New Management Tools – From Video Management Systems to Business Decision Systems

Directory of Open Access Journals (Sweden)

Emilian Cristian IRIMESCU

2015-06-01

Full Text Available In the last decades management was characterized by the increased use of Business Decision Systems, also called Decision Support Systems. More than that, systems that were until now used in a traditional way, for some simple activities (like security, migrated to the decision area of management. Some examples are the Video Management Systems from the physical security activity. This article will underline the way Video Management Systems passed to Business Decision Systems, which are the advantages of use thereof and which are the trends in this industry. The article will also analyze if at this moment Video Management Systems are real Business Decision Systems or if there are some functions missing to rank them at this level.

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…

Psychosocial Factors of Health Professionals' Intention to Use a Decision Aid for Down Syndrome Screening: Cross-Sectional Quantitative Study.

Science.gov (United States)

Abbasgholizadeh Rahimi, Samira; Lépine, Johanie; Croteau, Jordie; Robitaille, Hubert; Giguere, Anik Mc; Wilson, Brenda J; Rousseau, François; Lévesque, Isabelle; Légaré, France

2018-04-25

Decisions about prenatal screening for Down syndrome are difficult for women, as they entail risk, potential loss, and regret. Shared decision making increases women's knowledge of their choices and better aligns decisions with their values. Patient decision aids foster shared decision making but are rarely used in this context. One of the most promising strategies for implementing shared decision making is distribution of decision aids by health professionals. We aimed to identify factors influencing their intention to use a DA during prenatal visit for decisions about Down syndrome screening. We conducted a cross-sectional quantitative study. Using a Web panel, we conducted a theory-based survey of health professionals in Quebec province (Canada). Eligibility criteria were as follows: (1) family physicians, midwives, obstetrician-gynecologists, or trainees in these professions; (2) involved in prenatal care; and (3) working in Quebec province. Participants watched a video depicting a health professional using a decision aid during a prenatal consultation with a woman and her partner, and then answered a questionnaire based on an extended version of the theory of planned behavior, including some of the constructs of the theoretical domains framework. The questionnaire assessed 8 psychosocial constructs (attitude, anticipated regret, subjective norm, self-identity, moral norm, descriptive norm, self-efficacy, and perceived control), 7 related sets of behavioral beliefs (advantages, disadvantages, emotions, sources of encouragement or discouragement, incentives, facilitators, and barriers), and sociodemographic data. We performed descriptive, bivariate, and multiple linear regression analyses to identify factors influencing health professionals' intention to use a decision aid. Among 330 health professionals who completed the survey, 310 met the inclusion criteria: family physicians, 55.2% (171/310); obstetrician-gynecologists, 33.8% (105/310); and midwives, 11

AIDS: Administrative Decisions and Constitutional Rights.

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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)

Analytical evaluation of computer-based decision aids

International Nuclear Information System (INIS)

Kisner, R.A.

1985-01-01

This paper introduces a method for evaluating decision aids for nuclear power plant operators. The method involves a two-stage process of classification and analytical evaluation of display form and content. The classification scheme relates each specific aid to one or more general decision-making tasks. Evaluation then proceeds using a normative top-down design process based on the classification scheme by determining or deducing how various design issues associated with this process were resolved by the designer. The result is an assessment of the ''understandability'' of the aid as well as identification of the training and display features necessary to ensure understandability. 7 refs., 4 figs., 1 tab

Nurse aide decision making in nursing homes: factors affecting empowerment.

Science.gov (United States)

Chaudhuri, Tanni; Yeatts, Dale E; Cready, Cynthia M

2013-09-01

To evaluate factors affecting structural empowerment among nurse aides in nursing homes. Structural empowerment can be defined as the actual rather than perceived ability to make autonomous decisions within an organisation. Given the paucity of research on the subject, this study helps to close the gap by identifying factors that affect nurse aide empowerment, that is, decision-making among nurse aides. The data for the study come from self-administered questionnaires distributed to direct-care workers (nurse aides) in 11 nursing homes in a southern state in the USA. Ordinary least square regression models were estimated to analyse the effects of demographic predictors, personal factors (competency, emotional exhaustion and positive attitude) and structural characteristics (coworker and supervisor support, information availability and shared governance) on nurse aide decision-making. Findings suggest race among demographic predictors, emotional exhaustion among personal characteristics, and supervisor support, and shared governance among structural factors, significantly affect nurse aide decision-making. It is important to explore race as one of the central determinants of structural empowerment among nurse aides. In addition, the nature and type of emotional exhaustion that propels decision-making needs to be further examined. The study shows the importance of shared governance and supervisor support for fostering nurse aide empowerment. © 2013 Blackwell Publishing Ltd.

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

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

2015-09-24

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

Rade-aid: an operational tool for decision-makers

International Nuclear Information System (INIS)

Wagenaar, G.; van den Bosch, C.J.H.; Ehrhardt, J.; Steinhauer, C.; Morrey, M.; Robinson, C.A.

1991-01-01

If an accidental release of radionuclides occurs, decisions on countermeasures are required. Since the making of a decision involves many competing factors (for instance, the health risk versus the costs relating to a countermeasure), the decision-maker faces a problem. The aim of the RADE-AID (Radiological Accident DEcision AIDing) project is the development of a computer decision support system which can be used in the formulation of decisions. The theoretical background of the decision technique and its methods are outlined, together with the practical application of the technique in the form of the software package developed. Both the benefits of formal techniques and computerized tools in this field are discussed. In order to explore the appropriateness of the decision technique for the management of radiological emergencies, illustrative, but stylized, applications were carried out. Conclusions from these applications are discussed

Tactical Decision Aids High Bandwidth Links Using Autonomous Vehicles

Science.gov (United States)

2004-01-01

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

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…

Decision aid for women considering breast cancer screening

DEFF Research Database (Denmark)

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

2011-01-01

OBJECTIVES: The aim of this study was to describe the process and challenges of developing a decision aid for the national public breast cancer screening program in Finland. METHODS: An expert team with stakeholder representation used European guidelines and other literature as basis for selecting...... 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...... 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...

Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis

NARCIS (Netherlands)

Knops, Anouk M.; Legemate, Dink A.; Goossens, Astrid; Bossuyt, Patrick M. M.; Ubbink, Dirk T.

2013-01-01

To summarize the evidence available on the effects of decision aids in surgery. When consenting to treatment, few patients adequately understand their treatment options. To help patients make deliberate treatment choices, decision aids provide evidence-based information on the disease, treatment

Decision aids for people considering taking part in clinical trials.

Science.gov (United States)

Gillies, Katie; Cotton, Seonaidh C; Brehaut, Jamie C; Politi, Mary C; Skea, Zoe

2015-11-27

Several interventions have been developed to promote informed consent for participants in clinical trials. However, many of these interventions focus on the content and structure of information (e.g. enhanced information or changes to the presentation format) rather than the process of decision making. Patient decision aids support a decision making process about medical options. Decision aids support the decision process by providing information about available options and their associated outcomes, alongside information that enables patients to consider what value they place on particular outcomes, and provide structured guidance on steps of decision making. They have been shown to be effective for treatment and screening decisions but evidence on their effectiveness in the context of informed consent for clinical trials has not been synthesised. To assess the effectiveness of decision aids for clinical trial informed consent compared to no intervention, standard information (i.e. usual practice) or an alternative intervention on the decision making process. We searched the following databases and to March 2015: Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; MEDLINE (OvidSP) (from 1950); EMBASE (OvidSP) (from 1980); PsycINFO (OvidSP) (from 1806); ASSIA (ProQuest) (from 1987); WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/); ClinicalTrials.gov; ISRCTN Register (http://www.controlled-trials.com/isrctn/). We also searched reference lists of included studies and relevant reviews. We contacted study authors and other experts. There were no language restrictions. We included randomised and quasi-randomised controlled trials comparing decision aids in the informed consent process for clinical trials alone, or in conjunction with standard information (such as written or verbal) or alongside alternative interventions (e.g. paper-based versus web-based decision aids). Included trials involved

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.

Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature

Science.gov (United States)

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

2018-01-01

This Explanation and Elaboration (E&E) article expands on the 26 items in the Standards for UNiversal reporting of Decision Aid Evaluations guidelines. The E&E provides a rationale for each item and includes examples for how each item has been reported in published papers evaluating patient decision aids. The E&E focuses on items key to reporting studies evaluating patient decision aids and is intended to be illustrative rather than restrictive. Authors and reviewers may wish to use the E&E broadly to inform structuring of patient decision aid evaluation reports, or use it as a reference to obtain details about how to report individual checklist items. PMID:29467235

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

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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.

Probability of Survival Decision Aid (PSDA)

National Research Council Canada - National Science Library

Xu, Xiaojiang; Amin, Mitesh; Santee, William R

2008-01-01

A Probability of Survival Decision Aid (PSDA) is developed to predict survival time for hypothermia and dehydration during prolonged exposure at sea in both air and water for a wide range of environmental conditions...

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.

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

Science.gov (United States)

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

2016-01-01

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

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

Empirical Evaluation of a Decision-Analytic Aid.

Science.gov (United States)

1980-05-01

Morris, Smallwood , Lansford, and Gibbons (1980) state: "In the traditional paradigm, the decision-maker must decide to accept or reject the model. If he... Smallwood , R. D., Langford, R. K., & Gibbons, R. S. Analytic Procedures for Evaluating Decision Aids. Applied Decision Analysis, Inc. (Menlo Park, CA...Menlo Park, CA 94025 Department of Psychology University of Oklahoma Dr. Jesse Orlansky 455 West Lindsey Institute for Defense Analyses Norman , OK 73069

Development of a decision aid for children faced with the decision to undergo dental treatment with sedation or general anaesthesia.

Science.gov (United States)

Hulin, Joe; Baker, Sarah R; Marshman, Zoe; Albadri, Sondos; Rodd, Helen D

2017-09-01

Decision aids are tools used to help individuals faced with difficult healthcare decisions. They help patients further understand the treatment options available and encourage the sharing of information between patients and clinicians. To develop a decision aid for young patients faced with the decision to undergo dental treatment with inhalation sedation, intravenous sedation, or general anaesthesia (GA). Qualitative interviews with dental patients (aged 10-16 years), and their parents/guardians were used to inform the content of a draft decision aid. Following further revisions, a pilot evaluation of the decision aid was conducted. Patients referred for dental treatment with sedation or GA were recruited from a UK dental hospital. Patients (n = 15) and parents/guardians (n = 13) assigned to the intervention group received the decision aid and routine clinical counselling, whereas patients (n = 17) and parents/guardians (n = 13) in the control group only received routine clinical counselling. Participants completed measures of knowledge, decisional conflict, and dental anxiety. Knowledge scores were significantly higher for participants who received the decision aid when compared to standard care. There were no other significant differences between groups. A decision aid was successfully developed, and initial findings suggest such tools could be beneficial to dental sedation or GA patients and their parents/guardians. Further research is required on the use of such tools in primary care settings, with particular attention to the impact of the decision aid on attendance and completion rates of treatment. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Refining a brief decision aid in stable CAD: cognitive interviews

OpenAIRE

Kelly-Blake, Karen; Clark, Stacie; Dontje, Katherine; Olomu, Adesuwa; Henry, Rebecca C; Rovner, David R; Rothert, Marilyn L; Holmes-Rovner, Margaret

2014-01-01

Background We describe the results of cognitive interviews to refine the “Making Choices©” Decision Aid (DA) for shared decision-making (SDM) about stress testing in patients with stable coronary artery disease (CAD). Methods We conducted a systematic development process to design a DA consistent with International Patient Decision Aid Standards (IPDAS) focused on Alpha testing criteria. Cognitive interviews were conducted with ten stable CAD patients using the “think aloud” interview techniq...

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.

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.

Directory of Open Access Journals (Sweden)

Ariane Plaisance

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

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).

Assisting informed decision making for labour analgesia: a randomised controlled trial of a decision aid for labour analgesia versus a pamphlet

Directory of Open Access Journals (Sweden)

Torvaldsen Siranda

2010-04-01

Full Text Available Abstract Background Most women use some method of pain relief during labour. There is extensive research evidence available of pharmacological pain relief during labour; however this evidence is not readily available to pregnant women. Decision aids are tools that present evidence based information and allow preference elicitation. Methods We developed a labour analgesia decision aid. Using a RCT design women either received a decision aid or a pamphlet. Eligible women were primiparous, ≥ 37 weeks, planning a vaginal birth of a single infant and had sufficient English to complete the trial materials. We used a combination of affective (anxiety, satisfaction and participation in decision-making and behavioural outcomes (intention and analgesia use to assess the impact of the decision aid, which were assessed before labour. Results 596 women were randomised (395 decision aid group, 201 pamphlet group. There were significant differences in knowledge scores between the decision aid group and the pamphlet group (mean difference 8.6, 95% CI 3.70, 13.40. There were no differences between decisional conflict scores (mean difference -0.99 (95% CI -3.07, 1.07, or anxiety (mean difference 0.3, 95% CI -2.15, 1.50. The decision aid group were significantly more likely to consider their care providers opinion (RR 1.28 95%CI 0.64, 0.95. There were no differences in analgesia use and poor follow through between antenatal analgesia intentions and use. Conclusions This decision aid improves women's labour analgesia knowledge without increasing anxiety. Significantly, the decision aid group were more informed of labour analgesia options, and considered the opinion of their care providers more often when making their analgesia decisions, thus improving informed decision making. Trial Registration Trial registration no: ISRCTN52287533

The Impact of Video Gaming on Decision-Making and Teamworking Skills

Science.gov (United States)

Campus-Wide Information Systems, 2005

2005-01-01

Purpose: To discuss the considerable impact of video gaming on young players' decision-making and teamworking skills, and the belief that video games provide an invaluable "training camp" for business. Design/methodology/approach: An interview with John Beck, the author of the book Got Game: How a New Generation of Gamers Is Reshaping Business…

Rade-aid a decision support system to evaluate countermeasures after a radiological accident

International Nuclear Information System (INIS)

Wagenaar, G.; Van Den Bosch, C.J.H.; Weger, D. de.

1990-01-01

After Chernobyl the authorities in many countries were overwhelmed by the enormous amount of information that was being generated by measuring and monitoring programs. In making decisions, this information had to be combined with the results of specific countermeasures, in order to determine the optimal strategy with respect to a large number of consequences. The development of RADE-AID, the Radiological Accident Decision AIDing system, is aimed at providing a powerful tool in the decision-making process. RADE-AID is developed by TNO (The Netherlands) in a joint contract with KfK (FRG) and NRPB (UK). In the first phase a demonstration system will be built, called RADE-AID/D. RADE-AID/D will be used as a decision support system in the intermediate and late phase after a radiological accident. RADE-AID/D will consider countermeasures with respect to external exposure and internal exposure by food ingestion. Countermeasures are evaluated considering reduction in doses and in numbers of health effects, costs, and social effects. The paper covers the structure of the program, presentation of data and results, and the decision analysis technique that is being used. This decision analysis part is an important feature of the system; an advanced decision analysis technique is used, that is able to compare data of varying nature. Furthermore the place of RADE-AID in the decision-making process will be treated. RADE-AID/D is an interactive computer program, that offers the user the possibility to enter relevant data and to have data and results displayed in a variety of ways. Furthermore the system contains an advanced decision analysis technique, that is able to compare data of varying nature. Input data for the decision analysis calculations are provided by models from UFOMOD and MARC-codes

A Framework for Evaluating the Cost-Effectiveness of Patient Decision Aids: A Case Study Using Colorectal Cancer Screening

Science.gov (United States)

Cantor, Scott B.; Rajan, Tanya; Linder, Suzanne K.; Volk, Robert J.

2017-01-01

Objective Patient decision aids are important tools for facilitating balanced, evidence-based decision making. However, the potential of decision aids to lower health care utilization and costs is uncertain; few studies have investigated the cost-effectiveness of decision aids that change patient behavior. Using an example of a decision aid for colorectal cancer screening, we provide a framework for analyzing the cost-effectiveness of decision aids. Methods A decision-analytic model with two strategies (decision aid or no decision aid) was used to calculate expected costs in U.S. dollars and benefits measured in life-years saved (LYS). Data from a systematic review of ten studies about decision aid effectiveness was used to calculate the percentage increase in the number of people choosing screening instead of no screening. We then calculated the incremental cost per LYS with the use of the decision aid. Results The no decision aid strategy had an expected cost of $3,023 and yielded 18.19 LYS. The decision aid strategy cost $3,249 and yielded 18.20 LYS. The incremental cost-effectiveness ratio for the decision aid strategy was $36,126 per LYS. Results were sensitive to the cost of the decision aid and the percentage change in behavior caused by the decision aid. Conclusions This study provides proof-of-concept evidence for future studies examining the cost-effectiveness of decision aids. The results suggest that decision aids can be beneficial and cost-effective. PMID:25979678

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

2018-02-01

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.

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

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

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

Science.gov (United States)

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

2017-08-02

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

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...

Aiding Lay Decision Making Using a Cognitive Competencies Approach.

Science.gov (United States)

Maule, A J; Maule, Simon

2015-01-01

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.

Decision aid prototype development for parents considering adenotonsillectomy for their children with sleep disordered breathing

OpenAIRE

Maguire, Erin; Hong, Paul; Ritchie, Krista; Meier, Jeremy; Archibald, Karen; Chorney, Jill

2016-01-01

Background To describe the process involved in developing a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing. Methods A paper-based decision aid prototype was developed using the framework proposed by the International Patient Decision Aids Standards Collaborative. The decision aid focused on two main treatment options: watchful waiting and adenotonsillectomy. Usability was assessed with parents of pediatric patients and prov...

Acceptance of shared decision making with reference to an electronic library of decision aids (arriba-lib) and its association to decision making in patients: an evaluation study.

Science.gov (United States)

Hirsch, Oliver; Keller, Heidemarie; Krones, Tanja; Donner-Banzhoff, Norbert

2011-07-07

Decision aids based on the philosophy of shared decision making are designed to help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes. A patient decision aid can be regarded as a complex intervention because it consists of several presumably relevant components. Decision aids have rarely been field tested to assess patients' and physicians' attitudes towards them. It is also unclear what effect decision aids have on the adherence to chosen options. The electronic library of decision aids (arriba-lib) to be used within the clinical encounter has a modular structure and contains evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. We conducted an evaluation study in which 29 primary care physicians included 192 patients. After the consultation, patients filled in questionnaires and were interviewed via telephone two months later. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Patients were highly satisfied with arriba-lib and the process of shared decision making. Two-thirds of patients reached in the telephone interview wanted to be counselled again with arriba-lib. There was a high congruence between preferred and perceived decision making. Of those patients reached in the telephone interview, 80.7% said that they implemented the decision, independent of gender and education. Elderly patients were more likely to say that they implemented the decision. Shared decision making with our multi-modular electronic library of decision aids (arriba-lib) was accepted by a high number of patients. It has positive associations to general aspects of decision making in patients. It can be used for patient groups with a wide range of individual

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.

onlineDeCISion.org: a web-based decision aid for DCIS treatment.

Science.gov (United States)

Ozanne, Elissa M; Schneider, Katharine H; Soeteman, Djøra; Stout, Natasha; Schrag, Deborah; Fordis, Michael; Punglia, Rinaa S

2015-11-01

Women diagnosed with DCIS face complex treatment decisions and often do so with inaccurate and incomplete understanding of the risks and benefits involved. Our objective was to create a tool to guide these decisions for both providers and patients. We developed a web-based decision aid designed to provide clinicians with tailored information about a patient’s recurrence risks and survival outcomes following different treatment strategies for DCIS. A theoretical framework, microsimulation model (Soeteman et al., J Natl Cancer 105:774–781, 2013) and best practices for web-based decision tools guided the development of the decision aid. The development process used semi-structured interviews and usability testing with key stakeholders, including a diverse group of multidisciplinary clinicians and a patient advocate. We developed onlineDeCISion.​org to include the following features that were rated as important by the stakeholders: (1) descriptions of each of the standard treatment options available; (2) visual projections of the likelihood of time-specific (10-year and lifetime) breast-preservation, recurrence, and survival outcomes; and (3) side-by-side comparisons of down-stream effects of each treatment choice. All clinicians reviewing the decision aid in usability testing were interested in using it in their clinical practice. The decision aid is available in a web-based format and is planned to be publicly available. To improve treatment decision making in patients with DCIS, we have developed a web-based decision aid onlineDeCISion.​org that conforms to best practices and that clinicians are interested in using in their clinics with patients to better inform treatment decisions.

Right choice, right time: Evaluation of an online decision aid for youth depression.

Science.gov (United States)

Simmons, Magenta B; Elmes, Aurora; McKenzie, Joanne E; Trevena, Lyndal; Hetrick, Sarah E

2017-08-01

Appropriate treatment for youth depression is an important public health priority. Shared decision making has been recommended, yet no decision aids exist to facilitate this. The main objective of this study was to evaluate an online decision aid for youth depression. An uncontrolled cohort study with pre-decision, immediately post-decision and follow-up measurements. Young people (n=66) aged 12-25 years with mild, mild-moderate or moderate-severe depression were recruited from two enhanced primary care services. Online decision aid with evidence communication, preference elicitation and decision support components. The main outcome measures were ability to make a decision; whether the decision was in line with clinical practice guidelines, personal preferences and values; decisional conflict; perceived involvement; satisfaction with decision; adherence; and depression scores at follow-up. After using the decision aid, clients were more likely to make a decision in line with guideline recommendations (93% vs 70%; P=.004), were more able to make a decision (97% vs 79%; P=.022), had significantly reduced decisional conflict (17.8 points lower (95% CI: 13.3-22.9 points lower) on the Decisional Conflict Scale (range 0-100)) and felt involved and satisfied with their decision. At follow-up, clients had significantly reduced depression symptoms (2.7 points lower (95% CI: 1.3-4.0 points lower) on the Patient Health Questionnaire nine-item scale (range 0-27)) and were adherent to 88% (95% CI: 82%-94%) of treatment courses. A decision aid for youth depression can help ensure evidence-based, client-centred care, promoting collaboration in this often difficult to engage population. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Studies and Analyses of Vulnerabilities in Aided Adversarial Decision Making

National Research Council Canada - National Science Library

Llinas, James

1998-01-01

.... The aid" in the analysis (i.e., an automated decision aid) focuses upon a generic data fusion processor that estimates situation and threat states based on multisensor/multisource-based data assessments...

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

Science.gov (United States)

Portocarrero, Maria Esther Leiva; Giguère, Anik M C; Lépine, Johanie; Garvelink, Mirjam M; Robitaille, Hubert; Delanoë, Agathe; Lévesque, Isabelle; Wilson, Brenda J; Rousseau, François; Légaré, France

2017-03-20

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 influencing pregnant women's use of a patient decision aid for deciding about prenatal screening for Down syndrome (DS). This qualitative study was embedded in a sequential mixed-methods research program whose main aim is to implement shared decision-making (SDM) in the context of prenatal screening for DS in the province of Quebec, Canada. We planned to recruit a purposive sample of 45 pregnant women with low-risk pregnancy consulting for prenatal care at three clinical sites. Participating women watched a video depicting a prenatal care follow-up during which a pregnant woman, her partner and a health professional used a PtDA to decide about prenatal screening for DS. The women were then interviewed about factors that would influence the use of this PtDA using questions based on the Theoretical Domains Framework (TDF). We performed content analysis of transcribed verbatim interviews. Out of 216 eligible women, 100 agreed to participate (46% response rate) and 46 were interviewed. Regarding the type of health professional responsible for their prenatal care, 19 participants (41%) reported having made a decision about prenatal screening for DS with an obstetrician-gynecologist, 13 (28%) with a midwife, 12 (26%) with a family physician, and two (4%) decided on their own. We identified 54 factors that were mapped onto nine of the 12 TDF domains. The three most frequently-mentioned were: opinion of the pregnant woman's partner (n = 33, 72%), presentation of the PtDA by health professional and a discussion (n = 27, 72%), and not having encountered a PtDA (n = 26, 57%). This study allowed us to identify factors influencing pregnant women's use of a PtDA for prenatal screening for

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

Science.gov (United States)

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

2014-02-01

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

Constructing a relevant decision aid for parents of children with bronchopulmonary dysplasia.

Science.gov (United States)

Skibo, M; Guillen, U; Zhang, H; Munson, D; Mackley, A; Nilan, K; Kirpalani, H

2017-12-01

To develop and test a decision aid for counseling parents of children with bronchopulmonary dysplasia (BPD).Local problem:Parental education about complex conditions is not standardized and communication and understanding may not be adequate. Semi-structured interviews were conducted with 33 neonatal clinicians and 12 parents of children with BPD using a qualitative research design. The interviews were used to identify education topics that were felt to be important in BPD education. These topics were then used to create a visual decision aid to be used in counseling sessions with parents. The decision aid was then used in mock counseling sessions with 15 'experienced' participants and 7 'naïve' participants to assess its efficacy. The participants completed a pre and post test to assess change in knowledge as well as an 11-question Likert style acceptability survey. Implementation of a decision aid while educating parents about BPD. Topics identified during the interviews were used to create eight educational cards which included pictures, pictographs and statistics. Overall, participants thought the decision aid contained an appropriate amount of information, were easy to understand and improved their knowledge about BPD. Testing demonstrated a significant increase in knowledge in both the 'experienced' (Pdecision aid for parents of children with BPD may improve understanding of the condition and help facilitate communication between parents and doctors.

Refining a brief decision aid in stable CAD: cognitive interviews.

Science.gov (United States)

Kelly-Blake, Karen; Clark, Stacie; Dontje, Katherine; Olomu, Adesuwa; Henry, Rebecca C; Rovner, David R; Rothert, Marilyn L; Holmes-Rovner, Margaret

2014-02-13

We describe the results of cognitive interviews to refine the "Making Choices©" Decision Aid (DA) for shared decision-making (SDM) about stress testing in patients with stable coronary artery disease (CAD). We conducted a systematic development process to design a DA consistent with International Patient Decision Aid Standards (IPDAS) focused on Alpha testing criteria. Cognitive interviews were conducted with ten stable CAD patients using the "think aloud" interview technique to assess the clarity, usefulness, and design of each page of the DA. Participants identified three main messages: 1) patients have multiple options based on stress tests and they should be discussed with a physician, 2) take care of yourself, 3) the stress test is the gold standard for determining the severity of your heart disease. Revisions corrected the inaccurate assumption of item number three. Cognitive interviews proved critical for engaging patients in the development process and highlighted the necessity of clear message development and use of design principles that make decision materials easy to read and easy to use. Cognitive interviews appear to contribute critical information from the patient perspective to the overall systematic development process for designing decision aids.

Teaching advance care planning to medical students with a computer-based decision aid.

Science.gov (United States)

Green, Michael J; Levi, Benjamin H

2011-03-01

Discussing end-of-life decisions with cancer patients is a crucial skill for physicians. This article reports findings from a pilot study evaluating the effectiveness of a computer-based decision aid for teaching medical students about advance care planning. Second-year medical students at a single medical school were randomized to use a standard advance directive or a computer-based decision aid to help patients with advance care planning. Students' knowledge, skills, and satisfaction were measured by self-report; their performance was rated by patients. 121/133 (91%) of students participated. The Decision-Aid Group (n = 60) outperformed the Standard Group (n = 61) in terms of students' knowledge (p satisfaction with their learning experience (p student performance. Use of a computer-based decision aid may be an effective way to teach medical students how to discuss advance care planning with cancer patients.

Veterans Like Me: Formative evaluation of a patient decision aid design.

Science.gov (United States)

Gibson, Bryan; Butler, Jorie; Doyon, Katherine; Ellington, Lee; Bray, Bruce E; Zeng, Qing

2017-07-01

Patient decision aids are tools intended to facilitate shared decision-making. Currently development of a patient decision aid is resource intensive: it requires a decision-specific review of the scientific literature by experts to ascertain the potential outcomes under different treatments. The goal of this project was to conduct a formative evaluation of a generalizable, scalable decision aid component we call Veterans Like Me (VLme). VLme mines EHR data to present the outcomes of individuals "like you" on different treatments to the user. These outcome are presented through a combination of an icon array and simulated narratives. Twenty-six patients participated in semi-structured interviews intended to elicit feedback on the tool's functional and interface design. The interview focused on the filters users desired with which to make cases similar to them, the kinds of outcomes they wanted presented, and their envisioned use of the tool. The interview also elicited participants information needs and salient factors related to the therapeutic decision. The interview transcripts were analyzed using an iteratively refined coding schema and content analysis. . Participants generally expressed enthusiasm for the tool's design and functionality. Our analysis identified desired filters for users to view patients like themselves, outcome types that should be included in future iterations of the tool (e.g. patient reported outcomes), and information needs that need to be addressed for patients to effectively participate in shared decision making. Implications for the integration of our findings into the design of patient decision aids are discussed. Published by Elsevier Inc.

Tactical and strategic decision-making aids for nuclear power plant emergency response

International Nuclear Information System (INIS)

Cain, D.G.

1987-01-01

This paper examines the prospective role of computer-based decision aids for nuclear power plant emergency response. The role of these systems is subordinate to human activities, but in a complementary manner these systems process decision logic more accurately and foster a more thorough understanding of emergency situations than might other wise be possible. Within this context two decision support systems being developed are discussed. Both of these systems utilize technology derived from artificial intelligence, focussing on two different facets of emergency response. An automated emergency operating procedures (EOP) tracking expert system is described as a tactical aid for control room operator response. A reactor emergency action level monitor (REALM) expert system is proposed as a strategic decision aid for site emergency response. The discrimination between tactical and strategic decision-making is an intrinsic part of this examination

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

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.

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 χ 2 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.

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 ... process by presenting a point of departure from which procurement decisions may be made. .... M = number of titles available for purchase,. Qi.

A theory-based decision aid for patients with cancer: results of feasibility and acceptability testing of DecisionKEYS for cancer.

