34 resultados para End of life decision making
em Consorci de Serveis Universitaris de Catalunya (CSUC), Spain
Resumo:
Minimal models for the explanation of decision-making in computational neuroscience are based on the analysis of the evolution for the average firing rates of two interacting neuron populations. While these models typically lead to multi-stable scenario for the basic derived dynamical systems, noise is an important feature of the model taking into account finite-size effects and robustness of the decisions. These stochastic dynamical systems can be analyzed by studying carefully their associated Fokker-Planck partial differential equation. In particular, we discuss the existence, positivity and uniqueness for the solution of the stationary equation, as well as for the time evolving problem. Moreover, we prove convergence of the solution to the the stationary state representing the probability distribution of finding the neuron families in each of the decision states characterized by their average firing rates. Finally, we propose a numerical scheme allowing for simulations performed on the Fokker-Planck equation which are in agreement with those obtained recently by a moment method applied to the stochastic differential system. Our approach leads to a more detailed analytical and numerical study of this decision-making model in computational neuroscience.
Resumo:
Recent single-cell studies in monkeys (Romo et al., 2004) show that the activity of neurons in the ventral premotor cortex covaries with the animal's decisions in a perceptual comparison task regarding the frequency of vibrotactile events. The firing rate response of these neurons was dependent only on the frequency differences between the two applied vibrations, the sign of that difference being the determining factor for correct task performance. We present a biophysically realistic neurodynamical model that can account for the most relevant characteristics of this decision-making-related neural activity. One of the nontrivial predictions of this model is that Weber's law will underlie the perceptual discrimination behavior. We confirmed this prediction in behavioral tests of vibrotactile discrimination in humans and propose a computational explanation of perceptual discrimination that accounts naturally for the emergence of Weber's law. We conclude that the neurodynamical mechanisms and computational principles underlying the decision-making processes in this perceptual discrimination task are consistent with a fluctuation-driven scenario in a multistable regime.
Resumo:
We develop a mediation model in which firm size is proposed to affect the scale and quality of innovative output through the adoption of different decision styles during the R&D process. The aim of this study is to understand how the internal changes that firms undergo as they evolve from small to larger organizations affect R&D productivity. In so doing, we illuminate the underlying theoretical mechanism affecting two different dimensions of R&D productivity, namely the scale and quality of innovative output which have not received much attention in previous literature. Using longitudinal data of Spanish manufacturing firms we explore the validity of this mediation model. Our results show that as firms evolve in size, they increasingly emphasize analytical decision making, and consequently, large-sized firms aim for higher-quality innovations while small firms aim for a larger scale of innovative output.
Resumo:
Much of empirical economics involves regression analysis. However, does thepresentation of results affect economists ability to make inferences for decision makingpurposes? In a survey, 257 academic economists were asked to make probabilisticinferences on the basis of the outputs of a regression analysis presented in a standardformat. Questions concerned the distribution of the dependent variable conditional onknown values of the independent variable. However, many respondents underestimateduncertainty by failing to take into account the standard deviation of the estimatedresiduals. The addition of graphs did not substantially improve inferences. On the otherhand, when only graphs were provided (i.e., with no statistics), respondents weresubstantially more accurate. We discuss implications for improving practice in reportingresults of regression analyses.
Resumo:
We investigate whether the gender composition of teams affect theireconomic performance. We study a large business game, played in groups ofthree, where each group takes the role of a general manager. There are twoparallel competitions, one involving undergraduates and the other involvingMBAs. Our analysis shows that teams formed by three women aresignificantly outperformed by any other gender combination, both at theundergraduate and MBA levels. Looking across the performancedistribution, we find that for undergraduates, three women teams areoutperformed throughout, but by as much as 10pp at the bottom and by only1pp at the top. For MBAs, at the top, the best performing group is two menand one woman. The differences in performance are explained bydifferences in decision-making. We observe that three women teams are lessaggressive in their pricing strategies, invest less in R&D, and invest more insocial sustainability initiatives, than any other gender combination teams.Finally, we find support for the hypothesis that it is poor work dynamicsamong the three women teams that drives the results.
Resumo:
[spa] El índice del máximo y el mínimo nivel es una técnica muy útil, especialmente para toma de decisiones, que usa la distancia de Hamming y el coeficiente de adecuación en el mismo problema. En este trabajo, se propone una generalización a través de utilizar medias generalizadas y cuasi aritméticas. A estos operadores de agregación, se les denominará el índice del máximo y el mínimo nivel medio ponderado ordenado generalizado (GOWAIMAM) y cuasi aritmético (Quasi-OWAIMAM). Estos nuevos operadores generalizan una amplia gama de casos particulares como el índice del máximo y el mínimo nivel generalizado (GIMAM), el OWAIMAM, y otros. También se desarrolla una aplicación en la toma de decisiones sobre selección de productos.
