Search results for: patient centered decision making

Authors: Cristóbal Moënne-Loccoz, Rodrigo C. Vergara, Vladimir López, Domingo Mery, Diego Cosmelli

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Our daily interaction with computational interfaces is plagued of situations in which we go from inexperienced users to experts through self-motivated exploration of the same task. In many of these interactions, we must learn to find our way through a sequence of decisions and actions before obtaining the desired result. For instance, when drawing cash from an ATM machine, choices are presented in a step-by-step fashion so that a specific sequence of actions must be performed in order to produce the expected outcome. But, as they become experts in the use of such interfaces, do users adopt specific search and learning strategies? Moreover, if so, can we use this information to follow the process of expertise development and, eventually, predict future actions? This would be a critical step towards building truly adaptive interfaces that can facilitate interaction at different moments of the learning curve. Furthermore, it could provide a window into potential mechanisms underlying decision-making behavior in real world scenarios. Here we tackle this question using a simple game interface that instantiates a 4-level binary decision tree (BDT) sequential decision-making task. Participants have to explore the interface and discover an underlying concept-icon mapping in order to complete the game. We develop a Hidden Markov Model (HMM)-based approach whereby a set of stereotyped, hierarchically related search behaviors act as hidden states. Using this model, we are able to track the decision-making process as participants explore, learn and develop expertise in the use of the interface. Our results show that partitioning the problem space into such stereotyped strategies is sufficient to capture a host of exploratory and learning behaviors. Moreover, using the modular architecture of stereotyped strategies as a Mixture of Experts, we are able to simultaneously ask the experts about the user's most probable future actions. We show that for those participants that learn the task, it becomes possible to predict their next decision, above chance, approximately halfway through the game. Our long-term goal is, on the basis of a better understanding of real-world decision-making processes, to inform the construction of interfaces that can establish dynamic conversations with their users in order to facilitate the development of expertise.

Keywords: behavioral modeling, expertise acquisition, hidden markov models, sequential decision-making

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Authors: Cansu Kandemir, Marco Franchino

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To attain sustainability goals, the manufacturing industries must assess and improve their processes, adopt the latest technologies, and ensure minimal environmental impact. Ongoing debates claim that the definition of sustainability and its assessment is vague. Companies struggle with understanding which processes they should prioritise and necessitate a methodology to aid decision-making. For that reason, our investigation focused on defining a prioritisation guide to help to manufacture engineers identify areas of a facility to prioritise de-carbonisation efforts based on existing sources of data. The authors at the University of Sheffield Advanced Manufacturing Research Centre (AMRC) worked with a range of major businesses, including Food and Drink (Moy Park), Automotive (Nissan), Aerospace and Defence (BAE, Meggitt, Leonardo, and GKN) and Technology (Accenture and Intellium AI). Collected information has been integrated into a prioritisation guide framework that helps process comparison and decision-making. The framework developed in this study aims to ensure that companies have guidance on where to focus their efforts whilst striving to fulfil their environmental and societal obligations.

Keywords: decision making, sustainability, carbon emissions, manufacturing

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Authors: Priyanka Bharti

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Decades ago designs were based on common sense and tradition, but after an enhancement in visualization technology and research, we are now able to comprehend the cognitive ability involved in the decoding of the visual information. However, many fields in visuals need intense research to deliver an efficient explanation for the events. Visuals are an information representation mode through images, symbols and graphics. It plays an impactful role in decision making by facilitating quick recognition, comprehension, and analysis of a situation. They enhance problem-solving capabilities by enabling the processing of more data without overloading the decision maker. As research proves that, visuals offer an improved learning environment by a factor of 400 compared to textual information. Visual information engages learners at a cognitive level and triggers the imagination, which enables the user to process the information faster (visuals are processed 60,000 times faster in the brain than text). Appropriate information, visualization, and its presentation are known to aid and intensify the decision-making process for the users. However, most literature discusses the role of visual aids in comprehension and decision making during normal conditions alone. Unlike emergencies, in a normal situation (e.g. our day to day life) users are neither exposed to stringent time constraints nor face the anxiety of survival and have sufficient time to evaluate various alternatives before making any decision. An emergency is an unexpected probably fatal real-life situation which may inflict serious ramifications on both human life and material possessions unless corrective measures are taken instantly. The situation demands the exposed user to negotiate in a dynamic and unstable scenario in the absence or lack of any preparation, but still, take swift and appropriate decisions to save life/lives or possessions. But the resulting stress and anxiety restricts cue sampling, decreases vigilance, reduces the capacity of working memory, causes premature closure in evaluating alternative options, and results in task shedding. Limited time, uncertainty, high stakes and vague goals negatively affect cognitive abilities to take appropriate decisions. More so, theory of natural decision making by experts has been understood with far more depth than that of an ordinary user. Therefore, in this study, the author aims to understand the role of visual aids in supporting rapid comprehension to take appropriate decisions during an emergency situation.