Science.gov (United States)

Hollen, Patricia J; Gralla, Richard J; Jones, Randy A; Thomas, Christopher Y; Brenin, David R; Weiss, Geoffrey R; Schroen, Anneke T; Petroni, Gina R

2013-03-01

Appropriate utilization of treatment is a goal for all patients undergoing cancer treatment. Proper treatment maximizes benefit and limits exposure to unnecessary measures. This report describes findings of the feasibility and acceptability of implementing a short, clinic-based decision aid and presents an in-depth clinical profile of the participants. This descriptive study used a prospective, quantitative approach to obtain the feasibility and acceptability of a decision aid (DecisionKEYS for Balancing Choices) for use in clinical settings. It combined results of trials of patients with three different common malignancies. All groups used the same decision aid series. Participants included 80 patients with solid tumors (22 with newly diagnosed breast cancer, 19 with advanced prostate cancer, and 39 with advanced lung cancer) and their 80 supporters as well as their physicians and nurses, for a total of 160 participants and 10 health professionals. The decision aid was highly acceptable to patient and supporter participants in all diagnostic groups. It was feasible for use in clinic settings; the overall value was rated highly. Of six physicians, all found the interactive format with the help of the nurse as feasible and acceptable. Nurses also rated the decision aid favorably. This intervention provides the opportunity to enhance decision making about cancer treatment and warrants further study including larger and more diverse groups. Strengths of the study included a theoretical grounding, feasibility testing of a practical clinic-based intervention, and summative evaluation of acceptability of the intervention by patient and supporter pairs. Further research also is needed to test the effectiveness of the decision aid in diverse clinical settings and to determine if this intervention can decrease overall costs.

Decision aids for improved accuracy and standardization of mammographic diagnosis

International Nuclear Information System (INIS)

D'Orsi, C.J.; Getty, D.J.; Swets, J.A.; Pickett, R.M.; Seltzer, S.E.; McNeil, B.J.

1990-01-01

This paper examines the gains in the accuracy of mammographic diagnosis of breast cancer achievable from a pair of decision aids. Twenty-three potentially relevant perceptual features of mammograms were identified through interviews, psychometric tests, and consensus meetings with mammography specialists. Statistical analyses determined the 12 independent features that were most information diagnostically and assigned a weight to each according to its importance. Two decision aids were developed: a checklist that solicits a scale value from the radiologist for each feature and a computer program that merges those values optimally in an advisory estimate of the probability of malignancy. Six radiologists read a set of 150 cases, first in their usual way and later with the aids

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

Science.gov (United States)

Siminoff, L A; Sandberg, D E

2015-05-01

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

Addressing health literacy in patient decision aids

Science.gov (United States)

2013-01-01

Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies

A decision-aiding system: DACFOOD

International Nuclear Information System (INIS)

Despres, A.; Heymes, P.

1994-01-01

The DACFOOD (Decision Aiding for Contaminated FOODstuffs) system provides decision makers with necessary data for the implementation of optimized protection measures in case of radioactive contamination of foodstuffs. The system evaluates the dose impact due to ingestion of these products, calculates the dose reduction after implementation of specific actions and, by combining these actions, assesses several strategies by using their cost-effectiveness ratios. Such evaluations need the description of contamination as radionuclide activities in each foodstuff, and the description of consumers' groups according to their dietary habits. Then it is possible to define areas in which the doses received are reasonably homogeneous in different age classes. If deposition occurs at a period of the year without harvest, the system applies dynamic transfer models to calculate the concentration in future productions. (authors). 2 refs

Encounter Decision Aid vs. Clinical Decision Support or Usual Care to Support Patient-Centered Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized Trial II.

Directory of Open Access Journals (Sweden)

Annie LeBlanc

Full Text Available Osteoporosis Choice, an encounter decision aid, can engage patients and clinicians in shared decision making about osteoporosis treatment. Its effectiveness compared to the routine provision to clinicians of the patient's estimated risk of fracture using the FRAX calculator is unknown.Patient-level, randomized, three-arm trial enrolling women over 50 with osteopenia or osteoporosis eligible for treatment with bisphosphonates, where the use of Osteoporosis Choice was compared to FRAX only and to usual care to determine impact on patient knowledge, decisional conflict, involvement in the decision-making process, decision to start and adherence to bisphosphonates.We enrolled 79 women in the three arms. Because FRAX estimation alone and usual care produced similar results, we grouped them for analysis. Compared to these, use of Osteoporosis Choice increased patient knowledge (median score 6 vs. 4, p = .01, improved understanding of fracture risk and risk reduction with bisphosphonates (p = .01 and p<.0001, respectively, had no effect on decision conflict, and increased patient engagement in the decision making process (OPTION scores 57% vs. 43%, p = .001. Encounters with the decision aid were 0.8 minutes longer (range: 33 minutes shorter to 3.0 minutes longer. There were twice as many patients receiving and filling prescriptions in the decision aid arm (83% vs. 40%, p = .07; medication adherence at 6 months was no different across arms.Supporting both patients and clinicians during the clinical encounter with the Osteoporosis Choice decision aid efficiently improves treatment decision making when compared to usual care with or without clinical decision support with FRAX results.clinical trials.gov NCT00949611.

Online, Interactive Option Grid Patient Decision Aids and their Effect on User Preferences.

Science.gov (United States)

Scalia, Peter; Durand, Marie-Anne; Kremer, Jan; Faber, Marjan; Elwyn, Glyn

2018-01-01

Randomized trials have shown that patient decision aids can modify users' preferred healthcare options, but research has yet to identify the attributes embedded in these tools that cause preferences to shift. The aim of this study was to investigate people's preferences as they used decision aids for 5 health decisions and, for each of the following: 1) determine if using the interactive Option Grid led to a pre-post shift in preferences; 2) determine which frequently asked questions (FAQs) led to preference shifts; 3) determine the FAQs that were rated as the most important as users compared options. Interactive Option Grid decision aids enable users to view attributes of available treatment or screening options, rate their importance, and specify their preferred options before and after decision aid use. The McNemar-Bowker paired test was used to compare stated pre-post preferences. Multinomial logistic regressions were conducted to investigate possible associations between covariates and preference shifts. Overall, 626 users completed the 5 most-used tools: 1) Amniocentesis test: yes or no? ( n = 73); 2) Angina: treatment options ( n = 88); 3) Breast cancer: surgical options ( n = 265); 4) Prostate Specific Antigen (PSA) test: yes or no? ( n = 82); 5) Statins for heart disease risk: yes or no? ( n = 118). The breast cancer, PSA, and statins Option Grid decision aids generated significant preference shifts. Generally, users shifted their preference when presented with the description of the available treatment options, and the risk associated with each option. The use of decision aids for some, but not all health decisions, was accompanied by a shift in user preferences. Users typically valued information associated with risks, and chose more risk averse options after completing the interactive tool.

Aiding Lay Decision Making Using a Cognitive Competencies Approach

OpenAIRE

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 pr...

Effects of Video-Based Visual Training on Decision-Making and Reactive Agility in Adolescent Football Players

Directory of Open Access Journals (Sweden)

Alfred Nimmerichter

2015-12-01

Full Text Available This study investigated the trainability of decision-making and reactive agility via video-based visual training in young athletes. Thirty-four members of a national football academy (age: 14.4 ± 0.1 years were randomly assigned to a training (VIS; n = 18 or a control group (CON; n = 16. In addition to the football training, the VIS completed a video-based visual training twice a week over a period of six weeks during the competition phase. Using the temporal occlusion technique, the players were instructed to react on one-on-one situations shown in 40 videos. The number of successful decisions and the response time were measured with a video-based test. In addition, the reactive-agility sprint test was used. VIS significantly improved the number of successful decisions (22.2 ± 3.6 s vs. 29.8 ± 4.5 s; p < 0.001, response time (0.41 ± 0.10 s vs. 0.31 ± 0.10 s; p = 0.006 and reactive agility (2.22 ± 0.33 s vs. 1.94 ± 0.11 s; p = 0.001 pre- vs. post-training. No significant differences were found for CON. The results have shown that video-based visual training improves the time to make decisions as well as reactive agility sprint-time, accompanied by an increase in successful decisions. It remains to be shown whether or not such training can improve simulated or actual game performance.

Trustworthy patient decision aids: a qualitative analysis addressing the risk of competing interests

NARCIS (Netherlands)

Elwyn, G.; Dannenberg, M.; Blaine, A.; Poddar, U.; Durand, M.A.

2016-01-01

OBJECTIVE: Our aim in this study was to examine the competing interest policies and procedures of organisations who develop and maintain patient decision aids. DESIGN: Descriptive and thematic analysis of data collected from a cross-sectional survey of patient decision aid developer's competing

Selecting a risk-based tool to aid in decision making

Energy Technology Data Exchange (ETDEWEB)

Bendure, A.O.

1995-03-01

Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

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.

User Information Needs for Environmental Opinion-forming and Decision-making in Link-enriched Video

NARCIS (Netherlands)

A.C. Palumbo; L. Hardman (Lynda)

2013-01-01

htmlabstractLink-enriched video can support users in informative processes of environmental opinion-forming and decision-making. To enable this, we need to specify the information that should be captured in an annotation schema for describing the video. We conducted expert interviews to elicit

Rough set and rule-based multicriteria decision aiding

Directory of Open Access Journals (Sweden)

Roman Slowinski

2012-08-01

Full Text Available The aim of multicriteria decision aiding is to give the decision maker a recommendation concerning a set of objects evaluated from multiple points of view called criteria. Since a rational decision maker acts with respect to his/her value system, in order to recommend the most-preferred decision, one must identify decision maker's preferences. In this paper, we focus on preference discovery from data concerning some past decisions of the decision maker. We consider the preference model in the form of a set of "if..., then..." decision rules discovered from the data by inductive learning. To structure the data prior to induction of rules, we use the Dominance-based Rough Set Approach (DRSA. DRSA is a methodology for reasoning about data, which handles ordinal evaluations of objects on considered criteria and monotonic relationships between these evaluations and the decision. We review applications of DRSA to a large variety of multicriteria decision problems.

Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation

Science.gov (United States)

Cox, Christopher E.; Lewis, Carmen L.; Hanson, Laura C.; Hough, Catherine L.; Kahn, Jeremy M.; White, Douglas B.; Song, Mi-Kyung; Tulsky, James A.; Carson, Shannon S.

2013-01-01

Objective Shared decision making is inadequate in intensive care units (ICUs). Decision aids can improve decision making quality, though their role in an ICU setting is unclear. We aimed to develop and pilot test a decision aid for shared decision makers of patients undergoing prolonged mechanical ventilation. Setting ICUs at three medical centers. Subjects 53 surrogate decision makers and 58 physicians. Design and interventions We developed the decision aid using defined methodological guidelines. After an iterative revision process, formative cognitive testing was performed among surrogate-physician dyads. Next, we compared the decision aid to usual care control in a prospective, before/after design study. Measurements and main results Primary outcomes were physician-surrogate discordance for expected patient survival, comprehension of relevant medical information, and the quality of communication. Compared to control, the intervention group had lower surrogate-physician discordance (7 [10] vs 43 [21]), greater comprehension (11.4 [0.7] vs 6.1 [3.7]), and improved quality of communication (8.7 [1.3] vs 8.4 [1.3]) (all ppost-intervention. Hospital costs were lower in the intervention group ($110,609 vs $178,618; p=0.044); mortality did not differ by group (38% vs 50%, p=0.95). 94% of surrogates and 100% of physicians reported that the decision aid was useful in decision making. Conclusion We developed a prolonged mechanical ventilation decision aid that is feasible, acceptable, and associated with both improved decision making quality and less resource utilization. Further evaluation using a randomized controlled trial design is needed to evaluate the decision aid's effect on long-term patient and surrogate outcomes. PMID:22635048

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

The Pathways fertility preservation decision aid website for women with cancer: development and field testing.

Science.gov (United States)

Woodard, Terri L; Hoffman, Aubri S; Covarrubias, Laura A; Holman, Deborah; Schover, Leslie; Bradford, Andrea; Hoffman, Derek B; Mathur, Aakrati; Thomas, Jerah; Volk, Robert J

2018-02-01

To improve survivors' awareness and knowledge of fertility preservation counseling and treatment options, this study engaged survivors and providers to design, develop, and field-test Pathways: a fertility preservation patient decision aid website for young women with cancer©. Using an adapted user-centered design process, our stakeholder advisory group and research team designed and optimized the Pathways patient decision aid website through four iterative cycles of review and revision with clinicians (n = 21) and survivors (n = 14). Field-testing (n = 20 survivors) assessed post-decision aid scores on the Fertility Preservation Knowledge Scale, feasibility of assessing women's decision-making values while using the website, and website usability/acceptability ratings. Iterative stakeholder engagement optimized the Pathways decision aid website to meet survivors' and providers' needs, including providing patient-friendly information and novel features such as interactive value clarification exercises, testimonials that model shared decision making, financial/referral resources, and a printable personal summary. Survivors scored an average of 8.2 out of 13 (SD 1.6) on the Fertility Preservation Knowledge Scale. They rated genetic screening and having a biological child as strong factors in their decision-making, and 71% indicated a preference for egg freezing. Most women (> 85%) rated Pathways favorably, and all women (100%) said they would recommend it to other women. The Pathways decision aid is a usable and acceptable tool to help women learn about fertility preservation. The Pathways decision aid may help women make well-informed values-based decisions and prevent future infertility-related distress.

Comparison of Peer and Self-Video Modeling in Teaching First Aid Skills to Children with Intellectual Disability

Science.gov (United States)

Ozkan, Serife Yucesoy

2013-01-01

The purposes of this study were to (1) compare peer and self-video modeling in terms of effectiveness and efficiency in teaching first aid skills to children with intellectual disability and (2) analyze the error patterns made in probe sessions to determine whether the children who took the role of sufferers during the first aid skill sessions…

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...

A comparison of web-based versus print-based decision AIDS for prostate cancer screening: participants' evaluation and utilization.

Science.gov (United States)

Tomko, Catherine; Davis, Kimberly M; Luta, George; Krist, Alexander H; Woolf, Steven H; Taylor, Kathryn L

2015-01-01

Patient decision aids facilitate informed decision making for medical tests and procedures that have uncertain benefits. To describe participants' evaluation and utilization of print-based and web-based prostate cancer screening decision aids that were found to improve decisional outcomes in a prior randomized controlled trial. Men completed brief telephone interviews at baseline, one month, and 13 months post-randomization. Participants were primary care patients, 45-70 years old, who received the print-based (N = 628) or web-based decision aid (N = 625) and completed the follow-up assessments. We assessed men's baseline preference for web-based or print-based materials, time spent using the decision aids, comprehension of the overall message, and ratings of the content. Decision aid use was self-reported by 64.3 % (web) and 81.8 % (print) of participants. Significant predictors of decision aid use were race (white vs. non-white, OR = 2.43, 95 % CI: 1.77, 3.35), higher education (OR = 1.68, 95 % CI: 1.06, 2.70) and trial arm (print vs. web, OR = 2.78, 95 % CI: 2.03, 3.83). Multivariable analyses indicated that web-arm participants were more likely to use the website when they preferred web-based materials (OR: 1.91, CI: 1.17, 3.12), whereas use of the print materials was not significantly impacted by a preference for print-based materials (OR: 0.69, CI: 0.38, 1.25). Comprehension of the decision aid message (i.e., screening is an individual decision) did not significantly differ between arms in adjusted analyses (print: 61.9 % and web: 68.2 %, p = 0.42). Decision aid use was independently influenced by race, education, and the decision aid medium, findings consistent with the 'digital divide.' These results suggest that when it is not possible to provide this age cohort with their preferred decision aid medium, print materials will be more highly used than web-based materials. Although there are many advantages to web-based decision aids, providing an option for

Offering online recommendations with minimum customer input through conjoint-based decision aids

NARCIS (Netherlands)

De Bruyn, Arnaud; Liechty, John C.; Huizingh, Eelko K. R. E.; Lilien, Gary L.

2008-01-01

In their purchase decisions, online customers seek to improve decision quality while limiting search efforts. In practice, many merchants have understood the importance of helping customers in the decision-making process and provide online decision aids to their visitors. In this paper, we show how

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

Science.gov (United States)

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

2013-01-20

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

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

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

An advance care plan decision support video before major surgery: a patient- and family-centred approach.

Science.gov (United States)

Isenberg, Sarina R; Crossnohere, Norah L; Patel, Manali I; Conca-Cheng, Alison; Bridges, John F P; Swoboda, Sandy M; Smith, Thomas J; Pawlik, Timothy M; Weiss, Matthew; Volandes, Angelo E; Schuster, Anne; Miller, Judith A; Pastorini, Carolyn; Roter, Debra L; Aslakson, Rebecca A

2018-06-01

Video-based advanc care planning (ACP) tools have been studied in varied medical contexts; however, none have been developed for patients undergoing major surgery. Using a patient- and family-centredness approach, our objective was to implement human-centred design (HCD) to develop an ACP decision support video for patients and their family members when preparing for major surgery. The study investigators partnered with surgical patients and their family members, surgeons and other health professionals to design an ACP decision support video using key HCD principles. Adapting Maguire's HCD stages from computer science to the surgical context, while also incorporating Elwyn et al 's specifications for patient-oriented decision support tool development, we used a six-stage HCD process to develop the video: (1) plan HCD process; (2) specify where video will be used; (3) specify user and organisational requirements; (4) produce and test prototypes; (5) carry out user-based assessment; (6) field test with end users. Over 450 stakeholders were engaged in the development process contributing to setting objectives, applying for funding, providing feedback on the storyboard and iterations of the decision tool video. Throughout the HCD process, stakeholders' opinions were compiled and conflicting approaches negotiated resulting in a tool that addressed stakeholders' concerns. Our patient- and family-centred approach using HCD facilitated discussion and the ability to elicit and balance sometimes competing viewpoints. The early engagement of users and stakeholders throughout the development process may help to ensure tools address the stated needs of these individuals. NCT02489799. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Arriba-lib: association of an evidence-based electronic library of decision aids with communication and decision-making in patients and primary care physicians.

Science.gov (United States)

Hirsch, Oliver; Keller, Heidemarie; Krones, Tanja; Donner-Banzhoff, Norbert

2012-03-01

In shared decision-making, patients are empowered to actively ask questions and participate in decisions about their healthcare based on their preferences and values. Decision aids should help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes; however, they have rarely been field tested, especially in the primary care context. We therefore evaluated associations between the use of an interactive, transactional and evidence-based library of decision aids (arriba-lib) and communication and decision-making in patients and physicians in the primary care context. Our electronic library of decision aids ('arriba-lib') includes evidence-based modules for cardiovascular prevention, diabetes, coronary heart disease, atrial fibrillation and depression. Twenty-nine primary care physicians recruited 192 patients. We used questionnaires to ask patients and physicians about their experiences with and attitudes towards the programme. Patients were interviewed via telephone 2 months after the consultation. Data were analysed by general estimation equations, cross tab analyses and by using effect sizes. Only a minority (8.9%) of the consultations were felt to be too long because physicians said consultations were unacceptably extended by arriba-lib. We found a negative association between the detailedness of the discussion of the clinical problem's definition and the age of the patients. Physicians discuss therapeutic options in less detail with patients who have a formal education of less than 8 years. Patients who were counselled by a physician with no experience in using a decision aid more often reported that they do not remember being counselled with the help of a decision aid or do not wish to be counselled again with a decision aid. Arriba-lib has positive associations to the decision-making process in patients and physicians. It can also be used with older age groups and patients with less

Shared decision making and patient decision aids: knowledge, attitudes, and practices among Hawai'i physicians.

Science.gov (United States)

Alden, Dana L; Friend, John; Chun, Maria B J

2013-11-01

As the health care field moves toward patient-centered care (PCC), increasing emphasis has been placed on the benefits of patient decision aids for promoting shared decision making (SDM). This study provides a baseline measure of knowledge, attitudes, and practices (KAP) among Hawai'i's physicians with respect to patient decision aids (DAs). Physicians throughout the State of Hawai'i were invited to complete a survey assessing their knowledge, attitudes, and practices with respect to the clinical use of DAs. One hundred and seventy four valid surveys were analyzed. Reported awareness and use of DAs were low, but recognition of the benefits of SDM and openness to the use of DAs were very high. The leading perceived barriers to the implementation of DAs were lack of awareness, lack of resources, and limited physician time to learn about DA technology. However, a significant majority of the respondents reported that DAs could empower patients by improving knowledge (88%), increasing satisfaction with the consultation process (81%), and increasing compliance (74%). Among physicians currently employing DAs, use of brochures or options matrix sheets was the most common aid tool. However, leading recommended DA formats were paper-based brochures for clinic use (75%) and interactive online website programs for outside clinic use (73.5%). Given growing emphasis on the PCC model and the recognized desire of many patients to participate in the medical decision making process, positive responses toward SDM and the use of DAs by Hawai'i physicians are promising.

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

OpenAIRE

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

2015-01-01

Background 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 br...

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.

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.

Do personal stories make patient decision aids more effective? A critical review of theory and evidence

Science.gov (United States)

2013-01-01

Background Patient decision aids support people to make informed decisions between healthcare options. Personal stories provide illustrative examples of others’ experiences and are seen as a useful way to communicate information about health and illness. Evidence indicates that providing information within personal stories affects the judgments and values people have, and the choices they make, differentially from facts presented in non-narrative prose. It is unclear if including narrative communications within patient decision aids enhances their effectiveness to support people to make informed decisions. Methods A survey of primary empirical research employing a systematic review method investigated the effect of patient decision aids with or without a personal story on people’s healthcare judgements and decisions. Searches were carried out between 2005-2012 of electronic databases (Medline, PsycINFO), and reference lists of identified articles, review articles, and key authors. A narrative analysis described and synthesised findings. Results Of 734 citations identified, 11 were included describing 13 studies. All studies found participants’ judgments and/or decisions differed depending on whether or not their decision aid included a patient story. Knowledge was equally facilitated when the decision aids with and without stories had similar information content. Story-enhanced aids may help people recall information over time and/or their motivation to engage with health information. Personal stories affected both “system 1” (e.g., less counterfactual reasoning, more emotional reactions and perceptions) and “system 2” (e.g., more perceived deliberative decision making, more stable evaluations over time) decision-making strategies. Findings exploring associations with narrative communications, decision quality measures, and different levels of literacy and numeracy were mixed. The pattern of findings was similar for both experimental and real

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

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

A study on spatial decision support systems for HIV/AIDS prevention based on COM GIS technology

Science.gov (United States)

Yang, Kun; Luo, Huasong; Peng, Shungyun; Xu, Quanli

2007-06-01

Based on the deeply analysis of the current status and the existing problems of GIS technology applications in Epidemiology, this paper has proposed the method and process for establishing the spatial decision support systems of AIDS epidemic prevention by integrating the COM GIS, Spatial Database, GPS, Remote Sensing, and Communication technologies, as well as ASP and ActiveX software development technologies. One of the most important issues for constructing the spatial decision support systems of AIDS epidemic prevention is how to integrate the AIDS spreading models with GIS. The capabilities of GIS applications in the AIDS epidemic prevention have been described here in this paper firstly. Then some mature epidemic spreading models have also been discussed for extracting the computation parameters. Furthermore, a technical schema has been proposed for integrating the AIDS spreading models with GIS and relevant geospatial technologies, in which the GIS and model running platforms share a common spatial database and the computing results can be spatially visualized on Desktop or Web GIS clients. Finally, a complete solution for establishing the decision support systems of AIDS epidemic prevention has been offered in this paper based on the model integrating methods and ESRI COM GIS software packages. The general decision support systems are composed of data acquisition sub-systems, network communication sub-systems, model integrating sub-systems, AIDS epidemic information spatial database sub-systems, AIDS epidemic information querying and statistical analysis sub-systems, AIDS epidemic dynamic surveillance sub-systems, AIDS epidemic information spatial analysis and decision support sub-systems, as well as AIDS epidemic information publishing sub-systems based on Web GIS.

A global, incremental development method for a web-based prostate cancer treatment decision aid and usability testing in a Dutch clinical setting.

Science.gov (United States)

Cuypers, Maarten; Lamers, Romy Ed; Kil, Paul Jm; The, Regina; Karssen, Klemens; van de Poll-Franse, Lonneke V; de Vries, Marieke

2017-07-01

Many new decision aids are developed while aspects of existing decision aids could also be useful, leading to a sub-optimal use of resources. To support treatment decision-making in prostate cancer patients, a pre-existing evidence-based Canadian decision aid was adjusted to Dutch clinical setting. After analyses of the original decision aid and routines in Dutch prostate cancer care, adjustments to the decision aid structure and content were made. Subsequent usability testing (N = 11) resulted in 212 comments. Care providers mainly provided feedback on medical content, and patients commented most on usability and summary layout. All participants reported that the decision aid was comprehensible and well-structured and would recommend decision aid use. After usability testing, final adjustments to the decision aid were made. The presented methods could be useful for cultural adaptation of pre-existing tools into other languages and settings, ensuring optimal usage of previous scientific and practical efforts and allowing for a global, incremental decision aid development process.

Comparison of safety measures with a multicriteria decision aiding technique

International Nuclear Information System (INIS)

Lombard, J.

1985-01-01

Attributes such as political, social and psychological factors have to be taken into account for the decision-making process. Multiattribute decision-aiding techniques are used to cope with this multidimensionality of the risk management process. A simple example will be given to illustrate how such method can be helpful for the selection of proper safety measures in a rational way. (orig./HP) [de

The development of an online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making: a usability and pilot study.

Science.gov (United States)

Reumkens, Kelly; Tummers, Marly H E; Gietel-Habets, Joyce J G; van Kuijk, Sander M J; Aalfs, Cora M; van Asperen, Christi J; Ausems, Margreet G E M; Collée, Margriet; Dommering, Charlotte J; Kets, C Marleen; van der Kolk, Lizet E; Oosterwijk, Jan C; Tjan-Heijnen, Vivianne C G; van der Weijden, Trudy; de Die-Smulders, Christine E M; van Osch, Liesbeth A D M

2018-05-30

An online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making was developed. A two-phase usability test was conducted among 12 couples (N = 22; 2 persons participated without their partner) at risk for hereditary cancer and 15 health care providers. Couples and health care providers expressed similar suggestions for improvements, and evaluated the modified decision aid as acceptable, easy to use, and comprehensible. The final decision aid was pilot tested (N = 16) with paired sample t tests comparing main outcomes (decisional conflict, knowledge, realistic expectations regarding the reproductive options and decision self-efficacy) before (T0), immediately (T1) and 2 weeks after (T2) use of the decision aid. Pilot testing indicated decreased decisional conflict scores, increased knowledge, and improved realistic expectations regarding the reproductive options, at T1 and T2. No effect was found for couples' decision self-efficacy. The positive findings during usability testing were thus reflected in the pilot study. The decision aid will be further evaluated in a nationwide pretest-posttest study to facilitate implementation in the onco-genetic counselling setting. Ultimately, it is expected that the decision aid will enable end-users to make an informed decision.

Clinical use of patient decision-making aids for stone patients.

Science.gov (United States)

Lim, Amy H; Streeper, Necole M; Best, Sara L; Penniston, Kristina L; Nakada, Stephen Y

2017-08-01

Patient decision-making aids (PDMAs) help patients make informed healthcare decisions and improve patient satisfaction. The utility of PDMAs for patients considering treatments for urolithiasis has not yet been published. We report our experience using PDMAs developed at our institution in the outpatient clinical setting in patients considering a variety of treatment options for stones. Patients with radiographically confirmed urolithiasis were given PDMAs regarding treatment options for their stone(s) based on their clinical profile. We assessed patients' satisfaction, involvedness, and feeling of making a more informed decision with utilization of the PDMAs using a Likert Scale Questionnaire. Information was also collected regarding previous stone passage, history and type of surgical intervention for urolithiasis, and level of education. Patients (n = 43; 18 males, 23 females and two unknown) 53 +/- 14years old were included. Patients reported that they understood the advantages and disadvantages outlined in the PDMAs (97%), that the PDMAs helped them make a more informed decision (83%) and felt more involved in the decision making process (88%). Patients reported that the aids were presented in a balanced manner and used up-to-date scientific information (100%, 84% respectively). Finally, a majority of the patients prefer an expert's opinion when making a treatment decision (98%) with 73% of patients preferring to form their own opinion based on available information. Previous stone surgery was associated with patients feeling more involved with the decision making process (p = 0.0465). PDMAs have a promising role in shared decision-making in the setting of treatment options for nephrolithiasis.

Decision aids for familial breast cancer: exploring women's views using focus groups.

