Managing groundwater can be difficult because there is no common perspective among stakeholders about what they wish for their desired future conditions (DFCs) for Texas' aquifers. Conflicts over how to manage aquifers, whether to mine or sustain groundwater levels are complicated by diverse state and local approaches. This dissertation proposes a decision support method to derive acceptable future aquifer conditions through engaging stakeholders by combining five processes: landowner surveys, stakeholder and decision maker focus groups, contingent valuation, system element identification and scenario-testing. Surveys of water users identified conflicts among water users and decision makers' preferences. For example, how much is groundwater worth in Texas? Responses to two survey questions revealed a willingness to buy groundwater for an average of $2,872 per acre-foot. Most landowners most did not want to sell groundwater at any cost. Those willing to sell revealed an average of $4,069 per acre-foot. A survey of landowners and decision makers indicated that 41 percent of landowners indicated that no new users be issued permits to support stable Trinity Aquifer groundwater levels. Meanwhile, the decision makers chose a DFC of a 30 foot drawdown in the Trinity Aquifer over 50 years. Stakeholder surveys identified the 'best groundwater decision makers' as being the stakeholders or well owners, yet 75 percent of the decision makers preferred the groundwater conservation district board presidents. This suggests that stakeholders would prefer to be the decision makers rather than being asked for their preferences. One decision-maker focus group identified 12 elements representing their understanding of the DFC process. These elements form a system information diagram or preference map. Such a map can help identify alternative pathways for solving problems in the decision process. These complexities remain challenging as Texas moves toward more local regulatory control, more competing interests, and less certainty about Texas' future groundwater supply. / text

With an abundant average precipitation rate, Vietnam could be considered water-reach country. Unfortunately, the non-uniform spatial and temporal distribution of rainfall, coupled with a demographic and industrial development polarized on the two major river deltas, it makes the water resources extremely vulnerable. As consequence, severe depletions of groundwater table are reported all over the country, often in the range of 1-2 m per year and more. The subsequent land subsidence is just one of the drawbacks, another being the increasing salinity of coastal aquifers as sea water level continues to rise. Under these conditions, the natural groundwater replenishment alone is not anymore able to provide for a safe water supply, different studies indicating that the groundwater exploitation in major urban agglomerations like Hanoi or Ho Chi Minh City already passed the sustainability level. The solution presented in this paper implies making use of engineered methods for enhancing the natural groundwater recharge rates by enabling better percolation rates of surface water into subsurface and thus optimizing the regional water cycle. The method known as ‘managed aquifer recharge’ (MAR) is introduced, together with general guidelines and tools for planning of MAR schemes, such as the newly web-based decision support system INOWAS_DSS. / Với tốc độ lượng mưa trung bình dồi dào, Việt Nam có thể được coi là quốc gia có nguồn nước trong tầm tay. Thật không may, sự phân bố không gian và thời gian không đồng đều của lượng mưa, cùng với sự phát triển dân số và công nghiệp phân cực trên hai vùng châu thổ sông lớn làm cho các nguồn nước rất dễ bị tổn thương. Vì vậy, sự suy giảm nước ngầm nghiêm trọng được báo cáo trên khắp đất nước, thường mỗi năm giảm 1-2 m và nhiều hơn nữa. Hiện tượng sụt lún đất xảy ra sau đó chỉ là một trong những hạn chế, mặt khác là độ mặn ngày càng tăng của các tầng chứa nước ven biển do mực nước biển tiếp tục tăng. Dưới những điều kiện này, việc bổ sung nước ngầm tự nhiên đơn thuần không còn có thể cung ứng cho một nguồn cấp nước sạch an toàn. Các nghiên cứu khác nhau cho thấy rằng việc khai thác nước ngầm tại các đô thị lớn như Hà Nội hay thành phố Hồ Chí Minh đã vượt qua mức độ bền vững. Giải pháp được trình bày trong bài báo này gợi ý việc sử dụng các phương pháp thiết kế để nâng cao tỷ lệ tái nạp nước ngầm tự nhiên bằng cách cho phép tỷ lệ thẩm thấu tốt hơn nước mặt vào dưới bề mặt và do đó tối ưu hóa chu trình nước trong khu vực. Phương pháp được gọi là 'tái nạp nước ngầm có quản lý (MAR) được giới thiệu, cùng với các hướng dẫn chung và các công cụ để lập kế hoạch đề án MAR, ví dụ như hệ thống mớihỗ trợ quyết định dựa trên kết nối mạng INOWAS_DSS.