Keywords: cognition, visual, decision making, graphics, recognition

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Authors: P. T. Collett, M. Kershaw

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Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

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Authors: Adel Sabry Eesa, Adnan Mohsin Abdulazeez Brifcani, Zeynep Orman

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Feature selection has been used in many fields such as classification, data mining and object recognition and proven to be effective for removing irrelevant and redundant features from the original data set. In this paper, a new design of distributed intrusion detection system using a combination feature selection model based on bees and decision tree. Bees algorithm is used as the search strategy to find the optimal subset of features, whereas decision tree is used as a judgment for the selected features. Both the produced features and the generated rules are used by Decision Making Mobile Agent to decide whether there is an attack or not in the networks. Decision Making Mobile Agent will migrate through the networks, moving from node to another, if it found that there is an attack on one of the nodes, it then alerts the user through User Interface Agent or takes some action through Action Mobile Agent. The KDD Cup 99 data set is used to test the effectiveness of the proposed system. The results show that even if only four features are used, the proposed system gives a better performance when it is compared with the obtained results using all 41 features.

Keywords: distributed intrusion detection system, mobile agent, feature selection, bees algorithm, decision tree

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Authors: Katharina Fellnhofer

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The more information and knowledge that technology provides, the more important are profoundly human skills like intuition, the skill of using nonconscious information. As our world becomes more complex, shaken by crises, and characterized by uncertainty, time pressure, ambiguity, and rapidly changing conditions, intuition is increasingly recognized as a key human asset. However, due to methodological limitations of sample size or time frame or a lack of real-world or cross-cultural scope, precisely how to measure intuition when facing risks on a nonconscious level remains unclear. In light of the measurement challenge related to intuition’s nonconscious nature, a technique is introduced to measure intuition via hidden images as nonconscious additional information to trigger intuition. This technique has been tested in a within-subject fully online design with 62,721 real-world investment decisions made by 657 subjects in Europe and the United States. Bayesian models highlight the technique’s potential to measure skill at using nonconscious information for conscious decision making. Over the long term, solving the mysteries of intuition and mastering its use could be of immense value in personal and organizational decision-making contexts.

Keywords: cognition, intuition, investment decisions, methodology

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Authors: Mohammad Al-Mousawi

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This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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Authors: Cathryn Robinson, Bernard McKenna, David Rooney

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This paper argues that the application of values-based leadership increasingly challenges leaders in rules-based organisations, particularly in bureaucratic organisations such as the military, public service, police, and emergency services. Leaders are grappling to reconcile how to enact values-based leadership and decision-making when they are bound by rules, policies, and procedures. This interpretive study used a multi-faceted vignette (critical incident) as the basis of an interview with air force officers at three levels: executive, senior, and junior. In this way, practice is forced to intersect with discourse. The findings revealed a shared set of discourse themes (legal; rules; safety and risk; operational practice/theatre discourses), but also clear dialectical tensions. These tensions were evident in executive officers and senior leaders emphasizing rules and information themes, whereas junior officers emphasized decision making, collateral, and situation. These findings reveal discourse and practice incommensurability that could have grave implications in the conduct of war.

Keywords: critical incident, discourse analysis, rules-based, values-based

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Authors: Semire Yekta

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Many online retailers set up manual review teams to overcome the limitations of automated online fraud detection systems. This study critically examines the strategies they adapt in their decision-making process to set apart fraudulent individuals from non-fraudulent online shoppers. The study uses a mix method research approach. 32 in-depth interviews have been conducted alongside with participant observation and auto-ethnography. The study found out that all steps of the decision-making process are significantly affected by a level of subjectivity, personal understandings of online fraud, preferences and judgments and not necessarily by objectively identifiable facts. Rather clearly knowing who the fraudulent individuals are, the team members have to predict whether they think the customer might be a fraudster. Common strategies used are relying on the classification and fraud scorings in the automated fraud detection systems, weighing up arguments for and against the customer and making a decision, using cancellation to test customers’ reaction and making use of personal experiences and “the sixth sense”. The interaction in the team also plays a significant role given that some decisions turn into a group discussion. While customer data represent the basis for the decision-making, fraud management teams frequently make use of Google search and Google Maps to find out additional information about the customer and verify whether the customer is the person they claim to be. While this, on the one hand, raises ethical concerns, on the other hand, Google Street View on the address and area of the customer puts customers living in less privileged housing and areas at a higher risk of being classified as fraudsters. Phone validation is used as a final measurement to make decisions for or against the customer when previous strategies and Google Search do not suffice. However, phone validation is also characterized by individuals’ subjectivity, personal views and judgment on customer’s reaction on the phone that results in a final classification as genuine or fraudulent.

