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Sample records for surgical decision-making process

  1. Patients' perspective in the surgical decision-making process.

    PubMed

    Lim, Eric

    2012-11-01

    Barriers can arise if surgeons are unable to effectively convey information on benefits and risks or are unwilling to offer management choices based on patients' preferences. Facilitating shared decision making, allowing patients to carefully think and consider the alternatives, and empowering them to share in the decision-making process improve patient satisfaction and treatment adherence and represent the hallmark of an excellent clinician. PMID:23084617

  2. Decision making in surgical oncology.

    PubMed

    Lamb, B; Green, J S A; Vincent, C; Sevdalis, N

    2011-09-01

    Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation and recording of the MDTs decision. Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients. PMID:20719499

  3. Prospective Study of Surgical Decision-making Processes for Contralateral Prophylactic Mastectomy in Women with Breast Cancer

    PubMed Central

    Parker, Patricia A.; Peterson, Susan K.; Bedrosian, Isabelle; Crosby, Melissa A.; Shen, Yu; Black, Dalliah M.; Babiera, Gildy; Kuerer, Henry M.; Ying, Jun; Dong, Wenli; Cantor, Scott B.; Brewster, Abenaa M.

    2016-01-01

    Structured Abstract Objective We prospectively examined the psychosocial predictors and the decision-making process regarding contralateral prophylactic mastectomy (CPM) among women with sporadic breast cancer. Summary Background Data Increasing numbers of women with breast cancer are seeking CPM. Data are limited about the surgical decision-making process and the psychosocial factors that influence interest in CPM. Methods Women with early stage unilateral breast cancer (n=117) were recruited before their first surgical visit at MD Anderson and completed questionnaires assessing knowledge of and interest in CPM and associated psychosocial factors. After the appointment, women and their surgeons completed questions about the extent that various surgical options (including CPM) were discussed; also, the women rated their perceived likelihood of having CPM and the surgeons rated the appropriateness of CPM. Results Before their first visit, 50% of women were moderately to extremely interested in CPM and 12 (10%) of women had CPM at the time of their primary breast cancer surgery. Less knowledge about breast cancer (P=0.02) and greater cancer worry (P=0.03) predicted interest in CPM. Greater cancer worry predicted who had CPM (P=0.02). Interest in CPM before surgical visit and the likelihood of having CPM after the visit differed (P =<0.001). Surgeons’ rating of the appropriateness of CPM and the patient’s reported likelihood of having CPM were not significantly different (P=0.49). Conclusions Interest in CPM is common among women with sporadic breast cancer. The informational and emotional aspects of CPM may affect the decision to have CPM and should be addressed when discussing surgical options. PMID:25822675

  4. Surgical decision making in conservative mastectomies

    PubMed Central

    Rocco, Nicola; Nava, Maurizio Bruno

    2016-01-01

    We present some clinical advice to drive the decision process in performing conservative mastectomies. Several factors are taken into consideration to indicate these techniques. First of all, we need to identify patients who need a mastectomy due to the extension of the disease. In this case we suggest assessing patients anthropometric characteristics (breast volume—ptosis), and personal preferences regarding the extension of surgical treatment. Small, medium size, without ptosis or with moderate ptosis can be better served by standard nipple-sparing mastectomy. Large and ptotic breast can be removed and reconstructed performing a skin-reducing mastectomy. Mastectomies cannot replace breast conservation and should be discouraged whenever breast-conserving surgery can be performed with good results. However, in some selected cases, and especially in patients with small breast, conservative mastectomies with contralateral reshape can yield favourable results. PMID:26855911

  5. Thinking Processes Used by Nurses in Clinical Decision Making.

    ERIC Educational Resources Information Center

    Higuchi, Kathryn A. Smith; Donald, Janet G.

    2002-01-01

    Interviews with eight medical and surgical nurses and audits of patient charts investigated clinical decision-making processes. Predominant thinking processes were description of facts, selection of information, inference, syntheses, and verification, with differences between medical and surgical specialties. Exemplars of thinking processes…

  6. International Students Decision-Making Process

    ERIC Educational Resources Information Center

    Cubillo, Jose Maria; Sanchez, Joaquin; Cervino, Julio

    2006-01-01

    Purpose--The purpose of this paper is to propose a theoretical model that integrates the different groups of factors which influence the decision-making process of international students, analysing different dimensions of this process and explaining those factors which determine students' choice. Design/methodology/approach--A hypothetical model…

  7. Nonrational Processes in Ethical Decision Making

    ERIC Educational Resources Information Center

    Rogerson, Mark D.; Gottlieb, Michael C.; Handelsman, Mitchell M.; Knapp, Samuel; Younggren, Jeffrey

    2011-01-01

    Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasi-legal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior,…

  8. Decision-making processes of youth.

    PubMed

    Moore, J W; Jensen, B; Hauck, W E

    1990-01-01

    Research supports the theory that after administrators make a decision, feedback, both positive and negative, and also the administrators' perceived security vis-à-vis their position affect their level of commitment to a course of action. However, this research fails to recognize that subjects of college age playing administrators in the simulated, experimental treatments which have been presented in the research had nothing personally to lose if they made a bad decision--an orientation contradictory to the reality of most actual administrative positions. Additionally, the research ignores the interactional effects of the personality of decision makers in terms of their anxiety levels and the judgments they make. This study took both of these considerations into account by creating a decision-making situation within which prospective administrators made monetary commitments to long-term goals while their anxiety level, both as a basic personality attribute and an index of the reality of the decision-making process, was monitored under conditions of varying levels of job insecurity and resistance to their policies in relation to their decisions. Analyses revealed that contrary to the results of past research which used college students as subjects: (1) there is a significant negative correlation between levels of anxiety and commitments to previously chosen courses of action; (2) there are no significant effects of job security on commitment; and, most importantly, (3) high resistance to a policy decision leads to significantly less monetary commitments to long-term goals. The findings suggest that the basis for the contradictory results lies with the anxiety level of decision makers and the realism of experiencing a loss by making poor decisions. PMID:2264508

  9. School Board Decision Making: An Analysis of the Process

    ERIC Educational Resources Information Center

    Crum, Karen S.

    2007-01-01

    The goal of this study was to analyze the characteristics in the school board decision-making process and to discover whether school board members are aware of the characteristics surrounding the school board's decision-making process. Specifically, this study examines the decision-making process of a school board in Virginia, and it provides…

  10. Information Processing in Decision-Making Systems

    PubMed Central

    van der Meer, Matthijs; Kurth-Nelson, Zeb; Redish, A. David

    2015-01-01

    Decisions result from an interaction between multiple functional systems acting in parallel to process information in very different ways, each with strengths and weaknesses. In this review, the authors address three action-selection components of decision-making: The Pavlovian system releases an action from a limited repertoire of potential actions, such as approaching learned stimuli. Like the Pavlovian system, the habit system is computationally fast but, unlike the Pavlovian system permits arbitrary stimulus-action pairings. These associations are a “forward” mechanism; when a situation is recognized, the action is released. In contrast, the deliberative system is flexible but takes time to process. The deliberative system uses knowledge of the causal structure of the world to search into the future, planning actions to maximize expected rewards. Deliberation depends on the ability to imagine future possibilities, including novel situations, and it allows decisions to be taken without having previously experienced the options. Various anatomical structures have been identified that carry out the information processing of each of these systems: hippocampus constitutes a map of the world that can be used for searching/imagining the future; dorsal striatal neurons represent situation-action associations; and ventral striatum maintains value representations for all three systems. Each system presents vulnerabilities to pathologies that can manifest as psychiatric disorders. Understanding these systems and their relation to neuroanatomy opens up a deeper way to treat the structural problems underlying various disorders. PMID:22492194

  11. Gastroesophageal reflux disease: A review of surgical decision making

    PubMed Central

    Moore, Maureen; Afaneh, Cheguevara; Benhuri, Daniel; Antonacci, Caroline; Abelson, Jonathan; Zarnegar, Rasa

    2016-01-01

    Gastroesophageal reflux disease (GERD) is a very common disorder with increasing prevalence. It is estimated that up to 20%-25% of Americans experience symptoms of GERD weekly. Excessive reflux of acidic often with alkaline bile salt gastric and duodenal contents results in a multitude of symptoms for the patient including heartburn, regurgitation, cough, and dysphagia. There are also associated complications of GERD including erosive esophagitis, Barrett’s esophagus, stricture and adenocarcinoma of the esophagus. While first line treatments for GERD involve mainly lifestyle and non-surgical therapies, surgical interventions have proven to be effective in appropriate circumstances. Anti-reflux operations are aimed at creating an effective barrier to reflux at the gastroesophageal junction and thus attempt to improve physiologic and mechanical issues that may be involved in the pathogenesis of GERD. The decision for surgical intervention in the treatment of GERD, moreover, requires an objective confirmation of the diagnosis. Confirmation is achieved using various preoperative evaluations including: ambulatory pH monitoring, esophageal manometry, upper endoscopy (esophagogastroduodenoscopy) and barium swallow. Upon confirmation of the diagnosis and with appropriate patient criteria met, an anti-reflux operation is a good alternative to prolonged medical therapy. Currently, minimally invasive gastro-esophageal fundoplication is the gold standard for surgical intervention of GERD. Our review outlines the many factors that are involved in surgical decision-making. We will review the prominent features that reflect appropriate anti-reflux surgery and present suggestions that are pertinent to surgical practices, based on evidence-based studies. PMID:26843915

  12. Decision-Making Processes of Youth.

    ERIC Educational Resources Information Center

    Moore, J. William; And Others

    1990-01-01

    Undergraduates (n=142) participated in study on decision making in which prospective administrators made monetary commitments to long-term goals under varying conditions. Found significant negative correlation between anxiety level and commitments to previously chosen courses of action; no significant effects of job security on commitment; and…

  13. Teacher Empowerment in the Decision Making Process

    ERIC Educational Resources Information Center

    Hicks, George E.; DeWalt, Cassandra Sligh

    2006-01-01

    According to Erlandson and Bifano (1987), teacher empowerment is a vital dimension of the school's organization. Lieberman (1989) defined teacher empowerment as "empowering teachers to participate in group decisions and to have real decision-making roles in the school community" (p. 24). Furthermore, Summers (2006) addressed the need for…

  14. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  15. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  16. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  17. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  18. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  19. On the Decision-Making Process in Music Education.

    ERIC Educational Resources Information Center

    Jorgensen, Estelle R.

    1985-01-01

    Sketches a conceptual framework for the systematic description of decision-making processes in music education. Refers to existing formulations in education, management, marketing, and economics. Lists decision-making phases in music education, each exhibiting the characteristics of a social system. Offers a historical example of each phase. (AYC)

  20. Biomolecular decision-making process for self assembly.

    SciTech Connect

    Osbourn, Gordon Cecil

    2005-01-01

    The brain is often identified with decision-making processes in the biological world. In fact, single cells, single macromolecules (proteins) and populations of molecules also make simple decisions. These decision processes are essential to survival and to the biological self-assembly and self-repair processes that we seek to emulate. How do these tiny systems make effective decisions? How do they make decisions in concert with a cooperative network of other molecules or cells? How can we emulate the decision-making behaviors of small-scale biological systems to program and self-assemble microsystems? This LDRD supported research to answer these questions. Our work included modeling and simulation of protein populations to help us understand, mimic, and categorize molecular decision-making mechanisms that nonequilibrium systems can exhibit. This work is an early step towards mimicking such nanoscale and microscale biomolecular decision-making processes in inorganic systems.

  1. Dissolving decision making? Models and their roles in decision-making processes and policy at large.

    PubMed

    Zeiss, Ragna; van Egmond, Stans

    2014-12-01

    This article studies the roles three science-based models play in Dutch policy and decision making processes. Key is the interaction between model construction and environment. Their political and scientific environments form contexts that shape the roles of models in policy decision making. Attention is paid to three aspects of the wider context of the models: a) the history of the construction process; b) (changes in) the political and scientific environments; and c) the use in policy processes over longer periods of time. Models are more successfully used when they are constructed in a stable political and scientific environment. Stability and certainty within a scientific field seems to be a key predictor for the usefulness of models for policy making. The economic model is more disputed than the ecology-based model and the model that has its theoretical foundation in physics and chemistry. The roles models play in policy processes are too complex to be considered as straightforward technocratic powers. PMID:25549446

  2. Evolution of quantum-like modeling in decision making processes

    NASA Astrophysics Data System (ADS)

    Khrennikova, Polina

    2012-12-01

    The application of the mathematical formalism of quantum mechanics to model behavioral patterns in social science and economics is a novel and constantly emerging field. The aim of the so called 'quantum like' models is to model the decision making processes in a macroscopic setting, capturing the particular 'context' in which the decisions are taken. Several subsequent empirical findings proved that when making a decision people tend to violate the axioms of expected utility theory and Savage's Sure Thing principle, thus violating the law of total probability. A quantum probability formula was devised to describe more accurately the decision making processes. A next step in the development of QL-modeling in decision making was the application of Schrödinger equation to describe the evolution of people's mental states. A shortcoming of Schrödinger equation is its inability to capture dynamics of an open system; the brain of the decision maker can be regarded as such, actively interacting with the external environment. Recently the master equation, by which quantum physics describes the process of decoherence as the result of interaction of the mental state with the environmental 'bath', was introduced for modeling the human decision making. The external environment and memory can be referred to as a complex 'context' influencing the final decision outcomes. The master equation can be considered as a pioneering and promising apparatus for modeling the dynamics of decision making in different contexts.

  3. Evolution of quantum-like modeling in decision making processes

    SciTech Connect

    Khrennikova, Polina

    2012-12-18

    The application of the mathematical formalism of quantum mechanics to model behavioral patterns in social science and economics is a novel and constantly emerging field. The aim of the so called 'quantum like' models is to model the decision making processes in a macroscopic setting, capturing the particular 'context' in which the decisions are taken. Several subsequent empirical findings proved that when making a decision people tend to violate the axioms of expected utility theory and Savage's Sure Thing principle, thus violating the law of total probability. A quantum probability formula was devised to describe more accurately the decision making processes. A next step in the development of QL-modeling in decision making was the application of Schroedinger equation to describe the evolution of people's mental states. A shortcoming of Schroedinger equation is its inability to capture dynamics of an open system; the brain of the decision maker can be regarded as such, actively interacting with the external environment. Recently the master equation, by which quantum physics describes the process of decoherence as the result of interaction of the mental state with the environmental 'bath', was introduced for modeling the human decision making. The external environment and memory can be referred to as a complex 'context' influencing the final decision outcomes. The master equation can be considered as a pioneering and promising apparatus for modeling the dynamics of decision making in different contexts.

  4. Twelve Angry Jurors?: Argument in the Jury Decision Making Process.

    ERIC Educational Resources Information Center

    Burnett, Ann; Badzinski, Diane M.

    Although scholars know a great deal about how argument works in the small group process in general, little is known about the role of argument in the jury decision making process. A study used R. A. Meyers' (1991) coding scheme to analyze the argument in 80 juries. Subjects were 209 males and 203 females enrolled in communication courses at a…

  5. Privatized Student Housing and the Decision-Making Process

    ERIC Educational Resources Information Center

    Aska, Aaron C.

    2012-01-01

    This study will examine the decision-making process used to construct privatized student housing as well as the factors that contribute to that process among public four-year institutions in New Jersey. A growing number of public universities are exploring ways to develop successful public private partnerships (P3s) in an effort to improve…

  6. The Career Decision-Making Process of Chinese American Youth

    ERIC Educational Resources Information Center

    Okubo, Yuki; Yeh, Christine J.; Lin, Pei-Ying; Fujita, Kotoko; Shea, J. Mun-Yi

    2007-01-01

    The authors investigated how negotiating two cultural expectations may influence the career decision-making process of Chinese youth. In-depth interviews were conducted with 8 participants addressing issues of role models, career interests, and individuals with whom they discussed career concerns. Consensual Qualitative Research (C. E. Hill, B. J.…

  7. Developing Holocaust Curricula: The Content Decision-Making Process

    ERIC Educational Resources Information Center

    Lindquist, David H.