New and growing demands to finite and fully allocated water resources in the semi-arid southwestern United States mean that existing water resources must be managed with increasing efficiency to minimize shortages and associated social conflict. Computer based simulations can provide a powerful tool to aid in policy related decisions. This dissertation describes the development of a simulation model of the Rio Grande surface water and groundwater system for use in scenario evaluation. The primary model goal is to integrate cross disciplinary science at a basin scale, and make it easily accessible to a wide range of stakeholders. To achieve this at a river basin scale, three existing groundwater models and one surface water model were simplified and combined in a system dynamics framework using the commercial software package Powersim Studio 2005. To this physical model, a simple human behavioral model and user interface was added. The resulting scenario evaluation tool runs 40 year simulations on a laptop computer in tens of seconds, with inputs that are easily changed by non-expert users via a graphic, user friendly interface.

The dissertation dwells on the process of construction and housing negotiations. The topic’s relevancy is determined by the need to analyse construction and housing negotiations because this area received insufficient attention in research related to the civil engineering discipline of technological sciences in the context of the development of knowledge society. The main research objects are the negotiation process, the decision-making process, stakeholders who make decisions in the negotiation process and the micro and macrolevel environment in its entirety. The thesis deals with several main objectives: review of scientific research on negotiations in various countries worldwide; creation of the conceptual model for multiple criteria analysis of the housing quality and price equilibrium negotiation; development of the web-based decision support system for the housing quality and price equilibrium negotiations using multiple criteria analysis methods in decision-making; presentation of a practical implementation example; and description of the research on voice stress analysis in housing negotiations. The dissertation includes an introduction, four chapters, general conclusions, a list of literature and two annexes. Chapter 1 provides a detailed analysis of research and achievements of Lithuanian and foreign scientists in scientific areas dealing with negotiations and negotiation decision-support systems. Chapter 2, which is based on the analysis of scientific research and... [to full text] / Disertacijoje nagrinėjamas statybos ir jos produkcijos – būsto pirkimo-pardavimo derybų procesas. Temos aktualumą nulemia žinių visuomenės plėtros ir statybos sektoriaus derybų, kaip technologijos mokslų statybos inžinerijos kryptyje iki šiol mažai tyrinėtos srities, analizės poreikis. Pagrindiniai tyrimo objektai yra būstas, derybos dėl būsto pirkimo-pardavimo, sprendimų priėmimo procesas, derybų procese dalyvaujančios sprendimus priimančios grupės, mikro- ir makrolygmens aplinka kaip visuma. Darbe sprendžiami keli pagrindiniai tikslai ir uždaviniai: įvairių pasaulio šalių mokslininkų tyrimų derybų srityje apžvalgos atlikimas; būsto kainos ir kokybės pusiausvyros derybų daugiakriterinės analizės koncepcinio modelio sudarymas; būsto kainos ir kokybės pusiausvyros derybų internetinės sprendimų paramos sistemos sukūrimas, sprendimų priėmimui pasitelkiant daugiakriterinės analizės metodus; praktinio realizavimo pavyzdžio pateikimas; aprašomas atliktas būsto pardavėjų balso tyrimas. Disertaciją sudaro įvadas, keturi skyriai, bendrosios išvados, literatūros šaltinių sąrašas ir du priedai. Pirmame skyriuje detaliai analizuojami Lietuvos ir užsienio šalių mokslininkų tyrimai ir pasiekimai derybas bei derybų sprendimų paramos sistemas tiriančių mokslų srityse. Antrame skyriuje, remiantis pirmame skyriuje atlikta mokslinių tyrimų analize ir pasiekimais, išsamiai aprašomas sukurtas būsto kainos ir kokybės pusiausvyros derybų daugiakriterinės analizės koncepcinis modelis. Trečias... [toliau žr. visą tekstą]