Keywords: online fraud, data mining, manual review, social construction

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Authors: Mariella Pinna

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Sustainable entrepreneurship is an innovative corporate approach to create value combining economic, social and environmental goals over time. In the last two decades, the interest in sustainable entrepreneurship has flourished thanks to its potential to answer the current challenges of sustainable development. As a result, scholars are increasingly interested in understanding the determinants of the intentions to become a sustainable entrepreneur and consistent behavior. To date, prior studies provided empirical evidence for the influence of attitudes, perceived feasibility and desirability, values, and personality traits on the decision-making process of becoming a sustainable entrepreneur. Conversely, scant effort has been provided to understand which factors inhibit sustainable entrepreneurial intentions and behaviors. Therefore a global understanding of the sustainable entrepreneurship decision-making process is missing. This paper contributes to the debate on sustainable entrepreneurship by proposing a conceptual model that combines the factors which are predicted to facilitate and hinder the proclivity of individuals to become sustainable entrepreneurs. More in particular, the proposed framework theorizes about the role of the characteristics of the prospective sustainable entrepreneur (e.g., socio-demographic, psychological, cultural), the positive antecedents (e.g., attitude, social feasibility and desirability, among others) and the negative precursors (e.g., neutralization) in influencing sustainable entrepreneurship intentions and subsequent behavior. The proposed framework is expected to shed further light on the decision-making process of becoming a sustainable entrepreneur, which in turn, is of practical relevance for public policy institutions and the society as a whole to enhance the favorable conditions to create new sustainable ventures.

Keywords: sustainable entrepreneurship, entrepreneurial intentions, entrepreneurial decision-making, antecedents of entrepreneurial intention and behavior

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Authors: Catharina Lindberg, Cecilia Fagerstrom, Ania Willman

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Patients in high-tech care environments are usually dependent on both formal/informal caregivers and technology, highlighting their vulnerability and challenging their autonomy. Autonomy presumes that a person has education, experience, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could, therefore, be considered paradoxical, as in most cases these persons have impaired physical and/or metacognitive capacity. Therefore, to understand the prerequisites for patients to experience autonomy in high-tech care environments and to support them, there is a need to enhance knowledge and understanding of the concept of patient autonomy in this care context. The development of concepts and theories in a practice discipline such as nursing helps to improve both nursing care and nursing education. Theoretical development is important when clarifying a discipline, hence, a theoretical framework could be of use to nurses in high-tech care environments to support and defend the patient’s autonomy. A meta-synthesis was performed with the intention to be interpretative and not aggregative in nature. An amalgamation was made of the results from three previous studies, carried out by members of the same research group, focusing on the phenomenon of patient autonomy from a patient perspective within a caring context. Three basic approaches to theory development: derivation, synthesis, and analysis provided an operational structure that permitted the researchers to move back and forth between these approaches during their work in developing a theoretical framework. The results from the synthesis delineated that patient autonomy in a high-tech care context is: To be in control though trust, co-determination, and transition in everyday life. The theoretical framework contains several components creating the prerequisites for patient autonomy. Assumptions and propositional statements that guide theory development was also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients to remain or obtain patient autonomy in high-tech care environments were revealed: the strategy of control, the strategy of partnership, the strategy of trust, and the strategy of transition. This study suggests an extended knowledge base founded on theoretical reasoning about patient autonomy, providing an understanding of the strategies used by patients to achieve autonomy in the role of patient, in high-tech care environments. When possessing knowledge about the patient perspective of autonomy, the nurse/carer can avoid adopting a paternalistic or maternalistic approach. Instead, the patient can be considered to be a partner in care, allowing care to be provided that supports him/her in remaining/becoming an autonomous person in the role of patient.