    2008-01-01

    The content decision-making process involved in developing Holocaust curricula is unusually complex and problematic. Educators must consider factors such as historical accuracy, selection of topics covered, potential teaching materials (such as textbooks and literary texts), and graphic materials (such as films and photographs) as they plan their…

  8. Decision-Making and Thought Processes among Poker Players

    ERIC Educational Resources Information Center

    St. Germain, Joseph; Tenenbaum, Gershon

    2011-01-01

    This study was aimed at delineating decision-making and thought processing among poker players who vary in skill-level. Forty-five participants, 15 in each group, comprised expert, intermediate, and novice poker players. They completed the Computer Poker Simulation Task (CPST) comprised of 60 hands of No-Limit Texas Hold 'Em. During the CPST, they…

  9. Impact of Robotic Surgery on Decision Making: Perspectives of Surgical Teams

    PubMed Central

    Randell, Rebecca; Alvarado, Natasha; Honey, Stephanie; Greenhalgh, Joanne; Gardner, Peter; Gill, Arron; Jayne, David; Kotze, Alwyn; Pearman, Alan; Dowding, Dawn

    2015-01-01

    There has been rapid growth in the purchase of surgical robots in both North America and Europe in recent years. Whilst this technology promises many benefits for patients, the introduction of such a complex interactive system into healthcare practice often results in unintended consequences that are difficult to predict. Decision making by surgeons during an operation is affected by variables including tactile perception, visual perception, motor skill, and instrument complexity, all of which are changed by robotic surgery, yet the impact of robotic surgery on decision making has not been previously studied. Drawing on the approach of realist evaluation, we conducted a multi-site interview study across nine hospitals, interviewing 44 operating room personnel with experience of robotic surgery to gather their perspectives on how robotic surgery impacts surgeon decision making. The findings reveal both potential benefits and challenges of robotic surgery for decision making. PMID:26958244

  10. Use of PRA in Shuttle Decision Making Process

    NASA Technical Reports Server (NTRS)

    Boyer, Roger L.; Hamlin, Teri L.

    2010-01-01

    How do you use PRA to support an operating program? This presentation will explore how the Shuttle Program Management has used the Shuttle PRA in its decision making process. It will reveal how the PRA has evolved from a tool used to evaluate Shuttle upgrades like Electric Auxiliary Power Unit (EAPU) to a tool that supports Flight Readiness Reviews (FRR) and real-time flight decisions. Specific examples of Shuttle Program decisions that have used the Shuttle PRA as input will be provided including how it was used in the Hubble Space Telescope (HST) manifest decision. It will discuss the importance of providing management with a clear presentation of the analysis, applicable assumptions and limitations, along with estimates of the uncertainty. This presentation will show how the use of PRA by the Shuttle Program has evolved overtime and how it has been used in the decision making process providing specific examples.

  11. A decision-making process model of young online shoppers.

    PubMed

    Lin, Chin-Feng; Wang, Hui-Fang

    2008-12-01

    Based on the concepts of brand equity, means-end chain, and Web site trust, this study proposes a novel model called the consumption decision-making process of adolescents (CDMPA) to understand adolescents' Internet consumption habits and behavioral intention toward particular sporting goods. The findings of the CDMPA model can help marketers understand adolescents' consumption preferences and habits for developing effective Internet marketing strategies. PMID:19025465

  12. Primary osseous tumors of the pediatric spinal column: review of pathology and surgical decision making.

    PubMed

    Ravindra, Vijay M; Eli, Ilyas M; Schmidt, Meic H; Brockmeyer, Douglas L

    2016-08-01

    Spinal column tumors are rare in children and young adults, accounting for only 1% of all spine and spinal cord tumors combined. They often present diagnostic and therapeutic challenges. In this article, the authors review the current management of primary osseous tumors of the pediatric spinal column and highlight diagnosis, management, and surgical decision making. PMID:27476845

  13. Introduction of New Vaccines: Decision-making Process in Bangladesh

    PubMed Central

    Sarma, Haribondhu; Bari, Tajul I.; Koehlmoos, Tracey P.

    2013-01-01

    The understanding of the decision-making process in the introduction of new vaccines helps establish why vaccines are adopted or not. It also contributes to building a sustainable demand for vaccines in a country. The purpose of the study was to map and analyze the formal decision-making process in relation to the introduction of new vaccines within the context of health policy and health systems and identify the ways of making decisions to introduce new vaccines in Bangladesh. During February-April 2011, a qualitative assessment was made at the national level to evaluate the decision-making process around the adoption of new vaccines in Bangladesh. The study population included: policy-level people, programme heads or associates, and key decision-makers of the Government, private sector, non-governmental organizations, and international agencies at the national level. In total, 13 key informants were purposively selected. Data were collected by interviewing key informants and reviewing documents. Data were analyzed thematically. The findings revealed that the actors from different sectors at the policy level were involved in the decision-making process in the introduction of new vaccines. They included policy-makers from the ministries of health and family welfare, finance, and local government and rural development; academicians; researchers; representatives from professional associations; development partners; and members of different committees on EPI. They contributed to the introduction of new vaccines in their own capacity. The burden of disease, research findings on vaccine-preventable diseases, political issues relating to outbreaks of certain diseases, initiatives of international and local stakeholders, pressure of development partners, the Global Alliance for Vaccines and Immunization (GAVI) support, and financial matters were the key factors in the introduction of new vaccines in Bangladesh. The slow introduction and uptake of new vaccines is a concern

  14. Dissociating sensory from decision processes in human perceptual decision making

    PubMed Central

    Mostert, Pim; Kok, Peter; de Lange, Floris P.

    2015-01-01

    A key question within systems neuroscience is how the brain translates physical stimulation into a behavioral response: perceptual decision making. To answer this question, it is important to dissociate the neural activity underlying the encoding of sensory information from the activity underlying the subsequent temporal integration into a decision variable. Here, we adopted a decoding approach to empirically assess this dissociation in human magnetoencephalography recordings. We used a functional localizer to identify the neural signature that reflects sensory-specific processes, and subsequently traced this signature while subjects were engaged in a perceptual decision making task. Our results revealed a temporal dissociation in which sensory processing was limited to an early time window and consistent with occipital areas, whereas decision-related processing became increasingly pronounced over time, and involved parietal and frontal areas. We found that the sensory processing accurately reflected the physical stimulus, irrespective of the eventual decision. Moreover, the sensory representation was stable and maintained over time when it was required for a subsequent decision, but unstable and variable over time when it was task-irrelevant. In contrast, decision-related activity displayed long-lasting sustained components. Together, our approach dissects neuro-anatomically and functionally distinct contributions to perceptual decisions. PMID:26666393

  15. The process of decision making in reproductive medicine.

    PubMed

    Ludwig, Annika K; Diedrich, Klaus; Ludwig, Michael

    2005-11-01

    The decision-making process regarding the optimal infertility treatment strategy is influenced by several factors. In addition to the underlying cause of infertility, the process of decision making is also influenced by other factors. These factors are mainly (1) the duration of infertility, (2) patient's age, and (3) the number of previously performed treatment cycles of intrauterine insemination (IUI) or in vitro fertilization (IVF). The duration of infertility influences diagnostic steps as well as therapeutic options. With an infertility of at least 5 years the benefit of intrauterine insemination is limited and couples should be counseled to go forward with IVF. Patients age >or= 40 years should be treated with IVF, whereas patients age >or= 43 years should be counseled about their very limited chance to conceive even through IVF. The number of insemination cycles should be limited to four. Couples who have undergone at least six IVF cycles should be counseled to discontinue therapy. The treatment program should be as individualized as possible, with individual counseling that is adapted after each single treatment cycle. PMID:16317623

  16. Decision-making processes: the case of collective movements.

    PubMed

    Petit, Odile; Bon, Richard

    2010-07-01

    Besides focusing on the adaptive significance of collective movements, it is crucial to study the mechanisms and dynamics of decision-making processes at the individual level underlying the higher-scale collective movements. It is now commonly admitted that collective decisions emerge from interactions between individuals, but how individual decisions are taken, i.e. how far they are modulated by the behaviour of other group members, is an under-investigated question. Classically, collective movements are viewed as the outcome of one individual's initiation (the leader) for departure, by which all or some of the other group members abide. Individuals assuming leadership have often been considered to hold a specific social status. This hierarchical or centralized control model has been challenged by recent theoretical and experimental findings, suggesting that leadership can be more distributed. Moreover, self-organized processes can account for collective movements in many different species, even in those that are characterized by high cognitive complexity. In this review, we point out that decision-making for moving collectively can be reached by a combination of different rules, i.e. individualized (based on inter-individual differences in physiology, energetic state, social status, etc.) and self-organized (based on simple response) ones for any species, context and group size. PMID:20435103

  17. Qualitative modeling of the decision-making process using electrooculography.

    PubMed

    Marandi, Ramtin Zargari; Sabzpoushan, S H

    2015-12-01

    A novel method based on electrooculography (EOG) has been introduced in this work to study the decision-making process. An experiment was designed and implemented wherein subjects were asked to choose between two items from the same category that were presented within a limited time. The EOG and voice signals of the subjects were recorded during the experiment. A calibration task was performed to map the EOG signals to their corresponding gaze positions on the screen by using an artificial neural network. To analyze the data, 16 parameters were extracted from the response time and EOG signals of the subjects. Evaluation and comparison of the parameters, together with subjects' choices, revealed functional information. On the basis of this information, subjects switched their eye gazes between items about three times on average. We also found, according to statistical hypothesis testing-that is, a t test, t(10) = 71.62, SE = 1.25, p < .0001-that the correspondence rate of a subjects' gaze at the moment of selection with the selected item was significant. Ultimately, on the basis of these results, we propose a qualitative choice model for the decision-making task. PMID:25515839

  18. International Patients’ Travel Decision Making Process- A Conceptual Framework

    PubMed Central

    KHAN, Mohammad Jamal; CHELLIAH, Shankar; HARON, Mahmod Sabri

    2016-01-01

    Background: Role of information source, perceived benefits and risks, and destination image has significantly been examined in travel and tourism literature; however, in medical tourism it is yet to be examined thoroughly. The concept discussed in this article is drawn form well established models in tourism literature. Methods: The purpose of this research was to identify the source of information, travel benefits and perceived risks related to movement of international patients and develop a conceptual model based on well-established theory. Thorough database search (Science Direct, utmj.org, nih.gov, nchu.edu.tw, palgrave-journals, medretreat, Biomedcentral) was performed to fulfill the objectives of the study. Results: International patients always concern about benefits and risks related to travel. These benefits and risks form images of destination in the minds of international patients. Different sources of information make international patients acquaint about the associated benefits and risks, which later leads to development of intention to visit. This conceptual paper helps in establishing model for decision-making process of international patients in developing visit intention. Conclusion: Ample amount of literature is available detailing different factors involved in travel decision making of international patients; however literature explaining relationship between these factors is scarce. PMID:27114978

  19. Contingency Management and Deliberative Decision-Making Processes

    PubMed Central

    Regier, Paul S.; Redish, A. David

    2015-01-01

    Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation. PMID:26082725

  20. Surgical Decision Making for the Elderly Patients in Severe Head Injuries

    PubMed Central

    Shim, Jae-Jun; Yoon, Seok-Man; Oh, Jae-Sang; Bae, Hack-Gun; Doh, Jae-Won

    2014-01-01

    Objective Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3-8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion Ethical training and developing decision-making skills are necessary including shared decision making. PMID:25024822

  1. Information processing as a paradigm for decision making.

    PubMed

    Oppenheimer, Daniel M; Kelso, Evan

    2015-01-01

    For decades, the dominant paradigm for studying decision making--the expected utility framework--has been burdened by an increasing number of empirical findings that question its validity as a model of human cognition and behavior. However, as Kuhn (1962) argued in his seminal discussion of paradigm shifts, an old paradigm cannot be abandoned until a new paradigm emerges to replace it. In this article, we argue that the recent shift in researcher attention toward basic cognitive processes that give rise to decision phenomena constitutes the beginning of that replacement paradigm. Models grounded in basic perceptual, attentional, memory, and aggregation processes have begun to proliferate. The development of this new approach closely aligns with Kuhn's notion of paradigm shift, suggesting that this is a particularly generative and revolutionary time to be studying decision science. PMID:25559114

  2. Mass Spectrometry Imaging as a Tool for Surgical Decision-Making

    PubMed Central

    Calligaris, David; Norton, Isaiah; Feldman, Daniel R.; Ide, Jennifer L.; Dunn, Ian F.; Eberlin, Livia S.; Cooks, R. Graham; Jolesz, Ferenc A.; Golby, Alexandra J.; Santagata, Sandro; Agar, Nathalie Y.

    2014-01-01

    Despite significant advances in image-guided therapy, surgeons are still too often left with uncertainty when deciding to remove tissue. This binary decision between removing and leaving tissue during surgery implies that the surgeon should be able to distinguish tumor from healthy tissue. In neurosurgery, current image-guidance approaches such as magnetic resonance imaging (MRI) combined with neuro-navigation offer a map as to where the tumor should be, but the only definitive method to characterize the tissue at stake is histopathology. While extremely valuable information is derived from this gold standard approach, it is limited to very few samples during surgery and is not practically used for the delineation of tumor margins. The development and implementation of faster, comprehensive and complementary approaches for tissue characterization are required to support surgical decision-making – an incremental and iterative process with tumor removed in multiple and often minute biopsies. The development of atmospheric pressure ionization sources makes it possible to analyze tissue specimens with little to no sample preparation. Here, we highlight the value of desorption electrospray ionization (DESI) as one of many available approaches for the analysis of surgical tissue. Twelve surgical samples resected from a patient during surgery were analyzed and diagnosed as glioblastoma (GBM) tumor or necrotic tissue by standard histopathology, and mass spectrometry results were further correlated to histopathology for critical validation of the approach. The use of a robust statistical approach reiterated results from the qualitative detection of potential biomarkers of these tissue types. The correlation of the MS and histopathology results to magnetic resonance images brings significant insight into tumor presentation that could not only serve to guide tumor resection, but that is worthy of more detailed studies on our understanding of tumor presentation on MRI. PMID

  3. Use of Probabilistic Risk Assessment in Shuttle Decision Making Process

    NASA Technical Reports Server (NTRS)

    Boyer, Roger L.; Hamlin, Teri, L.

    2011-01-01

    This slide presentation reviews the use of Probabilistic Risk Assessment (PRA) to assist in the decision making for the shuttle design and operation. Probabilistic Risk Assessment (PRA) is a comprehensive, structured, and disciplined approach to identifying and analyzing risk in complex systems and/or processes that seeks answers to three basic questions: (i.e., what can go wrong? what is the likelihood of these occurring? and what are the consequences that could result if these occur?) The purpose of the Shuttle PRA (SPRA) is to provide a useful risk management tool for the Space Shuttle Program (SSP) to identify strengths and possible weaknesses in the Shuttle design and operation. SPRA was initially developed to support upgrade decisions, but has evolved into a tool that supports Flight Readiness Reviews (FRR) and near real-time flight decisions. Examples of the use of PRA for the shuttle are reviewed.

  4. Patient Participation in Surgical Treatment Decision Making from the Patients' Perspective: Validation of an Instrument

    PubMed Central

    Heggland, Liv-Helen; Øgaard, Torvald; Mikkelsen, Aslaug; Hausken, Kjell

    2012-01-01

    The aim of this paper is to describe the development of a new, brief, easy-to-administer self-reported instrument designed to assess patient participation in decision making in surgical treatment. We describe item generation, psychometric testing, and validity of the instrument. The final scale consisted of four factors: information dissemination (5 items), formulation of options (4 items), integration of information (4 items), and control (3 items). The analysis demonstrated a reasonable level of construct validity and reliability. The instrument applies to patients in surgical wards and can be used to identify the health services that are being provided and the areas that could strengthen patient participation. PMID:22830010

  5. Consensus versus Devil's Advocacy: The Influence of Decision Process and Task Structure on Strategic Decision Making.

    ERIC Educational Resources Information Center

    Murrell, Audrey J.; And Others

    1993-01-01

    Compares decision processes of consensus and devil's advocacy within an additive task, a disjunctive task, and a conjunctive task structure. Finds that high-conflict decision processes such as devil's advocacy enhances decision making in disjunctive tasks, retards decision making in additive tasks, but has no effect on decision making in…

  6. Space Launch System Complex Decision-Making Process

    NASA Technical Reports Server (NTRS)

    Lyles, Garry; Flores, Tim; Hundley, Jason; Monk, Timothy; Feldman,Stuart

    2012-01-01

    The Space Shuttle program has ended and elements of the Constellation Program have either been cancelled or transitioned to new NASA exploration endeavors. The National Aeronautics and Space Administration (NASA) has worked diligently to select an optimum configuration for the Space Launch System (SLS), a heavy lift vehicle that will provide the foundation for future beyond low earth orbit (LEO) large-scale missions for the next several decades. From Fall 2010 until Spring 2011, an SLS decision-making framework was formulated, tested, fully documented, and applied to multiple SLS vehicle concepts at NASA from previous exploration architecture studies. This was a multistep process that involved performing figure of merit (FOM)-based assessments, creating Pass/Fail gates based on draft threshold requirements, performing a margin-based assessment with supporting statistical analyses, and performing sensitivity analysis on each. This paper focuses on the various steps and methods of this process (rather than specific data) that allowed for competing concepts to be compared across a variety of launch vehicle metrics in support of the successful completion of the SLS Mission Concept Review (MCR) milestone.