Resumo:
[spa] El índice del máximo y el mínimo nivel es una técnica muy útil, especialmente para toma de decisiones, que usa la distancia de Hamming y el coeficiente de adecuación en el mismo problema. En este trabajo, se propone una generalización a través de utilizar medias generalizadas y cuasi aritméticas. A estos operadores de agregación, se les denominará el índice del máximo y el mínimo nivel medio ponderado ordenado generalizado (GOWAIMAM) y cuasi aritmético (Quasi-OWAIMAM). Estos nuevos operadores generalizan una amplia gama de casos particulares como el índice del máximo y el mínimo nivel generalizado (GIMAM), el OWAIMAM, y otros. También se desarrolla una aplicación en la toma de decisiones sobre selección de productos.
Resumo:
Background: The aim of this research was to characterize the experience of living with diabetes mellitus (DM) and identify patients" opinions of the quality of care received and the results of interventions. Methods: A descriptive, exploratory evaluation study using qualitative methodology was performed. Participants consisted of 40 adult patients diagnosed with DM and followed up in a public hospital in Barcelona, Spain. A semistructured interview and a focus group were used and a thematic content analysis was performed. Results: Patients described DM as a disease that is difficult to control and that provokes lifestyle changes requiring effort and sacrifice. Insulin treatment increased the perception of disease severity. The most frequent and dreaded complication was hypoglycemia. The main problems perceived by patients affecting the quality of care were related to a disease-centered medical approach, lack of information, limited participation in decision-making, and the administrative and bureaucratic problems of the health care system. Conclusion: The bureaucratic circuits of the health care system impair patients" quality of life and perceived quality of care. Health professionals should foster patient participation in decision-making. However, this requires not only training and appropriate attitudes, but also adequate staffing and materials.
Resumo:
Background: The aim of this research was to characterize the experience of living with diabetes mellitus (DM) and identify patients" opinions of the quality of care received and the results of interventions. Methods: A descriptive, exploratory evaluation study using qualitative methodology was performed. Participants consisted of 40 adult patients diagnosed with DM and followed up in a public hospital in Barcelona, Spain. A semistructured interview and a focus group were used and a thematic content analysis was performed. Results: Patients described DM as a disease that is difficult to control and that provokes lifestyle changes requiring effort and sacrifice. Insulin treatment increased the perception of disease severity. The most frequent and dreaded complication was hypoglycemia. The main problems perceived by patients affecting the quality of care were related to a disease-centered medical approach, lack of information, limited participation in decision-making, and the administrative and bureaucratic problems of the health care system. Conclusion: The bureaucratic circuits of the health care system impair patients" quality of life and perceived quality of care. Health professionals should foster patient participation in decision-making. However, this requires not only training and appropriate attitudes, but also adequate staffing and materials.
Resumo:
We analyse the use of the ordered weighted average (OWA) in decision-making giving special attention to business and economic decision-making problems. We present several aggregation techniques that are very useful for decision-making such as the Hamming distance, the adequacy coefficient and the index of maximum and minimum level. We suggest a new approach by using immediate weights, that is, by using the weighted average and the OWA operator in the same formulation. We further generalize them by using generalized and quasi-arithmetic means. We also analyse the applicability of the OWA operator in business and economics and we see that we can use it instead of the weighted average. We end the paper with an application in a business multi-person decision-making problem regarding production management
Resumo:
Abstract¿La deteción del espectro libre para las comunicaciones inalámbricas en un momento puntual es una tarea compleja cuyo desarrollo se simplica al realizarse de forma distribuida por una red de radio cognitiva. Sin embargo existes dificultades y vulnerabilidades de seguridad que han de ser tenidas en cuenta y solventadas a la hora de autenticar y validar los nodos de la red. Este artículo presenta una propuesta de mejora del protocolo fully distributed decision making protocol for CRN con el fin de llevar a cabo esta tarea de detección del espectro de una manera eficiente y segura.
Resumo:
Este artículo presenta una propuesta de mejora del protocolo fully distributed decision making protocol for CRN con el fin de llevar a cabo la tarea de detección del espectro libre para las comunicaciones inalámbricas de una manera eficiente y segura.
Resumo:
We analyse the use of the ordered weighted average (OWA) in decision-making giving special attention to business and economic decision-making problems. We present several aggregation techniques that are very useful for decision-making such as the Hamming distance, the adequacy coefficient and the index of maximum and minimum level. We suggest a new approach by using immediate weights, that is, by using the weighted average and the OWA operator in the same formulation. We further generalize them by using generalized and quasi-arithmetic means. We also analyse the applicability of the OWA operator in business and economics and we see that we can use it instead of the weighted average. We end the paper with an application in a business multi-person decision-making problem regarding production management
Resumo:
Background: As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods: Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24,and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results: The largest differences in QOL occurred in the first 16 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions: Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT.
Resumo:
Background: As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods: Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24,and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results: The largest differences in QOL occurred in the first 1-6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions: Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT.