision quality as self-assessed by MyDecisionQuality, a dually-personalised instrument that does...

  18. Running wavelet archetype aids the determination of heart rate from the video photoplethysmogram during motion.

    Science.gov (United States)

    Addison, Paul S; Foo, David M H; Jacquel, Dominique

    2017-07-01

    The extraction of heart rate from a video-based biosignal during motion using a novel wavelet-based ensemble averaging method is described. Running Wavelet Archetyping (RWA) allows for the enhanced extraction of pulse information from the time-frequency representation, from which a video-based heart rate (HRvid) can be derived. This compares favorably to a reference heart rate derived from a pulse oximeter.

  19. Consumer e-health education in HIV/AIDS: a pilot study of a web-based video workshop

    Directory of Open Access Journals (Sweden)

    O'Grady Laura A

    2006-02-01

    Full Text Available Abstract Background Members of the HIV/AIDS community are known to use web-based tools to support learning about treatment issues. Initial research indicated components such as message forums or web-based documentation were effectively used by persons with HIV/AIDS. Video has also shown promise as a technology to aid consumer health education. However, no research has been published thus far investigating the impact of web-based environments combining these components in an educational workshop format. Methods In this qualitative study HIV/AIDS community members provided feedback on an integrated web-based consumer health education environment. Participants were recruited through organizations that serve the HIV/AIDS community located in Toronto, Canada. Demographics, data on Internet use, including messages exchanged in the study environment were collected. A group interview provided feedback on usability of the study environment, preferences for information formats, use of the message forum, and other sources for learning about treatment information. Results In this pilot study analysis of the posted messages did not demonstrate use for learning of the workshop content. Participants did not generally find the environment of value for learning about treatment information. However, participants did share how they were meeting these needs. It was indicated that a combination of resources are being used to find and discuss treatment information, including in-person sources. Conclusion More research on the ways in which treatment information needs are being met by HIV/AIDS community members and how technology fits in this process is necessary before investing large amounts of money into web-based interventions. Although this study had a limited number of participants, the findings were unexpected and, therefore, of interest to those who intend to implement online consumer health education initiatives or interventions.

  20. ‘PICO-D Management’; a decision-aid for evidence-based chiropractic education and clinical practice

    National Research Council Canada - National Science Library

    Amorin-Woods, Lyndon G; Losco, Barrett E

    2016-01-01

    .... Results "PICO-D Man" (Patient-Intervention-Comparator-Outcome-Duration Management) is a decision-aid developed in an educational setting which field practitioners may also find useful for applying defensible evidence-based practice...

  1. Consumer Acceptance of Recommendations by Interactive Decision Aids: The Joint Role of Temporal Distance and Concrete vs. Abstract Communications

    NARCIS (Netherlands)

    C.F. Koehler (Clemens); E. Breugelmans (Els); B.G.C. Dellaert (Benedict)

    2010-01-01

    textabstractInteractive decision aids (IDAs) typically use concrete product feature-based approaches to interact with consumers. Recently however, interaction designs that focus on communicating abstract consumer needs have been suggested as a promising alternative. This article investigates how

  2. Scaffolded Video Self-Analysis: Discrepancies between Preservice Teachers' Perceived and Actual Instructional Decisions

    Science.gov (United States)

    Rich, Peter; Hannafin, Michael

    2009-01-01

    While video is commonly used to record "expert" teachers, video editing and analysis tools have made it possible for preservice teachers to systematically document, assess, analyze and adapt their own teaching practices. This case study documents the experience of three preservice teachers as they used a Web-based video analysis tool to analyze…

  3. A 'combined framework' approach to developing a patient decision aid: the PANDAs model.

    Science.gov (United States)

    Ng, Chirk Jenn; Mathers, Nigel; Bradley, Alastair; Colwell, Brigitte

    2014-10-24

    There is a lack of practical research frameworks to guide the development of patient decision aids [PtDAs]. This paper described how a PtDA was developed using the International Patient Decision Aids (IPDAS) guideline and UK Medical Research Council (UKMRC) frameworks to support patients when making treatment decisions in type 2 diabetes mellitus. This study used mixed methods to develop a PtDA for use in a UK general practice setting. A 10-member expert panel was convened to guide development and patients and clinicians were also interviewed individually using semi-structured interview guides to identify their decisional needs. Current literature was reviewed systematically to determine the best available evidence. The Ottawa Decision Support Framework was used to guide the presentation of the information and value clarification exercise. An iterative draft-review-revise process by the research team and review panel was conducted until the PtDA reached content and format 'saturation'. The PtDA was then pilot-tested by users in actual consultations to assess its acceptability and feasibility. The IPDAS and UKMRC frameworks were used throughout to inform the development process. The PANDAs PtDA was developed systematically and iteratively. Patients and clinicians highlighted the needs for information, decisional, emotional and social support, which were incorporated into the PtDA. The literature review identified gaps in high quality evidence and variations in patient outcome reporting. The PtDA comprised five components: background of the treatment options; pros and cons of each treatment option; value clarification exercise; support needs; and readiness to decide. This study has demonstrated the feasibility of combining the IPDAS and the UKMRC frameworks for the development and evaluation of a PtDA. Future studies should test this model for developing PtDAs across different decisions and healthcare contexts.

  4. Geriatric consultation can aid in complex treatment decisions for elderly cancer patients.

    Science.gov (United States)

    Schiphorst, A H W; Ten Bokkel Huinink, D; Breumelhof, R; Burgmans, J P J; Pronk, A; Hamaker, M E

    2016-05-01

    Treatment decisions for elderly cancer patients can be challenging. A geriatric assessment may identify unknown medical conditions, give insight on patients' ability to tolerate treatment and guide treatment decisions. Our aim was to study the value of a geriatric consultation in oncological decision-making. Data on cancer patients referred for geriatric consultation for clinical optimisation or due to uncertainty regarding their optimal treatment strategy were prospectively analysed. Outcome of geriatric evaluations, non-oncological interventions and suggested adaptations of oncological treatment proposals were evaluated. Seventy-two patients were referred for consultation, over half of which in a curative treatment setting. Prevalence of geriatric syndromes was 93%, previously undiagnosed conditions were identified in 49% of patients and non-oncological interventions were initiated in 56%. Time was spent discussing patients' priorities (53% of consultations), expectations on treatment (50%) and advance care planning (14%). For 82% of patients, suggestions were made regarding the optimal treatment decision: a more intensive treatment was recommended in 39%, a less intensive therapy for 42% and in 19% only supportive care was suggested. The results demonstrate that a geriatric consultation can aid in complex treatment decisions and may allow for a reduction in over- and undertreatment of elderly cancer patients. © 2015 John Wiley & Sons Ltd.

  5. Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making.

    Science.gov (United States)

    Waldron, Nicholas; Johnson, Claire E; Saul, Peter; Waldron, Heidi; Chong, Jeffrey C; Hill, Anne-Marie; Hayes, Barbara

    2016-10-06

    Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions. Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature. A subsequent iterative consensus process developed two intervention elements: (i) an updated 'Goals of Patient Care' (GOPC) form and process; (ii) an education video and resources for teaching advance CPR decision-making and communication. A multidisciplinary group of health professionals and policy-makers with experience in systems development, education and research provided critical feedback. Three key themes emerged from the focus groups and the literature, which identified a structure for the intervention: (i) knowing what to say; (ii) knowing how to say it; (iii) wanting to say it. The themes informed the development of a video to provide education about advance CPR decision-making framework, improving communication and contextualising relevant clinical issues. Critical feedback assisted in refining the video and further guided development and evolution of a medical GOPC approach to discussing and recording medical treatment and advance care plans. Through an iterative process of consultation and review, video-based education and an expanded GOPC form and approach were developed to address physician and systemic barriers to advance CPR decision-making and documentation. Implementation and evaluation across hospital settings is required to examine utility and determine effect on quality of care.

  6. The Legal Concept of Charity and its Expansion after the Aid/Watch Decision

    Directory of Open Access Journals (Sweden)

    Fiona Martin

    2011-11-01

    Full Text Available This paper provides the reader with an insight into the legal analysis of the concept of ‘charity’ and ‘charitable purpose’. This discussion is important in light of the 2010 High Court decision in Commissioner of Taxation v Aid/Watch Incorporated. It begins with an overview of the historical development of ‘charity’ as a legal concept. It then considers how this concept has been interpreted in the context of taxation law and in particular focuses on the arguments for and against a restriction of advocacy and political lobbying by charities. It concludes with an analysis of the Aid/Watch Case and how this may be applied in the future to other charitable entities.

  7. Patient-Centered Decision Support: Formative Usability Evaluation of Integrated Clinical Decision Support With a Patient Decision Aid for Minor Head Injury in the Emergency Department.

    Science.gov (United States)

    Melnick, Edward R; Hess, Erik P; Guo, George; Breslin, Maggie; Lopez, Kevin; Pavlo, Anthony J; Abujarad, Fuad; Powsner, Seth M; Post, Lori A

    2017-05-19

    The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions. Our objective is to formatively evaluate an electronic tool that not only helps clinicians at the bedside to determine the need for CT use based on the Canadian CT Head Rule but also promotes evidence-based conversations between patients and clinicians regarding patient-specific risk and patients' specific concerns. User-centered design with practice-based and participatory decision aid development was used to design, develop, and evaluate patient-centered decision support regarding CT use in minor head injury in the emergency department. User experience and user interface (UX/UI) development involved successive iterations with incremental refinement in 4 phases: (1) initial prototype development, (2) usability assessment, (3) field testing, and (4) beta testing. This qualitative approach involved input from patients, emergency care clinicians, health services researchers, designers, and clinical informaticists at every stage. The Concussion or Brain Bleed app is the product of 16 successive iterative revisions in accordance with UX/UI industry design standards. This useful and usable final product integrates clinical decision support with a patient decision aid. It promotes shared use by emergency clinicians and patients at the point of care within the emergency department context. This tablet computer app facilitates evidence-based conversations regarding CT in minor head injury. It is adaptable to individual clinician practice styles. The resultant tool

  8. Standards for UNiversal reporting of patient Decision Aid Evaluation studies: the development of SUNDAE Checklist.

    Science.gov (United States)

    Sepucha, Karen R; Abhyankar, Purva; Hoffman, Aubri S; Bekker, Hilary L; LeBlanc, Annie; Levin, Carrie A; Ropka, Mary; Shaffer, Victoria A; Sheridan, Stacey L; Stacey, Dawn; Stalmeier, Peep; Vo, Ha; Wills, Celia E; Thomson, Richard

    2017-12-21

    Patient decision aids (PDAs) are evidence-based tools designed to help patients make specific and deliberated choices among healthcare options. The International Patient Decision Aid Standards (IPDAS) Collaboration review papers and Cochrane systematic review of PDAs have found significant gaps in the reporting of evaluations of PDAs, including poor or limited reporting of PDA content, development methods and delivery. This study sought to develop and reach consensus on reporting guidelines to improve the quality of publications evaluating PDAs. An international workgroup, consisting of members from IPDAS Collaboration, followed established methods to develop reporting guidelines for PDA evaluation studies. This paper describes the results from three completed phases: (1) planning, (2) drafting and (3) consensus, which included a modified, two-stage, online international Delphi process. The work was conducted over 2 years with bimonthly conference calls and three in-person meetings. The workgroup used input from these phases to produce a final set of recommended items in the form of a checklist. The SUNDAE Checklist (Standards for UNiversal reporting of patient Decision Aid Evaluations) includes 26 items recommended for studies reporting evaluations of PDAs. In the two-stage Delphi process, 117/143 (82%) experts from 14 countries completed round 1 and 96/117 (82%) completed round 2. Respondents reached a high level of consensus on the importance of the items and indicated strong willingness to use the items when reporting PDA studies. The SUNDAE Checklist will help ensure that reports of PDA evaluation studies are understandable, transparent and of high quality. A separate Explanation and Elaboration publication provides additional details to support use of the checklist. © 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.

  9. Decision aids for patients considering total joint replacement: a cost-effectiveness analysis alongside a randomised controlled trial.

    Science.gov (United States)

    Trenaman, L; Stacey, D; Bryan, S; Taljaard, M; Hawker, G; Dervin, G; Tugwell, P; Bansback, N

    2017-10-01

    Shared decision-making (SDM) is a key priority to improve patient-centred care, and can play an important role in helping patients decide whether to undergo total joint arthroplasty (TJA). Patient decision aids can support SDM; however, they may incur an upfront cost. We aimed to estimate the health and economic effects of patient decision aids for TJA. A cost-effectiveness analysis of a randomised controlled trial (RCT) with 2-year follow-up. 343 patients were recruited from two orthopedic screening clinics in Ottawa, Canada. Patients were randomized to either a patient decision aid plus surgeon preference report (decision aid) or usual care. Primary outcomes were costs (in 2014 CAD$), quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER). Costs were calculated by multiplying self-reported resource use by unit costs. QALYs were calculated by mapping the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to EuroQol 5-Dimension (EQ-5D) health utilities. Costs and QALYs were discounted at 5%. Multiple imputation was used to handle missing data, and bootstrapping was used to estimate uncertainty. The sample comprised 167 intervention and 167 control group patients. The decision aid arm had fewer surgeries over the 2-year period thereby incurring a negative incremental cost of -$560 (95% CI: -$1358 to $426) per patient while providing 0.05 (95% CI: -0.04 to 0.13) additional QALYs per patient. Consequently, the decision aid arm was dominant. The use of a patient decision aid was associated with fewer health care costs, while producing similar health outcomes. CT00911638 (clinicaltrials.gov). Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  10. Assessing the acceptability and feasibility of encounter decision aids for early stage breast cancer targeted at underserved patients

    NARCIS (Netherlands)

    Alam, S.; Elwyn, G.; Percac-Lima, S.; Grande, S.; Durand, M.A.

    2016-01-01

    BACKGROUND: Women of low socioeconomic status (SES) diagnosed with early stage breast cancer are less likely to be involved in treatment decisions. They tend to report higher decisional regret and poorer communication. Evidence suggests that well-designed encounter decision aids (DAs) could improve

  11. WeAidU-a decision support system for myocardial perfusion images using artificial neural networks.

    Science.gov (United States)

    Ohlsson, Mattias

    2004-01-01

    This paper presents a computer-based decision support system for automated interpretation of diagnostic heart images (called WeAidU), which is made available via the Internet. The system is based on image processing techniques, artificial neural networks (ANNs) and large well-validated medical databases. We present results using artificial neural networks, and compare with two other classification methods, on a retrospective data set containing 1320 images from the clinical routine. The performance of the artificial neural networks detecting infarction and ischemia in different parts of the heart, measured as areas under the receiver operating characteristic curves, is in the range 0.83-0.96. These results indicate a high potential for the tool as a clinical decision support system.

  12. A multi-criteria decision aid methodology to design electric vehicles public charging networks

    Directory of Open Access Journals (Sweden)

    João Raposo

    2015-05-01

    Full Text Available This article presents a new multi-criteria decision aid methodology, dynamic-PROMETHEE, here used to design electric vehicle charging networks. In applying this methodology to a Portuguese city, results suggest that it is effective in designing electric vehicle charging networks, generating time and policy based scenarios, considering offer and demand and the city’s urban structure. Dynamic-PROMETHE adds to the already known PROMETHEE’s characteristics other useful features, such as decision memory over time, versatility and adaptability. The case study, used here to present the dynamic-PROMETHEE, served as inspiration and base to create this new methodology. It can be used to model different problems and scenarios that may present similar requirement characteristics.

  13. A multi-criteria decision aid methodology to design electric vehicles public charging networks

    Science.gov (United States)

    Raposo, João; Rodrigues, Ana; Silva, Carlos; Dentinho, Tomaz

    2015-05-01

    This article presents a new multi-criteria decision aid methodology, dynamic-PROMETHEE, here used to design electric vehicle charging networks. In applying this methodology to a Portuguese city, results suggest that it is effective in designing electric vehicle charging networks, generating time and policy based scenarios, considering offer and demand and the city's urban structure. Dynamic-PROMETHE adds to the already known PROMETHEE's characteristics other useful features, such as decision memory over time, versatility and adaptability. The case study, used here to present the dynamic-PROMETHEE, served as inspiration and base to create this new methodology. It can be used to model different problems and scenarios that may present similar requirement characteristics.

  14. Childbearing Decision Making: A Qualitative Study of Women Living with HIV/AIDS in Southwest Nigeria

    Directory of Open Access Journals (Sweden)

    Y. A. Sofolahan

    2012-01-01

    Full Text Available Using the PEN-3 model, the purpose of this qualitative study was to understand the factors responsible for the childbearing decisions of women living with HIV/AIDS (WLHA in Lagos, Nigeria. Sixty WLHA who sought care at a teaching hospital in Lagos were recruited to participate in in-depth interviews. The average age of the participants was 30 years, and 48 participants were receiving antiretroviral therapy. Healthcare and spiritual practices, healthcare provider-patient communication about childbearing, and husband/partner support emerged as factors that contribute to the childbearing decisions of WLHA. The findings reveal the importance of discussing sexual reproductive health and childbearing issues with WLHA in the healthcare context prior to pregnancy.

  15. A Framework of a Computerized Decision Aid to Improve Group Judgments

    Directory of Open Access Journals (Sweden)

    Utpal Bose

    2009-09-01

    Full Text Available In organizations, groups of decision makers often meet to make judgments as a group on issues and tasks such as, hiring a person who best fits an open position. In such tasks called cognitive conflict tasks, where there is no conflict of interest, group members attempting to reach a common solution often differ on their perspectives to the problem. Cognitive conflicts have been studied in the context of Social Judgment Theory, which posits that persons or judges make a set of judgments about a set of events based on observation of a set of cues related to the events. Disagreement arises because the judges fail to understand each other’s judgment making policies. In order to reduce disagreement and move the group towards a group judgment policy that has the consensus of the group members and is applied consistently, a computerized decision aid is proposed that can be built around a Group Support System using cognitive mapping as a method of providing cognitive feedback and the Analytic Hierarchy Process to process the conflicting criteria and help an individual formulate a judgment policy, as well as aggregate the individual policies into a group judgment policy. It is argued that such as decision aid by supporting every decision maker in the group to effectively use information about the task so that they have a good understanding of the judgment policy they form, to communicate their evaluation policies accurately to other members, and by providing an iterative mechanism through which members can arrive at a compromise solution to the task, is expected to improve the quality of group judgments.

  16. 'PICO-D Management'; a decision-aid for evidence-based chiropractic education and clinical practice.

    Science.gov (United States)

    Amorin-Woods, Lyndon G; Losco, Barrett E

    2016-01-01

    Various models and decision-making aids exist for chiropractic clinical practice. "PICO-D Man" (Patient-Intervention-Comparator-Outcome-Duration Management) is a decision-aid developed in an educational setting which field practitioners may also find useful for applying defensible evidence-based practice. Clinical decision-making involves understanding and evaluating both the proposed clinicalintervention(s) and the relevant and available management options with respect to describing the patient and their problem, clinical and cost effectiveness, safety, feasibility and time-frame. For people consulting chiropractors this decision-aid usually requires the practitioner to consider a comparison of usual chiropractic care, (clinical management including a combination of active care and passive manual interventions), to usual medical care usually including medications, or other allied healthmanagement options while being mindful of the natural history of the persons' condition.

  17. Cultural and Linguistic Adaptation of a Multimedia Colorectal Cancer Screening Decision Aid for Spanish Speaking Latinos

    Science.gov (United States)

    Ko, Linda K.; Reuland, Daniel; Jolles, Monica; Clay, Rebecca; Pignone, Michael

    2014-01-01

    As the United States becomes more linguistically and culturally diverse, there is a need for effective health communication interventions that target diverse and most vulnerable populations. Latinos also have the lowest colorectal (CRC) screening rates of any ethnic group in the U.S. To address such disparities, health communication interventionists are often faced with the challenge to adapt existing interventions from English into Spanish in a way that retains essential elements of the original intervention while also addressing the linguistic needs and cultural perspectives of the target population. We describe the conceptual framework, context, rationale, methods, and findings of a formative research process used in creating a Spanish language version of an evidenced-based (English language) multimedia CRC screening decision aid. Our multi-step process included identification of essential elements of the existing intervention, literature review, assessment of the regional context and engagement of key stakeholders, and solicitation of direct input from target population. We integrated these findings in the creation of the new adapted intervention. We describe how we used this process to identify and integrate socio-cultural themes such as personalism (personalismo), familism (familismo), fear (miedo), embarrassment (verguenza), power distance (respeto), machismo, and trust (confianza) into the Spanish language decision aid. PMID:24328496

  18. "Provoking conversations": case studies of organizations where Option Grid™ decision aids have become 'normalized'.

    Science.gov (United States)

    Scalia, Peter; Elwyn, Glyn; Durand, Marie-Anne

    2017-08-18

    Implementing patient decision aids in clinic workflow has proven to be a challenge for healthcare organizations and physicians. Our aim was to determine the organizational strategies, motivations, and facilitating factors to the routine implementation of Option Grid™ encounter decision aids at two independent settings. Case studies conducted by semi-structured interview, using the Normalization Process Theory (NPT) as a framework for thematic analysis. Twenty three interviews with physicians, nurses, hospital staff and stakeholders were conducted at: 1) CapitalCare Medical Group in Albany, New York; 2) HealthPartners Clinics in Minneapolis, Minnesota. 'Coherent' motivations were guided by financial incentives at CapitalCare, and by a 'champion' physician at HealthPartners. Nurses worked 'collectively' at both settings and played an important role at sites where successful implementation occurred. Some physicians did not understand the perceived utility of Option Grid™, which led to varying degrees of implementation success across sites. The appraisal work (reflexive monitoring) identified benefits, particularly in terms of information provision. Physicians at both settings, however, were concerned with time pressures and the suitability of the tool for patients with low levels of health literacy. Although both practice settings illustrated the mechanisms of normalization postulated by the theory, the extent to which Option Grid™ was routinely embedded in clinic workflow varied between sites, and between clinicians. Implementation of new interventions will require attention to an identified rationale (coherence), and to the collective action, cognitive participation, and assessment of value by organizational members of the organization.

  19. The Interaction of Decision Aid Usage, Training Methodology, and Personality Construct on Decision Making Among Dyadic Air Crews in a Military Environment

    Science.gov (United States)

    2003-04-01

    difficult, as our beliefs, attitudes, and preferences are composed in given contexts which often elicit Primacy and Recency effects on of information...a/rf produced improvemente of more than 4.5-foId above less ttained counterparts who were not provided an aid. Although Ae effect of group...91 Discussion 95 Manipulation Effects 97 Training 97 Decision Aids 101 Scenario Type (risk factor) 106 Homogeneity 108 Contingency

  20. The Longitudinal Impact of an Internet Safety Decision Aid for Abused Women.

    Science.gov (United States)

    Glass, Nancy E; Perrin, Nancy A; Hanson, Ginger C; Bloom, Tina L; Messing, Jill T; Clough, Amber S; Campbell, Jacquelyn C; Gielen, Andrea C; Case, James; Eden, Karen B

    2017-05-01

    Women experiencing intimate partner violence (IPV) navigate complex, dangerous decisions. Tailored safety information and safety planning, typically provided by domestic violence service providers, can prevent repeat IPV exposure and associated adverse health outcomes; however, few abused women access these services. The Internet represents a potentially innovative way to connect abused women with tailored safety planning resources and information. The purpose of this study was to compare safety and mental health outcomes at baseline, 6 months, and 12 months among abused women randomized to: (1) a tailored, Internet-based safety decision aid; or (2) control website (typical safety information available online). Multistate, community-based longitudinal RCT with one-to-one allocation ratio and blocked randomization. Data were collected March 2011-May 2013 and analyzed June-July 2015. Currently abused Spanish- or English-speaking women (N=720). A tailored Internet-based safety decision aid included priority-setting activities, risk assessment, and tailored feedback and safety plans. A control website offered typical safety information available online. Primary outcomes were decisional conflict, safety behaviors, and repeat IPV; secondary outcomes included depression and post-traumatic stress disorder. At 12 months, there were no significant group differences in IPV, depression, or post-traumatic stress disorder. Intervention women experienced significantly less decisional conflict after one use (β= -2.68, p=0.042) and greater increase in safety behaviors they rated as helpful from baseline to 12 months (12% vs 9%, p=0.033) and were more likely to have left the abuser (63% vs 53%, p=0.008). Women who left had higher baseline risk (14.9 vs 13.1, p=0.003) found more of the safety behaviors they tried helpful (61.1% vs 47.5%, pInternet-based safety planning represents a promising tool to reduce the public health impact of IPV. Copyright © 2017 American Journal of

  1. Towards the Significance of Decision Aid in Building Information Modeling (BIM Software Selection Process

    Directory of Open Access Journals (Sweden)

    Omar Mohd Faizal

    2014-01-01

    Full Text Available Building Information Modeling (BIM has been considered as a solution in construction industry to numerous problems such as delays, increased lead in times and increased costs. This is due to the concept and characteristic of BIM that will reshaped the way construction project teams work together to increase productivity and improve the final project outcomes (cost, time, quality, safety, functionality, maintainability, etc.. As a result, the construction industry has witnesses numerous of BIM software available in market. Each of this software has offers different function, features. Furthermore, the adoption of BIM required high investment on software, hardware and also training expenses. Thus, there is indentified that there is a need of decision aid for appropriated BIM software selection that fulfill the project needs. However, research indicates that there is limited study attempt to guide decision in BIM software selection problem. Thus, this paper highlight the importance of decision making and support for BIM software selection as it is vital to increase productivity, construction project throughout building lifecycle.

  2. Decisional outcomes following use of an interactive web-based decision aid for prostate cancer screening.

    Science.gov (United States)

    Tomko, Catherine; Davis, Kimberly; Ludin, Samantha; Kelly, Scott; Stern, Aaron; Luta, George; Taylor, Kathryn L

    2015-06-01

    Informed decision-making tools are recommended for men considering prostate cancer screening. We evaluated the extent to which use of an interactive, web-based decision aid was associated with decisional and screening outcomes. Participants (N = 253) were 57 (7.0) years old and completed telephone interviews at baseline, 1 month, and 13 months post-baseline. Tracking software captured minutes spent on the website (median = 33.9), sections viewed (median = 4.0/5.0), testimonials viewed (median = 4.0/6.0), and values clarification tool (VCT) use (77.3 %). In multivariable analyses, all four website use variables were positively associated with increased knowledge (p's < 0.05). Complete VCT use and number of informational sections were positively associated with greater decisional satisfaction (p's < 0.05). Decisional conflict and screening behavior were not associated with measures of website use. Increased use of informational content and interactive elements were related to improved knowledge and satisfaction. Methods to increase utilization of interactive website components may improve informed decision-making outcomes.

  3. Views of general practice staff about the use of a patient-oriented treatment decision aid in shared decision making for patients with type 2 diabetes : A mixed-methods study

    NARCIS (Netherlands)

    Wildeboer, Anita; du Pon, Esther; Schuling, Jan; Haaijer-Ruskamp, Flora M; Denig, Petra

    BACKGROUND: Decision aids can be used to support shared decision making (SDM). A patient-oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited. OBJECTIVES: To explore views of practice staff towards SDM and the DA. DESIGN:

  4. The loss of reason in patient decision aid research: do checklists damage the quality of informed choice interventions?

    Science.gov (United States)

    Bekker, Hilary L

    2010-03-01

    To discuss whether using the International Patient Decision Aids Standards (IPDAS) Collaboration checklist as a gold standard to judge interventions' quality is premature and potentially detrimental to the validity of resources designed to help patients make treatment choices. Conceptual review integrating the science behind individuals' decision making with the demands of designing complex, healthcare interventions. Patient decision aids are promoted as interventions to help professionals engage in shared and/or patient-centred care. The IPDAS domains were informed by experts' opinions of best practice. Decision scientists study how individuals make decisions, what biases their choices and how best to support decisions. There is debate from decision scientists about which component parts are the active ingredients that help people make decisions. Interventions to help patients make choices have different purposes, component parts and outcomes to those facilitating professional-patient communications. The IPDAS checklist will change to respond to new evidence from the decision sciences. Adhering uncritically to the IPDAS checklist may reduce service variation but is not sufficient to ensure interventions enable good patient decision making. Developers must be encouraged to reason about the IPDAS checklist to identify those component parts that do (not) meet their intervention's purpose. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Development of a decision aid for energy resource management for the Navajo Nation incorporating environmental cultural values

    Science.gov (United States)

    Necefer, Len Edward

    Decision-making surrounding pathways of future energy resource management are complexity and requires balancing tradeoffs of multiple environmental, social, economic, and technical outcomes. Technical decision aid can provide a framework for informed decision making, allowing individuals to better understand the tradeoff between resources, technology, energy services, and prices. While technical decision aid have made significant advances in evaluating these quantitative aspects of energy planning and performance, they have not been designed to incorporate human factors, such as preferences and behavior that are informed by cultural values. Incorporating cultural values into decision tools can provide not only an improved decision framework for the Navajo Nation, but also generate new insights on how these perspective can improve decision making on energy resources. Ensuring these aids are a cultural fit for each context has the potential to increase trust and promote understanding of the tradeoffs involved in energy resource management. In this dissertation I present the development of a technical tool that explicitly addresses cultural and spiritual values and experimentally assesses their influence on the preferences and decision making of Navajo citizens. Chapter 2 describes the results of a public elicitation effort to gather information about stakeholder views and concerns related to energy development in the Navajo Nation in order to develop a larger sample survey and a decision-support tool that links techno-economic energy models with sociocultural attributes. Chapter 3 details the methods of developing the energy decision aid and its underlying assumptions for alternative energy projects and their impacts. This tool also provides an alternative to economic valuation of cultural impacts based upon an ordinal index tied to environmental impacts. Chapter 4 details the the influence of various cultural, environmental, and economic outcome information provided

  6. 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.

  7. Tying up loose ends: a method for constructing and evaluating decision aids that meet blunt and sharp-end goals.

    Science.gov (United States)

    Keller, N; Czienskowski, U; Feufel, M A

    2014-01-01

    We present a methodological framework for constructing and evaluating decision aids--fast and frugal trees (FFTs)--ideally suited to the front line of an organisation. Their performance can be analysed in signal detection theory, allowing for transparent selection of FFTs given managerial-level trade-offs among type I and II errors. We extend FFTs from binary classification to selection from multiple actions (FFT multiple) as well as performance analysis to organisational goal states beyond type I and II error reduction. Concepts and framework are introduced and a tutorial-style example application (threat assessment at military checkpoints) is provided. Throughout, we discuss ways to deal with missing or incomplete data and show that the performance of decision aids may be overestimated if the effectiveness of actions is not heeded. The methodology can be used to construct and evaluate decision aids in any area characterised by dichotomised cues and a one-to-many mapping between categorisation outcomes and actions.

  8. Involving women in personalised decision-making on mode of delivery after caesarean section: the development and pilot testing of a patient decision aid

    NARCIS (Netherlands)

    Schoorel, E.N.; Vankan, E.; Scheepers, H.C.J.; Augustijn, B.C.; Dirksen, C.D.; Koning, M.; Kuijk, S.M. van; Kwee, A.; Melman, S.; Nijhuis, J.G.; Aardenburg, R.; Boer, K. de; Hasaart, T.H.M.; Mol, B.W.; Nieuwenhuijze, M.; Pampus, M.G. van; Roosmalen, J. van; Roumen, F.J.M.E.; Vries, R. de; Wouters, M.G.A.J.; Weijden, T.T. van der; Hermens, R.P.M.G.

    2014-01-01

    OBJECTIVE: To develop a patient decision aid (PtDA) for mode of delivery after caesarean section that integrates personalised prediction of vaginal birth after caesarean (VBAC) with the elicitation of patient preferences and evidence-based information. DESIGN: A PtDA was developed and pilot tested

  9. Development of a patient decision aid for type 2 diabetes mellitus for patients not achieving glycemic control on metformin alone

    Directory of Open Access Journals (Sweden)

    Shillington AC

    2015-04-01

    Full Text Available Alicia C Shillington,1 Nananda Col,2 Robert A Bailey,3 Mark A Jewell11EPI-Q, Inc., Oak Brook, IL, USA; 2Shared Decision-making Resources, Georgetown, ME, USA; 3Janssen Scientific Affairs, LLC, Raritan, NJ, USAPurpose: To describe the process used to develop an evidence-based patient decision aid (PDA that facilitates shared decision-making for treatment intensification in inadequately controlled type 2 diabetes mellitus (T2DM consistent with International Patient Decision Aids Standards.Methods: A PDA was developed by a multidisciplinary steering committee of clinicians, patient advocate, nurse, certified diabetes educators, and decision scientist, using a systematic development process. The process included defining the PDA scope and purpose, outlining the framework, content creation, and designing for integration into clinical practice. This was accomplished through a review of the literature and publically available educational materials and input from practicing clinicians and patients during development and iteratively refining content based on input. Patients with poorly controlled T2DM on metformin considering additional medication assessed the PDA during a pilot.Results: Testing identified six preference-sensitive domains important for choosing T2DM treatment: degree of glycemic response, avoiding weight gain, hypoglycemia risk and other adverse events, avoiding injections, convenience of dose administration, blood glucose monitoring, and cost of therapy. Patient feedback guided content revision. Treatment options were offered after presenting medication class risk–benefit information and eliciting patient values, goals, and preferences. The PDA received the highest International Patient Decision Aids Standards global score to date, 88/100, with 100% of criteria fully met for the following dimensions: development process, disclosures, evaluation process, evidence quality, guidance for users, information quality, language

  10. Impact of state aid on business decisions and financial stability of family farms in Croatia

    Directory of Open Access Journals (Sweden)

    Mateja JEŽ ROGELJ

    2017-03-01

    Full Text Available The aim of this paper is to identify farmers' attitudes towards the impact of state aid on business decisions and financial stability of farms. It will also identify the share of agricultural support in the total income of farms and the reasons for certain agricultural branches having unequal economic dependence on the support. Furthermore, it will investigate which of the two pillars of the CAP farmers consider being more important for their business and which factors would mostly contribute to the increase of production on their farms. The research involved 184 holders of family farms from all Croatian counties and the City of Zagreb. The data were analyzed using the univariate (frequency and two-variate (chi-square test method. The main production on the farms has a statistically significant (P<0.05 effect on the share of state support in the total income of the farm as well as on the influence of the amount of state support to business decisions. Most of the respondents engaged in animal husbandry and farming declared that their farms would not be financially viable in the case of state support abolition, while the situation is different in fruit growing, vegetable growing and floriculture. The paper also demonstrates the extent to which selected motivators (satisfactory state aid, higher purchase prices, less bureaucracy, lower taxes, assured market, cheap loans and availability of agricultural land are important to farmers when deciding whether to increase the agricultural production on their farms. Overall, the two pillars of the CAP are equally important for the farmers but there is a statistically significant difference in the importance of each pillar of the CAP in regard to the prevailing production on the farm. The results of the study demonstrate both the importance of state support for the business of certain agricultural producers, especially herders, and the difference in sensitivity to possible changes in support policy.

  11. LG based decision aid for naval tactical action officer's (TAO) workstation

    Science.gov (United States)

    Stilman, Boris; Yakhnis, Vladimir; Umanskiy, Oleg; Boyd, Ron

    2005-05-01

    In the increasingly NetCentric battlespace of the 21st century, Stilman Advanced Strategies Linguistic Geometry software has the potential to revolutionize the way that the Navy fights in two key areas: as a Tactical Decision Aid and for creating a relevant Common Operating Picture. Incorporating STILMAN's software into a prototype Tactical Action Officers (TAO) workstation as a Tactical Decision Aid (TDA) will allow warfighters to manage their assets more intelligently and effectively. This prototype workstation will be developed using human-centered design principles and will be an open, component-based architecture for combat control systems for future small surface combatants. It will integrate both uninhabited vehicles and onboard sensors and weapon systems across a squadron of small surface combatants. In addition, the hypergame representation of complex operations provides a paradigm for the presentation of a common operating picture to operators and personnel throughout the command hierarchy. In the hypergame technology there are game levels that span the range from the tactical to the global strategy level, with each level informing the others. This same principle will be applied to presenting the relevant common operating picture to operators. Each operator will receive a common operating picture that is appropriate for their level in the command hierarchy. The area covered by this operating picture and the level of detail contained within it will be dependent upon the specific tasks the operator is performing (supervisory vice tactical control) and the level of the operator (or command personnel) within the command hierarchy. Each level will inform the others to keep the picture concurrent and up-to-date.

  12. AIDS

    Science.gov (United States)

    ... smear to check for cancer of the anus Treatment HIV/AIDS is treated with medicines that stop the virus ... having a long-term illness. Outlook (Prognosis) With treatment, most people with HIV/AIDS can live a healthy and normal life. Current ...

  13. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis.

    Science.gov (United States)

    Pieterse, Arwen H; de Vries, Marieke

    2013-09-01

    Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic-based VCMs. To critically analyse the suitability of the 'take the best' (TTB) and 'tallying' fast and frugal heuristics in the context of patient decision making. Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. The specific nature of patient preference-sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. © 2011 John Wiley & Sons Ltd.

  14. Edge-aided virtual view rendering for multiview video plus depth

    Science.gov (United States)

    Muddala, Suryanarayana M.; Sjöström, Mârten; Olsson, Roger; Tourancheau, Sylvain

    2013-03-01

    Depth-Image-Based Rendering (DIBR) of virtual views is a fundamental method in three dimensional 3-D video applications to produce different perspectives from texture and depth information, in particular the multi-view-plus-depth (MVD) format. Artifacts are still present in virtual views as a consequence of imperfect rendering using existing DIBR methods. In this paper, we propose an alternative DIBR method for MVD. In the proposed method we introduce an edge pixel and interpolate pixel values in the virtual view using the actual projected coordinates from two adjacent views, by which cracks and disocclusions are automatically filled. In particular, we propose a method to merge pixel information from two adjacent views in the virtual view before the interpolation; we apply a weighted averaging of projected pixels within the range of one pixel in the virtual view. We compared virtual view images rendered by the proposed method to the corresponding view images rendered by state-of-theart methods. Objective metrics demonstrated an advantage of the proposed method for most investigated media contents. Subjective test results showed preference to different methods depending on media content, and the test could not demonstrate a significant difference between the proposed method and state-of-the-art methods.

  15. An exercise of stake holders involvement and multi-criteria decision aid for radioactively contaminated milk

    Energy Technology Data Exchange (ETDEWEB)

    Turcanu, C.O. [Universite Libre de Bruxelles (Belgium); Hardeman, F.; Carle, B. [Studiecentrum voor Kernenergie - Centre d' Etude de l' Energie Nucleaire, The Belgian Nuclear Research Centre Mol (Belgium)

    2006-07-01

    This paper focuses on a multi-criteria structuring process with stakeholders participation and illustrates its findings from a questionnaire conducted in the Belgian context. A multidisciplinary approach is adopted, which follows the practical problem in parallel with the methodological steps of multi-criteria decision aid. The chosen case study regards the countermeasures for the management of radioactively contaminated milk. This is motivated by the importance of milk in the food chain and the rapid transfer to milk of some radionuclides, such as{sup 131}I or {sup 137}Cs. The time framework addressed covers the early to intermediate phases of a radiological emergency. In case of milk, the limited storage facilities, as well as the constraints on the storage time of the fresh product (maximum 72 hours) lead to a certain time pressure on the decision process. The purpose of our analysis is twofold: on the one hand to provide support in case of a real crisis, but most importantly, to improve emergency preparedness and response and to facilitate exercises and training. The stakeholders interviewed range from real decision makers to representatives of the production and processing sectors. As expected, the points of view are sometimes divergent and therefore the results of the questionnaire are discussed and suggestions are formulated for conciliating the various points of view that come into play. The type of stakeholders process carried out is expected to ensure a higher degree of acceptability of the methodologies and tools employed. In the last section, provisional conclusions are drawn and directions for further development are envisaged. (N.C.)

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

    Science.gov (United States)

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

    2017-08-01

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

  17. Visual Aids for Patient, Family, and Physician Decision Making About Endovascular Thrombectomy for Acute Ischemic Stroke.

    Science.gov (United States)

    Tokunboh, Ivie; Vales Montero, Marta; Zopelaro Almeida, Matheus Fellipe; Sharma, Latisha; Starkman, Sidney; Szeder, Viktor; Jahan, Reza; Liebeskind, David; Gonzalez, Nestor; Demchuk, Andrew; Froehler, Michael T; Goyal, Mayank; Lansberg, Maarten G; Lutsep, Helmi; Schwamm, Lee; Saver, Jeffrey L

    2018-01-01

    Rapid decision making optimizes outcomes from endovascular thrombectomy for acute cerebral ischemia. Visual displays facilitate swift review of potential outcomes and can accelerate decision processes. From patient-level, pooled randomized trial data, 100 person-icon arrays (Kuiper-Marshall personographs) were generated showing beneficial and adverse effects of endovascular thrombectomy for patients with acute cerebral ischemia and large vessel occlusion using (1) automated (algorithmic) and (2) expert-guided joint outcome table specification. For the full 7-category modified Rankin Scale, thrombectomy added to IV tPA (intravenous tissue-type plasminogen activator) alone had number needed to treat to benefit 2.9 (95% confidence interval, 2.6-3.3) and number needed to harm 68.9 (95% confidence interval, 40-250); thrombectomy for patients ineligible for IV tPA had number needed to treat to benefit 2.3 (95% confidence interval, 2.1-2.5) and number needed to harm 100 (95% confidence interval, 62.5-250). Visual displays of treatment effects on 100 patients showed: with thrombectomy added to IV tPA alone, 34 patients have better disability outcome, including 14 more normal or near normal (modified Rankin Scale, 0-1); with thrombectomy for patients ineligible for IV tPA, 44 patients have a better disability outcome, including 16 more normal or nearly normal. Displays also showed that harm (increased modified Rankin Scale final disability) occurred in 1 of 100 patients in both populations, mediated by increased new territory infarcts. The person-icon figures integrated these outcomes, and early side-effects, in a single display. Visual decision aids are now available to rapidly educate healthcare providers, patients, and families about benefits and risks of endovascular thrombectomy, both when added to IV tPA in tPA-eligible patients and as the sole reperfusion treatment in tPA-ineligible patients. © 2017 American Heart Association, Inc.

  18. A randomized trial of a computer-tailored decision aid to improve prostate cancer screening decisions: results from the Take the Wheel trial.

    Science.gov (United States)

    Allen, Jennifer D; Othus, Megan K D; Hart, Alton; Tom, Laura; Li, Yi; Berry, Donna; Bowen, Deborah

    2010-09-01

    To evaluate a decision aid (DA) designed to promote informed decision making for prostate cancer screening. Twelve work sites were randomly assigned to an intervention or nonintervention comparison condition. Intervention sites received access to a computer-tailored DA at the workplace. Male employees age 45 years and above (n = 625) completed surveys at baseline and at 3-month follow-up, documenting aspects of informed decision making. Using an intention-to-treat analysis, men in the intervention group were significantly more likely to have made a screening decision and to have improved knowledge without increased decisional conflict, relative to men in the comparison group. These changes were observed despite the fact that only 30% of men in intervention sites used the DA. Among DA users, similar improvements were observed, although the magnitudes of changes were substantially greater, and significant improvements in decision self-efficacy were observed. A DA offered in the workplace promoted decision making, improved knowledge, and increased decision self-efficacy among users, without increasing decisional conflict. However, participation was suboptimal, suggesting that better methods for engaging men in workplace interventions are needed. IMPACT STATEMENT: This trial shows the efficacy of a computer-tailored DA in promoting informed decisions about prostate cancer screening. The DA was delivered through work sites, thereby providing access to resources required to participate in informed decision making without requiring a medical appointment. However, participation rates were suboptimal, and additional strategies for engaging men are needed. (c)2010 AACR.

  19. Development and piloting of a decision aid for women considering participation in the Sentinel Node Biopsy versus Axillary Clearance 2 breast cancer trial.

    Science.gov (United States)

    Juraskova, Ilona; Butow, Phyllis; Fisher, Alana; Bonner, Carissa; Anderson, Caroline; Bu, Stella; Scarlet, Jenni; Stockler, Martin R; Wetzig, Neil; Ung, Owen; Campbell, Ian

    2015-08-01

    This study aimed to (1) develop a decision aid for women considering participation in the Sentinel Node Biopsy versus Axillary Clearance 2 (SNAC-2) breast cancer surgical trial and (2) obtain evidence on its acceptability, feasibility, and potential efficacy in routine trial clinical practice via a two-stage pilot. The decision aid was developed according to International Patient Decision Aid Standards. Study 1: an initial pilot involved 25 members of the consumer advocacy group, Breast Cancer Network Australia. Study 2: the main pilot involved 20 women eligible to participate in the SNAC-2 trial in New Zealand. In both pilots, a questionnaire assessed: information and involvement preferences, decisional conflict, SNAC-2 trial-related understanding and attitudes, psychological distress, and general decision aid feedback. A follow-up telephone interview elicited more detailed feedback on the decision aid design and content. In both pilots, participants indicated good subjective and objective understanding of SNAC-2 trial and reported low decisional conflict and anxiety. The decision aid was found helpful when deciding about trial participation and provided additional, useful information to the standard trial information sheet. The development and two-stage piloting process for this decision aid resulted in a resource that women found very acceptable and helpful in assisting decision-making about SNAC-2 trial participation. The process and findings provide a guide for developing other trial decision aids. © The Author(s) 2015.

  20. Examination of skin lesions for cancer : Which clinical decision aids and tools are available in general practice?

    NARCIS (Netherlands)

    Koelink, Cecile J. L.; Jonkman, Marcel F.; Van der Meer, Klaas; Van der Heide, Wouter K.

    2014-01-01

    Background While skin cancer incidence is rising throughout Europe, general practitioners (GP) feel unsure about their ability to diagnose skin malignancies. Objectives To evaluate whether the GP has sufficient validated clinical decision aids and tools for the examination of potentially malignant

  1. A clinical decision aid for the selection of antithrombotic therapy for the prevention of stroke due to atrial fibrillation

    DEFF Research Database (Denmark)

    LaHaye, Stephen Andrew; Gibbens, Sabra Lynn; Ball, David Gerald Andrew

    2012-01-01

    The availability of new antithrombotic agents, each with a unique efficacy and bleeding profile, has introduced a considerable amount of clinical uncertainty with physicians. We have developed a clinical decision aid in order to assist clinicians in determining an optimal antithrombotic regime...

  2. Effects of a web-based decision aid regarding diagnostic self-testing. A single-blind randomized controlled trial

    NARCIS (Netherlands)

    Ickenroth, M.H.; Grispen, J.E.; Vries, N.K. de; Dinant, G.J.; Ronda, G.; Weijden, T.T. van der

    2016-01-01

    Currently, there are many diagnostic self-tests on body materials available to consumers. The aim of this study was to assess the effect of an online decision aid on diagnostic self-testing for cholesterol and diabetes on knowledge among consumers with an intention to take these tests. A randomized

  3. Impact of computer-based pregnancy-induced hypertension and diabetes decision AIDS on empowering pregnant women

    NARCIS (Netherlands)

    Aslani, Azam; Tara, Fatemeh; Ghalighi, Lila; Pournik, Omid; Ensing, Sabine; Abu-Hanna, Ameen; Eslami, Saeid

    2014-01-01

    We designed a computer-based decision aid (CDA) for use by pregnant women at home to investigate and participate in solving their pregnancy problems related to pregnancy-induced hypertension (PIH) and gestational diabetes (GD). The system cannot and is not intended to replace visits to physicians;

  4. A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney

    Directory of Open Access Journals (Sweden)

    Rachel E. Patzer

    2016-05-01

    Discussion: Engaging patients in health care choices can increase patient empowerment and improve knowledge and understanding of treatment choices. If the effectiveness of iChoose Kidney has a greater impact on patients with low health literacy, lower socioeconomic status, and minority race, this decision aid could help reduce disparities in access to kidney transplantation.

  5. 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

  6. Perceptions of Prostate Cancer Screening Controversy and Informed Decision Making: Implications for Development of a Targeted Decision Aid for Unaffected Male First-Degree Relatives.

    Science.gov (United States)

    Gwede, Clement K; Davis, Stacy N; Wilson, Shaenelle; Patel, Mitul; Vadaparampil, Susan T; Meade, Cathy D; Rivers, Brian M; Yu, Daohai; Torres-Roca, Javier; Heysek, Randy; Spiess, Philippe E; Pow-Sang, Julio; Jacobsen, Paul

    2015-01-01

    First-degree relatives (FDRs) of prostate cancer (PC) patients should consider multiple concurrent personal risk factors when engaging in informed decision making (IDM) about PC screening. This study assessed perceptions of IDM recommendations and risk-appropriate strategies for IDM among FDRs of varied race/ethnicity. A cross-sectional, qualitative study design was used. Study setting was a cancer center in southwest Florida. The study comprised 44 participants (24 PC patients and 20 unaffected FDRs). Focus groups and individual interviews were conducted and analyzed using content analysis and constant comparison methods. Patients and FDRs found the PC screening debate and IDM recommendations to be complex and counterintuitive. They overwhelmingly believed screening saves lives and does not have associated harms. There was a strongly expressed need to improve communication between patients and FDRs. A single decision aid that addresses the needs of all FDRs, rather than one separating by race/ethnicity, was recommended as sufficient by study participants. These perspectives guided the development of an innovative decision aid that deconstructs the screening controversy and IDM processes into simpler concepts and provides step-by-step strategies for FDRs to engage in IDM. Implementing IDM among FDRs is challenging because the IDM paradigm departs from historical messages promoting routine screening. These contradictions should be recognized and addressed for men to participate effectively in IDM. A randomized pilot study evaluating outcomes of the resulting decision aid is underway.

  7. Fast mode decision for the H.264/AVC video coding standard based on frequency domain motion estimation

    Science.gov (United States)

    Abdelazim, Abdelrahman; Mein, Stephen J.; Varley, Martin R.; Ait-Boudaoud, Djamel

    2011-07-01

    The H.264 video coding standard achieves high performance compression and image quality at the expense of increased encoding complexity. Consequently, several fast mode decision and motion estimation techniques have been developed to reduce the computational cost. These approaches successfully reduce the computational time by reducing the image quality and/or increasing the bitrate. In this paper we propose a novel fast mode decision and motion estimation technique. The algorithm utilizes preprocessing frequency domain motion estimation in order to accurately predict the best mode and the search range. Experimental results show that the proposed algorithm significantly reduces the motion estimation time by up to 97%, while maintaining similar rate distortion performance when compared to the Joint Model software.

  8. The development of a web- and a print-based decision aid for prostate cancer screening

    Directory of Open Access Journals (Sweden)

    Schwartz Marc D

    2010-03-01

    Full Text Available Abstract Background Whether early detection and treatment of prostate cancer (PCa will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs developed and tested, very few have included an exercise to help men clarify their values and preferences about PCa screening. Further, only one DA has utilized an interactive web-based format, which allows for an expansion and customization of the material. We describe the development of two DAs, a booklet and an interactive website, each with a values clarification component and designed for use in diverse settings. Methods We conducted two feasibility studies to assess men's (45-70 years Internet access and their willingness to use a web- vs. a print-based tool. The booklet was adapted from two previous versions evaluated in randomized controlled trials (RCTs and the website was created to closely match the content of the revised booklet. Usability testing was conducted to obtain feedback regarding draft versions of the materials. The tools were also reviewed by a plain language expert and the interdisciplinary research team. Feedback on the content and presentation led to iterative modifications of the tools. Results The feasibility studies confirmed that the Internet was a viable medium, as the majority of men used a computer, had access to the Internet, and Internet use increased over time. Feedback from the usability testing on the length, presentation, and content of the materials was incorporated into the final versions of the booklet and website. Both the feasibility studies and the usability testing highlighted the need to address men's informed decision making regarding screening. Conclusions Informed decision making for PCa screening is crucial at present and may be important for some time, particularly if a definitive recommendation either for or against screening does not

  9. How Patient Interactions with a Computer-Based Video Intervention Affect Decisions to Test for HIV

    Science.gov (United States)

    Aronson, Ian David; Rajan, Sonali; Marsch, Lisa A.; Bania, Theodore C.

    2014-01-01

    The current study examines predictors of HIV test acceptance among emergency department patients who received an educational video intervention designed to increase HIV testing. A total of 202 patients in the main treatment areas of a high-volume, urban hospital emergency department used inexpensive netbook computers to watch brief educational…

  10. Impact of a decision aid on reducing uncertainty: pilot study of women in their 40s and screening mammography.

    Science.gov (United States)

    Scariati, Paula; Nelson, Lisa; Watson, Lindsey; Bedrick, Stephen; Eden, Karen B

    2015-11-10

    In 2009 the United States Preventive Services Task Force updated its breast cancer screening guidelines to recommend that average-risk women obtain a screening mammogram every two years starting at age 50 instead of annually starting at age 40. Inconsistencies in data regarding the benefit versus risk of routine screening for women less than 50-years-of-age led to a second recommendation - that women in their forties engage in a shared decision making process with their provider to make an individualized choice about screening mammography that was right for them. In response, a web-based interactive mammography screening decision aid was developed and evaluated. The decision aid was developed using an agile, iterative process. It was further honed based on feedback from clinical and technical subject matter experts. A convenience sample of 51 age- and risk-appropriate women was recruited to pilot the aid. Pre-post decisional conflict and screening choice was assessed. Women reported a significant reduction in overall decisional conflict after using the decision aid (Z = -5.3, p < 0.001). These participants also reported statistically significant reductions in each of the decisional conflict subscales: feeling uncertain (Z = -4.7, p < 0.001), feeling uninformed (Z = -5.2, p < 0.001), feeling unclear about values (Z = -5.0, p < 0.001), and feeling unsupported (Z = -4.0, p < 0.001). However, a woman's intention to obtain a screening mammogram in the next 1-2 years was not significantly changed (Wilcoxon signed-rank Z = -1.508, p = 0.132). This mammography screening decision aid brings value to patient care not by impacting what a woman chooses but by lending clarity to why or how she chooses it.

  11. "Kinect-ing" with clinicians: a knowledge translation resource to support decision making about video game use in rehabilitation.

    Science.gov (United States)

    Levac, Danielle; Espy, Deborah; Fox, Emily; Pradhan, Sujata; Deutsch, Judith E

    2015-03-01

    Microsoft's Kinect for Xbox 360 virtual reality (VR) video games are promising rehabilitation options because they involve motivating, full-body movement practice. However, these games were designed for recreational use, which creates challenges for clinical implementation. Busy clinicians require decision-making support to inform game selection and implementation that address individual therapeutic goals. This article describes the development and preliminary evaluation of a knowledge translation (KT) resource to support clinical decision making about selection and use of Kinect games in physical therapy. The knowledge-to-action framework guided the development of the Kinecting With Clinicians (KWiC) resource. Five physical therapists with VR and video game expertise analyzed the Kinect Adventure games. A consensus-building method was used to arrive at categories to organize clinically relevant attributes guiding game selection and game play. The process and results of an exploratory usability evaluation of the KWiC resource by clinicians through interviews and focus groups at 4 clinical sites is described. Subsequent steps in the evaluation and KT process are proposed, including making the KWiC resource Web-based and evaluating the utility of the online resource in clinical practice. © 2015 American Physical Therapy Association.

  12. Application of the Consumer Decision-Making Model to Hearing Aid Adoption in First-Time Users.

    Science.gov (United States)

    Amlani, Amyn M

    2016-05-01

    Since 1980, hearing aid adoption rates have remained essentially the same, increasing at a rate equal to the organic growth of the population. Researchers have used theoretical models from psychology and sociology to determine those factors or constructs that lead to the adoption of hearing aids by first-time impaired listeners entering the market. In this article, a theoretical model, the Consumer Decision-Making Model (CDM), premised on the neobehavioral approach that considers an individual's psychological and cognitive emphasis toward a product or service, is described. Three theoretical models (i.e., transtheoretical, social model of disability, Health Belief Model), and their relevant findings to the hearing aid market, are initially described. The CDM is then presented, along with supporting evidence of the model's various factors from the hearing aid literature. Future applications of the CDM to hearing health care also are discussed.

  13. Consideration of Insulin Pumps or Continuous Glucose Monitors by Adolescents With Type 1 Diabetes and Their Parents: Stakeholder Engagement in the Design of Web-Based Decision Aids.

    Science.gov (United States)

    Wysocki, Tim; Hirschfeld, Fiona; Miller, Louis; Izenberg, Neil; Dowshen, Steven A; Taylor, Alex; Milkes, Amy; Shinseki, Michelle T; Bejarano, Carolina; Kozikowski, Chelsea; Kowal, Karen; Starr-Ashton, Penny; Ross, Judith L; Kummer, Mark; Carakushansky, Mauri; Lyness, D'Arcy; Brinkman, William; Pierce, Jessica; Fiks, Alexander; Christofferson, Jennifer; Rafalko, Jessica; Lawson, Margaret L

    2016-08-01

    This article describes the stakeholder-driven design, development, and testing of web-based, multimedia decision aids for youth with type 1 diabetes who are considering the insulin pump or continuous glucose monitoring and their parents. This is the initial phase of work designed to develop and evaluate the efficacy of these decision aids in promoting improved decision-making engagement with use of a selected device. Qualitative interviews of 36 parents and adolescents who had previously faced these decisions and 12 health care providers defined the content, format and structure of the decision aids. Experts in children's health media helped the research team to plan, create, and refine multimedia content and its presentation. A web development firm helped organize the content into a user-friendly interface and enabled tracking of decision aid utilization. Throughout, members of the research team, adolescents, parents, and 3 expert consultants offered perspectives about the website content, structure, and function until the design was complete. With the decision aid websites completed, the next phase of the project is a randomized controlled trial of usual clinical practice alone or augmented by use of the decision aid websites. Stakeholder-driven development of multimedia, web-based decision aids requires meticulous attention to detail but can yield exceptional resources for adolescents and parents contemplating major changes to their diabetes regimens. © 2016 The Author(s).

  14. An architecture for integrating distributed and cooperating knowledge-based Air Force decision aids

    Science.gov (United States)

    Nugent, Richard O.; Tucker, Richard W.

    1988-01-01

    MITRE has been developing a Knowledge-Based Battle Management Testbed for evaluating the viability of integrating independently-developed knowledge-based decision aids in the Air Force tactical domain. The primary goal for the testbed architecture is to permit a new system to be added to a testbed with little change to the system's software. Each system that connects to the testbed network declares that it can provide a number of services to other systems. When a system wants to use another system's service, it does not address the server system by name, but instead transmits a request to the testbed network asking for a particular service to be performed. A key component of the testbed architecture is a common database which uses a relational database management system (RDBMS). The RDBMS provides a database update notification service to requesting systems. Normally, each system is expected to monitor data relations of interest to it. Alternatively, a system may broadcast an announcement message to inform other systems that an event of potential interest has occurred. Current research is aimed at dealing with issues resulting from integration efforts, such as dealing with potential mismatches of each system's assumptions about the common database, decentralizing network control, and coordinating multiple agents.

  15. Cognitive Works Aids for C2 Planning: Actionable Information to Support Operational Decision Making

    National Research Council Canada - National Science Library

    Wampler, Jeffrey; Whitaker, Randall; Roth, Emilie; Scott, Ronald; Stilson, Mona; Thomas-Meyers, Gina

    2005-01-01

    .... This paper describes a design for a global mission planning C2 work aid. The discussion describes a cognitive based design approach to developing work aids called Work Centered Support Systems (WCSS...

  16. Serious Choices: A Protocol for an Environmental Scan of Patient Decision Aids for Seriously Ill People at Risk of Death Facing Choices about Life-Sustaining Treatments.

    Science.gov (United States)

    Saunders, Catherine H; Elwyn, Glyn; Kirkland, Kathryn; Durand, Marie-Anne

    2018-02-01

    Seriously ill people at high risk of death face difficult decisions, especially concerning the extent of medical intervention. Given the inherent difficulty and complexity of these decisions, the care they receive often does not align with their preferences. Patient decision aids that educate individuals about options and help them construct preferences about life-sustaining care may reduce the mismatch between the care people say they want and the care they receive. The quantity and quality of patient decision aids for those at high risk of death, however, are unknown. This protocol describes an approach for conducting an environmental scan of life-sustaining treatment patient decision aids for seriously ill patients, identified online and through informant analysis. We intend for the outcome to be an inventory of all life-sustaining treatment patient decision aids for seriously ill patients currently available (either publicly or proprietarily) along with information about their content, quality, and known use. We will identify patient decision aids in a three-step approach (1) mining previously published systematic reviews; (2) systematically searching online and in two popular app stores; and (3) undertaking a key informant survey. We will screen and assess the quality of each patient decision aid identified using the latest published draft of the U.S. National Quality Forum National Standards for the Certification of Patient Decision Aids. Additionally, we will evaluate readability via readable.io and content via inductive content analysis. We will also use natural language processing to assess the content of the decision aids. Researchers increasingly recognize the environmental scan as an optimal method for studying real-world interventions, such as patient decision aids. This study will advance our understanding of the availability, quality, and use of decision aids for life-sustaining interventions targeted at seriously ill patients. We also aim to provide

  17. Adolescent men's attitudes and decision-making in relation to an unplanned pregnancy. Responses to an interactive video drama.

    Science.gov (United States)

    Lohan, Maria; Cruise, Sharon; O'Halloran, Peter; Alderdice, Fiona; Hyde, Abbey

    2011-05-01

    This study confronts a gender bias in research on adolescent pregnancy by exploring adolescent men's decisions relating to a hypothetical unplanned pregnancy. A cross-sectional survey was conducted with adolescent men (N = 360) aged between 14 and 18 years attending schools in the Republic of Ireland. The study, the first of its kind in Europe, extends the small body of evidence on adolescent men and pregnancy decision-making by developing and examining reactions to an interactive video drama used in a comparable study in Australia. In addition, we tested a more comprehensive range of sociological and psychological determinants of adolescent men's decisions regarding an unplanned pregnancy. Results showed that adolescent men were more likely to choose to keep the baby in preference to abortion or adoption. Adolescent men's choice to continue the pregnancy (keep or adopt) in preference to abortion was significantly associated with anticipated feelings of regret in relation to abortion, perceived positive attitudes of own mother to keeping the baby and a feeling that a part of them might want a baby. Religiosity was also shown to underlie adolescent men's views on the perceived consequences of an abortion in their lives. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  18. Values clarification in a decision aid about fertility preservation: does it add to information provision?

    Science.gov (United States)

    Garvelink, Mirjam M; ter Kuile, Moniek M; Stiggelbout, Anne M; de Vries, Marieke

    2014-08-09

    We aimed to evaluate the effect of a decision aid (DA) with information only compared to a DA with values clarification exercise (VCE), and to study the role of personality and information seeking style in DA-use, decisional conflict (DC) and knowledge. Two scenario-based experiments were conducted with two different groups of healthy female participants. Dependent measures were: DC, knowledge, and DA-use (time spent, pages viewed, VCE used). Respondents were randomized between a DA with information only (VCE-) and a DA with information plus a VCE(VCE+) (experiment 1), or between information only (VCE-), information plus VCE without referral to VCE(VCE+), and information plus a VCE with specific referral to the VCE, requesting participants to use the VCE(VCE++) (experiment 2). In experiment 2 we additionally measured personality (neuroticism/conscientiousness) and information seeking style (monitoring/blunting). Experiment 1. There were no differences in DC, knowledge or DA-use between VCE- (n=70) and VCE+ (n=70). Both DAs lead to a mean gain in knowledge from 39% at baseline to 73% after viewing the DA. Within VCE+, VCE-users (n=32, 46%) reported less DC compared to non-users. Since there was no difference in DC between VCE- and VCE+, this is likely an effect of VCE-use in a self-selected group, and not of the VCE per se. Experiment 2. There were no differences in DC or knowledge between VCE- (n=65), VCE+ (n=66), VCE++ (n=66). In all groups, knowledge increased on average from 42% at baseline to 72% after viewing the DA. Blunters viewed fewer DA-pages (R=0.38, pknowledge after viewing the DA (R=0.15, pknowledge in healthy populations making hypothetical decisions, and use of the VCE did not improve knowledge or DC. Personality characteristics were associated to some extent with DA-use, information seeking styles with aspects of DC. More research is needed to make clear recommendations regarding the need for tailoring of information provision to personality

  19. 2D/3D video content adaptation decision engine based on content classification and user assessment

    Science.gov (United States)

    Fernandes, Rui; Andrade, M. T.

    2017-07-01

    Multimedia adaptation depends on several factors, such as the content itself, the consumption device and its characteristics, the transport and access networks and the user. An adaptation decision engine, in order to provide the best possible Quality of Experience to a user, needs to have information about all variables that may influence its decision. For the aforementioned factors, we implement content classification, define device classes, consider limited bandwidth scenarios and categorize user preferences based on a subjective quality evaluation test. The results of these actions generate vital information to pass to the adaptation decision engine so that its operation may provide the indication of the most suitable adaptation to perform that delivers the best possible outcome for the user under the existing constraints.

  20. Exploring the requirements for a decision aid on familial breast cancer in the UK context: a qualitative study with patients referred to a cancer genetics service.

    NARCIS (Netherlands)

    Iredale, R.; Rapport, F.; Sivell, S.; Jones, W.; Edwards, A.; Gray, J.; Elwyn, G.

    2008-01-01

    RATIONALE: Patients concerned about a family history of breast cancer can face difficult decisions about screening, prophylactic surgery and genetic testing. Decision aids can facilitate patient decision making and currently include leaflets and computerized tools. These are largely aimed at the

  1. Using a patient decision aid for insulin initiation in patients with type 2 diabetes: a qualitative analysis of doctor-patient conversations in primary care consultations in Malaysia.

    Science.gov (United States)

    Syed, Ayeshah; Mohd Don, Zuraidah; Ng, Chirk Jenn; Lee, Yew Kong; Khoo, Ee Ming; Lee, Ping Yein; Lim Abdullah, Khatijah; Zainal, Azlin

    2017-05-09

    To investigate whether the use of apatient decision aid (PDA) for insulin initiation fulfils its purpose of facilitating patient-centred decision-making through identifying how doctors and patients interact when using the PDA during primary care consultations. Conversation analysis of seven single cases of audio-recorded/video-recorded consultations between doctors and patients with type 2 diabetes, using a PDA on starting insulin. Primary care in three healthcare settings: (1) one private clinic; (2) two public community clinics and (3) one primary care clinic in a public university hospital, in Negeri Sembilan and the Klang Valley in Malaysia. Clinicians and seven patients with type 2 diabetes to whom insulin had been recommended. Purposive sampling was used to select a sample high in variance across healthcare settings, participant demographics and perspectives on insulin. Interaction between doctors and patients in a clinical consultation involving the use of a PDA about starting insulin. Doctors brought the PDA into the conversation mainly by asking information-focused 'yes/no' questions, and used the PDA for information exchange only if patients said they had not read it. While their contributions were limited by doctors' questions, some patients disclosed issues or concerns. Although doctors' PDA-related questions acted as a presequence to deliberation on starting insulin, their interactional practices raised questions on whether patients were informed and their preferences prioritised. Interactional practices can hinder effective PDA implementation, with habits from ordinary conversation potentially influencing doctors' practices and complicating their implementation of patient-centred decision-making. Effective interaction should therefore be emphasised in the design and delivery of PDAs and in training clinicians to use them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  2. Proof-of-concept study of a Web-based methotrexate decision aid for patients with rheumatoid arthritis.

    Science.gov (United States)

    Li, Linda C; Adam, Paul M; Backman, Catherine L; Lineker, Sydney; Jones, C Allyson; Lacaille, Diane; Townsend, Anne F; Yacyshyn, Elaine; Yousefi, Charlene; Tugwell, Peter; Leese, Jenny; Stacey, Dawn

    2014-10-01

    To assess the extent to which an online patient decision aid reduced decisional conflict and improved self-management knowledge/skills in patients who were considering methotrexate for rheumatoid arthritis (RA). We used a mixed-methods pre-post study design. Eligible participants had a diagnosis of RA, had been prescribed methotrexate but were unsure about starting it, and had access to the internet. Outcome included the Decisional Conflict Scale, the Methotrexate in RA Knowledge Test, and the Effective Consumer Scale. Paired t-tests were used to assess changes before and after the intervention. Randomly selected participants were interviewed at the end of the study about their experiences with the decision aid. Of 30 participants, 23 were women. Mean ± SD age was 54.9 ± 14.9 years and the median disease duration was 1 year (interquartile range 0.3-5.0 years). Mean ± SD decisional conflict changed from 49.50 ± 23.17 preintervention to 21.83 ± 24.12 postintervention (change -27.67 [95% confidence interval -39.89, -15.44]; P consumer attributes (mean ± SD 68.24 ± 12.46 preintervention and 72.94 ± 12.74 postintervention; P = 0.15). Three themes emerged from interviews of 11 participants: seeking confirmation of one's own knowledge of methotrexate, amplifying reluctance when they encountered information contradicting their own experiences, and clarifying thoughts about the next step during the process. Patients' decisional conflict and knowledge improved after using the patient decision aid. Interview findings further highlighted the power of patients' prior knowledge and experiences with RA on how they approach the information presented in a decision aid. Copyright © 2014 by the American College of Rheumatology.

  3. Evaluation of the Ryegrass Stem Rust Model STEMRUST_G and Its Implementation as a Decision Aid.

    Science.gov (United States)

    Pfender, W F; Coop, L B; Seguin, S G; Mellbye, M E; Gingrich, G A; Silberstein, T B

    2015-01-01

    STEMRUST_G, a simulation model for epidemics of stem rust in perennial ryegrass grown to maturity as a seed crop, was validated for use as a heuristic tool and as a decision aid for disease management with fungicides. Multistage validation had been used in model creation by incorporating previously validated submodels for infection, latent period duration, sporulation, fungicide effects, and plant growth. Validation of the complete model was by comparison of model output with observed disease severities in 35 epidemics at nine location-years in the Pacific Northwest of the United States. We judge the model acceptable for its purposes, based on several tests. Graphs of modeled disease progress were generally congruent with plotted disease severity observations. There was negligible average bias in the 570 modeled-versus-observed comparisons across all data, although there was large variance in size of the deviances. Modeled severities were accurate in >80% of the comparisons, where accuracy is defined as the modeled value being within twice the 95% confidence interval of the observed value, within ±1 day of the observation date. An interactive website was created to produce disease estimates by running STEMRUST_G with user-supplied disease scouting information and automated daily weather data inputs from field sites. The model and decision aid supplement disease managers' information by estimating the level of latent (invisible) and expressed disease since the last scouting observation, given season-long weather conditions up to the present, and it estimates effects of fungicides on epidemic development. In additional large-plot experiments conducted in grower fields, the decision aid produced disease management outcomes (management cost and seed yield) as good as or better than the growers' standard practice. In future, STEMRUST_G could be modified to create similar models and decision aids for stem rust of wheat and barley, after additional experiments to

  4. Conception d'un outil d'aide a la decision de technologies de fabrication additive en milieu aeronautique

    Science.gov (United States)

    Buvat, Gael

    La fabrication additive offre une opportunite d'amelioration des methodes de productions de pieces. Cependant, les technologies de fabrication additive sont diverses, les fournisseurs de services sont multiples et peu de personnel est forme pour operer sur ces technologies. L'objectif de cette etude est d'emettre une suggestion de concepts d'outils d'aide a la decision de technologies, de materiaux et de post-traitements de fabrication additive en milieu aeronautique. Trois sous-objectifs sont employes. Premierement, la definition des criteres de decision de technologies, de materiaux et de post-traitements de fabrication additive. Ensuite, l'elaboration d'un cahier des charges de l'outil d'aide a la decision en accord avec les besoins industriels du secteur aeronautique. Et enfin, la suggestion de trois concepts d'outils d'aide a la decision et leur evaluation par comparaison au cahier des charges etabli. Les criteres captures aupres de 11 industriels concernent des criteres de couts, de qualite, de conception et de delai d'obtention. Ensuite, nous avons elabore un cahier des charges permettant de reunir les besoins des industriels du secteur aeronautique selon trois axes qui constituent la colonne vertebrale des outils d'aide a la decision : une suggestion d'interface utilisateur, une suggestion de bases de donnees et un moteur de selection des technologies, des materiaux et des post-traitements de fabrication additive. La convivialite de l'interface utilisateur, l'evaluation de la qualite souhaitee par l'utilisateur et la prise en compte des etudes de cas realisees par le moteur de selection sont exemples de besoins que nous avons identifie au sein de cette etude. Nous avons ensuite transcrit ces besoins en specifications techniques pour permettre une evaluation du niveau de satisfaction des industriels au travers d'un pointage des trois concepts suggeres. Ces trois concepts d'outils d'aide a la decision ont ete realises respectivement grâce a Microsoft Excel

  5. Cognitive anchoring on self-generated decisions reduces operator reliance on automated diagnostic aids.

    Science.gov (United States)

    Madhavan, Poornima; Wiegmann, Douglas A

    2005-01-01

    Automation users often disagree with diagnostic aids that are imperfectly reliable. The extent to which users' agreements with an aid are anchored to their personal, self-generated diagnoses was explored. Participants (N = 75) performed 200 trials in which they diagnosed pump failures using an imperfectly reliable automated aid. One group (nonforced anchor, n = 50) provided diagnoses only after consulting the aid. Another group (forced anchor, n = 25) provided diagnoses both before and after receiving feedback from the aid. Within the nonforced anchor group, participants' self-reported tendency to prediagnose system failures significantly predicted their tendency to disagree with the aid, revealing a cognitive anchoring effect. Agreement rates of participants in the forced anchor group indicated that public commitment to a diagnosis did not strengthen this effect. Potential applications include the development of methods for reducing cognitive anchoring effects and improving automation utilization in high-risk domains.

  6. Back to the Bedside: Developing a Bedside Aid for Concussion and Brain Injury Decisions in the Emergency Department.

    Science.gov (United States)

    Melnick, Edward R; Lopez, Kevin; Hess, Erik P; Abujarad, Fuad; Brandt, Cynthia A; Shiffman, Richard N; Post, Lori A

    2015-01-01

    Current information-rich electronic health record (EHR) interfaces require large, high-resolution screens running on desktop computers. This interface compromises the provider's already limited time at the bedside by physically separating the patient from the doctor. The case study presented here describes a patient-centered clinical decision support (CDS) design process that aims to bring the physician back to the bedside by integrating a patient decision aid with CDS for shared use by the patient and provider on a touchscreen tablet computer for deciding whether or not to obtain a CT scan for minor head injury in the emergency department, a clinical scenario that could benefit from CDS but has failed previous implementation attempts. This case study follows the user-centered design (UCD) approach to build a bedside aid that is useful and usable, and that promotes shared decision-making between patients and their providers using a tablet computer at the bedside. The patient-centered decision support design process focuses on the prototype build using agile software development, but also describes the following: (1) the requirement gathering phase including triangulated qualitative research (focus groups and cognitive task analysis) to understand current challenges, (2) features for patient education, the physician, and shared decision-making, (3) system architecture and technical requirements, and (4) future plans for formative usability testing and field testing. We share specific lessons learned and general recommendations from critical insights gained in the patient-centered decision support design process about early stakeholder engagement, EHR integration, external expert feedback, challenges to two users on a single device, project management, and accessibility. Successful implementation of this tool will require seamless integration into the provider's workflow. This protocol can create an effective interface for shared decision-making and safe resource

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

    Science.gov (United States)

    Henderson, Claire; Brohan, Elaine; Clement, Sarah; Williams, Paul; Lassman, Francesca; Schauman, Oliver; Murray, Joanna; Murphy, Caroline; Slade, Mike; Thornicroft, Graham

    2012-08-31

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

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

    Directory of Open Access Journals (Sweden)

    Henderson Claire

    2012-08-01

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

  9. Low-Complexity Hierarchical Mode Decision Algorithms Targeting VLSI Architecture Design for the H.264/AVC Video Encoder

    Directory of Open Access Journals (Sweden)

    Guilherme Corrêa

    2012-01-01

    Full Text Available In H.264/AVC, the encoding process can occur according to one of the 13 intraframe coding modes or according to one of the 8 available interframes block sizes, besides the SKIP mode. In the Joint Model reference software, the choice of the best mode is performed through exhaustive executions of the entire encoding process, which significantly increases the encoder's computational complexity and sometimes even forbids its use in real-time applications. Considering this context, this work proposes a set of heuristic algorithms targeting hardware architectures that lead to earlier selection of one encoding mode. The amount of repetitions of the encoding process is reduced by 47 times, at the cost of a relatively small cost in compression performance. When compared to other works, the fast hierarchical mode decision results are expressively more satisfactory in terms of computational complexity reduction, quality, and bit rate. The low-complexity mode decision architecture proposed is thus a very good option for real-time coding of high-resolution videos. The solution is especially interesting for embedded and mobile applications with support to multimedia systems, since it yields good compression rates and image quality with a very high reduction in the encoder complexity.

  10. HIV and AIDS

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español HIV and AIDS KidsHealth / For Kids / HIV and AIDS ... actually the virus that causes the disease AIDS. HIV Hurts the Immune System People who are HIV ...

  11. Efficacy of educational video game versus traditional educational apps at improving physician decision making in trauma triage: randomized controlled trial.

    Science.gov (United States)

    Mohan, Deepika; Farris, Coreen; Fischhoff, Baruch; Rosengart, Matthew R; Angus, Derek C; Yealy, Donald M; Wallace, David J; Barnato, Amber E

    2017-12-12

    To determine whether a behavioral intervention delivered through a video game can improve the appropriateness of trauma triage decisions in the emergency department of non-trauma centers. Randomized clinical trial. Online intervention in national sample of emergency medicine physicians who make triage decisions at US hospitals. 368 emergency medicine physicians primarily working at non-trauma centers. A random sample (n=200) of those with primary outcome data was reassessed at six months. Physicians were randomized in a 1:1 ratio to one hour of exposure to an adventure video game (Night Shift) or apps based on traditional didactic education (myATLS and Trauma Life Support MCQ Review), both on iPads. Night Shift was developed to recalibrate the process of using pattern recognition to recognize moderate-severe injuries (representativeness heuristics) through the use of stories to promote behavior change (narrative engagement). Physicians were randomized with a 2×2 factorial design to intervention (game v traditional education apps) and then to the experimental condition under which they completed the outcome assessment tool (low v high cognitive load). Blinding could not be maintained after allocation but group assignment was masked during the analysis phase. Outcomes of a virtual simulation that included 10 cases; in four of these the patients had severe injuries. Participants completed the simulation within four weeks of their intervention. Decisions to admit, discharge, or transfer were measured. The proportion of patients under-triaged (patients with severe injuries not transferred to a trauma center) was calculated then (primary outcome) and again six months later, with a different set of cases (primary outcome of follow-up study). The secondary outcome was effect of cognitive load on under-triage. 149 (81%) physicians in the game arm and 148 (80%) in the traditional education arm completed the trial. Of these, 64/100 (64%) and 58/100 (58%), respectively

  12. Assessing the acceptability and feasibility of encounter decision aids for early stage breast cancer targeted at underserved patients.

    Science.gov (United States)

    Alam, Shama; Elwyn, Glyn; Percac-Lima, Sanja; Grande, Stuart; Durand, Marie-Anne

    2016-11-21

    Women of low socioeconomic status (SES) diagnosed with early stage breast cancer are less likely to be involved in treatment decisions. They tend to report higher decisional regret and poorer communication. Evidence suggests that well-designed encounter decision aids (DAs) could improve outcomes and potentially reduce healthcare disparities. Our goal was to evaluate the acceptability and feasibility of encounter decision aids (Option Grid, Comic Option Grid, and Picture Option Grid) adapted for a low-SES and low-literacy population. We used a multi-phase, mixed-methods approach. In phase 1, we conducted a focus group with rural community stakeholders. In phase 2, we developed and administered a web-based questionnaire with patients of low and high SES. In phase 3, we interviewed patients of low SES and relevant healthcare professionals. Data from phase 1 (n = 5) highlighted the importance of addressing treatment costs for patients. Data from phase 2 (n = 268) and phase 3 (n = 15) indicated that using both visual displays and numbers are helpful for understanding statistical information. Data from all three phases suggested that using plain language and simple images (Picture Option Grid) was most acceptable and feasible. The Comic Option Grid was deemed least acceptable. Option Grid and Picture Option Grid appeared acceptable and feasible in facilitating patient involvement and improving perceived understanding among patients of high and low SES. Picture Option Grid was considered most acceptable, accessible and feasible in the clinic visit. However, given the small sample sizes used, those findings need to be interpreted with caution. Further research is needed to determine the impact of pictorial and text-based encounter decision aids in underserved patients and across socioeconomic strata.

  13. Cognitive Systems Engineering Tool Survey - A Subtask in Support of Commander's Decision Aids for Predictive Battle-Space Awareness (CDA4PBA)

    National Research Council Canada - National Science Library

    Sanders, Mary; Fitzhugh, Elisabeth

    2005-01-01

    ...) DO 6, Commander's Decision Aids for Predictive Battle-Space Awareness, (CDA4PBA) is to identify system requirements necessary to capture the entire software and systems engineering process from concept...

  14. Intersubjective decision-making for computer-aided forging technology design

    Science.gov (United States)

    Kanyukov, S. I.; Konovalov, A. V.; Muizemnek, O. Yu.

    2017-12-01

    We propose a concept of intersubjective decision-making for problems of open-die forging technology design. The intersubjective decisions are chosen from a set of feasible decisions using the fundamentals of the decision-making theory in fuzzy environment according to the Bellman-Zadeh scheme. We consider the formalization of subjective goals and the choice of membership functions for the decisions depending on subjective goals. We study the arrangement of these functions into an intersubjective membership function. The function is constructed for a resulting decision, which is chosen from a set of feasible decisions. The choice of the final intersubjective decision is discussed. All the issues are exemplified by a specific technological problem. The considered concept of solving technological problems under conditions of fuzzy goals allows one to choose the most efficient decisions from a set of feasible ones. These decisions correspond to the stated goals. The concept allows one to reduce human participation in automated design. This concept can be used to develop algorithms and design programs for forging numerous types of forged parts.

  15. Visual AIDS for multimodal treatment options to support decision making of patients with colorectal cancer

    National Research Council Canada - National Science Library

    Hofmann, Sabine; Vetter, Janina; Wachter, Christiane; Henne-Bruns, Doris; Porzsolt, Franz; Kornmann, Marko

    2012-01-01

    .... However, their desire for autonomy is limited by lack of disease-specific knowledge. Visual aids may be helpful tools to present complex data in an easy-to-understand, graphic form to lay persons...

  16. Assessing the conceptual clarity and evidence base of quality criteria/standards developed for evaluating decision aids

    Science.gov (United States)

    McDonald, Heather; Charles, Cathy; Gafni, Amiram

    2011-01-01

    Abstract Context  Promoting patient participation in treatment decision making is of increasing interest to researchers, clinicians and policy makers. Decision aids (DAs) are advocated as one way to help achieve this goal. Despite their proliferation, there has been little agreement on criteria or standards for evaluating these tools. To fill this gap, an international collaboration of researchers and others interested in the development, content and quality of DAs have worked over the past several years to develop a checklist and, based on this checklist, an instrument for determining whether any given DA meets a defined set of quality criteria. Objective/Methods  In this paper, we offer a framework for assessing the conceptual clarity and evidence base used to support the development of quality criteria/standards for evaluating DAs. We then apply this framework to assess the conceptual clarity and evidence base underlying the International Patient Decision Aids Standards (IPDAS) checklist criteria for one of the checklist domains: how best to present in DAs probability information to patients on treatment benefits and risks. Conclusion  We found that some of the central concepts underlying the presenting probabilities domain were not defined. We also found gaps in the empirical evidence and theoretical support for this domain and criteria within this domain. Finally, we offer suggestions for steps that should be undertaken for further development and refinement of quality standards for DAs in the future. PMID:22050440

  17. Computer Aided Learning of Multiple Criteria Decision Making: An Integrated System and Its Effectiveness.

    Science.gov (United States)

    Quaddus, M. A.

    1997-01-01

    This discussion of multiple criteria decision making (MCDM) focuses on an integrated system called MOLP/PC for learning MCDM tools for real world decision making. Results of an empirical test to measure the effectiveness of MOLP/PC are discussed, and the use of MOLP/PC for college courses in Singapore and Australia is described. (Author/LRW)

  18. A Methodology to Aid the Coast Guard in the Decision to Procure or Maintain Telecommunications Systems.

    Science.gov (United States)

    1986-06-20

    INTRODUCTION ------------------------------------ 11 A. BACKGROUND ---------------------------------- 11 B. AREA OF EMPHASIS...Matrix Multiplication---------131 A.6 Inconsistency Determination Matrix-------133 6% ’. ,’ .. 4 [4-, ,- I. INTRODUCTION A. BACKGROUND This thesis is...above spreadsheets into a multi-criteria decision making ( MCDM ) methodology. This will be done in order to give the decision-maker the ability to

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

    Science.gov (United States)

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

    2017-09-01

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

  20. Going early, going late: the rationality of decisions about suicide in AIDS.

    Science.gov (United States)

    Battin, M P

    1994-12-01

    Where assistance in suicide is readily available to those dying of AIDS, as in the west coast gay communities of the United States and in the Netherlands, we must examine the different roles of physicians and friends (including lovers, spouses, family members, religious advisors, members of support groups, and intimate others) in helping a person with AIDS decide about and carry out suicide. This paper makes a central assumption: that where assistance in suicide is available, it is the moral obligation of others to protect and enhance as much as possible the rationality of that choice. Four components are identified in a rational choice about suicide in AIDS-whether it is a choice for or against suicide. Phrased as questions a person with AIDS might ask him- or herself, they are: (1) "Is suicide an option I want to consider?" (2) "Shall I hold out for the chance of a cure?" (3) "How shall I time my suicide?" (4) "What weight shall I give to the welfare and interests of others?" Although physicians often make assertions relevant to (1), they are appropriately involved only in (3); and although friends or intimate partners often provide the patient with anecdotal information relevant to (3), they should be involved primarily in (1). In short, both physicians and friends often intervene in the wrong parts of choices made by a person with AIDS about suicide.

  1. Video manometry of the sphincter of Oddi: a new aid for interpreting manometric tracings and excluding manometric artefacts

    DEFF Research Database (Denmark)

    Madácsy, L; Middelfart, H V; Matzen, Peter

    2000-01-01

    was to develop a new method sphincter of Oddi video manometry-based on simultaneous ESOM and real-time endoscopic image analysis, and to investigate the usefulness of video manometry for detecting manometric artefacts during ESOM. PATIENTS AND METHODS: Seven consecutive patients who had undergone cholecystectomy.......5+/-2.4/min (range: 1-12/min). On the ESOM tracing, 78% of the duodenal contractions had a corresponding pressure wave with an average duration of 2.8+/-0.4 seconds and an amplitude of 71.9+/-16.7 mm Hg. Other artefacts on the ESOM tracings, such as catheter movements, pseudocontractions, hyperventilation......, or retching, were also easily recognized using simultaneous ESOM and real-time endoscopic image analysis. CONCLUSIONS: Video manometry of the sphincter of Oddi is a promising new method for improving the analysis and documentation of ESOM tracings. It has several advantages over the conventional technique...

  2. Informed decision making before prostate-specific antigen screening: Initial results using the American Cancer Society (ACS) Decision Aid (DA) among medically underserved men.

    Science.gov (United States)

    Gökce, Mehmet I; Wang, Xuemei; Frost, Jacqueline; Roberson, Pamela; Volk, Robert J; Brooks, Durado; Canfield, Steven E; Pettaway, Curtis A

    2017-02-15

    The American Cancer Society (ACS) recommends men have the opportunity to make an informed decision about screening for prostate cancer (PCa). The ACS developed a unique decision aid (ACS-DA) for this purpose. However, to date, studies evaluating the efficacy of the ACS-DA are lacking. The authors evaluated the ACS-DA among a cohort of medically underserved men (MUM). A multiethnic cohort of MUM (n = 285) was prospectively included between June 2010 and December 2014. The ACS-DA was presented in a group format. Levels of knowledge on PCa were evaluated before and after the presentation. Participants' decisional conflict and thoughts about the presentation also were evaluated. Logistic regression analyses were performed to determine factors associated with having an adequate level of knowledge. Before receiving the ACS-DA, 33.1% of participants had adequate knowledge on PCa, and this increased to 77% after the DA (P ACS-DA to others. Use of the ACS-DA was feasible among MUM and led to increased PCa knowledge. This also correlated with low levels of decisional conflict. The ACS-DA presented to groups of men may serve as a feasible tool for informed decision making in a MUM population. Cancer 2017;123:583-591. © 2016 American Cancer Society. © 2016 American Cancer Society.

  3. A randomised controlled trial of the effects of a web-based PSA decision aid, Prosdex. Protocol

    Directory of Open Access Journals (Sweden)

    Griffiths Jeff

    2007-10-01

    Full Text Available Abstract Background Informed decision making is the theoretical basis in the UK for men's decisions about Prostate Specific Antigen (PSA testing for prostate cancer testing. The aim of this study is to evaluate the effect of a web-based PSA decision-aid, Prosdex, on informed decision making in men. The objective is to assess the effect of Prosdex on six specific outcomes: (i knowledge of PSA and prostate cancer-related issues – the principal outcome of the study; (ii attitudes to testing; (iii decision conflict; (iv anxiety; (v intention to undergo PSA testing; (vi uptake of PSA testing. In addition, a mathematical simulation model of the effects of Prosdex will be developed. Methods A randomised controlled trial with four groups: two intervention groups, one viewing Prosdex and the other receiving a paper version of the site; two control groups, the second controlling for the potential Hawthorn effect of the questionnaire used with the first control group. Men between the ages of 50 and 75, who have not previously had a PSA test, will be recruited from General Practitioners (GPs in Wales, UK. The principal outcome, knowledge, and four other outcome measures – attitudes to testing, decision conflict, anxiety and intention to undergo testing – will be measured with an online questionnaire, used by men in three of the study groups. Six months later, PSA test uptake will be ascertained from GP records; the online questionnaire will then be repeated. These outcomes, and particularly PSA test uptake, will be used to develop a mathematical simulation model, specifically to consider the impact on health service resources. Trial registration Current Controlled Trial: ISRCTN48473735.

  4. A decision aid for considering indomethacin prophylaxis vs. symptomatic treatment of PDA for extreme low birth weight infants

    Directory of Open Access Journals (Sweden)

    AlKharfi Turki M

    2011-09-01

    Full Text Available Abstract Background Decision Aids (DA are well established in various fields of medicine. It can improve the quality of decision-making and reduce decisional conflict. In neonatal care, and due to scientific equipoise, neonatologists caring for extreme low birth weight (ELBW infants are in need to elicit parents' preferences with regard to the use of indomethacin therapy in ELBW infants. We aimed to develop a DA that elicits parents' preferences with regard to indomethacin therapy in ELBW infants. Methods We developed a DA for the use of the indomethacin therapy in ELBW infants according to the Ottawa Decision Support Framework. The development process involved parents, neonatologists, DA developers and decision making experts. A pilot testing with healthy volunteers was conducted through an evaluation questionnaire, a knowledge scale, and a validated decisional conflict scale. Results The DA is a computer-based interactive tool. In the first part, the DA provides information about patent ductus arteriosus (PDA as a disease, the different treatment options, and the benefits and downsides of using indomethacin therapy in preterm infants. In the second part, it coaches the parent in the decision making process through clarifying values and preferences. Volunteers rated 10 out of 13 items of the DA positively and showed significant improvement on both the knowledge scale (p = 0.008 and the decisional conflict scale (p = 0.008. Conclusion We have developed a computer based DA to assess parental preferences with regard to indomethacin therapy in preterm infants. Future research will involve measurement of parental preferences to guide and augment the clinical decisions in current neonatal practice.

  5. Multi-Criteria Decision Aid for Sustainable Energy Prioritization Using Fuzzy Axiomatic Design

    OpenAIRE

    Basar Oztaysi; Mine Isik; Secil Ercan

    2013-01-01

    Sustainability has gained tremendous importance and has been an important issue both for policy makers and practitioners. Realizing that the resources on the earth are limited, renewable energy alternatives have flourished and started to replace the conventional energy alternatives. Energy planning using different energy alternatives, for the long term becomes a vital decision. In this study, fuzzy multi criteria decision- making methodologies, axiomatic design (AD) and analytic hierarchy pro...

  6. Sexual discourse and decision-making by urban youth in AIDS ...

    African Journals Online (AJOL)

    This article begins by considering the ethics and practicalities of researching sensitive issues with older children and young adults in the context of HIV/AIDS. As part of qualitative fieldwork in the municipality of Mbabane, Swaziland, family caregivers and learners at two secondary schools explained how and where sexual ...

  7. Cultural and linguistic adaptation of a multimedia colorectal cancer screening decision aid for Spanish-speaking Latinos.

    Science.gov (United States)

    Ko, Linda K; Reuland, Daniel; Jolles, Monica; Clay, Rebecca; Pignone, Michael

    2014-01-01

    As the United States becomes more linguistically and culturally diverse, there is a need for effective health communication interventions that target diverse, vulnerable populations, including Latinos. To address such disparities, health communication interventionists often face the challenge to adapt existing interventions from English into Spanish in a way that retains essential elements of the original intervention while also addressing the linguistic needs and cultural perspectives of the target population. The authors describe the conceptual framework, context, rationale, methods, and findings of a formative research process used in creating a Spanish-language version of an evidence-based (English language) multimedia colorectal cancer screening decision aid. The multistep process included identification of essential elements of the existing intervention, literature review, assessment of the regional context and engagement of key stakeholders, and solicitation of direct input from target population. The authors integrated these findings in the creation of the new adapted intervention. They describe how they used this process to identify and integrate sociocultural themes such as personalism (personalismo), familism (familismo), fear (miedo), embarrassment (verguenza), power distance (respeto), machismo, and trust (confianza) into the Spanish-language decision aid.

  8. Feasibility of a patient decision aid regarding disclosure of personal health information: qualitative evaluation of the Health Care Information Directive

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2004-09-01

    Full Text Available Abstract Background Concerns regarding the privacy of health information are escalating owing both to the growing use of information technology to store and exchange data and to the increasing demand on the part of patients to control the use of their medical records. The objective of this study was to evaluate the Health Care Information Directive (HCID, a recently-developed patient decision aid that aims to delineate the level of health information an individual is willing to share. Methods We convened a series of four focus group meetings with several communities in a large Canadian city. A total of 28 men and women participated, representing health care consumer advocates, urban professionals, senior citizens, and immigrants who speak English as a second language. Data were analysed using qualitative methods. Results Participants lacked substantial knowledge regarding the fate and uses of personal health information. They expressed mistrust concerning how their information will be used and protected. Several suggestions were made towards customizing the use of data according to specific needs rather than broad and full access to their charts. Furthermore, despite concern regarding the implementation of a tool like the HCID, participants were hopeful that a refined instrument could contribute to the improved regulation of health information. Conclusion This study indicated poor knowledge concerning the uses of personal health information, distrust concerning security provisions, and cautious support for a patient decision aid such as the HCID to improve control over health data.

  9. Use of a computerised decision aid (DA) to inform the decision process on adjuvant chemotherapy in patients with stage II colorectal cancer: development and preliminary evaluation.

    Science.gov (United States)

    Miles, A; Chronakis, I; Fox, J; Mayer, A

    2017-03-24

    To develop a computerised decision aid (DA) to inform the decision process on adjuvant chemotherapy in patients with stage II colorectal cancer, and examine perceived usefulness, acceptability and areas for improvement of the DA. Mixed methods. Single outpatient oncology department in central London. Consecutive recruitment of 13 patients with stage II colorectal cancer, 12 of whom completed the study. Inclusion criteria were: age >18 years; complete resection for stage II adenocarcinoma of the colon or rectum; patients within 14-56 days after surgery; no contraindication to adjuvant chemotherapy; able to give written informed consent. Exclusion criterion: previous chemotherapy. Patient perceived usefulness (assessed by the PrepDM questionnaire) and acceptability of the DA. PrepDM scores, measuring the perceived usefulness of the DA in preparing the patient to communicate with their doctor and make a health decision, were above those reported in other patient groups. Patient acceptability scores were also high; however, interviews showed that there was evidence of a lack of understanding of key information among some patients, in particular their baseline risk of recurrence, the net benefit of combination chemotherapy and the rationale for having chemotherapy when cancer had apparently gone. Patients found the DA acceptable and useful in supporting their decision about whether or not to have adjuvant chemotherapy. Suggested improvements for the DA include: sequential presentation of treatment options (eg, no treatment vs 1 drug, 1 drug vs 2 drugs) to enhance patient understanding of the difference between combination and single therapy, diagrams to help patients understand the rationale for chemotherapy to prevent a recurrence and inbuilt checks on patient understanding of baseline risk of recurrence and net benefit of chemotherapy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Statistically derived factors of varied importance to audiologists when making a hearing aid brand preference decision.

    Science.gov (United States)

    Johnson, Earl E; Mueller, H Gustav; Ricketts, Todd A

    2009-01-01

    To determine the amount of importance audiologists place on various items related to their selection of a preferred hearing aid brand manufacturer. Three hundred forty-three hearing aid-dispensing audiologists rated a total of 32 randomized items by survey methodology. Principle component analysis identified seven orthogonal statistical factors of importance. In rank order, these factors were Aptitude of the Brand, Image, Cost, Sales and Speed of Delivery, Exposure, Colleague Recommendations, and Contracts and Incentives. While it was hypothesized that differences among audiologists in the importance ratings of these factors would dictate their preference for a given brand, that was not our finding. Specifically, mean ratings for the six most important factors did not differ among audiologists preferring different brands. A statistically significant difference among audiologists preferring different brands was present, however, for one factor: Contracts and Incentives. Its assigned importance, though, was always lower than that for the other six factors. Although most audiologists have a preferred hearing aid brand, differences in the perceived importance of common factors attributed to brands do not largely determine preference for a particular brand.

  11. 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

  12. Tools to aid post-wildfire assessment and erosion-mitigation treatment decisions

    Science.gov (United States)

    Peter R. Robichaud; Louise E. Ashmun

    2013-01-01

    A considerable investment in post-fire research over the past decade has improved our understanding of wildfire effects on soil, hydrology, erosion and erosion-mitigation treatment effectiveness. Using this new knowledge, we have developed several tools to assist land managers with post-wildfire assessment and treatment decisions, such as prediction models, research...

  13. The Use of the Analytic Hierarchy Process to Aid Decision Making in Acquired Equinovarus Deformity

    NARCIS (Netherlands)

    van Til, Janine Astrid; Renzenbrink, G.J.; Dolan, J.G.; IJzerman, Maarten Joost

    2008-01-01

    Objective: To increase the transparency of decision making about treatment in patients with equinovarus deformity poststroke. - Design: The analytic hierarchy process (AHP) was used as a structured methodology to study the subjective rationale behind choice of treatment. - Setting: An 8-hour meeting

  14. Commander’s CBR-D Decision Training Aid (DECAID) Demonstration Model and Design Refinement

    Science.gov (United States)

    1989-07-12

    Event 9: &M EVENT 9: Piremain Pepl Firemnain Rupture P ocedurwpeislot1: Decision on whether and how to Detws resor Finemain. ~: Report of ruptured...require living cells for growth. Also, they are normally dependent on arthropod vectors for transmission, and are easily killed by heat, dehydration

  15. Computer-Aided Decisions in Human Services: Expert Systems and Multivariate Models.

    Science.gov (United States)

    Sicoly, Fiore

    1989-01-01

    This comparison of two approaches to the development of computerized supports for decision making--expert systems and multivariate models--focuses on computerized systems that assist professionals with tasks related to diagnosis or classification in human services. Validation of both expert systems and statistical models is emphasized. (39…

  16. Caries detection methods : Can they aid decision making for invasive sealant treatment?

    NARCIS (Netherlands)

    Pereira, AC; Verdonschot, EH; Huysmans, M

    2001-01-01

    The decision to place sealants is a difficult one, and it has been suggested that in a low risk population it may be efficient to wait until caries is detected in the fissure. An invasive sealant technique with fissure preparation may then be indicated. The diagnostic method used in the indication

  17. Computer-based clinical decision aids. A review of methods and assessment of systems

    NARCIS (Netherlands)

    Reisman, Y

    1996-01-01

    During the last three decades a great deal of research has been devoted to the development of integrated clinical decision support systems. This report aims to give a basic understanding of what is required for such a system. By means of a large literature study a survey is given of the major

  18. A Visual Aid to Decision-Making for People with Intellectual Disabilities

    Science.gov (United States)

    Bailey, Rebecca; Willner, Paul; Dymond, Simon

    2011-01-01

    Previous studies have shown that people with mild intellectual disabilities have difficulty in "weighing-up" information, defined as integrating information from two different sources for the purpose of reaching a decision. This was demonstrated in two very different procedures, temporal discounting and a scenario-based financial…

  19. Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards.

    Science.gov (United States)

    Montori, Victor M; LeBlanc, Annie; Buchholz, Angela; Stilwell, Diana L; Tsapas, Apostolos

    2013-01-01

    Patients and clinicians expect patient decision aids to be based on the best available research evidence. Since 2005, this expectation has translated into a quality dimension of the International Patient Decision Aid Standards. We reviewed the 2005 standards and the available literature on the evidence base of decision aids as well as searched for parallel activities in which evidence is brought to bear to inform clinical decisions. In conducting this work, we noted emerging and research issues that require attention and may inform this quality dimension in the future. This dimension requires patient decision aids to be based on research evidence about the relevant options and the nature and likelihood of their effect on outcomes that matter to patients. The synthesis of evidence should be comprehensive and up-to-date, and the evidence itself subject to critical appraisal. Ethical (informed patient choice), quality-of-care (patient-centered care), and scientific (evidence-based medicine) arguments justify this requirement. Empirical evidence suggests that over two thirds of available decision aids are based on high-quality evidence syntheses. Emerging issues identified include the duties of developers regarding the conduct of systematic reviews, the impact of comparative effectiveness research, their link with guidelines based on the same evidence, and how to present the developers' confidence in the estimates to the end-users. Systematic application of the GRADE system, common in contemporary practice guideline development, could enhance satisfaction of this dimension. While theoretical and practical issues remained to be addressed, high-quality patient decision aids should adhere to this dimension requiring they be based on comprehensive and up-to-date summaries of critically appraised evidence.

  20. Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases.

    Science.gov (United States)

    Hongoh, Valerie; Michel, Pascal; Gosselin, Pierre; Samoura, Karim; Ravel, André; Campagna, Céline; Cissé, Hassane Djibrilla; Waaub, Jean-Philippe

    2016-04-12

    The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration.

  1. Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases

    Directory of Open Access Journals (Sweden)

    Valerie Hongoh

    2016-04-01

    Full Text Available The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration.

  2. How and for whom are decision aids effective? Long-term psychological outcome of a randomized controlled trial in women with newly diagnosed breast cancer.

    Science.gov (United States)

    Vodermaier, Andrea; Caspari, Cornelia; Wang, Lisa; Koehm, Janna; Ditsch, Nina; Untch, Michael

    2011-01-01

    The current study evaluates the long-term psychological impact of a decision aid intervention for surgical and systemic treatment in women with newly diagnosed breast cancer from a previous reported randomized, controlled trial (Vodermaier et al., 2009). Patients (n = 111) were randomized into usual care, or a 20-min decision aid intervention plus an information brochure prior to consultation planning with the senior physician. The retention rate at 1 year was 88%. Linear mixed model analyses demonstrated that the intervention group experienced less decisional conflict (p = .047; d = .19), which was driven by perceptions of a more effective choice (p = .029; d = .20) over time. Subgroup analyses revealed that patients in the intervention group who participated in chemotherapy decision making showed better long-term body image outcomes (p = .009; d = .44), which were mediated by reduced depressive coping (p = .049). No effects emerged for anxiety and depressive symptoms, or for quality of life. Internal health locus of control moderated group effects on 'uncertainty with the decision' (p = .003). The study results provide novel evidence on the role of individual differences and the mechanisms behind decision aid effectiveness, and demonstrate the long-term impact of decision aid interventions on some indices of well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  3. The end of life decisions -- should physicians aid their patients in dying?

    Science.gov (United States)

    Sharma, B R

    2004-06-01

    Decisions pertaining to end of life whether legalized or otherwise, are made in many parts of the world but not reported on account of legal implications. The highly charged debate over voluntary euthanasia and physician assisted suicide was brought into the public arena again when two British doctors confessed to giving lethal doses of drugs to hasten the death of terminally ill patients. Lack of awareness regarding the distinction between different procedures on account of legal status granted to them in some countries is the other area of concern. Some equate withdrawal of life support measures to physician assisted suicide whereas physician assisted suicide is often misinterpreted as euthanasia. Debate among the medical practitioners, law makers and the public taking into consideration the cultural, social and religious ethos will lead to increased awareness, more safeguards and improvement of medical decisions concerning the end of life. International Human Rights Law can provide a consensual basis for such a debate on euthanasia.

  4. Nonlinear phase noise tolerance for coherent optical systems using soft-decision-aided ML carrier phase estimation enhanced with constellation partitioning

    Science.gov (United States)

    Li, Yan; Wu, Mingwei; Du, Xinwei; Xu, Zhuoran; Gurusamy, Mohan; Yu, Changyuan; Kam, Pooi-Yuen

    2018-02-01

    A novel soft-decision-aided maximum likelihood (SDA-ML) carrier phase estimation method and its simplified version, the decision-aided and soft-decision-aided maximum likelihood (DA-SDA-ML) methods are tested in a nonlinear phase noise-dominant channel. The numerical performance results show that both the SDA-ML and DA-SDA-ML methods outperform the conventional DA-ML in systems with constant-amplitude modulation formats. In addition, modified algorithms based on constellation partitioning are proposed. With partitioning, the modified SDA-ML and DA-SDA-ML are shown to be useful for compensating the nonlinear phase noise in multi-level modulation systems.

  5. Aid decision algorithms to estimate the risk in congenital heart surgery.

    Science.gov (United States)

    Ruiz-Fernández, Daniel; Monsalve Torra, Ana; Soriano-Payá, Antonio; Marín-Alonso, Oscar; Triana Palencia, Eddy

    2016-04-01

    In this paper, we have tested the suitability of using different artificial intelligence-based algorithms for decision support when classifying the risk of congenital heart surgery. In this sense, classification of those surgical risks provides enormous benefits as the a priori estimation of surgical outcomes depending on either the type of disease or the type of repair, and other elements that influence the final result. This preventive estimation may help to avoid future complications, or even death. We have evaluated four machine learning algorithms to achieve our objective: multilayer perceptron, self-organizing map, radial basis function networks and decision trees. The architectures implemented have the aim of classifying among three types of surgical risk: low complexity, medium complexity and high complexity. Accuracy outcomes achieved range between 80% and 99%, being the multilayer perceptron method the one that offered a higher hit ratio. According to the results, it is feasible to develop a clinical decision support system using the evaluated algorithms. Such system would help cardiology specialists, paediatricians and surgeons to forecast the level of risk related to a congenital heart disease surgery. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Applying Multi-Criteria Decision Aiding Techniques in the Process of Project Management within the Wedding Planning Business

    Directory of Open Access Journals (Sweden)

    Dorota Górecka

    2012-01-01

    Full Text Available Numerous problems that emerge in the process of project management can be presented as multi-criteria issues and solved with the help of appropriate methods. The contracting authority, selecting one tender out of many available tenders, assesses them, taking into account various criteria, e.g. price, expected execution time and the contractor's experience. The owner of a company intending to purchase the fixed assets requisite for the realization of the project behaves similarly, i.e. the most advantageous model of the device is chosen, taking into account not only its price but also production capacity, energy intensity, noise emission, service availability, etc. From among many concepts, the investor has to choose a solution which frequently constitutes a compromise between price, functional properties, durability and aesthetics of performance, as well as safety of the utilization and impact on the environment. The choice of an investment location depends not only on the market, financial and supply factors, but also on so called soft factors such as the perceived quality of institutions and the attitude of local communities. All such situations can be described in the same way: taking into account preferences of the decision maker, the best possible choice must be made out of a finite set of alternatives evaluated according to a finite set of criteria. There are many different methods that can be used to aid a decision maker in this choice, including, but not limited to, techniques based on the outranking relation, verbal decision analysis and the MACBETH method. In this article, they will be compared and their applicability to different types of decision making problems will be considered. Furthermore, the PROMETHEE II method with a veto threshold will be presented within the text. Because the application of project management in the wedding planning business has gained wide popularity, as an illustrative example an empirical study of

  7. Development and pilot testing of a decision aid for men considering genetic testing for breast and/or ovarian cancer-related mutations (BRCA1/2).

    Science.gov (United States)

    Juan, Anne S; Wakefield, Claire E; Kasparian, Nadine A; Kirk, Judy; Tyler, Janet; Tucker, Kathy

    2008-12-01

    Despite the fact that both men and women can carry a breast/ovarian cancer-related mutation, the main emphasis in genetic counseling for breast/ovarian cancer-related risk remains on females. This study aimed to develop and pilot a decision aid specifically designed for men with a strong family history of breast and/or ovarian cancer who are considering genetic testing. The decision aid was developed by a multidisciplinary team of experts and a consumer representative. It was then reviewed by 27 men who had previously undergone genetic testing to identify a mutation in a BRCA1 or BRCA2 gene. All men who reviewed the decision aid indicated that they would recommend the booklet to other men in the same situation, and 96% of the sample (n = 26) reported being "very satisfied" or "satisfied" with the information contained in the decision aid. The decision aid was perceived by all participants as "very relevant" or "quite relevant" for men considering genetic testing. Ninety-three percent of men felt that it was easy to weigh the pros and cons of genetic testing with the help of the decision aid. The perceived impact on participants' emotions and understanding of the genetic testing process was also assessed. Several factors may hinder men from effectively weighing up the potential benefits and risks of genetic testing. A greater understanding of these issues may help health professionals to encourage men with a strong family history of breast and/or ovarian cancer to learn about cancer risk and the appropriate management strategies for themselves and their female relatives.

  8. Cost effectiveness of a web-based decision aid for parents deciding about MMR vaccination: a three-arm cluster randomised controlled trial in primary care

    Science.gov (United States)

    Tubeuf, Sandy; Edlin, Richard; Shourie, Swati; Cheater, Francine M; Bekker, Hilary; Jackson, Cath

    2014-01-01

    Background Levels of measles in England and Wales are at their highest for 18 years, and strategies targeting the different groups of parents who do not vaccinate their children continue to be needed. Decision aids for decisions regarding childhood immunisation appear to be effective in achieving an increase in vaccine uptake but their cost effectiveness is unknown. Aim To assess the cost effectiveness of a web-based decision aid to increase uptake of the MMR vaccine. Design and setting Economic evaluation conducted alongside a cluster randomised controlled trial using urban GP practices in the north of England. Method Fifty GP practices in the north of England were randomised to one of three trial arms: decision aid, leaflet, usual practice. A total of 220 first-time parents (child aged 3–12 months) were recruited. Parents self-reported their contacts with the NHS and other previous/expected resource utilisation; associated costs were calculated. Vaccine-uptake data were collected from GP practices. A cost-effectiveness analysis was undertaken and provided the incremental cost per first-vaccine uptake. Multiple imputation was used to account for missing data and findings were adjusted for baseline differences in parents’ levels of decisional conflict regarding MMR vaccination. Results Of the 220 first-time parents recruited to the study, 179 completed the baseline and post-intervention questionnaires. MMR uptake was highest for those receiving the decision aid (42 out of 42, 100%) versus usual practice (61 out of 62, 98%) and leaflet arm (69 out of 75, 92%), and was associated with lower cost (–£9.20 versus usual practice and –£7.17 versus leaflet). Conclusion The decision aid has a high chance of being cost effective, regardless of the value placed on obtaining additional vaccinations. It also appears to offer an efficient means of decision support for parents. PMID:25071062

  9. Development and validation of a personalized, web-based decision aid for lung cancer screening using mixed methods: a study protocol.

    Science.gov (United States)

    Lau, Yan Kwan; Caverly, Tanner J; Cherng, Sarah T; Cao, Pianpian; West, Mindy; Arenberg, Douglas; Meza, Rafael

    2014-12-19

    The National Lung Screening Trial demonstrated that low-dose computed tomography (LDCT) screening could be an effective way to reduce lung cancer mortality. Informed decision-making in the context of lung cancer screening requires that potential screening subjects accurately recognize their own lung cancer risk, as well as the harms and benefits associated with screening, while taking into account their personal values and preferences. Our objective is to develop a Web-based decision aid in accordance with the qualifying and certification criteria in the International Patient Decision Aid Standards instrument version 4.0 that will assist patients in making informed decisions with regard to lung cancer screening. In "alpha" testing, a prototype of the decision aid was tested for usability with 10 potential screening participants in focus groups. Feedback was also sought from public health and health risk communication experts external to the study. Following that, improvements to the prototype were made accordingly, and "beta" testing was done in the form of a quasi-experimental design-a before-after study-with a group of 60 participants. Outcomes tested were knowledge, risk perception of lung cancer and lung cancer screening, decisional conflict, and acceptability of the decision aid as determined by means of a self-administered electronic survey. Focus groups of a subsample of survey participants will be conducted to gain further insight into usability issues. Alpha testing is completed. Beta testing is currently being carried out. As of 2014 December 7, 60 participants had completed the before-after study. We expect to have results by 2015 January 31. Qualitative data collection and analysis are expected to be completed by 2015 May 31. We hypothesize that this Web-based, interactive decision aid containing personalized, graphical, and contextual information on the benefits and harms of LDCT screening will increase knowledge, reduce decisional conflict, and

  10. Patient-Centered Robot-Aided Passive Neurorehabilitation Exercise Based on Safety-Motion Decision-Making Mechanism

    Directory of Open Access Journals (Sweden)

    Lizheng Pan

    2017-01-01

    Full Text Available Safety is one of the crucial issues for robot-aided neurorehabilitation exercise. When it comes to the passive rehabilitation training for stroke patients, the existing control strategies are usually just based on position control to carry out the training, and the patient is out of the controller. However, to some extent, the patient should be taken as a “cooperator” of the training activity, and the movement speed and range of the training movement should be dynamically regulated according to the internal or external state of the subject, just as what the therapist does in clinical therapy. This research presents a novel motion control strategy for patient-centered robot-aided passive neurorehabilitation exercise from the point of the safety. The safety-motion decision-making mechanism is developed to online observe and assess the physical state of training impaired-limb and motion performances and regulate the training parameters (motion speed and training rage, ensuring the safety of the supplied rehabilitation exercise. Meanwhile, position-based impedance control is employed to realize the trajectory tracking motion with interactive compliance. Functional experiments and clinical experiments are investigated with a healthy adult and four recruited stroke patients, respectively. The two types of experimental results demonstrate that the suggested control strategy not only serves with safety-motion training but also presents rehabilitation efficacy.

  11. Patient-Centered Robot-Aided Passive Neurorehabilitation Exercise Based on Safety-Motion Decision-Making Mechanism.

    Science.gov (United States)

    Pan, Lizheng; Song, Aiguo; Duan, Suolin; Yu, Zhuqing

    2017-01-01

    Safety is one of the crucial issues for robot-aided neurorehabilitation exercise. When it comes to the passive rehabilitation training for stroke patients, the existing control strategies are usually just based on position control to carry out the training, and the patient is out of the controller. However, to some extent, the patient should be taken as a "cooperator" of the training activity, and the movement speed and range of the training movement should be dynamically regulated according to the internal or external state of the subject, just as what the therapist does in clinical therapy. This research presents a novel motion control strategy for patient-centered robot-aided passive neurorehabilitation exercise from the point of the safety. The safety-motion decision-making mechanism is developed to online observe and assess the physical state of training impaired-limb and motion performances and regulate the training parameters (motion speed and training rage), ensuring the safety of the supplied rehabilitation exercise. Meanwhile, position-based impedance control is employed to realize the trajectory tracking motion with interactive compliance. Functional experiments and clinical experiments are investigated with a healthy adult and four recruited stroke patients, respectively. The two types of experimental results demonstrate that the suggested control strategy not only serves with safety-motion training but also presents rehabilitation efficacy.

  12. Real-time decision aiding - Aircraft guidance for wind shear avoidance

    Science.gov (United States)

    Stratton, D. A.; Stengel, Robert F.

    1992-01-01

    Modern control theory and artificial intelligence technology are applied to the Wind Shear Safety Advisor, a conceptual airborne advisory system to help flight crews avoid or survive encounter with hazardous low-altitude wind shear. Numerical and symbolic processes of the system fuse diverse, time-varying data from ground-based and airborne measurements. Simulated wind-shear-encounter scenarios illustrate the need to consider a variety of factors for optimal decision reliability. The wind-shear-encounter simulations show the Wind Shear Safety Advisor's potential for effectively integrating the available information, highlighting the benefits of the computational techniques employed.

  13. Development of a pediatric cardiac computer aided auscultation decision support system.

    Science.gov (United States)

    Pretorius, Eugene; Cronje, Matthys L; Strydom, Otto

    2010-01-01

    Developing countries have a large population of children living with undiagnosed heart murmurs. As a result of an accompanying skills shortage, most of these children will not get the necessary treatment. The objective of this paper was to develop a decision support system. This could enable health care providers in developing countries with tools to screen large amounts of children without the need for expensive equipment or specialist skills. For this purpose an algorithm was designed and tested to detect heart murmurs in digitally recorded signals. A specificity of 94% and a sensitivity of 91% were achieved using novel signal processing techniques and an ensemble of neural networks as classifier.

  14. Information Technology for Agriculture: Using it tools to aid decision-making process in small properties

    Directory of Open Access Journals (Sweden)

    Caroline de Oliveira Ferraz

    2017-07-01

    Full Text Available With the current scenario of agricultural competitiveness, the use of Information and Communication Technology (ICT tools has become increasingly common in the rural community, making life easier for farmers. The information obtained through Agroinformatics (Information Technology applied to agribusiness, serves as a basis for both decision-making, planning, and application of the best techniques and production processes. In Brazil, companies such as EMPRAPA (The Brazilian Agricultural Research Corporation work in the research and development of new technological tools, which seek to boost the agricultural production of small rural producers, reducing their costs and improving their results. But for this, it is necessary that the producers understand the concept of the importance in carrying out information collection in a correct way, because the information will be processed according to what is inserted in the systems. In this sense, this article aims to demonstrate through an explanatory research of qualitative nature and bibliographical character the importance of the use of ICT to support decision-making in the Brazilian rural sector. Also highlighting the benefits originated by the use of ICT in all stages of agricultural production and its accounting management, through examples of tools.

  15. Watchful waiting or induction of labour--a matter of informed choice: identification, analysis and critical appraisal of decision aids and patient information regarding care options for women with uncomplicated singleton late and post term pregnancies: a review.

    Science.gov (United States)

    Berger, Bettina; Schwarz, Christiane; Heusser, Peter

    2015-05-07

    Decision-making during pregnancy regarding different options of care can be difficult, particularly when risks of intervention versus no intervention for mother and baby are unclear. Unbiased information and support for decision making may be beneficial in these situations. The management of normal pregnancies at and beyond term is an example of such a situation. In order to determine the need to develop an evidence-based decision aid this paper searches, analyses and appraises patient decision aids and patient information leaflets regarding care options in cases of late term and post-term pregnancies, including complementary and alternative medicine (CAM). A literature search was carried out in a variety of lay and medical databases. written information related to uncomplicated singleton pregnancies and targeted at lay people. Analysis and appraisal of included material by means of quality criteria was set up based on the International Patient Decision Aid Standards accounting for evidence-basing of CAM options. Inclusion of two decision aids and eleven leaflets from four decision aids and sixteen leaflets. One decision aid met the quality criteria almost completely, the other one only insufficiently despite providing some helpful information. Only one leaflet is of good quality, but cannot substitute a decision aid. There is an urgent need for the design of an evidence-based decision aid of good quality for late-term or post-term pregnancy, particularly in German language.

  16. Combining Multicriteria Decision Aid and System Dynamics for the Control of Socio-economic Processes. An Iterative Real-time Procedure

    OpenAIRE

    Brans, J. P.; Chevalier, A.; Kunsch, P. L.; Macharis, C.; Schwaninger, Markus

    1998-01-01

    The paper presents the elements of a new methodology to control complex and hypercomplex socio-economic structures. The control process is iterative, combining the principles of System Dynamics, Control theory and the PROMETHEE Multicriteria Decision Aid (MCDA) methodology. It consists of three main stages: setting up and calibration of a quantitative model, definition of long-term strategies and short-term control. The purpose is to define within a panel of decision makers appropriate strate...

  17. The user testing toolset: a decision support system to aid the evaluation of assistive technology products.

    Science.gov (United States)

    Woodcock, Andree; Fielden, Simon; Bartlett, Richard

    2012-01-01

    Developers of assistive technology products need to ensure that their offerings meet the requirements of end users, and that usability issues have been discovered prior to manufacture. This may be difficult for SMEs (Small Medium Enterprises) who may lack the necessary skills and resources required to plan and conduct an evaluation. To assist SMEs in the assistive technology market, a stand alone, decision support system was developed to assist in the planning and evaluation of their products, taking into account the resources available, nature of the product being developed and stage of the design process. The responses given by the designer to 40 multiple choice questions are matched against a database of 42 research methods. The methods achieving the highest score in relation to all questions are displayed as the final output. The paper describes the development of the User Testing Toolset (UTT), including the additional functionality provided to ensure that the evaluation methods were correctly matched and weighted to the responses.

  18. [An expert system of aiding decision making in breast pathology connected to a clinical data base].

    Science.gov (United States)

    Brunet, M; Durrleman, S; Ferber, J; Ganascia, J G; Hacene, K; Hirt, F; Jouniaux, F; Meeus, L

    1987-01-01

    The René Huguenin Cancer Center holds a medical file for each patient which is intended to store and process medical data. Since 1970, we introduced computerization: a development plan was elaborated and simultaneously a statistical software (Clotilde--GSI/CFRO) was selected. Thus, we now have access to a large database, structured according to medical rationale, and utilizable with methods of artificial intelligence towards three objectives: improved data acquisition, decision making and exploitation. The first application was to breast pathology, which represents one of the Center's primary activities. The structure of the data concerning patients is by all criteria part of the medical knowledge. This information needs to be presented as well as processed with a suitable language. To this end, we chose a language-oriented object, Mering II, usable with Apple and IBM 4 micro-computers. This project has already allowed to work out an operational model.

  19. Development of Patients' Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jennifer [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); D' Alimonte, Laura [Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Angus, Jan [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Paszat, Larry [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Metcalfe, Kelly [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Whelan, Tim [Department of Radiation Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario (Canada); Llewellyn-Thomas, Hilary [Department of Community and Family Medicine, The Center of Informed Choice, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH (Lebanon); Warner, Eiran [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Franssen, Edmee [Consultant Statistician, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Szumacher, Ewa, E-mail: Ewa.Szumacher@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be

  20. Do Visual Aids Really Matter?

    OpenAIRE

    Kristine Fish; Jungwon Mun; RoseAnn A’Jontue

    2016-01-01

    Educational webcasts or video lectures as a teaching tool and a form of visual aid have become widely used with the rising prevalence of online and blended courses and with the increase of web-based video materials. Thus, research pertaining to factors enhancing the effectiveness of video lectures, such as number of visual aids, is critical. This study compared student evaluations before and after embedding additional visual aids throughout video lectures in an online course. Slide transition...

  1. The effect of a patient-oriented treatment decision aid for risk factor management in patients with diabetes (PORTDA-diab: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Denig Petra

    2012-11-01

    Full Text Available Abstract Background To improve risk factor management in diabetes, we need to support effective interactions between patients and healthcare providers. Our aim is to develop and evaluate a treatment decision aid that offers personalised information on treatment options and outcomes, and is intended to empower patients in taking a proactive role in their disease management. Important features are: (1 involving patients in setting goals together with their provider; (2 encourage them to prioritise on treatments that maximise relevant outcomes; and (3 integration of the decision aid in the practice setting and workflow. As secondary aim, we want to evaluate the impact of different presentation formats, and learn more from the experiences of the healthcare providers and patients with the decision aid. Methods and design We will conduct a randomised trial comparing four formats of the decision aid in a 2×2 factorial design with a control group. Patients with type 2 diabetes managed in 18 to 20 primary care practices in The Netherlands will be recruited. Excluded are patients with a recent myocardial infarction, stroke, heart failure, angina pectoris, terminal illness, cognitive deficits, >65 years at diagnosis, or not able to read Dutch. The decision aid is offered to the patients immediately before their quarterly practice consultation. The same decision information will be available to the healthcare provider for use during consultation. In addition, the providers receive a set of treatment cards, which they can use to discuss the benefits and risks of different options. Patients in the control group will receive care as usual. We will measure the effect of the intervention on patient empowerment, satisfaction with care, beliefs about medication, negative emotions, health status, prescribed medication, and predicted cardiovascular risk. Data will be collected with questionnaires and automated extraction from medical records in 6 months before and

  2. How the "Understanding Research Evidence" Web-Based Video Series From the National Collaborating Centre for Methods and Tools Contributes to Public Health Capacity to Practice Evidence-Informed Decision Making: Mixed-Methods Evaluation.

    Science.gov (United States)

    Chan, Linda; Mackintosh, Jeannie; Dobbins, Maureen

    2017-09-28

    The National Collaborating Centre for Methods and Tools (NCCMT) offers workshops and webinars to build public health capacity for evidence-informed decision-making. Despite positive feedback for NCCMT workshops and resources, NCCMT users found key terms used in research papers difficult to understand. The Understanding Research Evidence (URE) videos use plain language, cartoon visuals, and public health examples to explain complex research concepts. The videos are posted on the NCCMT website and YouTube channel. The first four videos in the URE web-based video series, which explained odds ratios (ORs), confidence intervals (CIs), clinical significance, and forest plots, were evaluated. The evaluation examined how the videos affected public health professionals' practice. A mixed-methods approach was used to examine the delivery mode and the content of the videos. Specifically, the evaluation explored (1) whether the videos were effective at increasing knowledge on the four video topics, (2) whether public health professionals were satisfied with the videos, and (3) how public health professionals applied the knowledge gained from the videos in their work. A three-part evaluation was conducted to determine the effectiveness of the first four URE videos. The evaluation included a Web-based survey, telephone interviews, and pretest and posttests, which evaluated public health professionals' experience with the videos and how the videos affected their public health work. Participants were invited to participate in this evaluation through various open access, public health email lists, through informational flyers and posters at the Canadian Public Health Association (CPHA) conference, and through targeted recruitment to NCCMT's network. In the Web-based surveys (n=46), participants achieved higher scores on the knowledge assessment questions from watching the OR (P=.04), CI (P=.04), and clinical significance (P=.05) videos but not the forest plot (P=.12) video, as

  3. Auditory decision aiding in supervisory control of multiple unmanned aerial vehicles.

    Science.gov (United States)

    Donmez, Birsen; Cummings, M L; Graham, Hudson D

    2009-10-01

    This article is an investigation of the effectiveness of sonifications, which are continuous auditory alerts mapped to the state of a monitored task, in supporting unmanned aerial vehicle (UAV) supervisory control. UAV supervisory control requires monitoring a UAV across multiple tasks (e.g., course maintenance) via a predominantly visual display, which currently is supported with discrete auditory alerts. Sonification has been shown to enhance monitoring performance in domains such as anesthesiology by allowing an operator to immediately determine an entity's (e.g., patient) current and projected states, and is a promising alternative to discrete alerts in UAV control. However, minimal research compares sonification to discrete alerts, and no research assesses the effectiveness of sonification for monitoring multiple entities (e.g., multiple UAVs). The authors conducted an experiment with 39 military personnel, using a simulated setup. Participants controlled single and multiple UAVs and received sonifications or discrete alerts based on UAV course deviations and late target arrivals. Regardless of the number of UAVs supervised, the course deviation sonification resulted in reactions to course deviations that were 1.9 s faster, a 19% enhancement, compared with discrete alerts. However, course deviation sonifications interfered with the effectiveness of discrete late arrival alerts in general and with operator responses to late arrivals when supervising multiple vehicles. Sonifications can outperform discrete alerts when designed to aid operators to predict future states of monitored tasks. However, sonifications may mask other auditory alerts and interfere with other monitoring tasks that require divided attention. This research has implications for supervisory control display design.

  4. Put listening to the test: An aid to decision making in language placement

    Directory of Open Access Journals (Sweden)

    Marais, Fiona

    2010-12-01

    Full Text Available Universities and other higher education establishments throughout the world, including South Africa, have become concerned about the academic literacy levels of the students they enrol. The problem at most South African tertiary education institutions, which is in line with global trends, is certainly considerable, with almost a third of the students identified as being at risk. A lack of ability in academic discourse is seen as a major cause of students' failure to complete their courses within the given period. In 2006, as part of a nationwide attempt to remedy the academic literacy crisis, Stellenbosch University, along with other academic establishments, officially decided to implement a test of academic literacy in both English and Afrikaans. At Stellenbosch University, the English version of this test is known as TALL (Test of Academic Literacy Levels. It was developed to assess reading and writing abilities in an academic context. The results are used to ‘stream’ students into programmes which assist them in acquiring the various skills deemed necessary for their academic success. Students are sorted according to their TALL results into 'high risk' and 'low to no risk' categories, however, a need has been identified for further screening of the borderline students whose performance in the test falls between these two groups. Administrative and logistical limitations have, thus far, prevented listening skills from being included in the construct of TALL, but there is general consensus that listening is an important skill, particularly at university level. The focus of the research project, reported on in this article, was to design, and put into practice, an academic listening test (ALT to assist in decision making regarding the placement of first-year students in approved language courses at Stellenbosch University. The qualitative and quantitative results obtained from the various administrations of ALT were analysed to determine the

  5. Development of a decision aid for the treatment of benign prostatic hyperplasia: A four stage method using a Delphi consensus study

    NARCIS (Netherlands)

    Lamers, R.E.D.; Cuypers, M.; Garvelink, M.M.; Vries, M. de; Bosch, J.L.H.R.; Kil, P.J.M.

    2016-01-01

    Objective: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Methods: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2:

  6. Development of a decision aid for the treatment of benign prostatic hyperplasia: A four stage method using a Delphi consensus study

    NARCIS (Netherlands)

    Lamers, R.E.; Cuypers, M.; Garvelink, M.M.; Vries, M. de; Bosch, J.L.; Kil, P.J.

    2016-01-01

    OBJECTIVE: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). METHODS: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2:

  7. Development of a decision aid for the treatment of benign prostatic hyperplasia : A four stage method using a Delphi consensus study

    NARCIS (Netherlands)

    Lamers, Romy E D; Cuypers, Maarten; Garvelink, Mirjam M.; Bosch, J. L H Ruud|info:eu-repo/dai/nl/088914364; Kil, Paul J M

    2016-01-01

    Objective: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Methods: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2:

  8. The Cat and the Pigeons: Some General Comments on (TP) Tax Rulings and State Aid After the Starbucks and Fiat Decisions

    NARCIS (Netherlands)

    Wattel, P.J.; Richelle, I.; Schön, W.; Traversa, E.

    2016-01-01

    The Commission State aid decisions on individual tax rulings have created legal uncertainty, which may have been one of their goals. This article comments on their political and policy merits and effects, it wonders whether EU law requires member States to have—and apply in a certain manner—specific

  9. The effect of a patient-oriented treatment decision aid for risk factor management in patients with diabetes (PORTDA-diab) : study protocol for a randomised controlled trial

    NARCIS (Netherlands)

    Denig, Petra; Dun, Mathijs; Schuling, Jan; Haaijer-Ruskamp, Flora M.; Voorham, Jaco

    2012-01-01

    Background: To improve risk factor management in diabetes, we need to support effective interactions between patients and healthcare providers. Our aim is to develop and evaluate a treatment decision aid that offers personalised information on treatment options and outcomes, and is intended to

  10. Standards as a tool aiding the decision processes in market economy

    Directory of Open Access Journals (Sweden)

    A. Tabor

    2010-07-01

    Full Text Available The long–lasting process of adaptation of the Polish standardisation system to the conditions of the European Community has not beencompleted yet. Its logical consequence is the need to shape the mentality of the entrepreneurs and make them understand the importance of standards and their value in a competitive market. It is the intention of the authors of this study to disclose the main aspects of standardisation at both Polish and European level, explain the model of standardisation system currently functioning in Poland, and against this background highlight the priorities in the standardisation policy adopted by the European Union, especially as regards some specific subjects, including – among others – problems related with environmental protection and occupational safety. In standardisation system, the problems of occupational safety and environmental protection are dealt with by a large group of standards harmonised with the New Approach Directive, which touches on the safety–related issues. Our knowledge of standards speaking the language of business is the challenge of modern times that should not be rejected, as in many cases it determines our competitiveness in the common market. The synthetic knowledge comprised in standards creates conditions for good decisions supporting the process of company development, strengthening its position in the European market, and creating the image of a successful modern enterprise ready to start cooperation with other enterprises, making – moreover – an important contribution to the economic management of products manufactured by various technological processes.

  11. Standards as a tool aiding the decision processes in market economy

    Directory of Open Access Journals (Sweden)

    A. Tabor

    2010-04-01

    Full Text Available The long–lasting process of adaptation of the Polish standardisation system to the conditions of the European Community has not beencompleted yet. Its logical consequence is the need to shape the mentality of the entrepreneurs and make them understand the importance of standards and their value in a competitive market. It is the intention of the authors of this study to disclose the main aspects of standardisation at both Polish and European level, explain the model of standardisation system currently functioning in Poland, and against this background highlight the priorities in the standardisation policy adopted by the European Union, especially as regards some specific subjects, including – among others – problems related with environmental protection and occupational safety. In standardisation system, the problems of occupational safety and environmental protection are dealt with by a large group of standards harmonised with the New Approach Directive, which touches on the safety–related issues. Our knowledge of standards speaking the language of business is the challenge of modern times that should not be rejected, as in many cases it determines our competitiveness in the common market. The synthetic knowledge comprised in standards creates conditions for good decisions supporting the process of company development, strengthening its position in the European market, and creating the image of a successful modern enterprise ready to start cooperation with other enterprises, making – moreover – an important contribution to the economic management of products manufactured by varioustechnological processes.

  12. Technologies and decision support systems to aid solid-waste management: a systematic review.

    Science.gov (United States)

    Vitorino de Souza Melaré, Angelina; Montenegro González, Sahudy; Faceli, Katti; Casadei, Vitor

    2017-01-01

    Population growth associated with population migration to urban areas and industrial development have led to a consumption relation that results in environmental, social, and economic problems. With respect to the environment, a critical concern is the lack of control and the inadequate management of the solid waste generated in urban centers. Among the challenges are proper waste-collection management, treatment, and disposal, with an emphasis on sustainable management. This paper presents a systematic review on scientific publications concerning decision support systems applied to Solid Waste Management (SWM) using ICTs and OR in the period of 2010-2013. A statistical analysis of the eighty-seven most relevant publications is presented, encompassing the ICTs and OR methods adopted in SWM, the processes of solid-waste management where they were adopted, and which countries are investigating solutions for the management of solid waste. A detailed discussion on how the ICTs and OR methods have been combined in the solutions was also presented. The analysis and discussion provided aims to help researchers and managers to gather insights on technologies/methods suitable the SWM challenges they have at hand, and on gaps that can be explored regarding technologies/methods that could be useful as well as the processes in SWM that currently do not benefit from using ICTs and OR methods. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. How important is Overdiagnosis to members of the public offered the chance to include it in an online multi-criteria decision aid for prostate cancer screening?

    DEFF Research Database (Denmark)

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

    Objectives To establish the proportion of men who chose to include Overdiagnosis as a criterion in an online multi-criteria decision aid for the prostate cancer screening decision; and to determine the relative importance assigned to Overdiagnosis by those who included it in their personalised aid....... Methods The data are from the 'Pick Your Own' arm of an Australian community panel-based trial involving men aged 40-69 years without diagnosed prostate cancer. The 720 participants were asked to choose between 1 and 10 criteria for inclusion in their aid. With only Overdiagnosis spelled out here......, the criteria, all preceded by ‘Avoiding’, were: LOSS OF LIFETIME; LOSS OF HEALTH; NEEDLESS BIOPSY; OVERDIAGNOSIS (and needless treatment) as a result of a PSA test detecting a cancer that would not have affected your life or health; URINARY PROBLEMS; BOWEL PROBLEMS; SEXUAL PROBLEMS; BURDEN of TREATMENT; BURDEN...

  14. Patient understanding of the revised USPSTF screening mammogram guidelines: need for development of patient decision aids

    Directory of Open Access Journals (Sweden)

    Allen Summer V

    2012-10-01

    Full Text Available Abstract Background The purpose of the study was to examine patients’ understanding of the revised screening mammogram guidelines released by the United States Preventive Services Task Force (USPSTF in 2009 addressing age at initiation and frequency of screening mammography. Methods Patients from the Departments of Family Medicine, Internal Medicine, and Obstetrics and Gynecology (n = 150 at a tertiary care medical center in the United States completed a survey regarding their understanding of the revised USPSTF guidelines following their release, within four to six months of their scheduled mammogram (March 2010 to May 2010. Results Of the patients surveyed, 97/147 (67% indicated increased confusion regarding the age and frequency of screening mammography, 61/148 (41% reported increased anxiety about mammograms, and 58/146 (40% reported anxiety about their own health status following the release of the revised screening guidelines. Most of the patients surveyed, 111/148 (75%, did not expect to change their timing or frequency of screening mammograms in the future. Conclusion Results from this survey suggested increased confusion and possibly an increase in patients’ anxiety related to screening mammography and their own health status following the release of the revised USPSTF screening mammogram guidelines to the public and subsequent media portrayal of the revised guidelines. Although the study did not specifically address causality for these findings, the results highlight the need for improvements in the communication of guidelines to patients and the public. Development of shared decision-making tools and outcomes should be considered to address the communication challenge.

  15. 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.

  16. Usability evaluation and adaptation of the e-health Personal Patient Profile-Prostate decision aid for Spanish-speaking Latino men.

    Science.gov (United States)

    Berry, Donna L; Halpenny, Barbara; Bosco, Jaclyn L F; Bruyere, John; Sanda, Martin G

    2015-07-24

    The Personal Patient Profile-Prostate (P3P), a web-based decision aid, was demonstrated to reduce decisional conflict in English-speaking men with localized prostate cancer early after initial diagnosis. The purpose of this study was to explore and enhance usability and cultural appropriateness of a Spanish P3P by Latino men with a diagnosis of prostate cancer. P3P was translated to Spanish and back-translated by three native Spanish-speaking translators working independently. Spanish-speaking Latino men with a diagnosis of localized prostate cancer, who had made treatment decisions in the past 24 months, were recruited from two urban clinical care sites. Individual cognitive interviews were conducted by two bilingual research assistants as each participant used the Spanish P3P. Notes of user behavior, feedback, and answers to direct questions about comprehension, usability and perceived usefulness were analyzed and categorized. Seven participants with a range of education levels identified 25 unique usability issues in navigation, content comprehension and completeness, sociocultural appropriateness, and methodology. Revisions were prioritized to refine the usability and cultural and linguistic appropriateness of the decision aid. Usability issues were discovered that are potential barriers to effective decision support. Successful use of decision aids requires adaptation and testing beyond translation. Our findings led to revisions further refining the usability and linguistic and cultural appropriateness of Spanish P3P.

  17. The Attitude of Physicians toward the Use of Patient Decision Aids in Iran as a Developing Country.

    Science.gov (United States)

    Rashidian, Hamideh; Nedjat, Saharnaz; Mounesan, Leila; Haghjou, Leila; Majdzadeh, Reza

    2015-01-01

    The patient decision aids (PDAs), which can facilitate the decision-making process when choosing the optimal method of treatment, are a challenge to patients. This study tried to determine the attitude of physicians on the barriers of using PDAs in the way of prioritizing and proposing solutions to them. This study was a cross-sectional research carried out on 150 clinical faculty members of research centers and scientific associations affiliated with Tehran University of Medical Sciences. The participants were chosen using the convenience sampling method. The attitude of physicians toward the application of PDAs was interviewed using a self-made questionnaire composed of 23 questions. The association between physicians' attitude to the use of PDAs and their characteristics was examined using the t-test, analysis of variance, and correlation test. The mean score of physicians' attitude was 76.2 (standard deviation =11.9) and the range was 33-107. There was a significant and direct association between the attitude toward the use of PDA and the respondents' age (r = 0.237, P = 0.007), years of experience (r = 0.205, P = 0.02), being male (P = 0.04), and working in the private sector (P = 0.009). The attitude score of instructors was significantly lower than that of professors (P = 0.02). The general attitude of physicians toward the use of PDAs was positive. However, apparently as a result of problems mentioned in this study for the developing countries such as Iran, it is much easier to employ these tools in centers run by the private sector. Usage of such tools in public centers necessitates systemic infrastructure as well as credits and budgets required for the training of patients and physicians.

  18. Effects of computer-aided clinical decision support systems in improving antibiotic prescribing by primary care providers: a systematic review.

    Science.gov (United States)

    Holstiege, Jakob; Mathes, Tim; Pieper, Dawid

    2015-01-01

    To assess the effectiveness of computer-aided clinical decision support systems (CDSS) in improving antibiotic prescribing in primary care. A literature search utilizing Medline (via PubMed) and Embase (via Embase) was conducted up to November 2013. Randomized controlled trials (RCTs) and cluster randomized trials (CRTs) that evaluated the effects of CDSS aiming at improving antibiotic prescribing practice in an ambulatory primary care setting were included for review. Two investigators independently extracted data about study design and quality, participant characteristics, interventions, and outcomes. Seven studies (4 CRTs, 3 RCTs) met our inclusion criteria. All studies were performed in the USA. Proportions of eligible patient visits that triggered CDSS use varied substantially between intervention arms of studies (range 2.8-62.8%). Five out of seven trials showed marginal to moderate statistically significant effects of CDSS in improving antibiotic prescribing behavior. CDSS that automatically provided decision support were more likely to improve prescribing practice in contrast to systems that had to be actively initiated by healthcare providers. CDSS show promising effectiveness in improving antibiotic prescribing behavior in primary care. Magnitude of effects compared to no intervention, appeared to be similar to other moderately effective single interventions directed at primary care providers. Additional research is warranted to determine CDSS characteristics crucial to triggering high adoption by providers as a perquisite of clinically relevant improvement of antibiotic prescribing. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.comFor numbered affiliations see end of article.

  19. The impact of a decision aid about heart disease prevention on patients' discussions with their doctor and their plans for prevention: a pilot randomized trial

    Directory of Open Access Journals (Sweden)

    Simpson Ross J

    2006-09-01

    Full Text Available Abstract Background Low utilization of effective coronary heart disease (CHD prevention strategies may be due to many factors, but chief among them is the lack of patient involvement in prevention decisions. We undertook this study to test the effectiveness of an individually-tailored, computerized decision aid about CHD on patients' discussions with their doctor and their plans for CHD prevention. Methods We conducted a pilot randomized trial in a convenience sample of adults with no previous history of cardiovascular disease to test the effectiveness of an individually-tailored, computerized decision aid about CHD prevention against a risk factor list that patients could present to their doctor. Results We enrolled 75 adults. Mean age was 53. 59% were female, 73% white, and 23% African-American. 66% had some college education. 43% had a 10-year CHD risk of 0–5%, 25% a risk of 6–10%, 24% a risk of 11–20%, and 5% a risk of > 20%. 78% had at least one option to reduce their CHD risk, but only 45% accurately identified the strategies best supported by evidence. 41 patients received the decision aid, 34 received usual care. In unadjusted analysis, the decision aid increased the proportion of patients who discussed CHD risk reduction with their doctor from 24% to 40% (absolute difference 16%; 95% CI -4% to +37% and increased the proportion who had a specific plan to reduce their risk from 24% to 37% (absolute difference 13%; 95% CI -7% to +34%. In pre-post testing, the decision aid also appeared to increase the proportion of patients with plans to intervene on their CHD risk (absolute increase ranging from 21% to 47% for planned medication use and 5% to 16% for planned behavioral interventions. Conclusion Our study confirms patients' limited knowledge about their CHD risk and effective risk reduction options and provides preliminary evidence that an individually-tailored decision aid about CHD prevention might be expected to increase patients

  20. Role of Psychosocial Factors and Health Literacy in Pregnant Women's Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey.

    Science.gov (United States)

    Delanoë, Agathe; Lépine, Johanie; Turcotte, Stéphane; Leiva Portocarrero, Maria Esther; Robitaille, Hubert; Giguère, Anik Mc; Wilson, Brenda J; Witteman, Holly O; Lévesque, Isabelle; Guillaumie, Laurence; Légaré, France

    2016-10-28

    Deciding about undergoing prenatal screening is difficult, as it entails risks, potential loss and regrets, and challenges to personal values. Shared decision making and decision aids (DAs) can help pregnant women give informed and values-based consent or refusal to prenatal screening, but little is known about factors influencing the use of DAs. The objective of this study was to identify the influence of psychosocial factors on pregnant women's intention to use a DA for prenatal screening for Down syndrome (DS). We also added health literacy variables to explore their influence on pregnant women's intention. We conducted a survey of pregnant women in the province of Quebec (Canada) using a Web panel. Eligibility criteria included age >18 years, >16 weeks pregnant, low-risk pregnancy, and having decided about prenatal screening for the current pregnancy. We collected data based on an extended version of the Theory of Planned Behavior assessing 7 psychosocial constructs (intention, attitude, anticipated regret, subjective norm, descriptive norm, moral norm, and perceived control), 3 related sets of beliefs (behavioral, normative, and control beliefs), 4 health literacy variables, and sociodemographics. Eligible women watched a video depicting the behavior of interest before completing a Web-based questionnaire. We performed descriptive, bivariate, and ordinal logistic regression analyses. Of the 383 eligible pregnant women who agreed to participate, 350 pregnant women completed the Web-based questionnaire and 346 were retained for analysis (completion rate 350/383, 91.4%; mean age 30.1, SD 4.3, years). In order of importance, factors influencing intention to use a DA for prenatal screening for DS were attitude (odds ratio, OR, 9.16, 95% CI 4.02-20.85), moral norm (OR 7.97, 95% CI 4.49-14.14), descriptive norm (OR 2.83, 95% CI 1.63-4.92), and anticipated regret (OR 2.43, 95% CI 1.71-3.46). Specific attitudinal beliefs significantly related to intention were that

  1. Joining forces for food security - Linking earth observation and crowd-sourcing for improved decision-support to aid organizations

    Science.gov (United States)

    Enenkel, M.; Dorigo, W.; See, L. M.; Vinck, P.; Pham, P.

    2013-12-01

    Droughts statistically exceed all other natural disasters in spatio-temporal extent, number of people affected or financial loss. Triggered by crop failure, food insecurity is a major manifestation of agricultural drought and water scarcity. However, other socio-economic precursors, such as chronically low levels of disaster preparedness, hampered access to food security or a lack of social safety nets are equally important factors. Consequently, this study is focused on two complementary developments - a new satellite-derived agricultural drought index and a mobile phone application. The Combined Drought Index (CDI) is enhanced by replacing field measurements of temperature and rainfall modelled/assimilated data. The vegetation component is replaced by a smoothed NDVI dataset. A soil moisture component is introduced to close the gap between rainfall deficiencies and the first visible impacts of atmospheric anomalies on vegetation. The mobile phone application enables the validation of drought index outputs and gives aid organizations an opportunity to increase the speed of socio-economic vulnerability assessments. Supported by Doctors without Borders (MSF) this approach aims at decreasing uncertainties in decision-making via a more holistic risk framework.

  2. A flexible decision-aided maximum likelihood phase estimation in hybrid QPSK/OOK coherent optical WDM systems

    Science.gov (United States)

    Zhang, Yong; Wang, Yulong

    2016-04-01

    Although decision-aided (DA) maximum likelihood (ML) phase estimation (PE) algorithm has been investigated intensively, block length effect impacts system performance and leads to the increasing of hardware complexity. In this paper, a flexible DA-ML algorithm is proposed in hybrid QPSK/OOK coherent optical wavelength division multiplexed (WDM) systems. We present a general cross phase modulation (XPM) model based on Volterra series transfer function (VSTF) method to describe XPM effects induced by OOK channels at the end of dispersion management (DM) fiber links. Based on our model, the weighted factors obtained from maximum likelihood method are introduced to eliminate the block length effect. We derive the analytical expression of phase error variance for the performance prediction of coherent receiver with the flexible DA-ML algorithm. Bit error ratio (BER) performance is evaluated and compared through both theoretical derivation and Monte Carlo (MC) simulation. The results show that our flexible DA-ML algorithm has significant improvement in performance compared with the conventional DA-ML algorithm as block length is a fixed value. Compared with the conventional DA-ML with optimum block length, our flexible DA-ML can obtain better system performance. It means our flexible DA-ML algorithm is more effective for mitigating phase noise than conventional DA-ML algorithm.

  3. Mathematical prediction of core body temperature from environment, activity, and clothing: The heat strain decision aid (HSDA).

    Science.gov (United States)

    Potter, Adam W; Blanchard, Laurie A; Friedl, Karl E; Cadarette, Bruce S; Hoyt, Reed W

    2017-02-01

    Physiological models provide useful summaries of complex interrelated regulatory functions. These can often be reduced to simple input requirements and simple predictions for pragmatic applications. This paper demonstrates this modeling efficiency by tracing the development of one such simple model, the Heat Strain Decision Aid (HSDA), originally developed to address Army needs. The HSDA, which derives from the Givoni-Goldman equilibrium body core temperature prediction model, uses 16 inputs from four elements: individual characteristics, physical activity, clothing biophysics, and environmental conditions. These inputs are used to mathematically predict core temperature (Tc) rise over time and can estimate water turnover from sweat loss. Based on a history of military applications such as derivation of training and mission planning tools, we conclude that the HSDA model is a robust integration of physiological rules that can guide a variety of useful predictions. The HSDA model is limited to generalized predictions of thermal strain and does not provide individualized predictions that could be obtained from physiological sensor data-driven predictive models. This fully transparent physiological model should be improved and extended with new findings and new challenging scenarios. Published by Elsevier Ltd.

  4. A Study on the Application of Defect Data Mining in the Aid Decision Making of Dispatching and Control Integration

    Directory of Open Access Journals (Sweden)

    Guo Hongzuo

    2015-01-01

    Full Text Available The purpose of the research project is to design an aid decision-making system of dispatching and control integration that cooperates with expert judgments based on the data mining of equipment defects so as to improve the risk pre-warning and pre-control ability of unattended centralized monitoring, enhance the level of centralized monitoring operation and guarantee the safety and stability of power system in the dispatching and control integration system. Defect analysis and condition based maintenance are deeply integrated in this research project. Condition data of equipment defects is firstly obtained and then classified, aggregated and analyzed. Through the model training of SVM, the law of the big data when equipment defects occur is obtained and the operation curve of equipment and the current status information are matched so that the risk of defects can be confirmed and the accuracy of risk anticipation can be effectively improved. In this research project, familial defects of equipment and the expert system are incorporated into the system design range and the practicability of the system is enhanced.

  5. Developing a computer touch-screen interactive colorectal screening decision aid for a low-literacy African American population: lessons learned.

    Science.gov (United States)

    Bass, Sarah Bauerle; Gordon, Thomas F; Ruzek, Sheryl Burt; Wolak, Caitlin; Ruggieri, Dominique; Mora, Gabriella; Rovito, Michael J; Britto, Johnson; Parameswaran, Lalitha; Abedin, Zainab; Ward, Stephanie; Paranjape, Anuradha; Lin, Karen; Meyer, Brian; Pitts, Khaliah

    2013-07-01

    African Americans have higher colorectal cancer (CRC) mortality than White Americans and yet have lower rates of CRC screening. Increased screening aids in early detection and higher survival rates. Coupled with low literacy rates, the burden of CRC morbidity and mortality is exacerbated in this population, making it important to develop culturally and literacy appropriate aids to help low-literacy African Americans make informed decisions about CRC screening. This article outlines the development of a low-literacy computer touch-screen colonoscopy decision aid using an innovative marketing method called perceptual mapping and message vector modeling. This method was used to mathematically model key messages for the decision aid, which were then used to modify an existing CRC screening tutorial with different messages. The final tutorial was delivered through computer touch-screen technology to increase access and ease of use for participants. Testing showed users were not only more comfortable with the touch-screen technology but were also significantly more willing to have a colonoscopy compared with a "usual care group." Results confirm the importance of including participants in planning and that the use of these innovative mapping and message design methods can lead to significant CRC screening attitude change.

  6. Automated in-core image generation from video to aid visual inspection of nuclear power plant cores

    Energy Technology Data Exchange (ETDEWEB)

    Murray, Paul, E-mail: paul.murray@strath.ac.uk [Department of Electronic and Electrical Engineering, University of Strathclyde, Technology and Innovation Centre, 99 George Street, Glasgow, G1 1RD (United Kingdom); West, Graeme; Marshall, Stephen; McArthur, Stephen [Dept. Electronic and Electrical Engineering, University of Strathclyde, Royal College Building, 204 George Street, Glasgow G1 1XW (United Kingdom)

    2016-04-15

    system will result in significant time savings on the critical outage path for the plant operator and will allow improved visualization of the surface of the inside of fuel channels, far beyond that which can be gained from manually analysing the raw video footage as is done at present.

  7. [The adaptation and validation to Spanish of the questionnaire Aid to Capacity Evaluation (ACE), for the assessment of the ability of patients in medical decision-making].

    Science.gov (United States)

    Moraleda Barba, Sandra; Ballesta Rodríguez, M Isabel; Delgado Quero, Antonio Luis; Lietor Villajos, Norberto; Moreno Corredor, Andrés; Delgado Rodríguez, Miguel

    2015-03-01

    To adapt and validate the Spanish version of the Aid to Capacity Evaluation scale, designed to assess the capacity of the adult in medical decision-making, both in diagnosis and treatment processes. Observational study of prospective validation. Primary and hospital care of the basic health area of Jaen. One hundred twenty-nine patients. Questionnaire which included sociodemographic variables, concerning the decision (scope, type of decision, the need for written informed consent), assessment of the capacity to the Aid to Capacity Evaluation scale and other related comorbidity (hearing loss, alcoholism, cognitive level variables with the Mini-Mental State Examination and depression by Goldberg or Yesavage test). The tool is considered viable. The conclusions of the expert panel were favorable. The result of the criteria' validity, comparing the results with the assessment of the experts (forensic and psychiatrist) was very satisfying (P<.001). The intra-observer reliability was low (kappa=0,135). Interobserver reliability remained high (kappa=0.74). The internal consistency was awarded an alpha of Cronbach's 0,645 for the reduced model of 6 items. The Aid to Capacity Evaluation scale was adapted to Spanish, demonstrating adequate internal consistency and construct validity. Its use in clinical practice could contribute to the identification of patients unable to make a particular medical decision and/or to give an informed consent. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  8. Providing Quantitative Information and a Nudge to Undergo Stool Testing in a Colorectal Cancer Screening Decision Aid: A Randomized Clinical Trial.

    Science.gov (United States)

    Schwartz, Peter H; Perkins, Susan M; Schmidt, Karen K; Muriello, Paul F; Althouse, Sandra; Rawl, Susan M

    2017-08-01

    Guidelines recommend that patient decision aids should provide quantitative information about probabilities of potential outcomes, but the impact of this information is unknown. Behavioral economics suggests that patients confused by quantitative information could benefit from a "nudge" towards one option. We conducted a pilot randomized trial to estimate the effect sizes of presenting quantitative information and a nudge. Primary care patients (n = 213) eligible for colorectal cancer screening viewed basic screening information and were randomized to view (a) quantitative information (quantitative module), (b) a nudge towards stool testing with the fecal immunochemical test (FIT) (nudge module), (c) neither a nor b, or (d) both a and b. Outcome measures were perceived colorectal cancer risk, screening intent, preferred test, and decision conflict, measured before and after viewing the decision aid, and screening behavior at 6 months. Patients viewing the quantitative module were more likely to be screened than those who did not ( P = 0.012). Patients viewing the nudge module had a greater increase in perceived colorectal cancer risk than those who did not ( P = 0.041). Those viewing the quantitative module had a smaller increase in perceived risk than those who did not ( P = 0.046), and the effect was moderated by numeracy. Among patients with high numeracy who did not view the nudge module, those who viewed the quantitative module had a greater increase in intent to undergo FIT ( P = 0.028) than did those who did not. The limitations of this study were the limited sample size and single healthcare system. Adding quantitative information to a decision aid increased uptake of colorectal cancer screening, while adding a nudge to undergo FIT did not increase uptake. Further research on quantitative information in decision aids is warranted.