  7. Shared Surgical Decision Making and Youth Resilience Correlates of Satisfaction With Clinical Outcomes.

    PubMed

    Kapp-Simon, Kathleen A; Edwards, Todd; Ruta, Caroline; Bellucci, Claudia Crilly; Aspirnall, Cassandra L; Strauss, Ronald P; Topolski, Tari D; Rumsey, Nichola J; Patrick, Donald L

    2015-07-01

    The aim of this study was to identify factors associated with youth satisfaction with surgical procedures performed to address oral cleft or craniofacial conditions (CFCs). It was hypothesized that youth mental health, participation in decision making, perceived consequences of living with a CFC, and coping strategies would be associated with satisfaction with past surgeries. A total of 203 youth between the ages of 11 and 18 years (mean age = 14.5, standard deviation = 2.0, 61% male participants, 78% oral cleft) completed a series of questionnaires measuring depression, self-esteem, participation in decision making, condition severity, negative and positive consequences of having a CFC, coping, and satisfaction with past surgeries. Multiple regression analysis using boot-strapping techniques found that youth participation in decision making, youth perception of positive consequences of having a CFC, and coping accounted for 32% of the variance in satisfaction with past surgeries (P < 0.001). Youth age, sex, and assessment of condition severity were not significantly associated with satisfaction with surgical outcome. Depression, self-esteem, and negative consequences of having a CFC were not associated with satisfaction with past surgeries. Youth should be actively involved in the decision for craniofacial surgery. Youth who were more satisfied with their surgical outcomes also viewed themselves as having gained from the experience of living with a CFC. They felt that having a CFC made them stronger people and they believed that they were more accepting of others and more in touch with others' feelings because of what they had been through. PMID:26114527

  8. Simulating the Foreign Policy Decision-Making Process in the Undergraduate Classroom

    ERIC Educational Resources Information Center

    Loggins, Julie A.

    2009-01-01

    A simulation of the foreign policy decision-making process, as described in this article, can assist an instructor in linking students' abstract understanding of complex political events, circumstances, and decision making to the real-world interplay of the multiple factors involved in decision making. It is this type of active learning that helps…

  9. Anticipatory network models of multicriteria decision-making processes

    NASA Astrophysics Data System (ADS)

    Skulimowski, Andrzej M. J.

    2014-01-01

    In this article, we will investigate the properties of a compromise solution selection method based on modelling the consequences of a decision as factors influencing the decision making in subsequent problems. Specifically, we assume that the constraints and preference structures in the (k + 1)st multicriteria optimisation problem depend on the values of criteria in the k-th problem. To make a decision in the initial problem, the decision maker should take into account the anticipated outcomes of each linked future decision problem. This model can be extended to a network of linked decision problems, such that causal relations are defined between the time-ordered nodes. Multiple edges starting from a decision node correspond to different future scenarios of consequences at this node. In addition, we will define the relation of anticipatory feedback, assuming that some decision makers take into account the anticipated future consequences of their decisions described by a network of optimisers - a class of information processing units introduced in this article. Both relations (causal and anticipatory) form a feedback information model, which makes possible a selection of compromise solutions taking into account the anticipated consequences. We provide constructive algorithms to solve discrete multicriteria decision problems that admit the above preference information structure. An illustrative example is presented in Section 4. Various applications of the above model, including the construction of technology foresight scenarios, are discussed in the final section of this article.

  10. Memory and Processing Limits in Decision-Making.

    ERIC Educational Resources Information Center

    Klapp, Stuart T.

    According to the classical working memory perspective, tasks such as command and control decision-making should be performed less effectively if extraneous material must be retained in short-term memory. Only marginal support for this prediction was obtained for a simulation involving scheduling trucking and transportation missions, although…

  11. An Assessment of Decision-Making Processes in Dual-Career Marriages.

    ERIC Educational Resources Information Center

    Kingsbury, Nancy M.

    As large numbers of women enter the labor force, decision making and power processes have assumed greater importance in marital relationships. A sample of 51 (N=101) dual-career couples were interviewed to assess independent variables predictive of process power, process outcome, and subjective outcomes of decision making in dual-career families.…

  12. Climate Change Scenario Planning in Alaska's National Parks: Stakeholder Involvement in the Decision-Making Process

    SciTech Connect

    Ernst, Kathleen M; Van Riemsdijk, Dr. Micheline

    2013-01-01

    This article studies the participation of stakeholders in climate change decision-making in Alaska s National Parks. We place stakeholder participation within literatures on environmental and climate change decision-making. We conducted participant observation and interviews in two planning workshops to investigate the decision-making process, and our findings are three-fold. First, the inclusion of diverse stakeholders expanded climate change decision-making beyond National Park Service (NPS) institutional constraints. Second, workshops of the Climate Change Scenario Planning Project (CCSPP) enhanced institutional understandings of participants attitudes towards climate change and climate change decision-making. Third, the geographical context of climate change influences the decision-making process. As the first regional approach to climate change decision-making within the NPS, the CCSPP serves as a model for future climate change planning in public land agencies. This study shows how the participation of stakeholders can contribute to robust decisions, may move climate change decision-making beyond institutional barriers, and can provide information about attitudes towards climate change decision-making.

  13. Parents and Peers: Their Importance in the Career Decision Making Process.

    ERIC Educational Resources Information Center

    Daniels, M. Harry; And Others

    This paper examines the role played by parents in their children's career decision-making process. Parents are identified as preeminent influences of adolescents' career decision making, a fact that has been largely unrecognized by career guidance personnel and school administrators, as evidenced by the lack of programs designed to enable parents…

  14. Free-Choice Learning Suited to Women's Participation Needs in Environmental Decision-Making Processes

    ERIC Educational Resources Information Center

    Skanavis, Constantina; Sakellari, Maria

    2012-01-01

    United Nations mandates recognize the need to promote the full participation of women in environmental decision-making processes on the basis of gender equality. But, there remains a profound lack of effective women's participation in some sectors of environmental decision-making. Free-choice environmental learning offers an effective educational…

  15. Evaluating the Usefulness of Scanning Systems as Information Sources in the Decision-Making Process.

    ERIC Educational Resources Information Center

    Wills, Sandra J.

    Research indicates that the role of information can be ambiguous in the decision-making process. Because relevance can be a problem with respect to information used in decision making, organizations should strive to achieve a linkage between flows of information and the making of specific decisions. Information flow between organizations and their…

  16. Stakeholders' Perception of Who Influences the Decision-Making Processes in Ontario's Public Postsecondary Education Institutions

    ERIC Educational Resources Information Center

    Powell, Billroy

    2008-01-01

    This paper reports the findings of a study conducted on stakeholders' perception of who influences the decision-making processes in Ontario's public postsecondary education institutions. The study identified and interviewed representatives of those stakeholder groups that are frequently written about as the main forces behind decision making in…

  17. The Use of Art in the Medical Decision-Making Process of Oncology Patients

    ERIC Educational Resources Information Center

    Czamanski-Cohen, Johanna

    2012-01-01

    The introduction of written informed consent in the 1970s created expectations of shared decision making between doctors and patients that has led to decisional conflict for some patients. This study utilized a collaborative, intrinsic case study approach to the decision-making process of oncology patients who participated in an open art therapy…

  18. Disciplined Decision Making in an Interdisciplinary Environment: Some Implications for Clinical Applications of Statistical Process Control.

    ERIC Educational Resources Information Center

    Hantula, Donald A.

    1995-01-01

    Clinical applications of statistical process control (SPC) in human service organizations are considered. SPC is seen as providing a standard set of criteria that serves as a common interface for data-based decision making, which may bring decision making under the control of established contingencies rather than the immediate contingencies of…

  19. Climate change scenario planning in Alaska's National Parks: Stakeholder involvement in the decision-making process

    SciTech Connect

    Ernst, Kathleen M; Van Riemsdijk, Dr. Micheline

    2013-01-01

    This article studies the participation of stakeholders in climate change decision-making in Alaska s National Parks. We place stakeholder participation within literatures on environmental and climate change decision-making. We conducted participant observation and interviews in two planning workshops to investigate the decision-making process, and our findings are three-fold. First, the inclusion of diverse stakeholders expanded climate change decision-making beyond National Park Service (NPS) institutional constraints. Second, workshops of the Climate Change Scenario Planning Project (CCSPP) enhanced institutional understandings of participants attitudes towards climate change and climate change decision-making. Third, the geographical context of climate change influences the decisionmaking process. As the first regional approach to climate change decision-making within the NPS, the CCSPP serves as a model for future climate change planning in public land agencies. This study shows how the participation of stakeholders can contribute to robust decisions, may move climate change decision-making beyond institutional barriers, and can provide information about attitudes towards climate change decision-making.

  20. Interpersonal influences on patients’ surgical decision making: the role of close others

    PubMed Central

    Rini, Christine; Jandorf, Lina; Goldsmith, Rachel E.; Manne, Sharon L.; Harpaz, Noam; Itzkowitz, Steven H.

    2011-01-01

    Patients make medical decisions in consultation with their partner, family, and friends. However, little is known about the ways in which these close others influence their decisions, particularly with respect to discrete decisions such as those related to medical treatments. This cross-sectional study investigated their influence on the surgical decisions of inflammatory bowel disease patients referred for surgery to remove their colon (N = 91). Guided by research on social control and classic research on power and influence in close relationships, we identified four types of close other decision influence: persuasion, assistance with understanding, indirect influence, and negative influence. Linear logistic and regression analyses showed that patients were more likely to have surgery when their close other used persuasion, and they reported lower decisional conflict when their close other helped them understand the decision. Patients were less likely to have surgery and reported greater decisional conflict when their close other used negative influence tactics. Findings demonstrate the importance of considering social context when investigating patient decision making. PMID:21308408

  1. Decision-Making in the Surgical Treatment of Breast Cancer: Factors Influencing Women’s Choices for Mastectomy and Breast Conserving Surgery

    PubMed Central

    Bellavance, Emily Catherine; Kesmodel, Susan Beth

    2016-01-01

    One of the most difficult decisions a woman can be faced with when choosing breast cancer treatment is whether or not to undergo breast conserving surgery or mastectomy. The factors that influence these treatment decisions are complex and involve issues regarding access to health care, concerns for cancer recurrence, and the impact of surgery on body image and sexuality. Understanding these factors will help practitioners to improve patient education and to better guide patients through this decision-making process. Although significant scientific and societal advances have been made in improving women’s choices for the breast cancer treatment, there are still deficits in the decision-making processes surrounding the surgical treatment of breast cancer. Further research is needed to define optimal patient education and shared decision-making practices in this area. PMID:27066455

  2. The Computational Complexity of Valuation and Motivational Forces in Decision-Making Processes.

    PubMed

    Redish, A David; Schultheiss, Nathan W; Carter, Evan C

    2016-01-01

    The concept of value is fundamental to most theories of motivation and decision making. However, value has to be measured experimentally. Different methods of measuring value produce incompatible valuation hierarchies. Taking the agent's perspective (rather than the experimenter's), we interpret the different valuation measurement methods as accessing different decision-making systems and show how these different systems depend on different information processing algorithms. This identifies the translation from these multiple decision-making systems into a single action taken by a given agent as one of the most important open questions in decision making today. We conclude by looking at how these different valuation measures accessing different decision-making systems can be used to understand and treat decision dysfunction such as in addiction. PMID:25981912

  3. Theory of mind and decision-making processes are impaired in Parkinson's disease.

    PubMed

    Xi, Chunhua; Zhu, Youling; Mu, Yanfang; Chen, Bing; Dong, Bin; Cheng, Huaidong; Hu, Panpan; Zhu, Chunyan; Wang, Kai

    2015-02-15

    Prefrontal cortex plays a vital role in the theory of mind (ToM) and decision making, as shown in functional brain imaging and lesion studies. Considering the primary neuropathology of Parkinson's disease (PD) involving the frontal lobe system, patients with PD are expected to exhibit deficits in ToM and social decision making. The aim of this study was to investigate affective ToM and decision making in patients with PD and healthy controls (HC) in a task assessing affective ToM (Reading the Mind in the Eyes, RME) and two decision-making tasks (Iowa Gambling Task, IGT; Game of Dice Task, GDT). Consistent with previous findings, patients with PD were impaired in the affective ToM task, and when making decisions under ambiguity and in risk situations. The score of emotion recognition in the RME task was negatively correlated with the severity of the disease and positively correlated with the total number of advantageous cards chosen in the IGT. However, the final capital in the GDT was correlated with memory impairment. The present study implies that affective ToM and decision making under ambiguity may share similar neural mechanisms, while decision making under ambiguity and decision making under risk may involve processing within different neural networks. PMID:25435317

  4. The Decision-Making Process of a Small Task Group.

    ERIC Educational Resources Information Center

    Roderick, Joan C.

    1985-01-01

    This article focuses on the following areas of group process: the nature of the task group, the steps taken to reach a decision, and the ways in which a leader can effectively manage the inevitable conflict that emerges within groups as the problem-solving process progresses. (CT)

  5. When Family Considerations Influence Work Decisions: Decision-Making Processes

    ERIC Educational Resources Information Center

    Powell, Gary N.; Greenhaus, Jeffrey H.

    2012-01-01

    The work-family literature has provided an abundance of evidence that various family factors are linked to various work decisions, suggesting that the "family-relatedness" of work decisions is a prevalent phenomenon (Greenhaus & Powell, 2012). However, the cognitive processes by which such linkages occur have received little attention. We offer a…

  6. Decision making. A step-by-step process.

    PubMed

    McConnell, E A

    1989-05-01

    Some decisions affect no one but ourselves, and others affect more than one person. Some decisions are quite simple and have minimal, if any, ramifications; other decisions are more complex and can have major ramifications. Some decisions are easy to make because a person has the experience and knowledge, and other decisions require extensive deliberation because of their complexity or because a person may lack knowledge in that area. Making effective decisions is not an inherent gift, but the process can be learned. The decision a person makes today will someday be the base from which to assess a new situation. PMID:2729970

  7. Detecting fast, online reasoning processes in clinical decision making.

    PubMed

    Flores, Amanda; Cobos, Pedro L; López, Francisco J; Godoy, Antonio

    2014-06-01

    In an experiment that used the inconsistency paradigm, experienced clinical psychologists and psychology students performed a reading task using clinical reports and a diagnostic judgment task. The clinical reports provided information about the symptoms of hypothetical clients who had been previously diagnosed with a specific mental disorder. Reading times of inconsistent target sentences were slower than those of control sentences, demonstrating an inconsistency effect. The results also showed that experienced clinicians gave different weights to different symptoms according to their relevance when fluently reading the clinical reports provided, despite the fact that all the symptoms were of equal diagnostic value according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The diagnostic judgment task yielded a similar pattern of results. In contrast to previous findings, the results of the reading task may be taken as direct evidence of the intervention of reasoning processes that occur very early, rapidly, and online. We suggest that these processes are based on the representation of mental disorders and that these representations are particularly suited to fast retrieval from memory and to making inferences. They may also be related to the clinicians' causal reasoning. The implications of these results for clinician training are also discussed. PMID:24274045

  8. Who decides? The decision-making process of juvenile judges concerning minors with mental disorders.

    PubMed

    Cappon, Leen

    2016-01-01

    Previous research on juvenile judges' decision-making process has neglected the role of the different actors involved in judicial procedures. The decision can be considered as a result of information exchange between the different actors involved. The process of making a decision is equally important as the decision itself, especially when the decision considers minors with mental disorders. The presence and the type of interaction determine the information available to the juvenile judges to make their final decision. The overall aim of this study is to gain insight into the role of all actors, including the juvenile judge, in the juvenile judge's decision-making process in cases relating to minors with mental disorders. Semi-structured interviews were carried out with professional actors (n=32), minors (n=31) and parents (n=17). The findings indicated that the judge's decision is overall the result of an interaction between the juvenile judge, the social services investigator and the youth psychiatrist. The other professional actors, the minors and the parents had only a limited role in the decision-making process. The research concludes that the judge's decision-making process should be based on dialogue, and requires enhanced collaboration between the juvenile court and youth psychiatrists from mental health services. Future decision-making research should pay more attention to the interactions of the actors that guide a juvenile judge's decision. PMID:27033974

  9. Fuzzy methods in decision making process - A particular approach in manufacturing systems

    NASA Astrophysics Data System (ADS)

    Coroiu, A. M.