Disertacijoje nagrinėjamas statybos ir jos produkcijos – būsto pirkimo-pardavimo derybų procesas. Temos aktualumą nulemia žinių visuomenės plėtros ir statybos sektoriaus derybų, kaip technologijos mokslų statybos inžinerijos kryptyje iki šiol mažai tyrinėtos srities, analizės poreikis. Pagrindiniai tyrimo objektai yra būstas, derybos dėl būsto pirkimo-pardavimo, sprendimų priėmimo procesas, derybų procese dalyvaujančios sprendimus priimančios grupės, mikro- ir makrolygmens aplinka kaip visuma. Darbe sprendžiami keli pagrindiniai tikslai ir uždaviniai: įvairių pasaulio šalių mokslininkų tyrimų derybų srityje apžvalgos atlikimas; būsto kainos ir kokybės pusiausvyros derybų daugiakriterinės analizės koncepcinio modelio sudarymas; būsto kainos ir kokybės pusiausvyros derybų internetinės sprendimų paramos sistemos sukūrimas, sprendimų priėmimui pasitelkiant daugiakriterinės analizės metodus; praktinio realizavimo pavyzdžio pateikimas; aprašomas atliktas būsto pardavėjų balso tyrimas. Disertaciją sudaro įvadas, keturi skyriai, bendrosios išvados, literatūros šaltinių sąrašas ir du priedai. Pirmame skyriuje detaliai analizuojami Lietuvos ir užsienio šalių mokslininkų tyrimai ir pasiekimai derybas bei derybų sprendimų paramos sistemas tiriančių mokslų srityse. Antrame skyriuje, remiantis pirmame skyriuje atlikta mokslinių tyrimų analize ir pasiekimais, išsamiai aprašomas sukurtas būsto kainos ir kokybės pusiausvyros derybų daugiakriterinės analizės koncepcinis modelis. Trečias... [toliau žr. visą tekstą] / The dissertation dwells on the process of construction and housing negotiations. The topic’s relevancy is determined by the need to analyse construction and housing negotiations because this area received insufficient attention in research related to the civil engineering discipline of technological sciences in the context of the development of knowledge society. The main research objects are the negotiation process, the decision-making process, stakeholders who make decisions in the negotiation process and the micro and macrolevel environment in its entirety. The thesis deals with several main objectives: review of scientific research on negotiations in various countries worldwide; creation of the conceptual model for multiple criteria analysis of the housing quality and price equilibrium negotiation; development of the web-based decision support system for the housing quality and price equilibrium negotiations using multiple criteria analysis methods in decision-making; presentation of a practical implementation example; and description of the research on voice stress analysis in housing negotiations. The dissertation includes an introduction, four chapters, general conclusions, a list of literature and two annexes. Chapter 1 provides a detailed analysis of research and achievements of Lithuanian and foreign scientists in scientific areas dealing with negotiations and negotiation decision-support systems. Chapter 2, which is based on the analysis of scientific research... [to full text]