  9. Fast Mode Decision in the HEVC Video Coding Standard by Exploiting Region with Dominated Motion and Saliency Features.

    Science.gov (United States)

    Podder, Pallab Kanti; Paul, Manoranjan; Murshed, Manzur

    2016-01-01

    The emerging High Efficiency Video Coding (HEVC) standard introduces a number of innovative and powerful coding tools to acquire better compression efficiency compared to its predecessor H.264. The encoding time complexities have also increased multiple times that is not suitable for realtime video coding applications. To address this limitation, this paper employs a novel coding strategy to reduce the time complexity in HEVC encoder by efficient selection of appropriate block-partitioning modes based on human visual features (HVF). The HVF in the proposed technique comprise with human visual attention modelling-based saliency feature and phase correlation-based motion features. The features are innovatively combined through a fusion process by developing a content-based adaptive weighted cost function to determine the region with dominated motion/saliency (RDMS)- based binary pattern for the current block. The generated binary pattern is then compared with a codebook of predefined binary pattern templates aligned to the HEVC recommended block-paritioning to estimate a subset of inter-prediction modes. Without exhaustive exploration of all modes available in the HEVC standard, only the selected subset of modes are motion estimated and motion compensated for a particular coding unit. The experimental evaluation reveals that the proposed technique notably down-scales the average computational time of the latest HEVC reference encoder by 34% while providing similar rate-distortion (RD) performance for a wide range of video sequences.

  10. Do Visual Aids Really Matter?

    National Research Council Canada - National Science Library

    Fish, Kristine; Mun, Jungwon; A'Jontue, RoseAnn

    2016-01-01

    Educational webcasts or video lectures as a teaching tool and a form of visual aid have become widely used with the rising prevalence of online and blended courses and with the increase of web-based video materials...

  11. Patient Acceptability of the Yorkshire Dialysis Decision Aid (YoDDA) Booklet: A Prospective Non-Randomized Comparison Study Across 6 Predialysis Services.

    Science.gov (United States)

    Winterbottom, Anna E; Gavaruzzi, Teresa; Mooney, Andrew; Wilkie, Martin; Davies, Simon J; Crane, Dennis; Tupling, Ken; Baxter, Paul D; Meads, David M; Mathers, Nigel; Bekker, Hilary L

    2016-01-01

    ♦ Patients are satisfied with their kidney care but want more support in making dialysis choices. Predialysis leaflets vary across services, with few being sufficient to enable patients' informed decision making. We describe the acceptability of a patient decision aid and feasibility of evaluating its effectiveness within usual predialysis practice. ♦ Prospective non-randomized comparison design, Usual Care or Usual Care Plus Yorkshire Dialysis Decision Aid Booklet (+YoDDA), in 6 referral centers (Yorkshire-Humber, UK) for patients with sustained deterioration of kidney function. Consenting (C) patients completed questionnaires after predialysis consultation (T1), and 6 weeks later (T2). Measures assessed YoDDA's utility to support patients' decisions and integration within usual care. ♦ Usual Care (n = 105) and +YoDDA (n = 84) participant characteristics were similar: male (62%), white (94%), age (mean = 62.6; standard deviation [SD] 14.4), kidney disease severity (glomerular filtration rate [eGFR] mean = 14.7; SD 3.7); decisional conflict was < 25; choice-preference for home versus hospital dialysis approximately 50:50. Patients valued receiving YoDDA, reading it on their own (96%), and sharing it with family (72%). The +YoDDA participants had higher scores for understanding kidney disease, reasoning about options, feeling in control, sharing their decision with family. Study engagement varied by center (estimated range 14 - 49%; mean 45%); participants varied in completion of decision quality measures. ♦ Receiving YoDDA as part of predialysis education was valued and useful to patients with worsening kidney disease. Integrating YoDDA actively within predialysis programs will meet clinical guidelines and patient need to support dialysis decision making in the context of patients' lifestyle. Copyright © 2016 International Society for Peritoneal Dialysis.

  12. Exploring the clinical decision-making used by experienced cardiorespiratory physiotherapists: A mixed method qualitative design of simulation, video recording and think aloud techniques.

    Science.gov (United States)

    Thackray, Debbie; Roberts, Lisa

    2017-02-01

    The ability of physiotherapists to make clinical decisions is a vital component of being an autonomous practitioner, yet this complex phenomenon has been under-researched in cardiorespiratory physiotherapy. The purpose of this study was to explore clinical decision-making (CDM) by experienced physiotherapists in a scenario of a simulated patient experiencing acute deterioration of their respiratory function. The main objective of this observational study was to identify the actions, thoughts, and behaviours used by experienced cardiorespiratory physiotherapists in their clinical decision-making processes. A mixed-methods (qualitative) design employing observation and think-aloud, was adopted using a computerised manikin in a simulated environment. The participants clinically assessed the manikin programmed with the same clinical signs, under standardised conditions in the clinical skills practice suite, which was set up as a ward environment. Experienced cardiorespiratory physiotherapists, recruited from clinical practice within a 50-mile radius of the University(*). Participants were video-recorded throughout the assessment and treatment and asked to verbalise their thought processes using the 'think-aloud' method. The recordings were transcribed verbatim and managed using a Framework approach. Eight cardiorespiratory physiotherapists participated (mean 7years clinical experience, range 3.5-16years. CDM was similar to the collaborative hypothetico-deductive model, five-rights nursing model, reasoning strategies, inductive reasoning and pattern recognition. However, the CDM demonstrated by the physiotherapists was complex, interactive and iterative. Information processing occurred continuously throughout the whole interaction with the patient, and the specific cognitive skills of recognition, matching, discriminating, relating, inferring, synthesising and prediction were identified as being used sequentially. The findings from this study were used to develop a new

  13. An evaluation of operating room safety and efficiency: pilot utilization of a structured focus group format and three-dimensional video mock-up to inform design decision.

    Science.gov (United States)

    Watkins, Nicholas; Kobelja, Mark; Peavey, Erin; Thomas, Stephen; Lyon, John

    2011-01-01

    The purpose of this investigation was to identify safety and efficiency-related design features for inclusion in operating room (OR) construction documents. Organizations are confronted with an array of challenges when planning an OR, including inefficiencies in operations, adverse events, and a variety of innovations to choose from. Currently, techniques that can be used in design practice and to inform design decision making for implementable OR solutions are limited. The project team used a structured focus group format with mixed methods to solicit 19 varying surgical team members' reactions to a three-dimensional video mock-up of a proposed OR. Data from the 19 participants were analyzed using stepwise multiple regression and content analysis of open-ended responses. Results demonstrate that several features of the proposed OR design predict meaningful outcomes, including flexibility and satisfaction with the OR setup, adverse event prevention, team performance, and distractions and interruptions. Participants' suggested solutions include universal booms to support anesthetic and perfusion capabilities, a fixed circulating nursing workstation that faces the patient and is at the foot of the operating room table, a wall-mounted monitor across from the surgeon, and wiring to support a touch-screen control arm in OR surgical fields. Findings from structured focus groups with mixed methods lead to implementable design solutions for construction documentation. The expeditious qualities and objectivity of the format are value-adds to the design decision-making process. Future research should use various techniques such as virtual technologies and building information modeling.

  14. Deriving video content type from HEVC bitstream semantics

    Science.gov (United States)

    Nightingale, James; Wang, Qi; Grecos, Christos; Goma, Sergio R.

    2014-05-01

    As network service providers seek to improve customer satisfaction and retention levels, they are increasingly moving from traditional quality of service (QoS) driven delivery models to customer-centred quality of experience (QoE) delivery models. QoS models only consider metrics derived from the network however, QoE models also consider metrics derived from within the video sequence itself. Various spatial and temporal characteristics of a video sequence have been proposed, both individually and in combination, to derive methods of classifying video content either on a continuous scale or as a set of discrete classes. QoE models can be divided into three broad categories, full reference, reduced reference and no-reference models. Due to the need to have the original video available at the client for comparison, full reference metrics are of limited practical value in adaptive real-time video applications. Reduced reference metrics often require metadata to be transmitted with the bitstream, while no-reference metrics typically operate in the decompressed domain at the client side and require significant processing to extract spatial and temporal features. This paper proposes a heuristic, no-reference approach to video content classification which is specific to HEVC encoded bitstreams. The HEVC encoder already makes use of spatial characteristics to determine partitioning of coding units and temporal characteristics to determine the splitting of prediction units. We derive a function which approximates the spatio-temporal characteristics of the video sequence by using the weighted averages of the depth at which the coding unit quadtree is split and the prediction mode decision made by the encoder to estimate spatial and temporal characteristics respectively. Since the video content type of a sequence is determined by using high level information parsed from the video stream, spatio-temporal characteristics are identified without the need for full decoding and can

  15. Expert Systems, Job Aids, and the Future of Instructional Technology; and Decision Tables, the Poor Person's Answer to "Expert Systems."

    Science.gov (United States)

    Harmon, Paul; Pipe, Peter

    1986-01-01

    Describes design and presents examples of industrial use of small expert systems and guidelines for choosing problems which lend themselves to small tool solutions. Use of microcomputer facilitated decision tables to diagnose and categorize people, things, and issues is suggested, and development of three decision table formats is described. (MBR)

  16. A multiattribute utility analysis of sites nominated for characterization for the first radioactive-waste repository: A decision-aiding methodology

    Energy Technology Data Exchange (ETDEWEB)

    none,

    1986-05-01

    In December 1984, the Department of Energy (DOE) published draft environmental assessments (EAs) to support the proposed nomination of five sites and the recommendation of three sites for characterization for the first radioactive-waste repository. A chapter common to all the draft EAs (Chapter 7) presented rankings of the five sites against the postclosure and the preclosure technical siting guidelines. To determine which three sites appeared most favorable for recommendation for characterization, three simple quantitative methods were used to aggregate the rankings assigned to each site for the various technical guidelines. In response to numerous comments on the methods, the DOE has undertaken a formal application of one of them (hereafter referred to as the decision-aiding methodology) for the purpose of obtaining a more rigorous evaluation of the nominated sites. The application of the revised methodology is described in this report. The method of analysis is known as multiattribute utility analysis; it is a tool for providing insights as to which sites are preferable and why. The decision-aiding methodology accounts for all the fundamental considerations specified by the siting guidelines and uses as source information the data and evaluations reported or referenced in the EAs. It explicitly addresses the uncertainties and value judgments that are part of all siting problems. Furthermore, all scientific and value judgments are made explicit for the reviewer. An independent review of the application of the decision-aiding methodology has been conducted by the Board on Radioactive Waste Management of the National Academy of Sciences; the comments of the Board are included as an appendix to this report.

  17. Star Wars in psychotherapy: video games in the office.

    Science.gov (United States)

    Ceranoglu, Tolga Atilla

    2010-01-01

    Video games are used in medical practice during psycho-education in chronic disease management, physical therapy, rehabilitation following traumatic brain injury, and as an adjunct in pain management during medical procedures or cancer chemotherapy. In psychiatric practice, video games aid in social skills training of children with developmental delays and in cognitive behavioral therapy (CBT). This most popular children's toy may prove a useful tool in dynamic psychotherapy of youth. The author provides a framework for using video games in psychotherapy by considering the characteristics of video games and describes the ways their use has facilitated various stages of therapeutic process. Just as other play techniques build a relationship and encourage sharing of emotional themes, sitting together in front of a console and screen facilitates a relationship and allows a safe path for the patient's conflict to emerge. During video game play, the therapist may observe thought processes, impulsivity, temperament, decision-making, and sharing, among other aspects of a child's clinical presentation. Several features inherent to video games require a thoughtful approach as resistance and transference in therapy may be elaborated differently in comparison to more traditional toys. Familiarity with the video game content and its dynamics benefits child mental health clinicians in their efforts to help children and their families.

  18. Usability evaluation and adaptation of the e-health Personal Patient Profile-Prostate decision aid for Spanish-speaking Latino men

    OpenAIRE

    Berry, Donna L.; Halpenny, Barbara; Bosco, Jaclyn L. F.; Bruyere, John; Sanda, Martin G.

    2015-01-01

    Background The Personal Patient Profile-Prostate (P3P), a web-based decision aid, was demonstrated to reduce decisional conflict in English-speaking men with localized prostate cancer early after initial diagnosis. The purpose of this study was to explore and enhance usability and cultural appropriateness of a Spanish P3P by Latino men with a diagnosis of prostate cancer. Methods P3P was translated to Spanish and back-translated by three native Spanish-speaking translators working independent...

  19. GT-MSOCC - A domain for research on human-computer interaction and decision aiding in supervisory control systems. [Georgia Tech - Multisatellite Operations Control Center

    Science.gov (United States)

    Mitchell, Christine M.

    1987-01-01

    The Georgia Tech-Multisatellite Operations Control Center (GT-MSOCC), a real-time interactive simulation of the operator interface to a NASA ground control system for unmanned earth-orbiting satellites, is described. The GT-MSOCC program for investigating a range of modeling, decision aiding, and workstation design issues related to the human-computer interaction is discussed. A GT-MSOCC operator function model is described in which operator actions, both cognitive and manual, are represented as the lowest level discrete control network nodes, and operator action nodes are linked to information needs or system reconfiguration commands.

  20. Why Breast Cancer Risk by the Numbers Is Not Enough: Evaluation of a Decision Aid in Multi-Ethnic, Low-Numerate Women.

    Science.gov (United States)

    Kukafka, Rita; Yi, Haeseung; Xiao, Tong; Thomas, Parijatham; Aguirre, Alejandra; Smalletz, Cindy; David, Raven; Crew, Katherine

    2015-07-14

    Breast cancer risk assessment including genetic testing can be used to classify people into different risk groups with screening and preventive interventions tailored to the needs of each group, yet the implementation of risk-stratified breast cancer prevention in primary care settings is complex. To address barriers to breast cancer risk assessment, risk communication, and prevention strategies in primary care settings, we developed a Web-based decision aid, RealRisks, that aims to improve preference-based decision-making for breast cancer prevention, particularly in low-numerate women. RealRisks incorporates experience-based dynamic interfaces to communicate risk aimed at reducing inaccurate risk perceptions, with modules on breast cancer risk, genetic testing, and chemoprevention that are tailored. To begin, participants learn about risk by interacting with two games of experience-based risk interfaces, demonstrating average 5-year and lifetime breast cancer risk. We conducted four focus groups in English-speaking women (age ≥18 years), a questionnaire completed before and after interacting with the decision aid, and a semistructured group discussion. We employed a mixed-methods approach to assess accuracy of perceived breast cancer risk and acceptability of RealRisks. The qualitative analysis of the semistructured discussions assessed understanding of risk, risk models, and risk appropriate prevention strategies. Among 34 participants, mean age was 53.4 years, 62% (21/34) were Hispanic, and 41% (14/34) demonstrated low numeracy. According to the Gail breast cancer risk assessment tool (BCRAT), the mean 5-year and lifetime breast cancer risk were 1.11% (SD 0.77) and 7.46% (SD 2.87), respectively. After interacting with RealRisks, the difference in perceived and estimated breast cancer risk according to BCRAT improved for 5-year risk (P=.008). In the qualitative analysis, we identified potential barriers to adopting risk-appropriate breast cancer prevention

  1. Use of powered electric vehicles in automobile fleets. Help elements for decision; Utilisation de vehicules electriques dans les flottes automobiles. Elements d`aide a la decision

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    One of the primary causes of degradation in the quality of urban life is automobile transportation. The introduction of electric vehicles within automobile fleets can help mitigate some of the associated impacts. This guide has assembled a set of technical tools vital to all fleet managers, whether they be with public-sector agencies or companies, who are involved in vehicle-purchasing decisions. It deals with the specific issues related to the use, maintenance and acquisition of electric vehicles. Besides those elements intended to convince both decision-makers and users alike, the automobile fleet manager will find herein, as a conclusion, some examples of comparative economic assessments. These serve to highlight the opportunities available for using electric vehicles in a wide variety of situations. (authors) 18 refs.

  2. What matters most: protocol for a randomized controlled trial of breast cancer surgery encounter decision aids across socioeconomic strata.

    Science.gov (United States)

    Durand, Marie-Anne; Yen, Renata West; O'Malley, A James; Politi, Mary C; Dhage, Shubhada; Rosenkranz, Kari; Weichman, Katie; Margenthaler, Julie; Tosteson, Anna N A; Crayton, Eloise; Jackson, Sherrill; Bradley, Ann; Volk, Robert J; Sepucha, Karen; Ozanne, Elissa; Percac-Lima, Sanja; Song, Julia; Acosta, Jocelyn; Mir, Nageen; Elwyn, Glyn

    2018-02-13

    Breast cancer is the most commonly diagnosed malignancy in women. Mastectomy and breast-conserving surgery (BCS) have equivalent survival for early stage breast cancer. However, each surgery has different benefits and harms that women may value differently. Women of lower socioeconomic status (SES) diagnosed with early stage breast cancer are more likely to experience poorer doctor-patient communication, lower satisfaction with surgery and decision-making, and higher decision regret compared to women of higher SES. They often play a more passive role in decision-making and are less likely to undergo BCS. Our aim is to understand how best to support women of lower SES in making decisions about early stage breast cancer treatments and to reduce disparities in decision quality across socioeconomic strata. We will conduct a three-arm, multi-site randomized controlled superiority trial with stratification by SES and clinician-level randomization. At four large cancer centers in the United States, 1100 patients (half higher SES and half lower SES) will be randomized to: (1) Option Grid, (2) Picture Option Grid, or (3) usual care. Interviews, field-notes, and observations will be used to explore strategies that promote the interventions' sustained use and dissemination. Community-Based Participatory Research will be used throughout. We will include women aged at least 18 years of age with a confirmed diagnosis of early stage breast cancer (I to IIIA) from both higher and lower SES, provided they speak English, Spanish, or Mandarin Chinese. Our primary outcome measure is the 16-item validated Decision Quality Instrument. We will use a regression framework, mediation analyses, and multiple informants analysis. Heterogeneity of treatment effects analyses for SES, age, ethnicity, race, literacy, language, and study site will be performed. Currently, women of lower SES are more likely to make treatment decisions based on incomplete or uninformed preferences, potentially

  3. Computer Based Decision Support Tool for Helicopter Mission Planning in Disaster Relief and Military Operations (Outil informatique d’aide a la decision pour la planification des missions d’helicopteres dans des operations militaires et de secours en cas de catastrophe)

    Science.gov (United States)

    2008-06-01

    TR-SAS-045 Computer Based Decision Support Tool for Helicopter Mission Planning in Disaster Relief and Military Operations (Outil informatique ...Computer Based Decision Support Tool for Helicopter Mission Planning in Disaster Relief and Military Operations (Outil informatique d’aide à la...RTO-TR-SAS-045 Outil informatique d’aide à la décision pour la planification des missions d’hélicoptères dans des opérations militaires et de

  4. Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making

    Directory of Open Access Journals (Sweden)

    Gwenan M. Knight

    2016-01-01

    Full Text Available The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy, the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions.

  5. First Aid: Choking

    Science.gov (United States)

    ... Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet First Aid: Choking KidsHealth > For Parents > First Aid: Choking Print A A A Choking can be a life-threatening emergency. Your child might be choking if ...

  6. Qualitative analysis of decision making by speech-language pathologists in the design of aided visual displays.

    Science.gov (United States)

    McFadd, Emily; Wilkinson, Krista

    2010-06-01

    For children with complex communication needs, augmentative and alternative communication (AAC) devices offer a functional way to communicate thoughts and feelings. Despite many significant advances in the field, effective and efficient aided communication can remain a challenge for some clients and their partners. One critical element of aided AAC intervention is systematic attention to the design of the communication display itself. A well-designed display will foster communication outcomes; a poorly designed one might have the opposite effect. Surprisingly, to our knowledge there are no studies of the strategies that clinicians actually employ when putting together a display. In this research note, we examine, on a case-by-case basis, the strategies six clinicians used when constructing display pages, as a means of highlighting potential areas that might warrant systematic research on display design.

  7. Combination of uncertainty theories and decision-aiding methods for natural risk management in a context of imperfect information

    Science.gov (United States)

    Tacnet, Jean-Marc; Dupouy, Guillaume; Carladous, Simon; Dezert, Jean; Batton-Hubert, Mireille

    2017-04-01

    In mountain areas, natural phenomena such as snow avalanches, debris-flows and rock-falls, put people and objects at risk with sometimes dramatic consequences. Risk is classically considered as a combination of hazard, the combination of the intensity and frequency of the phenomenon, and vulnerability which corresponds to the consequences of the phenomenon on exposed people and material assets. Risk management consists in identifying the risk level as well as choosing the best strategies for risk prevention, i.e. mitigation. In the context of natural phenomena in mountainous areas, technical and scientific knowledge is often lacking. Risk management decisions are therefore based on imperfect information. This information comes from more or less reliable sources ranging from historical data, expert assessments, numerical simulations etc. Finally, risk management decisions are the result of complex knowledge management and reasoning processes. Tracing the information and propagating information quality from data acquisition to decisions are therefore important steps in the decision-making process. One major goal today is therefore to assist decision-making while considering the availability, quality and reliability of information content and sources. A global integrated framework is proposed to improve the risk management process in a context of information imperfection provided by more or less reliable sources: uncertainty as well as imprecision, inconsistency and incompleteness are considered. Several methods are used and associated in an original way: sequential decision context description, development of specific multi-criteria decision-making methods, imperfection propagation in numerical modeling and information fusion. This framework not only assists in decision-making but also traces the process and evaluates the impact of information quality on decision-making. We focus and present two main developments. The first one relates to uncertainty and imprecision

  8. The development of a multi-criteria decision analysis aid to help with contraceptive choices: My Contraception Tool.

    Science.gov (United States)

    French, Rebecca S; Cowan, Frances M; Wellings, Kaye; Dowie, Jack

    2014-04-01

    My Contraception Tool (MCT) applies the principles of multi-criteria decision analysis to the choice of contraceptive method. Its purpose is to make the decision-making process transparent to the user and to suggest a method to them based on their own preferences. The contraceptive option that emerges as optimal from the analysis takes account of the probability of a range of outcomes and the relative weight ascribed to them by the user. The development of MCT was a collaborative project between London School of Hygiene & Tropical Medicine, Brook, FPA and Maldaba Ltd. MCT is available online via the Brook and FPA websites. In this article we describe MCT's development and how it works. Further work is needed to assess the impact it has on decision quality and contraceptive behaviour.

  9. Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

    Science.gov (United States)

    Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

    2014-07-01

    Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and

  10. 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.

  11. Development of a decision aid for the treatment of benign prostatic hyperplasia: A four stage method using a Delphi consensus study.

    Science.gov (United States)

    Lamers, Romy E D; Cuypers, Maarten; Garvelink, Mirjam M; de Vries, Marieke; Bosch, J L H Ruud; Kil, Paul J M

    2016-07-01

    To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2: Identifying patients' needs and expectations, 3: Development of DA content and structure, 4: Usability testing with LUTS/BPH patients. 1 (N=15): Dutch urologists reached consensus on 61% of the statements concerning users' criteria, decision options, structure, and medical content. 2 (N=24): Consensus was reached in 69% on statements concerning the need for improvement of information provision, the need for DA development and that the DA should clarify patients' preferences. 3: DA development based on results from stage 1 and stage 2. 4 (N=10): Pros of the DA were clear information provision, systematic design and easy to read and re-read. A LUTS/BPH DA containing VCEs(**) was developed in cooperation with urologists and patients following a structured 4 stage method and was stated to be well accepted. This method can be adopted for the development of DAs to support other medical decision issues. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Digital Solutions for Informed Decision Making: An Academic-Community Partnership for the Development of a Prostate Cancer Decision Aid for African-American Men

    Science.gov (United States)

    Owens, Otis L.; Friedman, Daniela B.; Brandt, Heather M.; Bernhardt, Jay M.; Hébert, James R.

    2014-01-01

    African-American (AA) men are significantly more likely to die of prostate cancer (PrCA) than other racial groups, and there is a critical need to identify strategies for providing information about PrCA screening and the importance of informed decision making (IDM). To assess whether a computer-based IDM intervention for PrCA screening would be appropriate for AA men, this formative evaluation study examined their (1) PrCA risk and screening knowledge, (2) decision-making processes for PrCA screening, (3) usage of, attitudes toward, and access to interactive communication technologies (ICTs), and (4) perceptions regarding a future novel computer-based PrCA education intervention. A purposive convenience sample of 39 AA men aged 37–66 years in the Southeastern United States were recruited through faith-based organizations to participate in one of six 90-minute focus groups and complete a 45-item descriptive survey. Participants were generally knowledgeable about PrCA; however, few engaged in IDM with their doctor and few were informed about the associated risks and uncertainties of PrCA screening. Most participants used ICTs on a daily basis for various purposes including health information seeking. Most participants were open to a novel computer-based intervention if the system was easy to use and its animated avatars were culturally appropriate. Because study participants had low exposure to IDM for PrCA, but frequently used ICTs, IDM interventions using ICTs (e.g, computers) hold promise for AA men and should be explored for feasibility and effectiveness. These interventions should aim to increase PrCA screening knowledge and stress the importance of participating in IDM with their doctor. PMID:25563381

  13. Perceived barriers and facilitators of using a Web-based interactive decision aid for colorectal cancer screening in community practice settings: findings from focus groups with primary care clinicians and medical office staff.

    Science.gov (United States)

    Jimbo, Masahito; Shultz, Cameron Garth; Nease, Donald Eugene; Fetters, Michael Derwin; Power, Debra; Ruffin, Mack Thomas

    2013-12-18

    Information is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening. To address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow. Five focus groups in five community practice settings were conducted with 8 physicians, 1 physician assistant, and 18 clinic staff. Focus groups were organized using a semistructured discussion guide designed to identify factors that mediate and impede the use of a Web-based decision aid intended to clarify patient preferences for colorectal cancer screening and to trigger shared decision making during the clinical encounter. All physicians, the physician assistant, and 8 of the 18 clinic staff were active participants in the focus groups. Clinician and staff participants from each setting reported a belief that the Web-based patient-led decision aid could be an informative and educational tool; in all but one setting participants reported a readiness to recommend the tool to patients. The exception related to clinicians from one clinic who described a preference for patients having fewer screening choices, noting that a colonoscopy was the preferred screening modality for patients in their clinic. Perceived barriers to utilizing the Web-based decision aid included patients' lack of Internet access or low computer literacy, and potential impediments to the clinics' daily workflow. Expanding patients' use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients' screening preferences. Participants described that a system to link the online decision aid to a computerized reminder

  14. A GIS- and Fuzzy Set-Based Online Land Price Evaluation Approach Supported by Intelligence-Aided Decision-Making

    Directory of Open Access Journals (Sweden)

    Sheng Li

    2016-07-01

    Full Text Available In recent years, with the reforms to the land use system and the development of urbanization in China, land price evaluation has tended towards marketization. Prices are determined by the government, the land transaction market and the public. It is necessary to propose higher standards to be used in the evaluation process. This paper presents an online land price evaluation approach for convenience in evaluation. In a network environment, taking advantage of the data services provided by various departments, we propose two models to assist in decision-making: (1 a geographic information system (GIS- and fuzzy set-based location factor quantification model, which adopts dynamic data, rules and quantification measures (based on the road network to dynamically quantify location factors, thus transforming fuzzy sets into appropriate values; and (2 a neartude-based transaction sample push model, which quantifies the similarity between a given land and other samples, thus providing a basis for decision-making by an appraiser. This approach is applied in Shenzhen to evaluate its ability to simplify the work of appraisers and make their decisions more intuitive and objective in a real case.

  15. Video microblogging

    DEFF Research Database (Denmark)

    Bornoe, Nis; Barkhuus, Louise

    2010-01-01

    Microblogging is a recently popular phenomenon and with the increasing trend for video cameras to be built into mobile phones, a new type of microblogging has entered the arena of electronic communication: video microblogging. In this study we examine video microblogging, which is the broadcasting...... of short videos. A series of semi-structured interviews offers an understanding of why and how video microblogging is used and what the users post and broadcast....

  16. The Performance Analysis of the Map-Aided Fuzzy Decision Tree Based on the Pedestrian Dead Reckoning Algorithm in an Indoor Environment

    Directory of Open Access Journals (Sweden)

    Kai-Wei Chiang

    2015-12-01

    Full Text Available Hardware sensors embedded in a smartphone allow the device to become an excellent mobile navigator. A smartphone is ideal for this task because its great international popularity has led to increased phone power and since most of the necessary infrastructure is already in place. However, using a smartphone for indoor pedestrian navigation can be problematic due to the low accuracy of sensors, imprecise predictability of pedestrian motion, and inaccessibility of the Global Navigation Satellite System (GNSS in some indoor environments. Pedestrian Dead Reckoning (PDR is one of the most common technologies used for pedestrian navigation, but in its present form, various errors tend to accumulate. This study introduces a fuzzy decision tree (FDT aided by map information to improve the accuracy and stability of PDR with less dependency on infrastructure. First, the map is quickly surveyed by the Indoor Mobile Mapping System (IMMS. Next, Bluetooth beacons are implemented to enable the initializing of any position. Finally, map-aided FDT can estimate navigation solutions in real time. The experiments were conducted in different fields using a variety of smartphones and users in order to verify stability. The contrast PDR system demonstrates low stability for each case without pre-calibration and post-processing, but the proposed low-complexity FDT algorithm shows good stability and accuracy under the same conditions.

  17. Impact of a web-based treatment decision aid for early-stage prostate cancer on shared decision-making and health outcomes: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Cuypers, Maarten; Lamers, Romy E D; Kil, Paul J M; van de Poll-Franse, Lonneke V; de Vries, Marieke

    2015-05-27

    At an early stage, prostate cancer patients are often eligible for more than one treatment option, or may choose to defer curative treatment. Without a pre-existing superior option, a patient has to weigh his personal preferences against the risks and benefits of each alternative to select the most appropriate treatment. Given this context, in prostate cancer treatment decision-making, it is particularly suitable to follow the principles of shared decision-making (SDM), especially with the support of specific instruments like decision aids (DAs). Although several alternatives are available, present tools are not sufficiently compatible with routine clinical practice. To overcome existing barriers and to stimulate structural implementation of DAs and SDM in clinical practice, a web-based prostate cancer treatment DA was developed to fit clinical workflow. Following the structure of an existing DA, Dutch content was developed, and values clarification methods (VCMs) were added. The aim of this study is to investigate the effect of this DA on (shared) treatment choice and patient-reported outcomes. Nineteen Dutch hospitals are included in a pragmatic, cluster randomized controlled trial, with an intervention and a control arm. In the intervention group, the DA will be offered after diagnosis, and a summary of the patients' preferences, which were identified with the DA, can be discussed by the patient and his clinician during later consultation. Patients in the control group will receive information and decisional support as usual. Results from both groups on decisional conflict, treatment choice and the experience with involvement in the decision-making process are compared. Patients are requested to fill in questionnaires after treatment decision-making but before treatment is started, and 6 and 12 months later. This will allow the development of treatment satisfaction, decisional regret, and quality of life to be monitored. Clinicians from both groups will evaluate

  18. Emerging medical informatics with case-based reasoning for aiding clinical decision in multi-agent system.

    Science.gov (United States)

    Shen, Ying; Colloc, Joël; Jacquet-Andrieu, Armelle; Lei, Kai

    2015-08-01

    This research aims to depict the methodological steps and tools about the combined operation of case-based reasoning (CBR) and multi-agent system (MAS) to expose the ontological application in the field of clinical decision support. The multi-agent architecture works for the consideration of the whole cycle of clinical decision-making adaptable to many medical aspects such as the diagnosis, prognosis, treatment, therapeutic monitoring of gastric cancer. In the multi-agent architecture, the ontological agent type employs the domain knowledge to ease the extraction of similar clinical cases and provide treatment suggestions to patients and physicians. Ontological agent is used for the extension of domain hierarchy and the interpretation of input requests. Case-based reasoning memorizes and restores experience data for solving similar problems, with the help of matching approach and defined interfaces of ontologies. A typical case is developed to illustrate the implementation of the knowledge acquisition and restitution of medical experts. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. The role of advance euthanasia directives as an aid to communication and shared decision-making in dementia.

    Science.gov (United States)

    Hertogh, C M P M

    2009-02-01

    Recent evaluation of the practice of euthanasia and related medical decisions at the end of life in the Netherlands has shown a slight decrease in the frequency of physician-assisted death since the enactment of the Euthanasia Law in 2002. This paper focuses on the absence of euthanasia cases concerning patients with dementia and a written advance euthanasia directive, despite the fact that the only real innovation of the Euthanasia Law consisted precisely in allowing physicians to act upon such directives. The author discusses two principal reasons for this absence. One relates to the uncertainty about whether patients with advanced dementia truly experience the suffering they formerly feared. There is reason to assume that they don't, as a consequence of psychological adaptation and progressive unawareness (anosognosia). The second, more fundamental reason touches upon the ethical relevance of shared understanding and reciprocity. The author argues that, next to autonomy and mercifulness, "reciprocity" is a condition sine qua non for euthanasia. The absence thereof in advanced dementia renders euthanasia morally inconceivable, even if there are signs of suffering and notwithstanding the presence of an advance euthanasia directive. This does not mean, however, that advance euthanasia directives of patients with dementia are worthless. They might very well have a role in the earlier stages of certain subtypes of the disease. To illustrate this point the author presents a case in which the advance directive helped to create a window of opportunity for reciprocity and shared decision-making.

  20. 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)

  1. Video demystified

    CERN Document Server

    Jack, Keith

    2004-01-01

    This international bestseller and essential reference is the "bible" for digital video engineers and programmers worldwide. This is by far the most informative analog and digital video reference available, includes the hottest new trends and cutting-edge developments in the field. Video Demystified, Fourth Edition is a "one stop" reference guide for the various digital video technologies. The fourth edition is completely updated with all new chapters on MPEG-4, H.264, SDTV/HDTV, ATSC/DVB, and Streaming Video (Video over DSL, Ethernet, etc.), as well as discussions of the latest standards throughout. The accompanying CD-ROM is updated to include a unique set of video test files in the newest formats. *This essential reference is the "bible" for digital video engineers and programmers worldwide *Contains all new chapters on MPEG-4, H.264, SDTV/HDTV, ATSC/DVB, and Streaming Video *Completely revised with all the latest and most up-to-date industry standards.

  2. Development of a web-based patient decision aid for initiating disease modifying anti-rheumatic drugs using user-centred design methods.

    Science.gov (United States)

    Nota, Ingrid; Drossaert, Constance H C; Melissant, Heleen C; Taal, Erik; Vonkeman, Harald E; Haagsma, Cees J; van de Laar, Mart A F J

    2017-04-26

    A main element of patient-centred care, Patient Decision Aids (PtDAs) facilitate shared decision-making (SDM). A recent update of the International Patient Decision Aids Standards (IPDAS) emphasised patient involvement during PtDA development, but omitted a methodology for doing so. This article reports on the value of user-centred design (UCD) methods for the development of a PtDA that aims to support inflammatory arthritis patients in their choice between disease modifying anti-rheumatic drugs (DMARDs). The IPDAS development process model in combination with UCD methods were applied. The process was overseen by an eight-member multidisciplinary steering group. Patients and health professionals were iteratively consulted. Qualitative in-depth interviews combined with rapid prototyping were conducted with patients to assess their needs for specific functionality, content and design of the PtDA. Group meetings with health professionals were organized to assess patients' needs and to determine how the PtDA should be integrated into patient pathways. The current literature was reviewed to determine the clinical evidence to include in the PtDA. To evaluate usability among patients, they were observed using the PtDA while thinking aloud and then interviewed. The combination of patient interviews with rapid prototyping revealed that patients wanted to compare multiple DMARDs both for their clinical aspects and implications for daily life. Health professionals mainly wanted to refer patients to a reliable, easily adjustable source of information about DMARDs. A web-based PtDA was constructed consisting of four parts: 1) general information about SDM, inflammatory arthritis and DMARDs; 2) an application to compare particular DMARDs; 3) value clarification exercises; and 4) a printed summary of patients' notes, preferences, worries and questions that they could bring to discuss with their rheumatologist. The study demonstrated that UCD methods can be of great value for the

  3. A Three-Phase Decision Model of Computer-Aided Coding for the Iranian Classification of Health Interventions (IRCHI)

    Science.gov (United States)

    Azadmanjir, Zahra; Safdari, Reza; Ghazisaeedi, Marjan; Mokhtaran, Mehrshad; Kameli, Mohammad Esmail

    2017-01-01

    Introduction: Accurate coded data in the healthcare are critical. Computer-Assisted Coding (CAC) is an effective tool to improve clinical coding in particular when a new classification will be developed and implemented. But determine the appropriate method for development need to consider the specifications of existing CAC systems, requirements for each type, our infrastructure and also, the classification scheme. Aim: The aim of the study was the development of a decision model for determining accurate code of each medical intervention in Iranian Classification of Health Interventions (IRCHI) that can be implemented as a suitable CAC system. Methods: first, a sample of existing CAC systems was reviewed. Then feasibility of each one of CAC types was examined with regard to their prerequisites for their implementation. The next step, proper model was proposed according to the structure of the classification scheme and was implemented as an interactive system. Results: There is a significant relationship between the level of assistance of a CAC system and integration of it with electronic medical documents. Implementation of fully automated CAC systems is impossible due to immature development of electronic medical record and problems in using language for medical documenting. So, a model was proposed to develop semi-automated CAC system based on hierarchical relationships between entities in the classification scheme and also the logic of decision making to specify the characters of code step by step through a web-based interactive user interface for CAC. It was composed of three phases to select Target, Action and Means respectively for an intervention. Conclusion: The proposed model was suitable the current status of clinical documentation and coding in Iran and also, the structure of new classification scheme. Our results show it was practical. However, the model needs to be evaluated in the next stage of the research. PMID:28883671

  4. Applying quantitative benefit-risk analysis to aid regulatory decision making in diagnostic imaging: methods, challenges, and opportunities.

    Science.gov (United States)

    Agapova, Maria; Devine, Emily Beth; Bresnahan, Brian W; Higashi, Mitchell K; Garrison, Louis P

    2014-09-01

    Health agencies making regulatory marketing-authorization decisions use qualitative and quantitative approaches to assess expected benefits and expected risks associated with medical interventions. There is, however, no universal standard approach that regulatory agencies consistently use to conduct benefit-risk assessment (BRA) for pharmaceuticals or medical devices, including for imaging technologies. Economics, health services research, and health outcomes research use quantitative approaches to elicit preferences of stakeholders, identify priorities, and model health conditions and health intervention effects. Challenges to BRA in medical devices are outlined, highlighting additional barriers in radiology. Three quantitative methods--multi-criteria decision analysis, health outcomes modeling and stated-choice survey--are assessed using criteria that are important in balancing benefits and risks of medical devices and imaging technologies. To be useful in regulatory BRA, quantitative methods need to: aggregate multiple benefits and risks, incorporate qualitative considerations, account for uncertainty, and make clear whose preferences/priorities are being used. Each quantitative method performs differently across these criteria and little is known about how BRA estimates and conclusions vary by approach. While no specific quantitative method is likely to be the strongest in all of the important areas, quantitative methods may have a place in BRA of medical devices and radiology. Quantitative BRA approaches have been more widely applied in medicines, with fewer BRAs in devices. Despite substantial differences in characteristics of pharmaceuticals and devices, BRA methods may be as applicable to medical devices and imaging technologies as they are to pharmaceuticals. Further research to guide the development and selection of quantitative BRA methods for medical devices and imaging technologies is needed. Copyright © 2014 AUR. Published by Elsevier Inc. All rights

  5. Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research: Implementing the patient-driven research paradigm to aid decision making in stroke care.

    Science.gov (United States)

    Xian, Ying; O'Brien, Emily C; Fonarow, Gregg C; Olson, DaiWai M; Schwamm, Lee H; Hannah, Deidre; Lindholm, Brianna; Maisch, Lesley; Lytle, Barbara L; Greiner, Melissa A; Wu, Jingjing; Peterson, Eric D; Pencina, Michael J; Hernandez, Adrian F

    2015-07-01

    Stroke is common and costly, annually depriving the lives and well-being of 800,000 Americans. Despite demonstrated efficacy in clinical trials, questions remain about the safety and clinical effectiveness of various treatment options given patient characteristics, conditions, preferences, and their desired outcomes. The Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) is a Patient-Centered Outcomes Research Institute-sponsored project designed to help patients, physicians, and other stakeholders make informed decisions regarding stroke care and improve outcomes through patient-centered comparative effectiveness research. The primary outcomes identified and prioritized by stroke patients are "home time" (time spent alive and outside a hospital) and major adverse cardiovascular events. With inputs from stroke patients themselves, a series of comparative safety and effectiveness analyses will be performed across 3 prioritized therapeutic areas identified as important by stroke survivors: oral anticoagulants, statin therapy, and antidepressants. We obtained data from Get With the Guidelines-Stroke linked with Medicare claims and follow-up telephone interviews. Our combined retrospective and prospective research strategy allows the evaluation of the safety and effectiveness of various treatment options and patient-centered longitudinal outcomes. To ensure the rapid translation of findings into clinical practice, results will be disseminated to stroke survivors, caregivers, and health care providers through traditional and social media, including an online decision aid tool. PROSPER is a patient-centered outcome research study guided by patients, caregivers, and the broader health care community. By addressing knowledge gaps in treatment uncertainties through comparative effectiveness research, PROSPER has the potential to improve decision making in stroke care and patient outcomes reflecting individual patient

  6. An Assessment of the Level of Influence of Family Life and HIV/AIDS Education on Knowledge, Attitude and Decision Making among Adolescents with Hearing Impairment in Some States in Nigeria

    Science.gov (United States)

    Adeniyi, S. O.; Oyewumi, A. M.; Fakolade, O. A.

    2011-01-01

    This study investigated knowledge, attitude and decision making on HIV/AIDS among adolescents with hearing impairment in Oyo, Lagos and Kwara States. Seventy-six respondents participated in the study with age range between 16 and 20. The research adopted a descriptive survey research design. Seventy-six students with hearing impairment…

  7. A decision aiding and action management tool to control the energy demand - from conception to development; Un outil d`aide a la decision et de gestion des actions pour la maitrise de la demande d`energie - de la conception au developpement

    Energy Technology Data Exchange (ETDEWEB)

    Kaehler, J.W.M.

    1993-07-06

    This work presents a synthesis of three points: the environment, energy and man. The consideration of these aspects allows us to confront the unequal distribution of energy resources, the constraints and political influences which determine the exploitation of these energy resources, and the concentration of the consumption of energy by one fifth of the world`s population and the perspective of future growth of energy use by the remaining four-fifths. It is understanding of the importance and the benefits of reducing energy requirements, combined with the environmental perspectives, that forms the core of the Integrated Resource Planning of Least is proposed. This framework will utilize the knowledge of the engineer for developing a system to aid with decision making and the management of information, and particularly with the notions henceforth referred to as `Demand-Site Management` as applied to the electrical grid. The model of such a Management Information System which demonstrates these theoretical advances is called SIADEME (Systeme Interactif d`Aide a la Decision et de Gestion des Actions de Maitrise de la Demande d`energie). This includes some examples for the management of electricity demand for both the lighting and refrigeration cases in large (> 2500 m{sup 2}) supermarkets for the French environmental and energy management agency (Ademe). (author) 216 refs.

  8. Developing a Climate Service: Using Hydroclimate Monitoring and Forecasting to Aid Decision Making in Africa and Latin America

    Science.gov (United States)

    Wood, E. F.; Sheffield, J.; Fisher, C. K.; Chaney, N.; Wanders, N.

    2015-12-01

    forecast skill and the effective delivery of the information to decision makers.

  9. Impact of sociodemographic patient characteristics on the efficacy of decision AIDS: a patient-level meta-analysis of 7 randomized trials.

    Science.gov (United States)

    Coylewright, Megan; Branda, Megan; Inselman, Jonathan W; Shah, Nilay; Hess, Erik; LeBlanc, Annie; Montori, Victor M; Ting, Henry H

    2014-05-01

    Decision aids (DAs) increase patient knowledge, reduce decisional conflict, and promote shared decision making (SDM). The extent to which they do so across diverse sociodemographic patient groups is unknown. We conducted a patient-level meta-analysis of 7 randomized trials of DA versus usual care comprising 771 encounters between patients and clinicians discussing treatment options for chest pain, myocardial infarction, diabetes mellitus, and osteoporosis. Using a random effects model, we examined the impact of sociodemographic patient characteristics (age, sex, education, income, and insurance status) on the outcomes of knowledge transfer, decisional conflict, and patient involvement in SDM. Because of small numbers of people of color in the study population, we were not powered to investigate the role of race. Most patients were aged ≥65 years (61%), white (94%), and women (59%); two thirds had greater than a high school education. Compared with usual care, DA patients gained knowledge, were more likely to know their risk, and had less decisional conflict along with greater involvement in SDM. These gains were largely consistent across sociodemographic patient groups, with DAs demonstrating similar efficacy when used with vulnerable patients such as the elderly and those with less income and less formal education. Differences in efficacy were found only in knowledge of risk in 1 subgroup, with greater efficacy among those with higher education (35% versus 18%; P=0.02). In this patient-level meta-analysis of 7 randomized trials, DAs were efficacious across diverse sociodemographic groups as measured by knowledge transfer, decisional conflict, and patient involvement in SDM. To the extent that DAs increase patient knowledge and participation in SDM, they have potential to impact health disparities related to these factors. © 2014 American Heart Association, Inc.

  10. Exploring the relationship between patients' information preference style and knowledge acquisition process in a computerized patient decision aid randomized controlled trial.

    Science.gov (United States)

    Sawka, Anna M; Straus, Sharon; Rodin, Gary; Tsang, Richard W; Brierley, James D; Rotstein, Lorne; Segal, Phillip; Gafni, Amiram; Ezzat, Shereen; Goldstein, David P

    2015-06-19

    We have shown in a randomized controlled trial that a computerized patient decision aid (P-DA) improves medical knowledge and reduces decisional conflict, in early stage papillary thyroid cancer patients considering adjuvant radioactive iodine treatment. Our objectives were to examine the relationship between participants' baseline information preference style and the following: 1) quantity of detailed information obtained within the P-DA, and 2) medical knowledge. We randomized participants to exposure to a one-time viewing of a computerized P-DA (with usual care) or usual care alone. In pre-planned secondary analyses, we examined the relationship between information preference style (Miller Behavioural Style Scale, including respective monitoring [information seeking preference] and blunting [information avoidance preference] subscale scores) and the following: 1) the quantity of detailed information obtained from the P-DA (number of supplemental information clicks), and 2) medical knowledge. Spearman correlation values were calculated to quantify relationships, in the entire study population and respective study arms. In the 37 P-DA users, high monitoring information preference was moderately positively correlated with higher frequency of detailed information acquisition in the P-DA (r = 0.414, p = 0.011). The monitoring subscale score weakly correlated with increased medical knowledge in the entire study population (r = 0.268, p = 0.021, N = 74), but not in the respective study arms. There were no significant associations with the blunting subscale score. Individual variability in information preferences may affect the process of information acquisition from computerized P-DA's. More research is needed to understand how individual information preferences may impact medical knowledge acquisition and decision-making.

  11. Digital video.

    Science.gov (United States)

    Johnson, Don; Johnson, Mike

    2004-04-01

    The process of digital capture, editing, and archiving video has become an important aspect of documenting arthroscopic surgery. Recording the arthroscopic findings before and after surgery is an essential part of the patient's medical record. The hardware and software has become more reasonable to purchase, but the learning curve to master the software is steep. Digital video is captured at the time of arthroscopy to a hard disk, and written to a CD at the end of the operative procedure. The process of obtaining video of open procedures is more complex. Outside video of the procedure is recorded on digital tape with a digital video camera. The camera must be plugged into a computer to capture the video on the hard disk. Adobe Premiere software is used to edit the video and render the finished video to the hard drive. This finished video is burned onto a CD. We outline the choice of computer hardware and software for the manipulation of digital video. The techniques of backup and archiving the completed projects and files also are outlined. The uses of digital video for education and the formats that can be used in PowerPoint presentations are discussed.

  12. VIDEO AIDED TEACHING OF ENGLISH FOR MEDICAL PURPOSES IN ROMANIAN HIGHER EDUCATION / L’ENSEIGNEMENT DE L’ANGLAIS MÉDICAL À L’AIDE DES MOYENS AUDIO-VISUELS DANS LES UNIVERSITÉS DE ROUMANIE / PREDAREA LIMBII ENGLEZE PENTRU SCOPURI MEDICALE CU AJUTORUL MIJLOACELOR AUDIO-VIZUALE, ÎN ÎNVĂŢĂMÂNTUL SUPERIOR DIN ROMÂNIA

    Directory of Open Access Journals (Sweden)

    Iulia Cristina Frînculescu

    2013-11-01

    Full Text Available This article focuses on a teaching method that is still underused in Romania, generally due to lack of facilities and/or training, resulting in an inability on the part of the teacher to cope with the new technologies nowadays used in English language teaching. The present study argues in favour of using video in medical language learning, and to this end it provides some samples of home-grown materials for watching purposes that can be used in the classroom. The various types of exercises presented, combined with the video sequences they are made on, are intended to point out that video aided teaching of English for Medical Purposes (EMP can be highly motivating, as it uniquely allows students to look at medical situations while working on different areas of language.

  13. Decision analysis using decision trees for a simple clinical decision.

    Science.gov (United States)

    Blakley, Brian

    2012-10-01

    To illustrate the use of decision trees with a utility index in clinical decision making. A decision tree was created related to whether or not to perform a tonsillectomy. Data from the literature were applied to a common hypothetical clinical scenario. A decision tree graphically represents the typical decision-making process that many clinicians use. The addition of utility functions permitted consideration of the adverse or beneficial effects of outcomes, altering the treatment decision. Quantitative tools such as decision trees may quantify outcome preferences and aid in clinical decision making, but the proper tool and background data are essential.

  14. The Use of Statistical Parametric Mapping (SPM96 as a Decision Aid in the Differential Diagnosis of Dementia Using 99mTc-HMPAO SPECT

    Directory of Open Access Journals (Sweden)

    A. Barnes

    2000-01-01

    Full Text Available In this study standard patterns of cerebral perfusion based on classifications described in the literature have been chosen and the ability of experienced imaging specialists to categorise the 99mTc HMPAO SPECT scans of patients referred to the department for investigation of dementia has been compared before and after the calculation of Statistical Parametric Maps (SPM—Wellcome Dept of Cognitive Neurology. The primary aim was to investigate whether SPM is an effective decision aid and whether it impacts on the confidence of image reporting. The secondary aim was to examine the influence of SPM on the agreement between image reporting and clinical diagnosis. The results showed that there was a slight decrease in agreement between the imaging specialists after the introduction of additional information from SPM (K = 0.57 to K = 0.5 and that agreement between imaging reporting (including information from SPM and clinical diagnosis was moderate (K = 0.28. This study was able to confirm that SPM is capable of producing meaningful significance maps of individual patients in a routine clinical environment. However, there was no overwhelming evidence that SPM was able to resolve many of the dilemmas associated with the use of SPECT for the differential diagnosis of dementia. In particular, interpretation of SPECT perfusion patterns in dementia is a bigger problem than the initial identification of abnormalities.

  15. Decision-making guide for management of agriculture in the case of a nuclear accident; Guide d'aide a la decision pour la gestion du milieu agricole en cas d'accident nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Reales, N. [Institut de Radioprotection et de Surete Nucleaire (IRSN), 92 - Clamart (France); Fourrie, L. [Association De Coordination Technique Agricole, 75 - Paris (France); Quinio, C.; Grastilleur, Ch. [Ministere de l' Agriculture et de la Peche, 75 - Paris (France). Direction Generale de l' Alimentation

    2008-07-15

    For several years, agricultural and nuclear professionals in France have been working on how to manage the agricultural situation in the event of a nuclear accident. This work resulted in measures at both the national (Aube nuclear safety exercises in 2003, INEX3 in 2005) and international levels (EURATOM Programmes). Following on from the European FARMING (FP5) and EURANOS (FP6) works, ACTA', IRSN and six agricultural technical institutes which are specialized in agricultural production and processing network (arable crop [especially cereals, maize, pulses, potatoes and forage crops], fruits and vegetables, vine and wine, livestock farming [cattle, sheep, goats, pigs, poultry]), created a resource adapted to the French context: the Decision-aiding Tool for the Management of Agriculture in case of a Nuclear Accident. Devised for the Ministry of Agriculture services supporting state officials in a radiation emergency, this manual focuses on the early phase following the accident when the state of emergency would make discussion on countermeasures with a large stakeholder panel impossible. Supported by the Ministry of Agriculture and Fisheries and the French Nuclear Safety Authority, this project increased knowledge of post-accident management strategies and made an important contribution to the national think tank set up within the framework of the French Steering Committee for managing the post-event phase of a nuclear accident (CODIRPA). This article describes how the manual evolved throughout the project and the development of new resources. (authors)

  16. Immersive video

    Science.gov (United States)

    Moezzi, Saied; Katkere, Arun L.; Jain, Ramesh C.

    1996-03-01

    Interactive video and television viewers should have the power to control their viewing position. To make this a reality, we introduce the concept of Immersive Video, which employs computer vision and computer graphics technologies to provide remote users a sense of complete immersion when viewing an event. Immersive Video uses multiple videos of an event, captured from different perspectives, to generate a full 3D digital video of that event. That is accomplished by assimilating important information from each video stream into a comprehensive, dynamic, 3D model of the environment. Using this 3D digital video, interactive viewers can then move around the remote environment and observe the events taking place from any desired perspective. Our Immersive Video System currently provides interactive viewing and `walkthrus' of staged karate demonstrations, basketball games, dance performances, and typical campus scenes. In its full realization, Immersive Video will be a paradigm shift in visual communication which will revolutionize television and video media, and become an integral part of future telepresence and virtual reality systems.

  17. The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 3, Analysis for final programmatic recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Prindle, N.H.; Boak, D.M.; Weiner, R.F. [and others

    1996-05-01

    Systems Prioritization Method (SPM) is a decision-aiding tool developed by Sandia National Laboratories for the US DOE Carlsbad Area Office (DOE/CAO). This tool provides an analytical basis for programmatic decision making for the Waste Isolation Pilot Plant (WIPP). SPM integrates decision-analysis techniques, performance,a nd risk-assessment tools, and advanced information technology. Potential outcomes of proposed activities and combination of activities are used to calculate a probability of demonstrating compliance (PDC) with selected regulations. The results are presented in a decision matrix showing cost, duration, and maximum PDC for all activities in a given cost and duration category. This is the third and final volume in the series which presents the analysis for final programmatic recommendations.

  18. Video games

    OpenAIRE

    Kolář, Vojtěch

    2012-01-01

    This thesis is based on a detailed analysis of various topics related to the question of whether video games can be art. In the first place it analyzes the current academic discussion on this subject and confronts different opinions of both supporters and objectors of the idea, that video games can be a full-fledged art form. The second point of this paper is to analyze the properties, that are inherent to video games, in order to find the reason, why cultural elite considers video games as i...

  19. Computer-aided decision making.

    Science.gov (United States)

    Keith M. Reynolds; Daniel L. Schmoldt

    2006-01-01

    Several major classes of software technologies have been used in decisionmaking for forest management applications over the past few decades. These computer-based technologies include mathematical programming, expert systems, network models, multi-criteria decisionmaking, and integrated systems. Each technology possesses unique advantages and disadvantages, and has...

  20. Effects of a Web-Based Patient Decision Aid on Biologic and Small-Molecule Agents for Rheumatoid Arthritis: Results From a Proof-of-Concept Study.

    Science.gov (United States)

    Li, Linda C; Shaw, Chris D; Lacaille, Diane; Yacyshyn, Elaine; Jones, C Allyson; Koehn, Cheryl; Hoens, Alison M; Geldman, Jasmina; Sayre, Eric C; Macdonald, Graham G; Leese, Jenny; Bansback, Nick

    2017-05-23

    To assess the extent to which ANSWER-2, an interactive online patient decision aid, reduces patients' decisional conflict and improves their medication-related knowledge and self-management capacity. We used a pre-post study design. Eligible participants had a diagnosis of rheumatoid arthritis (RA), had been recommended to start using a biologic agent or small-molecule agent or to switch to a new one, and had internet access. Access to ANSWER-2 was provided immediately after enrollment. Outcome measures included 1) the Decisional Conflict Scale (DCS), 2) the Medication Education Impact Questionnaire (MeiQ), and 3) the Partners in Health Scale (PIHS). A paired t-test was used to assess differences pre- and postintervention. The majority of the 50 participants were women (n = 40), and the mean ± SD age of participants was 49.6 ± 12.2 years. The median disease duration was 5 years (25th, 75th percentile: 2, 10 years). The mean ± SD DCS score was 45.9 ± 25.1 preintervention and 25.1 ± 21.8 postintervention (mean change of -21.2 of 100 [95% confidence interval (95% CI) -28.1, -14.4], P 1.0], P = 0.009). Findings from the MeiQ were mixed, with statistically significant differences found only in the self-management subscales. Patients' decisional conflict decreased and perceived self-management capacity improved after using ANSWER-2. Future research comparing the effectiveness of ANSWER-2 with that of educational material on biologic agents will provide further insight into its value in RA management. © 2017, American College of Rheumatology.

  1. A universal decision support system. Addressing the decision-making needs of patients, families, and clinicians in the setting of critical illness.

    Science.gov (United States)

    Cox, Christopher E; White, Douglas B; Abernethy, Amy P

    2014-08-15

    In the setting of a complex critical illness, preference-sensitive decision making-choosing between two or more reasonable treatment options-can be difficult for patients, families, and clinicians alike. A common challenge to making high-quality decisions in this setting is a lack of critical information access and sharing among participants. Decision aids-brochures, web applications, and videos-are a major focus of current research because mounting evidence suggests they can improve decision-making quality and enhance collaborative shared decision making. However, many decision aids have important limitations, including a relatively narrow capacity for personalization, an inability to gather and generate clinical data, a focus on only a single disease or treatment, and high developmental costs. To address these issues and to help guide future research, we propose a model of "universal" electronic decision support that can be easily adapted by clinicians and patients/families for whatever decision is at hand. In this scalable web-based platform, a general shared decision-making core structure would accommodate simple, interchangeable disease and treatment information modules. The format and content of the system could be adapted to decisional participants' unique characteristics, abilities, and needs. Universal decision support can better standardize a decisional approach and also allow a unique degree of personalization within a framework of shared decision making. We also discuss potential criticisms of this approach as well as strategies that can overcome them in a critical illness setting.

  2. Development and preliminary evaluation of an online educational video about whole-genome sequencing for research participants, patients, and the general public.

    Science.gov (United States)

    Sanderson, Saskia C; Suckiel, Sabrina A; Zweig, Micol; Bottinger, Erwin P; Jabs, Ethylin Wang; Richardson, Lynne D

    2016-05-01

    As whole-genome sequencing (WGS) increases in availability, WGS educational aids are needed for research participants, patients, and the general public. Our aim was therefore to develop an accessible and scalable WGS educational aid. We engaged multiple stakeholders in an iterative process over a 1-year period culminating in the production of a novel 10-minute WGS educational animated video, "Whole Genome Sequencing and You" (https://goo.gl/HV8ezJ). We then presented the animated video to 281 online-survey respondents (the video-information group). There were also two comparison groups: a written-information group (n = 281) and a no-information group (n = 300). In the video-information group, 79% reported the video was easy to understand, satisfaction scores were high (mean 4.00 on 1-5 scale, where 5 = high satisfaction), and knowledge increased significantly. There were significant differences in knowledge compared with the no-information group but few differences compared with the written-information group. Intention to receive personal results from WGS and decisional conflict in response to a hypothetical scenario did not differ between the three groups. The educational animated video, "Whole Genome Sequencing and You," was well received by this sample of online-survey respondents. Further work is needed to evaluate its utility as an aid to informed decision making about WGS in other populations.Genet Med 18 5, 501-512.

  3. Do Visual Aids Really Matter?

    Directory of Open Access Journals (Sweden)

    Kristine Fish

    2016-01-01

    Full Text Available Educational webcasts or video lectures as a teaching tool and a form of visual aid have become widely used with the rising prevalence of online and blended courses and with the increase of web-based video materials. Thus, research pertaining to factors enhancing the effectiveness of video lectures, such as number of visual aids, is critical. This study compared student evaluations before and after embedding additional visual aids throughout video lectures in an online course. Slide transitions occurred on average every 40 seconds for the pre-treatment group with approximately 600 visuals total, compared to slide transitions every 10 seconds for the post-treatment group with approximately 2,000 visuals total. All students received the same audio recordings. Research questions addressed are: (1 Are student perceptions of the effectiveness of examples used to illustrate concepts affected by number of visual aids? (2 Is the extent to which students feel engaged during the lectures affected by number of visual aids? (3 Are students’ perceived overall learning experiences affected by number of visual aids? Surprisingly, results indicate that for questions #1 and #3, student ratings of those who viewed videos with fewer visuals rated their experiences higher than students who viewed more visuals. There was no significant difference found for question #2. Conclusion: Although some visuals have been shown to enhance learning, too many visuals may be a deterrent to learning.

  4. The video lecture

    OpenAIRE

    Crook, Charles; Schofield, Louise

    2017-01-01

    Vocabulary for describing the structures, roles, and relationships characteristic of traditional, or ‘offline’, education has been seamlessly applied to the designs of ‘online’ education. One example is the lecture, delivered as a video recording. The purpose of this research is to consider the concept of ‘lecture’ as realised in both offline and online contexts. We explore how media differences entail different student experiences and how these differences relate to design decisions associat...

  5. How Setswana Cultural Beliefs and Practices on Sexuality Affect Teachers' and Adolescents' Sexual Decisions, Practices, and Experiences as well as HIV/AIDS and STI Prevention in Select Botswanan Secondary Schools.

    Science.gov (United States)

    Nleya, Paul T; Segale, Emelda

    2015-01-01

    The article reports on the aspects of a Botswana Ministry of Education and Skills Development (MoE & SD) HIV/AIDS Instructional Television (ITV) project modeled on a similar HIV/AIDS program implemented in Brazil. This Teacher Capacity Building Project (TCBP) in Botswana is in its initial years of implementation. Its overall goal is to contribute to the prevention and mitigation of the impact of HIV and AIDS by strengthening the capacity of the education and communication sectors to deliver interactive, distance HIV/AIDS education primarily to teachers so that they act as agents of behavior change among the in-school youth. One of the components of the TCBP program is a live teacher education television HIV/AIDS program called Talk Back program. Talk Back is a collaborative effort of the MoE & SD and the Botswana national television station. The Talk Back program involves development and implementation of weekly 1 hour live HIV/AIDS education interactive TV broadcasts for teachers. The development of the live programs is guided by a curriculum that provides a wide range of themes related to HIV/AIDS and education. This article reports the results of a survey of a sample of teachers and students at junior secondary schools and senior secondary schools, first, on their views and opinions regarding the Talk Back program as a TCBP. Second, how Setswana cultural beliefs, myths, and practices on sexuality affect teachers' and adolescents' sexual decisions, practices, and experiences as well as HIV/AIDS and sexually transmitted infection prevention. A questionnaire survey and focus group interviews were used as data collection instruments in selected secondary schools. The findings of the study suggest that the Talk Back program has not met much success as a TCBP. The findings further suggest that several myths, beliefs, misconceptions, and attitudes about HIV/AIDS exist among Botswana teachers and students and thus make it difficult for the Talk Back program to impart

  6. Video Podcasts

    DEFF Research Database (Denmark)

    Nortvig, Anne Mette; Sørensen, Birgitte Holm

    2016-01-01

    This project’s aim was to support and facilitate master’s students’ preparation and collaboration by making video podcasts of short lectures available on YouTube prior to students’ first face-to-face seminar. The empirical material stems from group interviews, from statistical data created through...... YouTube analytics and from surveys answered by students after the seminar. The project sought to explore how video podcasts support learning and reflection online and how students use and reflect on the integration of online activities in the videos. Findings showed that students engaged actively...

  7. The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 2, Summary of technical input and model implementation

    Energy Technology Data Exchange (ETDEWEB)

    Prindle, N.H.; Mendenhall, F.T.; Trauth, K.; Boak, D.M. [Sandia National Labs., Albuquerque, NM (United States); Beyeler, W. [Science Applications International Corp., Albuquerque, NM (United States); Hora, S. [Hawaii Univ., Hilo, HI (United States); Rudeen, D. [New Mexico Engineering Research Inst., Albuquerque, NM (United States)

    1996-05-01

    The Systems Prioritization Method (SPM) is a decision-aiding tool developed by Sandia National Laboratories (SNL). SPM provides an analytical basis for supporting programmatic decisions for the Waste Isolation Pilot Plant (WIPP) to meet selected portions of the applicable US EPA long-term performance regulations. The first iteration of SPM (SPM-1), the prototype for SPM< was completed in 1994. It served as a benchmark and a test bed for developing the tools needed for the second iteration of SPM (SPM-2). SPM-2, completed in 1995, is intended for programmatic decision making. This is Volume II of the three-volume final report of the second iteration of the SPM. It describes the technical input and model implementation for SPM-2, and presents the SPM-2 technical baseline and the activities, activity outcomes, outcome probabilities, and the input parameters for SPM-2 analysis.

  8. Network-aware scalable video monitoring system for emergency situations with operator-managed fidelity control

    Science.gov (United States)

    Al Hadhrami, Tawfik; Nightingale, James M.; Wang, Qi; Grecos, Christos

    2014-05-01

    In emergency situations, the ability to remotely monitor unfolding events using high-quality video feeds will significantly improve the incident commander's understanding of the situation and thereby aids effective decision making. This paper presents a novel, adaptive video monitoring system for emergency situations where the normal communications network infrastructure has been severely impaired or is no longer operational. The proposed scheme, operating over a rapidly deployable wireless mesh network, supports real-time video feeds between first responders, forward operating bases and primary command and control centers. Video feeds captured on portable devices carried by first responders and by static visual sensors are encoded in H.264/SVC, the scalable extension to H.264/AVC, allowing efficient, standard-based temporal, spatial, and quality scalability of the video. A three-tier video delivery system is proposed, which balances the need to avoid overuse of mesh nodes with the operational requirements of the emergency management team. In the first tier, the video feeds are delivered at a low spatial and temporal resolution employing only the base layer of the H.264/SVC video stream. Routing in this mode is designed to employ all nodes across the entire mesh network. In the second tier, whenever operational considerations require that commanders or operators focus on a particular video feed, a `fidelity control' mechanism at the monitoring station sends control messages to the routing and scheduling agents in the mesh network, which increase the quality of the received picture using SNR scalability while conserving bandwidth by maintaining a low frame rate. In this mode, routing decisions are based on reliable packet delivery with the most reliable routes being used to deliver the base and lower enhancement layers; as fidelity is increased and more scalable layers are transmitted they will be assigned to routes in descending order of reliability. The third tier

  9. Protocol for a randomised controlled trial of a web-based healthy relationship tool and safety decision aid for women experiencing domestic violence (I-DECIDE).

    Science.gov (United States)

    Hegarty, Kelsey; Tarzia, Laura; Murray, Elizabeth; Valpied, Jodie; Humphreys, Cathy; Taft, Angela; Gold, Lisa; Glass, Nancy

    2015-08-01

    Domestic violence is a serious problem affecting the health and wellbeing of women globally. Interventions in health care settings have primarily focused on screening and referral, however, women often may not disclose abuse to health practitioners. The internet offers a confidential space in which women can assess the health of their relationships and make a plan for safety and wellbeing for themselves and their children. This randomised controlled trial is testing the effectiveness of a web-based healthy relationship tool and safety decision aid (I-DECIDE). Based broadly on the IRIS trial in the United States, it has been adapted for the Australian context where it is conducted entirely online and uses the Psychosocial Readiness Model as the basis for the intervention. In this two arm, pragmatic randomised controlled trial, women who have experienced abuse or fear of a partner in the previous 6 months will be computer randomised to receive either the I-DECIDE website or a comparator website (basic relationship and safety advice). The intervention includes self-directed reflection exercises on their relationship, danger level, priority setting, and results in an individualised, tailored action plan. Primary self-reported outcomes are: self-efficacy (General Self-Efficacy Scale) immediately after completion, 6 and 12 months post-baseline; and depressive symptoms (Centre for Epidemiologic Studies Depression Scale, Revised, 6 and 12 months post-baseline). Secondary outcomes include mean number of helpful actions for safety and wellbeing, mean level of fear of partner and cost-effectiveness. This fully-automated trial will evaluate a web-based self-information, self-reflection and self-management tool for domestic violence. We hypothesise that the improvement in self-efficacy and mental health will be mediated by increased perceived support and awareness encouraging positive change. If shown to be effective, I-DECIDE could be easily incorporated into the community

  10. 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

    Full Text Available Le brevet compte parmi les meilleurs outils qui permettent la surveillance de l'évolution de la technologie. Comme les publications de brevets se trouvent répertoriées dans des bases de données, celles-ci peuvent être utilisées à des fins statistiques pour établir des panoramas de l'activité technique internationale. Ceci n'est cependant possible qu'avec une base de données qui couvre bien l'ensemble des brevets déposés dans le monde, et qui fournit des informations homogènes et non redondantes dans des zones bien définies pour que les opérations de comptage ne biaisent pas les résultats. Il faut aussi disposer d'un système effectuant les calculs : plusieurs produits sont actuellement disponibles pour effectuer ce genre d'analyse. Depuis 1986, l'institut Français du Pétrole (IFP s'est intéressé à l'étude statistique des brevets, ce qui lui permet de présenter une approche méthodologique, à la fois pour poser le problème et analyser les résultats. De telles analyses rentrent ensuite dans la panoplie des outils d'aide à la décision, car mettant en évidence une certaine interprétation du passé, elles peuvent permettre des projections dans l'avenir. A patent is one of the best tools for monitoring technological developments. Since patent publications are listed in databases, these latter can be used for statistical purposes to provide an overall view of international technical activity. This is possible, however, only with a database effectively covering all patents taken out in the world and giving homogeneous and nonredundant information in well-defined areas so that counting operations do not skew the results. A system must also be available for doing the counting. Several products can currently be used for making this type of analysis. Since 1985, Institut Français du Pétrole (IFP has been studying patent statistics and has developed a methodological approach to both posing the problem and analyzing the results

  11. Imagining life with an ostomy: Does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?☆

    Science.gov (United States)

    Angott, Andrea M.; Comerford, David A.; Ubel, Peter A.

    2014-01-01

    Objective To test a video intervention as a way to improve predictions of mood and quality-of-life with an emotionally evocative medical condition. Such predictions are typically inaccurate, which can be consequential for decision making. Method In Part 1, people presently or formerly living with ostomies predicted how watching a video depicting a person changing his ostomy pouch would affect mood and quality-of-life forecasts for life with an ostomy. In Part 2, participants from the general public read a description about life with an ostomy; half also watched a video depicting a person changing his ostomy pouch. Participants’ quality-of-life and mood forecasts for life with an ostomy were assessed. Results Contrary to our expectations, and the expectations of people presently or formerly living with ostomies, the video did not reduce mood or quality-of-life estimates, even among participants high in trait disgust sensitivity. Among low-disgust participants, watching the video increased quality-of-life predictions for ostomy. Conclusion Video interventions may improve mood and quality-of-life forecasts for medical conditions, including those that may elicit disgust, such as ostomy. Practice implications Video interventions focusing on patients’ experience of illness continue to show promise as components of decision aids, even for emotionally charged health states such as ostomy. PMID:23177398

  12. Acquisition and production of skilled behavior in dynamic decision-making tasks: Modeling strategic behavior in human-automation interaction: Why and aid can (and should) go unused

    Science.gov (United States)

    Kirlik, Alex

    1991-01-01

    Advances in computer and control technology offer the opportunity for task-offload aiding in human-machine systems. A task-offload aid (e.g., an autopilot, an intelligent assistant) can be selectively engaged by the human operator to dynamically delegate tasks to an automated system. Successful design and performance prediction in such systems requires knowledge of the factors influencing the strategy the operator develops and uses for managing interaction with the task-offload aid. A model is presented that shows how such strategies can be predicted as a function of three task context properties (frequency and duration of secondary tasks and costs of delaying secondary tasks) and three aid design properties (aid engagement and disengagement times, aid performance relative to human performance). Sensitivity analysis indicates how each of these contextual and design factors affect the optimal aid aid usage strategy and attainable system performance. The model is applied to understanding human-automation interaction in laboratory experiments on human supervisory control behavior. The laboratory task allowed subjects freedom to determine strategies for using an autopilot in a dynamic, multi-task environment. Modeling results suggested that many subjects may indeed have been acting appropriately by not using the autopilot in the way its designers intended. Although autopilot function was technically sound, this aid was not designed with due regard to the overall task context in which it was placed. These results demonstrate the need for additional research on how people may strategically manage their own resources, as well as those provided by automation, in an effort to keep workload and performance at acceptable levels.

  13. Do Sign Language Videos Improve Web Navigation for Deaf Signer Users?

    Science.gov (United States)

    Fajardo, Inmaculada; Parra, Elena; Canas, Jose J.

    2010-01-01

    The efficacy of video-based sign language (SL) navigation aids to improve Web search for Deaf Signers was tested by two experiments. Experiment 1 compared 2 navigation aids based on text hyperlinks linked to embedded SL videos, which differed in the spatial contiguity between the text hyperlink and SL video (contiguous vs. distant). Deaf Signers'…

  14. Observational study of the development and evaluation of a fertility preservation patient decision aid for teenage and adult women diagnosed with cancer: the Cancer, Fertility and Me research protocol.

    Science.gov (United States)

    Jones, G L; Hughes, J; Mahmoodi, N; Greenfield, D; Brauten-Smith, G; Skull, J; Gath, J; Yeomanson, D; Baskind, E; Snowden, J A; Jacques, R M; Velikova, G; Collins, K; Stark, D; Phillips, R; Lane, S; Bekker, H L

    2017-03-13

    Women diagnosed with cancer and facing potentially sterilising cancer treatment have to make time-pressured decisions regarding fertility preservation with specialist fertility services while undergoing treatment of their cancer with oncology services. Oncologists identify a need for resources enabling them to support women's fertility preservation decisions more effectively; women report wanting more specialist information to make these decisions. The overall aim of the 'Cancer, Fertility and Me' study is to develop and evaluate a new evidence-based patient decision aid (PtDA) for women with any cancer considering fertility preservation to address this unmet need. This is a prospective mixed-method observational study including women of reproductive age (16 years +) with a new diagnosis of any cancer across two regional cancer and fertility centres in Yorkshire, UK. The research involves three stages. In stage 1, the aim is to develop the PtDA using a systematic method of evidence synthesis and multidisciplinary expert review of current clinical practice and patient information. In stage 2, the aim is to assess the face validity of the PtDA. Feedback on its content and format will be ascertained using questionnaires and interviews with patients, user groups and key stakeholders. Finally, in stage 3 the acceptability of using this resource when integrated into usual cancer care pathways at the point of cancer diagnosis and treatment planning will be evaluated. This will involve a quantitative and qualitative evaluation of the PtDA in clinical practice. Measures chosen include using count data of the PtDAs administered in clinics and accessed online, decisional and patient-reported outcome measures and qualitative feedback. Quantitative data will be analysed using descriptive statistics, paired sample t-tests and CIs; interviews will be analysed using thematic analysis. Research Ethics Committee approval (Ref: 16/EM/0122) and Health Research Authority approval

  15. Akademisk video

    DEFF Research Database (Denmark)

    Frølunde, Lisbeth

    2017-01-01

    Dette kapitel har fokus på metodiske problemstillinger, der opstår i forhold til at bruge (digital) video i forbindelse med forskningskommunikation, ikke mindst online. Video har længe været benyttet i forskningen til dataindsamling og forskningskommunikation. Med digitaliseringen og internettet er...... der dog opstået nye muligheder og udfordringer i forhold til at formidle og distribuere forskningsresultater til forskellige målgrupper via video. Samtidig er klassiske metodologiske problematikker som forskerens positionering i forhold til det undersøgte stadig aktuelle. Både klassiske og nye...... problemstillinger diskuteres i kapitlet, som rammesætter diskussionen ud fra forskellige positioneringsmuligheder: formidler, historiefortæller, eller dialogist. Disse positioner relaterer sig til genrer inden for ’akademisk video’. Afslutningsvis præsenteres en metodisk værktøjskasse med redskaber til planlægning...

  16. Video Analytics

    DEFF Research Database (Denmark)

    This book collects the papers presented at two workshops during the 23rd International Conference on Pattern Recognition (ICPR): the Third Workshop on Video Analytics for Audience Measurement (VAAM) and the Second International Workshop on Face and Facial Expression Recognition (FFER) from Real...... World Videos. The workshops were run on December 4, 2016, in Cancun in Mexico. The two workshops together received 13 papers. Each paper was then reviewed by at least two expert reviewers in the field. In all, 11 papers were accepted to be presented at the workshops. The topics covered in the papers...

  17. Hearing aid adjustment

    DEFF Research Database (Denmark)

    Heinemann, Trine; Matthews, Ben; Raudaskoski, Pirkko Liisa

    2012-01-01

    to the interaction during hearing aid fitting. This report of a Danish pilot study describes two such problems. The first problem arises from the requirement that the audiologist needs to ‘translate’ the patient’s subjective hearing description for making technological decisions. The second problem is the way...... in which the hearing aid user’s implicit and often unrealistic expectations are handled. This kind of research has potential application for developing a model of best practices....

