990 resultados para Shared-decision making


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Decision making at the front end of innovation is critical for the success of companies. This paper presents a method, called decision making based on knowledge (DeBK), which was created to analyze the decision-making process at the front end. The method evaluates the knowledge of project information and the importance of decision criteria, compiling a measure that indicates whether decisions are founded on available knowledge and what criteria are in fact being considered to delineate them. The potential contribution of DeBK is corroborated through two projects that faced decision-making issues at the front end of innovation. © 2014 RADMA and John Wiley & Sons Ltd.

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After committing to an action, a decision-maker can change their mind to revise the action. Such changes of mind can even occur when the stream of information that led to the action is curtailed at movement onset. This is explained by the time delays in sensory processing and motor planning which lead to a component at the end of the sensory stream that can only be processed after initiation. Such post-initiation processing can explain the pattern of changes of mind by asserting an accumulation of additional evidence to a criterion level, termed change-of-mind bound. Here we test the hypothesis that physical effort associated with the movement required to change one's mind affects the level of the change-of-mind bound and the time for post-initiation deliberation. We varied the effort required to change from one choice target to another in a reaching movement by varying the geometry of the choice targets or by applying a force field between the targets. We show that there is a reduction in the frequency of change of mind when the separation of the choice targets would require a larger excursion of the hand from the initial to the opposite choice. The reduction is best explained by an increase in the evidence required for changes of mind and a reduced time period of integration after the initial decision. Thus the criteria to revise an initial choice is sensitive to energetic costs.

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Bistable switches are frequently encountered in biological systems. Typically, a bistable switch models a binary decision where each decision corresponds to one of the two stable equilibria. Recently, we showed that the global decision-making process in bistable switches strongly depends on a particular equilibrium point of these systems, their saddle point. In particular, we showed that a saddle point with a time-scale separation between its attractive and repulsive directions can delay the decision-making process. In this paper, we study the effects of white Gaussian noise on this mechanism of delayed decision-making induced by the saddle point. Results show that the mean decision-time strongly depends on the balance between the initial distance to the separatrix and the noise strength. © IFAC.

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Aim and objectives To examine how nurses collect and use cues from respiratory assessment to inform their decisions as they wean patients from ventilatory support. Background Prompt and accurate identification of the patient's ability to sustain reduction of ventilatory support has the potential to increase the likelihood of successful weaning. Nurses' information processing during the weaning from mechanical ventilation has not been well-described. Design A descriptive ethnographic study exploring critical care nurses' decision-making processes when weaning mechanically ventilated patients from ventilatory support in the real setting. Methods Novice and expert Scottish and Greek nurses from two tertiary intensive care units were observed in real practice of weaning mechanical ventilation and were invited to participate in reflective interviews near the end of their shift. Data were analysed thematically using concept maps based on information processing theory. Ethics approval and informed consent were obtained. Results Scottish and Greek critical care nurses acquired patient-centred objective physiological and subjective information from respiratory assessment and previous knowledge of the patient, which they clustered around seven concepts descriptive of the patient's ability to wean. Less experienced nurses required more encounters of cues to attain the concepts with certainty. Subjective criteria were intuitively derived from previous knowledge of patients' responses to changes of ventilatory support. All nurses used focusing decision-making strategies to select and group cues in order to categorise information with certainty and reduce the mental strain of the decision task. Conclusions Nurses used patient-centred information to make a judgment about the patients' ability to wean. Decision-making strategies that involve categorisation of patient-centred information can be taught in bespoke educational programmes for mechanical ventilation and weaning. Relevance to clinical practice Advanced clinical reasoning skills and accurate detection of cues in respiratory assessment by critical care nurses will ensure optimum patient management in weaning mechanical ventilation

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Mobile devices offer a common platform for both leisure and work-related tasks but this has resulted in a blurred boundary between home and work. In this paper we explore the security implications of this blurred boundary, both for the worker and the employer. Mobile workers may not always make optimum security-related choices when ‘on the go’ and more impulsive individuals may be particularly affected as they are considered more vulnerable to distraction. In this study we used a task scenario, in which 104 users were asked to choose a wireless network when responding to work demands while out of the office. Eye-tracking data was obtained from a subsample of 40 of these participants in order to explore the effects of impulsivity on attention. Our results suggest that impulsive people are more frequent users of public devices and networks in their day-to-day interactions and are more likely to access their social networks on a regular basis. However they are also likely to make risky decisions when working on-the-go, processing fewer features before making those decisions. These results suggest that those with high impulsivity may make more use of the mobile Internet options for both work and private purposes but they also show attentional behavior patterns that suggest they make less considered security-sensitive decisions. The findings are discussed in terms of designs that might support enhanced deliberation, both in the moment and also in relation to longer term behaviors that would contribute to a better work-life balance.

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We consider challenges associated with application domains in which a large number of distributed, networked sensors must perform a sensing task repeatedly over time. For the tasks we consider, there are three significant challenges to address. First, nodes have resource constraints imposed by their finite power supply, which motivates computations that are energy-conserving. Second, for the applications we describe, the utility derived from a sensing task may vary depending on the placement and size of the set of nodes who participate, which often involves complex objective functions for nodes to target. Finally, nodes must attempt to realize these global objectives with only local information. We present a model for such applications, in which we define appropriate global objectives based on utility functions and specify a cost model for energy consumption. Then, for an important class of utility functions, we present distributed algorithms which attempt to maximize the utility derived from the sensor network over its lifetime. The algorithms and experimental results we present enable nodes to adaptively change their roles over time and use dynamic reconfiguration of routes to load balance energy consumption in the network.

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How does the brain make decisions? Speed and accuracy of perceptual decisions covary with certainty in the input, and correlate with the rate of evidence accumulation in parietal and frontal cortical "decision neurons." A biophysically realistic model of interactions within and between Retina/LGN and cortical areas V1, MT, MST, and LIP, gated by basal ganglia, simulates dynamic properties of decision-making in response to ambiguous visual motion stimuli used by Newsome, Shadlen, and colleagues in their neurophysiological experiments. The model clarifies how brain circuits that solve the aperture problem interact with a recurrent competitive network with self-normalizing choice properties to carry out probablistic decisions in real time. Some scientists claim that perception and decision-making can be described using Bayesian inference or related general statistical ideas, that estimate the optimal interpretation of the stimulus given priors and likelihoods. However, such concepts do not propose the neocortical mechanisms that enable perception, and make decisions. The present model explains behavioral and neurophysiological decision-making data without an appeal to Bayesian concepts and, unlike other existing models of these data, generates perceptual representations and choice dynamics in response to the experimental visual stimuli. Quantitative model simulations include the time course of LIP neuronal dynamics, as well as behavioral accuracy and reaction time properties, during both correct and error trials at different levels of input ambiguity in both fixed duration and reaction time tasks. Model MT/MST interactions compute the global direction of random dot motion stimuli, while model LIP computes the stochastic perceptual decision that leads to a saccadic eye movement.

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When brain mechanism carry out motion integration and segmentation processes that compute unambiguous global motion percepts from ambiguous local motion signals? Consider, for example, a deer running at variable speeds behind forest cover. The forest cover is an occluder that creates apertures through which fragments of the deer's motion signals are intermittently experienced. The brain coherently groups these fragments into a trackable percept of the deer in its trajectory. Form and motion processes are needed to accomplish this using feedforward and feedback interactions both within and across cortical processing streams. All the cortical areas V1, V2, MT, and MST are involved in these interactions. Figure-ground processes in the form stream through V2, such as the seperation of occluding boundaries of the forest cover from the boundaries of the deer, select the motion signals which determine global object motion percepts in the motion stream through MT. Sparse, but unambiguous, feauture tracking signals are amplified before they propogate across position and are intergrated with far more numerous ambiguous motion signals. Figure-ground and integration processes together determine the global percept. A neural model predicts the processing stages that embody these form and motion interactions. Model concepts and data are summarized about motion grouping across apertures in response to a wide variety of displays, and probabilistic decision making in parietal cortex in response to random dot displays.