    2015-11-01

    We are living in a competitive environment, so we can see and understand that the most of manufacturing firms do the best in order to accomplish meeting demand, increasing quality, decreasing costs, and delivery rate. In present a stake point of interest is represented by the development of fuzzy technology. A particular approach for this is represented through the development of methodologies to enhance the ability to managed complicated optimization and decision making aspects involving non-probabilistic uncertainty with the reason to understand, development, and practice the fuzzy technologies to be used in fields such as economic, engineering, management, and societal problems. Fuzzy analysis represents a method for solving problems which are related to uncertainty and vagueness; it is used in multiple areas, such as engineering and has applications in decision making problems, planning and production. As a definition for decision making process we can use the next one: result of mental processes based upon cognitive process with a main role in the selection of a course of action among several alternatives. Every process of decision making can be represented as a result of a final choice and the output can be represented as an action or as an opinion of choice. Different types of uncertainty can be discovered in a wide variety of optimization and decision making problems related to planning and operation of power systems and subsystems. The mixture of the uncertainty factor in the construction of different models serves for increasing their adequacy and, as a result, the reliability and factual efficiency of decisions based on their analysis. Another definition of decision making process which came to illustrate and sustain the necessity of using fuzzy method: the decision making is an approach of choosing a strategy among many different projects in order to achieve some purposes and is formulated as three different models: high risk decision, usual risk

  10. 14 CFR § 1216.303 - NEPA process in NASA planning and decision making.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false NEPA process in NASA planning and decision... Act (NEPA) § 1216.303 NEPA process in NASA planning and decision making. (a) NEPA requires the... integration of the NEPA process with NASA project and program planning improves Agency decisions and...

  11. 14 CFR 1216.303 - NEPA process in NASA planning and decision making.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false NEPA process in NASA planning and decision...) § 1216.303 NEPA process in NASA planning and decision making. (a) NEPA requires the systematic... the NEPA process with NASA project and program planning improves Agency decisions and ensures that:...

  12. “And I think that we can fix it”: Mental Models used in High-Risk Surgical Decision Making

    PubMed Central

    Kruser, Jacqueline M; Pecanac, Kristen E; Brasel, Karen J; Cooper, Zara; Steffens, Nicole; McKneally, Martin; Schwarze, Margaret L

    2014-01-01

    Objective To examine how surgeons use the “fix-it” model to communicate with patients before high-risk operations. Background The “fix-it” model characterizes disease as an isolated abnormality that can be restored to normal form and function through medical intervention. This mental model is familiar to patients and physicians, but it is ineffective for chronic conditions and treatments that cannot achieve normalcy. Overuse may lead to permissive decision making favoring intervention. Efforts to improve surgical decision making will need to consider how mental models function in clinical practice, including “fix-it”. Methods We observed surgeons who routinely perform high-risk surgery during preoperative discussions with patients. We used qualitative content analysis to explore the use of “fix-it” in 48 audio-recorded conversations. Results Surgeons used the “fix-it” model for two separate purposes during preoperative conversations; 1) as an explanatory tool to facilitate patient understanding of disease and surgery and 2) as a deliberation framework to assist in decision making. Although surgeons commonly used “fix-it” as an explanatory model, surgeons explicitly discussed limitations of the “fix-it” model as an independent rationale for operating as they deliberated about the value of surgery. Conclusions While the use of “fix-it” is familiar for explaining medical information to patients, surgeons recognize that the model can be problematic for determining the value of an operation. Whether patients can transition between understanding how their disease is fixed with surgery to a subsequent deliberation about whether they should have surgery is unclear and may have broader implications for surgical decision making. PMID:25749396

  13. The role of orbitofrontal cortex in decision making: a component process account.

    PubMed

    Fellows, Lesley K

    2007-12-01

    Clinical accounts of the effects of damage to orbitofrontal cortex (OFC) have provided important clues about the functions of this region in humans. Patients with OFC injury can demonstrate relatively isolated difficulties with decision making, and the development of laboratory tasks that captured these difficulties was an important advance. However, much of the work to date has been limited by the use of a single, complex decision-making task and by a narrow focus on risky decisions. A fuller understanding of the neural basis of decision making requires identification of the simpler components that underlie this complex behavior. Here, I review evidence that OFC lesions disrupt reversal learning in humans, as in animals, and show that this deficit in reversal learning is an important mechanism underlying the difficulties of such patients in the Iowa gambling task. Reversal learning, in turn, can be decomposed into simpler processes: a failure to rapidly learn from negative feedback may be the critical difficulty for OFC patients. OFC damage can also affect forms of decision making that do not require trial-by-trial learning. Preference judgment is a simple form of decision making that requires comparing the relative value of options. Humans with OFC lesions are more inconsistent in their choices, even in very simple preference judgment tasks. These results are broadly consistent with the view that OFC is critically involved in representing the relative value of stimuli, but also raise the possibility that this region plays distinct roles in reinforcement learning and value-based judgment. PMID:17846161

  14. Utilising Benchmarking to Inform Decision-Making at the Institutional Level: A Research-Informed Process

    ERIC Educational Resources Information Center

    Booth, Sara

    2013-01-01

    Benchmarking has traditionally been viewed as a way to compare data only; however, its utilisation as a more investigative, research-informed process to add rigor to decision-making processes at the institutional level is gaining momentum in the higher education sector. Indeed, with recent changes in the Australian quality environment from the…

  15. An Assessment of Decision-Making Styles/Processes of Consumer Education Students.

    ERIC Educational Resources Information Center

    Bertelson, Catherine L.

    1986-01-01

    Reports on a study to determine the decision-making processes and styles used by consumer education students when confronted with a consumer credit problem. Tests were administered to 27 secondary students. Findings revealed that gender determines to a great extent the process and style used. (Author/CH)

  16. A Dual-Process Approach to Health Risk Decision Making: The Prototype Willingness Model

    ERIC Educational Resources Information Center

    Gerrard, Meg; Gibbons, Frederick X.; Houlihan, Amy E.; Stock, Michelle L.; Pomery, Elizabeth A.

    2008-01-01

    Although dual-process models in cognitive, personality, and social psychology have stimulated a large body of research about analytic and heuristic modes of decision making, these models have seldom been applied to the study of adolescent risk behaviors. In addition, the developmental course of these two kinds of information processing, and their…

  17. Age, Time, and Decision Making: From Processing Speed to Global Time Horizons

    PubMed Central

    Löckenhoff, Corinna E.

    2013-01-01

    Time and time perceptions are integral to decision making because any meaningful choice is embedded in a temporal context and requires the evaluation of future preferences and outcomes. The present review examines the influence of chronological age on time perceptions and horizons and discusses implications for decision making across the life span. Time influences and interacts with decision making in multiple ways. Specifically, this review examines the following topic areas: (1) processing speed and decision time, (2) internal clocks and time estimation, (3) mental representations of future time and intertemporal choice, and (4) global time horizons. For each aspect, patterns of age differences and implications for decision strategies and quality are discussed. The conclusion proposes frameworks to integrate different lines of research and identifies promising avenues for future inquiry. PMID:22023567

  18. Decision making, procedural compliance, and outcomes definition in U.S. forest service planning processes

    SciTech Connect

    Stern, Marc J.; Predmore, S. Andrew

    2011-04-15

    The National Environmental Policy Act (NEPA) dictates a process of analyzing and disclosing the likely impacts of proposed agency actions on the human environment. This study addresses two key questions related to NEPA implementation in the U.S. Forest Service: 1) how do Interdisciplinary (ID) team leaders and decision makers conceptualize the outcomes of NEPA processes? And 2), how does NEPA relate to agency decision making? We address these questions through two separate online surveys that posed questions about recently completed NEPA processes - the first with the ID team leaders tasked with carrying out the processes, and the second with the line officers responsible for making the processes' final decisions. Outcomes of NEPA processes include impacts on public relations, on employee morale and team functioning, on the achievement of agency goals, and on the achievement of NEPA's procedural requirements (disclosure) and substantive intent (minimizing negative environmental impacts). Although both tended to view public relations outcomes as important, decision makers' perceptions of favorable outcomes were more closely linked to the achievement of agency goals and process efficiency than was the case for ID team leaders. While ID team leaders' responses suggest that they see decision making closely integrated with the NEPA process, decision makers more commonly decoupled decision making from the NEPA process. These findings suggest a philosophical difference between ID team leaders and decision makers that may pose challenges for both the implementation and the evaluation of agency NEPA. We discuss the pros and cons of integrating NEPA with decision making or separating the two. We conclude that detaching NEPA from decision making poses greater risks than integrating them.

  19. Review of Current International Decision-Making Processes for Newborn Screening: Lessons for Australia

    PubMed Central

    Metternick-Jones, Selina Carolyne; Lister, Karla Jane; Dawkins, Hugh J. S.; White, Craig Anthony; Weeramanthri, Tarun Stephen

    2015-01-01

    Newborn bloodspot screening has been operating successfully in Australia for almost 50 years. Recently, the development of new technologies and treatments has led to calls for the addition of new conditions to the screening programs. Internationally, it is recognized by governments that national policies for newborn screening should support transparent and evidence-based decision making, and promote consistency between states within a country. Australia is lagging behind the international community, and currently has no national policies or decision-making processes, agreed by government, to support its newborn screening programs. In contrast, New Zealand (NZ), the United Kingdom (UK), and the United States of America (US) have robust and transparent processes to assess conditions for screening, which have been developed by, and have pathways to, government. This review provides detail on the current policy environment for newborn screening in Australia, highlighting that there are a number of risks to the programs resulting from the lack of a decision-making process. It also describes the processes used to assess conditions for newborn screening in the US, UK, and NZ. These examples highlight the benefits of developing a national decision-making process, including ensuring that screening is evidence based and effective. These examples also provide models that might be considered for Australia, as well as other countries currently seeking to introduce or expand newborn bloodspot screening. PMID:26442241

  20. The Decision-Making Process for Requests for Late Termination of Pregnancy in Israel.

    ERIC Educational Resources Information Center

    Gagin, Roni; Oded, Ofrah; Cohen, Mimi; Itskovitz, Joseph

    2001-01-01

    This paper outlines and reflects on current procedures in Israel for requesting a late termination of pregnancy (LTP) and the subsequent decision-making processes, using data collected in 1995-97 from 183 women. Discusses the responsibility of the health system and social workers to address the need for enhanced support for women requesting LTPs.…

  1. THE DECISION-MAKING PROCESS OF SCHOOL DISTRICTS REGARDING VOCATIONAL EDUCATION AND TRAINING PROGRAMS.

    ERIC Educational Resources Information Center

    BEAL, GEORGE M.; AND OTHERS

    THE SUPERINTENDENTS OF 195 OF 209 SCHOOL DISTRICTS HOLDING BOND ISSUE ELECTIONS DURING A 5-YEAR PERIOD RESPONDED TO A QUESTIONNAIRE. OF THESE, 20 OF THE 24 WHOSE BOND ISSUES INVOLVED VOCATIONAL EDUCATION WERE INTERVIEWED IN A TWO-PHASE STUDY TO ANALYZE THE DECISION MAKING PROCESS, IDENTIFY THE VARIABLES ASSOCIATED WITH SUCCESS OR FAILURE, AND TO…

  2. Child Care Decision Making: Understanding Priorities and Processes Used by Low-Income Families in Minnesota

    ERIC Educational Resources Information Center

    Forry, Nicole; Isner, Tabitha K.; Daneri, Maria P.; Tout, Kathryn

    2014-01-01

    Research Findings: Few studies have described parents' child care decision-making process, yet understanding how parents make child care choices is fundamental to developing effective services to promote the selection of high-quality care. This study used latent profile analysis to distinguish subgroups of low-income parents identified as…

  3. Decision Making and Information Processing under Various Uncertainty Conditions. Final Report.

    ERIC Educational Resources Information Center

    Schipper, Lowell M.; Doherty, Michael

    Seven experiments were conducted concerning decision making and information processing under conditions of uncertainty. Several different experimental tasks were used; all presented the subject with multiple independent sources of information regarding the likelihood that some event would occur. Study 1 subjects were Air Force pilots; all other…

  4. Special Education Eligibility: An Examination of the Decision-Making Process

    ERIC Educational Resources Information Center

    Kirkland, Erin K. B.

    2012-01-01

    The purpose of this study was to investigate the influence of private practitioner and educational advocate opinions on school-based administrators' decision-making thought processes when making a recommendation for special education eligibility. Special education eligibility is a school-based team decision that involves multiple…

  5. Improving the Process of Career Decision Making: An Action Research Approach

    ERIC Educational Resources Information Center

    Greenbank, Paul

    2011-01-01

    Purpose: This study adopts an action research approach with the aim of improving the process of career decision making among undergraduates in a business school at a "new" university in the UK. Design/methodology/approach: The study utilised unfreezing techniques, multiple case studies in conjunction with the principle of analogical encoding, and…

  6. Amotivation and Indecision in the Decision-Making Processes Associated with University Entry

    ERIC Educational Resources Information Center

    Jung, Jae Yup

    2013-01-01

    This study developed and tested two models that examined the decision-making processes of adolescents relating to entry into university, in terms of the extent to which they may be amotivated and undecided. The models incorporated variables derived from self-determination theory, expectancy-value theory, and research on occupational indecision. A…

  7. Domestic Abuse and Child Contact: Positioning Children in the Decision-Making Process

    ERIC Educational Resources Information Center

    Holt, Stephanie

    2011-01-01

    Drawing on a three-year Irish research study, this paper focuses on the decision-making process in child contact, specifically the assessment and management of risk of continuing abuse to young people previously exposed to domestic abuse. A mixed methodological approach involved the completion of survey questionnaires by 219 mothers and the…

  8. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  9. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  10. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  11. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  12. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  13. Quantifying Japanese Residents' Preferences for Public Meetings in Watershed Decision-Making Process

    ERIC Educational Resources Information Center

    Sakagami, Masaji; Ohno, Tomohiko; Tanaka, Takuya

    2010-01-01

    In this article, we quantified Japanese residents' potential preferences for public participation, specifically public meetings, concerning regional environmental issues in Yodo River watershed decision-making process. We conducted a choice experiments (CE) survey in the Yodo River watershed in Japan. Our findings confirmed that residents assign a…

  14. Factors Affecting Long-Term-Care Residents' Decision-Making Processes as They Formulate Advance Directives

    ERIC Educational Resources Information Center

    Lambert, Heather C.; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E. D.

    2005-01-01

    Purpose: The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. Design and Methods: This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a…

  15. Multiple Case Studies of Public Library Systems in New York State: Service Decision-Making Processes

    ERIC Educational Resources Information Center

    Ren, Xiaoai

    2012-01-01

    This research examined the functions and roles of public library systems in New York State and the services they provide for individual libraries and the public. The dissertation further studied the service decision-making processes at three selected New York State cooperative public library systems. Public library systems have played an important…

  16. Teachers and Decision-Making Processes: An Italian Exploratory Study on Individual and Collaborative Decisions

    ERIC Educational Resources Information Center

    Parmigiani, Davide

    2012-01-01

    This research was aimed at highlighting the decision-making processes of Italian teachers; in particular, we have focused on individual and collaborative decisions developed both during meetings and in the classroom. The study has underlined the features of teachers' decisions when decisions are made in groups and individually. A questionnaire was…

  17. Inferential Judgments Affecting the Decision-Making Process in the Attorney General's Commission on Pornography.

    ERIC Educational Resources Information Center

    Gouran, Dennis S.

    Although the Attorney General's Commission on Pornography, also known as the Meese Commission, has been criticized excessively at times for threatening freedom of speech and press and individual rights to privacy, an analysis of its "Final Report" reveals numerous deficiencies in the Commission's decision-making process. These deficiencies,…

  18. Categorization = Decision Making + Generalization

    PubMed Central

    Seger, Carol A; Peterson, Erik J.