Keywords: autonomy, caring, concept development, high-tech care, theory development

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Authors: Bright C. Opara, Gideon C. Uboegbulam

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This study can be appreciated from the significant role culture exert in purchase decision of durable goods the world over. This study is motivated by cultural diversity in Nigeria and socio-economic changes that have taken place in the recent times. These call for the validation of similarly studies in order to formulate informed marketing strategies that will enhance purchase behaviour. This study therefore, is set out to examine the cultural influence in family purchase decision-making for durable goods in the three major ethnic groups in Nigeria (Hausa, Ibo, and Yoruba). The primary data was sourced using structured and semi-structured research questionnaire, while the secondary information was generated from existing / available relevant literature journals / periodicals. A judgmental sampling technique was used to determine the sample size of 300 households. The Analysis of Variance (ANOVA) statistical tool was used to test the hypotheses, with the aid of Statistical Packages for Social Sciences (SPSS) version 17.0. The finding showed that cultural influence on the family Purchase Decision of Durable Goods does not significantly differ in three ethnic groups, and that family Purchase Decision Making for Durable Goods does not significantly differ in the three ethnic groups. We therefore, conclude that culture do not really impact significantly on the purchase behaviour of the three ethnic groups in the Nigeria as it does in some others. However, there is need for marketers and marketing decision makers not to generalise the findings of this study. This is because of the significant role culture play in purchase behaviour which differs from one culture or country to another.

Keywords: cultural, durable goods, influence, purchase decision

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Authors: Hsiao-Lin Fang

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Every life is precious, and comprehensive care should be provided to individuals who are in the final stages of their lives. Hospice-shared care aims to provide optimal symptom control and palliative care to terminal (cancer) patients through the implementation of shared care, and to support patients and their families in making various physical and psychological adjustments in the face of death. This report examines a 10-year-boy diagnosed with Out-of-Hospital Cardiac Arrest (OHCA). The individual fainted when swimming at school and underwent 31 minutes of cardiopulmonary resuscitation (CPR). While receiving treatment at the hospital, the individual received extracorporeal membrane oxygenation(ECMO) due to unstable hemodynamics. Urgent cardiac catheterization found: Suspect acute fulminant myocarditis or underlying cardiomyopathy with acute decompensation, After the active rescue by the medical team, hemodynamics still showed only mean pressure value. With respect to the patient, interdepartmental hospice-shared care was implemented and a do-not-resuscitate (DNR) order was signed after family discussions were conducted. Assistance and instructions were provided as part of the comfort care process. A farewell gathering attended by the patient’s relatives, friends, teachers, and classmates was organized in an intensive care unit (ICU) in order to look back on the patient’s life and the beautiful memories that were created, as well as to alleviate the sorrow felt by family members, including the patient’s father and sister. For example, the patient was presented with drawings and accompanied to a garden to pick flowers. In this manner, the patient was able to say goodbye before death. Finally, the patient’s grandmother and father participated in the clinical hospice care and post-mortem care processes. A hospice-shared care clinician conducted regular follow-ups and provided care to the family of the deceased, supporting family members through the sorrowful period. Birth, old age, sickness, and death are the natural phases of human life. In recent years, growing attention has been paid to human-centered hospice care. Hospice care is individual holistic care provided by a professional team and it involves the provision of comprehensive care to a terminal patient. Hospice care aims to satisfy the physical, psychological, mental, and social needs of patients and their families. It does not involve the cessation of treatment but rather avoids the exacerbation or extension of the suffering endured by patients, thereby preserving the dignity and quality of life during the end-of-life period. Patients enjoy the company of others as they complete the last phase of their lives, and their families also receive guidance on how they can move on with their own lives after the patient’s death.

Keywords: hospice-shared care, extracorporeal membrane oxygenation (ECMO), hospice-shared care, child patient

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Authors: Prakash Singh

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The question that arises is whether a theory such as the Collegial Leadership Model of Emancipation (COLME) has the potency to introduce leadership change by empowering and emancipating their employees. It is a fallacy to simply assume that experience alone, in the absence of theory, will contribute to this knowledge base to develop collegial leaders. The focus of this study is to therefore ascertain whether the COLME can serve as a conceptual framework to transform traditional bureaucratic management practices (TBMPs) in order to promote shared decision-making in organizations such as schools. All the respondents in this exploratory qualitative study embraced collegiality to transform TBMPs in their organizations. For the positive effects to be sustained, the collegial practices need to be evolutionary and emancipatory in order to evoke the values of collegial leadership as elucidated by the findings of this study. Interviewees affirmed that the COLME provides an astute framework to develop commendable collegial leadership practices as it clearly outlines procedures to develop and use the leadership potential of all the employees in order to foster joint accountability. They acknowledged that when the principles of collegiality are flexibly applied, they contribute to the creation of a holistic milieu in which all employees are able to express themselves freely, without fear of failure, and thus feel that they are part of the democratic decision-making process. Evidently, a conceptual framework such as the COLME can serve as a benchmark for leadership effectiveness because organizational outcomes need to be measured against standards of excellence in meeting both employee and customer expectations.

Keywords: collegial leadership model, employee empowerment, shared decision-making, traditional bureaucratic management practices

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Authors: Dina Siniora, Jasia Baig

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During the past few decades, the healthcare system has undergone profound changes in their healthcare decision-making competencies and moral aptitudes due to the vast advancement in technology, clinical skills, and scientific knowledge. Healthcare decision-making deals with morally contentious dilemmas ranging from illness, life and death judgments that require sensitivity and awareness towards the patient’s preferences while taking into consideration medicine’s abilities and boundaries. As the ever-evolving field of medicine continues to become more scientifically and morally multifarious; physicians and the hospital administrators increasingly rely on ethics committees to resolve problems that arise in everyday patient care. The role and latitude of responsibilities of ethics committees which includes being dispute intermediaries, moral analysts, policy educators, counselors, advocates, and reviewers; suggest the importance and effectiveness of a fully integrated committee. Despite achievements on Integrated Ethics and progress in standards and competencies, there is an imminent necessity for further improvement in quality within ethics consultation services in areas of credentialing, professionalism and standards of quality, as well as the quality of healthcare throughout the system. These concerns can be resolved first by collecting data about particular quality gaps and comprehend the level to which ethics committees are consistent with newly published ASBH quality standards. Policymakers should pursue improvement strategies that target both academic bioethics community and major stakeholders at hospitals, who directly influence ethics committees. This broader approach oriented towards education and intervention outcome in conjunction with preventive ethics to address disparities in quality on a systematic level. Adopting tools for improving competencies and processes within ethics consultation by implementing a credentialing process, upholding normative significance for the ASBH core competencies, advocating for professional Code of Ethics, and further clarifying the internal structures will improve productivity, patient satisfaction, and institutional integrity. This cannot be systemically achieved without a written certification exam for HCEC practitioners, credentialing and privileging HCEC practitioners at the hospital level, and accrediting HCEC services at the institutional level.

Keywords: ethics consultation, hospital, medical ethics, quality

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Authors: B. Vikram, Y. Anu Leena, Y. Anu Neena, M. V. Krishna Rao, V. S. S. Kumar

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The industry is often criticized for inefficiencies in outcomes such as time and cost overruns, low productivity, poor quality and inadequate customer satisfaction. To enhance the chances for construction projects to be successful, selecting an able contractor is one of the fundamental decisions to be made by clients. The selection of the most appropriate contractor is a multi-criteria decision making (MCDM) process. In this paper, multi-attribute utility theory (MAUT) is employed utilizing the multiplicative form of utility function for ranking the prequalified contractors. Performance assessment criteria covering contracting company attributes, experience record, past performance, performance potential, financial stability and project specific criteria are considered for contractor evaluation. A case study of multistoried building for which four contractors submitted bids is considered to illustrate the applicability of multiplicative approach of MAUT to rank the prequalified contractors. The proposed MAUT decision making methodology can also be employed to other decision making situations.

Keywords: multi-attribute utility theory, construction industry, prequalification, contractor

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Authors: Ali Abbas

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Industrial Engineering is a broad multidisciplinary field with intersections and applications in numerous areas. In out current environment, the path from a phenomenon to value involves numerous people with expertise in various areas including domain knowledge of a field and the ability to make decisions within an operating environment that lead to value creation. We propose some skills that industrial engineering programs should focus on, and argue that an industrial engineer is a decision maker instead of a problem solver.

Keywords: decision analysis, problem-solving, value creation, industrial engineering

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Authors: Manita Ale, Ganesh P. Shivakoti, Ram C. Bastakoti

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Irrigation system, a system for enhancing agricultural productivity, requires regular maintenance in order to avoid irregular allocation of water. For maintenance of the system in long run, farmers’ participation plays a key role increasing the performance of system. The performance of any irrigation system mainly relies on various factors which affect collective action plus decision making, as well as their shared impacts. The paper consists of system level information that were collected from 12 Irrigation Systems (IS) from three-sampled districts of Nepal and the household information that were collected from 160 irrigation water users. The results reveal that, out of 12 sampled irrigation systems, only 4 systems shows high performance levels. The high performance level of those systems was characterized on the basis of adequate availability of water, good maintenance of system infrastructure, and conformance to existing rules followed. In addition, the paper compares different irrigation systems based on trust, reciprocity, cropping intensity, command area and yield as tools to indicate the importance of collective action in performance of irrigation system.

