Risk-informed decision-making in the presence of epistemic uncertainty

An important issue in risk analysis is the distinction between epistemic and aleatory uncertainties. In this paper, the use of distinct representation formats for aleatory and epistemic uncertainties is advocated, the latter being modelled by sets of possible values. Modern uncertainty theories based on convex sets of probabilities are known to be instrumental for hybrid representations where aleatory and epistemic components of uncertainty remain distinct. Simple uncertainty representation techniques based on fuzzy intervals and p-boxes are used in practice. This paper outlines a risk analysis methodology from elicitation of knowledge about parameters to decision. It proposes an elicitation methodology where the chosen representation format depends on the nature and the amount of available information. Uncertainty propagation methods then blend Monte Carlo simulation and interval analysis techniques. Nevertheless, results provided by these techniques, often in terms of probability intervals, may be too complex to interpret for a decision-maker and we, therefore, propose to compute a unique indicator of the likelihood of risk, called confidence index. It explicitly accounts for the decisionmaker’s attitude in the face of ambiguity. This step takes place at the end of the risk analysis process, when no further collection of evidence is possible that might reduce the ambiguity due to epistemic uncertainty. This last feature stands in contrast with the Bayesian methodology, where epistemic uncertainties on input parameters are modelled by single subjective probabilities at the beginning of the risk analysis process.

Design and Implementation of a Low Cost Virtual Rugby Decision Making Interactive

The paper describes the design and implementation of a novel low cost virtual rugby decision making interactive for use in a visitor centre. Original laboratory-based experimental work in decision making in rugby, using a virtual reality headset [1] is adapted for use in a public visitor centre, with consideration given to usability, costs, practicality and health and safety. Movement of professional rugby players was captured and animated within a virtually recreated stadium. Users then interact with these virtual representations via use of a lowcost sensor (Microsoft Kinect) to attempt to block them. Retaining the principles of perception and action, egocentric viewpoint, immersion, sense of presence, representative design and game design the system delivers an engaging and effective interactive to illustrate the underlying scientific principles of deceptive movement. User testing highlighted the need for usability, system robustness, fair and accurate scoring, appropriate level of difficulty and enjoyment.

Factors influencing patients with stage 5 chronic kidney disease to opt for conservative management: a practitioner research study

Aims and objectives. This study explored decision-making experiences of patients with stage 5 chronic kidney disease when opting for conservative management of their renal failure.

Background. Dialysis is an invasive treatment, and for some older patients, there is an associated treatment burden of dialysis-related symptoms. An alternative choice is conservative management, but little is known about those who make this decision and how they are supported through the process.

Design. Qualitative practitioner research study.

Method. Data were generated from nine patients' naturally occurring clinic consultations with a renal clinical nurse specialist between May 2010 - July 2010. Interviews were transcribed verbatim and findings fed back at three multi-disciplinary meetings to check for relevance and resonance. Common themes were identified and codes applied.

Results. Patients reported age and having to travel three times a week to hospital for dialysis as reasons not to opt for treatment. Others felt well without dialysis not wanting to upset the 'status quo' or to burden loved ones. Most felt equipped to make the decision following explanation and discussion with the clinical nurse specialist in the renal clinic.

Conclusions. Patients opting for conservative management give numerous reasons for this including old age, travel limitations, feeling well without dialysis and not wanting to be a burden, but appear content with their decision. One-to-one discussions with the clinical nurse specialist appear helpful during the decision-making process presenting an opportunity for advancing nursing roles in the chronic kidney disease service.

Relevance to clinical practice. Understanding patients' reasons for refusing dialysis assists in supporting until death. There is an opportunity for developing nursing practice to meet the multi-faceted needs of this group.

A Visual Analytics Framework for Strategic Airlift Decision Making

The foundational concept of Network Enabled Capability relies on effective, timely information sharing. This information is used in analysis, trade and scenario studies, and ultimately decision-making. In this paper, the concept of visual analytics is explored as an enabler to facilitate rapid, defensible, and superior decision-making. By coupling analytical reasoning with the exceptional human capability to rapidly internalize and understand visual data, visual analytics allows individual and collaborative decision-making to occur in the face of vast and disparate data, time pressures, and uncertainty. An example visual analytics framework is presented in the form of a decision-making environment centered on the Lockheed C-5A and C-5M aircraft. This environment allows rapid trade studies to be conducted on design, logistics, and capability within the aircraft?s operational roles. Through this example, the use of a visual analytics decision-making environment within a military environment is demonstrated.

The effects of job demands and low job control on work-family conflict: The role of fairness in decision making and management

The present study examined whether Perceptions of organizational fairness (the procedural and interactional components) were able to diminish the negative effects of high job demands and low job control on the balance between work and family. The study participants were 713 women working in long-term care for elderly people in Finland. The results showed that high job demands, low job control, and unfair decision making were associated with high levels of time-based work interference with family (WIF). Perceptions of organizational fairness were found to partially mediate the association between Job control and WIF In addition, fair treatment and management protected against WIF when demands were low but were unable to bluffer against the negative effects of high job demands. (C) 2008 Wiley Periodicals, Inc.

The influence of evidence-based medicine training on decision-making in relation to over-the-counter medicines: a qualitative study

Objectives
To explore the role of evidence of effectiveness when making decisions about over-the-counter (OTC) medication and to ascertain whether evidence-based medicine training raised awareness in decision-making. Additionally, this work aimed to complement the findings of a previous study because all participants in this current study had received training in evidence-based medicine (unlike the previous participants).

Methods
Following ethical approval and an e-mailed invitation, face-to-face, semi-structured interviews were conducted with newly registered pharmacists (who had received training in evidence-based medicine as part of their MPharm degree) to discuss the role of evidence of effectiveness with OTC medicines. Interviews were recorded and transcribed verbatim. Following transcription, all data were entered into the NVivo software package (version 8). Data were coded and analysed using a constant comparison approach.

Key findings
Twenty-five pharmacists (7 males and 18 females; registered for less than 4 months) were recruited and all participated in the study. Their primary focus with OTC medicines was safety; sales of products (including those that lack evidence of effectiveness) were justified provided they did no harm. Meeting patient expectation was also an important consideration and often superseded evidence. Despite knowledge of the concept, and an awareness of ethical requirements, an evidence-based approach was not routinely implemented by these pharmacists. Pharmacists did not routinely utilize evidence-based resources when making decisions about OTC medicines and some felt uncomfortable discussing the evidence-base for OTC products with patients.

Conclusions
The evidence-based medicine training that these pharmacists received appeared to have limited influence on OTC decision-making. More work could be conducted to ensure that an evidence-based approach is routinely implemented in practice

Integrating textual analysis and evidential reasoning for decision making in Engineering design

Decision making is an important element throughout the life-cycle of large-scale projects. Decisions are critical as they have a direct impact upon the success/outcome of a project and are affected by many factors including the certainty and precision of information. In this paper we present an evidential reasoning framework which applies Dempster-Shafer Theory and its variant Dezert-Smarandache Theory to aid decision makers in making decisions where the knowledge available may be imprecise, conflicting and uncertain. This conceptual framework is novel as natural language based information extraction techniques are utilized in the extraction and estimation of beliefs from diverse textual information sources, rather than assuming these estimations as already given. Furthermore we describe an algorithm to define a set of maximal consistent subsets before fusion occurs in the reasoning framework. This is important as inconsistencies between subsets may produce results which are incorrect/adverse in the decision making process. The proposed framework can be applied to problems involving material selection and a Use Case based in the Engineering domain is presented to illustrate the approach. © 2013 Elsevier B.V. All rights reserved.