The objective of this thesis is to formalize, model, align and operationalize the evidence-based clinical algorithms of co-morbid chronic heart failure (CHF) and atrial fibrillation (AF) in order to provide clinical recommendations, care coordination and decision support to general practitioners (GPs). This thesis addresses following healthcare knowledge modeling issues: (a) modeling of healthcare knowledge, especially in terms of clinical guidelines and clinical pathways, to develop an ontology-based knowledge model for handling co-morbid diseases; (b) computerization of clinical pathways to offer point-of-care decision support; (c) alignment of ontologically-modeled disease-specific clinical pathways to handle co-morbid diseases; and (d) the provision of computerized decision support to GPs, based on modeled clinical guidelines and pathways, to assist them in handling co-morbid diseases. An elaborate OWL CP ontology for co-morbid CHF and AF was developed that can be executed to support the diagnosis and management of co-morbid CHF and AF in a general practice setting. / In this thesis we present an ontology based decision-support framework for handling co-morbidities by the alignment of ontologically modeled clinical practice guidelines (CPGs). The objective of this thesis is to formalize, model, align and operationalize the evidence-based clinical algorithms of co-morbid chronic heart failure (CHF) and atrial fibrillation (AF) in order to provide evidence-based clinical recommendations, care coordination and decision support to general practitioners (GPs) for effective management of CHF and AF. In this regard, the thesis addresses the following healthcare knowledge modeling issues: (a) modeling of healthcare knowledge, especially in terms of clinical guidelines and clinical pathways, to develop an ontology-based healthcare knowledge model for handling co-morbid diseases; (b) computerization of clinical pathways to offer point-of-care decision support; (c) alignment of ontologically-modeled disease-specific clinical pathways to handle co-morbid diseases; and (d) the provision of computerized decision support to general practitioners, based on modeled clinical guidelines and pathways, to assist them in handling chronic and co-morbid diseases. An elaborate OWL CP ontology for co-morbid CHF and AF—the CP ontology was developed that can be executed to support the diagnosis and management of co-morbid CHF and AF in a general practice setting. We have developed a decision support framework termed COMET (Co-morbidity Ontological Modeling & ExecuTion) that can handle three patient care scenarios, (i) patient has CHF; (ii) patient has AF; and (iii) patient develops a co-morbidity of both AF and CHF. COMET is accessible by web and is designed for GPs. COMET has been evaluated, both by simulated cases and by health professionals (GP and specialist), for its ability to handle single disease and comorbid care scenarios based on patient data and related constraints. The output at every phase is compared with the expected output as per single disease or comorbid management. Our results show that the resultant sequence of plans and their outcomes are comparable to the CP knowledge. Also, our ontology was able to handle any updates in the CP knowledge as advised by the domain experts

Constructing a Bayesian Network requires the conditional probabilities table (CPT) to be acquired, one for each variable or node in the network. When data mining is not available, CPTs must be acquired from the domain experts. The complexity of the direct elicitation is exponential on the number of parents of a variable, making direct elicitation from human experts impractical for a large number of causes. Causal models such as Noisy-OR, Noisy-AND, Noisy-MIN, Noisy-MAX and Recursive Noisy-OR have been developed that allow CPTs acquisition to be achieved with linear complexity on the number of causes. Their representation power is measured by their ability to encode the causal interactions. Causal interactions can be categorized into two types: reinforcing and undermining. The Non-Impeding Noisy-AND or NIN-AND tree causal model, developed by Xiang and Jia, is capable of modeling both types of interaction while retaining the linear complexity. The main challenge in utilizing the NIN-AND tree model to generate a CPT is that it requires its tree topology to be elicited. A NIN-AND tree topology is an encoding of the causal interactions between the causes. In this work we present two methods, Structure Elimination (SE) and Pairwise Causal Interaction (PCI), that allow indirect elicitations of the NIN-AND tree topology using some additional probabilities elicited from experts. We conduct human-based experiment to investigate the e ectiveness of the two methods in terms of accuracy by comparing them to the Direct Numerical (DN) elicitation method. We recruit participants from second year Computer Science students at the University of Guelph. The process involves training a participant into domain expert using a known NIN-AND tree model then acquire another NIN-AND tree model by applying the SE and PCI methods. The CPTs produced by the acquired NIN-AND tree models are then compared to the one obtained by using the DN method. Comparable CPT accuracies are obtained among models generated by di erent methods, even though SE and PCI requires a much smaller number of parameters in comparison to DN.