    2013-01-01

    We rarely, if ever, repeatedly encounter exactly the same situation. This makes generalization crucial for real world decision making. We argue that categorization, the study of generalizable representations, is a type of decision making, and that categorization learning research would benefit from approaches developed to study the neuroscience of decision making. Similarly, methods developed to examine generalization and learning within the field of categorization may enhance decision making research. We first discuss perceptual information processing and integration, with an emphasis on accumulator models. We then examine learning the value of different decision making choices via experience, emphasizing reinforcement learning modeling approaches. Next we discuss how value is combined with other factors in decision making, emphasizing the effects of uncertainty. Finally, we describe how a final decision is selected via thresholding processes implemented by the basal ganglia and related regions. We also consider how memory related functions in the hippocampus may be integrated with decision making mechanisms and contribute to categorization. PMID:23548891

  19. The decision-making process when starting terminal care as assessed by nursing staff.

    PubMed

    Kuuppelomäki, Merja

    2002-01-01

    This article deals with making decisions about starting terminal care. The results are part of a larger survey on nurses' conceptions of terminal care in community health centres in Finland. The importance, frequency and timing of decision making as well as communication and the number of investigations and procedures carried out are examined. The relationship between decision making and the size of a health centre's catchment population is also discussed. The results make it possible to compare the current situation in Finland with the national law on patients' rights. The sample consisted of 328 nurses who worked on the wards of 32 community health centres. The data were collected by means of a structured questionnaire and processed with the Statistical Package for Social Sciences software. The nurses agreed that explicit decision making and documentation about starting terminal care were necessary, but it was highlighted that the practice had many shortcomings. Decisions were often made too late and the patients were not always aware of their situation; family members and the nursing staff were mostly better informed. It was noted that many investigations and other procedures were carried out on terminally ill patients, often at the request of family members. Decision making was found to have some relationship to the size of a health centre's catchment area. PMID:16010895

  20. Cochlear Implant: the complexity involved in the decision making process by the family1

    PubMed Central

    Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

    2014-01-01

    Objective to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Method qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Results knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusion deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention. PMID:25029052

  1. Process control and risky decision-making: moderation by general mental ability and need for cognition.

    PubMed

    Burkolter, Dina; Kluge, Annette

    2012-01-01

    Human factors and ergonomics research could benefit from focusing more strongly on individual differences--especially trait variables. The present study suggests the analysis of moderator effects as a promising way to enhance understanding of trait variables and process control performance. Process control performance was studied by analysing moderator effects of general mental ability (GMA) and need for cognition (NC) on risky decision-making (RDM) and performance. Fifty engineering students were trained on a process control task using a computer-based simulation for three hours and tested twice thereafter. Risky decision-making was measured using a computerised gambling task while GMA and NC were assessed with questionnaires. Risky decision-making in interaction with each GMA and NC explained variance in performance over and above variance explained by the single effects. In conclusion, the analysis of moderator effects between individual difference variables and process control performance seems promising. Practitioner Summary: Individual difference variables affect learning and performance, but have often not been studied to any great extent in human factors research. This article suggests a promising approach to studying individual differences--moderator analyses--and illustrates how such differences can lead to a better understanding of what determines process control performance. PMID:22897454

  2. [Nurses' subjectivity production and the decision-making in the process of care].

    PubMed

    Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa

    2013-06-01

    This study aimed to understand the relationship between Nurse's production of subjectivity and the decision-making in the process of Nursing care. A qualitative design of research was conducted. The investigation was carried out with twelve nurses who work at the Associação de Caridade Santa Casa do Rio Grande, a hospital located in Rio Grande, RS, Brazil. For data collection, focus group technique was used three meetings were conducted in december 2011. The results were presented in semantic categories: Capitalist System: maintenance of employment bond; Submission System: institutionalized culture and vision of society; Nursing Hierarchical System; and Values System: feeling of guilt and lack of professional recognition. The capitalist system mediates, mainly, the behavior that prevails in the decision-making process in Nursing care. PMID:24015473

  3. Information Technology Process Improvement Decision-Making: An Exploratory Study from the Perspective of Process Owners and Process Managers

    ERIC Educational Resources Information Center

    Lamp, Sandra A.

    2012-01-01

    There is information available in the literature that discusses information technology (IT) governance and investment decision making from an executive-level perception, yet there is little information available that offers the perspective of process owners and process managers pertaining to their role in IT process improvement and investment…

  4. [The ethical reflection approach in decision-making processes in health institutes].

    PubMed

    Gruat, Renaud

    2015-12-01

    Except in the specific case of end-of-life care, the law says nothing about the way in which health professionals must carry out ethical reflection regarding the treatment of their patients. A problem-solving methodology called the "ethical reflection approach" performed over several stages can be used. The decision-making process involves the whole team and draws on the ability of each caregiver to put forward a reasoned argument, in the interest of the patient. PMID:26675109

  5. Backcountry snowmobilers' risk perceptions, avalanche related information seeking behaviours, preparedness and decision-making processes

    NASA Astrophysics Data System (ADS)

    Baker, Jennifer

    Although there has been substantial research on the avoidance of risk, much less has been completed on voluntary risk. This study examined backcountry snowmobilers' risk perceptions, avalanche related information seeking behaviours, and decision-making processes when dealing with avalanches and backcountry risk in Canada. To accomplish this, in-depth, semi-structured interviews were conducted with 17 participants who were involved in backcountry snowmobiling. Interviews were done both in person and by telephone. The results of this study show that, unlike previous research on snowmobilers, the participants of this study were well prepared and knowledgeable about backcountry risks. All 17 participants stated that they carried a shovel, probe, and transceiver with them on each backcountry trip, and 10 participants had taken an avalanche safety course. Group dynamics and positive peer pressure were influential in promoting safe backcountry behaviour. KEYWORDS: Backcountry snowmobiling, Avalanches, Voluntary Risk, Preparedness, Decision-Making.

  6. Planetary protection, legal ambiguity and the decision making process for Mars sample return

    NASA Technical Reports Server (NTRS)

    Race, M. S.

    1996-01-01

    As scientists and mission planners develop planetary protection requirements for future Mars sample return missions, they must recognize the socio-political context in which decisions about the mission will be made and pay careful attention to public concerns about potential back contamination of Earth. To the extent that planetary protection questions are unresolved or unaddressed at the time of an actual mission, they offer convenient footholds for public challenges in both legal and decision making realms, over which NASA will have little direct control. In this paper, two particular non-scientific areas of special concern are discussed in detail: 1) legal issues and 2) the decision making process. Understanding these areas is critical for addressing legitimate public concerns as well as for fulfilling procedural requirements regardless whether sample return evokes public controversy. Legal issues with the potential to complicate future missions include: procedural review under National Environmental Policy Act (NEPA); uncertainty about institutional control and authority; conflicting regulations and overlapping jurisdictions; questions about international treaty obligations and large scale impacts; uncertanities about the nature of the organism; and constitutional and regulatory concerns about quarantine, public health and safety. In light of these important legal issues, it is critical that NASA consider the role and timing of public involvement in the decision making process as a way of anticipating problem areas and preparing for legitimate public questions and challenges to sample return missions.

  7. Diffusion Modelling Reveals the Decision Making Processes Underlying Negative Judgement Bias in Rats

    PubMed Central

    Hales, Claire A.; Robinson, Emma S. J.; Houghton, Conor J.

    2016-01-01

    Human decision making is modified by emotional state. Rodents exhibit similar biases during interpretation of ambiguous cues that can be altered by affective state manipulations. In this study, the impact of negative affective state on judgement bias in rats was measured using an ambiguous-cue interpretation task. Acute treatment with an anxiogenic drug (FG7142), and chronic restraint stress and social isolation both induced a bias towards more negative interpretation of the ambiguous cue. The diffusion model was fit to behavioural data to allow further analysis of the underlying decision making processes. To uncover the way in which parameters vary together in relation to affective state manipulations, independent component analysis was conducted on rate of information accumulation and distances to decision threshold parameters for control data. Results from this analysis were applied to parameters from negative affective state manipulations. These projected components were compared to control components to reveal the changes in decision making processes that are due to affective state manipulations. Negative affective bias in rodents induced by either FG7142 or chronic stress is due to a combination of more negative interpretation of the ambiguous cue, reduced anticipation of the high reward and increased anticipation of the low reward. PMID:27023442

  8. Planetary protection, legal ambiguity and the decision making process for Mars sample return

    NASA Astrophysics Data System (ADS)

    Race, M. S.

    As scientists and mission planners develop planetary protection requirements for future Mars sample return missions, they must recognize the socio-political context in which decisions about the mission will be made and pay careful attention to public concerns about potential back contamination of Earth. To the extent that planetary protection questions are unresolved or unaddressed at the time of an actual mission, they offer convenient footholds for public challenges in both legal and decision making realms, over which NASA will have little direct control. In this paper, two particular non-scientific areas of special concern are discussed in detail: 1) legal issues and 2) the decision making process. Understanding these areas is critical for addressing legitimate public concerns as well as for fulfilling procedural requirements regardless whether sample return evokes public controversy. Legal issues with the potential to complicate future missions include: procedural review under NEPA; uncertainty about institutional control and authority; conflicting regulations and overlapping jurisdictions; questions about international treaty obligations and large scale impacts; uncertainties about the nature of the organism; and constitutional and regulatory concerns about quarantine, public health and safety. In light of these important legal issues, it is critical that NASA consider the role and timing of public involvement in the decision making process as a way of anticipating problem areas and preparing for legitimate public questions and challenges to sample return missions.

  9. Planetary protection, legal ambiguity and the decision making process for Mars sample return.

    PubMed

    Race, M S

    1996-01-01

    As scientists and mission planners develop planetary protection requirements for future Mars sample return missions, they must recognize the socio-political context in which decisions about the mission will be made and pay careful attention to public concerns about potential back contamination of Earth. To the extent that planetary protection questions are unresolved or unaddressed at the time of an actual mission, they offer convenient footholds for public challenges in both legal and decision making realms, over which NASA will have little direct control. In this paper, two particular non-scientific areas of special concern are discussed in detail: 1) legal issues and 2) the decision making process. Understanding these areas is critical for addressing legitimate public concerns as well as for fulfilling procedural requirements regardless whether sample return evokes public controversy. Legal issues with the potential to complicate future missions include: procedural review under National Environmental Policy Act (NEPA); uncertainty about institutional control and authority; conflicting regulations and overlapping jurisdictions; questions about international treaty obligations and large scale impacts; uncertanities about the nature of the organism; and constitutional and regulatory concerns about quarantine, public health and safety. In light of these important legal issues, it is critical that NASA consider the role and timing of public involvement in the decision making process as a way of anticipating problem areas and preparing for legitimate public questions and challenges to sample return missions. PMID:11538983

  10. The detrimental effects of emotional process dysregulation on decision-making in substance dependence

    PubMed Central

    Murphy, Anna; Taylor, Eleanor; Elliott, Rebecca

    2012-01-01

    Substance dependence is complex and multifactorial, with many distinct pathways involved in both the development and subsequent maintenance of addictive behaviors. Various cognitive mechanisms have been implicated, including impulsivity, compulsivity, and impaired decision-making. These mechanisms are modulated by emotional processes, resulting in increased likelihood of initial drug use, sustained substance dependence, and increased relapse during periods of abstinence. Emotional traits, such as sensation-seeking, are risk factors for substance use, and chronic drug use can result in further emotional dysregulation via effects on reward, motivation, and stress systems. We will explore theories of hyper and hypo sensitivity of the brain reward systems that may underpin motivational abnormalities and anhedonia. Disturbances in these systems contribute to the biasing of emotional processing toward cues related to drug use at the expense of natural rewards, which serves to maintain addictive behavior, via enhanced drug craving. We will additionally focus on the sensitization of the brain stress systems that result in negative affect states that continue into protracted abstinence that is may lead to compulsive drug-taking. We will explore how these emotional dysregulations impact upon decision-making controlled by goal-directed and habitual action selections systems, and, in combination with a failure of prefrontal inhibitory control, mediate maladaptive decision-making observed in substance dependent individuals such that they continue drug use in spite of negative consequences. An understanding of the emotional impacts on cognition in substance dependent individuals may guide the development of more effective therapeutic interventions. PMID:23162443

  11. An Integrative Process Approach on Judgment and Decision Making: The Impact of Arousal, Affect, Motivation, and Cognitive Ability

    ERIC Educational Resources Information Center

    Roets, Arne; Van Hiel, Alain

    2011-01-01

    This article aims to integrate the findings from various research traditions on human judgment and decision making, focusing on four process variables: arousal, affect, motivation, and cognitive capacity/ability. We advocate a broad perspective referred to as the integrative process approach (IPA) of decision making, in which these process…

  12. Household Decision-Making Process: It's Effect on School Dropout Behavior for Girls in the Secondary School Level in Bangladesh

    ERIC Educational Resources Information Center

    Shahidul, S. M.

    2013-01-01

    This study aims to understand the parents' household decision-making process with respect to allowing girls to drop out of school, an area that has, thus far, been overlooked in the research regarding school dropouts. This paper has examined the household decision-making process between fathers and mothers and explores how their respective levels…

  13. Confident Surgical Decision Making in Temporal Lobe Epilepsy by Heterogeneous Classifier Ensembles

    PubMed Central

    Fakhraei, Shobeir; Soltanian-Zadeh, Hamid; Jafari-Khouzani, Kourosh; Elisevich, Kost; Fotouhi, Farshad

    2015-01-01

    In medical domains with low tolerance for invalid predictions, classification confidence is highly important and traditional performance measures such as overall accuracy cannot provide adequate insight into classifications reliability. In this paper, a confident-prediction rate (CPR) which measures the upper limit of confident predictions has been proposed based on receiver operating characteristic (ROC) curves. It has been shown that heterogeneous ensemble of classifiers improves this measure. This ensemble approach has been applied to lateralization of focal epileptogenicity in temporal lobe epilepsy (TLE) and prediction of surgical outcomes. A goal of this study is to reduce extraoperative electrocorticography (eECoG) requirement which is the practice of using electrodes placed directly on the exposed surface of the brain. We have shown that such goal is achievable with application of data mining techniques. Furthermore, all TLE surgical operations do not result in complete relief from seizures and it is not always possible for human experts to identify such unsuccessful cases prior to surgery. This study demonstrates the capability of data mining techniques in prediction of undesirable outcome for a portion of such cases. PMID:26609547

  14. Deciding about Decision Making.

    ERIC Educational Resources Information Center

    Hewitson, Mal

    Educational administrators have the power to determine the nature of decision-making structures and processes within their institutions and the extent to which decisions are implemented. This paper reviews assumptions underlying decision-making structures and processes established by school administrators; examines potential individual motives…

  15. Cervical spondylotic myelopathy: a review of surgical indications and decision making.

    PubMed Central

    Law, M. D.; Bernhardt, M.; White, A. A.

    1993-01-01

    Cervical spondylotic myelopathy (CSM) is frequently underdiagnosed and undertreated. The key to the initial diagnosis is a careful neurologic examination. The physical findings may be subtle, thus a high index of suspicion is helpful. Poor prognostic indicators and, therefore, absolute indications for surgery are: 1. Progression of signs and symptoms. 2. Presence of myelopathy for six months or longer. 3. Compression ratio approaching 0.4 or transverse area of the spinal cord of 40 square millimeters or less. Improvement is unusual with nonoperative treatment and almost all patients progressively worsen. Surgical intervention is the most predictable way to prevent neurologic deterioration. The recommended decompression is anterior when there is anterior compression at one or two levels and no significant developmental narrowing of the canal. For compression at more than two levels, developmental narrowing of the canal, posterior compression, and ossification of the posterior longitudinal ligament, we recommend posterior decompression. In order for posterior decompression to be effective there must be lordosis of the cervical spine. If kyphosis is present, anterior decompression is needed. Kyphosis associated with a developmentally narrow canal or posterior compression may require combined anterior and posterior approaches. Fusion is required for instability. Images Figure 1 PMID:8209553

  16. The Relationship between Level of Academic Education and Reversible and Irreversible Processes of Probability Decision-Making.

    ERIC Educational Resources Information Center

    Klein, J.

    1999-01-01

    A study examined the effect of formal academic education on cognitive processes in decision making in 940 undergraduate students, graduate students, and alumni in the social sciences, humanities, and physical and biological sciences. Although academic studies correlate positively with better performance in each of the decision-making stages, they…

  17. Decision making using AHP (Analytic Hierarchy Process) and fuzzy set theory in waste management

    SciTech Connect

    Chung, J.Y.; Lee, K.J.; Kim, C.D.

    1995-12-31

    The major problem is how to consider the differences in opinions, when many experts are involved in decision making process. This paper provides a simple general methodology to treat the differences in various opinions. The authors determined the grade of membership through the process of magnitude estimation derived from pairwise comparisons and AHP developed by Saaty. They used fuzzy set theory to consider the differences in opinions and obtain the priorities for each alternative. An example, which can be applied to radioactive waste management, also was presented. The result shows a good agreement with the results of averaging methods.