  18. The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 1, Synopsis of method and results

    Energy Technology Data Exchange (ETDEWEB)

    Prindle, N.H.; Mendenhall, F.T.; Boak, D.M. [and others

    1996-05-01

    In March 1994, the US Department of Energy Carlsbad Area Office (DOE/CAO) embarked on an effort to design and implement a performance- based decision-aiding tool to provide an analytical basis for planning, prioritizing, and selecting programmatic options for the Waste Isolation Pilot Plant (WIPP). This tool, called Systems Prioritization Method (SPM) defines the most viable combinations of scientific investigations, engineered alternatives (EAs), and waste acceptance criteria (WAC) for supporting the final WIPP compliance application. The scope of SPM is restricted to selected portions of applicable Environmental Protection Agency (EPA) long-term performance regulations. SPM calculates the probabilities of certain sets of activities demonstrating compliance with various regulations. SPM provides results in the form of a decision matrix to identify cost-effective programmatic paths with a high probability of successfully demonstrating compliance.

  19. [Experience assisting an AIDS-infected homosexual patient and his same-sex partner make a do-not-resuscitate decision].

    Science.gov (United States)

    Wang, Shu-Jang; Lai, Pei-Yu; Liou, Siao-Ying; Ko, Wen-Chien; Ko, Nai-Ying

    2012-10-01

    Family members play an important role in the process of writing advance directives. Homosexual men infected with HIV often wish to authorize their intimate same-sex partner or friends rather than immediate family members to make medical decisions on their behalf. Although same-sex marriage is currently illegal in Taiwan, HIV infected homosexual patients are able to write advance directives appointing their same-sex partner to be their surrogate decision maker for end-of-life medical decisions. This case report describes an experience assisting a homosexual patient with HIV to write his advance directives. The nurse assisted the patient and his partner to make a self-determined decision not to resuscitate. Family conferences held to discuss the patient's decisions regarding resuscitation helped legitimize his partner's primary role in making end-of-life healthcare decisions on his behalf. As an advocate for patient rights, nurses should understand the law as it relates to homosexuality and end-of-life decision making, inform patients on the durable power of autonomy, and help execute their advance directives.

  20. Organizational Decisions.

    Science.gov (United States)

    1982-03-01

    information systems, coupled with powerful comuters using problem solving algoriths, we can literally compute mathematically opt imal solutions...Differences in the Process Organizational and Human Decision Processes Chapter 2 METHODS AN D ODELS Prescription Versus Description METHODS Mathemat ico...Introduct ion Analogic aand Mathematical Aids Sensitivity of N.bdels Linear Programning Mhltiple Utility Theory Team Theo r" 2/7/82 Contents Organizational

  1. Proposal for Development of EBM-CDSS (Evidence-Based Clinical Decision Support System) to Aid Prognostication in Terminally Ill Patients

    Science.gov (United States)

    2013-10-01

    34survival"[All Fields] OR "survival"[ MeSH Terms]). To retrieve RCTs in PubMed , we employed strategies suggested by Haynes14 with the following...Decision Curve Analysis: An application to hospice referral for terminal patients. BMC Med Inform Decis Mak. 2011 Dec 23;11(1):77. PubMed PMID...for eliciting decision makers’ preferences and decision-making. BMC Med Inform Decis Mak. 2010;10:51. PubMed PMID: 20846413. Pubmed Central PMCID

  2. Apoios de decisão: instrumento de auxílio à medicina baseada em preferências. Uma revisão conceitual Decision aids: an instrument to eliciting patient preference. Current concepts

    Directory of Open Access Journals (Sweden)

    Mirhelen Mendes de Abreu

    2006-08-01

    Full Text Available A necessidade da incorporação das preferências dos pacientes nas tomadas de decisão é uma realidade da assistência médica contemporânea, que caracteriza a medicina baseada em preferências. Os apoios de decisão são instrumentos que surgem como mecanismos de auxílio ao médico a expor riscos e benefícios de uma determinada tomada de decisão, sendo um mecanismo facilitador para a decisão compartilhada. Na literatura médica, particularmente em reumatologia, nota-se um emergente interesse pelo estudo das preferências dos pacientes nos ensaios clínicos. Este artigo de revisão tem por objetivo conceituar e caracterizar os apoios de decisão e suas implicações na pesquisa e prática clínicas, bem como ressaltar os princípios metodológicos necessários para a sua utilização e desenvolvimento.Patient preferences in decision making is one reality of the medical assistance, which characterizes the value based medicine. The decision aids are instruments that appear as support mechanisms for the doctor to exercise this model of decision making. In medical literature, particularly in rheumatology, an emergent interest on patient's preference study is noticed in clinical trials. The aim of this article is to appraise and to characterize the decision aids and its implications in the practical research and clinics, as well as standing out the necessary methodology principles for its use and development.

  3. Video Analytics

    DEFF Research Database (Denmark)

    This book collects the papers presented at two workshops during the 23rd International Conference on Pattern Recognition (ICPR): the Third Workshop on Video Analytics for Audience Measurement (VAAM) and the Second International Workshop on Face and Facial Expression Recognition (FFER) from Real W...

  4. Stream On: Video Servers in the Real World.

    Science.gov (United States)

    Tristram, Claire

    1995-01-01

    Despite plans for corporate training networks, digital ad-insertion systems, hotel video-on-demand, and interactive television, only small scale video networks presently work. Four case studies examine the design and implementation decisions for different markets: corporate; advertising; hotel; and commercial video via cable, satellite or…

  5. Applying a Multiple Screening Program Aided by a Guideline-driven Computerized Decision Support System—A Pilot Experience in Yun-Lin, Taiwan

    Directory of Open Access Journals (Sweden)

    Jou-Wei Lin

    2007-01-01

    Conclusion: A computer-aided screening program driven by the US Preventive Services Task Force recommendations has been successfully implemented in Yun-Lin, Taiwan, and provided useful information about local epidemiology and implications for future health policy making. [J Formos Med Assoc 2007; 106(1:58-68

  6. Video enhancement effectiveness for target detection

    Science.gov (United States)

    Simon, Michael; Fischer, Amber; Petrov, Plamen

    2011-05-01

    Unmanned aerial vehicles (UAVs) capture real-time video data of military targets while keeping the warfighter at a safe distance. This keeps soldiers out of harm's way while they perform intelligence, surveillance and reconnaissance (ISR) and close-air support troops in contact (CAS-TIC) situations. The military also wants to use UAV video to achieve force multiplication. One method of achieving effective force multiplication involves fielding numerous UAVs with cameras and having multiple videos processed simultaneously by a single operator. However, monitoring multiple video streams is difficult for operators when the videos are of low quality. To address this challenge, we researched several promising video enhancement algorithms that focus on improving video quality. In this paper, we discuss our video enhancement suite and provide examples of video enhancement capabilities, focusing on stabilization, dehazing, and denoising. We provide results that show the effects of our enhancement algorithms on target detection and tracking algorithms. These results indicate that there is potential to assist the operator in identifying and tracking relevant targets with aided target recognition even on difficult video, increasing the force multiplier effect of UAVs. This work also forms the basis for human factors research into the effects of enhancement algorithms on ISR missions.

  7. A Nonlinear Decision-Based Algorithm for Removal of Strip Lines, Drop Lines, Blotches, Band Missing and Impulses in Images and Videos

    Directory of Open Access Journals (Sweden)

    D. Ebenezer

    2008-10-01

    Full Text Available A decision-based nonlinear algorithm for removal of strip lines, drop lines, blotches, band missing, and impulses in images is presented. The algorithm performs two simultaneous operations, namely, detection of corrupted pixels and estimation of new pixels for replacing the corrupted pixels. Removal of these artifacts is achieved without damaging edges and details. The algorithm uses an adaptive length window whose maximum size is 5×5 to avoid blurring due to large window sizes. However, the restricted window size renders median operation less effective whenever noise is excessive in which case the proposed algorithm automatically switches to mean filtering. The performance of the algorithm is analyzed in terms of mean square error [MSE], peak-signal-to-noise ratio [PSNR], and image enhancement factor [IEF] and compared with standard algorithms already in use. Improved performance of the proposed algorithm is demonstrated. The advantage of the proposed algorithm is that a single algorithm can replace several independent algorithms required for removal of different artifacts.

  8. A Nonlinear Decision-Based Algorithm for Removal of Strip Lines, Drop Lines, Blotches, Band Missing and Impulses in Images and Videos

    Directory of Open Access Journals (Sweden)

    Manikandan S

    2008-01-01

    Full Text Available Abstract A decision-based nonlinear algorithm for removal of strip lines, drop lines, blotches, band missing, and impulses in images is presented. The algorithm performs two simultaneous operations, namely, detection of corrupted pixels and estimation of new pixels for replacing the corrupted pixels. Removal of these artifacts is achieved without damaging edges and details. The algorithm uses an adaptive length window whose maximum size is to avoid blurring due to large window sizes. However, the restricted window size renders median operation less effective whenever noise is excessive in which case the proposed algorithm automatically switches to mean filtering. The performance of the algorithm is analyzed in terms of mean square error [MSE], peak-signal-to-noise ratio [PSNR], and image enhancement factor [IEF] and compared with standard algorithms already in use. Improved performance of the proposed algorithm is demonstrated. The advantage of the proposed algorithm is that a single algorithm can replace several independent algorithms required for removal of different artifacts.

  9. New integrated and multiscale decision-aiding framework in a context of imperfect information: application to the assessment of torrent checkdams' effectiveness.

    Science.gov (United States)

    Tacnet, Jean-Marc; Carladous, Simon; Dezert, Jean; Batton-Hubert, Mireille

    2017-04-01

    Mountain natural phenomena (e.g. torrential floods) put people and buildings at risk. Civil engineering protection works such as torrent check-dams are designed to mitigate those natural risks. Protection works act on both causes and effects of phenomena to reduce consequences and therefore risks. For instance, check-dams control sediment production and liquid/solid flow of torrential floods: several series of dams are located in the headwaters of a watershed, each having specific functions. All those works are damaged by time passing and flood impacts. Effectiveness assessment is needed to define, compare or choose strategies for investment and maintenance which are essential issues in risk management process. Decision support tools are expected to analyze at different scales both their technical effectiveness (related to their structural state and functional effects on phenomena such as stopping, braking, guiding, etc.) and their economic efficiency through comparison between benefits and costs. Several methods, often based on expert knowledge, have already been developed to care about decision under risk. But uncertainty has also to be considered, since decisions are indeed often taken in a context of lack of information and knowledge on natural phenomena, heterogeneity of available information and, finally, reliability of sources. First methods derived from classical industrial contexts, such as dependability analysis, are used to formalize expert knowledge used for decision-making. After having defined the concept of effectiveness, dependability analysis are used to identify decision contexts and problems: criteria and indicators are identified in relation with structural or functional features. Then, innovative and multi-scales multi-criteria decision-making methods (MCDMs) and frameworks are proposed to help assessing protection works effectiveness. They combine classical MCDM approaches, belief function, fuzzy sets and possibility theories. Those methods

  10. Video Marketing: How Important are Videos for the Hospitality Industry in Finland?

    OpenAIRE

    Hofstede, Bianca

    2017-01-01

    In the past few years, there has been many changes to the business environment of many companies. This has led to the development of new marketing forms, such as video marketing. Video marketing is increasingly popular. However, not all companies are successful in their video marketing efforts and researchers struggle to reach consensus in solving certain problems. The popularity and uncertainty of this topic has led to the decision to use it for this research. The objective of this paper is ...

  11. Video Analytics

    DEFF Research Database (Denmark)

    This book collects the papers presented at two workshops during the 23rd International Conference on Pattern Recognition (ICPR): the Third Workshop on Video Analytics for Audience Measurement (VAAM) and the Second International Workshop on Face and Facial Expression Recognition (FFER) from Real...... include: re-identification, consumer behavior analysis, utilizing pupillary response for task difficulty measurement, logo detection, saliency prediction, classification of facial expressions, face recognition, face verification, age estimation, super-resolution, pose estimation, and pain recognition...

  12. Video Analytics

    DEFF Research Database (Denmark)

    include: re-identification, consumer behavior analysis, utilizing pupillary response for task difficulty measurement, logo detection, saliency prediction, classification of facial expressions, face recognition, face verification, age estimation, super-resolution, pose estimation, and pain recognition......This book collects the papers presented at two workshops during the 23rd International Conference on Pattern Recognition (ICPR): the Third Workshop on Video Analytics for Audience Measurement (VAAM) and the Second International Workshop on Face and Facial Expression Recognition (FFER) from Real...

  13. Improving Shipboard Decision Making in the CBR-D (Chemical/Biological Radiological Defense) Environment: Concepts of Use for and Functional Description of a Decision Aid/Training System (DECAID)

    Science.gov (United States)

    1988-08-19

    for Firefighting and Smoke Control 1. Alert appropriate fire party -, 2. Determine optimal technique for fighting fire and controlling smoke 3...Prepare evacuation plans 5. Alert medical/first aid personnel E. Direct Firefighting and Smoke Control Activities 1. Inform seniors in chain of command of...firefighting and smoke control status 2. Specify plan of attack to fire party leader 3. Specify fire boundaries, evacuation plan, closure, ventilation

  14. Achieving involvement: process outcomes from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice.

    NARCIS (Netherlands)

    Elwyn, G.; Edwards, A.; Hood, K.; Robling, M.; Atwell, C.; Russell, I.; Wensing, M.J.P.; Grol, R.P.T.M.

    2004-01-01

    BACKGROUND: A consulting method known as 'shared decision making' (SDM) has been described and operationalized in terms of several 'competences'. One of these competences concerns the discussion of the risks and benefits of treatment or care options-'risk communication'. Few data exist on

  15. Making the Decision to Breastfeed

    Medline Plus

    Full Text Available ... It's Only Natural > Planning ahead Making the decision to breastfeed YouTube embed video: YouTube embed video: https:// ... Content last updated: January 18, 2013. Print Return to top Accessibility | Privacy policy | Disclaimers | FOIA | Link to ...

  16. The accuracy and reproducibility of video assessment in the pitch-side management of concussion in elite rugby.

    Science.gov (United States)

    Fuller, G W; Kemp, S P T; Raftery, M

    2017-03-01

    To investigate the accuracy and reliability of side-line video review of head impact events to aid identification of concussion in elite sport. Diagnostic accuracy and inter-rater agreement study. Immediate care, match day and team doctors involved in the 2015 Rugby Union World Cup viewed 20 video clips showing broadcaster's footage of head impact events occurring during elite Rugby matches. Subjects subsequently recorded whether any criteria warranting permanent removal from play or medical room head injury assessment were present. The accuracy of these ratings were compared to consensus expert opinion by calculating mean sensitivity and specificity across raters. The reproducibility of doctor's decisions was additionally assessed using raw agreement and Gwets AC1 chance corrected agreement coefficient. Forty rugby medicine doctors were included in the study. Compared to the expert reference standard overall sensitivity and specificity of doctors decisions were 77.5% (95% CI 73.1-81.5%) and 53.3% (95% CI 48.2-58.2%) respectively. Overall there was raw agreement of 67.8% (95% CI 57.9-77.7%) between doctors across all video clips. Chance corrected Gwets AC1 agreement coefficient was 0.39 (95% CI 0.17-0.62), indicating fair agreement. Rugby World Cup doctors' demonstrated moderate accuracy and fair reproducibility in head injury event decision making when assessing video clips of head impact events. The use of real-time video may improve the identification, decision making and management of concussion in elite sports. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  17. A computer decision aid for medical prevention: a pilot qualitative study of the Personalized Estimate of Risks (EsPeR system

    Directory of Open Access Journals (Sweden)

    Zunino Sylvain

    2003-11-01

    Full Text Available Abstract Background Many preventable diseases such as ischemic heart diseases and breast cancer prevail at a large scale in the general population. Computerized decision support systems are one of the solutions for improving the quality of prevention strategies. Methods The system called EsPeR (Personalised Estimate of Risks combines calculation of several risks with computerisation of guidelines (cardiovascular prevention, screening for breast cancer, colorectal cancer, uterine cervix cancer, and prostate cancer, diagnosis of depression and suicide risk. We present a qualitative evaluation of its ergonomics, as well as it's understanding and acceptance by a group of general practitioners. We organised four focus groups each including 6–11 general practitioners. Physicians worked on several structured clinical scenari os with the help of EsPeR, and three senior investigators leaded structured discussion sessions. Results The initial sessions identified several ergonomic flaws of the system that were easily corrected. Both clinical scenarios and discussion sessions identified several problems related to the insufficient comprehension (expression of risks, definition of familial history of disease, and difficulty for the physicians to accept some of the recommendations. Conclusion Educational, socio-professional and organisational components (i.e. time constraints for training and use of the EsPeR system during consultation as well as acceptance of evidence-based decision-making should be taken into account before launching computerised decision support systems, or their application in randomised trials.

  18. AIDS (image)

    Science.gov (United States)

    AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. ...

  19. Foreign aid

    DEFF Research Database (Denmark)

    Tarp, Finn

    2008-01-01

    Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles and instituti......Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles...... and institutions of the aid system; and (c) discusses whether aid has been effective. While much of the original optimism about the impact of foreign aid needed modification, there is solid evidence that aid has indeed helped further growth and poverty reduction...

  20. Multi-criteria aid for group decision making on gas pipeline risk analysis; Apoio multicriterio a decisao em grupo na analise de risco em gasodutos

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, Yuri G.; Cavalcante, Cristiano A.V.; Brito, Anderson J. de M.; Almeida, Adiel T. de [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil)

    2008-07-01

    Risks are, by nature, subjective, and therefore, complex. They present multidimensional aspects and involve various stakeholders. The pipelines transmission and distribution of natural gas (NG) involve various scenarios of risks, resulting from the distinct environments where the supply chain of NG is inserted. This paper proposes a multi criteria model for group decision support, based on the GDSS PROMETHEE approach, for risk assessment in pipelines sections. The proposed model aims to establish a ranking between the sections of a pipeline network, in order to provide insights to the definition of risk mitigation actions. (author)

  1. Star Wars in Psychotherapy: Video Games in the Office

    Science.gov (United States)

    Ceranoglu, Tolga Atilla

    2010-01-01

    Objective: Video games are used in medical practice during psycho-education in chronic disease management, physical therapy, rehabilitation following traumatic brain injury, and as an adjunct in pain management during medical procedures or cancer chemotherapy. In psychiatric practice, video games aid in social skills training of children with…

  2. Online Video Gaming: What Should Educational Psychologists Know?

    Science.gov (United States)

    Griffiths, Mark

    2010-01-01

    Based on a significant increase in correspondence to the author from parents, teachers and psychologists concerning "addiction" to online video games like "World of Warcraft", this paper provides a brief overview of the main issues surrounding excessive video game playing among adolescents. As an aid to educational psychologists, and based on two…

  3. Using smart phone video to supplement communication of radiology imaging in a neurosurgical unit: technical note.

    Science.gov (United States)

    Shivapathasundram, Ganeshwaran; Heckelmann, Michael; Sheridan, Mark

    2012-04-01

    The use of smart phones within medicine continues to grow at the same rate as mobile phone technology continues to evolve. One use of smart phones within medicine is in the transmission of radiological images to consultant neurosurgeons who are off-site in an emergency setting. In our unit, this has allowed quick, efficient, and safe communication between consultant neurosurgeon and trainees, aiding in rapid patient assessment and management in emergency situations. To describe a new means of smart phone technology use in the neurosurgical setting, where the video application of smart phones allows transfer of a whole series of patient neuroimaging via multimedia messaging service to off-site consultant neurosurgeons. METHOD/TECHNIQUE: Using the video application of smart phones, a 30-second video of an entire series of patient neuroimaging was transmitted to consultant neurosurgeons. With this information, combined with a clinical history, accurate management decisions were made. This technique has been used on a number of emergency situations in our unit to date. Thus far, the imaging received by consultants has been a very useful adjunct to the clinical information provided by the on-site trainee, and has helped expedite management of patients. While the aim should always be for the specialist neurosurgeon to review the imaging in person, in emergency settings, this is not always possible, and we feel that this technique of smart phone video is a very useful means for rapid communication with neurosurgeons.

  4. Decision support for the definition of wind turbine systems adequacy to site specificities and weak electrical networks; Aide a la decision pour la definition d'un systeme eolien, adequation au site et a un reseau faible

    Energy Technology Data Exchange (ETDEWEB)

    Arbaoui, A

    2006-10-15

    A decision support system for the definition of wind turbine systems is developed by taking into account the wind and site characteristics, the wind turbine components and the electrical network properties close to the site. The approach is based on functional analysis, on the investigation of the functional fluxes and on the definition of a model suitable for supporting decision at the preliminary stages of wind turbine design. The complete set of solutions derived from the model is determined using a Constraint Satisfaction Problem solver. The intrinsic capability of the model to support decision is derived from the investigation of the model parsimony, precision, exactness and specialization. The model takes into account performance criteria resulting from knowledge of manufacturers, distributors and investors. These criteria are used to discriminate design alternatives. Design alternatives correspond to choices of site (wind, electric network) and wind turbine architectures (related to 7 design variables). Performance criteria are the cost of electric kWh, the amount of energy being produced and the discounted total cost of the project. Electric network connection to wind turbines is taken into account through slow variations of the voltage and Flickers phenomenon. First, the maximal rate of penetration of the wind turbine energy production is determined. Next, two design alternatives have been investigated to improve wind turbine system integration in electric distribution networks. These alternatives are a reactive power control system and an inertial energy storage system. Inertial storage systems seem to be more expensive than reactive power control systems for this type of application. The influence of site specificities on decision making process has been established through three different sites (a Mediterranean site and two sites located in northern Europe). Profits relative to the cost of kWh appear to be high for Mediterranean sites. Most of the

  5. Privacy-protecting video surveillance

    Science.gov (United States)

    Wickramasuriya, Jehan; Alhazzazi, Mohanned; Datt, Mahesh; Mehrotra, Sharad; Venkatasubramanian, Nalini

    2005-02-01

    Forms of surveillance are very quickly becoming an integral part of crime control policy, crisis management, social control theory and community consciousness. In turn, it has been used as a simple and effective solution to many of these problems. However, privacy-related concerns have been expressed over the development and deployment of this technology. Used properly, video cameras help expose wrongdoing but typically come at the cost of privacy to those not involved in any maleficent activity. This work describes the design and implementation of a real-time, privacy-protecting video surveillance infrastructure that fuses additional sensor information (e.g. Radio-frequency Identification) with video streams and an access control framework in order to make decisions about how and when to display the individuals under surveillance. This video surveillance system is a particular instance of a more general paradigm of privacy-protecting data collection. In this paper we describe in detail the video processing techniques used in order to achieve real-time tracking of users in pervasive spaces while utilizing the additional sensor data provided by various instrumented sensors. In particular, we discuss background modeling techniques, object tracking and implementation techniques that pertain to the overall development of this system.

  6. Special Needs: Planning for Adulthood (Videos)

    Medline Plus

    Full Text Available ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... Needs Giving Teens a Voice in Health Care Decisions How to Find Affordable Health Care How to ...

  7. INCOMMANDS TDP: Development of Decision Aid Implementation Guidance for the INCOMMANDS Human Factors Design and Evaluation Guide (Elaboration des Directives Relatives a la Mise en Oeuvre de l’Aide a la Decision Pour le Guide de Conception et d’evaluation Tenant Compte des Facteurs Humains - INCOMMANDS)

    Science.gov (United States)

    2007-05-01

    catégories d’aides à la décision particulières suivantes : aides à la gestion de l’information (directives en vue d’optimiser et d’organiser...une prise de décision efficace) et aides au contrôle et à la gestion (directives en vue de réduire les problèmes qui dépassent l’opérateur). Enfin... connaissance de la situation, de la charge de travail et à la confiance manifestées par l’opérateur, et ainsi de suite. Les critères exacts d’après

  8. Sediment source fingerprinting as an aid to catchment management: A review of the current state of knowledge and a methodological decision-tree for end-users

    Science.gov (United States)

    Collins, A.L; Pulley, S.; Foster, I.D.L; Gellis, Allen; Porto, P.; Horowitz, A.J.

    2017-01-01

    The growing awareness of the environmental significance of fine-grained sediment fluxes through catchment systems continues to underscore the need for reliable information on the principal sources of this material. Source estimates are difficult to obtain using traditional monitoring techniques, but sediment source fingerprinting or tracing procedures, have emerged as a potentially valuable alternative. Despite the rapidly increasing numbers of studies reporting the use of sediment source fingerprinting, several key challenges and uncertainties continue to hamper consensus among the international scientific community on key components of the existing methodological procedures. Accordingly, this contribution reviews and presents recent developments for several key aspects of fingerprinting, namely: sediment source classification, catchment source and target sediment sampling, tracer selection, grain size issues, tracer conservatism, source apportionment modelling, and assessment of source predictions using artificial mixtures. Finally, a decision-tree representing the current state of knowledge is presented, to guide end-users in applying the fingerprinting approach.

  9. The cost-effectiveness of a novel SIAscopic diagnostic aid for the management of pigmented skin lesions in primary care: a decision-analytic model.

    Science.gov (United States)

    Wilson, Edward C F; Emery, Jon D; Kinmonth, Ann Louise; Prevost, A Toby; Morris, Helen C; Humphrys, Elka; Hall, Per N; Burrows, Nigel; Bradshaw, Lucy; Walls, Joe; Norris, Paul; Johnson, Margaret; Walter, Fiona M

    2013-01-01

    Pigmented skin lesions are commonly presented in primary care. Appropriate diagnosis and management is challenging because the vast majority are benign. The MoleMate system is a handheld SIAscopy scanner integrated with a primary care diagnostic algorithm aimed at improving the management of pigmented skin lesions in primary care. This decision-model-based economic evaluation draws on the results of a randomized controlled trial of the MoleMate system versus best practice (ISRCTN79932379) to estimate the expected long-term cost and health gain of diagnosis with the MoleMate system versus best practice in an English primary care setting. The model combines trial results with data from the wider literature to inform long-term prognosis, health state utilities, and cost. Results are reported as mean and incremental cost and quality-adjusted life-years (QALYs) gained, incremental cost-effectiveness ratio with probabilistic sensitivity analysis, and value of information analysis. Over a lifetime horizon, the MoleMate system is expected to cost an extra £18 over best practice alone, and yield an extra 0.01 QALYs per patient examined. The incremental cost-effectiveness ratio is £1,896 per QALY gained, with a 66.1% probability of being below £30,000 per QALY gained. The expected value of perfect information is £43.1 million. Given typical thresholds in the United Kingdom (£20,000-£30,000 per QALY), the MoleMate system may be cost-effective compared with best practice diagnosis alone in a primary care setting. However, there is considerable decision uncertainty, driven particularly by the sensitivity and specificity of MoleMate versus best practice, and the risk of disease progression in undiagnosed melanoma; future research should focus on reducing uncertainty in these parameters. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  10. Subjective hearing-related quality-of-life is a major factor in the decision to continue using hearing aids among older persons.

    Science.gov (United States)

    Maeda, Yukihide; Sugaya, Akiko; Nagayasu, Rie; Nakagawa, Atsuko; Nishizaki, Kazunori

    2016-09-01

    Audiological parameters alone do not determine the choice to use hearing aids (HA). Subjective hearing-related QoL is a major factor that determines whether or not an older person will continue to wear HA. This study aimed to identify which audiological parameters and quality-of-life (QoL) measures determine whether or not older persons will continue wearing HA. Charts of 157 patients aged ≥65 years who attended the HA service unit at the Otolaryngology Department were retrospectively reviewed. After HA fitting and a trial, the patients were divided into groups, depending upon whether or not they wanted to continue wearing the HA (users, 58.2%; non-users, 41.8%) and then audiological parameters were compared between them. At least 4 months after the HA fitting, the self-reported QoL questionnaire, Hearing Handicap Inventory for the Elderly (HHIE), was mailed to all 157 patients and HHIE scores were compared between HA users and non-users. Speech discrimination score and dynamic range did not significantly differ between HA users and non-users. A difference in the average hearing threshold was marginally significant. The response rate to the HHIE was 65.2%. Total HHIE and emotional scores were higher (more impaired) among HA users than non-users.

  11. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... NEI YouTube Videos > NEI YouTube Videos: Amblyopia NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration ... Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Amblyopia Embedded video for NEI YouTube Videos: ...

  12. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... YouTube Videos > NEI YouTube Videos: Amblyopia NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia ... of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Amblyopia Embedded video for NEI YouTube Videos: Amblyopia ...

  13. NEI You Tube Videos: Amblyopia

    Science.gov (United States)

    ... YouTube Videos > NEI YouTube Videos: Amblyopia NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia ... of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Amblyopia Embedded video for NEI YouTube Videos: Amblyopia ...

  14. Exploring Novice Teachers' Cognitive Processes Using Digital Video Technology: A Qualitative Case Study

    Science.gov (United States)

    Sun-Ongerth, Yuelu

    2012-01-01

    This dissertation describes a qualitative case study that investigated novice teachers' video-aided reflection on their own teaching. To date, most studies that have investigated novice teachers' video-aided reflective practice have focused on examining novice teachers' levels of reflective writing rather than the cognitive…

  15. Shared Decision Making in Neurocritical Care.

    Science.gov (United States)

    Khan, Muhammad Waqas; Muehlschlegel, Susanne

    2017-11-01

    Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses shared decision making in general and in the intensive care unit in particular and facilitators and barriers for the creation and implementation of International Patient Decision Aids Standards Collaboration-compliant decision aids for the intensive care unit and neuro-intensive care unit. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Hearing Aids

    Science.gov (United States)

    ... Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for ... well. For example, if you want to play music, ask your audiologist about a program designed for ...

  17. HIV/AIDS knowledge and health-related attitudes and behaviors among deaf and hearing adolescents in southern Brazil.

    Science.gov (United States)

    Bisol, Cláudia Alquati; Sperb, Tania Mara; Brewer, Toye H; Kato, Sérgio Kakuta; Shor-Posner, Gail

    2008-01-01

    HIV/AIDS knowledge and health-related attitudes and behaviors among deaf and hearing adolescents in southern Brazil are described. Forty-two deaf students attending a special nonresidential public school for the deaf and 50 hearing students attending a regular public school, ages 15-21 years, answered a computer-assisted questionnaire. (There was simultaneous video translation of questions to Brazilian Sign Language.) A branched decision-tree structure was used to determine level of sexual experience and hearing status. Deaf participants scored lower on HIV/AIDS knowledge, demonstrating a need to improve school-based instruction and develop campaigns tailored to this group's requirements. Though the hearing students reported more sexual activity than the deaf students, no other significant differences were found in health-related attitudes and behaviors. Two findings of concern are the high rate of sexual abuse reported by deaf participants and the large number of deaf adolescents reporting having a friend with AIDS.

  18. DanceChemistry: Helping Students Visualize Chemistry Concepts through Dance Videos

    Science.gov (United States)

    Tay, Gidget C.; Edwards, Kimberly D.

    2015-01-01

    A visual aid teaching tool, the DanceChemistry video series, has been developed to teach fundamental chemistry concepts through dance. These educational videos portray chemical interactions at the molecular level using dancers to represent chemical species. Students reported that the DanceChemistry videos helped them visualize chemistry ideas in a…

  19. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos was designed ... Activity Role of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic ...

  20. Development of a New Approach to Aid in Visual Identification of Murine iPS Colonies Using a Fuzzy Logic Decision Support System

    Science.gov (United States)

    Bassaneze, Vinicius; Sacramento, Chester Bittencourt; Freire, Rodolfo; Alencar, Patrícia Fernandes De; Ortega, Neli Regina Siqueira; Krieger, Jose Eduardo

    2013-01-01

    The a priori identification of induced pluripotent stem cells remains a challenge. Being able to quickly identify the most embryonic stem cell-similar induced pluripotent stem cells when validating results could help to reduce costs and save time. In this context, tools based on non-classic logic can be useful in creating aid-systems based on visual criteria. True colonies when viewed at 100x magnification have been found to have the following 3 characteristics: a high degree of border delineation, a more uniform texture, and the absence of a cracked texture. These visual criteria were used for fuzzy logic modeling. We investigated the possibility of predicting the presence of alkaline phosphatase activity, typical of true induced pluripotent stem cell colonies, after 25 individuals, with varying degrees of experience in working with murine iPS cells, categorized the images of 136 colonies based on visual criteria. Intriguingly, the performance evaluation by area under the ROC curve (16 individuals with satisfactory performance), Spearman correlation (all statistically significant), and Cohen's Kappa agreement analysis (all statistically significant) demonstrates that the discriminatory capacity of different evaluators are similar, even those who have never cultivated cells. Thus, we report on a new system to facilitate visual identification of murine- induced pluripotent stem cell colonies that can be useful for staff training and opens the possibility of exploring visual characteristics of induced pluripotent stem cell colonies with their functional peculiarities. The fuzzy model has been integrated as a web-based tool named “2see-iPS” which is freely accessed at http://genetica.incor.usp.br/2seeips/. PMID:23950970

  1. 61214++++','DOAJ-ART-EN'); return false;" href="+++++https://jual.nipissingu.ca/wp-content/uploads/sites/25/2014/06/v61214.m4v">61214++++">Jailed - Video

    Directory of Open Access Journals (Sweden)

    Cameron CULBERT

    2012-07-01

    Full Text Available As the public education system in Northern Ontario continues to take a downward spiral, a plethora of secondary school students are being placed in an alternative educational environment. Juxtaposing the two educational settings reveals very similar methods and characteristics of educating our youth as opposed to using a truly alternative approach to education. This video reviews the relationship between public education and alternative education in a remote Northern Ontario setting. It is my belief that the traditional methods of teaching are not appropriate in educating at risk students in alternative schools. Paper and pencil worksheets do not motivate these students to learn and succeed. Alternative education should emphasize experiential learning, a just in time curriculum based on every unique individual and the students true passion for everyday life. Cameron Culbert was born on February 3rd, 1977 in North Bay, Ontario. His teenage years were split between attending public school and his willed curriculum on the ski hill. Culbert spent 10 years (1996-2002 & 2006-2010 competing for Canada as an alpine ski racer. His passion for teaching and coaching began as an athlete and has now transferred into the classroom and the community. As a graduate of Nipissing University (BA, BEd, MEd. Camerons research interests are alternative education, physical education and technology in the classroom. Currently Cameron is an active educator and coach in Northern Ontario.

  2. Computer-Aided Decision Support for Melanoma Detection Applied on Melanocytic and Nonmelanocytic Skin Lesions: A Comparison of Two Systems Based on Automatic Analysis of Dermoscopic Images

    Directory of Open Access Journals (Sweden)

    Kajsa Møllersen

    2015-01-01

    Full Text Available Commercially available clinical decision support systems (CDSSs for skin cancer have been designed for the detection of melanoma only. Correct use of the systems requires expert knowledge, hampering their utility for nonexperts. Furthermore, there are no systems to detect other common skin cancer types, that is, nonmelanoma skin cancer (NMSC. As early diagnosis of skin cancer is essential, there is a need for a CDSS that is applicable to all types of skin lesions and is suitable for nonexperts. Nevus Doctor (ND is a CDSS being developed by the authors. We here investigate ND’s ability to detect both melanoma and NMSC and the opportunities for improvement. An independent test set of dermoscopic images of 870 skin lesions, including 44 melanomas and 101 NMSCs, were analysed by ND. Its sensitivity to melanoma and NMSC was compared to that of Mole Expert (ME, a commercially available CDSS, using the same set of lesions. ND and ME had similar sensitivity to melanoma. For ND at 95% melanoma sensitivity, the NMSC sensitivity was 100%, and the specificity was 12%. The melanomas misclassified by ND at 95% sensitivity were correctly classified by ME, and vice versa. ND is able to detect NMSC without sacrificing melanoma sensitivity.

  3. Sediment source fingerprinting as an aid to catchment management: A review of the current state of knowledge and a methodological decision-tree for end-users.

    Science.gov (United States)

    Collins, A L; Pulley, S; Foster, I D L; Gellis, A; Porto, P; Horowitz, A J

    2017-06-01

    The growing awareness of the environmental significance of fine-grained sediment fluxes through catchment systems continues to underscore the need for reliable information on the principal sources of this material. Source estimates are difficult to obtain using traditional monitoring techniques, but sediment source fingerprinting or tracing procedures, have emerged as a potentially valuable alternative. Despite the rapidly increasing numbers of studies reporting the use of sediment source fingerprinting, several key challenges and uncertainties continue to hamper consensus among the international scientific community on key components of the existing methodological procedures. Accordingly, this contribution reviews and presents recent developments for several key aspects of fingerprinting, namely: sediment source classification, catchment source and target sediment sampling, tracer selection, grain size issues, tracer conservatism, source apportionment modelling, and assessment of source predictions using artificial mixtures. Finally, a decision-tree representing the current state of knowledge is presented, to guide end-users in applying the fingerprinting approach. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Video Design Games

    DEFF Research Database (Denmark)

    Smith, Rachel Charlotte; Christensen, Kasper Skov; Iversen, Ole Sejer

    We introduce Video Design Games to train educators in teaching design. The Video Design Game is a workshop format consisting of three rounds in which participants observe, reflect and generalize based on video snippets from their own practice. The paper reports on a Video Design Game workshop...

  5. Defocus cue and saliency preserving video compression

    Science.gov (United States)

    Khanna, Meera Thapar; Chaudhury, Santanu; Lall, Brejesh

    2016-11-01

    There are monocular depth cues present in images or videos that aid in depth perception in two-dimensional images or videos. Our objective is to preserve the defocus depth cue present in the videos along with the salient regions during compression application. A method is provided for opportunistic bit allocation during the video compression using visual saliency information comprising both the image features, such as color and contrast, and the defocus-based depth cue. The method is divided into two steps: saliency computation followed by compression. A nonlinear method is used to combine pure and defocus saliency maps to form the final saliency map. Then quantization values are assigned on the basis of these saliency values over a frame. The experimental results show that the proposed scheme yields good results over standard H.264 compression as well as pure and defocus saliency methods.

  6. Characterization of social video

    Science.gov (United States)

    Ostrowski, Jeffrey R.; Sarhan, Nabil J.

    2009-01-01

    The popularity of social media has grown dramatically over the World Wide Web. In this paper, we analyze the video popularity distribution of well-known social video websites (YouTube, Google Video, and the AOL Truveo Video Search engine) and characterize their workload. We identify trends in the categories, lengths, and formats of those videos, as well as characterize the evolution of those videos over time. We further provide an extensive analysis and comparison of video content amongst the main regions of the world.

  7. Video visual analytics

    OpenAIRE

    Höferlin, Markus Johannes

    2013-01-01

    The amount of video data recorded world-wide is tremendously growing and has already reached hardly manageable dimensions. It originates from a wide range of application areas, such as surveillance, sports analysis, scientific video analysis, surgery documentation, and entertainment, and its analysis represents one of the challenges in computer science. The vast amount of video data renders manual analysis by watching the video data impractical. However, automatic evaluation of video material...