NARCIS (Netherlands)

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

2006-01-01

BACKGROUND: There is increasing need for accessible information about familial breast cancer for those facing complex decisions around genetic testing, screening and treatment. Information currently includes leaflets and computerized decision aids, offering interactive interfaces to clarify complex

Protocol for the evaluation of a decision aid for women with a breech-presenting baby [ISRCTN14570598

Directory of Open Access Journals (Sweden)

Peat Brian

2004-12-01

Full Text Available Abstract Background There is now good evidence about the management options for pregnant women with a breech presentation (buttocks or feet rather than head-first at term; external cephalic version (ECV – the turning of a breech baby to a head-down position and/or planned caesarean section (CS. Each of these options has benefits and risks and the relative importance of these vary for each woman, subject to her personal values and preferences, a situation where a decision aid may be helpful. Decision aids are designed to assist patients and their doctors in making informed decisions using information that is unbiased and based on high quality research evidence. Decision aids are non-directive in the sense that they do not aim to steer the user towards any one option, but rather to support decision making which is informed and consistent with personal values. The ECV decision aid was developed using the Ottawa Decision Support Framework, including a systematic review of the evidence about the benefits and risks of the options for breech pregnancy. It comprises an audiotape with a supplementary booklet and worksheet, a format that can be taken home and discussed with a partner. This project aims to evaluate the ECV decision aid for women with a breech presenting baby in late pregnancy. Study design We aim to evaluate the effectiveness of the decision aid compared with usual care in a randomised controlled trial in maternity hospitals that offer ECV. The study group will receive the decision aid in addition to usual care and the control group will receive standard information on management options for breech presentation from their usual pregnancy care provider. Approximately 184 women with a single breech-presenting baby at greater than 34 weeks gestation and who are clinically eligible for ECV will be recruited for the trial. The primary outcomes of the study are knowledge, decisional conflict, anxiety and satisfaction with decision-making that

Protocol for the evaluation of a decision aid for women with a breech-presenting baby [ISRCTN14570598

Science.gov (United States)

Roberts, Christine L; Nassar, Natasha; Barratt, Alexandra; Raynes-Greenow, Camille H; Peat, Brian; Henderson-Smart, David

2004-01-01

Background There is now good evidence about the management options for pregnant women with a breech presentation (buttocks or feet rather than head-first) at term; external cephalic version (ECV) – the turning of a breech baby to a head-down position and/or planned caesarean section (CS). Each of these options has benefits and risks and the relative importance of these vary for each woman, subject to her personal values and preferences, a situation where a decision aid may be helpful. Decision aids are designed to assist patients and their doctors in making informed decisions using information that is unbiased and based on high quality research evidence. Decision aids are non-directive in the sense that they do not aim to steer the user towards any one option, but rather to support decision making which is informed and consistent with personal values. The ECV decision aid was developed using the Ottawa Decision Support Framework, including a systematic review of the evidence about the benefits and risks of the options for breech pregnancy. It comprises an audiotape with a supplementary booklet and worksheet, a format that can be taken home and discussed with a partner. This project aims to evaluate the ECV decision aid for women with a breech presenting baby in late pregnancy. Study design We aim to evaluate the effectiveness of the decision aid compared with usual care in a randomised controlled trial in maternity hospitals that offer ECV. The study group will receive the decision aid in addition to usual care and the control group will receive standard information on management options for breech presentation from their usual pregnancy care provider. Approximately 184 women with a single breech-presenting baby at greater than 34 weeks gestation and who are clinically eligible for ECV will be recruited for the trial. The primary outcomes of the study are knowledge, decisional conflict, anxiety and satisfaction with decision-making that will be assessed using

Value assessment aid to complex decision making. Final report

International Nuclear Information System (INIS)

Humphress, G.; Lewis, E.

1982-07-01

Value assessment (VA) is a new decision aid that can improve the performance of decisionmakers confronted with multiple attributes and conflicting objectives. Managers who are not supported by formal decision aids turn to various ''satisficing'' or effort-reducing biases that can lead to serious errors in the decisionmaking process. Value assessment, on the other hand, is an optimizing approach to problem-solving behavior. VA helps decisionmakers overcome the tendency to turn to effort-reducing biases by reducing the complexity of making tradeoffs and weighing all available information. Many of the issues which confront modern electric utility managements are complex, multiple attribute problems which must be viewed from engineering, financial and socio-political perspectives simultaneously. Added to this are the complications contributed by factors like uncertainty, risk, incomplete information and conflicting objectives among the public it serves. This is the complex decisionmaking arena which VA is intended to support

Decision aids: when 'nudging' patients to make a particular choice is more ethical than balanced, nondirective content.

Science.gov (United States)

Blumenthal-Barby, J S; Cantor, Scott B; Russell, Heidi Voelker; Naik, Aanand D; Volk, Robert J

2013-02-01

Patient decision aids, such as instructional leaflets describing treatment options for prostate cancer, are designed to help educate patients so that they can share in decisions about their care. Developers of these decision aids strive for balance, aiming to be as neutral, unbiased, and nondirective as possible. We argue that balance should not always be a goal, and we identify three situations where it should not be. For example, men diagnosed with early-stage prostate cancer frequently are not advised by their physicians that active surveillance is a reasonable alternative to immediate surgery or radiation. It may be desirable to design decision aids that promote active surveillance as an option. We recognize that the arguments put forth in this article are controversial. But they are also justified. We challenge medical decision makers and decision aid developers to determine if and when patients should be "nudged" toward one option or another.

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

Directory of Open Access Journals (Sweden)

Chou-Chen Wang

2014-01-01

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

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

Intra-annual wave resource characterization for energy exploitation: A new decision-aid tool

International Nuclear Information System (INIS)

Carballo, R.; Sánchez, M.; Ramos, V.; Fraguela, J.A.; Iglesias, G.

2015-01-01

Highlights: • A decision-aid tool is developed for computing the monthly performance of WECs. • It allows the generation of high-resolution monthly characterization matrices. • The decision-aid tool is implemented to the Death Coast (N Spain). • The monthly matrices can be obtained at any coastal location within the Death Coast. • The tool is applied to a coastal location of a proposed wave farm. - Abstract: The wave energy resource is usually characterized by a significant variability throughout the year. In estimating the power performance of a Wave Energy Converter (WEC) it is fundamental to take into account this variability; indeed, an estimate based on mean annual values may well result in a wrong decision making. In this work, a novel decision-aid tool, iWEDGE (intra-annual Wave Energy Diagram GEnerator) is developed and implemented to a coastal region of interest, the Death Coast (Spain), one of the regions in Europe with the largest wave resource. Following a comprehensive procedure, and based on deep water wave data and high-resolution numerical modelling, this tool provides the monthly high-resolution characterization matrices (or energy diagrams) for any location of interest. In other words, the information required for the accurate computation of the intra-annual performance of any WEC at any location within the region covered is made available. Finally, an application of iWEDGE to the site of a proposed wave farm is presented. The results obtained highlight the importance of the decision-aid tool herein provided for wave energy exploitation

Promoting the dissemination of decision aids: an odyssey in a dysfunctional health care financing system.

Science.gov (United States)

Billings, John

2004-01-01

The usefulness of patient decision aids (PtDAs) is well documented, yet they are not in widespread use. Barriers include assuring balance and fairness (auspices matter), the cost of producing and maintaining them, and getting them into the hands of patients at the right time. The Foundation for Informed Medical Decision Making and its for-profit partner, Health Dialog, have developed a creative business model that helps overcome these barriers and has greatly expanded the reach of decision aids.

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

Science.gov (United States)

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

2008-02-01

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

[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.

Balancing the presentation of information and options in patient decision aids: an updated review.

Science.gov (United States)

Abhyankar, Purva; Volk, Robert J; Blumenthal-Barby, Jennifer; Bravo, Paulina; Buchholz, Angela; Ozanne, Elissa; Vidal, Dale Colins; Col, Nananda; Stalmeier, Peep

2013-01-01

Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals' knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options. A literature search related to patient decision aids and balance was conducted on Medline, using MeSH terms and PubMed; this search supplemented the 2011 Cochrane Collaboration's review of patient decision aids trials. Only English language articles relevant to patient decision making and addressing the balance of information and options were included. All members of the team independently screened clusters of articles; uncertainties were resolved by seeking review by another member. The team then worked in sub-groups to extract and synthesise data on theory, definitions, and evidence reported in these studies. A total of 40 articles met the inclusion criteria. Of these, six explained the rationale for balancing the presentation of information and options. Twelve defined "balance"; the definition of "balance" that emerged is as follows: "The complete and unbiased presentation of the relevant options and the information about those options-in content and in format-in a way that enables individuals to process this information without bias". Ten of the 40 articles reported assessing the balance of the relevant decision aid. All 10 did so exclusively from the users' or patients' perspective, using a five-point Likert-type scale. Presenting information in a side-by-side display form was

[Evaluation of the decision aid "Entscheidungshilfe Prostatakrebs" from the patients' view : Results from the first three months].

Science.gov (United States)

Groeben, C; Ihrig, A; Hölscher, T; Krones, T; Kessler, E; Kliesch, S; Wülfing, C; Koch, R; Wirth, M P; Huber, J

2016-12-01

The decision aid "Entscheidungshilfe Prostatakrebs" is available online free of charge since June 2016. It is designed to support patients with their treatment decision-making and to lighten the burden on their treating urologists. This study evaluates usage data from the first 3 months. The ICHOM standard set was applied to allow a personalised presentation and to collect relevant data for subsequent counselling. Additionally, personal preferences and psychological burden were assessed amongst others. We collected anonymous data. A multivariate model evaluated predictors for high user satisfaction. From June through August 2016 a total of 319 patients used the decision aid, showing a continuous monthly increase in the number of users. There were n = 219 (68.7%) complete questionnaires. Median age was 66.1 ± 8.0 years. The oncological risk was low in 30.3%, intermediate in 43.6% and high in 26.1%. A majority of 57.5% used the decision aid together with their partner, 35.1% alone and 5.5% with their children. In all, 54.8% were "very satisfied" and 32.0% were "satisfied" with the decision aid for a total satisfaction rate of about 87%. The only predictors of total satisfaction were the usage mode and reported distress level. As shown by the continuously increasing number of users this decision aid is becoming well established in German urology. Patients' overall ratings are very positive. The majority of patients use the decision aid with their partner. This represents a significant advantage of a multimedia approach compared to print media.

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

Science.gov (United States)

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

2007-01-01

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

Predictors of eyewitness identification decisions from video lineups in England: A field study

OpenAIRE

horry, ruth; Memon, Amina; Wright, Daniel; Milne, Rebecca

2012-01-01

Eyewitness identification decisions from 1,039 real lineups in England were analysed. Identification procedures have undergone dramatic change in the United Kingdom over recent years. Video lineups are now standard procedure, in which each lineup member is seen sequentially. The whole lineup is seen twice before the witness can make a decision, and the witness can request additional viewings of the lineup. A key aim of this paper was to investigate the association between repeated viewing and...

Decision aids for second-line palliative chemotherapy: a randomised phase II multicentre trial

NARCIS (Netherlands)

Oostendorp, L.J.M.; Ottevanger, P.B.; Donders, A.R.T.; Wouw, A.J. van de; Schoenaker, I.J.; Smilde, T.J.; Graaf, W.T.A. van der; Stalmeier, P.F.M.

2017-01-01

BACKGROUND: There is increasing recognition of the delicate balance between the modest benefits of palliative chemotherapy and the burden of treatment. Decision aids (DAs) can potentially help patients with advanced cancer with these difficult treatment decisions, but providing detailed information

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...

Biased lineup instructions and face identification from video images.

Science.gov (United States)

Thompson, W Burt; Johnson, Jaime

2008-01-01

Previous eyewitness memory research has shown that biased lineup instructions reduce identification accuracy, primarily by increasing false-positive identifications in target-absent lineups. Because some attempts at identification do not rely on a witness's memory of the perpetrator but instead involve matching photos to images on surveillance video, the authors investigated the effects of biased instructions on identification accuracy in a matching task. In Experiment 1, biased instructions did not affect the overall accuracy of participants who used video images as an identification aid, but nearly all correct decisions occurred with target-present photo spreads. Both biased and unbiased instructions resulted in high false-positive rates. In Experiment 2, which focused on video-photo matching accuracy with target-absent photo spreads, unbiased instructions led to more correct responses (i.e., fewer false positives). These findings suggest that investigators should not relax precautions against biased instructions when people attempt to match photos to an unfamiliar person recorded on video.

A global, incremental development method for a web-based prostate cancer treatment decision aid and usability testing in a Dutch clinical setting

NARCIS (Netherlands)

Cuypers, M.; Lamers, R.E.D.; Kil, P.J.M.; The, R.; Karssen, K.; van de Poll-Franse, L.V.; de Vries, M.

2018-01-01

Many new decision aids are developed while aspects of existing decision aids could also be useful, leading to a sub-optimal use of resources. To support treatment decision-making in prostate cancer patients, a pre-existing evidence-based Canadian decision aid was adjusted to Dutch clinical setting.

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

Science.gov (United States)

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

2011-06-01

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

Intelligent decision aids for abnormal events in nuclear power plants

International Nuclear Information System (INIS)

Kafka, P.; Polke, H.

1988-01-01

German nuclear power plants are characterized by a high degree of automation, not only for normal operation but also for abnormal events. Therefore the role of the operating personnel is mainly a supervisory function. Nevertheless, for a spectrum of unexpected events the operating personnel have to react with manual recovery actions. In order to minimize human error in such recovery actions, different kinds of intelligent decision aid support the operators today. In this paper such aids are discussed and one of them is described in more detail. (author)

A risk-based decision-aiding tool for waste disposal

International Nuclear Information System (INIS)

Weiner, R.F.; Reiser, A.S.; Elcock, C.G.; Nevins, S.

1997-01-01

N-CART (the National Spent Nuclear Fuel Program Cost Analysis and Risk Tool) is being developed to aid in low-risk, cost-effective, timely management of radioactive waste and spent nuclear fuel, and can therefore be used in management of mixed waste. N-CART provides evaluation of multiple alternatives and presents the consequences of proposed waste management activities in a clear and concise format. N-CART's decision-aiding analyses include comparisons and sensitivity analyses of multiple alternatives and allows the user to perform quick turn-around open-quotes what ifclose quotes studies to investigate various scenarios. Uncertainties in data (such as cost and schedule of various activities) are represented as distributions. N-CART centralizes documentation of the bases of program alternatives and program decisions, thereby supporting responses to stakeholders concerns. The initial N-CART design considers regulatory requirements, costs, and schedules for alternative courses of action. The final design will include risks (public health, occupational, economic, scheduling), economic benefits, and the impacts of secondary waste generation. An optimization tool is being incorporated that allows the user to specify the relative importance of cost, time risks, and other bases for decisions. The N-CART prototype can be used to compare the costs and schedules of disposal alternatives for mixed low-level radioactive waste (MLLW) and greater-than-Class-C (GTCC) waste, as well as spent nuclear fuel (SNF) and related scrap material

Development and initial testing of a computer-based patient decision aid to promote colorectal cancer screening for primary care practice

Directory of Open Access Journals (Sweden)

Fowler Beth

2005-11-01

Full Text Available Abstract Background Although colorectal cancer screening is recommended by major policy-making organizations, rates of screening remain low. Our aim was to develop a patient-directed, computer-based decision aid about colorectal cancer screening and investigate whether it could increase patient interest in screening. Methods We used content from evidence-based literature reviews and our previous decision aid research to develop a prototype. We performed two rounds of usability testing with representative patients to revise the content and format. The final decision aid consisted of an introductory segment, four test-specific segments, and information to allow comparison of the tests across several key parameters. We then conducted a before-after uncontrolled trial of 80 patients 50–75 years old recruited from an academic internal medicine practice. Results Mean viewing time was 19 minutes. The decision aid improved patients' intent to ask providers for screening from a mean score of 2.8 (1 = not at all likely to ask, 4 = very likely to ask before viewing the decision aid to 3.2 afterwards (difference, 0.4; p Conclusion We conclude that a computer-based decision aid can increase patient intent to be screened and increase interest in screening. Practice Implications: This decision aid can be viewed by patients prior to provider appointments to increase motivation to be screened and to help them decide about which modality to use for screening. Further work is required to integrate the decision aid with other practice change strategies to raise screening rates to target levels.

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.

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.

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.

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.

Discriminating talent-identified junior Australian football players using a video decision-making task.

Science.gov (United States)

Woods, Carl T; Raynor, Annette J; Bruce, Lyndell; McDonald, Zane

2016-01-01

This study examined if a video decision-making task could discriminate talent-identified junior Australian football players from their non-talent-identified counterparts. Participants were recruited from the 2013 under 18 (U18) West Australian Football League competition and classified into two groups: talent-identified (State U18 Academy representatives; n = 25; 17.8 ± 0.5 years) and non-talent-identified (non-State U18 Academy selection; n = 25; 17.3 ± 0.6 years). Participants completed a video decision-making task consisting of 26 clips sourced from the Australian Football League game-day footage, recording responses on a sheet provided. A score of "1" was given for correct and "0" for incorrect responses, with the participants total score used as the criterion value. One-way analysis of variance tested the main effect of "status" on the task criterion, whilst a bootstrapped receiver operating characteristic (ROC) curve assessed the discriminant ability of the task. An area under the curve (AUC) of 1 (100%) represented perfect discrimination. Between-group differences were evident (P talent-identified and non-talent-identified participants, respectively. Future research should investigate the mechanisms leading to the superior decision-making observed in the talent-identified group.

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 ...

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

Using linguistic descriptions with multi-criteria decision aid approaches in urban energy systems

OpenAIRE

Afsordegan, Arayeh; Sánchez Soler, Monica; Agell Jané, Núria; Gamboa Jimenez, Gonzalo; Cremades Oliver, Lázaro Vicente

2015-01-01

Multi-Criteria Decision Aid (MCDA) methods include various collections of mathematical techniques related to decision support systems in non-deterministic environments to support such applications as facility management, disaster management and urban planning. This paper applies MCDA approaches based on qualitative reasoning techniques with linguistic labels assessment. The aim of this method is ranking multi-attribute alternatives in group decision-making with qualitative labels. Finally ...

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

NARCIS (Netherlands)

Brouwer, E.; Ozbugday, F.C.

2011-01-01

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

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

NARCIS (Netherlands)

Brouwer, E.; Ozbugday, F.C.

2010-01-01

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

Decision aiding in public policy generation and implementation: a multicriteria approach to evaluate territorial resilience

Directory of Open Access Journals (Sweden)

Maria Franca Norese

2016-12-01

Full Text Available A decision aid process should be the result of an interaction between analysts, decision makers and stakeholders. Decision aiding is sometimes required when the problem situation is new and a formal decision system does not exist. Its role becomes that of facilitating the Intelligence phase of a decision process. In other situations, a criticism of certain policy making processes and their use of data, which may be available in institutional databases or are required as indicators for the decision process, motivates an intervention oriented towards structure knowledge and improvements of these processes. A preliminary study, which includes modelling and application of multi-criteria methods, can clarify a complex and new situation, propose a consistent approach for the later phases of a decision process or propose a different and more effective use of the data. A case study is proposed here to describe this methodological approach in relation to the disaster resilience of municipalities near the mbrone River, in Tuscany (Italy.

Development of a patient decision aid for prevention of myocardial infarction in type 2 diabetes - rationale, design and pilot testing.

Science.gov (United States)

Lenz, Matthias; Kasper, Jürgen; Mühlhauser, Ingrid

2009-10-19

Development and testing of a decision aid about prevention of myocardial infarction for persons with type 2 diabetes. Development and testing were guided by the UK Medical Research Council's guidance for the development and evaluation of complex interventions. This comprised a systematic literature review, a focus group of 9 potential providers, modelling a prototype, interviews to qualitatively explore understanding and additional information needs, and revision of the decision aid. The decision aid includes evidence-based information, a tool for individual risk-assessment, worksheets, and an action plan. Five diabetes educators and 15 patients underwent two 60-minutes face-to-face interviews, firstly browsing the decision aid for the first time and then after using it. Both groups differed in their ratings. Overall, the decision aid was rated to present essential information in a complex but understandable and unbiased manner. Difficulties involved understanding of terminology and risk interpretation. "Social status as a risk factor" was the most challenged content by educators but considered as highly important by patients. The risk assessment tool was used inadequately. 5 patients allocated themselves into false risk categories. After revision of the tool, all 12 patients who were recruited for reassessment used the tool correctly. The decision aid was evaluated with diabetes educators and patients. Qualitative data analysis revealed aspects for revision. The decision aid is planned to be part of a shared decision making programme, comprising a strategy for patient counselling and educational modules addressed to providers. Quantitative evaluation is required to assess its effectiveness.

Regional Climate Change and Development of Public Health Decision Aids

Science.gov (United States)

Hegedus, A. M.; Darmenova, K.; Grant, F.; Kiley, H.; Higgins, G. J.; Apling, D.

2011-12-01

According to the World Heath Organization (WHO) climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations. Worldwide, the occurrence of some diseases and other threats to human health depend predominantly on local climate patterns. Rising average temperatures, in combination with changing rainfall patterns and humidity levels, alter the lifecycle and regional distribution of certain disease-carrying vectors, such as mosquitoes, ticks and rodents. In addition, higher surface temperatures will bring heat waves and heat stress to urban regions worldwide and will likely increase heat-related health risks. A growing body of scientific evidence also suggests an increase in extreme weather events such as floods, droughts and hurricanes that can be destructive to human health and well-being. Therefore, climate adaptation and health decision aids are urgently needed by city planners and health officials to determine high risk areas, evaluate vulnerable populations and develop public health infrastructure and surveillance systems. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. WRF model is initialized with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model simulations forced with the Special Report on Emissions (SRES) A1B emissions scenario. Our methodology involves development of climatological indices of extreme weather, quantifying the risk of occurrence of water/rodent/vector-borne diseases as well as developing various heat stress related decision aids. Our results indicate that the downscale simulations provide the necessary

Exploring the use of Option Grid™ patient decision aids in a sample of clinics in Poland.

Science.gov (United States)

Scalia, Peter; Elwyn, Glyn; Barr, Paul; Song, Julia; Zisman-Ilani, Yaara; Lesniak, Monika; Mullin, Sarah; Kurek, Krzysztof; Bushell, Matt; Durand, Marie-Anne

2018-05-29

Research on the implementation of patient decision aids to facilitate shared decision making in clinical settings has steadily increased across Western countries. A study which implements decision aids and measures their impact on shared decision making has yet to be conducted in the Eastern part of Europe. To study the use of Option Grid TM patient decision aids in a sample of Grupa LUX MED clinics in Warsaw, Poland, and measure their impact on shared decision making. We conducted a pre-post interventional study. Following a three-month period of usual care, clinicians from three Grupa LUX MED clinics received a one-hour training session on how to use three Option Grid TM decision aids and were provided with copies for use for four months. Throughout the study, all eligible patients were asked to complete the three-item CollaboRATE patient-reported measure of shared decision making after their clinical encounter. CollaboRATE enables patients to assess the efforts clinicians make to: (i) inform them about their health issues; (ii) listen to 'what matters most'; (iii) integrate their treatment preference in future plans. A Hierarchical Logistic Regression model was performed to understand which variables had an effect on CollaboRATE. 2,048 patients participated in the baseline phase; 1,889 patients participated in the intervention phase. Five of the thirteen study clinicians had a statistically significant increase in their CollaboRATE scores (pOption Grid TM helped some clinicians practice shared decision making as reflected in CollaboRATE scores, but most clinicians did not have a significant increase in their scores. Our study indicates that the effect of these interventions may be dependent on clinic contexts and clinician engagement. Copyright © 2018. Published by Elsevier GmbH.

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.

Breast cancer anxiety's associations with responses to a chemoprevention decision aid.

Science.gov (United States)

Dillard, Amanda J; Scherer, Laura; Ubel, Peter A; Smith, Dylan M; Zikmund-Fisher, Brian J; McClure, Jennifer B; Greene, Sarah; Stark, Azadeh; Fagerlin, Angela

2013-01-01

Few studies have examined how specific emotions may affect decision-making processes. Anxiety may be especially relevant in health decisions such as those related to cancer in which thoughts of illness or death may be abundant. We examined associations between women's anxiety about developing breast cancer and variables related to their decision to take a medication that could reduce their chances of the disease. Six-hundred and thirty-two American women, who had an increased risk of breast cancer, reviewed a web-based decision aid about tamoxifen. We examined associations between their baseline, self-reported anxiety about developing the disease and post decision aid measures including knowledge about tamoxifen, attitude toward the medication, and behavioral intentions to look for more information and take the medication. Results showed that anxiety was not associated with knowledge about tamoxifen, but it was associated with attitude toward the medication such that women who were more anxious about developing breast cancer were more likely to think the benefits were worth the risks. Greater anxiety was also associated with greater behavioral intentions to look for additional information and take the medication in the next few months. Secondary analyses showed that behavioral intentions were related to knowledge of tamoxifen and attitude toward the medication only for women who were reporting low levels of anxiety. Overall, the findings suggest that anxiety about breast cancer may motivate interest in tamoxifen and not necessarily through affecting knowledge or attitudes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Usability testing of ANSWER: a web-based methotrexate decision aid for patients with rheumatoid arthritis.

Science.gov (United States)

Li, Linda C; Adam, Paul M; Townsend, Anne F; Lacaille, Diane; Yousefi, Charlene; Stacey, Dawn; Gromala, Diane; Shaw, Chris D; Tugwell, Peter; Backman, Catherine L

2013-12-01

Decision aids are evidence-based tools designed to inform people of the potential benefit and harm of treatment options, clarify their preferences and provide a shared decision-making structure for discussion at a clinic visit. For patients with rheumatoid arthritis (RA) who are considering methotrexate, we have developed a web-based patient decision aid called the ANSWER (Animated, Self-serve, Web-based Research Tool). This study aimed to: 1) assess the usability of the ANSWER prototype; 2) identify strengths and limitations of the ANSWER from the patient's perspective. The ANSWER prototype consisted of: 1) six animated patient stories and narrated information on the evidence of methotrexate for RA; 2) interactive questionnaires to clarify patients' treatment preferences. Eligible participants for the usability test were patients with RA who had been prescribed methotrexate. They were asked to verbalize their thoughts (i.e., think aloud) while using the ANSWER, and to complete the System Usability Scale (SUS) to assess overall usability (range = 0-100; higher = more user friendly). Participants were audiotaped and observed, and field notes were taken. The testing continued until no new modifiable issues were found. We used descriptive statistics to summarize participant characteristics and the SUS scores. Content analysis was used to identified usability issues and navigation problems. 15 patients participated in the usability testing. The majority were aged 50 or over and were university/college graduates (n = 8, 53.4%). On average they took 56 minutes (SD = 34.8) to complete the tool. The mean SUS score was 81.2 (SD = 13.5). Content analysis of audiotapes and field notes revealed four categories of modifiable usability issues: 1) information delivery (i.e., clarity of the information and presentation style); 2) navigation control (i.e., difficulties in recognizing and using the navigation control buttons); 3) layout (i.e., position of the

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

Long-term health outcomes of a decision aid: data from a randomized trial of adjuvant! In women with localized breast cancer.

Science.gov (United States)

Vickers, Andrew J; Elkin, Elena B; Peele, Pamela B; Dickler, Maura; Siminoff, Laura A

2009-01-01

Women with localized breast cancer face difficult decisions about adjuvant therapy. Several decision aids are available to help women choose between treatment options. Decision aids are known to affect treatment choices and may therefore affect patient survival. The authors aimed to model the effects of the Adjuvant! decision aid on expected survival in women with early stage breast cancer. Data were obtained from a randomized trial of Adjuvant! (n = 395). To calculate the effects of the decision aid on survival, the authors used the Adjuvant! survival predictions as a surrogate endpoint. Data from each arm were entered separately into statistical models to estimate change in survival associated with receiving the Adjuvant! decision aid. Most women (approximately 85%) chose a treatment option that maximized predicted survival. The effects of the decision aid on outcome could not be modeled because a small number of women (n = 12, 3%) chose treatment options associated with a large (5%-14%) loss in survival. These women-most typically estrogen receptor positive but refusing hormonal therapy-were equally divided between Adjuvant! and control groups and were not distinguished by medical or demographic factors. Expected benefit from treatment is a key variable in understanding patient behavior. A small number of women refuse adjuvant treatment associated with large increases in predicted survival, even when they are explicitly informed about the degree of benefit they would forgo. Investigation of the effects of decision aids on cancer survival is unlikely to be fruitful due to power considerations.

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.

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

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

Directory of Open Access Journals (Sweden)

Glyn Elwyn

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

Investigation towards link-enriched video: user information needs for environmental opinion-forming and decision-making

NARCIS (Netherlands)

A.C. Palumbo

2012-01-01

htmlabstractLink-enriched video can support users in processes of environmental opinion-forming and decision-making. For this, audiovisual content must be represented and annotated to enable automatic link generation and computer manipulation. Given the time and budget constraints of

Studies and Analyses of Aided Adversarial Decision Making. Phase 2: Research on Human Trust in Automation

National Research Council Canada - National Science Library

Llinas, James

1998-01-01

.... Given that offensive IW operations may interfere with automated, data-fusion based decision aids, it is necessary to understand how personnel may rely on or trust these aids when appropriate (e.g...

DECIDE: a Decision Support Tool to Facilitate Parents' Choices Regarding Genome-Wide Sequencing.

Science.gov (United States)

Birch, Patricia; Adam, S; Bansback, N; Coe, R R; Hicklin, J; Lehman, A; Li, K C; Friedman, J M

2016-12-01

We describe the rationale, development, and usability testing for an integrated e-learning tool and decision aid for parents facing decisions about genome-wide sequencing (GWS) for their children with a suspected genetic condition. The online tool, DECIDE, is designed to provide decision-support and to promote high quality decisions about undergoing GWS with or without return of optional incidental finding results. DECIDE works by integrating educational material with decision aids. Users may tailor their learning by controlling both the amount of information and its format - text and diagrams and/or short videos. The decision aid guides users to weigh the importance of various relevant factors in their own lives and circumstances. After considering the pros and cons of GWS and return of incidental findings, DECIDE summarizes the user's responses and apparent preferred choices. In a usability study of 16 parents who had already chosen GWS after conventional genetic counselling, all participants found DECIDE to be helpful. Many would have been satisfied to use it alone to guide their GWS decisions, but most would prefer to have the option of consulting a health care professional as well to aid their decision. Further testing is necessary to establish the effectiveness of using DECIDE as an adjunct to or instead of conventional pre-test genetic counselling for clinical genome-wide sequencing.

How do patients between the age of 65 and 75 use a web-based decision aid for treatment choice in localized prostate cancer?

Science.gov (United States)

Schrijvers, Jessie; Vanderhaegen, Joke; Van Poppel, Hendrik; Haustermans, Karin; Van Audenhove, Chantal

2013-08-01

This study was designed to evaluate the use of a web-based decision aid by a 65plus patient group in their decision-making process for treatment of localized prostate cancer. Of particular interest was the use of technology features such as patients' statements, comparative tables, and a values clarification tool. One hundred men from the University Hospital of Leuven campus, Gasthuisberg, were invited to use the web-based decision aid in their decision-making process. Twenty-six men were excluded based on non- or limited use of the decision aid. Of the remaining 74 men, user specifications, decision aid surfing characteristics by means of web-log data, and especially the use of technology features were analyzed. Men spent on average 30 minutes on the web-based decision aid. Most time was spent on the pages with information on treatment options. These pages were also most frequently accessed. The use of the feature 'comparative tables' was the highest, followed by the 'values clarification tool'. According to age (70 years) differences were observed for the time spent on the decision aid, the pages accessed, and the use of the technology features. Despite concerns about the usability of a web-based decision aid for elderly patients, these results indicated that the majority of 65plus persons with good internet skills use a web-based decision aid as well as its incorporated technology features. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

Development and Pilot Testing of a Decision Aid for Genomic Research Participants Notified of Clinically Actionable Research Findings for Cancer Risk.