  18. An analytical hierarchy process for decision making of high-level-waste management

    SciTech Connect

    Wang, J.H.C.; Jang, W.

    1995-12-01

    To prove the existence value of nuclear technology for the world of post cold war, demonstration of safe rad-waste disposal is essential. High-level-waste (HLW) certainly is the key issue to be resolved. To assist a rational and persuasive process on various disposal options, an Analytical Hierarchy Process (AHP) for the decision making of HLW management is presented. The basic theory and rationale are discussed, and applications are shown to illustrate the usefulness of the AHP. The authors wish that the AHP can provide a better direction for the current doomed situations of Taiwan nuclear industry, and to exchange with other countries for sharing experiences on the HLW management.

  19. Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes

    PubMed Central

    Clarinval, Caroline; Biller-Andorno, Nikola

    2014-01-01

    Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575

  20. Adolescents' risky decision-making activates neural networks related to social cognition and cognitive control processes.

    PubMed

    Rodrigo, María José; Padrón, Iván; de Vega, Manuel; Ferstl, Evelyn C

    2014-01-01

    This study examines by means of functional magnetic resonance imaging the neural mechanisms underlying adolescents' risk decision-making in social contexts. We hypothesize that the social context could engage brain regions associated with social cognition processes and developmental changes are also expected. Sixty participants (adolescents: 17-18, and young adults: 21-22 years old) read narratives describing typical situations of decision-making in the presence of peers. They were asked to make choices in risky situations (e.g., taking or refusing a drug) or ambiguous situations (e.g., eating a hamburger or a hotdog). Risky as compared to ambiguous scenarios activated bilateral temporoparietal junction (TPJ), bilateral middle temporal gyrus (MTG), right medial prefrontal cortex, and the precuneus bilaterally; i.e., brain regions related to social cognition processes, such as self-reflection and theory of mind (ToM). In addition, brain structures related to cognitive control were active [right anterior cingulate cortex (ACC), bilateral dorsolateral prefrontal cortex (DLPFC), bilateral orbitofrontal cortex], whereas no significant clusters were obtained in the reward system (ventral striatum). Choosing the dangerous option involved a further activation of control areas (ACC) and emotional and social cognition areas (temporal pole). Adolescents employed more neural resources than young adults in the right DLPFC and the right TPJ in risk situations. When choosing the dangerous option, young adults showed a further engagement in ToM related regions (bilateral MTG) and in motor control regions related to the planning of actions (pre-supplementary motor area). Finally, the right insula and the right superior temporal gyrus were more activated in women than in men, suggesting more emotional involvement and more intensive modeling of the others' perspective in the risky conditions. These findings call for more comprehensive developmental accounts of decision-making in

  1. Adolescents’ risky decision-making activates neural networks related to social cognition and cognitive control processes

    PubMed Central

    Rodrigo, María José; Padrón, Iván; de Vega, Manuel; Ferstl, Evelyn C.

    2014-01-01

    This study examines by means of functional magnetic resonance imaging the neural mechanisms underlying adolescents’ risk decision-making in social contexts. We hypothesize that the social context could engage brain regions associated with social cognition processes and developmental changes are also expected. Sixty participants (adolescents: 17–18, and young adults: 21–22 years old) read narratives describing typical situations of decision-making in the presence of peers. They were asked to make choices in risky situations (e.g., taking or refusing a drug) or ambiguous situations (e.g., eating a hamburger or a hotdog). Risky as compared to ambiguous scenarios activated bilateral temporoparietal junction (TPJ), bilateral middle temporal gyrus (MTG), right medial prefrontal cortex, and the precuneus bilaterally; i.e., brain regions related to social cognition processes, such as self-reflection and theory of mind (ToM). In addition, brain structures related to cognitive control were active [right anterior cingulate cortex (ACC), bilateral dorsolateral prefrontal cortex (DLPFC), bilateral orbitofrontal cortex], whereas no significant clusters were obtained in the reward system (ventral striatum). Choosing the dangerous option involved a further activation of control areas (ACC) and emotional and social cognition areas (temporal pole). Adolescents employed more neural resources than young adults in the right DLPFC and the right TPJ in risk situations. When choosing the dangerous option, young adults showed a further engagement in ToM related regions (bilateral MTG) and in motor control regions related to the planning of actions (pre-supplementary motor area). Finally, the right insula and the right superior temporal gyrus were more activated in women than in men, suggesting more emotional involvement and more intensive modeling of the others’ perspective in the risky conditions. These findings call for more comprehensive developmental accounts of decision-making

  2. Factors Affecting the Corporate Decision-Making Process of Air Transport Manufacturers

    NASA Technical Reports Server (NTRS)

    Ollila, R. G.; Hill, J. D.; Noton, B. R.; Duffy, M. A.; Epstein, M. M.

    1976-01-01

    Fuel economy is a pivotal question influencing the future sale and utilization of commercial aircraft. The NASA Aircraft Energy Efficiency (ACEE) Program Office has a program intended to accelerate the readiness of advanced technologies for energy efficient aircraft. Because the decision to develop a new airframe or engine is a major financial hazard for manufacturers, it is important to know what factors influence the decision making process. A method is described for identifying and ranking individuals and organizations involved at each stage of commercial air transport development, and the barriers that must be overcome in adopting new technologies.

  3. On Accuracy of Knowledge Acquisition for Decision Making Processes Acquiring Subjective Information on the Internet

    NASA Astrophysics Data System (ADS)

    Fujimoto, Kazunori; Yamamoto, Yutaka

    This paper presents a mathematical model for decision making processes where the knowledge for the decision is constructed automatically from subjective information on the Internet. This mathematical model enables us to know the required degree of accuracy of knowledge acquisition for constructing decision support systems using two technologies: automated knowledge acquisition from information on the Internet and automated reasoning about the acquired knowledge. The model consists of three elements: knowledge source, which is a set of subjective information on the Internet, knowledge acquisition, which acquires knowledge base within a computer from the knowledge source, and decision rule, which chooses a set of alternatives by using the knowledge base. One of the important features of this model is that the model contains not only decision making processes but also knowledge acquisition processes. This feature enables to analyze the decision processes with the sufficiency of knowledge sources and the accuracy of knowledge acquisition methods. Based on the model, decision processes by which the knowledge source and the knowledge base lead to the same choices are given and the required degree of accuracy of knowledge acquisition is quantified as required accuracy value. In order to show the way to utilize the value for designing the decision support systems, the value is calculated by using some examples of knowledge sources and decision rules. This paper also describes the computational complexity of the required accuracy value calculation and shows a computation principle for reducing the complexity to the polynomial order of the size of knowledge sources.

  4. Process of allogeneic hematopoietic cell transplantation decision making for older adults.

    PubMed

    Randall, J; Keven, K; Atli, T; Ustun, C

    2016-05-01

    Allogeneic hematopoietic cell transplantation (alloHCT) may be the only curative option for some older adults with hematologic malignancies, and its associated risks of significant morbidity and mortality warrant a clear, informed decision-making process. As older adults have not been transplanted routinely until recent years, younger people have been the prototypical group around whom the current process has developed. Yet, this process is applied to older adults who have different considerations than younger patients when making their transplant decision. Older adults do not have the open-ended lives of younger patients and are entitled to consider how to spend their remaining time. They also possess maturity and experience, and with proper knowledge, they can make informed choices rather than moving forward in the transplant process unaware. Notably, older patients face similar problems with the informed decision-making process in nephrology. Strategies such as providing education about alloHCT gradually and repeatedly during induction, presenting recent knowledge from the literature in plain language, and utilizing a team approach to patient education may help older adults make the best decision about transplant in light of their situation and values. Understanding when and how older adults decide on alloHCT is an important first step to further exploring this problem. PMID:26457910

  5. The decision making process on new vaccines introduction in South Africa.

    PubMed

    Ngcobo, Ntombenhle Judith; Cameron, Neil A

    2012-09-01

    South Africa has a functional decision making process for the introduction of new vaccines; with an established National Immunisation Technical Advisory Group (NITAG), referred to as National Advisory Group on Immunisation (NAGI). South Africa has played a leadership role in the African continent with introduction of new vaccines, which dates back to 1995 with the introduction of hepatitis B, followed by the Haemophilus influenzae type b in 1999 and recently the national roll out of the pneumococcal conjugate and rotavirus vaccines in 2009. NAGI has the responsibility to deliberate on key policy issues as part of the process for decision making on the introduction of new vaccines. In developing recommendations NAGI considers: disease burden, cost effectiveness, and the impact on the Expanded Programme on Immunisation (EPI). Although guidance and recommendations from WHO are considered, the decision to introduce a new vaccine in South Africa is based on local data. NAGI recommendations are presented to the National Department of Health (NDOH). The NDOH pursues the matter further through the involvement of provinces. When an agreement has been reached to accept the NAGI recommendations, the NDOH seeks funding from the Ministry of Finance (MOF). Once funds are available, the new vaccines are implemented by the immunisation programme. Although there is an established functional system for decision making in South Africa, some areas need to be addressed. A system should be developed to allow the NDOH, NAGI and the MOF to engage in the deliberations on financial and economic impact of new vaccines. It is further recommended that a committee be established that will assess the programmatic issues to weigh the potential benefits of a new vaccine. Furthermore, political commitment should support the immunisation programme and strengthen it so that it can make an impact in the achievement of the Millennium Development Goal no. 4 of reducing child mortality. PMID:22939028

  6. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors

    PubMed Central

    Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

    2015-01-01

    A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions. PMID:26284011

  7. Prenatal genetic testing: an investigation of determining factors affecting the decision-making process.

    PubMed

    Pivetti, Monica; Melotti, Giannino

    2013-02-01

    Despite the increase in popularity of prenatal genetic testing, relatively little is known about the role psychological factors play in the decision-making process. In this analogue study, a sample of Italian female university students was used to investigate determining factors that predict the intention of undergoing prenatal genetic testing. Structural Equation Modelling was used to describe the dynamic interplay between knowledge, beliefs, attitudes and health-related behaviour such as prenatal genetic testing. Following the Theory of Reasoned Action, three dimensions predicted the intention to undergo prenatal genetic testing: the need for more scientific information, a positive attitude towards genetic testing, and the inclination to terminate pregnancy after receiving a positive test result. Results showed that less religious women tended to be more in favour of prenatal tests and in undertaking such tests. This preliminary study provides genetic counsellors and policy makers with a clearer picture of their clients' motives and attitudes behind the decision-making process of prenatal genetic testing, contributing to improving both the communication process between counsellors and their clients and the organization of genetic services. PMID:22477148

  8. Modification of the Decision-Making Capability in the Social Force Model for the Evacuation Process

    NASA Astrophysics Data System (ADS)

    Zainuddin, Zarita; Shuaib, Mohammed

    2010-01-01

    The Social Force Model is one of the most successful microscopic pedestrian models that represent the well-organized phenomena of the pedestrian flow. The model has been modified for evacuation process by incorporating physical forces when contact exists, on one hand, and incorporating factors into the preferred velocity to govern the individual's behavior corresponding to the situation under consideration (normal or evacuation) on the other hand. The latter incorporation has enhanced the ability of the model to represent the decision-making process of pedestrians. However, the variety of pedestrian's abilities to make decisions in emergency situations has not been incorporated properly into the model. In this article we enhance the decision-making capability of the independent pedestrians first by improving the assessment process of selecting an exit from the set of exits available in the physical environment by considering a new factor (crowd at exits); and second, by incorporating following crowds as a new feature for those who are independent. A simulation of an emergency situation inside a room is performed to validate our work.

  9. Understanding and shifting drug-related decisions: Contributions of automatic decision-making processes

    PubMed Central

    Carpenter, Kenneth M.; Bedi, Gillinder; Vadhan, Nehal P.

    2015-01-01

    While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse, and may offer important avenues for developing novel intervention strategies. PMID:26084667

  10. Family therapists' ethical decision-making processes in two duty-to-warn situations.

    PubMed

    Burkemper, Ellen M

    2002-04-01

    This quantitative study investigated the ethical decision-making process of 177 Missouri members of the American Association for Marriage and Family Therapy using two in-session duty-to-warn scenarios of child abuse and HIV transmission. The components of the critical-evaluative level of ethical decision making include the lower-level decision components of personal/therapeutic response, professional ethics, and legal considerations/laws of the State, and the components of the higher-level decision base, the meta-ethical principles, which are nonmaleficence, autonomy, beneficence, fidelity, and justice. Statistical results indicated that in the child abuse scenario, professional ethics and legal considerations/laws of the State were considered most important, whereas in the HIV scenario, professional ethics were the preferred lower-level decision base. Across scenarios, the preferred higher-level decision base was nonmaleficence. There were differences across the child abuse and HIV scenarios in the perceived significance of the remaining lower-level decision base items as well as differences in perceived significance and ordering of the remaining meta-ethical principles. Limitations are discussed. PMID:11977380

  11. Approach of Decision Making Based on the Analytic Hierarchy Process for Urban Landscape Management

    NASA Astrophysics Data System (ADS)

    Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

    2013-03-01

    This paper proposes a two-stage group decision making approach to urban landscape management and planning supported by the analytic hierarchy process. The proposed approach combines an application of the consensus convergence model and the weighted geometric mean method. The application of the proposed approach is shown on a real urban landscape planning problem with a park-forest in Belgrade, Serbia. Decision makers were policy makers, i.e., representatives of several key national and municipal institutions, and experts coming from different scientific fields. As a result, the most suitable management plan from the set of plans is recognized. It includes both native vegetation renewal in degraded areas of park-forest and continued maintenance of its dominant tourism function. Decision makers included in this research consider the approach to be transparent and useful for addressing landscape management tasks. The central idea of this paper can be understood in a broader sense and easily applied to other decision making problems in various scientific fields.

  12. Development of an instrument to understand the child protective services decision-making process, with a focus on placement decisions.

    PubMed

    Dettlaff, Alan J; Christopher Graham, J; Holzman, Jesse; Baumann, Donald J; Fluke, John D

    2015-11-01

    When children come to the attention of the child welfare system, they become involved in a decision-making process in which decisions are made that have a significant effect on their future and well-being. The decision to remove children from their families is particularly complex; yet surprisingly little is understood about this decision-making process. This paper presents the results of a study to develop an instrument to explore, at the caseworker level, the context of the removal decision, with the objective of understanding the influence of the individual and organizational factors on this decision, drawing from the Decision Making Ecology as the underlying rationale for obtaining the measures. The instrument was based on the development of decision-making scales used in prior decision-making studies and administered to child protection caseworkers in several states. Analyses included reliability analyses, principal components analyses, and inter-correlations among the resulting scales. For one scale regarding removal decisions, a principal components analysis resulted in the extraction of two components, jointly identified as caseworkers' decision-making orientation, described as (1) an internal reference to decision-making and (2) an external reference to decision-making. Reliability analyses demonstrated acceptable to high internal consistency for 9 of the 11 scales. Full details of the reliability analyses, principal components analyses, and inter-correlations among the seven scales are discussed, along with implications for practice and the utility of this instrument to support the understanding of decision-making in child welfare. PMID:25913382

  13. Reinventing Decision Making.

    ERIC Educational Resources Information Center

    Klempen, Robert A.

    2003-01-01

    Describes how three Wisconsin school superintendents used the process of situation appraisal and decision analysis to improve their problem-solving and decision-making capabilities and those of their leadership teams. Provides several examples. (PKP)

  14. How Effective Is a Virtual Consultation Process in Facilitating Multidisciplinary Decision-Making for Malignant Epidural Spinal Cord Compression?

    SciTech Connect

    Fitzpatrick, David; Grabarz, Daniel; Wang, Lisa; Bezjak, Andrea; Fehlings, Michael G.; Fosker, Christopher; Rampersaud, Raja; Wong, Rebecca K.S.

    2012-10-01

    Purpose: The purpose of this study was to assess the accuracy of a virtual consultation (VC) process in determining treatment strategy for patients with malignant epidural spinal cord compression (MESCC). Methods and Materials: A prospective clinical database was maintained for patients with MESCC. A virtual consultation process (involving exchange of key predetermined clinical information and diagnostic imaging) facilitated rapid decision-making between oncologists and spinal surgeons. Diagnostic imaging was reviewed retrospectively (by R.R.) for surgical opinions in all patients. The primary outcome was the accuracy of virtual consultation opinion in predicting the final treatment recommendation. Results: After excluding 20 patients who were referred directly to the spinal surgeon, 125 patients were eligible for virtual consultation. Of the 46 patients who had a VC, surgery was recommended in 28 patients and actually given to 23. A retrospective review revealed that 5/79 patients who did not have a VC would have been considered surgical candidates. The overall accuracy of the virtual consultation process was estimated at 92%. Conclusion: The VC process for MESCC patients provides a reliable means of arriving at a multidisciplinary opinion while minimizing patient transfer. This can potentially shorten treatment decision time and enhance clinical outcomes.