  8. Objective video presentation QoE predictor for smart adaptive video streaming

    Science.gov (United States)

    Wang, Zhou; Zeng, Kai; Rehman, Abdul; Yeganeh, Hojatollah; Wang, Shiqi

    2015-09-01

    How to deliver videos to consumers over the network for optimal quality-of-experience (QoE) has been the central goal of modern video delivery services. Surprisingly, regardless of the large volume of videos being delivered everyday through various systems attempting to improve visual QoE, the actual QoE of end consumers is not properly assessed, not to say using QoE as the key factor in making critical decisions at the video hosting, network and receiving sites. Real-world video streaming systems typically use bitrate as the main video presentation quality indicator, but using the same bitrate to encode different video content could result in drastically different visual QoE, which is further affected by the display device and viewing condition of each individual consumer who receives the video. To correct this, we have to put QoE back to the driver's seat and redesign the video delivery systems. To achieve this goal, a major challenge is to find an objective video presentation QoE predictor that is accurate, fast, easy-to-use, display device adaptive, and provides meaningful QoE predictions across resolution and content. We propose to use the newly developed SSIMplus index (https://ece.uwaterloo.ca/~z70wang/research/ssimplus/) for this role. We demonstrate that based on SSIMplus, one can develop a smart adaptive video streaming strategy that leads to much smoother visual QoE impossible to achieve using existing adaptive bitrate video streaming approaches. Furthermore, SSIMplus finds many more applications, in live and file-based quality monitoring, in benchmarking video encoders and transcoders, and in guiding network resource allocations.

  9. Video-assisted segmentation of speech and audio track

    Science.gov (United States)

    Pandit, Medha; Yusoff, Yusseri; Kittler, Josef; Christmas, William J.; Chilton, E. H. S.

    1999-08-01

    Video database research is commonly concerned with the storage and retrieval of visual information invovling sequence segmentation, shot representation and video clip retrieval. In multimedia applications, video sequences are usually accompanied by a sound track. The sound track contains potential cues to aid shot segmentation such as different speakers, background music, singing and distinctive sounds. These different acoustic categories can be modeled to allow for an effective database retrieval. In this paper, we address the problem of automatic segmentation of audio track of multimedia material. This audio based segmentation can be combined with video scene shot detection in order to achieve partitioning of the multimedia material into semantically significant segments.

  10. Brand Aid

    DEFF Research Database (Denmark)

    Richey, Lisa Ann; Ponte, Stefano

    A critical account of the rise of celebrity-driven “compassionate consumption” Cofounded by the rock star Bono in 2006, Product RED exemplifies a new trend in celebrity-driven international aid and development, one explicitly linked to commerce, not philanthropy. Brand Aid offers a deeply informed...

  11. Impact of an Abbreviated Cardiac Enzyme Protocol to Aid Rapid Discharge of Patients with Cocaine-associated Chest Pain in the Clinical Decision Unit

    Directory of Open Access Journals (Sweden)

    Faheem W. Guirgis

    2014-03-01

    Full Text Available Introduction: In 2007 there were 64,000 visits to the emergency department (ED for possible myocardial infarction (MI related to cocaine use. Prior studies have demonstrated that low- to intermediate-risk patients with cocaine-associated chest pain can be safely discharged after 9-12 hours of observation. The goal of this study was to determine the safety of an 8-hour protocol for ruling out MI in patients who presented with cocaine-associated chest pain. Methods: We conducted a retrospective review of patients treated with an 8-hour cocaine chest pain protocol between May 1, 2011 and November 30, 2012 who were sent to the clinical decision unit (CDU for observation. The protocol included serial cardiac biomarker testing with Troponin-T, CK-MB (including delta CK-MB, and total CK at 0, 2, 4, and 8 hours after presentation with cardiac monitoring for the observation period. Patients were followed up for adverse cardiac events or death within 30 days of discharge. Results: There were 111 admissions to the CDU for cocaine chest pain during the study period. One patient had a delta CK-MB of 1.6 ng/ml, but had negative Troponin-T at all time points. No patient had a positive Troponin-T or CK-MB at 0, 2, 4 or 8 hours, and there were no MIs or deaths within 30 days of discharge. Most patients were discharged home (103 and there were 8 inpatient admissions from the CDU. Of the admitted patients, 2 had additional stress tests that were negative, 1 had additional cardiac biomarkers that were negative, and all 8 patients were discharged home. The estimated risk of missing MI using our protocol is, with 99% confidence, less than 5.1% and with 95% confidence, less than 3.6% (99% CI, 0-5.1%; 95% CI, 0-3.6%. Conclusion: Application of an abbreviated cardiac enzyme protocol resulted in the safe and rapid discharge of patients presenting to the ED with cocaine-associated chest pain. [West J Emerg Med. 2014;15(2:180–183.

  12. Video Eases End-of-Life Care Discussions

    Science.gov (United States)

    Patients with advanced cancer who watched a video that depicts options for end-of-life care were more certain of their end-of-life decision making than patients who only listened to a verbal narrative.

  13. Video Games as a Multifaceted Medium: A Review of Quantitative Social Science Research on Video Games and a Typology of Video Game Research Approaches

    Directory of Open Access Journals (Sweden)

    James D. Ivory

    2013-01-01

    Full Text Available Although there is a vast and useful body of quantitative social science research dealing with the social role and impact of video games, it is difficult to compare studies dealing with various dimensions of video games because they are informed by different perspectives and assumptions, employ different methodologies, and address different problems. Studies focusing on different social dimensions of video games can produce varied findings about games’ social function that are often difficult to reconcile— or even contradictory. Research is also often categorized by topic area, rendering a comprehensive view of video games’ social role across topic areas difficult. This interpretive review presents a novel typology of four identified approaches that categorize much of the quantitative social science video game research conducted to date: “video games as stimulus,” “video games as avocation,” “video games as skill,” and “video games as social environment.” This typology is useful because it provides an organizational structure within which the large and growing number of studies on video games can be categorized, guiding comparisons between studies on different research topics and aiding a more comprehensive understanding of video games’ social role. Categorizing the different approaches to video game research provides a useful heuristic for those critiquing and expanding that research, as well as an understandable entry point for scholars new to video game research. Further, and perhaps more importantly, the typology indicates when topics should be explored using different approaches than usual to shed new light on the topic areas. Lastly, the typology exposes the conceptual disconnects between the different approaches to video game research, allowing researchers to consider new ways to bridge gaps between the different approaches’ strengths and limitations with novel methods.

  14. Audio-Visual Aid in Teaching "Fatty Liver"

    Science.gov (United States)

    Dash, Sambit; Kamath, Ullas; Rao, Guruprasad; Prakash, Jay; Mishra, Snigdha

    2016-01-01

    Use of audio visual tools to aid in medical education is ever on a rise. Our study intends to find the efficacy of a video prepared on "fatty liver," a topic that is often a challenge for pre-clinical teachers, in enhancing cognitive processing and ultimately learning. We prepared a video presentation of 11:36 min, incorporating various…

  15. HIV / AIDS

    Science.gov (United States)

    ... in the United States and the international community. Globally, AIDS-related deaths have dropped by 45 percent ... Career Stage Postdocs' Guide to Gaining Independence Small Business Programs Compare NIAID’s Small Business Programs High-Priority ...

  16. Expert Behavior in Children's Video Game Play.

    Science.gov (United States)

    VanDeventer, Stephanie S.; White, James A.

    2002-01-01

    Investigates the display of expert behavior by seven outstanding video game-playing children ages 10 and 11. Analyzes observation and debriefing transcripts for evidence of self-monitoring, pattern recognition, principled decision making, qualitative thinking, and superior memory, and discusses implications for educators regarding the development…

  17. Graphic Representations as Tools for Decision Making.

    Science.gov (United States)

    Howard, Judith

    2001-01-01

    Focuses on the use of graphic representations to enable students to improve their decision making skills in the social studies. Explores three visual aids used in assisting students with decision making: (1) the force field; (2) the decision tree; and (3) the decision making grid. (CMK)

  18. Acoustic Neuroma Educational Video

    Medline Plus

    Full Text Available ... support group for me? Find a Group Upcoming Events Video Library Photo Gallery One-on-One Support ... group for me? Find a group Back Upcoming events Video Library Photo Gallery One-on-One Support ...

  19. Video Games and Citizenship

    National Research Council Canada - National Science Library

    Bourgonjon, Jeroen; Soetaert, Ronald

    2013-01-01

    ... by exploring a particular aspect of digitization that affects young people, namely video games. They explore the new social spaces which emerge in video game culture and how these spaces relate to community building and citizenship...

  20. Videos, Podcasts and Livechats

    Medline Plus

    Full Text Available ... Doctor Find a Provider Meet the Team Blog Articles News Resources Links Videos Podcasts Webinars For the ... Doctor Find a Provider Meet the Team Blog Articles News Provider Directory Donate Resources Links Videos Podcasts ...

  1. Videos, Podcasts and Livechats

    Medline Plus

    Full Text Available ... Doctor Find a Provider Meet the Team Blog Articles & Stories News Resources Links Videos Podcasts Webinars For ... Doctor Find a Provider Meet the Team Blog Articles & Stories News Provider Directory Donate Resources Links Videos ...

  2. Digital Video in Research

    DEFF Research Database (Denmark)

    Frølunde, Lisbeth

    2012-01-01

    questions of our media literacy pertaining to authoring multimodal texts (visual, verbal, audial, etc.) in research practice and the status of multimodal texts in academia. The implications of academic video extend to wider issues of how researchers harness opportunities to author different types of texts......Is video becoming “the new black” in academia, if so, what are the challenges? The integration of video in research methodology (for collection, analysis) is well-known, but the use of “academic video” for dissemination is relatively new (Eriksson and Sørensen). The focus of this paper is academic...... video, or short video essays produced for the explicit purpose of communicating research processes, topics, and research-based knowledge (see the journal of academic videos: www.audiovisualthinking.org). Video is increasingly used in popular showcases for video online, such as YouTube and Vimeo, as well...

  3. Acoustic Neuroma Educational Video

    Medline Plus

    Full Text Available ... Back Support Groups Is a support group for me? Find a Group Upcoming Events Video Library Photo ... Support Groups Back Is a support group for me? Find a group Back Upcoming events Video Library ...

  4. Acoustic Neuroma Educational Video

    Medline Plus

    Full Text Available ... group for me? Find a Group Upcoming Events Video Library Photo Gallery One-on-One Support ANetwork ... for me? Find a group Back Upcoming events Video Library Photo Gallery One-on-One Support Back ...

  5. Videos, Podcasts and Livechats

    Medline Plus

    Full Text Available ... the Team Blog Articles & Stories News Resources Links Videos Podcasts Webinars For the Media For Clinicians For ... Family Caregivers Glossary Menu In this section Links Videos Podcasts Webinars For the Media For Clinicians For ...

  6. Videos, Podcasts and Livechats

    Science.gov (United States)

    ... the Team Blog Articles & Stories News Resources Links Videos Podcasts Webinars For the Media For Clinicians For ... Family Caregivers Glossary Menu In this section Links Videos Podcasts Webinars For the Media For Clinicians For ...

  7. Videos, Podcasts and Livechats

    Medline Plus

    Full Text Available ... a Provider Meet the Team Blog Articles & Stories News Resources Links Videos Podcasts Webinars For the Media ... a Provider Meet the Team Blog Articles & Stories News Provider Directory Donate Resources Links Videos Podcasts Webinars ...

  8. Acoustic Neuroma Educational Video

    Medline Plus

    Full Text Available ... for me? Find a Group Upcoming Events Video Library Photo Gallery One-on-One Support ANetwork Peer ... me? Find a group Back Upcoming events Video Library Photo Gallery One-on-One Support Back ANetwork ...

  9. Video Screen Capture Basics

    Science.gov (United States)

    Dunbar, Laura

    2014-01-01

    This article is an introduction to video screen capture. Basic information of two software programs, QuickTime for Mac and BlueBerry Flashback Express for PC, are also discussed. Practical applications for video screen capture are given.

  10. Videos, Podcasts and Livechats

    Medline Plus

    Full Text Available ... News Resources Links Videos Podcasts Webinars For the Media For Clinicians For Policymakers For Family Caregivers Glossary ... this section Links Videos Podcasts Webinars For the Media For Clinicians For Policymakers For Family Caregivers Glossary ...

  11. Transmission of compressed video

    Science.gov (United States)

    Pasch, H. L.

    1990-09-01

    An overview of video coding is presented. The aim is not to give a technical summary of possible coding techniques, but to address subjects related to video compression in general and to the transmission of compressed video in more detail. Bit rate reduction is in general possible by removing redundant information; removing information the eye does not use anyway; and reducing the quality of the video. The codecs which are used for reducing the bit rate, can be divided into two groups: Constant Bit rate Codecs (CBC's), which keep the bit rate constant, but vary the video quality; and Variable Bit rate Codecs (VBC's), which keep the video quality constant by varying the bit rate. VBC's can be in general reach a higher video quality than CBC's using less bandwidth, but need a transmission system that allows the bandwidth of a connection to fluctuate in time. The current and the next generation of the PSTN does not allow this; ATM might. There are several factors which influence the quality of video: the bit error rate of the transmission channel, slip rate, packet loss rate/packet insertion rate, end-to-end delay, phase shift between voice and video, and bit rate. Based on the bit rate of the coded video, the following classification of coded video can be made: High Definition Television (HDTV); Broadcast Quality Television (BQTV); video conferencing; and video telephony. The properties of these classes are given. The video conferencing and video telephony equipment available now and in the next few years can be divided into three categories: conforming to 1984 CCITT standard for video conferencing; conforming to 1988 CCITT standard; and conforming to no standard.

  12. Making good physics videos

    Science.gov (United States)

    Lincoln, James

    2017-05-01

    Online videos are an increasingly important way technology is contributing to the improvement of physics teaching. Students and teachers have begun to rely on online videos to provide them with content knowledge and instructional strategies. Online audiences are expecting greater production value, and departments are sometimes requesting educators to post video pre-labs or to flip our classrooms. In this article, I share my advice on creating engaging physics videos.

  13. Desktop video conferencing

    OpenAIRE

    Potter, Ray; Roberts, Deborah

    2007-01-01

    This guide aims to provide an introduction to Desktop Video Conferencing. You may be familiar with video conferencing, where participants typically book a designated conference room and communicate with another group in a similar room on another site via a large screen display. Desktop video conferencing (DVC), as the name suggests, allows users to video conference from the comfort of their own office, workplace or home via a desktop/laptop Personal Computer. DVC provides live audio and visua...

  14. 47 CFR 79.3 - Video description of video programming.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Video description of video programming. 79.3... CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.3 Video description of video programming. (a) Definitions. For purposes of this section the following definitions shall apply: (1...

  15. Video Self-Modeling

    Science.gov (United States)

    Buggey, Tom; Ogle, Lindsey

    2012-01-01

    Video self-modeling (VSM) first appeared on the psychology and education stage in the early 1970s. The practical applications of VSM were limited by lack of access to tools for editing video, which is necessary for almost all self-modeling videos. Thus, VSM remained in the research domain until the advent of camcorders and VCR/DVD players and,…

  16. Tracing Sequential Video Production

    DEFF Research Database (Denmark)

    Otrel-Cass, Kathrin; Khalid, Md. Saifuddin

    2015-01-01

    With an interest in learning that is set in collaborative situations, the data session presents excerpts from video data produced by two of fifteen students from a class of 5th semester techno-anthropology course. Students used video cameras to capture the time they spent working with a scientist...... video, nature of the interactional space, and material and spatial semiotics....

  17. Developing a Promotional Video

    Science.gov (United States)

    Epley, Hannah K.

    2014-01-01

    There is a need for Extension professionals to show clientele the benefits of their program. This article shares how promotional videos are one way of reaching audiences online. An example is given on how a promotional video has been used and developed using iMovie software. Tips are offered for how professionals can create a promotional video and…

  18. The decision evaluation scales

    NARCIS (Netherlands)

    Stalmeier, PFM; Roosmalen, MS; Verhoef, LCG; Hoekstra-Weebers, JEHM; Oosterwijk, JC; Moog, U; Hoogerbrugge, N; van Daal, WAJ

    There are several instruments to assess how patients evaluate their medical treatment choice. These are used to evaluate decision aids. Our objective is to investigate which psychological factors play a role when patients evaluate their medical treatment choices. A pool of 36 items was constructed,

  19. Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

    Science.gov (United States)

    Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Ogahara, Kakuya; Sawada, Tatsunori; Uezu, Sei; Nagatani, Ryutaro; Yamauchi, Keita

    2016-01-01

    Background Care-home residents are mostly inactive, have little interaction with staff, and are dependent on staff to engage in daily occupations. We recently developed an iPad application called the Aid for Decision-making in Occupation Choice (ADOC) to promote shared decision-making in activities and occupation-based goal setting by choosing from illustrations describing daily activities. This study aimed to evaluate if interventions based on occupation-based goal setting using the ADOC could focus on meaningful activities to improve quality of life and independent activities of daily living, with greater cost-effectiveness than an impairment-based approach as well as to evaluate the feasibility of conducting a large cluster, randomized controlled trial. Method In this single (assessor)-blind pilot cluster randomized controlled trial, the intervention group (ADOC group) received occupational therapy based on occupation-based goal setting using the ADOC, and the interventions were focused on meaningful occupations. The control group underwent an impairment-based approach focused on restoring capacities, without goal setting tools. In both groups, the 20-minute individualized intervention sessions were conducted twice a week for 4 months. Main Outcome Measures Short Form-36 (SF-36) score, SF-6D utility score, quality adjusted life years (QALY), Barthel Index, and total care cost. Results We randomized and analyzed 12 facilities (44 participants, 18.5% drop-out rate), with 6 facilities each allocated to the ADOC (n = 23) and control (n = 21) groups. After the 4-month intervention, the ADOC group had a significantly greater change in the BI score, with improved scores (P = 0.027, 95% CI 0.41 to 6.87, intracluster correlation coefficient = 0.14). No other outcome was significantly different. The incremental cost-effectiveness ratio, calculated using the change in BI score, was $63.1. Conclusion The results suggest that occupational therapy using the ADOC for older

  20. Decision Aids Using Heterogeneous Intelligence Analysis

    Science.gov (United States)

    2010-08-20

    would however give us dependence on the network. TAVI and TINDER are two sensor providers that stood out as being able to provide us with in- put on...ferent form-factor adopted that will provide additional viewing capability, especially in difficult lighting conditions. A side benefit of this is

  1. Environmental Data Collection Sensor to Decision Aid

    National Research Council Canada - National Science Library

    Harris, Michael

    2004-01-01

    .... Accurate near real-time environmental data is critical to the success of Mine Warfare operations as was demonstrated in Operation Iraqi Freedom in clearing the approach to the deep water port of Umm Qasr...

  2. Advanced video coding systems

    CERN Document Server

    Gao, Wen

    2015-01-01

    This comprehensive and accessible text/reference presents an overview of the state of the art in video coding technology. Specifically, the book introduces the tools of the AVS2 standard, describing how AVS2 can help to achieve a significant improvement in coding efficiency for future video networks and applications by incorporating smarter coding tools such as scene video coding. Topics and features: introduces the basic concepts in video coding, and presents a short history of video coding technology and standards; reviews the coding framework, main coding tools, and syntax structure of AV

  3. Intelligent video surveillance systems

    CERN Document Server

    Dufour, Jean-Yves

    2012-01-01

    Belonging to the wider academic field of computer vision, video analytics has aroused a phenomenal surge of interest since the current millennium. Video analytics is intended to solve the problem of the incapability of exploiting video streams in real time for the purpose of detection or anticipation. It involves analyzing the videos using algorithms that detect and track objects of interest over time and that indicate the presence of events or suspect behavior involving these objects.The aims of this book are to highlight the operational attempts of video analytics, to identify possi

  4. VBR video traffic models

    CERN Document Server

    Tanwir, Savera

    2014-01-01

    There has been a phenomenal growth in video applications over the past few years. An accurate traffic model of Variable Bit Rate (VBR) video is necessary for performance evaluation of a network design and for generating synthetic traffic that can be used for benchmarking a network. A large number of models for VBR video traffic have been proposed in the literature for different types of video in the past 20 years. Here, the authors have classified and surveyed these models and have also evaluated the models for H.264 AVC and MVC encoded video and discussed their findings.

  5. Types of Hearing Aids

    Science.gov (United States)

    ... Consumer Devices Consumer Products Hearing Aids Types of Hearing Aids Share Tweet Linkedin Pin it More sharing ... are some features for hearing aids? What are hearing aids? Hearing aids are sound-amplifying devices designed ...

  6. Flip Video for Dummies

    CERN Document Server

    Hutsko, Joe

    2010-01-01

    The full-color guide to shooting great video with the Flip Video camera. The inexpensive Flip Video camera is currently one of the hottest must-have gadgets. It's portable and connects easily to any computer to transfer video you shoot onto your PC or Mac. Although the Flip Video camera comes with a quick-start guide, it lacks a how-to manual, and this full-color book fills that void! Packed with full-color screen shots throughout, Flip Video For Dummies shows you how to shoot the best possible footage in a variety of situations. You'll learn how to transfer video to your computer and then edi

  7. Overview - Be Smart. Be Well. STD Videos

    Centers for Disease Control (CDC) Podcasts

    2010-03-15

    This video, produced by Be Smart. Be Well., raises awareness of Sexually Transmitted Diseases (STDs): 1) What are they? 2) Why they matter? and, 3) What can I do about them? Footage courtesy of Be Smart. Be Well., featuring CDC's Dr. John Douglas, Division of Sexually Transmitted Disease Prevention.  Created: 3/15/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/15/2010.

  8. Game-Based Learning Aids in Second Life

    Science.gov (United States)

    Young, William, II; Franklin, Teresa; Cooper, Tessa; Carroll, Stephen; Liu, Chang

    2012-01-01

    In an age of technological advancement, video games have been found to be effective teaching aids in middle school science classrooms. A National Science Foundation (NSF) project at Ohio University, known as STEAM, (Science and Technology Enrichment for Appalachian Middle Schoolers), has examined Second Life as a curriculum aid through the design,…

  9. Development of a Decision Aid for Cardiopulmonary Resuscitation Involving Intensive Care Unit Patients' and Health Professionals' Participation Using User-Centered Design and a Wiki Platform for Rapid Prototyping: A Research Protocol.

    Science.gov (United States)

    Plaisance, Ariane; Witteman, Holly O; Heyland, Daren Keith; Ebell, Mark H; Dupuis, Audrey; Lavoie-Bérard, Carole-Anne; Légaré, France; Archambault, Patrick Michel

    2016-02-11

    Cardiopulmonary resuscitation (CPR) is an intervention used in cases of cardiac arrest to revive patients whose heart has stopped. Because cardiac arrest can have potentially devastating outcomes such as severe neurological deficits even if CPR is performed, patients must be involved in determining in advance if they want CPR in the case of an unexpected arrest. Shared decision making (SDM) facilitates discussions about goals of care regarding CPR in intensive care units (ICUs). Patient decision aids (DAs) are proven to support the implementation of SDM. Many patient DAs about CPR exist, but they are not universally implemented in ICUs in part due to lack of context and cultural adaptation. Adaptation to local context is an important phase of implementing any type of knowledge tool such as patient DAs. User-centered design supported by a wiki platform to perform rapid prototyping has previously been successful in creating knowledge tools adapted to the needs of patients and health professionals (eg, asthma action plans). This project aims to explore how user-centered design and a wiki platform can support the adaptation of an existing DA for CPR to the local context. The primary objective is to use an existing DA about CPR to create a wiki-based DA that is adapted to the context of a single ICU and tailorable to individual patient's risk factors while employing user-centered design. The secondary objective is to document the use of a wiki platform for the adaptation of patient DAs. This study will be conducted in a mixed surgical and medical ICU at Hôtel-Dieu de Lévis, Quebec, Canada. We plan to involve all 5 intensivists and recruit at least 20 alert and oriented patients admitted to the ICU and their family members if available. In the first phase of this study, we will observe 3 weeks of daily interactions between patients, families, intensivists, and other allied health professionals. We will specifically observe 5 dyads of attending intensivists and alert

  10. Brand Aid

    DEFF Research Database (Denmark)

    Richey, Lisa Ann; Ponte, Stefano

    2011-01-01

    activists, scholars and venture capitalists, discusses the pros and cons of changing the world by ‘voting with your dollars’. Lisa Ann Richey and Stefano Ponte (Professor at Roskilde University and Senior Researcher at DIIS respectively), authors of Brand Aid: Shopping Well to Save the World, highlight how...

  11. Using video in childbirth research.

    Science.gov (United States)

    Harte, J Davis; Homer, Caroline Se; Sheehan, Athena; Leap, Nicky; Foureur, Maralyn

    2017-03-01

    Conducting video-research in birth settings raises challenges for ethics review boards to view birthing women and research-midwives as capable, autonomous decision-makers. This study aimed to gain an understanding of how the ethical approval process was experienced and to chronicle the perceived risks and benefits. The Birth Unit Design project was a 2012 Australian ethnographic study that used video recording to investigate the physical design features in the hospital birthing space that might influence both verbal and non-verbal communication and the experiences of childbearing women, midwives and supporters. Participants and research context: Six women, 11 midwives and 11 childbirth supporters were filmed during the women's labours in hospital birth units and interviewed 6 weeks later. Ethical considerations: The study was approved by an Australian Health Research Ethics Committee after a protracted process of negotiation. The ethics committee was influenced by a traditional view of research as based on scientific experiments resulting in a poor understanding of video-ethnographic research, a paradigmatic view of the politics and practicalities of modern childbirth processes, a desire to protect institutions from litigation, and what we perceived as a paternalistic approach towards protecting participants, one that was at odds with our aim to facilitate situations in which women could make flexible, autonomous decisions about how they might engage with the research process. The perceived need for protection was overly burdensome and against the wishes of the participants themselves; ultimately, this limited the capacity of the study to improve care for women and babies. Recommendations are offered for those involved in ethical approval processes for qualitative research in childbirth settings. The complexity of issues within childbirth settings, as in most modern healthcare settings, should be analysed using a variety of research approaches, beyond efficacy

  12. Understanding Video Games

    DEFF Research Database (Denmark)

    Heide Smith, Jonas; Tosca, Susana Pajares; Egenfeldt-Nielsen, Simon

    From Pong to PlayStation 3 and beyond, Understanding Video Games is the first general introduction to the exciting new field of video game studies. This textbook traces the history of video games, introduces the major theories used to analyze games such as ludology and narratology, reviews...... the economics of the game industry, examines the aesthetics of game design, surveys the broad range of game genres, explores player culture, and addresses the major debates surrounding the medium, from educational benefits to the effects of violence. Throughout the book, the authors ask readers to consider...... larger questions about the medium: * What defines a video game? * Who plays games? * Why do we play games? * How do games affect the player? Extensively illustrated, Understanding Video Games is an indispensable and comprehensive resource for those interested in the ways video games are reshaping...

  13. Collaborative Video Sketching

    DEFF Research Database (Denmark)

    Henningsen, Birgitte; Gundersen, Peter Bukovica; Hautopp, Heidi

    2017-01-01

    This paper introduces to what we define as a collaborative video sketching process. This process links various sketching techniques with digital storytelling approaches and creative reflection processes in video productions. Traditionally, sketching has been used by designers across various...... forms and through empirical examples, we present and discuss the video recording of sketching sessions, as well as development of video sketches by rethinking, redoing and editing the recorded sessions. The empirical data is based on workshop sessions with researchers and students from universities...... and university colleges and primary and secondary school teachers. As researchers, we have had different roles in these action research case studies where various video sketching techniques were applied.The analysis illustrates that video sketching can take many forms, and two common features are important...

  14. Reflections on academic video

    Directory of Open Access Journals (Sweden)

    Thommy Eriksson

    2012-11-01

    Full Text Available As academics we study, research and teach audiovisual media, yet rarely disseminate and mediate through it. Today, developments in production technologies have enabled academic researchers to create videos and mediate audiovisually. In academia it is taken for granted that everyone can write a text. Is it now time to assume that everyone can make a video essay? Using the online journal of academic videos Audiovisual Thinking and the videos published in it as a case study, this article seeks to reflect on the emergence and legacy of academic audiovisual dissemination. Anchoring academic video and audiovisual dissemination of knowledge in two critical traditions, documentary theory and semiotics, we will argue that academic video is in fact already present in a variety of academic disciplines, and that academic audiovisual essays are bringing trends and developments that have long been part of academic discourse to their logical conclusion.

  15. Clients experience of video recordings of their psychotherapy

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard; Jensen, Karen Boelt; Madsen, Ninna Skov

    the current relatively widespread use video one finds only a very limited numbers empirical study of how these recordings is experienced by the clients. Aim: After a brief discussion of the pro and cons of the use of video recordings this paper presents a qualitative, explorative study of clients’ experiences......Background: Due to the development of technologies and the low costs video recording of psychotherapy sessions have gained ground in training and supervision. While some praise the advantages others decline to use this technological aid for ethical, theoretical or clinical reasons. Despite...

  16. Practicality in Virtuality: Finding Student Meaning in Video Game Education

    Science.gov (United States)

    Barko, Timothy; Sadler, Troy D.

    2013-04-01

    This paper looks at the conceptual differences between video game learning and traditional classroom and laboratory learning. It explores the notion of virtual experience by comparing a commonly used high school laboratory protocol on DNA extraction with a similar experience provided by a biotechnology themed video game. When considered conceptually, the notion of virtual experience is not limited to those experiences generated by computer aided technology, as with a video game or computer simulation. The notion of virtuality can apply to many real world experiences as well. It is proposed that the medium of the learning experience, be it video game or classroom, is not an important distinction to consider; instead, we should seek to determine what kinds of meaningful experiences apply for both classrooms and video games.

  17. Tactile Aids

    Directory of Open Access Journals (Sweden)

    Mohtaramossadat Homayuni

    1996-04-01

    Full Text Available Tactile aids, which translate sound waves into vibrations that can be felt by the skin, have been used for decades by people with severe/profound hearing loss to enhance speech/language development and improve speechreading.The development of tactile aids dates from the efforts of Goults and his co-workers in the 1920s; Although The power supply was too voluminous and it was difficult to carry specially by children, it was too huge and heavy to be carried outside the laboratories and its application was restricted to the experimental usage. Nowadays great advances have been performed in producing this instrument and its numerous models is available in markets around the world.

  18. Sound for digital video

    CERN Document Server

    Holman, Tomlinson

    2013-01-01

    Achieve professional quality sound on a limited budget! Harness all new, Hollywood style audio techniques to bring your independent film and video productions to the next level.In Sound for Digital Video, Second Edition industry experts Tomlinson Holman and Arthur Baum give you the tools and knowledge to apply recent advances in audio capture, video recording, editing workflow, and mixing to your own film or video with stunning results. This fresh edition is chockfull of techniques, tricks, and workflow secrets that you can apply to your own projects from preproduction

  19. Green Power Partnership Videos

    Science.gov (United States)

    The Green Power Partnership develops videos on a regular basis that explore a variety of topics including, Green Power partnership, green power purchasing, Renewable energy certificates, among others.

  20. Traditional lesion detection aids.

    Science.gov (United States)

    Neuhaus, K W; Ellwood, R; Lussi, A; Pitts, N B

    2009-01-01

    Lesion detection aids ideally aim at increasing the sensitivity of visual caries detection without trading off too much in terms of specificity. The use of a dental probe (explorer), bitewing radiography and fibre-optic transillumination (FOTI) have long been recommended for this purpose. Today, probing of suspected lesions in the sense of checking the 'stickiness' is regarded as obsolete, since it achieves no gain of sensitivity and might cause irreversible tooth damage. Bitewing radiography helps to detect lesions that are otherwise hidden from visual examination, and it should therefore be applied to a new patient. The diagnostic performance of radiography at approximal and occlusal sites is different, as this relates to the 3-dimensional anatomy of the tooth at these sites. However, treatment decisions have to take more into account than just lesion extension. Bitewing radiography provides additional information for the decision-making process that mainly relies on the visual and clinical findings. FOTI is a quick and inexpensive method which can enhance visual examination of all tooth surfaces. Both radiography and FOTI can improve the sensitivity of caries detection, but require sufficient training and experience to interpret information correctly. Radiography also carries the burden of the risks and legislation associated with using ionizing radiation in a health setting and should be repeated at intervals guided by the individual patient's caries risk. Lesion detection aids can assist in the longitudinal monitoring of the behaviour of initial lesions. Copyright 2009 S. Karger AG, Basel

  1. Making the Decision to Breastfeed

    Medline Plus

    Full Text Available ... Submit Home > It's Only Natural > Planning ahead Making the decision to breastfeed YouTube embed video: YouTube embed ... and players A federal government website managed by the Office on Women’s Health in the Office of ...

  2. Fiscal state aid and real estate collective investment vehicles (CIVs)

    NARCIS (Netherlands)

    Vermeulen, H.

    2011-01-01

    State aid is an issue that does not immediately come to mind on the topic of real estate collective investment vehicles (CIVs). Nevertheless the question of state aid plays an important role. Last year, the European Commission charged with the monitoring of state aid has taken an important decision

  3. Acoustic Neuroma Educational Video

    Medline Plus

    Full Text Available ... a Group Upcoming Events Video Library Photo Gallery One-on-One Support ANetwork Peer Support Program Community Connections Overview ... group Back Upcoming events Video Library Photo Gallery One-on-One Support Back ANetwork Peer Support Program ...

  4. Reviews in instructional video

    NARCIS (Netherlands)

    van der Meij, Hans

    2017-01-01

    This study investigates the effectiveness of a video tutorial for software training whose construction was based on a combination of insights from multimedia learning and Demonstration-Based Training. In the videos, a model of task performance was enhanced with instructional features that were

  5. Digital Video Editing

    Science.gov (United States)

    McConnell, Terry

    2004-01-01

    Monica Adams, head librarian at Robinson Secondary in Fairfax country, Virginia, states that librarians should have the technical knowledge to support projects related to digital video editing. The process of digital video editing and the cables, storage issues and the computer system with software is described.

  6. AudioMove Video

    DEFF Research Database (Denmark)

    2012-01-01

    Live drawing video experimenting with low tech techniques in the field of sketching and visual sense making. In collaboration with Rune Wehner and Teater Katapult.......Live drawing video experimenting with low tech techniques in the field of sketching and visual sense making. In collaboration with Rune Wehner and Teater Katapult....

  7. Making Good Physics Videos

    Science.gov (United States)

    Lincoln, James

    2017-01-01

    Online videos are an increasingly important way technology is contributing to the improvement of physics teaching. Students and teachers have begun to rely on online videos to provide them with content knowledge and instructional strategies. Online audiences are expecting greater production value, and departments are sometimes requesting educators…

  8. SECRETS OF SONG VIDEO

    Directory of Open Access Journals (Sweden)

    Chernyshov Alexander V.

    2014-04-01

    Full Text Available The article focuses on the origins of the song videos as TV and Internet-genre. In addition, it considers problems of screen images creation depending on the musical form and the text of a songs in connection with relevant principles of accent and phraseological video editing and filming techniques as well as with additional frames and sound elements.

  9. Acoustic Neuroma Educational Video

    Medline Plus

    Full Text Available ... support group for me? Find a Group Upcoming Events Video Library Photo Gallery One-on-One Support ANetwork Peer ... group for me? Find a group Back Upcoming events Video Library Photo Gallery One-on-One Support Back ANetwork ...

  10. Personal Digital Video Stories

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Henningsen, Birgitte Sølbeck; Louw, Arnt Vestergaard

    2016-01-01

    agenda focusing on video productions in combination with digital storytelling, followed by a presentation of the digital storytelling features. The paper concludes with a suggestion to initiate research in what is identified as Personal Digital Video (PDV) Stories within longitudinal settings, while...

  11. The Video Generation.

    Science.gov (United States)

    Provenzo, Eugene F., Jr.

    1992-01-01

    Video games are neither neutral nor harmless but represent very specific social and symbolic constructs. Research on the social content of today's video games reveals that sex bias and gender stereotyping are widely evident throughout the Nintendo games. Violence and aggression also pervade the great majority of the games. (MLF)

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos ... member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression ...

  13. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Corner / Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos was designed to help you learn more about Rheumatoid Arthritis (RA). You will learn how the diagnosis of ...

  14. Rheumatoid Arthritis Educational Video Series

    Science.gov (United States)

    ... Corner / Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos was designed to help you learn more about Rheumatoid Arthritis (RA). You will learn how the diagnosis of ...

  15. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding Extramural Research Division ... Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Amblyopia Embedded video ...

  16. Modeling 3D Unknown object by Range Finder and Video Camera ...

    African Journals Online (AJOL)

    Computer-generated and video images are superimposed. The man-machine interface functions deal mainly with on line building of graphic aids to improve perception, updating the geometric database of the robotic site, and video control of the robot. The superimposition of the real and virtual worlds is carried out through ...

  17. Blending Video Games with Learning: Issues and Challenges with Classroom Implementations in the Turkish Context

    Science.gov (United States)

    Tuzun, Hakan

    2007-01-01

    The research design for this study focuses on examining the core issues and challenges when video games are used in the classroom. For this purpose three naturalistic contexts in Turkey were examined in which educational video games were used as the basis for teaching units on world continents and countries, first aid, and basic computer hardware…

  18. Social video content delivery

    CERN Document Server

    Wang, Zhi; Zhu, Wenwu

    2016-01-01

    This brief presents new architecture and strategies for distribution of social video content. A primary framework for socially-aware video delivery and a thorough overview of the possible approaches is provided. The book identifies the unique characteristics of socially-aware video access and social content propagation, revealing the design and integration of individual modules that are aimed at enhancing user experience in the social network context. The change in video content generation, propagation, and consumption for online social networks, has significantly challenged the traditional video delivery paradigm. Given the massive amount of user-generated content shared in online social networks, users are now engaged as active participants in the social ecosystem rather than as passive receivers of media content. This revolution is being driven further by the deep penetration of 3G/4G wireless networks and smart mobile devices that are seamlessly integrated with online social networking and media-sharing s...

  19. Special Needs: Planning for Adulthood (Videos)

    Medline Plus

    Full Text Available ... Family Life First Aid & Safety Doctors & Hospitals Q&A Recipes En Español Teachers - Looking for Health Lessons? ... Are Reading Can Diabetes Be Prevented? Giving Teens a Voice in Health Care Decisions Teaching Kids Not ...

  20. A new video studio for CERN

    CERN Multimedia

    Anaïs Vernede

    2011-01-01

    On Monday, 14 February 2011 CERN's new video studio was inaugurated with a recording of "Spotlight on CERN", featuring an interview with the DG, Rolf Heuer.   CERN's new video studio. Almost all international organisations have a studio for their audiovisual communications, and now it's CERN’s turn to acquire such a facility. “In the past, we've made videos using the Globe audiovisual facilities and sometimes using the small photographic studio, which is equipped with simple temporary sets that aren’t really suitable for video,” explains Jacques Fichet, head of CERN‘s audiovisual service. Once the decision had been taken to create the new 100 square-metre video studio, the work took only five months to complete. The studio, located in Building 510, is equipped with a cyclorama (a continuous smooth white wall used as a background) measuring 3 m in height and 16 m in length, as well as a teleprompter, a rail-mounted camera dolly fo...