Science.gov (United States)

Willis, Amanda M; Smith, Sian K; Meiser, Bettina; Ballinger, Mandy L; Thomas, David M; Tattersall, Martin; Young, Mary-Anne

2018-02-17

Germline genomic testing is increasingly used in research to identify genetic causes of disease, including cancer. However, there is evidence that individuals who are notified of clinically actionable research findings have difficulty making informed decisions regarding uptake of genetic counseling for these findings. This study aimed to produce and pilot test a decision aid to assist participants in genomic research studies who are notified of clinically actionable research findings to make informed choices regarding uptake of genetic counseling. Development was guided by published literature, the International Patient Decision Aid Standards, and the expertise of a steering committee of clinicians, researchers, and consumers. Decision aid acceptability was assessed by self-report questionnaire. All 19 participants stated that the decision aid was easy to read, clearly presented, increased their understanding of the implications of taking up research findings, and would be helpful in decision-making. While low to moderate levels of distress/worry were reported after reading the booklet, a majority of participants also reported feeling reassured. All participants would recommend the booklet to others considering uptake of clinically actionable research findings. Results indicate the decision aid is acceptable to the target audience, with potential as a useful decision support tool for genomic research participants.

Record Desktop Activity as Streaming Videos for Asynchronous, Video-Based Collaborative Learning.

Science.gov (United States)

Chang, Chih-Kai

As Web-based courses using videos have become popular in recent years, the issue of managing audiovisual aids has become noteworthy. The contents of audiovisual aids may include a lecture, an interview, a featurette, an experiment, etc. The audiovisual aids of Web-based courses are transformed into the streaming format that can make the quality of…

Review of Multi-Criteria Decision Aid for Integrated Sustainability Assessment of Urban Water Systems - MCEARD

Science.gov (United States)

Integrated sustainability assessment is part of a new paradigm for urban water decision making. Multi-criteria decision aid (MCDA) is an integrative framework used in urban water sustainability assessment, which has a particular focus on utilising stakeholder participation. Here ...

Perceptions of shared decision making and decision aids among rural primary care clinicians.

Science.gov (United States)

King, Valerie J; Davis, Melinda M; Gorman, Paul N; Rugge, J Bruin; Fagnan, L J

2012-01-01

Shared decision making (SDM) and decision aids (DAs) increase patients' involvement in health care decisions and enhance satisfaction with their choices. Studies of SDM and DAs have primarily occurred in academic centers and large health systems, but most primary care is delivered in smaller practices, and over 20% of Americans live in rural areas, where poverty, disease prevalence, and limited access to care may increase the need for SDM and DAs. To explore perceptions and practices of rural primary care clinicians regarding SDM and DAs. Cross-sectional survey. Setting and Participants Primary care clinicians affiliated with the Oregon Rural Practice-based Research Network. Surveys were returned by 181 of 231 eligible participants (78%); 174 could be analyzed. Two-thirds of participants were physicians, 84% practiced family medicine, and 55% were male. Sixty-five percent of respondents were unfamiliar with the term shared decision making, but following definition, 97% reported that they found the approach useful for conditions with multiple treatment options. Over 90% of clinicians perceived helping patients make decisions regarding chronic pain and health behavior change as moderate/hard in difficulty. Although 69% of respondents preferred that patients play an equal role in making decisions, they estimate that this happens only 35% of the time. Time was reported as the largest barrier to engaging in SDM (63%). Respondents were receptive to using DAs to facilitate SDM in print- (95%) or web-based formats (72%), and topic preference varied by clinician specialty and decision difficulty. Rural clinicians recognized the value of SDM and were receptive to using DAs in multiple formats. Integration of DAs to facilitate SDM in routine patient care may require addressing practice operation and reimbursement.

A decision aid for men with early stage prostate cancer: theoretical basis and a test by surrogate patients

Science.gov (United States)

Feldman‐Stewart, Deb; Brundage, Michael D.; Van Manen, Lori

2008-01-01

Background We developed a decision aid for patients with curable prostate cancer based on Svenson’s DiffCon Theory of Decision Making. This study was designed to determine if surrogate patients using the aid could understand the information presented, complete all tasks, show evidence of differentiation, and arrive at a preferred treatment choice. Methods Men, at least 50 years old and never diagnosed with prostate cancer, were recruited through local advertisements. Participants were asked to imagine that they were a case‐scenario patient. Then they completed the decision aid interview, which included three components: (i) information presentation, with comprehension questions, (ii) exercises to help identify attributes important to the decision, and (iii) value‐clarification exercises. Results Sixty‐nine men volunteered. They had a mean age of 61.2 (range 50–83) years, 37% had no formal education beyond high school, and 87% were living with a partner. All participants completed all aspects of the interview. They answered an average of 10 comprehension questions each, with a mean of 94.7% correct without a prompt. Each attribute in the information presented was identified by at least one participant as important to his decision. Participants identified a median of five attributes as important (ranges 1–14) at each of three points during the interview; 75% changed at least one important attribute during the interview. Forty‐nine per cent of participants also identified attributes as important that were not included in the presented information. Participants showed a wide range of values in each of seven trade‐off exercises. Eighty‐eight per cent of participants showed evidence of differentiation; 75% had a clear treatment preference by the end of the interview. Conclusions Our decision aid appears to meet its goals for surrogate patients and illustrates the strengths of the DiffCon theory. The ability of the aid to accommodate wide

Effects of Video-Based Visual Training on Decision-Making and Reactive Agility in Adolescent Football Players

OpenAIRE

Alfred Nimmerichter; Nikolaus J. R. Weber; Klaus Wirth; Andreas Haller

2015-01-01

This study investigated the trainability of decision-making and reactive agility via video-based visual training in young athletes. Thirty-four members of a national football academy (age: 14.4 ± 0.1 years) were randomly assigned to a training (VIS; n = 18) or a control group (CON; n = 16). In addition to the football training, the VIS completed a video-based visual training twice a week over a period of six weeks during the competition phase. Using the temporal occlusion technique, the playe...

Development and evaluation of a patient decision aid for young people and parents considering fixed orthodontic appliances.

Science.gov (United States)

Marshman, Zoe; Eddaiki, Abdussalam; Bekker, Hilary L; Benson, Philip E

2016-12-01

To develop and evaluate a child-centred patient decision aid for young people, and their parents, supporting shared decision making about fixed orthodontic appliance treatment with dental health professionals, namely the Fixed Appliance Decision Aid (FADA). The studies were undertaken in a UK teaching dental hospital orthodontic department in 2013-2014. The development phase involved an interview study with: (a) 10 patients (12-16 years old), and their parents, receiving orthodontic care to investigate treatment decision making and inform the content of the FADA and (b) 23 stakeholders critiquing the draft decision aid's content, structure and utility. The evaluation phase employed a pre-/post-test study design, with 30 patients (12-16 years old) and 30 parents. Outcomes included the Decisional Conflict Scale; measures of orthodontic treatment expectations and knowledge. Qualitative analysis identified two informational needs: effectiveness of treatment on orthodontic outcomes and treatment consequences for patients' lives. Quantitative analysis found decisional conflict reduced in both patients (mean difference -12.3, SD 15.3, 95% CI 6.6-17.9; p orthodontic treatment increased; expectations about care were unchanged. Using the FADA may enable dental professionals to support patients and their parents, decisions about fixed appliance treatments more effectively, ensuring young people's preferences are integrated into care planning.

Weather Avoidance Using Route Optimization as a Decision Aid: An AWIN Topical Study. Phase 1

Science.gov (United States)

1998-01-01

The aviation community is faced with reducing the fatal aircraft accident rate by 80 percent within 10 years. This must be achieved even with ever increasing, traffic and a changing National Airspace System. This is not just an altruistic goal, but a real necessity, if our growing level of commerce is to continue. Honeywell Technology Center's topical study, "Weather Avoidance Using Route Optimization as a Decision Aid", addresses these pressing needs. The goal of this program is to use route optimization and user interface technologies to develop a prototype decision aid for dispatchers and pilots. This decision aid will suggest possible diversions through single or multiple weather hazards and present weather information with a human-centered design. At the conclusion of the program, we will have a laptop prototype decision aid that will be used to demonstrate concepts to industry for integration into commercialized products for dispatchers and/or pilots. With weather a factor in 30% of aircraft accidents, our program will prevent accidents by strategically avoiding weather hazards in flight. By supplying more relevant weather information in a human-centered format along with the tools to generate flight plans around weather, aircraft exposure to weather hazards can be reduced. Our program directly addresses the NASA's five year investment areas of Strategic Weather Information and Weather Operations (simulation/hazard characterization and crew/dispatch/ATChazard monitoring, display, and decision support) (NASA Aeronautics Safety Investment Strategy: Weather Investment Recommendations, April 15, 1997). This program is comprised of two phases, Phase I concluded December 31, 1998. This first phase defined weather data requirements, lateral routing algorithms, an conceptual displays for a user-centered design. Phase II runs from January 1999 through September 1999. The second phase integrates vertical routing into the lateral optimizer and combines the user

Ecological rationality: a framework for understanding and aiding the aging decision maker.

Science.gov (United States)

Mata, Rui; Pachur, Thorsten; von Helversen, Bettina; Hertwig, Ralph; Rieskamp, Jörg; Schooler, Lael

2012-01-01

The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people's decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into reduced decision quality. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision environment in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker.

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.

What factors influence health professionals to use decision aids for Down syndrome prenatal screening?

Science.gov (United States)

Lépine, Johanie; Leiva Portocarrero, Maria Esther; Delanoë, Agathe; Robitaille, Hubert; Lévesque, Isabelle; Rousseau, François; Wilson, Brenda J; Giguère, Anik M C; Légaré, France

2016-09-05

Health professionals are expected to engage pregnant women in shared decision making to help them make informed values-based decisions about prenatal screening. Patient decision aids (PtDAs) foster shared decision-making, but are rarely used in this context. Our objective was to identify factors that could influence health professionals to use a PtDA for decisions about prenatal screening for Down syndrome during a clinical pregnancy follow-up. We planned to recruit a purposive sample of 45 health professionals (obstetrician-gynecologists, family physicians and midwives) involved in the care of pregnant women in three clinical sites (15 per site). Participating health professionals first watched a video showing two simulated consecutive prenatal follow-up consultations during which a pregnant woman, her partner and a health professional used a PtDA about Down syndrome prenatal screening. Participants were then interviewed about factors that would influence their use of the PtDA. Questions were based on the Theoretical Domains Framework. We performed content analyses of transcribed verbatim interviews. Out of 42 eligible health professionals approached, 36 agreed to be interviewed (86 % response rate). Of these, 27 were female (75 %), nine were obstetrician-gynecologists (25 %), 15 were family physicians (42 %), and 12 were midwives (33 %), with a mean age of 42.1 ± 11.6 years old. We identified 35 distinct factors reported by 20 % or more participants that were mapped onto 10 of the 12 of the Theoretical Domains Framework domains. The six most frequently mentioned factors influencing use of the PtDA were: 1) a positive appraisal (n = 29, 81 %, beliefs about consequences domain); 2) its availability in the office (n = 27, 75 %, environmental context and resources domain); 3) colleagues' approval (n = 27, 75 %, social influences domain); 4) time constraints (n = 26, 72 %, environmental context and resources domain); 5) finding it a

Piloting the feasibility of head-mounted video technology to augment student feedback during simulated clinical decision-making: An observational design pilot study.

Science.gov (United States)

Forbes, Helen; Bucknall, Tracey K; Hutchinson, Alison M

2016-04-01

Clinical decision-making is a complex activity that is critical to patient safety. Simulation, augmented by feedback, affords learners the opportunity to learn critical clinical decision-making skills. More detailed feedback following simulation exercises has the potential to further enhance student learning, particularly in relation to developing improved clinical decision-making skills. To investigate the feasibility of head-mounted video camera recordings, to augment feedback, following acute patient deterioration simulations. Pilot study using an observational design. Ten final-year nursing students participated in three simulation exercises, each focussed on detection and management of patient deterioration. Two observers collected behavioural data using an adapted version of Gaba's Clinical Simulation Tool, to provide verbal feedback to each participant, following each simulation exercise. Participants wore a head-mounted video camera during the second simulation exercise only. Video recordings were replayed to participants to augment feedback, following the second simulation exercise. Data were collected on: participant performance (observed and perceived); participant perceptions of feedback methods; and head-mounted video camera recording feasibility and capability for detailed audio-visual feedback. Management of patient deterioration improved for six participants (60%). Increased perceptions of confidence (70%) and competence (80%), were reported by the majority of participants. Few participants (20%) agreed that the video recording specifically enhanced their learning. The visual field of the head-mounted video camera was not always synchronised with the participant's field of vision, thus affecting the usefulness of some recordings. The usefulness of the video recordings, to enhance verbal feedback to participants on detection and management of simulated patient deterioration, was inconclusive. Modification of the video camera glasses, to improve

Video-Aided GPS/INS Positioning and Attitude Determination

National Research Council Canada - National Science Library

Brown, Alison; Silva, Randy

2006-01-01

... precise positioning and attitude information to be maintained, even during periods of extended GPS dropouts. This relies on information extracted from the video images of reference points and features to continue to update the inertial navigation solution. In this paper, the principles of the video-update method aredescribed.

Development and testing of a decision aid for women considering delayed breast reconstruction.

Science.gov (United States)

Metcalfe, Kelly; Zhong, Toni; O'Neill, Anne C; McCready, David; Chan, Linda; Butler, Kate; Brennenstuhl, Sarah; Hofer, Stefan O P

2018-03-01

The decision to have post-mastectomy breast reconstruction (PMBR) is highly complex and many women feel ill equipped to make this decision. Decision aids have been advocated to promote patient involvement in decision-making by streamlining and standardizing communication between the patient and the health care professional. In this study, we report on the development and testing of a decision aid (DA) for breast cancer survivors considering delayed PMBR. The DA was developed and evaluated in three phases. The first phase included the development of the DA with input and review by practitioners and key stakeholders. The second phase involved pilot testing of the feasibility and acceptability of the DA with a convenience sample of women with delayed PMBR. The third phase involved a pretest/post-test evaluation of the DA for women who were making decisions about their PMBR options. The DA was developed using the Ottawa Decision Support Framework. In the second phase of the study, 21 women completed the acceptability survey, of whom 100% reported that they would recommend the DA to other women. In the third phase, decisional conflict decreased significantly (p < 0.001) and knowledge increased significantly (p < 0.001) from prior to using the DA to 1-2 weeks after using the DA. The DA is feasible and acceptable to women considering delayed PMBR. Furthermore, the DA is effective at reducing decisional conflict and increasing knowledge about delayed PMBR. The DA is an appropriate tool to be used in addition with standard care in women considering PMBR. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Decision optimization of case-based computer-aided decision systems using genetic algorithms with application to mammography

International Nuclear Information System (INIS)

Mazurowski, Maciej A; Habas, Piotr A; Zurada, Jacek M; Tourassi, Georgia D

2008-01-01

This paper presents an optimization framework for improving case-based computer-aided decision (CB-CAD) systems. The underlying hypothesis of the study is that each example in the knowledge database of a medical decision support system has different importance in the decision making process. A new decision algorithm incorporating an importance weight for each example is proposed to account for these differences. The search for the best set of importance weights is defined as an optimization problem and a genetic algorithm is employed to solve it. The optimization process is tailored to maximize the system's performance according to clinically relevant evaluation criteria. The study was performed using a CAD system developed for the classification of regions of interests (ROIs) in mammograms as depicting masses or normal tissue. The system was constructed and evaluated using a dataset of ROIs extracted from the Digital Database for Screening Mammography (DDSM). Experimental results show that, according to receiver operator characteristic (ROC) analysis, the proposed method significantly improves the overall performance of the CAD system as well as its average specificity for high breast mass detection rates

Identifying design considerations for a shared decision aid for use at the point of outpatient clinical care: An ethnographic study at an inner city clinic.

Science.gov (United States)

Hajizadeh, Negin; Perez Figueroa, Rafael E; Uhler, Lauren M; Chiou, Erin; Perchonok, Jennifer E; Montague, Enid

2013-03-06

Computerized decision aids could facilitate shared decision-making at the point of outpatient clinical care. The objective of this study was to investigate whether a computerized shared decision aid would be feasible to implement in an inner-city clinic by evaluating the current practices in shared decision-making, clinicians' use of computers, patient and clinicians' attitudes and beliefs toward computerized decision aids, and the influence of time on shared decision-making. Qualitative data analysis of observations and semi-structured interviews with patients and clinicians at an inner-city outpatient clinic. The findings provided an exploratory look at the prevalence of shared decision-making and attitudes about health information technology and decision aids. A prominent barrier to clinicians engaging in shared decision-making was a lack of perceived patient understanding of medical information. Some patients preferred their clinicians make recommendations for them rather than engage in formal shared decision-making. Health information technology was an integral part of the clinic visit and welcomed by most clinicians and patients. Some patients expressed the desire to engage with health information technology such as viewing their medical information on the computer screen with their clinicians. All participants were receptive to the idea of a decision aid integrated within the clinic visit although some clinicians were concerned about the accuracy of prognostic estimates for complex medical problems. We identified several important considerations for the design and implementation of a computerized decision aid including opportunities to: bridge clinician-patient communication about medical information while taking into account individual patients' decision-making preferences, complement expert clinician judgment with prognostic estimates, take advantage of patient waiting times, and make tasks involved during the clinic visit more efficient. These findings

Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group

Science.gov (United States)

Bourmaud, Aurelie; Soler-Michel, Patricia; Oriol, Mathieu; Regnier, Véronique; Tinquaut, Fabien; Nourissat, Alice; Bremond, Alain; Moumjid, Nora; Chauvin, Franck

2016-01-01

Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated. PMID:26883201

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.

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

National Research Council Canada - National Science Library

Schipani, Salvatore

2003-01-01

..., processing, and acting upon information is often inadequate. The current research examined two levels of training, decision aiding, and homogeneity on group performance, using a personality concept classified "action orientation...

Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.

Science.gov (United States)

Poost-Foroosh, Laya; Jennings, Mary Beth; Cheesman, Margaret F

2015-03-01

Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology-related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. A cross-sectional approach was used to obtain online and paper-based concept ratings. Participants were 43 adults (age range, 45-85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated "the importance of each of the statements in a person's decision to purchase a hearing aid" on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. There was a significant difference in the mean ratings for clients and clinicians for

First Aid and Safety

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español First Aid & Safety Keeping your child safe is your top ... do in an emergency, how to stock a first-aid kit, where to call for help, and more. ...

Ecological Rationality: A Framework for Understanding and Aiding the Aging Decision Maker

Directory of Open Access Journals (Sweden)

Rui eMata

2012-02-01

Full Text Available Ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. The concept of ecological rationality focuses the study of cognition on two key questions: First, what are the environmental regularities to which people’s decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environments? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into diminished decision performance. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision ecology in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker.

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.

Predictors of eyewitness identification decisions from video lineups in England: a field study.

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Horry, Ruth; Memon, Amina; Wright, Daniel B; Milne, Rebecca

2012-08-01

Eyewitness identification decisions from 1,039 real lineups in England were analysed. Identification procedures have undergone dramatic change in the United Kingdom over recent years. Video lineups are now standard procedure, in which each lineup member is seen sequentially. The whole lineup is seen twice before the witness can make a decision, and the witness can request additional viewings of the lineup. A key aim of this paper was to investigate the association between repeated viewing and eyewitness decisions. Repeated viewing was strongly associated with increased filler identification rates, suggesting that witnesses who requested additional viewings were more willing to guess. In addition, several other factors were associated with lineup outcomes, including the age difference between the suspect and the witness, the type of crime committed, and delay. Overall, the suspect identification rate was 39%, the filler identification rate was 26% and the lineup rejection rate was 35%. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

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.

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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).

Decision aid use during post-biopsy consultations for localized prostate cancer.

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Holmes-Rovner, Margaret; Srikanth, Akshay; Henry, Stephen G; Langford, Aisha; Rovner, David R; Fagerlin, Angela

2018-02-01

Decision Aids (DAs) effectively translate medical evidence for patients but are not routinely used in clinical practice. Little is known about how DAs are used during patient-clinician encounters. To characterize the content and communicative function of high-quality DAs during diagnostic clinic visits for prostate cancer. 252 men newly diagnosed with localized prostate cancer who had received a DA, 45 treating physicians at 4 US Veterans Administration urology clinics. Qualitative analysis of transcribed audio recordings was used to inductively develop categories capturing content and function of all direct references to DAs (booklet talk). The presence or absence of any booklet talk per transcript was also calculated. Booklet talk occurred in 55% of transcripts. Content focused on surgical procedures (36%); treatment choice (22%); and clarifying risk classification (17%). The most common function of booklet talk was patient corroboration of physicians' explanations (42%), followed by either physician or patient acknowledgement that the patient had the booklet. Codes reflected the absence of DA use for shared decision-making. In regression analysis, predictors of booklet talk were fewer years of patient education (P = .027) and more time in the encounter (P = .027). Patient race, DA type, time reading the DA, physician informing quality and physician age did not predict booklet talk. Results show that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Balancing emotion and cognition: a case for decision aiding in conservation efforts.

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Wilson, Robyn S

2008-12-01

Despite advances in the quality of participatory decision making for conservation, many current efforts still suffer from an inability to bridge the gap between science and policy. Judgment and decision-making research suggests this gap may result from a person's reliance on affect-based shortcuts in complex decision contexts. I examined the results from 3 experiments that demonstrate how affect (i.e., the instantaneous reaction one has to a stimulus) influences individual judgments in these contexts and identified techniques from the decision-aiding literature that help encourage a balance between affect-based emotion and cognition in complex decision processes. In the first study, subjects displayed a lack of focus on their stated conservation objectives and made decisions that reflected their initial affective impressions. Value-focused approaches may help individuals incorporate all the decision-relevant objectives by making the technical and value-based objectives more salient. In the second study, subjects displayed a lack of focus on statistical risk and again made affect-based decisions. Trade-off techniques may help individuals incorporate relevant technical data, even when it conflicts with their initial affective impressions or other value-based objectives. In the third study, subjects displayed a lack of trust in decision-making authorities when the decision involved a negatively affect-rich outcome (i.e., a loss). Identifying shared salient values and increasing procedural fairness may help build social trust in both decision-making authorities and the decision process.

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

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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.

Use of video taping during simulator training

International Nuclear Information System (INIS)

Helton, M.; Young, P.

1987-01-01

The use of a video camera for training is not a new idea and is used throughout the country for training in such areas as computers, car repair, music and even in such non-technical areas as fishing. Reviewing a taped simulator training session will aid the student in his job performance regardless of the position he holds in his organization. If the student is to be examined on simulator performance, video will aid in this training in many different ways

The computer-aided design of a servo system as a multiple-criteria decision problem

NARCIS (Netherlands)

Udink ten Cate, A.J.

1986-01-01

This paper treats the selection of controller gains of a servo system as a multiple-criteria decision problem. In contrast to the usual optimization-based approaches to computer-aided design, inequality constraints are included in the problem as unconstrained objectives. This considerably simplifies

Operation and validation of the decision aid system 'CAIRE' in complex terrain

International Nuclear Information System (INIS)

De Witt, H.; Nuesser, A.; Brenk, H.D.

1998-01-01

In cases of nuclear emergencies it is the primary task of emergency response forces and decision making authorities to act properly. Based on telemetric surveillance networks, an advanced automatic on-line decision support system named CAIRE (Computer Aided Response to Emergencies) has been developed and is in operation now at 4 sites as a real time emergency response tool. This tool is designed to provide decision makers with precise radiation exposure data for the population at risk. Depending on the individual layout of the connected telemetric networks, CAIRE is able to satisfy the following main requirements: automatic identification of the source location and of the source term, automatic diagnosis of the actual radiological situation and identification of the endangered area, projection of the radiological situation, delivery of all this information in the form computer graphics. (R.P.)

If a Picture Is Worth a Thousand Words Is Video Worth a Million? Differences in Affective and Cognitive Processing of Video and Text Cases

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Yadav, Aman; Phillips, Michael M.; Lundeberg, Mary A.; Koehler, Matthew J.; Hilden, Katherine; Dirkin, Kathryn H.

2011-01-01

In this investigation we assessed whether different formats of media (video, text, and video + text) influenced participants' engagement, cognitive processing and recall of non-fiction cases of people diagnosed with HIV/AIDS. For each of the cases used in the study, we designed three informationally-equivalent versions: video, text, and video +…

Imagining life with an ostomy: Does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?☆

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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

Shared decision-making to improve attention-deficit hyperactivity disorder care.

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Brinkman, William B; Hartl Majcher, Jessica; Poling, Lauren M; Shi, Gaoyan; Zender, Mike; Sucharew, Heidi; Britto, Maria T; Epstein, Jeffery N

2013-10-01

To examine the effect of a shared decision-making intervention with parents of children newly diagnosed with attention-deficit/hyperactivity disorder. Seven pediatricians participated in a pre/post open trial of decision aids for use before and during the office visit to discuss diagnosis and develop a treatment plan. Encounters pre- (n=21, control group) and post-intervention implementation (n=33, intervention group) were compared. We video-recorded encounters and surveyed parents. Compared to controls, intervention group parents were more involved in shared decision-making (31.2 vs. 43.8 on OPTION score, pdecision-making with parents. Parents were better informed about treatment options without increasing visit duration. Interventions are available to prepare parents for visits and enable physicians to elicit parent preferences and involvement in decision-making. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

The effect of offering different numbers of colorectal cancer screening test options in a decision aid: a pilot randomized trial

Directory of Open Access Journals (Sweden)

Brenner Alison RT

2008-01-01

Full Text Available Abstract Background Decision aids can improve decision making processes, but the amount and type of information that they should attempt to communicate is controversial. We sought to compare, in a pilot randomized trial, two colorectal cancer (CRC screening decision aids that differed in the number of screening options presented. Methods Adults ages 48–75 not currently up to date with screening were recruited from the community and randomized to view one of two versions of our previously tested CRC screening decision aid. The first version included five screening options: fecal occult blood test (FOBT, sigmoidoscopy, a combination of FOBT and sigmoidoscopy, colonoscopy, and barium enema. The second discussed only the two most frequently selected screening options, FOBT and colonoscopy. Main outcomes were differences in screening interest and test preferences between groups after decision aid viewing. Patient test preference was elicited first without any associated out-of-pocket costs (OPC, and then with the following costs: FOBT-$10, sigmoidoscopy-$50, barium enema-$50, and colonoscopy-$200. Results 62 adults participated: 25 viewed the 5-option decision aid, and 37 viewed the 2-option version. Mean age was 54 (range 48–72, 58% were women, 71% were White, 24% African-American; 58% had completed at least a 4-year college degree. Comparing participants that viewed the 5-option version with participants who viewed the 2-option version, there were no differences in screening interest after viewing (1.8 vs. 1.9, t-test p = 0.76. Those viewing the 2-option version were somewhat more likely to choose colonoscopy than those viewing the 5-option version when no out of pocket costs were assumed (68% vs. 46%, p = 0.11, but not when such costs were imposed (41% vs. 42%, p = 1.00. Conclusion The number of screening options available does not appear to have a large effect on interest in colorectal cancer screening. The effect of offering differing

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

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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.

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

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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.

Patient‐focussed decision‐making in early‐stage prostate cancer: insights from a cognitively based decision aid

Science.gov (United States)

Feldman‐Stewart, Deb; Brundage, Michael D; Manen, Lori Van; Svenson, Ola

2004-01-01

Abstract Purpose  To study the cognitive processes of early‐stage prostate cancer patients as they determined which treatment they preferred, using our cognitively based decision aid. Method  The aid was a one‐to‐one interview that included the structured presentation of information, listing exercises in which the patient identified attributes important to his decision, and trade‐off exercises to help him weigh and integrate those attributes together. At various points of the interview, patients identified the attributes they felt were important to their decision, rated their treatment options and completed standardized assessments relating to their decision. In addition, patients participated in a follow‐up interview at the time they made their actual treatment decision and again 3 months later. Results  Sixty of 70 (86%) of the invited patients participated in the study. Participating patients identified a median of four important attributes (range 1–10); 36 different attributes were identified at some point in the interview by the group. During the interview, 78% of patients changed which attributes they considered important, and 72% changed their treatment ratings. Stability of treatment choice after the interview and lack of regret after the decision were each positively associated with increasing differentiation between treatment options over time. Conclusions  The decision process appears to be dynamic for the patients with great variability across patients in what is important to the decision. Increasing stability of choice and lack of regret appear to be related positively to increasing difference over time in how attractive the preferred option is over its closest competitor, rather than to the size of the difference at any one point in time. PMID:15117387

Special Needs: Planning for Adulthood (Videos)

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Full Text Available ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals Videos Recipes ...

Adaptive intrusion data system (AIDS) software routines

International Nuclear Information System (INIS)

Corlis, N.E.

1980-07-01

An Adaptive Intrusion Data System (AIDS) was developed to collect information from intrusion alarm sensors as part of an evaluation system to improve sensor performance. AIDS is a unique digital data-compression, storage, and formatting system; it also incorporates a capability for video selection and recording for assessment of the sensors monitored by the system. The system is software reprogrammable to numerous configurations that may be used for the collection of environmental, bilevel, analog, and video data. This report describes the software routines that control the different AIDS data-collection modes, the diagnostic programs to test the operating hardware, and the data format. Sample data printouts are also included

Viral Transmissions: Safer Sex Videos, Disability, and Queer Politics

OpenAIRE

Karisa Butler-Wall

2016-01-01

Bringing disability studies into conversation with queer histories of AIDS activism, this article examines the relationship between disability and queer politics in safer sex videos created by AIDS activists in the 1980s. As a form of what the author terms "guerrilla biopolitics," safer sex videos insisted on the viability of queer life and sexual expression at a historical moment of intense homophobia and sex negativity. At the same time, the vision of sexual health and identity they offered...

Special Needs: Planning for Adulthood (Videos)

Medline Plus

Full Text Available ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals Videos ...