Keywords: collective action, decision-making, farmers’ participation, performance

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Authors: Badr A. Al-Jehani

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Nowadays, contractor selection is a critical activity of the project owner. Selecting the right contractor is essential to the project manager for the success of the project, and this cab happens by using the proper selecting method. Traditionally, the contractor is being selected based on his offered bid price. This approach focuses only on the price factor and forgetting other essential factors for the success of the project. In this research paper, the Analytic Network Process (ANP) method is used as a decision tool model to select the most appropriate contractor. This decision-making method can help the clients who work in the construction industry to identify contractors who are capable of delivering satisfactory outcomes. Moreover, this research paper provides a case study of selecting the proper contractor among three contractors by using ANP method. The case study identifies and computes the relative weight of the eight criteria and eleven sub-criteria using a questionnaire.

Keywords: contractor selection, project management, decision-making, bidding

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Authors: Kristina Rosengren, Petra Brannefors, Eric Carlstrom

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Background: Implementation and use of person-centered care (PCC) is increasing worldwide, and why the current study intends to increase knowledge regarding how PCC is used in different European countries. Purpose: To describe the extent of person-centred care in 23 European countries in relation to use specific countries healthcare system (Beveridge, Bismarck, Mixed/OOP). Methods: The study was conducted by literature review inspired by Spice, both scientific empirical studies (Cinahl, Medline, Scopus) as well as grey literature (Google) were used. Totally 1194 documents were included divided into Cinahl n=139, Medline n=245, Scopus n=493 and Google n=317. Data were analysed with descriptive (percentage, range) regarding content and scope of PCC/country according to content and scope of PCC in each country, grouped into the healthcare system (Beveridge, Bismarck, Mixed/OOP) and geographic placement. Results: PCC were most common in UK (England, Scotland, Wales, North Ireland), n=481, 40.3%, Sweden (n=231, 19.3%), The Netherlands (n=80, 6.7%), Ireland (n=79, 6.6%) and Norway (n=61, 5.1%); and less common in Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Beveridge healthcare system (12/23=0.5217, 52.2%) show 85 percent of documents with advantage of scientific literature valued 2.92 (n=999, 0.55-4.07), compare to advantage of grey literature in Bismarck (10/23=0.4347, 43.5%) with 15 percentage valued 2.35 (n=190, 0-3.27) followed by Mixed/OOP (1/23=4%) with 0.4 valued 2.25. Conclusions: Seven out of 10 countries with Beveridge health system used PCC compare to less-used PCC in countries with the Bismarck system. Research, as well as national regulations regarding PCC, are important tools to motivate the advantage of PCC in clinical practice. Moreover, implementation of PCC needs a systematic approach, from national (politicians), regional (guideline) and local (specific healthcare settings) levels visualized by decision-making as law, mission, policies, and routines in clinical practice to establish a well-integrated phenomenon in Europe.

Keywords: Beveridge, Bismarck, Europe, evidence-based, literature review, person-centered care

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Authors: Evagelos Korobilis-Magas, Adekunle Oke

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The constantly increasing tendency towards a global economy and the subsequent increase in exporting, as a result, has inevitably led to a growing interest in the topic of export success as well. Numerous studies, particularly in the past three decades, have examined a plethora of determinants to export performance. However, to the authors' best knowledge, no study up to date has ever considered decision quality as a potential antecedent to export success by attempting to test the relationship between decision quality and export performance. This is a surprising deficiency given that the export marketing literature has long ago suggested that quality decisions are regarded as the crucial intervening variable between sound decision–making and export performance. This study integrates the different definitions of decision quality proposed in the literature and the key themes incorporated therein and adapts it to an export context. Apart from laying the conceptual foundations for the delineation of this elusive but very important construct, this study is the first ever to test the relationship between decision quality and export performance. Based on survey data from a sample of 189 British export decision-makers and within a contingency theory framework, the results reveal that there is a direct, positive link between decision quality and export performance. This finding opens significant future research avenues and has very important implications for both theory and practice.