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Political drivers such as the Kyoto protocol, the EU Energy Performance of Buildings Directive and the Energy end use and Services Directive have been implemented in response to an identified need for a reduction in human related CO2 emissions. Buildings account for a significant portion of global CO2 emissions, approximately 25-30%, and it is widely acknowledged by industry and research organisations that they operate inefficiently. In parallel, unsatisfactory indoor environmental conditions have proven to negatively impact occupant productivity. Legislative drivers and client education are seen as the key motivating factors for an improvement in the holistic environmental and energy performance of a building. A symbiotic relationship exists between building indoor environmental conditions and building energy consumption. However traditional Building Management Systems and Energy Management Systems treat these separately. Conventional performance analysis compares building energy consumption with a previously recorded value or with the consumption of a similar building and does not recognise the fact that all buildings are unique. Therefore what is required is a new framework which incorporates performance comparison against a theoretical building specific ideal benchmark. Traditionally Energy Managers, who work at the operational level of organisations with respect to building performance, do not have access to ideal performance benchmark information and as a result cannot optimally operate buildings. This thesis systematically defines Holistic Environmental and Energy Management and specifies the Scenario Modelling Technique which in turn uses an ideal performance benchmark. The holistic technique uses quantified expressions of building performance and by doing so enables the profiled Energy Manager to visualise his actions and the downstream consequences of his actions in the context of overall building operation. The Ideal Building Framework facilitates the use of this technique by acting as a Building Life Cycle (BLC) data repository through which ideal building performance benchmarks are systematically structured and stored in parallel with actual performance data. The Ideal Building Framework utilises transformed data in the form of the Ideal Set of Performance Objectives and Metrics which are capable of defining the performance of any building at any stage of the BLC. It is proposed that the union of Scenario Models for an individual building would result in a building specific Combination of Performance Metrics which would in turn be stored in the BLC data repository. The Ideal Data Set underpins the Ideal Set of Performance Objectives and Metrics and is the set of measurements required to monitor the performance of the Ideal Building. A Model View describes the unique building specific data relevant to a particular project stakeholder. The energy management data and information exchange requirements that underlie a Model View implementation are detailed and incorporate traditional and proposed energy management. This thesis also specifies the Model View Methodology which complements the Ideal Building Framework. The developed Model View and Rule Set methodology process utilises stakeholder specific rule sets to define stakeholder pertinent environmental and energy performance data. This generic process further enables each stakeholder to define the resolution of data desired. For example, basic, intermediate or detailed. The Model View methodology is applicable for all project stakeholders, each requiring its own customised rule set. Two rule sets are defined in detail, the Energy Manager rule set and the LEED Accreditor rule set. This particular measurement generation process accompanied by defined View would filter and expedite data access for all stakeholders involved in building performance. Information presentation is critical for effective use of the data provided by the Ideal Building Framework and the Energy Management View definition. The specifications for a customised Information Delivery Tool account for the established profile of Energy Managers and best practice user interface design. Components of the developed tool could also be used by Facility Managers working at the tactical and strategic levels of organisations. Informed decision making is made possible through specified decision assistance processes which incorporate the Scenario Modelling and Benchmarking techniques, the Ideal Building Framework, the Energy Manager Model View, the Information Delivery Tool and the established profile of Energy Managers. The Model View and Rule Set Methodology is effectively demonstrated on an appropriate mixed use existing ‘green’ building, the Environmental Research Institute at University College Cork, using the Energy Management and LEED rule sets. Informed Decision Making is also demonstrated using a prototype scenario for the demonstration building.

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This PhD thesis investigates the potential use of science communication models to engage a broader swathe of actors in decision making in relation to scientific and technological innovation in order to address possible democratic deficits in science and technology policy-making. A four-pronged research approach has been employed to examine different representations of the public(s) and different modes of engagement. The first case study investigates whether patient-groups could represent an alternative needs-driven approach to biomedical and health sciences R & D. This is followed by enquiry into the potential for Science Shops to represent a bottom-up approach to promote research and development of local relevance. The barriers and opportunities for the involvement of scientific researchers in science communication are next investigated via a national survey which is comparable to a similar survey conducted in the UK. The final case study investigates to what extent opposition or support regarding nanotechnology (as an emerging technology) is reflected amongst the YouTube user community and the findings are considered in the context of how support or opposition to new or emerging technologies can be addressed using conflict resolution based approaches to manage potential conflict trajectories. The research indicates that the majority of communication exercises of relevance to science policy and planning take the form of a one-way flow of information with little or no facility for public feedback. This thesis proposes that a more bottom-up approach to research and technology would help broaden acceptability and accountability for decisions made relating to new or existing technological trajectories. This approach could be better integrated with and complementary to government, institutional, e.g. university, and research funding agencies activities and help ensure that public needs and issues are better addressed directly by the research community. Such approaches could also facilitate empowerment of societal stakeholders regarding scientific literacy and agenda-setting. One-way information relays could be adapted to facilitate feedback from representative groups e.g. Non-governmental organisations or Civil Society Organisations (such as patient groups) in order to enhance the functioning and socio-economic relevance of knowledge-based societies to the betterment of human livelihoods.

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In many real world situations, we make decisions in the presence of multiple, often conflicting and non-commensurate objectives. The process of optimizing systematically and simultaneously over a set of objective functions is known as multi-objective optimization. In multi-objective optimization, we have a (possibly exponentially large) set of decisions and each decision has a set of alternatives. Each alternative depends on the state of the world, and is evaluated with respect to a number of criteria. In this thesis, we consider the decision making problems in two scenarios. In the first scenario, the current state of the world, under which the decisions are to be made, is known in advance. In the second scenario, the current state of the world is unknown at the time of making decisions. For decision making under certainty, we consider the framework of multiobjective constraint optimization and focus on extending the algorithms to solve these models to the case where there are additional trade-offs. We focus especially on branch-and-bound algorithms that use a mini-buckets algorithm for generating the upper bound at each node of the search tree (in the context of maximizing values of objectives). Since the size of the guiding upper bound sets can become very large during the search, we introduce efficient methods for reducing these sets, yet still maintaining the upper bound property. We define a formalism for imprecise trade-offs, which allows the decision maker during the elicitation stage, to specify a preference for one multi-objective utility vector over another, and use such preferences to infer other preferences. The induced preference relation then is used to eliminate the dominated utility vectors during the computation. For testing the dominance between multi-objective utility vectors, we present three different approaches. The first is based on a linear programming approach, the second is by use of distance-based algorithm (which uses a measure of the distance between a point and a convex cone); the third approach makes use of a matrix multiplication, which results in much faster dominance checks with respect to the preference relation induced by the trade-offs. Furthermore, we show that our trade-offs approach, which is based on a preference inference technique, can also be given an alternative semantics based on the well known Multi-Attribute Utility Theory. Our comprehensive experimental results on common multi-objective constraint optimization benchmarks demonstrate that the proposed enhancements allow the algorithms to scale up to much larger problems than before. For decision making problems under uncertainty, we describe multi-objective influence diagrams, based on a set of p objectives, where utility values are vectors in Rp, and are typically only partially ordered. These can be solved by a variable elimination algorithm, leading to a set of maximal values of expected utility. If the Pareto ordering is used this set can often be prohibitively large. We consider approximate representations of the Pareto set based on ϵ-coverings, allowing much larger problems to be solved. In addition, we define a method for incorporating user trade-offs, which also greatly improves the efficiency.