The need for decision and communication aids: a survey of breast cancer survivors.

Science.gov (United States)

Belkora, Jeffrey K; Miller, Melissa F; Dougherty, Kasey; Gayer, Christopher; Golant, Mitch; Buzaglo, Joanne S

2015-03-01

Qualitative studies have identified barriers to communication and informed decision making among breast cancer survivors making treatment decisions. The prevalence of these barriers is unknown. To quantify the need for decision support among breast cancer survivors. We surveyed 2,521 breast cancer survivors participating in an online registry hosted by the Cancer Support Community to find out what proportion of breast cancer patients: made decisions during their first visit with a specialist; received satisfactory information before that visit; asked questions and received responses; and endorsed expanded use of decision support. We received 1,017 (41%) responses and analyzed 917 surveys from women who lived in the United States. Most of the respondents recalled making treatment decisions during their first visit (52%). A minority (14%) received information before the first specialist visit. At least 25% of respondents rated their satisfaction below 7 on a scale of 10 for decision-making, information, and questions asked and answered. Respondents endorsed the need for assistance with obtaining information, listing questions, taking notes, and making audio-recordings of visits. The respondent sample skewed younger and had higher-stage cancer compared with all breast cancer survivors. Responses were subject to recall bias. Cancer survivors expressed gaps in their care with respect to reviewing information, asking questions, obtaining answers, and making decisions. Implementing decision and communication aids immediately upon diagnosis, when treatment decisions are being made, would address these gaps. ©2015 Frontline Medical Communications.

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

NARCIS (Netherlands)

Pieterse, A.H.; de Vries, M.

2013-01-01

Background  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

Semiorders, Intervals Orders and Pseudo Orders Preference Structures in Multiple Criteria Decision Aid Methods

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Fernández Barberis, Gabriela

2013-06-01

Full Text Available During the last decades, an important number of Multicriteria Decision Aid Methods (MCDA has been proposed to help the decision maker to select the best compromise alternative. Meanwhile, the PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluations family of outranking method and their applications has attracted much attention from academics and practitioners. In this paper, an extension of these methods is presented, consisting of analyze its functioning under New Preference Structures (NPS. The preference structures taken into account are, namely: semiorders, intervals orders and pseudo orders. These structures outstandingly improve the modelization as they give more flexibility, amplitude and certainty at the preferences formulation, since they tend to abandon the Complete Transitive Comparability Axiom of Preferences in order to substitute it by the Partial Comparability Axiom of Preferences. It must be remarked the introduction of Incomparability relations to the analysis and the consideration of preference structures that accept the Indifference intransitivity. The NPS incorporation is carried out in three phases that the PROMETHEE Methodology takes in: preference structure enrichment, dominance relation enrichment and outranking relation exploitation for decision aid, in order to finally arrive at solving the alternatives ranking problem through the PROMETHEE I or the PROMETHEE II utilization, according to whether a partial ranking or a complete one, is respectively required under the NPS

Justification, optimization and decision-aiding in existing exposure situations

International Nuclear Information System (INIS)

Hedemann-Jensen, Per

2004-01-01

The existing ICRP system of radiological protection from 1990 (ICRP Publication 60) can be seen as a binary or dual-line system dealing with protection in exposure situations categorized as either practices or interventions. The distinction between practices and interventions is summarized in the paper with focus on some of the problems experienced in making such a distinction. The protection principles within the existing system of protection are presented with emphasis on the application to de facto or existing exposure situations. Decision on countermeasures to mitigate the consequences of existing exposure situations such as nuclear or radiological accidents and naturally occurring exposure situations include factors or attributes describing benefits from the countermeasure and those describing harm. Some of these attributes are discussed and the general process of justification of intervention and optimization of protection arriving at generic reference levels for implementing protective measures is presented. In addition, the role of radiological protection professionals and other stakeholders in the decision-making process is discussed. Special attention is given to the question whether radiological protection should form only one of many decision-aiding inputs to a broader societal decision-making process or whether societal aspects should be fully integrated into the radiological protection framework. The concepts of practices and interventions, however logical they are, have created some confusion when applied to protection of the public following a nuclear or radiological accident. These problems may be solved in a new set of general ICRP recommendations on radiological protection, which are anticipated to supersede Publication 60 in 2005. The evolution of the basic ICRP principles for radiological protection in existing exposure situations into a new set of ICRP recommendations is briefly discussed based upon the various material that has been presented

Impact of a decision aid about stratified ovarian cancer risk-management on women’s knowledge and intentions: a randomised online experimental survey study

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Susanne F. Meisel

2017-11-01

Full Text Available Abstract Background Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk of ovarian cancer and reducing unnecessary interventions for women at lower risk. Amounts of information given to women may influence key informed decision-related outcomes, e.g. knowledge. The primary aim of this study was to compare informed decision-related outcomes between women given one of two versions (gist vs. extended of a decision aid about stratified ovarian cancer risk-management. Methods This was an experimental survey study comparing the effects of brief (gist information with lengthier, more detailed (extended information on cognitions relevant to informed decision-making about participating in risk-stratified ovarian cancer screening. Women with no personal history of ovarian cancer were recruited through an online survey company and randomised to view the gist (n = 512 or extended (n = 519 version of a website-based decision aid and completed an online survey. Primary outcomes were knowledge and intentions. Secondary outcomes included attitudes (values and decisional conflict. Results There were no significant differences between the gist and extended conditions in knowledge about ovarian cancer (time*group interaction: F = 0.20, p = 0.66 or intention to participate in ovarian cancer screening based on genetic risk assessment (t(1029 = 0.43, p = 0.67. There were also no between-groups differences in secondary outcomes. In the sample overall (n = 1031, knowledge about ovarian cancer increased from before to after exposure to the decision aid (from 5.71 to 6.77 out of a possible 10: t = 19.04, p < 0.001, and 74% of participants said that they would participate in ovarian cancer screening based on genetic risk assessment. Conclusions No differences in knowledge or

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

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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.

Deep learning aided decision support for pulmonary nodules diagnosing: a review.

Science.gov (United States)

Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping; He, Jianxing; Liu, Bo

2018-04-01

Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing.

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

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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.

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.

Direct migration motion estimation and mode decision to decoder for a low-complexity decoder Wyner-Ziv video coding

Science.gov (United States)

Lei, Ted Chih-Wei; Tseng, Fan-Shuo

2017-07-01

This paper addresses the problem of high-computational complexity decoding in traditional Wyner-Ziv video coding (WZVC). The key focus is the migration of two traditionally high-computationally complex encoder algorithms, namely motion estimation and mode decision. In order to reduce the computational burden in this process, the proposed architecture adopts the partial boundary matching algorithm and four flexible types of block mode decision at the decoder. This approach does away with the need for motion estimation and mode decision at the encoder. The experimental results show that the proposed padding block-based WZVC not only decreases decoder complexity to approximately one hundredth that of the state-of-the-art DISCOVER decoding but also outperforms DISCOVER codec by up to 3 to 4 dB.

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.

A single-blind randomised controlled trial of the effects of a web-based decision aid on self-testing for cholesterol and diabetes. study protocol

Directory of Open Access Journals (Sweden)

Ickenroth Martine HP

2012-01-01

Full Text Available Abstract Background Self-tests, tests on body materials to detect medical conditions, are widely available to the general public. Self-testing does have advantages as well as disadvantages, and the debate on whether self-testing should be encouraged or rather discouraged is still ongoing. One of the concerns is whether consumers have sufficient knowledge to perform the test and interpret the results. An online decision aid (DA with information on self-testing in general, and test specific information on cholesterol and diabetes self-testing was developed. The DA aims to provide objective information on these self-tests as well as a decision support tool to weigh the pros and cons of self-testing. The aim of this study is to evaluate the effect of the online decision aid on knowledge on self-testing, informed choice, ambivalence and psychosocial determinants. Methods/Design A single blind randomised controlled trial in which the online decision aid 'zelftestwijzer' is compared to short, non-interactive information on self-testing in general. The entire trial will be conducted online. Participants will be selected from an existing Internet panel. Consumers who are considering doing a cholesterol or diabetes self-test in the future will be included. Outcome measures will be assessed directly after participants have viewed either the DA or the control condition. Weblog files will be used to record participants' use of the decision aid. Discussion Self-testing does have important pros and cons, and it is important that consumers base their decision whether they want to do a self-test or not on knowledge and personal values. This study is the first to evaluate the effect of an online decision aid for self-testing. Trial registration Dutch Trial Register: NTR3149

Impact of a decision aid about stratified ovarian cancer risk-management on women's knowledge and intentions: a randomised online experimental survey study.

Science.gov (United States)

Meisel, Susanne F; Freeman, Maddie; Waller, Jo; Fraser, Lindsay; Gessler, Sue; Jacobs, Ian; Kalsi, Jatinderpal; Manchanda, Ranjit; Rahman, Belinda; Side, Lucy; Wardle, Jane; Lanceley, Anne; Sanderson, Saskia C

2017-11-16

Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk of ovarian cancer and reducing unnecessary interventions for women at lower risk. Amounts of information given to women may influence key informed decision-related outcomes, e.g. knowledge. The primary aim of this study was to compare informed decision-related outcomes between women given one of two versions (gist vs. extended) of a decision aid about stratified ovarian cancer risk-management. This was an experimental survey study comparing the effects of brief (gist) information with lengthier, more detailed (extended) information on cognitions relevant to informed decision-making about participating in risk-stratified ovarian cancer screening. Women with no personal history of ovarian cancer were recruited through an online survey company and randomised to view the gist (n = 512) or extended (n = 519) version of a website-based decision aid and completed an online survey. Primary outcomes were knowledge and intentions. Secondary outcomes included attitudes (values) and decisional conflict. There were no significant differences between the gist and extended conditions in knowledge about ovarian cancer (time*group interaction: F = 0.20, p = 0.66) or intention to participate in ovarian cancer screening based on genetic risk assessment (t(1029) = 0.43, p = 0.67). There were also no between-groups differences in secondary outcomes. In the sample overall (n = 1031), knowledge about ovarian cancer increased from before to after exposure to the decision aid (from 5.71 to 6.77 out of a possible 10: t = 19.04, p type of content for decision aids about stratified ovarian cancer risk-management. This study was registered with the ISRCTN registry; registration number: ISRCTN48627877 .

The AFFORD clinical decision aid to identify emergency department patients with atrial fibrillation at low risk for 30-day adverse events.

Science.gov (United States)

Barrett, Tyler W; Storrow, Alan B; Jenkins, Cathy A; Abraham, Robert L; Liu, Dandan; Miller, Karen F; Moser, Kelly M; Russ, Stephan; Roden, Dan M; Harrell, Frank E; Darbar, Dawood

2015-03-15

There is wide variation in the management of patients with atrial fibrillation (AF) in the emergency department (ED). We aimed to derive and internally validate the first prospective, ED-based clinical decision aid to identify patients with AF at low risk for 30-day adverse events. We performed a prospective cohort study at a university-affiliated tertiary-care ED. Patients were enrolled from June 9, 2010, to February 28, 2013, and followed for 30 days. We enrolled a convenience sample of patients in ED presenting with symptomatic AF. Candidate predictors were based on ED data available in the first 2 hours. The decision aid was derived using model approximation (preconditioning) followed by strong bootstrap internal validation. We used an ordinal outcome hierarchy defined as the incidence of the most severe adverse event within 30 days of the ED evaluation. Of 497 patients enrolled, stroke and AF-related death occurred in 13 (3%) and 4 (aid included the following: age, triage vitals (systolic blood pressure, temperature, respiratory rate, oxygen saturation, supplemental oxygen requirement), medical history (heart failure, home sotalol use, previous percutaneous coronary intervention, electrical cardioversion, cardiac ablation, frequency of AF symptoms), and ED data (2 hours heart rate, chest radiograph results, hemoglobin, creatinine, and brain natriuretic peptide). The decision aid's c-statistic in predicting any 30-day adverse event was 0.7 (95% confidence interval 0.65, 0.76). In conclusion, in patients with AF in the ED, Atrial Fibrillation and Flutter Outcome Risk Determination provides the first evidence-based decision aid for identifying patients who are at low risk for 30-day adverse events and candidates for safe discharge. Copyright © 2015 Elsevier Inc. All rights reserved.

A hierarchical decision aid in a debate on national energy policy

International Nuclear Information System (INIS)

Haemaelaeinen, R.P.; Seppaelaeinen, T.; Oehladt, K.; Ruusunen, J.

1985-12-01

A wide public depate on the future energy policy of Finland has been going on for the past few years, and at the moment the discussion is centered around the question whether a new nuclear power plant should be built or not. To clarify the differences between anti-nuclear and pro-nuclear opinions, a decision analysis of the issue was conducted with a microcomputer-based decision aid which utilizes the Analytic Hierarchy Process. The participants representing the opposite opinions were the Minister of Finance and a chief industrial executive. This paper presents the preference profiles of the participants and sensitivity analyses of the results, and discusses the implications of the results for the depate. Essential sources of opinion differences are pointed out and a deeper understanding of the issue is gained. This enables focusing the depate on the critical questions and elimination of less important criteria, which otherwise might receive disproportonate attention

The pros and cons of funnel plots as an aid to risk communication and patient decision making.

Science.gov (United States)

Rakow, Tim; Wright, Rebecca J; Spiegelhalter, David J; Bull, Catherine

2015-05-01

Funnel plots, which simultaneously display a sample statistic and the corresponding sample size for multiple cases, have a range of applications. In medicine, they are used to display treatment outcome rates and caseload volume by institution, which can inform strategic decisions about health care delivery. We investigated lay people's understanding of such plots and explored their suitability as an aid to individual treatment decisions. In two studies, 172 participants answered objective questions about funnel plots representing the surgical outcomes (survival or mortality rates) of institutions varying in caseload, and indicated their preferred institutions. Accuracy for extracting objective information was high, unless question phrasing was inconsistent with the plot's survival/mortality framing, or participants had low numeracy levels. Participants integrated caseload-volume and outcome-rate data when forming preferences, but were influenced by reference lines on the plot to make inappropriate discriminations between institutions with similar outcome rates. With careful choice of accompanying language, funnel plots can be readily understood and are therefore a useful tool for communicating risk. However, they are less effective as a decision aid for individual patient's treatment decisions, and we recommend refinements to the standard presentation of the plots if they are to be used for that purpose. © 2014 The British Psychological Society.

Audio-visual aid in teaching "fatty liver".

Science.gov (United States)

Dash, Sambit; Kamath, Ullas; Rao, Guruprasad; Prakash, Jay; Mishra, Snigdha

2016-05-06

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 concepts of the topic, while keeping in view Mayer's and Ellaway guidelines for multimedia presentation. A pre-post test study on subject knowledge was conducted for 100 students with the video shown as intervention. A retrospective pre study was conducted as a survey which inquired about students understanding of the key concepts of the topic and a feedback on our video was taken. Students performed significantly better in the post test (mean score 8.52 vs. 5.45 in pre-test), positively responded in the retrospective pre-test and gave a positive feedback for our video presentation. Well-designed multimedia tools can aid in cognitive processing and enhance working memory capacity as shown in our study. In times when "smart" device penetration is high, information and communication tools in medical education, which can act as essential aid and not as replacement for traditional curriculums, can be beneficial to the students. © 2015 by The International Union of Biochemistry and Molecular Biology, 44:241-245, 2016. © 2015 The International Union of Biochemistry and Molecular Biology.

Development of an integrated decision support system to aid cognitive activities of operators

International Nuclear Information System (INIS)

Lee, Seung Jun; Seong, Poong Hyun

2007-01-01

As digital and computer technologies have grown, Human-Machine Interfaces (HMIs) have evolved. In safety-critical systems, especially in Nuclear Power Plants (NPPs), HMIs are important for reducing operational costs, the number of necessary operators, and the probability of accident occurrence. Efforts have been made to improve Main Control Room (MCR) interface design and to develop automated or decision support systems to ensure convenient operation and maintenance. In this paper, an integrated decision support system to aid operator cognitive processes is proposed for advanced MCRs of future NPPs. This work suggests the design concept of a decision support system which accounts for an operator's cognitive processes. The proposed system supports not only a particular task, but also the entire operation process based on a human cognitive process model. In this paper, the operator's operation processes are analyzed according to a human cognitive process model and appropriate support systems that support each cognitive process activity are suggested

Evaluation of a Patient Decision Aid for Unicompartmental or Total Knee Arthroplasty for Medial Knee Osteoarthritis.

Science.gov (United States)

de Jesus, Christopher; Stacey, Dawn; Dervin, Geoffrey F

2017-11-01

Many patients with isolated medial compartment osteoarthritis are candidates for either unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). A novel patient decision aid (PDA) was developed to educate patients on both interventions and prepare them for making the decision with their surgeon. The study objective was to evaluate the acceptability and usefulness of a PDA for informing and helping patients reach a surgical preference without increasing decisional conflict. A PDA was developed in accordance with the criteria listed by Ottawa Decision Support Framework and prospectively tested in UKA and TKA patients, who were mailed the PDAs to complete at home along with outcome measures before surgeon consultation. Of 50 patients who consented to participate, 45 patients (26 men, 19 women) used the PDA. Quantitative analysis of acceptability, decisional conflict, knowledge, and preferred surgical option was then performed. Mean patient age was 64.6 years (range, 50-80 years). Patients rated the PDA as acceptable: 84.4% indicated balanced presentation of information and 77.8% asserted that PDA helped them to make decisions between UKA and TKA. Mean knowledge score was 86.6% and total decisional conflict was 19.7 out of 100. Of 45, 33 stated a preferred option (24 UKA; 9 TKA; 12 unsure). Patients understood the majority of the benefits and risks for each surgical option without increasing decisional conflict. The decision aid for advanced medial compartment osteoarthritis is shown to be acceptable and useful for choosing between UKA and TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

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…

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

Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol.

Science.gov (United States)

Oostendorp, Linda J M; Ottevanger, Petronella B; van der Graaf, Winette T A; Stalmeier, Peep F M

2011-02-14

There is a continuing debate on the desirability of informing patients with cancer and thereby involving them in treatment decisions. On the one hand, information uptake may be hampered, and additional stress could be inflicted by involving these patients. On the other hand, even patients with advanced cancer desire information on risks and prognosis. To settle the debate, a decision aid will be developed and presented to patients with advanced disease at the point of decision making. The aid is used to assess the amount of information desired. Factors related to information desire are explored, as well as the ability of the medical oncologist to judge the patient's information desire. The effects of the information on patient well-being are assessed by comparing the decision aid group with a usual care group. This study is a randomized controlled trial of patients with advanced colorectal, breast, or ovarian cancer who have started treatment with first-line palliative chemotherapy. The trial will consist of 100 patients in the decision aid group and 70 patients in the usual care group. To collect complete data of 170 patients, 246 patients will be approached for the study. Patients will complete a baseline questionnaire on sociodemographic data, well-being measures, and psychological measures, believed to predict information desire. The medical oncologist will judge the patient's information desire. After disease progression is diagnosed, the medical oncologist offers the choice between second-line palliative chemotherapy plus best supportive care (BSC) and BSC alone. Randomization will take place to determine whether patients will receive usual care (n = 70) or usual care and the decision aid (n = 100). The aid offers information about the potential risks and benefits of both treatment options, in terms of adverse events, tumour response, and survival. Patients decide for each item whether they desire the information or not. Two follow-up questionnaires will

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

Science.gov (United States)

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

2014-12-12

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

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

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…

Evaluating the utility of a patient decision aid for potential participants of a prostate cancer trial (RAVES-TROG 08.03)

International Nuclear Information System (INIS)

Sundaresan, Puma; Turner, Sandra; Kneebone, Andrew; Pearse, Maria; Butow, Phyllis

2011-01-01

Randomised controlled trials (RCTs) can be hampered by poor patient accrual and retention. Decision aids (DAs) containing simple, evidence-based information, may assist patients with decision-making regarding trial participation. The current DA was of use for 95% of participants. Further evaluation of the DA in a RCT is currently underway.

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

Decision aiding model for the evaluation of agricultural countermeasures after an accidental release of radionuclides to the environment

International Nuclear Information System (INIS)

Turcanu, C.

2009-01-01

Implementation of remedial actions after a radiological contamination of the environment has to take into account, alongside with radiological and feasibility criteria, also the acceptability of the countermeasures, ethical and environmental considerations, as well as the spatial variation and the needs of people in urban, rural and industrial environments. This highlights multi-criteria analysis as a suitable tool, since it is able to structure discussions and to facilitate a common understanding of the decision problem, with the values and priorities of the actors involved. The related theoretical framework, multi-criteria decision aid (MCDA), has emerged from the operational research field as an answer given to a couple of important questions encountered in complex decision problems. Firstly, the aim is not to replace the decision maker with a mathematical model, but to support him to construct his solution by describing and evaluating his options. Secondly, instead of using a unique criterion capturing all aspects of the problem, in MCDA one seeks to build multiple criteria, representing several points of view. The methods belonging to MCDA can be classified as multi-attribute utility/value methods, outranking methods and interactive methods. Past attempts to apply multi-criteria analysis in the context of nuclear emergency management have highlighted however the need to better integrate the operational and socio-political context of the decision-making process into the tools and models developed for decision-support. This PhD project had two main objectives: 1) to develop a multi-criteria decision aid model for the decision problem on countermeasures for contaminated milk, that better accommodates the nuclear crisis management context in Belgium and 2) to build prototype tools implementing and demonstrating the methodology developed

Decision analysis multicriteria analysis

International Nuclear Information System (INIS)

Lombard, J.

1986-09-01

The ALARA procedure covers a wide range of decisions from the simplest to the most complex one. For the simplest one the engineering judgement is generally enough and the use of a decision aiding technique is therefore not necessary. For some decisions the comparison of the available protection option may be performed from two or a few criteria (or attributes) (protection cost, collective dose,...) and the use of rather simple decision aiding techniques, like the Cost Effectiveness Analysis or the Cost Benefit Analysis, is quite enough. For the more complex decisions, involving numerous criteria or for decisions involving large uncertainties or qualitative judgement the use of these techniques, even the extended cost benefit analysis, is not recommended and appropriate techniques like multi-attribute decision aiding techniques are more relevant. There is a lot of such particular techniques and it is not possible to present all of them. Therefore only two broad categories of multi-attribute decision aiding techniques will be presented here: decision analysis and the outranking analysis

Improving nuclear power plant safety through operator aids

International Nuclear Information System (INIS)

1987-12-01

In October 1986, the IAEA convened a one-week Technical Committee Meeting on Improving Nuclear Power Plant Safety Through Operator Aids. The term ''operator aid'' or more formally ''operator support system'' refers to a class of devices designed to be added to a nuclear power plant control station to assist an operator in performing his job and thereby decrease the probability of operator error. The addition of a carefully planned and designed operator aid should result in an increase in nuclear power plant safety and reliability. Operator aids encompass a wide range of devices from the very simple, such as color coding a display to distinguish it out of a group of similar displays, to the very complex, such as a computer-generated video display which concentrates a number of scattered indicator readings located around a control room into a concise display in front of the operator. This report provides guidelines and information to help make a decision as to whether an operator aid is needed, what kinds of operator aids are available and whether it should be purchased or developed by the utility. In addition, a discussion is presented on advanced operator aids to provide information on what may become available in the future. The broad scope of these guidelines makes it most suitable for use by a multi-disciplinary team. The document consists of two parts. The recommendations and results of the meeting discussions are given in the first part. The second part is the annex where the papers presented at the Technical Committee Meeting are printed. A separate abstract was prepared for each of the 10 papers. Refs, figs and tabs

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.

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.

Decision aiding techniques for site remediation

International Nuclear Information System (INIS)

Van de Walle, B.

1996-01-01

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

Mismatch between health-care professionals' and patients' views on a diabetes patient decision aid: a qualitative study.

Science.gov (United States)

Lee, Ping Yein; Khoo, Ee Ming; Low, Wah Yun; Lee, Yew Kong; Abdullah, Khatijah Lim; Azmi, Syahidatul Akmal; Ng, Chirk Jenn

2016-04-01

Malaysia is an Asian country with population of diverse culture and health perceptions. Patient decision aid (PDA) is a new tool in Malaysia. Patients' and health-care professionals' (HCPs) expectation of a PDA is unknown. We aimed to explore patients' and health-care professionals'(HCPs) views on the information needed in a patient decision aid (PDA) on insulin initiation developed for patients with type 2 diabetes mellitus (T2DM). We used a qualitative design and thematic approach. Three main primary health-care settings in Malaysia: public university-based primary care clinics, public health-care clinics and private general practices. We conducted focus groups and one-to-one interviews with a purposive sample of health professionals and patients with type 2 diabetes. We interviewed 18 patients and 13 HCPs. Patients viewed the content of the PDA as simple and clear. However, HCPs felt the PDA might be difficult for patients with low literacy to understand. HCPs thought the PDA was too lengthy. Nevertheless, patients would prefer more information. HCPs tended to focus on benefits of insulin, while patients wanted to know the impact of insulin on their quality of life and practical issues regarding insulin and its side-effects. Patients preferred numbers to weigh the risks and benefits of treatment options. HCPs' views that presenting numbers in a PDA would be too complex for patients to understand. It is important to consider including issues related to psycho-social impact of treatment to patients when developing a patient decision aid. © 2015 John Wiley & Sons Ltd.

Women's role in reproductive health decision making and vulnerability to STD and HIV/AIDS in Ekiti, Nigeria.

Science.gov (United States)

Orubuloye, I O; Oguntimehin, F; Sadiq, T

1997-01-01

An exploratory study of women's role in reproductive decision making in Ekiti shows that women in the state are increasingly taking active decisions on matters affecting their daily lives. More women than ever before believed that they could take decisions on family size, when to have a baby and choice of spacing period. The cultural barrier against short postpartum abstinence appeared to have diminished and sex during lactation was not considered a major cultural and religious taboo. Knowledge of contraception has become universal in recent years, and the majority of women take decisions on the method and timing of family planning. All women who used family planning considered their decision in this regard very important. The ability of women to take decisions on these issues may not only enhance their bargaining power but also reduce their vulnerability to STDs including AIDS from diseased or high-risk partners.

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.

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

Science.gov (United States)

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

2014-01-01

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. A PtDA was developed and pilot tested using the International Patients Decision Aid Standards (IPDAS) criteria. Obstetric health care in the Netherlands. A multidisciplinary steering group, an expert panel, and 25 future users of the PtDA, i.e. women with a previous caesarean section. The development consisted of a construction phase (definition of scope and purpose, and selection of content, framework, and format) and a pilot testing phase by interview. The process was supervised by a multidisciplinary steering group. Usability, clarity, and relevance. The construction phase resulted in a booklet including unbiased balanced information on mode of birth after caesarean section, a preference elicitation exercise, and tailored risk information, including a prediction model for successful VBAC. During pilot testing, visualisation of risks and clarity formed the main basis for revisions. Pilot testing showed the availability of tailored structured information to be the main factor involving women in decision-making. The PtDA meets 39 out of 50 IPDAS criteria (78%): 23 out of 23 criteria for content (100%) and 16 out of 20 criteria for the development process (80%). Criteria for effectiveness (n = 7) were not evaluated. An evidence-based PtDA was developed, with the probability of successful VBAC and the availability of structured information as key items. It is likely that the PtDA enhances the quality of decision-making on mode of birth after caesarean section. © 2013 Royal College of Obstetricians and Gynaecologists.

The importance of decision-making aids in the energy area: from planning to the management of disorder and climate change

International Nuclear Information System (INIS)

Taverdet-Popiolek, N.

2011-01-01

The purpose of this article is to situate decision-making aids in the energy area in France and show how the tools have changed over time as a function of the changing economic and political context. The challenges faced, already important in the post-war era due to reconstruction, are now huge due to supply constraints and global warming. While it is the State's responsibility to address these issues, as the players in the energy area currently are mainly in the private sphere, we look at decisions taken both by the State and by companies. Schematically, we compare two major periods: that of post-war planning through the eighties, and that of risk management, which has been current practice since market deregulation. From the methodological standpoint, we show that decision-making aids borrow tools from varied disciplines ranging from economics through management to futurology and long range planning. (author)

Special Needs: Planning for Adulthood (Videos)

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Special Needs: Planning for Adulthood (Videos)

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Point-of-views representation for hypothetical reasoning: application to decision-aid

International Nuclear Information System (INIS)

Diaz, Antoine

1992-01-01

Most of the knowledge based Decision Support Systems must deal with two difficulties in problem solving representation: reasoning with incomplete knowledge and managing contradictory reasoning. We propose a method which answers the question of reasoning revision when a contradiction occurs, while preserving the functionalities of the De Kleer's ATMS System for simulating hypothetical reasoning. As a matter of fact, these functionalities are particularly suitable for decision aiding problems. In order to formalize the ATMS, we use a resolution method called Cat-resolution (Cayrol and Tayrac). This method allows the computation of ATMS functions relating to a set of propositional clauses by saturating this set. Owing to this choice, we can use the same principles as ATMS on the saturation trace. Each clause in the saturated set can be linked to the sets of initial clauses justifying its derivation by Cat-resolution. The reasoning inconsistency is now managed. First the user can identify the source of the inconsistency thanks to the empty clause explanation. Then he can try to restore the reasoning consistency by relaxing at least one of the initial clauses justifying the empty clause. The computation of 'partial' ATMS, representing a point of view in the decision-making problem, is more effective owing to the justifications of the derived clauses. (author) [fr

Special Needs: Planning for Adulthood (Videos)

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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 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.

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…

Personal Digital Video Stories

DEFF Research Database (Denmark)

Ørngreen, Rikke; Henningsen, Birgitte Sølbeck; Louw, Arnt Vestergaard

2016-01-01

The drop-out rate among students attending vocational training institutions is higher than for other forms of education at the same entry level (in Denmark, but also generally in Europe). A recent Danish reform has aided students, who enter the first part of the basic program directly from primar...... students are at school and in practical placements with companies. This may increase students’ social engagement and interest in the subject matter, together with greater awareness of professional identity, which could help decrease drop-out rates for vocational training.......The drop-out rate among students attending vocational training institutions is higher than for other forms of education at the same entry level (in Denmark, but also generally in Europe). A recent Danish reform has aided students, who enter the first part of the basic program directly from primary...... multimedia and video productions in Vocational Educational Training (VET). These video productions focused on the subjects of their future profession, and increased students’ motivation and experience of professional pride. Through a semistructured literature review, the paper then argues for a research...

Rate control scheme for consistent video quality in scalable video codec.

Science.gov (United States)

Seo, Chan-Won; Han, Jong-Ki; Nguyen, Truong Q

2011-08-01

Multimedia data delivered to mobile devices over wireless channels or the Internet are complicated by bandwidth fluctuation and the variety of mobile devices. Scalable video coding has been developed as an extension of H.264/AVC to solve this problem. Since scalable video codec provides various scalabilities to adapt the bitstream for the channel conditions and terminal types, scalable codec is one of the useful codecs for wired or wireless multimedia communication systems, such as IPTV and streaming services. In such scalable multimedia communication systems, video quality fluctuation degrades the visual perception significantly. It is important to efficiently use the target bits in order to maintain a consistent video quality or achieve a small distortion variation throughout the whole video sequence. The scheme proposed in this paper provides a useful function to control video quality in applications supporting scalability, whereas conventional schemes have been proposed to control video quality in the H.264 and MPEG-4 systems. The proposed algorithm decides the quantization parameter of the enhancement layer to maintain a consistent video quality throughout the entire sequence. The video quality of the enhancement layer is controlled based on a closed-form formula which utilizes the residual data and quantization error of the base layer. The simulation results show that the proposed algorithm controls the frame quality of the enhancement layer in a simple operation, where the parameter decision algorithm is applied to each frame.

Video genre classification using multimodal features

Science.gov (United States)

Jin, Sung Ho; Bae, Tae Meon; Choo, Jin Ho; Ro, Yong Man

2003-12-01

We propose a video genre classification method using multimodal features. The proposed method is applied for the preprocessing of automatic video summarization or the retrieval and classification of broadcasting video contents. Through a statistical analysis of low-level and middle-level audio-visual features in video, the proposed method can achieve good performance in classifying several broadcasting genres such as cartoon, drama, music video, news, and sports. In this paper, we adopt MPEG-7 audio-visual descriptors as multimodal features of video contents and evaluate the performance of the classification by feeding the features into a decision tree-based classifier which is trained by CART. The experimental results show that the proposed method can recognize several broadcasting video genres with a high accuracy and the classification performance with multimodal features is superior to the one with unimodal features in the genre classification.

Exploration of the impact of a voice activated decision support system (VADSS) with video on resuscitation performance by lay rescuers during simulated cardiopulmonary arrest.

Science.gov (United States)

Hunt, Elizabeth A; Heine, Margaret; Shilkofski, Nicole S; Bradshaw, Jamie Haggerty; Nelson-McMillan, Kristen; Duval-Arnould, Jordan; Elfenbein, Ron

2015-03-01

To assess whether access to a voice activated decision support system (VADSS) containing video clips demonstrating resuscitation manoeuvres was associated with increased compliance with American Heart Association Basic Life Support (AHA BLS) guidelines. This was a prospective, randomised controlled trial. Subjects with no recent clinical experience were randomised to the VADSS or control group and participated in a 5-min simulated out-of-hospital cardiopulmonary arrest with another 'bystander'. Data on performance for predefined outcome measures based on the AHA BLS guidelines were abstracted from videos and the simulator log. 31 subjects were enrolled (VADSS 16 vs control 15), with no significant differences in baseline characteristics. Study subjects in the VADSS were more likely to direct the bystander to: (1) perform compressions to ventilations at the correct ratio of 30:2 (VADSS 15/16 (94%) vs control 4/15 (27%), p=compressor versus ventilator roles after 2 min (VADSS 12/16 (75%) vs control 2/15 (13%), p=0.001). The VADSS group took longer to initiate chest compressions than the control group: VADSS 159.5 (±53) s versus control 78.2 (±20) s, pcontrol 75.4 (±8.0), p=0.35. The use of an audio and video assisted decision support system during a simulated out-of-hospital cardiopulmonary arrest prompted lay rescuers to follow cardiopulmonary resuscitation (CPR) guidelines but was also associated with an unacceptable delay to starting chest compressions. Future studies should explore: (1) if video is synergistic to audio prompts, (2) how mobile technologies may be leveraged to spread CPR decision support and (3) usability testing to avoid unintended consequences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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...

Special Needs: Planning for Adulthood (Videos)

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Special Needs: Planning for Adulthood (Videos)

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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.

Tracing Sequential Video Production

DEFF Research Database (Denmark)

Otrel-Cass, Kathrin; Khalid, Md. Saifuddin

2015-01-01

, for one week in 2014, and collected and analyzed visual data to learn about scientists’ practices. The visual material that was collected represented the agreed on material artifacts that should aid the students' reflective process to make sense of science technology practices. It was up to the student...... video, nature of the interactional space, and material and spatial semiotics....

Computer-generated video fly-through: an aid to visual impact assessment for windfarms

International Nuclear Information System (INIS)

Neilson, G.; Leeming, T.; Hall, S.

1998-01-01

Computer generated video fly-through provides a new method of assessing the visual impact of wind farms. With a PC, software and digital terrain model of the wind farm it is possible to produce videos ranging from wireframe to realistically shaded models. Using computer generated video fly-through visually sensitive corridors can be explored fully, wind turbine rotors can be seen in motion, critical viewpoints can be identified for photomontages and the context of the wind farm appreciated better. This paper describes the techniques of computer generated video fly through and examines its various applications in visual impact assessment of wind farms. (Author)

Design and development of a decision aid to enhance shared decision making by patients with an asymptomatic abdominal aortic aneurysm

Directory of Open Access Journals (Sweden)

Dirk T Ubbink

2008-11-01

Full Text Available Dirk T Ubbink1,2, Anouk M Knops1, Sjaak Molenaar1, Astrid Goossens11Department of Quality Assurance and Process Innovation and 2Department of Surgery, Academic Medical Center, Amsterdam, The NetherlandsObjective: To design, develop, and evaluate an evidence-based decision aid (DA for patients with an asymptomatic abdominal aortic aneurysm (AAA to inform them about the pros and cons of their treatment options (ie, surgery or watchful observation and to help them make a shared decision.Methods: A multidisciplinary team defined criteria for the desired DA as to design, medical content and functionality, particularly for elderly users. Development was according to the international standard (IPDAS. Fifteen patients with an AAA, who were either treated or not yet treated, evaluated the tool.Results: A DA was developed to offer information about the disease, the risks and benefits of surgical treatment and watchful observation, and the individual possibilities and threats based on the patient’s aneurysm diameter and risk profile. The DA was improved and judged favorably by physicians and patients.Conclusion: This evidence-based DA for AAA patients, developed according to IPDAS criteria, is likely to be a simple, user-friendly tool to offer patients evidence-based information about the pros and cons of treatment options for AAA, to improve patients’ understanding of the disease and treatment options, and may support decision making based on individual values.Keywords: decision support techniques, research design, program development, abdominal aortic aneurysm, decision making

Does Patient Preference Measurement in Decision Aids Improve Decisional Conflict? A Randomized Trial in Men with Prostate Cancer.

Science.gov (United States)

Shirk, Joseph D; Crespi, Catherine M; Saucedo, Josemanuel D; Lambrechts, Sylvia; Dahan, Ely; Kaplan, Robert; Saigal, Christopher

2017-12-01

Shared decision making (SDM) has been advocated as an approach to medical decision making that can improve decisional quality. Decision aids are tools that facilitate SDM in the context of limited physician time; however, many decision aids do not incorporate preference measurement. We aim to understand whether adding preference measurement to a standard patient educational intervention improves decisional quality and is feasible in a busy clinical setting. Men with incident localized prostate cancer (n = 122) were recruited from the Greater Los Angeles Veterans Affairs (VA) Medical Center urology clinic, Olive View UCLA Medical Center, and Harbor UCLA Medical Center from January 2011 to May 2015 and randomized to education with a brochure about prostate cancer treatment or software-based preference assessment in addition to the brochure. Men undergoing preference assessment received a report detailing the relative strength of their preferences for treatment outcomes used in review with their doctor. Participants completed instruments measuring decisional conflict, knowledge, SDM, and patient satisfaction with care before and/or after their cancer consultation. Baseline knowledge scores were low (mean 62%). The baseline mean total score on the Decisional Conflict Scale was 2.3 (±0.9), signifying moderate decisional conflict. Men undergoing preference assessment had a significantly larger decrease in decisional conflict total score (p = 0.023) and the Perceived Effective Decision Making subscale (p = 0.003) post consult compared with those receiving education only. Improvements in satisfaction with care, SDM, and knowledge were similar between groups. Individual-level preference assessment is feasible in the clinic setting. Patients with prostate cancer who undergo preference assessment are more certain about their treatment decisions and report decreased levels of decisional conflict when making these decisions.

Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools.

Science.gov (United States)

Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S; Aguirre, Alejandra N; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D; Kukafka, Rita

2015-01-01

The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention.

Video: useful tool for delivering family planning messages.

Science.gov (United States)

Sumarsono, S K

1985-10-01

cheaper and simpler than film production. Video will be very helpful as a communication aid in group meetings. It can also be used as a teaching aid for training.

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

Security training with interactive laser-video-disk technology

International Nuclear Information System (INIS)

Wilson, D.

1988-01-01

DOE, through its contractor EG and G Energy Measurements, Inc., has developed a state-of-the-art interactive-video system for use at the Department of Energy's Central Training Academy. Called the Security Training and Evaluation Shooting System (STRESS), the computer-driven decision shooting system employs the latest is laservideo-disk technology. STRESS is designed to provide realistic and stressful training for security inspectors employed by the DOE and its contractors. The system uses wide-screen video projection, sophisticated scenario-branching technology, and customized video scenarios especially designed for the DOE. Firing a weapon that has been modified to shoot ''laser bullets,'' and wearing a special vest that detects ''hits'': the security inspector encounters adversaries on the wide screen who can shoot or be shot by the inspector in scenarios that demand fast decisions. Based on those decisions, the computer provides instantaneous branching to different scenes, giving the inspector confrontational training with the realism and variability of real life

Serious Video Games for Health How Behavioral Science Guided the Development of a Serious Video Game.

Science.gov (United States)

Thompson, Debbe; Baranowski, Tom; Buday, Richard; Baranowski, Janice; Thompson, Victoria; Jago, Russell; Griffith, Melissa Juliano

2010-08-01

Serious video games for health are designed to entertain players while attempting to modify some aspect of their health behavior. Behavior is a complex process influenced by multiple factors, often making it difficult to change. Behavioral science provides insight into factors that influence specific actions that can be used to guide key game design decisions. This article reports how behavioral science guided the design of a serious video game to prevent Type 2 diabetes and obesity among youth, two health problems increasing in prevalence. It demonstrates how video game designers and behavioral scientists can combine their unique talents to create a highly focused serious video game that entertains while promoting behavior change.

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.

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.

Temporal visual cues aid speech recognition

DEFF Research Database (Denmark)

Zhou, Xiang; Ross, Lars; Lehn-Schiøler, Tue

2006-01-01

of audio to generate an artificial talking-face video and measured word recognition performance on simple monosyllabic words. RESULTS: When presenting words together with the artificial video we find that word recognition is improved over purely auditory presentation. The effect is significant (p......BACKGROUND: It is well known that under noisy conditions, viewing a speaker's articulatory movement aids the recognition of spoken words. Conventionally it is thought that the visual input disambiguates otherwise confusing auditory input. HYPOTHESIS: In contrast we hypothesize...... that it is the temporal synchronicity of the visual input that aids parsing of the auditory stream. More specifically, we expected that purely temporal information, which does not convey information such as place of articulation may facility word recognition. METHODS: To test this prediction we used temporal features...

Polar Coding with CRC-Aided List Decoding

Science.gov (United States)

2015-08-01

TECHNICAL REPORT 2087 August 2015 Polar Coding with CRC-Aided List Decoding David Wasserman Approved...list decoding . RESULTS Our simulation results show that polar coding can produce results very similar to the FEC used in the Digital Video...standard. RECOMMENDATIONS In any application for which the DVB-S2 FEC is considered, polar coding with CRC-aided list decod - ing with N = 65536

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...

Special Needs: Planning for Adulthood (Videos)

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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...

Decision making in the reactor control room

International Nuclear Information System (INIS)

Nelson, W.R.

1982-01-01

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

Can social tagged images aid concept-based video search?

NARCIS (Netherlands)

Setz, A.T.; Snoek, C.G.M.

2009-01-01

This paper seeks to unravel whether commonly available social tagged images can be exploited as a training resource for concept-based video search. Since social tags are known to be ambiguous, overly personalized, and often error prone, we place special emphasis on the role of disambiguation. We

Decisions and Reasons: Examining Preservice Teacher Decision-Making through Video Self-Analysis

Science.gov (United States)

Rich, Peter J.; Hannafin, Michael J.

2008-01-01

Methods used to study teacher thinking have both provided insight into the cognitive aspects of teaching and resulted in new, as yet unresolved, relationships between practice and theory. Recent developments in video-analysis tools have allowed preservice teachers to analyze both their practices and thinking, providing important feedback for…

a Sensor Aided H.264/AVC Video Encoder for Aerial Video Sequences with in the Loop Metadata Correction

Science.gov (United States)

Cicala, L.; Angelino, C. V.; Ruatta, G.; Baccaglini, E.; Raimondo, N.

2015-08-01

Unmanned Aerial Vehicles (UAVs) are often employed to collect high resolution images in order to perform image mosaicking and/or 3D reconstruction. Images are usually stored on board and then processed with on-ground desktop software. In such a way the computational load, and hence the power consumption, is moved on ground, leaving on board only the task of storing data. Such an approach is important in the case of small multi-rotorcraft UAVs because of their low endurance due to the short battery life. Images can be stored on board with either still image or video data compression. Still image system are preferred when low frame rates are involved, because video coding systems are based on motion estimation and compensation algorithms which fail when the motion vectors are significantly long and when the overlapping between subsequent frames is very small. In this scenario, UAVs attitude and position metadata from the Inertial Navigation System (INS) can be employed to estimate global motion parameters without video analysis. A low complexity image analysis can be still performed in order to refine the motion field estimated using only the metadata. In this work, we propose to use this refinement step in order to improve the position and attitude estimation produced by the navigation system in order to maximize the encoder performance. Experiments are performed on both simulated and real world video sequences.

A Novel Decision Aid to Support Informed Decision-Making Process in Patients with a Symptomatic Nonlower Pole Renal Stone <20 mm in Diameter.

Science.gov (United States)

Gökce, Mehmet İlker; Esen, Barış; Sancı, Adem; Akpınar, Cağrı; Süer, Evren; Gülpınar, Ömer

2017-07-01

Stone disease is an important health problem, and patients have different treatment choices. Shared decision making is recommended for deciding the treatment type, but patient education is necessary. Decision aids (DAs) are used for this aim, and herein, we developed a novel DA for patients with symptomatic nonlower pole renal stones group assessment resulted in a total score of 50/54. Patient evaluation of the DA resulted in favorable outcomes, and patients generally recommended its use by other patients. This novel DA for patients with a symptomatic nonlower pole renal stone <20 mm showed promising results and was well accepted by the patients. We believe that this DA will have a positive impact on patients' level of knowledge. Increased level of knowledge will also improve the patients' contribution to the shared decision-making process. A further prospective randomized trial to compare with the standard patient informing process is also planned.

"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.

The development and use of decision aiding techniques for establishing intervention levels

International Nuclear Information System (INIS)

Kelly, G.N.; Sinnaeve, J.

1989-01-01

Following the Chernobyl accident there has been considerable international discussion on the principles underlying the choice of intervention levels and their practical application. While there is broad agreement on the underlying principles - that is to put potentially exposed individuals into a better position in the sense that lower overall risks are achieved at reasonable cost in financial and social terms - the determination of what constitutes the most appropriate type and level of intervention in any particular circumstances is more complex. Within the CEC Radiation Protection Research Programme techniques are being developed to aid well founded and more transparent decisions on the choice of intervention levels. The techniques are described and areas identified where they might usefully be applied

The Wind Atlas for South Africa (WASA): A tool to aid developers and decision makers

CSIR Research Space (South Africa)

Mabille, E

2015-10-01

Full Text Available ): A tool to aid developers and decision makers Eugene Mabille The WASA Project Team SANEDI South African National Energy Development Institute • executing agency – contracting the implementing partners • coordination and dissemination UCT... to produce wind atlas for generalised surface conditions (uniform terrain and roughness). Files compatible with WAsP software.  Used for the first WASA published in 2012.  KAMM/WAsP method, numerically very cheap, gives good results  underestimation...

Special Needs: Planning for Adulthood (Videos)

Medline Plus

Full Text Available [Skip to Content] for Parents Parents site Sitio para padres General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ...

Viral Transmissions: Safer Sex Videos, Disability, and Queer Politics

Directory of Open Access Journals (Sweden)

Karisa Butler-Wall

2016-12-01

Full Text Available Bringing disability studies into conversation with queer histories of AIDS activism, this article examines the relationship between disability and queer politics in safer sex videos created by AIDS activists in the 1980s. As a form of what the author terms "guerrilla biopolitics," safer sex videos insisted on the viability of queer life and sexual expression at a historical moment of intense homophobia and sex negativity. At the same time, the vision of sexual health and identity they offered risked reproducing racialized and classed ideologies of ableism. Seeking to "crip" our understandings of safer sex discourses and practices, this study explores how risk reduction techniques have been historically linked to imperatives of compulsory able-bodiedness, precluding alternative expressions of queer/crip life.

Effect of decision aid for breast cancer prevention on decisional conflict in women with a BRCA1 or BRCA2 mutation: a multisite, randomized, controlled trial.

Science.gov (United States)

Metcalfe, Kelly A; Dennis, Cindy-Lee; Poll, Aletta; Armel, Susan; Demsky, Rochelle; Carlsson, Lindsay; Nanda, Sonia; Kiss, Alexander; Narod, Steven A

2017-03-01

Women with a BRCA1 or BRCA2 mutation are at high risk for breast cancer and must make important decisions about breast cancer prevention and screening. In the current study, we report a multisite, randomized, controlled trial evaluating the effectiveness of a decision aid for breast cancer prevention in women with a BRCA mutation with no previous diagnosis of cancer. Within 1 month of receiving a positive BRCA result, women were randomized to receive either usual care (control group) or decision aid (intervention group). Participants were followed at 3, 6, and 12 months; were asked about preventive measures; and completed standardized questionnaires assessing decision making and psychosocial functioning. One hundred fifty women were randomized. Mean cancer-related distress scores were significantly lower in the intervention group compared with the control group at 6 months (P = 0.01) and at 12 months postrandomization (P = 0.05). Decisional conflict scores declined over time for both groups and at no time were there statistical differences between the two groups. The decision aid for breast cancer prevention in women with a BRCA1 or BRCA2 mutation is effective in significantly decreasing cancer-related distress within the year following receipt of positive genetic test results.Genet Med 19 3, 330-336.

Effect of decision making on ultrasonic examination performance

International Nuclear Information System (INIS)

Harris, D.H.

1992-05-01

A decision aid was developed to overcome examiner limitations in information processing and decision making during ultrasonic examinations. The aid provided a means of noting signal characteristics as they were observed during the examination, and of presenting them simultaneously for decision making. The aid also served as a way of providing detailed feedback on examination performance during training. The aid was incorporated into worksheets used for the conduct of practice examinations during ultrasonic examination training. To support the introduction and use of the decision aid, one hour of supplementary training was inserted in an existing 64-hour training course on ultrasonic detection of defects. This study represented a modest step in improving the performance of ultrasonic examinations in nuclear power plants. Findings indicated that aided decision making supported by limited training can significantly improve ultrasonic detection performance

Developing an Android-Based Patient Decision Aid Based on Ottawa Standards for Patients After Kidney Transplant and Its Usability Evaluation.

Science.gov (United States)

Zare Moayedi, Mahboobeh; Aslani, Azam; Fakhrahmad, Mostafa; Ezzatzadegan J, Shahrokh

2018-01-01

This study was conducted to develop an android based patient decision aid (PDA) as a self-care instrument for patients after kidney transplant and its usability evaluation. In this study, the systematic development process of Android-based self-care application for patients after kidney transplant based on Ottawa standard was included: scoping, assemble steering group, analysis of requirements, designing, develop of a prototype and system evaluation. The PDA is a self-triage system that will help early identification of risk symptoms in patients, and help manage them. System recommendations for risk signs are: Refer to the nearest hospital or healthcare center without delay, refer to the doctor and tell your doctor in the next visit. To identify patient care needs, a semi-structured interview with members of steering group, including patients and clinical experts, was conducted by the researchers. A prototype of the decision aid was made according to identified needs in the previous step. Finally, in order to evaluate its usability rate by using the System Usability Scale (SUS) questionnaire, it was used by exerts and patients. This study identified information needs, risk signs and steps that patients need to make appropriate decisions about them. The main capabilities of the decision aid are features such as reminders for appointment/test, time of taking medication, registration of symptoms, weight, blood pressure, body temperature, advising to patient in case of signs of risk, weight, blood pressure, body temperature and test results which were reported in the diagram. The mean score of system's usability evaluated by medical informatics specialists, clinicians, and patients were 88.33, 95, and 91. PDAs was usable and desirable from the point of view of medical informatics specialists, clinicians and patients.

Medical video server construction.

Science.gov (United States)

Dańda, Jacek; Juszkiewicz, Krzysztof; Leszczuk, Mikołaj; Loziak, Krzysztof; Papir, Zdzisław; Sikora, Marek; Watza, Rafal

2003-01-01

The paper discusses two implementation options for a Digital Video Library, a repository used for archiving, accessing, and browsing of video medical records. Two crucial issues to be decided on are a video compression format and a video streaming platform. The paper presents numerous decision factors that have to be taken into account. The compression formats being compared are DICOM as a format representative for medical applications, both MPEGs, and several new formats targeted for an IP networking. The comparison includes transmission rates supported, compression rates, and at least options for controlling a compression process. The second part of the paper presents the ISDN technique as a solution for provisioning of tele-consultation services between medical parties that are accessing resources uploaded to a digital video library. There are several backbone techniques (like corporate LANs/WANs, leased lines or even radio/satellite links) available, however, the availability of network resources for hospitals was the prevailing choice criterion pointing to ISDN solutions. Another way to provide access to the Digital Video Library is based on radio frequency domain solutions. The paper describes possibilities of both, wireless and cellular network's data transmission service to be used as a medical video server transport layer. For the cellular net-work based solution two communication techniques are used: Circuit Switched Data and Packet Switched Data.

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

Decision-Aiding and Optimization for Vertical Navigation of Long-Haul Aircraft

Science.gov (United States)

Patrick, Nicholas J. M.; Sheridan, Thomas B.

1996-01-01

different airspace design and air traffic management policies. A decision aid is proposed which would combine the pilot's notion of optimality with the GA-based optimization, provide the pilot with a number of alternative pareto-optimal trajectories, and allow him to consider unmodelled attributes and constraints in choosing among them. A solution to the problem of displaying alternatives in a multi-attribute decision space is also presented.

A randomized study of multimedia informational aids for research on medical practices: Implications for informed consent.

Science.gov (United States)

Kraft, Stephanie A; Constantine, Melissa; Magnus, David; Porter, Kathryn M; Lee, Sandra Soo-Jin; Green, Michael; Kass, Nancy E; Wilfond, Benjamin S; Cho, Mildred K

2017-02-01

Participant understanding is a key element of informed consent for enrollment in research. However, participants often do not understand the nature, risks, benefits, or design of the studies in which they take part. Research on medical practices, which studies standard interventions rather than new treatments, has the potential to be especially confusing to participants because it is embedded within usual clinical care. Our objective in this randomized study was to compare the ability of a range of multimedia informational aids to improve participant understanding in the context of research on medical practices. We administered a web-based survey to members of a proprietary online panel sample selected to match national US demographics. Respondents were randomized to one of five arms: four content-equivalent informational aids (animated videos, slideshows with voice-over, comics, and text) and one no-intervention control. We measured knowledge of research on medical practices using a summary knowledge score from 10 questions based on the content of the informational aids. We used analysis of variance and paired t-tests to compare knowledge scores between arms. There were 1500 completed surveys (300 in each arm). Mean knowledge scores were highest for the slideshows with voice-over (65.7%), followed by the animated videos (62.7%), comics (60.7%), text (57.2%), and control (50.3%). Differences between arms were statistically significant except between the slideshows with voice-over and animated videos and between the animated videos and comics. Informational aids that included an audio component (animated videos and slideshows with voice-over) had higher knowledge scores than those without an audio component (64.2% vs 59.0%, p informational aids with a character-driven story component (animated videos and comics) and those without. Our results show that simple multimedia aids that use a dual-channel approach, such as voice-over with visual reinforcement, can

Review of decision aids for nuclear-plant operators

International Nuclear Information System (INIS)

Kisner, R.A.

1983-01-01

Responses to various computer-based operational aids varied widely in detail, thus forcing distillation of the salient features of many operational aids from information sources other than the initial questionnaire. These sources included technical and management presentations, technical papers and reports, personal discussions, taped responses, sales brochures, system specifications and schematics, and other documents. The data base is dynamic, not static, owing to the nature of current trends in operational aid development. The information contained in it is subject to review and revision by the developing organizations. More systems are pending review and entry into the data base; hence the list is incomplete

Video in Non-Formal Education: A Bibliographical Study.

Science.gov (United States)

Lewis, Peter M.

Intended to inform United Nations member states about the application of electronic recording and replaying devices in the nonformal education domain, this bibliographic study surveys the literature on video. Since the study is meant to be of particular use to decision makers in developing countries, video projects in North America and Western…

Impact of a web-based prostate cancer treatment decision aid on patient-reported decision process parameters: results from the Prostate Cancer Patient Centered Care trial.

Science.gov (United States)

Cuypers, Maarten; Lamers, Romy E D; Kil, Paul J M; van de Poll-Franse, Lonneke V; de Vries, Marieke

2018-05-12

To compare patients' evaluation of the treatment decision-making process in localized prostate cancer between counseling that included an online decision aid (DA) and standard counseling. Eighteen Dutch hospitals were randomized to DA counseling (n = 235) or the control group with standard counseling (n = 101) in a pragmatic, cluster randomized controlled trial. The DA was provided to patients at, or soon after diagnosis. Decisional conflict, involvement, knowledge, and satisfaction with information were assessed with a questionnaire after treatment decision-making. Anxiety and depression served as covariates. The levels of decision involvement and conflict were comparable between patients in both groups. Patients with a DA felt more knowledgeable but scored equally well on a knowledge test as patients without a DA. Small significant negative effects were found on satisfaction with information and preparation for decision-making. A preference for print over online and depression and anxiety symptoms was negatively associated with satisfaction and conflict scores in the DA group. The DA aimed to support shared decision-making, while outcomes for a majority of DA users were comparable to patients who received standard counseling. Patients, who are less comfortable with the online DA format or experience anxiety or depression symptoms, could require more guidance toward shared decision-making. To evaluate long-term DA effects, follow-up evaluation on treatment satisfaction and decisional regret will be done.

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.

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

International Nuclear Information System (INIS)

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

Adaptive Intrusion Data System (AIDS)

International Nuclear Information System (INIS)

Corlis, N.E.

1980-05-01

The adaptive intrusion data system (AIDS) was developed to collect data from intrusion alarm sensors as part of an evaluation system to improve sensor performance. AIDS is a unique data system which uses computer controlled data systems, video cameras and recorders, analog-to-digital conversion, environmental sensors, and digital recorders to collect sensor data. The data can be viewed either manually or with a special computerized data-reduction system which adds new data to a data base stored on a magnetic disc recorder. This report provides a synoptic account of the AIDS as it presently exists. Modifications to the purchased subsystems are described, and references are made to publications which describe the Sandia-designed subsystems

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.

Serious Video Games for Health How Behavioral Science Guided the Development of a Serious Video Game

OpenAIRE

Thompson, Debbe; Baranowski, Tom; Buday, Richard; Baranowski, Janice; Thompson, Victoria; Jago, Russell; Griffith, Melissa Juliano

2010-01-01

Serious video games for health are designed to entertain players while attempting to modify some aspect of their health behavior. Behavior is a complex process influenced by multiple factors, often making it difficult to change. Behavioral science provides insight into factors that influence specific actions that can be used to guide key game design decisions. This article reports how behavioral science guided the design of a serious video game to prevent Type 2 diabetes and obesity among you...

Preparing Parents to Make An Informed Choice About Antibiotic Use for Common Acute Respiratory Infections in Children: A Randomised Trial of Brief Decision Aids in a Hypothetical Scenario.

Science.gov (United States)

Coxeter, Peter D; Del Mar, Chris B; Hoffmann, Tammy C

2017-08-01

Childhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process. The aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children. Adult parents of children aged 1-16 years (n = 120) were recruited from community settings and then randomised using a computer-generated randomisation sequence to receive a decision aid (n = 60) or fact sheet (n = 60). Allocation was concealed and used sealed and opaque sequentially numbered envelopes. Participants self-completed questionnaires at baseline and immediately post-intervention. The primary outcome was informed choice (conceptual and numerical knowledge; attitudes towards, and intention to use, antibiotics for a future ARI). Secondary outcomes were decisional conflict, decisional self-efficacy, and material acceptability. After reading the information, significantly more intervention group participants made an informed choice [57%] compared with control group participants [29%] [difference 28, 95% confidence interval (CI) 11-45%, p decision aids prepared parents to make an informed choice about antibiotic use more than fact sheets, in a hypothetical situation. Their effect within a consultation needs to be evaluated. Clinical Trials Registration Number: ACTRN12615000843550.

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

not include such ‘sureness’ criteria. Methods: In the fixed criteria arm of an Australian trial of decision aids relating to PSA testing for prostate cancer 727 respondents supplied their importance weights for 5 criteria (loss of lifetime, needless biopsy, and bowel, urinary and sexual problems). Combining...... 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...... was calculated and those whose AD was .01 or less were defined as being in effective equipoise. These ADs were then correlated with respondent’s scores on the self-weighted and self-rated instrument, MyDecisionQuality, which contains 8 items (Options, Effects, Importance, Chances, Trust, Support, Control...