Keywords: export performance, decision quality, mixed methods, contingency theory

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Authors: Giuseppe Timperio, Robert de Souza

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Logistics operations in the context of disaster response are characterized by a high degree of complexity due to the combined effect of a large number of stakeholders involved, time pressure, uncertainties at various levels, massive deployment of goods and personnel, and gigantic financial flow to be managed. It also involves several autonomous parties such as government agencies, militaries, NGOs, UN agencies, private sector to name few, to have a highly collaborative approach especially in the critical phase of the immediate response. This is particularly true in the context of L3 emergencies that are the most severe, large-scale humanitarian crises. Decision-making processes in disaster management are thus extremely difficult due to the presence of multiple decision-makers involved, and the complexity of the tasks being tackled. Hence, in this paper, we look at applying ICT based solutions to enable a speedy and effective decision making in the golden window of humanitarian operations. A high-level view of ICT based solutions in the context of logistics operations for humanitarian response in Southeast Asia is presented, and their viability in a real-life case about logistics network design is explored.

Keywords: decision support, disaster preparedness, humanitarian logistics, network design

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Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the ｍedical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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Authors: Rashida Suleiman, Asamoah Jnr. Boakye, Suleiman Ahmed Ibn Ahmed

Abstract:

In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. MYCIN is a groundbreaking illustration of a clinical decision support system (CDSS), which was developed to assist physicians in the diagnosis and treatment of bacterial infections by providing suggestions for antibiotic regimens. MYCIN was one of the earliest expert systems to demonstrate how CDSSs may assist human decision-making in complicated areas. Relevant databases were searched using google scholar, PubMed and general Google search, which were peculiar to clinical decision support systems. The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of MYCIN, a clinical decision support system. Inferences drawn from the articles showed some usage of MYCIN for problem-based learning among clinicians and students in some countries. Furthermore, the data demonstrated that MYCIN had completed clinical testing at Stanford University Hospital following years of research. The system (MYCIN) was shown to be extremely accurate and effective in diagnosing and treating bacterial infections, and it demonstrated how CDSSs might enhance clinical decision-making in difficult circumstances. Despite the challenges MYCIN presents, the benefits of its usage to clinicians, students and software developers are enormous.

Keywords: clinical decision support system, MYCIN, diagnosis, bacterial infections, support systems

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Authors: Koray Altintas, Ozalp Vayvay

Abstract:

Increased global issues such as depletion of sources, environmental problems and social inequality triggered public awareness towards finding sustainable solutions in order to ensure the well-being of the current as well as future generations. Since energy plays a significant role in improved social and economic well-being and is imperative on both industrial and commercial wealth creation, it is a must to develop a standardized set of metrics which makes it possible to indicate the present condition relative to conditions in the past and to develop any perspective which is required to frame actions for the future. This is not an easy task by considering the complexity of the issue which requires integrating economic, environmental and social aspects of sustainable energy. Multi-criteria decision making (MCDM) can be considered as a form of integrated sustainability evaluation and a decision support approach that can be used to solve complex problems featuring; conflicting objectives, different forms of data and information, multi-interests and perspectives. On that matter, MCDM methods are useful for providing solutions to complex energy management problems. The aim of this study is to review MCDM approaches that can be used for examining sustainable energy management. This study presents an insight into MCDM techniques and methods that can be useful for engineers, researchers and policy makers working in the energy sector.

Keywords: sustainable energy, sustainability criteria, multi-criteria decision making, sustainability dimensions

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Authors: Dinmukhamed T., Vassiliy S.

Abstract:

This article suggests the idea of fitting clothes and accessories based on augmented reality. A logical data model has been developed, taking into account the decision-making module (colors, style, type, material, popularity, etc.) based on personal data (age, gender, weight, height, leg size, hoist length, geolocation, photogrammetry, number of purchases of certain types of clothing, etc.) and statistical data of the purchase history (number of items, price, size, color, style, etc.). Also, in order to provide information to the user, it is planned to develop an augmented reality system using a QR code. This system of selection and fitting of clothing and accessories based on augmented reality will be used in stores to reduce the time for the buyer to make a decision on the choice of clothes.