  15. Decision Making and Cancer

    PubMed Central

    Reyna, Valerie F.; Nelson, Wendy L.; Han, Paul K.; Pignone, Michael P.

    2014-01-01

    We review decision-making along the cancer continuum in the contemporary context of informed and shared decision making, in which patients are encouraged to take a more active role in their health care. We discuss challenges to achieving informed and shared decision making, including cognitive limitations and emotional factors, but argue that understanding the mechanisms of decision making offers hope for improving decision support. Theoretical approaches to decision making that explain cognition, emotion, and their interaction are described, including classical psychophysical approaches, dual-process approaches that focus on conflicts between emotion versus cognition (or reason), and modern integrative approaches such as fuzzy-trace theory. In contrast to the earlier emphasis on rote use of numerical detail, modern approaches emphasize understanding the bottom-line gist of options (which encompasses emotion and other influences on meaning) and retrieving relevant social and moral values to apply to those gist representations. Finally, research on interventions to support better decision making in clinical settings is reviewed, drawing out implications for future research on decision making and cancer. PMID:25730718

  16. Visual anticipation biases conscious decision making but not bottom-up visual processing

    PubMed Central

    Mathews, Zenon; Cetnarski, Ryszard; Verschure, Paul F. M. J.

    2015-01-01

    Prediction plays a key role in control of attention but it is not clear which aspects of prediction are most prominent in conscious experience. An evolving view on the brain is that it can be seen as a prediction machine that optimizes its ability to predict states of the world and the self through the top-down propagation of predictions and the bottom-up presentation of prediction errors. There are competing views though on whether prediction or prediction errors dominate the formation of conscious experience. Yet, the dynamic effects of prediction on perception, decision making and consciousness have been difficult to assess and to model. We propose a novel mathematical framework and a psychophysical paradigm that allows us to assess both the hierarchical structuring of perceptual consciousness, its content and the impact of predictions and/or errors on conscious experience, attention and decision-making. Using a displacement detection task combined with reverse correlation, we reveal signatures of the usage of prediction at three different levels of perceptual processing: bottom-up fast saccades, top-down driven slow saccades and consciousnes decisions. Our results suggest that the brain employs multiple parallel mechanism at different levels of perceptual processing in order to shape effective sensory consciousness within a predicted perceptual scene. We further observe that bottom-up sensory and top-down predictive processes can be dissociated through cognitive load. We propose a probabilistic data association model from dynamical systems theory to model the predictive multi-scale bias in perceptual processing that we observe and its role in the formation of conscious experience. We propose that these results support the hypothesis that consciousness provides a time-delayed description of a task that is used to prospectively optimize real time control structures, rather than being engaged in the real-time control of behavior itself. PMID:25741290

  17. Teacher Participation in the Decision-Making Process: Reality and Repercussions in Indian Higher Education

    ERIC Educational Resources Information Center

    Mehta, Deepa; Gardia, Alok; Rathore, H. C. S.

    2010-01-01

    The study reported here focused on comparing teachers' actual and desired participation in different decision-making situations and examined how participation in decision making differs in Indian higher educational institutions. The paper provides a comparison of findings with similar studies conducted in Western settings regarding the…

  18. Analytic hierarchy process as module for productivity evaluation and decision-making of the operation theater

    PubMed Central

    Ezzat, Abdelrahman E. M.; Hamoud, Hesham S.

    2016-01-01

    The analytic hierarchy process (AHP) is a theory of measurement through pairwise comparisons and relies on the judgments of experts to derive priority scales, these scales that measure intangibles in relative terms. The aim of the article was to develop a model for productivity measurement of the operation theater (OT), which could be applied as a model for quality improvement and decision-making. AHP is used in this article to evolve such a model. The steps consist of identifying the critical success factors for measuring the productivity of OT, identifying subfactors that inflauence the critical factors, comparing the pairwise, deriving their relative importance and ratings, and calculating the cumulative effect according to the attributes in OT. The cumulative productivitycan be calculated by the end and can be compared Ideal productivity to measure the productive of OT in percentage fraction. Hence, the productivity could be calculated. Hence, AHP is a very useful model to measure the productivity in OT. PMID:26955599

  19. Analytic hierarchy process as module for productivity evaluation and decision-making of the operation theater.

    PubMed

    Ezzat, Abdelrahman E M; Hamoud, Hesham S

    2016-01-01

    The analytic hierarchy process (AHP) is a theory of measurement through pairwise comparisons and relies on the judgments of experts to derive priority scales, these scales that measure intangibles in relative terms. The aim of the article was to develop a model for productivity measurement of the operation theater (OT), which could be applied as a model for quality improvement and decision-making. AHP is used in this article to evolve such a model. The steps consist of identifying the critical success factors for measuring the productivity of OT, identifying subfactors that inflauence the critical factors, comparing the pairwise, deriving their relative importance and ratings, and calculating the cumulative effect according to the attributes in OT. The cumulative productivitycan be calculated by the end and can be compared Ideal productivity to measure the productive of OT in percentage fraction. Hence, the productivity could be calculated. Hence, AHP is a very useful model to measure the productivity in OT. PMID:26955599

  20. Workshop on using natural language processing applications for enhancing clinical decision making: an executive summary

    PubMed Central

    Pai, Vinay M; Rodgers, Mary; Conroy, Richard; Luo, James; Zhou, Ruixia; Seto, Belinda

    2014-01-01

    In April 2012, the National Institutes of Health organized a two-day workshop entitled ‘Natural Language Processing: State of the Art, Future Directions and Applications for Enhancing Clinical Decision-Making’ (NLP-CDS). This report is a summary of the discussions during the second day of the workshop. Collectively, the workshop presenters and participants emphasized the need for unstructured clinical notes to be included in the decision making workflow and the need for individualized longitudinal data tracking. The workshop also discussed the need to: (1) combine evidence-based literature and patient records with machine-learning and prediction models; (2) provide trusted and reproducible clinical advice; (3) prioritize evidence and test results; and (4) engage healthcare professionals, caregivers, and patients. The overall consensus of the NLP-CDS workshop was that there are promising opportunities for NLP and CDS to deliver cognitive support for healthcare professionals, caregivers, and patients. PMID:23921193

  1. Cancer treatment decision-making processes for older patients with complex needs: a qualitative study

    PubMed Central

    Hughes, Jane; Farrington, Naomi; Richardson, Alison

    2015-01-01

    Objectives Although older people can experience complex health and social care needs alongside a primary cancer diagnosis, little is understood about how cancer treatment decisions are made for this population. This study aimed to investigate how cancer treatment decisions are formulated for older people with complex health and social care needs and the factors that shape these processes. Design Qualitative study involving semistructured interviews and non-participant observations. Framework approach used for data analysis. Setting Breast and colorectal cancer services in five English NHS hospital trusts. Participants Interviews: purposive sample of 22 clinicians directly involved in a face-to-face clinical role with patients regarding cancer treatment and care, maximising variation across clinical roles, tumour types and trusts. Observations: purposive sample of five cancer multidisciplinary meetings, maximising variation across location, team size and tumour type. Results The initial stages of cancer treatment decision-making are team-based, medically dominated and focused on the cancer. For patients with complex health and social care needs that extend beyond cancer pathology, later and less visible stages in the decision-making process are more haphazard and may result in less effective and workable treatment plans, as individual clinicians struggle to devise and deliver these plans without breaching time-based targets. Conclusions Service targets that focus resources solely on the presenting disease can disadvantage older patients with complex health and social care needs that extend beyond this primary diagnosis. Care should be taken to ensure time-based targets do not disincentivise thorough and timely assessment that can lead to the formulation of treatment plans tailored to individual needs and circumstances. PMID:26667015

  2. Dual Processes in Decision Making and Developmental Neuroscience: A Fuzzy-Trace Model

    PubMed Central

    Reyna, Valerie F.; Brainerd, Charles J.

    2011-01-01

    From Piaget to the present, traditional and dual-process theories have predicted improvement in reasoning from childhood to adulthood, and improvement has been observed. However, developmental reversals—that reasoning biases emerge with development —have also been observed in a growing list of paradigms. We explain how fuzzy-trace theory predicts both improvement and developmental reversals in reasoning and decision making. Drawing on research on logical and quantitative reasoning, as well as on risky decision making in the laboratory and in life, we illustrate how the same small set of theoretical principles apply to typical neurodevelopment, encompassing childhood, adolescence, and adulthood, and to neurological conditions such as autism and Alzheimer's disease. For example, framing effects—that risk preferences shift when the same decisions are phrases in terms of gains versus losses—emerge in early adolescence as gist-based intuition develops. In autistic individuals, who rely less on gist-based intuition and more on verbatim-based analysis, framing biases are attenuated (i.e., they outperform typically developing control subjects). In adults, simple manipulations based on fuzzy-trace theory can make framing effects appear and disappear depending on whether gist-based intuition or verbatim-based analysis is induced. These theoretical principles are summarized and integrated in a new mathematical model that specifies how dual modes of reasoning combine to produce predictable variability in performance. In particular, we show how the most popular and extensively studied model of decision making—prospect theory—can be derived from fuzzy-trace theory by combining analytical (verbatim-based) and intuitive (gist-based) processes. PMID:22096268

  3. Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC)

    PubMed Central

    2013-01-01

    Background Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals’ perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. Methods The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign (‘Ask 3 Questions’); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. Results A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: ‘coherence,’ ‘cognitive participation,’ ‘collective action,’ and ‘reflexive monitoring.’ Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose (‘coherence’). Shared

  4. Fellowship and Practice Composition Affect Surgical Decision Making in Patients with Adult Degenerative Scoliosis: Spinal Deformity versus Degenerative Spinal Surgeons

    PubMed Central

    Protopsaltis, Themistocles; Patel, Ashish; Yoo, Andrew; Lonner, Baron

    2015-01-01

    Background For the Adult Degenerative Scoliosis (ADS) patient with radiculopathy, there is no clear data in the literature to guide the spine surgeon's decision making in choosing between limited decompression alone, short segment fusion, or longer arthrodesis of the deformity. This study investigates the differences in operative planning, for patients with ADS and radiculopathy, between two groups of spine surgeons based on fellowship experience and practice composition. Methods Six Degenerative Spine surgeons (Group 1) and 6 Spinal Deformity surgeons (Group 2) were shown 7 cases of patients with ADS and radiculopathy. Surgeons completed a questionnaire detailing their planned operative intervention including the number of fusion levels, if any, approach, choice of bone graft, and interbody device. Pearson Correlation was used to investigate the association between fellowship training, practice composition, number of levels fused, and other variables. Intraclass correlation (ICC) analysis was used to investigate the internal consistency among the groups. Results There was a direct correlation between fellowship deformity experience and practice composition (r=0.75, p<0.01), and between deformity practice composition and the number of planned fusion levels (r=0.90, p<0.001). Group 1 surgeons fused a mean 3.7 vertebral levels (range 0-6.7), while Group 2 surgeons fused a mean 10.8 levels (range 4-16.5). Group 2 surgeons fused a significantly greater number of levels for each case than degenerative surgeons on paired student t-test (p=0.002). Group 1 surgeons chose decompression alone more commonly than deformity surgeons (p<0.05). Group 2 surgeons had significantly higher group consistency by ICC analysis (p=0.004). Conclusions Fellowship and practice composition influence the physician's surgical planning in ADS. There is a lack of standardized treatment paradigms for the management of radiculopathy in patients with ADS. PMID:26114090

  5. A Qualitative Analysis of the Decision-Making Process for Patients with Severe Lower Leg Trauma

    PubMed Central

    Aravind, Maya; Shauver, Melissa J.; Chung, Kevin C.

    2010-01-01

    Background Choosing the appropriate treatment for grade IIIB and IIIC open tibial fractures is a difficult decision for both the patient and the physician. Current research shows that the functional outcomes for reconstruction are similar to those for below-knee amputation, but little investigation of the qualitative outcomes of either treatment option has been done from the patient perspective. This study was designed to perform a qualitative analysis of patient preferences for amputation or reconstruction. Methods 20 patients with type IIIB or IIIC open tibial fractures participated in the study. These patients had undergone either amputation or reconstruction between 1997 and 2007. Semi-structured interviews were conducted and qualitative outcomes were assessed. Results Interviews highlighted several issues involved with medical decision-making. Participants described not having a role in deciding which medical treatment to choose. Family and spouses played a greater role, often due to patients’ being medicated when needing to make a treatment choice. Both amputation and reconstruction patients described being satisfied with the outcomes of their surgical treatments, but also expressed second thoughts about their treatment choices. Conclusions The findings of this study emphasize how difficult it is to assign preference to one medical treatment over another. The study reveals how the role of the patient is limited in making a decision about pursuing amputation or reconstruction. Instead there is a continued need for physicians to discuss treatment options and risks with family members who act on the patient’s behalf, as well as incorporating the patient’s preference in this complex decision. PMID:20697318

  6. Graphics Processing Unit-Based Bioheat Simulation to Facilitate Rapid Decision Making Associated with Cryosurgery Training.

    PubMed

    Keelan, Robert; Zhang, Hong; Shimada, Kenji; Rabin, Yoed

    2016-04-01

    This study focuses on the implementation of an efficient numerical technique for cryosurgery simulations on a graphics processing unit as an alternative means to accelerate runtime. This study is part of an ongoing effort to develop computerized training tools for cryosurgery, with prostate cryosurgery as a developmental model. The ability to perform rapid simulations of various test cases is critical to facilitate sound decision making associated with medical training. Consistent with clinical practice, the training tool aims at correlating the frozen region contour and the corresponding temperature field with the target region shape. The current study focuses on the feasibility of graphics processing unit-based computation using C++ accelerated massive parallelism, as one possible implementation. Benchmark results on a variety of computation platforms display between 3-fold acceleration (laptop) and 13-fold acceleration (gaming computer) of cryosurgery simulation, in comparison with the more common implementation on a multicore central processing unit. While the general concept of graphics processing unit-based simulations is not new, its application to phase-change problems, combined with the unique requirements for cryosurgery optimization, represents the core contribution of the current study. PMID:25941162

  7. The cognitive processes underlying affective decision-making predicting adolescent smoking behaviors in a longitudinal study

    PubMed Central

    Xiao, Lin; Koritzky, Gilly; Johnson, C. Anderson; Bechara, Antoine

    2013-01-01

    This study investigates the relationship between three different cognitive processes underlying the Iowa Gambling Task (IGT) and adolescent smoking behaviors in a longitudinal study. We conducted a longitudinal study of 181 Chinese adolescents in Chengdu City, China. The participants were followed from 10th to 11th grade. When they were in the 10th grade (Time 1), we tested these adolescents' decision-making using the IGT and working memory capacity using the Self-ordered Pointing Test (SOPT). Self-report questionnaires were used to assess school academic performance and smoking behaviors. The same questionnaires were completed again at the 1-year follow-up (Time 2). The Expectancy-Valence (EV) Model was applied to distill the IGT performance into three different underlying psychological components: (i) a motivational component which indicates the subjective weight the adolescents assign to gains vs. losses; (ii) a learning-rate component which indicates the sensitivity to recent outcomes vs. past experiences; and (iii) a response component which indicates how consistent the adolescents are between learning and responding. The subjective weight to gains vs. losses at Time 1 significantly predicted current smokers and current smoking levels at Time 2, controlling for demographic variables and baseline smoking behaviors. Therefore, by decomposing the IGT into three different psychological components, we found that the motivational process of weight gain vs. losses may serve as a neuropsychological marker to predict adolescent smoking behaviors in a general youth population. PMID:24101911

  8. Physics of the Mind:. Opinion Dynamics and Decision Making Processes Based on a Binary Network Model

    NASA Astrophysics Data System (ADS)

    Kusmartsev, F. V.; Kürten, Karl E.