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

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

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

Science.gov (United States)

Husain, Sara; Kadir, Masood; Fatmi, Zafar

2007-01-23

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

Evaluating the content and development of decision aid tools for the management of menopause: A scoping review.

Science.gov (United States)

Siyam, Tasneem; Sultani, Humirah; Ross, Sue; Chatterley, Trish; Yuksel, Nese

2017-12-01

Decision-making during menopause (especially surgical menopause) can be complex given the variability in risk-benefit perceptions of menopausal treatments. Decision aid tools (DATs) help women participate in decision-making about options. Our objective is to identify and evaluate the content and development of DATs for managing menopause, with a special focus on surgical menopause. We systematically searched electronic databases, including MEDLINE and EMBASE, from inception to March 2017 for relevant records. The principal inclusion criterion was that papers reported studies on DATs for managing menopause. Search terms were derived from two concepts: menopause and DATs. Data extracted were presented in written evidence tables and narrative summaries. Our search yielded 18,801 records. Of these, 26 records met our inclusion criteria, which gave rise to 12 DATs from peer-reviewed literature and 6 from grey literature. Seventeen DATs were focused on natural menopause and two targeted surgical menopause, both identified from grey literature. More than half were published before the Women's Health Initiative (WHI) publication and 70% before the release of the International Patient Decision Aid Standards (IPDAS). Very few studies reported the full development of the DAT involved, and less than half of DATs were informed by a needs assessment to identify the decisional needs of their target population. Most DATs focused on hormone therapy as a treatment option and did not provide a comprehensive overview of other options. None of the DATs reported the steps involved in finding, appraising and summarizing scientific content of the tool. This review highlights several limitations in the content and development of DATs for managing menopause. No peer-reviewed DATs were identified for surgical menopause. A need for a complete, evidence-based DAT in the context of surgical menopause is identified. Copyright © 2017 Elsevier B.V. All rights reserved.

Right For Me: protocol for a cluster randomised trial of two interventions for facilitating shared decision-making about contraceptive methods.

Science.gov (United States)

Thompson, Rachel; Manski, Ruth; Donnelly, Kyla Z; Stevens, Gabrielle; Agusti, Daniela; Banach, Michelle; Boardman, Maureen B; Brady, Pearl; Colón Bradt, Christina; Foster, Tina; Johnson, Deborah J; Li, Zhongze; Norsigian, Judy; Nothnagle, Melissa; Olson, Ardis L; Shepherd, Heather L; Stern, Lisa F; Tosteson, Tor D; Trevena, Lyndal; Upadhya, Krishna K; Elwyn, Glyn

2017-10-22

Despite the observed and theoretical advantages of shared decision-making in a range of clinical contexts, including contraceptive care, there remains a paucity of evidence on how to facilitate its adoption. This paper describes the protocol for a study to assess the comparative effectiveness of patient-targeted and provider-targeted interventions for facilitating shared decision-making about contraceptive methods. We will conduct a 2×2 factorial cluster randomised controlled trial with four arms: (1) video+prompt card, (2) decision aids+training, (3) video+prompt card and decision aids+training and (4) usual care. The clusters will be clinics in USA that deliver contraceptive care. The participants will be people who have completed a healthcare visit at a participating clinic, were assigned female sex at birth, are aged 15-49 years, are able to read and write English or Spanish and have not previously participated in the study. The primary outcome will be shared decision-making about contraceptive methods. Secondary outcomes will be the occurrence of a conversation about contraception in the healthcare visit, satisfaction with the conversation about contraception, intended contraceptive method(s), intention to use a highly effective method, values concordance of the intended method(s), decision regret, contraceptive method(s) used, use of a highly effective method, use of the intended method(s), adherence, satisfaction with the method(s) used, unintended pregnancy and unwelcome pregnancy. We will collect study data via longitudinal patient surveys administered immediately after the healthcare visit, four weeks later and six months later. We will disseminate results via presentations at scientific and professional conferences, papers published in peer-reviewed, open-access journals and scientific and lay reports. We will also make an anonymised copy of the final participant-level dataset available to others for research purposes. Clinical

Improving Hearing Aid Self-Efficacy and Utility Through Revising a Hearing Aid User Guide: A Pilot Study.

Science.gov (United States)

McMullan, Alexandra; Kelly-Campbell, Rebecca J; Wise, Kim

2018-03-08

This pilot study aimed to investigate whether revising a hearing aid user guide (HAUG) is associated with improved hearing aid self-efficacy and utility performance. In Part 1, an HAUG was evaluated using the Suitability Assessment of Material (SAM) and readability formulas (Flesch Reading Ease [Flesch, 1943], Flesch-Kincaid Readability Formula [Kincaid, Fishburne, Rogers, & Chissom, 1957], and Simple Measure of Gobbledygook [McLaughlin, 1969]). The HAUG was revised using results from the SAM and best practice guidelines. The revision included generating a video. In Part 2, 30 adults with hearing impairment were randomly assigned to use either the original guide (N = 15) or the revised guide and video (N = 15) to perform a utility task. Participants' self-efficacy was measured using the Basic and Advanced Handling subscales of the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids questionnaire. SAM and readability were compared between the original and revised guides (Doak, Doak, & Root, 1996). SAM and readability were improved following the revision. Participants in the revised guide group performed significantly better on the utility task and on the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids subscales than participants in the original guide group. These results are encouraging as they indicate that there is scope to influence self-efficacy and utility performance through the use of appropriate HAUGs.

Patient and family communication during consultation visits: The effects of a decision aid for treatment decision-making for localized prostate cancer.

Science.gov (United States)

Song, Lixin; Tyler, Christina; Clayton, Margaret F; Rodgiriguez-Rassi, Eleanor; Hill, Latorya; Bai, Jinbing; Pruthi, Raj; Bailey, Donald E

2017-02-01

To analyze the effects of a decision aid on improving patients' and family members' information giving and question asking during consultations for prostate cancer treatment decision-making. This study is a secondary analysis of archived audio-recorded real-time consultation visits with participants from a randomized clinical trial. Participants were randomly assigned into three groups: TD-intervention targeted patient-only; TS-intervention targeted patients and family members; and control-a handout on staying healthy during treatment. We conducted content analysis using a researcher-developed communication coding system. Using SAS 9.3, we conducted Chi-square/Fisher's exact test to examine whether information giving and question asking among patients and family members varied by groups when discussing different content/topics. Compared with those in the TS and control groups, significantly higher percentages of participants in the TD group demonstrated information giving in discussing topics about diagnosis, treatment options, risks and benefits, and preferences; and engaged in question asking when discussing diagnosis, watchful waiting/active surveillance, risks and benefits, and preferences for treatment impacts. Information support and communication skills training for patients were effective in improving communication during treatment decision-making consultations. Providing information about prostate cancer and communication skills training empower patients and their family members. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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.

Nest-crowdcontrol: Advanced video-based crowd monitoring for large public events

OpenAIRE

Monari, Eduardo; Fischer, Yvonne; Anneken, Mathias

2015-01-01

Current video surveillance systems still lack of intelligent video and data analysis modules for supporting situation awareness of decision makers. Especially in mass gatherings like large public events, the decision maker would benefit from different views of the area, especially from crowd density estimations. This article describes a multi-camera system called NEST and its application for crowd density analysis. First, the overall system design is presented. Based on this, the crowd densit...

Hierarchical structure for audio-video based semantic classification of sports video sequences

Science.gov (United States)

Kolekar, M. H.; Sengupta, S.

2005-07-01

A hierarchical structure for sports event classification based on audio and video content analysis is proposed in this paper. Compared to the event classifications in other games, those of cricket are very challenging and yet unexplored. We have successfully solved cricket video classification problem using a six level hierarchical structure. The first level performs event detection based on audio energy and Zero Crossing Rate (ZCR) of short-time audio signal. In the subsequent levels, we classify the events based on video features using a Hidden Markov Model implemented through Dynamic Programming (HMM-DP) using color or motion as a likelihood function. For some of the game-specific decisions, a rule-based classification is also performed. Our proposed hierarchical structure can easily be applied to any other sports. Our results are very promising and we have moved a step forward towards addressing semantic classification problems in general.

Multi-criteria decision aid approach for the selection of the best compromise management scheme for ELVs: the case of Cyprus.

Science.gov (United States)

Mergias, I; Moustakas, K; Papadopoulos, A; Loizidou, M

2007-08-25

Each alternative scheme for treating a vehicle at its end of life has its own consequences from a social, environmental, economic and technical point of view. Furthermore, the criteria used to determine these consequences are often contradictory and not equally important. In the presence of multiple conflicting criteria, an optimal alternative scheme never exists. A multiple-criteria decision aid (MCDA) method to aid the Decision Maker (DM) in selecting the best compromise scheme for the management of End-of-Life Vehicles (ELVs) is presented in this paper. The constitution of a set of alternatives schemes, the selection of a list of relevant criteria to evaluate these alternative schemes and the choice of an appropriate management system are also analyzed in this framework. The proposed procedure relies on the PROMETHEE method which belongs to the well-known family of multiple criteria outranking methods. For this purpose, level, linear and Gaussian functions are used as preference functions.

S4HARA: System for HIV/AIDS resource allocation.

Science.gov (United States)

Lasry, Arielle; Carter, Michael W; Zaric, Gregory S

2008-03-26

HIV/AIDS resource allocation decisions are influenced by political, social, ethical and other factors that are difficult to quantify. Consequently, quantitative models of HIV/AIDS resource allocation have had limited impact on actual spending decisions. We propose a decision-support System for HIV/AIDS Resource Allocation (S4HARA) that takes into consideration both principles of efficient resource allocation and the role of non-quantifiable influences on the decision-making process for resource allocation. S4HARA is a four-step spreadsheet-based model. The first step serves to identify the factors currently influencing HIV/AIDS allocation decisions. The second step consists of prioritizing HIV/AIDS interventions. The third step involves allocating the budget to the HIV/AIDS interventions using a rational approach. Decision-makers can select from several rational models of resource allocation depending on availability of data and level of complexity. The last step combines the results of the first and third steps to highlight the influencing factors that act as barriers or facilitators to the results suggested by the rational resource allocation approach. Actionable recommendations are then made to improve the allocation. We illustrate S4HARA in the context of a primary healthcare clinic in South Africa. The clinic offers six types of HIV/AIDS interventions and spends US$750,000 annually on these programs. Current allocation decisions are influenced by donors, NGOs and the government as well as by ethical and religious factors. Without additional funding, an optimal allocation of the total budget suggests that the portion allotted to condom distribution be increased from 1% to 15% and the portion allotted to prevention and treatment of opportunistic infections be increased from 43% to 71%, while allocation to other interventions should decrease. Condom uptake at the clinic should be increased by changing the condom distribution policy from a pull system to a push

Assessing the acceptability and usability of an interactive serious game in aiding treatment decisions for patients with localized prostate cancer.

Science.gov (United States)

Reichlin, Lindsey; Mani, Nithya; McArthur, Kara; Harris, Amy M; Rajan, Nithin; Dacso, Clifford C

2011-01-12

Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men's awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers. This study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game. The study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey. A total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient's health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes. Serious games are a promising approach to health education and decision support for older men. Participants

Improving Listening And Speaking Skills By Using Animation Videos And Discussion Method

OpenAIRE

Amalia, Rizka

2014-01-01

Listening and speaking are the important skills that have to be mastered by the students. By having these skills, the students can communicate with others easily. There are many strategies that can be used to teach listening and speaking skills. One of the strategies is by using animation videos. Many students of all ages still like watching animation videos for they are interesting. Animation videos can help the students more understand because they present visual context aids that assist th...

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...

Computer-Aided Facilities Management Systems (CAFM).

Science.gov (United States)

Cyros, Kreon L.

Computer-aided facilities management (CAFM) refers to a collection of software used with increasing frequency by facilities managers. The six major CAFM components are discussed with respect to their usefulness and popularity in facilities management applications: (1) computer-aided design; (2) computer-aided engineering; (3) decision support…

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.

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.

Experience in a Climate Microworld: Influence of Surface and Structure Learning, Problem Difficulty, and Decision Aids in Reducing Stock-Flow Misconceptions

Directory of Open Access Journals (Sweden)

Medha Kumar

2018-03-01

Full Text Available Research shows that people’s wait-and-see preferences for actions against climate change are a result of several factors, including cognitive misconceptions. The use of simulation tools could help reduce these misconceptions concerning Earth’s climate. However, it is still unclear whether the learning in these tools is of the problem’s surface features (dimensions of emissions and absorptions and cover-story used or of the problem’s structural features (how emissions and absorptions cause a change in CO2 concentration under different CO2 concentration scenarios. Also, little is known on how problem’s difficulty in these tools (the shape of CO2 concentration trajectory, as well as the use of these tools as a decision aid influences performance. The primary objective of this paper was to investigate how learning about Earth’s climate via simulation tools is influenced by problem’s surface and structural features, problem’s difficulty, and decision aids. In experiment 1, we tested the influence of problem’s surface and structural features in a simulation called Dynamic Climate Change Simulator (DCCS on subsequent performance in a paper-and-pencil Climate Stabilization (CS task (N = 100 across four between-subject conditions. In experiment 2, we tested the effects of problem’s difficulty in DCCS on subsequent performance in the CS task (N = 90 across three between-subject conditions. In experiment 3, we tested the influence of DCCS as a decision aid on subsequent performance in the CS task (N = 60 across two between-subject conditions. Results revealed a significant reduction in people’s misconceptions in the CS task after performing in DCCS compared to when performing in CS task in the absence of DCCS. The decrease in misconceptions in the CS task was similar for both problems’ surface and structural features, showing both structure and surface learning in DCCS. However, the proportion of misconceptions was similar across

Selection of Film Clips and Development of a Video for the Investigation of Sexual Decision Making among Men Who Have Sex with Men

Science.gov (United States)

Woolf-King, Sarah E.; Maisto, Stephen; Carey, Michael; Vanable, Peter

2013-01-01

Experimental research on sexual decision making is limited, despite the public health importance of such work. We describe formative work conducted in advance of an experimental study designed to evaluate the effects of alcohol intoxication and sexual arousal on risky sexual decision making among men who have sex with men. In Study 1, we describe the procedures for selecting and validating erotic film clips (to be used for the experimental manipulation of arousal). In Study 2, we describe the tailoring of two interactive role-play videos to be used to measure risk perception and communication skills in an analog risky sex situation. Together, these studies illustrate a method for creating experimental stimuli to investigate sexual decision making in a laboratory setting. Research using this approach will support experimental research that affords a stronger basis for drawing causal inferences regarding sexual decision making. PMID:19760530

Mirrored morality: an exploration of moral choice in video games.

Science.gov (United States)

Weaver, Andrew J; Lewis, Nicky

2012-11-01

This exploratory study was designed to examine how players make moral choices in video games and what effects these choices have on emotional responses to the games. Participants (n=75) filled out a moral foundations questionnaire (MFQ) and then played through the first full act of the video game Fallout 3. Game play was recorded and content analyzed for the moral decisions made. Players also reported their enjoyment of and emotional reactions to the game and reflected on the decisions they made. The majority of players made moral decisions and behaved toward the nonplayer game characters they encountered as if these were actual interpersonal interactions. Individual differences in decision making were predicted by the MFQ. Behaving in antisocial ways did increase guilt, but had no impact on enjoyment.

The International Decision Support Initiative Reference Case for Economic Evaluation: An Aid to Thought.

Science.gov (United States)

Wilkinson, Thomas; Sculpher, Mark J; Claxton, Karl; Revill, Paul; Briggs, Andrew; Cairns, John A; Teerawattananon, Yot; Asfaw, Elias; Lopert, Ruth; Culyer, Anthony J; Walker, Damian G

2016-12-01

Policymakers in high-, low-, and middle-income countries alike face challenging choices about resource allocation in health. Economic evaluation can be useful in providing decision makers with the best evidence of the anticipated benefits of new investments, as well as their expected opportunity costs-the benefits forgone of the options not chosen. To guide the decisions of health systems effectively, it is important that the methods of economic evaluation are founded on clear principles, are applied systematically, and are appropriate to the decision problems they seek to inform. The Bill and Melinda Gates Foundation, a major funder of economic evaluations of health technologies in low- and middle-income countries (LMICs), commissioned a "reference case" through the International Decision Support Initiative (iDSI) to guide future evaluations, and improve both the consistency and usefulness to decision makers. The iDSI Reference Case draws on previous insights from the World Health Organization, the US Panel on Cost-Effectiveness in Health Care, and the UK National Institute for Health and Care Excellence. Comprising 11 key principles, each accompanied by methodological specifications and reporting standards, the iDSI Reference Case also serves as a means of identifying priorities for methods research, and can be used as a framework for capacity building and technical assistance in LMICs. The iDSI Reference Case is an aid to thought, not a substitute for it, and should not be followed slavishly without regard to context, culture, or history. This article presents the iDSI Reference Case and discusses the rationale, approach, components, and application in LMICs. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Deep Learning for Video Game Playing

OpenAIRE

Justesen, Niels; Bontrager, Philip; Togelius, Julian; Risi, Sebastian

2017-01-01

In this article, we review recent Deep Learning advances in the context of how they have been applied to play different types of video games such as first-person shooters, arcade games, and real-time strategy games. We analyze the unique requirements that different game genres pose to a deep learning system and highlight important open challenges in the context of applying these machine learning methods to video games, such as general game playing, dealing with extremely large decision spaces...

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; 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:

The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs

Science.gov (United States)

Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

2011-01-01

The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs. PMID:21816958

Multi-modal Video Surveillance Aided by Pyroelectric Infrared Sensors

OpenAIRE

Magno , Michele; Tombari , Federico; Brunelli , Davide; Di Stefano , Luigi; Benini , Luca

2008-01-01

International audience; The interest in low-cost and small size video surveillance systems able to collaborate in a network has been increasing over the last years. Thanks to the progress in low-power design, research has greatly reduced the size and the power consumption of such distributed embedded systems providing flexibility, quick deployment and allowing the implementation of effective vision algorithms performing image processing directly on the embedded node. In this paper we present ...

Computer-aided detection as a decision assistant in chest radiography

Science.gov (United States)

Samulski, Maurice R. M.; Snoeren, Peter R.; Platel, Bram; van Ginneken, Bram; Hogeweg, Laurens; Schaefer-Prokop, Cornelia; Karssemeijer, Nico

2011-03-01

Background. Contrary to what may be expected, finding abnormalities in complex images like pulmonary nodules in chest radiographs is not dominated by time-consuming search strategies but by an almost immediate global interpretation. This was already known in the nineteen-seventies from experiments with briefly flashed chest radiographs. Later on, experiments with eye-trackers showed that abnormalities attracted the attention quite fast but often without further reader actions. Prolonging one's search seldom leads to newly found abnormalities and may even increase the chance of errors. The problem of reading chest radiographs is therefore not dominated by finding the abnormalities, but by interpreting them. Hypothesis. This suggests that readers could benefit from computer-aided detection (CAD) systems not so much by their ability to prompt potential abnormalities, but more from their ability to 'interpret' the potential abnormalities. In this paper, this hypothesis was investigated by an observer experiment. Experiment. In one condition, the traditional CAD condition, the most suspicious CAD locations were shown to the subjects, without telling them the levels of suspiciousness according to CAD. In the other condition, interactive CAD condition, levels of suspiciousness were given, but only when readers requested them at specified locations. These two conditions focus on decreasing search errors and decision errors, respectively. Results of reading without CAD were also recorded. Six subjects, all non-radiologists, read 223 chest radiographs in both conditions. CAD results were obtained from the OnGuard 5.0 system developed by Riverain Medical (Miamisburg, Ohio). Results. The observer data were analyzed by Location Response Operating Characteristic analysis (LROC). It was found that: 1) With the aid of CAD, the performance is significantly better than without CAD; 2) The performance with interactive CAD is significantly better than with traditional CAD at low false

Mapping of multiple criteria for priority setting of health interventions: an aid for decision makers

Directory of Open Access Journals (Sweden)

Tromp Noor

2012-12-01

Full Text Available Abstract Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frameworks. This map can be an aid to decision makers to identify the relevant criteria for priority setting in their specific context. Methods We made an inventory of all possible criteria for priority setting on the basis of literature review. We categorized the criteria according to both health system frameworks that spell out a country’s health system goals and input. We reason that the criteria that decision makers use in priority setting exercises are a direct manifestation of this. Results Our map includes thirty-one criteria that are distributed among five categories that reflect the goals of a health system (i.e. to improve level of health, fair distribution of health, responsiveness, social & financial risk protection and efficiency and leadership/governance one category that reflects feasibiliy based on the health system building blocks (i.e. service delivery, health care workforce , information, medical products, vaccines & technologies, financing and. Conclusions This conceptual mapping of criteria, based on well-established health system frameworks, will further develop the field of priority setting by assisting decision makers in the identification of multiple criteria for selection of health interventions.

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

S4HARA: System for HIV/AIDS resource allocation

Directory of Open Access Journals (Sweden)

Carter Michael W

2008-03-01

Full Text Available Abstract Background HIV/AIDS resource allocation decisions are influenced by political, social, ethical and other factors that are difficult to quantify. Consequently, quantitative models of HIV/AIDS resource allocation have had limited impact on actual spending decisions. We propose a decision-support System for HIV/AIDS Resource Allocation (S4HARA that takes into consideration both principles of efficient resource allocation and the role of non-quantifiable influences on the decision-making process for resource allocation. Methods S4HARA is a four-step spreadsheet-based model. The first step serves to identify the factors currently influencing HIV/AIDS allocation decisions. The second step consists of prioritizing HIV/AIDS interventions. The third step involves allocating the budget to the HIV/AIDS interventions using a rational approach. Decision-makers can select from several rational models of resource allocation depending on availability of data and level of complexity. The last step combines the results of the first and third steps to highlight the influencing factors that act as barriers or facilitators to the results suggested by the rational resource allocation approach. Actionable recommendations are then made to improve the allocation. We illustrate S4HARA in the context of a primary healthcare clinic in South Africa. Results The clinic offers six types of HIV/AIDS interventions and spends US$750,000 annually on these programs. Current allocation decisions are influenced by donors, NGOs and the government as well as by ethical and religious factors. Without additional funding, an optimal allocation of the total budget suggests that the portion allotted to condom distribution be increased from 1% to 15% and the portion allotted to prevention and treatment of opportunistic infections be increased from 43% to 71%, while allocation to other interventions should decrease. Conclusion Condom uptake at the clinic should be increased by

[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.

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.

The influence of video recordings on beginning therapists’ learning in psychotherapy training

DEFF Research Database (Denmark)

Jacobsen, Claus Haugaard; Olesen, Mette Kirk; Kløve, Astrid

the current relatively widespread use of video, one finds only a very limited number of empirical studies on how these recordings specifically influence the learning process of the beginning therapist. Aim: After a brief discussion of the pro and cons of the use of video recordings this paper presents......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...

Expanding the Reach of Participatory Risk Management: Testing an Online Decision-Aiding Framework for Informing Internally Consistent Choices.

Science.gov (United States)

Bessette, Douglas L; Campbell-Arvai, Victoria; Arvai, Joseph

2016-05-01

This article presents research aimed at developing and testing an online, multistakeholder decision-aiding framework for informing multiattribute risk management choices associated with energy development and climate change. The framework was designed to provide necessary background information and facilitate internally consistent choices, or choices that are in line with users' prioritized objectives. In order to test different components of the decision-aiding framework, a six-part, 2 × 2 × 2 factorial experiment was conducted, yielding eight treatment scenarios. The three factors included: (1) whether or not users could construct their own alternatives; (2) the level of detail regarding the composition of alternatives users would evaluate; and (3) the way in which a final choice between users' own constructed (or highest-ranked) portfolio and an internally consistent portfolio was presented. Participants' self-reports revealed the framework was easy to use and providing an opportunity to develop one's own risk-management alternatives (Factor 1) led to the highest knowledge gains. Empirical measures showed the internal consistency of users' decisions across all treatments to be lower than expected and confirmed that providing information about alternatives' composition (Factor 2) resulted in the least internally consistent choices. At the same time, those users who did not develop their own alternatives and were not shown detailed information about the composition of alternatives believed their choices to be the most internally consistent. These results raise concerns about how the amount of information provided and the ability to construct alternatives may inversely affect users' real and perceived internal consistency. © 2015 Society for Risk Analysis.

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

An Optimization Model for the Allocation of University Based Merit Aid

Science.gov (United States)

Sugrue, Paul K.

2010-01-01

The allocation of merit-based financial aid during the college admissions process presents postsecondary institutions with complex and financially expensive decisions. This article describes the application of linear programming as a decision tool in merit based financial aid decisions at a medium size private university. The objective defined for…

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.

Thinking Images: Doing Philosophy in Film and Video

Science.gov (United States)

Parkes, Graham

2009-01-01

Over the past several decades film and video have been steadily infiltrating the philosophy curriculum at colleges and universities. Traditionally, teachers of philosophy have not made much use of "audiovisual aids" in the classroom beyond the chalk board or overhead projector, with only the more adventurous playing audiotapes, for example, or…

Video-Guidance Design for the DART Rendezvous Mission

Science.gov (United States)

Ruth, Michael; Tracy, Chisholm

2004-01-01

NASA's Demonstration of Autonomous Rendezvous Technology (DART) mission will validate a number of different guidance technologies, including state-differenced GPS transfers and close-approach video guidance. The video guidance for DART will employ NASA/Marshall s Advanced Video Guidance Sensor (AVGS). This paper focuses on the terminal phase of the DART mission that includes close-approach maneuvers under AVGS guidance. The closed-loop video guidance design for DART is driven by a number of competing requirements, including a need for maximizing tracking bandwidths while coping with measurement noise and the need to minimize RCS firings. A range of different strategies for attitude control and docking guidance have been considered for the DART mission, and design decisions are driven by a goal of minimizing both the design complexity and the effects of video guidance lags. The DART design employs an indirect docking approach, in which the guidance position targets are defined using relative attitude information. Flight simulation results have proven the effectiveness of the video guidance design.

A randomized study of multimedia informational aids for research on medical practices: implications for informed consent

Science.gov (United States)

Kraft, Stephanie A; Constantine, Melissa; Magnus, David; Porter, Kathryn M.; Lee, Sandra Soo-Jin; Green, Michael; Kass, Nancy E; Wilfond, Benjamin S.; Cho, Mildred K

2016-01-01

Background/aims Participant understanding is a key element of informed consent for enrollment in research. However, participants often do not understand the nature, risks, benefits, or design of the studies in which they take part. Research on medical practices, which studies standard interventions rather than new treatments, has the potential to be especially confusing to participants because it is embedded within usual clinical care. Our objective in this randomized study was to compare the ability of a range of multimedia informational aids to improve participant understanding in the context of research on medical practices. Methods We administered a Web-based survey to members of a proprietary online panel sample selected to match national U.S. demographics. Respondents were randomized to one of five arms: four content-equivalent informational aids (animated videos, slideshows with voiceover, comics, and text), and one no-intervention control. We measured knowledge of research on medical practices using a summary knowledge score from 10 questions based on the content of the informational aids. We used ANOVA and paired t-tests to compare knowledge scores between arms. Results There were 1500 completed surveys (300 in each arm). Mean knowledge scores were highest for the slideshows with voiceover (65.7%), followed by the animated videos (62.7%), comics (60.7%), text (57.2%), and control (50.3%). Differences between arms were statistically significant except between the slideshows with voiceover and animated videos and between the animated videos and comics. Informational aids that included an audio component (animated videos and slideshows with voiceover) had higher knowledge scores than those without an audio component (64.2% versus 59.0%, peffectively than text alone. However, the relatively low knowledge scores suggest that targeted informational aids may be needed to teach some particularly challenging concepts. Nonetheless, our results demonstrate the

The development of the CoRE-Values framework as an aid to ethical decision-making.

Science.gov (United States)

Manson, Helen M

2012-01-01

Ethical analysis frameworks can help to identify the ethical dimensions to clinical care and provide a method for justifying clinical decisions. Published frameworks, however, have some limitations to easy, practical use. The aim was to identify a comprehensive yet easy-to-use framework that clarifies ethical decision-making, suitable for use by medical learners and clinical educators. A literature search identified published frameworks that define the components of ethical clinical decision-making. On this basis, a new framework, the 'CoRE-Values Compass and Grid' was constructed. This was formally evaluated during a medical school interprofessional teaching session. For 88% of 228 medical and nursing students, the new framework was easy to understand; 85% reported it as easy to use. The framework improved awareness of the ethical dimensions to a clinical scenario for 97% of students and the ability to systematically identify ethical aspects for 83%. Students and instructors reported that the framework helped to link ethics theory with clinical practice. The framework was described as a useful educational tool by 85% of students and 95% of instructors. The 'CoRE-Values Compass and Grid' is a new framework, shown to aid the systematic identification and consideration of ethical aspects to clinical cases.

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

Science.gov (United States)

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

2018-02-01

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

Microprocessor-based, on-line decision aid for resolving conflicting nuclear reactor instrumentation

International Nuclear Information System (INIS)

Alesso, H.P.