Keywords: augmented reality, online store, decision-making module, like QR code, clothing store, queue

Procedia PDF Downloads 119

Authors: David Tresner-Kirsch

Abstract:

Reconciling patient medication lists from multiple sources is a critical task supporting the safe delivery of patient care. Manual reconciliation is a time-consuming and error-prone process, and recently attempts have been made to develop efficiency- and safety-oriented automated support for professionals performing the task. An important capability of any such support system is automated alignment – finding which medications from a list correspond to which medications from a different source, regardless of misspellings, naming differences (e.g. brand name vs. generic), or changes in treatment (e.g. switching a patient from one antidepressant class to another). This work describes a new algorithmic solution to this alignment task, using a greedy matching approach based on string similarity, edit distances, concept extraction and normalization, and synonym search derived from the RxNorm nomenclature. The accuracy of this algorithm was evaluated against a gold-standard corpus of 681 medication records; this evaluation found that the algorithm predicted alignments with 99% precision and 91% recall. This performance is sufficient to support decision support applications for medication reconciliation.

Keywords: clinical decision support, medication reconciliation, natural language processing, RxNorm

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Authors: Nitu Marilena Cristina

Abstract:

Decentralization of the education system is an educational policy option necessary from the perspective of democratizing internal life and streamlining service administration public. The experience of recent years has shown that decisions taken at central level do not to take into account all situations and especially all the specific needs and interests of the various institutions and individuals. A democratic society implies that the decision-making process is brought closer to the place of application, allowing citizens to take part in the decision-making that affects them directly or indirectly. Essentially decentralization of pre-university education is the transfer of authority, responsibility and resources in decision-making and general management, and financially to the educational units and the local community. This creates a frame of an effective collaboration between school and community. Modern theories on the leadership of education advocate the adoption of decentralization measures and participatory strategies. Numerous countries confronted with the educational impasse has appealed to these strategies. Reforming projects have begun application diversified and nuanced social decentralization models according to the specific social and educational situation. Analysis of legal provisions and measures adopted in the framework of the reform process indicates that, at least formally, decentralization is the solution chosen.

Keywords: decentralization, educational, management, reforming

Procedia PDF Downloads 139

Authors: Siripen Yiamjanya, Kevin Wongleedee

Abstract:

This research paper aims to identify travel motivation by push and pull factors that affected decision making of international tourists in selecting Thailand as their destination choice. A total of 200 international tourists who traveled to Thailand during January and February, 2014 were used as the sample in this study. A questionnaire was employed as a tool in collecting the data, conducted in Bangkok. The list consisted of 30 attributes representing both psychological factors as “push- based factors” and destination factors as “pull-based factors”. Mean and standard deviation were used in order to find the top ten travel motives that were important determinants in the respondents’ decision making process to select Thailand as their destination choice. The finding revealed the top ten travel motivations influencing international tourists to select Thailand as their destination choice included [i] getting experience in foreign land; [ii] Thai food; [iii] learning new culture; [iv] relaxing in foreign land; [v] wanting to learn new things; [vi] being interested in Thai culture, and traditional markets; [vii] escaping from same daily life; [viii] enjoying activities; [ix] adventure; and [x] good weather. Classification of push- based and pull- based motives suggested that getting experience in foreign land was the most important push motive for international tourists to travel, while Thai food portrayed its highest significance as pull motive. Discussion and suggestions were also made for tourism industry of Thailand.

Keywords: decision making, destination choice, international tourist, pull factor, push factor, Thailand, travel motivation

Procedia PDF Downloads 363

Authors: Bidzina Matsaberidze

Abstract:

It is known that, in emergency situations, multi-attribute group decision-making (MAGDM) models are characterized by insufficient objective data and a lack of time to respond to the task. Evidence theory is an effective tool for describing such incomplete information in decision-making models when the expert and his knowledge are involved in the estimations of the MAGDM parameters. We consider an emergency decision-making model, where expert assessments on humanitarian aid from distribution centers (HADC) are represented in q-rung ortho-pair fuzzy numbers, and the data structure is described within the data body theory. Based on focal probability construction and experts’ evaluations, an objective function-distribution centers’ selection ranking index is constructed. Our approach for solving the constructed bicriteria partitioning problem consists of two phases. In the first phase, based on the covering’s matrix, we generate a matrix, the columns of which allow us to find all possible partitionings of the HADCs with the service centers. Some constraints are also taken into consideration while generating the matrix. In the second phase, based on the matrix and using our exact algorithm, we find the partitionings -allocations of the HADCs to the centers- which correspond to the Pareto-optimal solutions. For an illustration of the obtained results, a numerical example is given for the facility location-selection problem.

Keywords: emergency MAGDM, q-rung orthopair fuzzy sets, evidence theory, HADC, facility location problem, multi-objective combinatorial optimization problem, Pareto-optimal solutions

Procedia PDF Downloads 62