Background: Considerable amount of inappropriate antibiotic utilization has been observed in both acute and non-acute care hospitals. Literature has shown that strategies such as an order entry (OE) and computer decision support system (DSS) have improved prescribing practices in acute care settings. However, there is limited research on the effect of OE on antibiotic utilization in non-acute care settings. Objective: To determine the relationship between OE with DSS and antibiotic utilization in a complex continuing care and rehabilitation hospital. Methods: A retrospective analysis of OE and Pharmacy dispensing data, prospectively collected between July 1, 1999 and December 31, 2005, was conducted. Dispensing events for oral and intravenous antibiotics were merged with corresponding OE’s (when present) to form a final database of 4,739 dispensing events with 2,397 OE’s. The presence of OE and the proportion of OE to dispensing events formed the exposure variable while antibiotic utilization in defined daily dose (DDD) was calculated using dose and number of doses of an antibiotic. Antibiotic utilization was examined at the hospital and individual service in-patient unit levels (complex continuing care/CCC and rehabilitation medicine/REH). Statistical analysis consisting of multiple regression modeling was conducted to determine the association between use of OE and antibiotic utilization. Results: A best-fit model using multiple regression analysis at hospital level indicated a significant positive relationship between the presence of OE and antibiotic utilization when service, patient age, gender and antibiotic classes were accounted for. This model explained 11% of the variation in antibiotic utilization. No significant associations were found in the CCC in-patient unit while in the REH in-patient unit a significant positive relationship between the presence of OE and antibiotic utilization was observed. Similarly, antibiotic utilization increased significantly with increase in the proportion of OE to dispensing events at the hospital and REH in-patient unit levels but not in the CCC in-patient unit. Conclusion: The results of this study demonstrate that antibiotic utilization increased over the years following the inception of the OE system with DSS at the study hospital. Further research is required to examine the effect of OE with a rudimentary DSS on antibiotic utilization management in non-acute care. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2007-07-13 10:47:38.035

<p>Diss. (sammanfattning) Umeå : Umeå universitet, 2003</p> / digitalisering@umu

This research addresses the design and development of a decision support tool to provide healthcare policy makers with insights and feedback when evaluating proposed patient flow and infection mitigation and control strategies in the emergency department (ED). An agent-based modeling (ABM) approach was used to simulate EDs, designed to be tuneable to specific parameters related to specification of topography, agent characteristics and behaviours, and the application in question. In this way, it allows for the user to simulate various ‘what-if’ scenarios related to infection spread and patient flow, where such policy questions may otherwise be left “best intent open loop” in practice. Infection spread modeling and patient flow modeling have been addressed by mathematical and queueing models in the past; however, the application of an ABM approach at the level of an institution is novel. A conjecture of this thesis is that such a tool should be augmented with Machine Learning (ML) technology to assist in performing optimization or search in which patient flow and infection spread are signals or variables of interest. Therefore this work seeks to design and demonstrate a decision support tool with ML capability for optimizing ED processes. The primary contribution of this thesis is the development of a novel, flexible, and tuneable framework for spatial, human-scale ABM in the context of a decision support tool for healthcare policy relating to infection spread and patient flow within EDs . The secondary contribution is the demonstration of the utility of ML for automatic policy generation with respect to the ABM tool. The application of ML to automatically generate healthcare policy in concert with an ABM is believed to be novel and of emerging practical importance. The tertiary contribution is the development and testing of a novel heuristic specific to the ML paradigm used: Genetic Programming (GP). This heuristic aids learning tasks performed in conjunction with ABMs for healthcare policy. The primary contribution is clearly demonstrated within this thesis. The others are of a more difficult nature; the groundwork has been laid for further work in these areas that are likely to remain open for the foreseeable future.