1981-01-01

We describe one design for a microprocessor-based, on-line decision aid for identifying and resolving false, conflicting, or misleading instrument indications resulting from certain systems interactions for a pressurized water reactor. The system processes sensor signals from groups of instruments that track together under nominal transient and certain accident conditions, and alarms when they do not track together. We examine multiple-casualty systems interaction and formulate a trial grouping of variables that track together under specified conditions. A two-of-three type redundancy check of key variables provides alarm and indication of conflicting information when one signal suddenly tracks in opposition due to multiple casualty, instrument failure, and/or locally abnormal conditions. Since a vote count of two of three variables in conflict as inconclusive evidence, the system is not designed to provide tripping or corrective action, but improves the operator/instrument interface by providing additional and partially digested information

In-network adaptation of SHVC video in software-defined networks

Science.gov (United States)

Awobuluyi, Olatunde; Nightingale, James; Wang, Qi; Alcaraz Calero, Jose Maria; Grecos, Christos

2016-04-01

Software Defined Networks (SDN), when combined with Network Function Virtualization (NFV) represents a paradigm shift in how future networks will behave and be managed. SDN's are expected to provide the underpinning technologies for future innovations such as 5G mobile networks and the Internet of Everything. The SDN architecture offers features that facilitate an abstracted and centralized global network view in which packet forwarding or dropping decisions are based on application flows. Software Defined Networks facilitate a wide range of network management tasks, including the adaptation of real-time video streams as they traverse the network. SHVC, the scalable extension to the recent H.265 standard is a new video encoding standard that supports ultra-high definition video streams with spatial resolutions of up to 7680×4320 and frame rates of 60fps or more. The massive increase in bandwidth required to deliver these U-HD video streams dwarfs the bandwidth requirements of current high definition (HD) video. Such large bandwidth increases pose very significant challenges for network operators. In this paper we go substantially beyond the limited number of existing implementations and proposals for video streaming in SDN's all of which have primarily focused on traffic engineering solutions such as load balancing. By implementing and empirically evaluating an SDN enabled Media Adaptation Network Entity (MANE) we provide a valuable empirical insight into the benefits and limitations of SDN enabled video adaptation for real time video applications. The SDN-MANE is the video adaptation component of our Video Quality Assurance Manager (VQAM) SDN control plane application, which also includes an SDN monitoring component to acquire network metrics and a decision making engine using algorithms to determine the optimum adaptation strategy for any real time video application flow given the current network conditions. Our proposed VQAM application has been implemented and

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

2017-01-01

Background 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. Objective 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. Methods 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. Results 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

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.

Moral license in video games: when being right can mean doing wrong.

Science.gov (United States)

Ellithorpe, Morgan E; Cruz, Carlos; Velez, John A; Ewoldsen, David R; Bogert, Adam K

2015-04-01

Research on video game violence has found largely consistent evidence that violence in video games tends to be associated with an increase in antisocial behavior. However, this body of work has mostly ignored one prominent feature of many violent games: moral decision making. It is possible that the influence of video game violence could change when moral decisions are brought into the context. One way video games change behavior is through changes in players' self-perceptions, a process called identity simulation. In addition, a perspective called moral license predicts that these effects should not necessarily be consistent across behaviors, in that people should try to balance selfishness with keeping the moral high ground across many behaviors. Therefore, moral choices (or immoral choices) in a video game may predict less moral (or more moral) behaviors right after the game. However, later behavior may revert yet again, creating a cycle of pro- and antisocial behaviors. The present experiment asks participants to make moral choices in a video game, and then measures their behavior on two subsequent tasks. Results indicate that taking what participants perceive to be the more moral mind-set in the video game predicts more antisocial behavior on the first task, but more pro-social behavior on the next task. These results support identity simulation and moral license processes in a video game and moral behavior context, and indicate that there may be greater complexity in video game violence effects than previously understood.

Testing Video and Social Media for Engaging Users of the U.S. Climate Resilience Toolkit

Science.gov (United States)

Green, C. J.; Gardiner, N.; Niepold, F., III; Esposito, C.

2015-12-01

We developed a custom video production stye and a method for analyzing social media behavior so that we may deliberately build and track audience growth for decision-support tools and case studies within the U.S. Climate Resilience Toolkit. The new style of video focuses quickly on decision processes; its 30s format is well-suited for deployment through social media. We measured both traffic and engagement with video using Google Analytics. Each video included an embedded tag, allowing us to measure viewers' behavior: whether or not they entered the toolkit website; the duration of their session on the website; and the number pages they visited in that session. Results showed that video promotion was more effective on Facebook than Twitter. Facebook links generated twice the number of visits to the toolkit. Videos also increased Facebook interaction overall. Because most Facebook users are return visitors, this campaign did not substantially draw new site visitors. We continue to research and apply these methods in a targeted engagement and outreach campaign that utilizes the theory of social diffusion and social influence strategies to grow our audience of "influential" decision-makers and people within their social networks. Our goal is to increase access and use of the U.S. Climate Resilience Toolkit.

The influence of video recordings on beginning therapist’s learning in psychotherapy training

DEFF Research Database (Denmark)

Jacobsen, Claus Haugaard; Olesen, Mette Kirk; Kløve, Astrid

2010-01-01

the current relatively widespread use of video, one finds only a very limited number of empirical studies on how these recordings specifically influence the learning process of the beginning therapist. Aim: After a brief discussion of the pro and cons of the use of video recordings this paper presents......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...

Decision support in vaccination policies.

Science.gov (United States)

Piso, B; Wild, C

2009-10-09

Looking across boarders reveals that the national immunization programs of various countries differ in their vaccination schedules and decisions regarding the implementation and funding of new vaccines. The aim of this review is to identify decision aids and crucial criteria for a rational decision-making process on vaccine introduction and to develop a theoretical framework for decision-making based on available literature. Systematic literature search supplemented by hand-search. We identified five published decision aids for vaccine introduction and program planning in industrialized countries. Their comparison revealed an overall similarity with some differences in the approach as well as criteria. Burden of disease and vaccine characteristics play a key role in all decision aids, but authors vary in their views on the significance of cost-effectiveness analyses. Other relevant factors that should be considered before vaccine introduction are discussed to highly differing extents. These factors include the immunization program itself as well as its conformity with other programs, its feasibility, acceptability, and equity, as well as ethical, legal and political considerations. Assuming that the most comprehensive framework possible will not provide a feasible tool for decision-makers, we suggest a stepwise procedure. Though even the best rational approach and most comprehensive evaluation is limited by remaining uncertainties, frameworks provide at least a structured approach to evaluate the various aspects of vaccine implementation decision-making. This process is essential in making consistently sound decisions and will facilitate the public's confidence in the decision and its realization.

Making fair decisions about financing care for persons with AIDS.

Science.gov (United States)

Roper, W L; Winkenwerder, W

1988-01-01

An estimated 40 percent of the nation's 55,000 persons with acquired immunodeficiency syndrome (AIDS) have received care under the Medicaid Program, which is administered by the Health Care Financing Administration (HCFA) and funded jointly by the Federal Government and the States. In fiscal year 1988, Medicaid will spend between $700 and $750 million for AIDS care and treatment. Medicaid spending on AIDS is likely to reach $2.4 billion by fiscal year 1992, an estimate that does not include costs of treatment with zidovudine (AZT). Four policy principles are proposed for meeting this new cost burden in a way that is fair, responsive, efficient, and in harmony with our current joint public-private system of health care financing. The four guidelines are to (a) treat AIDS as any other serious disease, without the creation of a disease-specific entitlement program; (b) bring AIDS treatment financing into the mainstream of the health care financing system, making it a shared responsibility and promoting initiatives such as high-risk insurance pools: (c) give States the flexibility to meet local needs, including Medicaid home care and community-based care services waivers; (d) encourage health care professionals to meet their obligation to care for AIDS patients. PMID:3131823

Evidence-based surgery: Dissemination, communication, decision aids

NARCIS (Netherlands)

Knops, A.M.

2013-01-01

Surgeons are expected to make treatment decisions that are based on the best available evidence. Moreover, they are called to recognise that important decisions should also be shared with patients. While dissemination of evidence-based surgery and communication of evidence to patients have been

Computer aided diagnosis of diabetic peripheral neuropathy

Science.gov (United States)

Chekh, Viktor; Soliz, Peter; McGrew, Elizabeth; Barriga, Simon; Burge, Mark; Luan, Shuang

2014-03-01

Diabetic peripheral neuropathy (DPN) refers to the nerve damage that can occur in diabetes patients. It most often affects the extremities, such as the feet, and can lead to peripheral vascular disease, deformity, infection, ulceration, and even amputation. The key to managing diabetic foot is prevention and early detection. Unfortunately, current existing diagnostic techniques are mostly based on patient sensations and exhibit significant inter- and intra-observer differences. We have developed a computer aided diagnostic (CAD) system for diabetic peripheral neuropathy. The thermal response of the feet of diabetic patients following cold stimulus is captured using an infrared camera. The plantar foot in the images from a thermal video are segmented and registered for tracking points or specific regions. The temperature recovery of each point on the plantar foot is extracted using our bio-thermal model and analyzed. The regions that exhibit abnormal ability to recover are automatically identified to aid the physicians to recognize problematic areas. The key to our CAD system is the segmentation of infrared video. The main challenges for segmenting infrared video compared to normal digital video are (1) as the foot warms up, it also warms up the surrounding, creating an ever changing contrast; and (2) there may be significant motion during imaging. To overcome this, a hybrid segmentation algorithm was developed based on a number of techniques such as continuous max-flow, model based segmentation, shape preservation, convex hull, and temperature normalization. Verifications of the automatic segmentation and registration using manual segmentation and markers show good agreement.

Automated music selection of video ads

Directory of Open Access Journals (Sweden)

Wiesener Oliver

2017-07-01

Full Text Available The importance of video ads on social media platforms can be measured by views. For instance, Samsung’s commercial ad for one of its new smartphones reached more than 46 million viewers at Youtube. A video ad addresses the visual as well as the auditive sense of users. Often the visual sense is busy in the sense that users focus other screens than the screen with the video ad. This is called the second screen syndrome. Therefore, the importance of the audio channel seems to grow. To get back the visual attention of users that are deflected from other visual impulses it appears reasonable to adapt the music to the target group. Additionally, it appears useful to adapt the music to content of the video. Thus, the overall success of a video ad could by increased by increasing the attention of the users. Humans typically make the decision about the music of a video ad. If there is a correlation between music, products and target groups, a digitization of the music selection process seems to be possible. Since the digitization progress in the music sector is mainly focused on music composing this article strives for making a first step towards the digitization of the music selection.

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.

Constructing narratives to describe video events using aided communication

NARCIS (Netherlands)

Smith, M.M.; Batorowicz, B.; Sandberg, A.D.; Murray, J.; Stadskleiv, K.; Balkom, L.J.M. van; Neuvonen, K.; Tetzchner, S. von

2018-01-01

Narratives are a pervasive form of discourse and a rich source for exploring a range of language and cognitive skills. The limited research base to date suggests that narratives generated using aided communication may be structurally simple, and that features of cohesion and reference may be

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....

Using a group decision support system to make investment prioritisation decisions

OpenAIRE

Read, Martin; Gear, Tony; Minkes, Leonard; Irving, Ann

2013-01-01

This paper is concerned with how decision making groups involved in making investment prioritisation decisions involving funding of technology and science projects may be supported by a group decision support system (GDSS). While interested in decision outcomes, the primary focus of this paper is the role of a group support system as an aid to developing shared understanding within a group. The paper develops the conceptual framework of decision-making, communication and group support, and de...

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

International Nuclear Information System (INIS)

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

2003-01-01

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

Evaluating Adaptation of a Cancer Clinical Trial Decision Aid for Rural Cancer Patients: A Mixed-Methods Approach.

Science.gov (United States)

Pathak, Swati; George, Nerissa; Monti, Denise; Robinson, Kathy; Politi, Mary C

2018-06-03

Rural-residing cancer patients often do not participate in clinical trials. Many patients misunderstand cancer clinical trials and their rights as participant. The purpose of this study is to modify a previously developed cancer clinical trials decision aid (DA), incorporating the unique needs of rural populations, and test its impact on knowledge and decision outcomes. The study was conducted in two phases. Phase I recruited 15 rural-residing cancer survivors in a qualitative usability study. Participants navigated the original DA and provided feedback regarding usability and implementation in rural settings. Phase II recruited 31 newly diagnosed rural-residing cancer patients. Patients completed a survey before and after using the revised DA, R-CHOICES. Primary outcomes included decisional conflict, decision self-efficacy, knowledge, communication self-efficacy, and attitudes towards and willingness to consider joining a trial. In phase I, the DA was viewed positively by rural-residing cancer survivors. Participants provided important feedback about factors rural-residing patients consider when thinking about trial participation. In phase II, after using R-CHOICES, participants had higher certainty about their choice (mean post-test = 3.10 vs. pre-test = 2.67; P = 0.025) and higher trial knowledge (mean percentage correct at post-test = 73.58 vs. pre-test = 57.77; P decision self-efficacy, communication self-efficacy, and attitudes towards or willingness to join trials. The R-CHOICES improved rural-residing patients' knowledge of cancer clinical trials and reduced conflict about making a trial decision. More research is needed on ways to further support decisions about trial participation among this population.

Toward a More Robust and Efficient Usability Testing Method of Clinical Decision Support for Nurses Derived From Nursing Electronic Health Record Data.

Science.gov (United States)

Lopez, Karen Dunn; Febretti, Alessandro; Stifter, Janet; Johnson, Andrew; Wilkie, Diana J; Keenan, Gail

2017-10-01

To develop methods for rapid and simultaneous design, testing, and management of multiple clinical decision support (CDS) features to aid nurse decision-making. We used quota sampling, think-aloud and cognitive interviews, and deductive and inductive coding of synchronized audio video data and archival libraries. Our methods and organizational tools allowed us to rapidly improve the usability, understandability, and usefulness of CDS in a generalizable sample of practicing nurses. The method outlined allows the rapid integration of nursing terminology based electronic health record data into routine workflow and holds strong potential for improving patient outcomes. The methods and organizational tools for development of multiple CDS system features can be used to translate knowledge into practice. © 2016 NANDA International, Inc.

Helping decision makers frame, analyze, and implement decisions

Science.gov (United States)

Runge, Michael C.; McDonald-Madden, Eve

2018-01-01

All decisions have the same recognizable elements. Context, objectives, alternatives, consequences, and deliberation. Decision makers and analysts familiar with these elements can quickly see the underlying structure of a decision.There are only a small number of classes of decisions. These classes differ in the cognitive and scientific challenge they present to the decision maker; the ability to recognize the class of decision leads a decision maker to tools to aid in the analysis.Sometimes we need more information, sometimes we don’t. The role of science in a decision-making process is to provide the predictions that link the alternative actions to the desired outcomes. Investing in more science is only valuable if it helps to choose a better action.Implementation. The successful integration of decision analysis into environmental decisions requires careful attention to the decision, the people, and the institutions involved.

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.

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.

Science.gov (United States)

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

2018-02-01

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. To explore views of practice staff towards SDM and the DA. A mixed-methods study within the Dutch PORTDA-diab trial. Included were 17 practices with staff members who were responsible for routine diabetes care and had worked with the DA, and 209 of their patients. Interviews were conducted focusing on applicability, usefulness and feasibility of the DA. Interviews were tape-recorded, transcribed verbatim and subjected to content analysis for identifying and classifying views. Patient-reported data about the use of the DA were collected. Associations between specific views and use of the DA were tested using Pearson point-biserial correlation. The majority of practice staff expressed positive views towards SDM, which was associated with making more use of the DA. Most of the staff expressed that the DA stimulated a two-way conversation. By using the DA, several became aware of their paternalistic approach. Some staff experienced a conflict with the content of the DA, which was associated with making less use of the DA. The DA was considered useful by practice staff to support SDM. A positive view towards SDM was a facilitator, whereas experiencing a conflict with the content of the DA was a barrier for making use of the DA. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Advancement of thyroid surgery video recording: A comparison between two full HD head mounted video cameras.

Science.gov (United States)

Ortensi, Andrea; Panunzi, Andrea; Trombetta, Silvia; Cattaneo, Alberto; Sorrenti, Salvatore; D'Orazi, Valerio

2017-05-01

The aim of this study was to test two different video cameras and recording systems used in thyroid surgery in our Department. This is meant to be an attempt to record the real point of view of the magnified vision of surgeon, so as to make the viewer aware of the difference with the naked eye vision. In this retrospective study, we recorded and compared twenty thyroidectomies performed using loupes magnification and microsurgical technique: ten were recorded with GoPro ® 4 Session action cam (commercially available) and ten with our new prototype of head mounted video camera. Settings were selected before surgery for both cameras. The recording time is about from 1 to 2 h for GoPro ® and from 3 to 5 h for our prototype. The average time of preparation to fit the camera on the surgeon's head and set the functionality is about 5 min for GoPro ® and 7-8 min for the prototype, mostly due to HDMI wiring cable. Videos recorded with the prototype require no further editing, which is mandatory for videos recorded with GoPro ® to highlight the surgical details. the present study showed that our prototype of video camera, compared with GoPro ® 4 Session, guarantees best results in terms of surgical video recording quality, provides to the viewer the exact perspective of the microsurgeon and shows accurately his magnified view through the loupes in thyroid surgery. These recordings are surgical aids for teaching and education and might be a method of self-analysis of surgical technique. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

Science.gov (United States)

Wong, Charlene A; Kulhari, Sajal; McGeoch, Ellen J; Jones, Arthur T; Weiner, Janet; Polsky, Daniel; Baker, Tom

2018-05-29

The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the total cost estimates on public versus private exchanges for a standardized consumer. Nearly all studied consumer decision aids saw increased deployment in the public marketplaces in OEP4 compared to OEP3. Over half of the public exchanges (n = 7 of 13) had total cost estimators (versus 5 of 14 in OEP3) in window-shopping and integrated provider lookups (window-shopping: 7; real-shopping: 8). The most common default plan orders were by premium or total cost estimate. Notable features on private health insurance exchanges were unique data presentation (e.g., infographics) and further personalized shopping (e.g., recommended plan flags). Health plan total cost estimates varied substantially between the public and private exchanges (average difference $1526). The ACA's public health insurance exchanges offered more tools in OEP4 to help consumers select a plan. While private health insurance exchanges presented notable features, the total cost estimates for a standardized consumer varied widely on public

The use of decision analytic techniques in energy policy decisions

International Nuclear Information System (INIS)

Haemaelaeinen, R.P.; Seppaelaeinen, T.O.

1986-08-01

The report reviews decision analytic techniques and their applications to energy policy decision making. Decision analysis consists in techniques for structuring the essential elements of a decision problem and mathematical methods for ranking the alternatives from a set of simple judgments. Because modeling subjective judgments is characteristic of decision analysis, the models can incorporate qualitative factors and values, which escape traditional energy modeling. Decision analysis has been applied to choices among energy supply alternatives, siting energy facilities, selecting nuclear waste repositories, selecting research and development projects, risk analysis and prioritizing alternative energy futures. Many applications are done in universities and research institutions, but during the 70's the use of decision analysis has spread both to the public and the private sector. The settings where decision analysis has been applied range from aiding a single decision maker to clarifying opposing points of view. Decision analytic methods have also been linked with energy models. The most valuable result of decision analysis is the clarification of the problem at hand. Political decisions cannot be made solely on the basis of models, but models can be used to gain insight of the decision situation. Models inevitably simplify reality, so they must be regarded only as aids to judgment. So far there has been only one decision analysis of energy policy issues in Finland with actual political decision makers as participants. The experiences of this project and numerous foreign applications do however suggest that the decision analytic approach is useful in energy policy questions. The report presents a number of Finnish energy policy decisions where decision analysis might prove useful. However, the applicability of the methods depends crucially on the actual circumstances at hand

Hierarchical video surveillance architecture: a chassis for video big data analytics and exploration

Science.gov (United States)

Ajiboye, Sola O.; Birch, Philip; Chatwin, Christopher; Young, Rupert

2015-03-01

There is increasing reliance on video surveillance systems for systematic derivation, analysis and interpretation of the data needed for predicting, planning, evaluating and implementing public safety. This is evident from the massive number of surveillance cameras deployed across public locations. For example, in July 2013, the British Security Industry Association (BSIA) reported that over 4 million CCTV cameras had been installed in Britain alone. The BSIA also reveal that only 1.5% of these are state owned. In this paper, we propose a framework that allows access to data from privately owned cameras, with the aim of increasing the efficiency and accuracy of public safety planning, security activities, and decision support systems that are based on video integrated surveillance systems. The accuracy of results obtained from government-owned public safety infrastructure would improve greatly if privately owned surveillance systems `expose' relevant video-generated metadata events, such as triggered alerts and also permit query of a metadata repository. Subsequently, a police officer, for example, with an appropriate level of system permission can query unified video systems across a large geographical area such as a city or a country to predict the location of an interesting entity, such as a pedestrian or a vehicle. This becomes possible with our proposed novel hierarchical architecture, the Fused Video Surveillance Architecture (FVSA). At the high level, FVSA comprises of a hardware framework that is supported by a multi-layer abstraction software interface. It presents video surveillance systems as an adapted computational grid of intelligent services, which is integration-enabled to communicate with other compatible systems in the Internet of Things (IoT).

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."

Analytic Procedures For Designing and Evaluating Decision Aids.

Science.gov (United States)

1980-04-01

the taxonomy of decision charateristics . Chapter 5 applies the taxonomies to the information processing functions needed for AAW decisions, and...rationality emphasizes the extent to which organizations and other social institutions consist of individuals who pursue individual objectives by means of...adaptive rationality is always wrong or naive; most of us know persons that seem to be naturally good decision-makers. There is no logic that guarantees

Portrayal of generalized anxiety disorder in YouTube™ videos.

Science.gov (United States)

MacLean, Sarah A; Basch, Corey H; Reeves, Rachel; Basch, Charles E

2017-12-01

Individuals often search the Internet for information about their medical conditions, such as generalized anxiety disorder (GAD), a common mental health disorder. To describe the content of the most popular videos on YouTube™ related to GAD. Videos with at least 50,000 views in October 2016 were coded for information regarding symptoms, treatments and causes for GAD. Associations of content with factors such as popularity and focus on a personal experience were examined. The search returned 95 videos, which had been collectively viewed 37,044,555 times. Most (65%) were uploaded by consumers and 56% were about a personal experience. The most common symptoms mentioned were worry or panic (72%) and social anxiety (46%). Many videos (63%) mentioned at least one treatment, but only 26% mentioned any cause of anxiety. Videos that focused on a personal experience were significantly less likely to mention other phobias ( p = .036), panic disorder ( p = .033) and sleep issues ( p = .016). The majority of the most popular videos on YouTube ™ related to GAD were produced by consumers. Improved understanding about what information is available and popular online can assist mental health professionals in aiding their patients and in producing media that is likely to be viewed.

Video performance for high security applications

International Nuclear Information System (INIS)

Connell, Jack C.; Norman, Bradley C.

2010-01-01

The complexity of physical protection systems has increased to address modern threats to national security and emerging commercial technologies. A key element of modern physical protection systems is the data presented to the human operator used for rapid determination of the cause of an alarm, whether false (e.g., caused by an animal, debris, etc.) or real (e.g., a human adversary). Alarm assessment, the human validation of a sensor alarm, primarily relies on imaging technologies and video systems. Developing measures of effectiveness (MOE) that drive the design or evaluation of a video system or technology becomes a challenge, given the subjectivity of the application (e.g., alarm assessment). Sandia National Laboratories has conducted empirical analysis using field test data and mathematical models such as binomial distribution and Johnson target transfer functions to develop MOEs for video system technologies. Depending on the technology, the task of the security operator and the distance to the target, the Probability of Assessment (PAs) can be determined as a function of a variety of conditions or assumptions. PAs used as an MOE allows the systems engineer to conduct trade studies, make informed design decisions, or evaluate new higher-risk technologies. This paper outlines general video system design trade-offs, discusses ways video can be used to increase system performance and lists MOEs for video systems used in subjective applications such as alarm assessment.

Rational Suicide and AIDS: Considerations for the Psychotherapist.

Science.gov (United States)

Werth, James L., Jr.

1992-01-01

Reviews literature on suicide and terminal illnesses. Examines suicide rate for persons with Acquired Immune Deficiency Syndrome (AIDS). Explores physical and psychosocial factors that may contribute to decision by person with AIDS to commit suicide. Applies Siegel's criteria for rational suicide to case of person with AIDS. Examines role of…

The Short Life and Ignominious Death of ALA Video and Special Projects.

Science.gov (United States)

Handman, Gary

1991-01-01

Discussion of videocassettes in our culture and the function of video collections in libraries focuses on the creation and demise of a unit sponsored by the American Library Association, the ALA Video and Special Projects. The unit's role is discussed and funding decisions that led to its demise are explained. (LRW)

Spatiotemporal video deinterlacing using control grid interpolation

Science.gov (United States)

Venkatesan, Ragav; Zwart, Christine M.; Frakes, David H.; Li, Baoxin

2015-03-01

With the advent of progressive format display and broadcast technologies, video deinterlacing has become an important video-processing technique. Numerous approaches exist in the literature to accomplish deinterlacing. While most earlier methods were simple linear filtering-based approaches, the emergence of faster computing technologies and even dedicated video-processing hardware in display units has allowed higher quality but also more computationally intense deinterlacing algorithms to become practical. Most modern approaches analyze motion and content in video to select different deinterlacing methods for various spatiotemporal regions. We introduce a family of deinterlacers that employs spectral residue to choose between and weight control grid interpolation based spatial and temporal deinterlacing methods. The proposed approaches perform better than the prior state-of-the-art based on peak signal-to-noise ratio, other visual quality metrics, and simple perception-based subjective evaluations conducted by human viewers. We further study the advantages of using soft and hard decision thresholds on the visual performance.

For Video Streaming/Delivery: Is HTML5 the Real Fix?

Directory of Open Access Journals (Sweden)

John Millard

2013-10-01

Full Text Available The general movement towards streaming or playing videos on the web has grown exponentially in the last decade. The combination of new streaming technologies and faster Internet connections continue to provide enhanced and robust user experience for video content. For many organizations, adding videos on their websites has transitioned from a “cool” feature to a mission critical service. Some of the benefits in putting videos online include: to engage and convert visitors, to raise awareness or drive interest, to share inspirational stories or recent unique events, etc. Along with the growth in the use and need for video content on the web; delivering videos online also remains a messy activity for developers and web teams. Examples of existing challenges include creating more accessible videos with captions and delivering content (using adaptive streaming for the diverse range of mobile and tablet devices. In this article, we report on the decision-making and early results in using the Kaltura video platform in two popular library platforms: CONTENTdm and DSpace.

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…

Piracy versus Netflix : Subscription Video on Demand Dissatisfaction as an Antecedent of Piracy

OpenAIRE

Riekkinen, Janne

2018-01-01

Drawing from cognitive dissonance and neutralization theories, this study seeks to improve the understanding on consumer decision-making between the current legal and illegal video consumption alternatives. We develop and test a research model featuring Subscription Video on Demand (SVOD) satisfaction and various dimensions of SVOD quality as antecedents of video piracy neutralizations and attitudes. Based on results from an online survey among Finnish SVOD users, SVOD satisfaction is primari...

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.

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.

"Aid to Thought"--Just Simulate It!

Science.gov (United States)

Kinczkowski, Linda; Cardon, Phillip; Speelman, Pamela

2015-01-01

This paper provides examples of Aid-to-Thought uses in urban decision making, classroom laboratory planning, and in a ship antiaircraft defense system. Aid-to-Thought modeling and simulations are tools students can use effectively in a STEM classroom while meeting Standards for Technological Literacy Benchmarks O and R. These projects prepare…

Development and pilot testing of a Decision Aid (DA) for women with early-stage breast cancer considering contralateral prophylactic mastectomy.

Science.gov (United States)

Ager, B; Jansen, J; Porter, D; Phillips, K A; Glassey, R; Butow, P

2018-05-22

Describe the development, acceptability and feasibility of a Decision Aid (DA) for women with early-stage breast cancer (BC) at average contralateral breast cancer (CBC) risk considering contralateral prophylactic mastectomy (CPM). The DA was developed using the International Patient Decision Aid Standards (IPDAS) and the Ottawa Decision Support Framework. It provides evidence-based information about CPM in a booklet format combining text, graphs and images of surgical options. Twenty-three women with a history of early-stage breast cancer were interviewed in person or over the phone using a 'think aloud approach'. Framework analysis was used to code and analyse data. Twenty-three women participated in the study. Mean age of participants was 58.6 years and time since diagnosis ranged from 14 months to 21 years. Five women had CPM and eighteen had not. Women strongly endorsed the DA. Many felt validated by a section on appearance and found information on average risk of recurrence and metastases helpful, however, noted the importance of discussing personal risk with their surgeon. Many requested more information on surgery details (time taken, recovery) and costs of the different options. The DA was acceptable to women, including the format, content and proposed implementation strategies. Practical and financial issues are important to women in considering treatment options. Women appreciate information about CPM at diagnosis and emphasised the importance of discussing potential downsides of the procedure in addition to benefits. The DA was considered acceptable to facilitate such discussions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Implications of Modern Decision Science for Military Decision-Support Systems

Science.gov (United States)

2005-01-01

Stock of Naturalistic Decision Making," Journal of Behavioral Decision Making, Vol. 14, No. 5, 2001, pp. 331-352. Llinas, James, Ann Bisantz, Colin Drury ...on aided adversarial decisionmaking (Llinas, Bisantz, Drury , Song, and Jian, 1998). Cohen argues for a situation-specific trust model: The problem of...and P. Fishwick, eds., 2000, pp. 1739-1746. Camerer, Colin F., "Individual Decision Making," in John H. Kagel and Alvin E. Roth, eds., Handbook of

Induction of Ordinal Decision Trees

NARCIS (Netherlands)

J.C. Bioch (Cor); V. Popova (Viara)

2003-01-01

textabstractThis paper focuses on the problem of monotone decision trees from the point of view of the multicriteria decision aid methodology (MCDA). By taking into account the preferences of the decision maker, an attempt is made to bring closer similar research within machine learning and MCDA.

The modular integrated video system (MIVS)

International Nuclear Information System (INIS)

Schneider, S.L.; Sonnier, C.S.

1987-01-01

The Modular Integrated Video System (MIVS) is being developed for the International Atomic Energy Agency (IAEA) for use in facilities where mains power is available and the separation of the Camera and Recording Control Unit is desirable. The system is being developed under the US Program for Technical Assistance to the IAEA Safeguards (POTAS). The MIVS is designed to be a user-friendly system, allowing operation with minimal effort and training. The system software, through the use of a Liquid Crystal Display (LCD) and four soft keys, leads the inspector through the setup procedures to accomplish the intended surveillance or maintenance task. Review of surveillance data is accomplished with the use of a Portable Review Station. This Review Station will aid the inspector in the review process and determine the number of missed video scenes during a surveillance period

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