    2009-12-01

    We propose a new theory of the human mind. The formation of human mind is considered as a collective process of the mutual interaction of people via exchange of opinions and formation of collective decisions. We investigate the associated dynamical processes of the decision making when people are put in different conditions including risk situations in natural catastrophes when the decision must be made very fast or at national elections. We also investigate conditions at which the fast formation of opinion is arising as a result of open discussions or public vote. Under a risk condition the system is very close to chaos and therefore the opinion formation is related to the order disorder transition. We study dramatic changes which may happen with societies which in physical terms may be considered as phase transitions from ordered to chaotic behavior. Our results are applicable to changes which are arising in various social networks as well as in opinion formation arising as a result of open discussions. One focus of this study is the determination of critical parameters, which influence a formation of stable mind, public opinion and where the society is placed "at the edge of chaos". We show that social networks have both, the necessary stability and the potential for evolutionary improvements or self-destruction. We also show that the time needed for a discussion to take a proper decision depends crucially on the nature of the interactions between the entities as well as on the topology of the social networks.

  9. Physics of the Mind:. Opinion Dynamics and Decision Making Processes Based on a Binary Network Model

    NASA Astrophysics Data System (ADS)

    Kusmartsev, F. V.; Kürten, Karl E.

    We propose a new theory of the human mind. The formation of human mind is considered as a collective process of the mutual interaction of people via exchange of opinions and formation of collective decisions. We investigate the associated dynamical processes of the decision making when people are put in different conditions including risk situations in natural catastrophes when the decision must be made very fast or at national elections. We also investigate conditions at which the fast formation of opinion is arising as a result of open discussions or public vote. Under a risk condition the system is very close to chaos and therefore the opinion formation is related to the order disorder transition. We study dramatic changes which may happen with societies which in physical terms may be considered as phase transitions from ordered to chaotic behavior. Our results are applicable to changes which are arising in various social networks as well as in opinion formation arising as a result of open discussions. One focus of this study is the determination of critical parameters, which influence a formation of stable mind, public opinion and where the society is placed “at the edge of chaos”. We show that social networks have both, the necessary stability and the potential for evolutionary improvements or self-destruction. We also show that the time needed for a discussion to take a proper decision depends crucially on the nature of the interactions between the entities as well as on the topology of the social networks.

  10. Protocol for a pre-implementation and post-implementation study on shared decision-making in the surgical treatment of women with early-stage breast cancer

    PubMed Central

    Savelberg, Wilma; Moser, Albine; Smidt, Marjolein; Boersma, Liesbeth; Haekens, Christel; van der Weijden, Trudy

    2015-01-01

    Background The majority of patients diagnosed with early-stage breast cancer are in a position to choose between having a mastectomy or lumpectomy with radiation therapy (breast-conserving therapy). Since the long-term survival rates for mastectomy and for lumpectomy with radiation therapy are comparable, patients’ informed preferences are important for decision-making. Although most clinicians believe that they do include patients in the decision-making process, the information that women with breast cancer receive regarding the surgical options is often rather subjective, and does not invite patients to express their preferences. Shared decision-making (SDM) is meant to help patients clarify their preferences, resulting in greater satisfaction with their final choice. Patient decision aids can be very supportive in SDM. We present the protocol of a study to β test a patient decision aid and optimise strategies for the implementation of SDM regarding the treatment of early-stage breast cancer in the actual clinical setting. Methods/design This paper concerns a pre-implementation and post-implementation study, lasting from October 2014 to June 2015. The intervention consists of implementing SDM using a patient decision aid. The intervention will be evaluated using qualitative and quantitative measures, acquired prior to, during and after the implementation of SDM. Outcome measures are knowledge about treatment, perceived SDM and decisional conflict. We will also conduct face-to-face interviews with a sample of these patients and their care providers, to assess their experiences with the implementation of SDM and the patient decision aid. Ethics and dissemination This protocol was approved by the Maastricht University Medical Centre (MUMC) ethics committee. The findings will be disseminated through peer-reviewed journal articles and presentations at national conferences. Findings will be used to finalise a multi-faceted implementation strategy to test the

  11. Impairments in an early stage of the decision-making process in patients with ventromedial prefrontal damage: preliminary results.

    PubMed

    Eggen, Céline; Huber, Oswald; Bär, Arlette; Huber, Odilo W; Perrig, Walter J; Müri, René; Gutbrod, Klemens

    2015-01-01

    Lesions of the ventromedial prefrontal cortex can result in a deficient decision-making behavior. So far, most experimental results in the neuropsychological decision-making research have been obtained with gambling tasks. Due to their high complexity, it is difficult to evaluate the underlying processes of the decision-making deficits. The aim of this study was to assess if patients with ventromedial prefrontal damage compared to patients with dorsolateral prefrontal damage and controls show a deficit in an early stage of the decision-making process. Nine patients with ventromedial prefrontal damage, three with dorsolateral prefrontal damage, and eleven healthy controls were tested with a newly developed decision task in which they had to search actively for the information they needed for their decisions. Our results show that patients with ventromedial prefrontal damage compared to the brain-lesioned dorsolateral prefrontal control group and healthy controls searched less for information with regard to risk defusing operators or consequences of their decisions indicating impairment already in the early stage of the decision-making process. PMID:25080839

  12. Combined Economic and Hydrologic Modeling to Support Collaborative Decision Making Processes

    NASA Astrophysics Data System (ADS)

    Sheer, D. P.

    2008-12-01

    For more than a decade, the core concept of the author's efforts in support of collaborative decision making has been a combination of hydrologic simulation and multi-objective optimization. The modeling has generally been used to support collaborative decision making processes. The OASIS model developed by HydroLogics Inc. solves a multi-objective optimization at each time step using a mixed integer linear program (MILP). The MILP can be configured to include any user defined objective, including but not limited too economic objectives. For example, an estimated marginal value for water for crops and M&I use were included in the objective function to drive trades in a model of the lower Rio Grande. The formulation of the MILP, constraints and objectives, in any time step is conditional: it changes based on the value of state variables and dynamic external forcing functions, such as rainfall, hydrology, market prices, arrival of migratory fish, water temperature, etc. It therefore acts as a dynamic short term multi-objective economic optimization for each time step. MILP is capable of solving a general problem that includes a very realistic representation of the physical system characteristics in addition to the normal multi-objective optimization objectives and constraints included in economic models. In all of these models, the short term objective function is a surrogate for achieving long term multi-objective results. The long term performance for any alternative (especially including operating strategies) is evaluated by simulation. An operating rule is the combination of conditions, parameters, constraints and objectives used to determine the formulation of the short term optimization in each time step. Heuristic wrappers for the simulation program have been developed improve the parameters of an operating rule, and are initiating research on a wrapper that will allow us to employ a genetic algorithm to improve the form of the rule (conditions, constraints

  13. Group Dynamics: Toward a Study of the Administrative/Supervisory Leadership Role Within Group Decision-Making Processes.

    ERIC Educational Resources Information Center

    McGowan, Francis, II

    Group processes are an integral part of the educational enterprise, but "effectiveness of group processes" does not necessarily follow from the simple act of group formation. The administrator has the responsibility of exercising effective group leadership. Group formation, group task functions or assignments, and decision-making processes are…

  14. Searching Choices: Quantifying Decision-Making Processes Using Search Engine Data.

    PubMed

    Moat, Helen Susannah; Olivola, Christopher Y; Chater, Nick; Preis, Tobias

    2016-07-01

    When making a decision, humans consider two types of information: information they have acquired through their prior experience of the world, and further information they gather to support the decision in question. Here, we present evidence that data from search engines such as Google can help us model both sources of information. We show that statistics from search engines on the frequency of content on the Internet can help us estimate the statistical structure of prior experience; and, specifically, we outline how such statistics can inform psychological theories concerning the valuation of human lives, or choices involving delayed outcomes. Turning to information gathering, we show that search query data might help measure human information gathering, and it may predict subsequent decisions. Such data enable us to compare information gathered across nations, where analyses suggest, for example, a greater focus on the future in countries with a higher per capita GDP. We conclude that search engine data constitute a valuable new resource for cognitive scientists, offering a fascinating new tool for understanding the human decision-making process. PMID:27245264

  15. Power to Punish Norm Violations Affects the Neural Processes of Fairness-Related Decision Making.

    PubMed

    Cheng, Xuemei; Zheng, Li; Li, Lin; Guo, Xiuyan; Wang, Qianfeng; Lord, Anton; Hu, Zengxi; Yang, Guang

    2015-01-01

    Punishing norm violations is considered an important motive during rejection of unfair offers in the ultimatum game (UG). The present study investigates the impact of the power to punish norm violations on people's responses to unfairness and associated neural correlates. In the UG condition participants had the power to punish norm violations, while an alternate condition, the impunity game (IG), was presented where participants had no power to punish norm violations since rejection only reduced the responder's income to zero. Results showed that unfair offers were rejected more often in UG compared to IG. At the neural level, anterior insula and dorsal anterior cingulate cortex were more active when participants received and rejected unfair offers in both UG and IG. Moreover, greater dorsolateral prefrontal cortex activity was observed when participants rejected than accepted unfair offers in UG but not in IG. Ventromedial prefrontal cortex activation was higher in UG than IG when unfair offers were accepted as well as when rejecting unfair offers in IG as opposed to UG. Taken together, our results demonstrate that the power to punish norm violations affects not only people's behavioral responses to unfairness but also the neural correlates of the fairness-related social decision-making process. PMID:26696858

  16. Power to Punish Norm Violations Affects the Neural Processes of Fairness-Related Decision Making

    PubMed Central

    Cheng, Xuemei; Zheng, Li; Li, Lin; Guo, Xiuyan; Wang, Qianfeng; Lord, Anton; Hu, Zengxi; Yang, Guang

    2015-01-01

    Punishing norm violations is considered an important motive during rejection of unfair offers in the ultimatum game (UG). The present study investigates the impact of the power to punish norm violations on people’s responses to unfairness and associated neural correlates. In the UG condition participants had the power to punish norm violations, while an alternate condition, the impunity game (IG), was presented where participants had no power to punish norm violations since rejection only reduced the responder’s income to zero. Results showed that unfair offers were rejected more often in UG compared to IG. At the neural level, anterior insula and dorsal anterior cingulate cortex were more active when participants received and rejected unfair offers in both UG and IG. Moreover, greater dorsolateral prefrontal cortex activity was observed when participants rejected than accepted unfair offers in UG but not in IG. Ventromedial prefrontal cortex activation was higher in UG than IG when unfair offers were accepted as well as when rejecting unfair offers in IG as opposed to UG. Taken together, our results demonstrate that the power to punish norm violations affects not only people’s behavioral responses to unfairness but also the neural correlates of the fairness-related social decision-making process. PMID:26696858

  17. Recruit, screen, and hire: staff selection and the decision-making process.

    PubMed

    Melville, S D

    1977-01-01

    This article focuses on the role of the clinician-manager in staff selection. The duties of the clinician-manager in a mental health center include those tasks described as "recruit, screen, and hire" but little or no guidance on the steps involved in this sequence of events is available. The "how" of hiring is transmitted by word of mouth, by following another's example, or by trial and error. This article examines the component parts of staff selection from the assimilation of procedures, rules, and regulation of the public authority under which a particular mental health center operates, to the compilation of a "short list" of those to be screened and finally the risk taking and decision-making process by the clinician-manager who makes the choice. Some speculation on the emotional impact it has on the clinician-manager is examined. The impact of personal value judgments of the selector are considered. Recommendations are made for the inclusion of training in staff selection by academic programs for mental health administrators. PMID:614780

  18. Cognitive processes underlying impaired decision-making under uncertainty in gambling disorder

    PubMed Central

    Brevers, Damien; Koritzky, Gilly; Bechara, Antoine; Noël, Xavier

    2014-01-01

    Objective Pathological gamblers display at the Iowa Gambling Task (IGT) a strong preference for choices featuring high immediate rewards, but higher unpredictable and more delayed losses. The present study aimed, by applying the Expectancy-Valence (EV) model to the IGT, at identifying impaired components of decision-making under uncertainty in pathological gamblers. Methods Twenty pathological gamblers and 20 non-gamblers performed the IGT. The EV model breaks down IGT performance into three cognitive processes: (i) the subjective weight that the individual assigns to gains versus losses (gain/loss parameter), (ii) the degree of prominence given to recently-obtained information, compared to past experience (recency parameter), and (iii) the consistency between learning and responding (consistency parameter). Results Pathological gamblers obtained higher scores on the gain/loss parameter as compared to controls, indicating higher sensitivity to monetary gains. This measure was also correlated with the degree of gambling dependence severity. No between-group difference was observed in the recency and the consistency parameters. Conclusion These findings suggest that pathological gamblers’ strong preference for choices featuring high rewards but higher losses during the IGT is due to a hypersensitivity for large monetary gains, which might reflect a hypersensitivity in their reward systems. In contrast, we found in pathological gamblers no evidence of inability to integrate information across time, a function that has been shown previously to be linked to damage in the prefrontal cortex. PMID:24980287

  19. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    PubMed

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice. PMID:26244571

  20. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing

    PubMed Central

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called “threshold probability” at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today’s clinical practice. PMID:26244571

  1. Roles of the Different Sub-Regions of the Insular Cortex in Various Phases of the Decision-Making Process

    PubMed Central

    Droutman, Vita; Bechara, Antoine; Read, Stephen J.

    2015-01-01

    This paper presents a coherent account of the role of the insular cortex (IC) in decision-making. We follow a conceptualization of decision-making that is very close to one previously proposed by Ernst and Paulus (2005): that the decision process is a progression of four phases: (1) re-focusing attention; (2) evaluation; (3) action; and (4) outcome processing, and we present evidence for the insula’s role in all these phases. We review the existing work on insula’s functional anatomy that subdivides the IC into posterior, dorsal anterior and ventral anterior regions. We re-map the results provided by the existing literature into these subdivisions wherever possible, to identify the components’ role in each decision making phase. In addition, we identify a self-regulating quality of the IC focused on harm avoidance. PMID:26635559

  2. Roles of the Different Sub-Regions of the Insular Cortex in Various Phases of the Decision-Making Process.

    PubMed

    Droutman, Vita; Bechara, Antoine; Read, Stephen J

    2015-01-01

    This paper presents a coherent account of the role of the insular cortex (IC) in decision-making. We follow a conceptualization of decision-making that is very close to one previously proposed by Ernst and Paulus (2005): that the decision process is a progression of four phases: (1) re-focusing attention; (2) evaluation; (3) action; and (4) outcome processing, and we present evidence for the insula's role in all these phases. We review the existing work on insula's functional anatomy that subdivides the IC into posterior, dorsal anterior and ventral anterior regions. We re-map the results provided by the existing literature into these subdivisions wherever possible, to identify the components' role in each decision making phase. In addition, we identify a self-regulating quality of the IC focused on harm avoidance. PMID:26635559

  3. Thermodynamic view on decision-making process: emotions as a potential power vector of realization of the choice.

    PubMed

    Pakhomov, Anton; Sudin, Natalya

    2013-12-01

    This research is devoted to possible mechanisms of decision-making in frames of thermodynamic principles. It is also shown that the decision-making system in reply to emotion includes vector component which seems to be often a necessary condition to transfer system from one state to another. The phases of decision-making system can be described as supposed to be nonequilibrium and irreversible to which thermodynamics laws are applied. The mathematical model of a decision choice, proceeding from principles of the nonlinear dynamics considering instability of movement and bifurcation is offered. The thermodynamic component of decision-making process on the basis of vector transfer of energy induced by emotion at the given time is surveyed. It is proposed a three-modular model of decision making based on principles of thermodynamics. Here it is suggested that at entropy impact due to effect of emotion, on the closed system-the human brain,-initially arises chaos, then after fluctuations of possible alternatives which were going on-reactions of brain zones in reply to external influence, an order is forming and there is choice of alternatives, according to primary entrance conditions and a state of the closed system. Entropy calculation of a choice expectation of negative and positive emotion shows judgment possibility of existence of "the law of emotion conservation" in accordance with several experimental data. PMID:24427219

  4. Beyond Self-Report: Emerging Methods for Capturing Individual Differences in Decision-Making Process

    PubMed Central

    Connors, Brenda L.; Rende, Richard; Colton, Timothy J.

    2016-01-01

    People vary in the way in which they approach decision-making, which impacts real-world behavior. There has been a surge of interest in moving beyond reliance on self-report measures to capture such individual differences. Particular emphasis has been placed on devising and applying a range of methodologies that include experimental, neuroscience, and observational paradigms. This paper provides a selective review of recent studies that illustrate the methods and yield of these approaches in terms of generating a deeper understanding of decision-making style and the notable differences that can be found across individuals. PMID:26973589

  5. Retrospective study of emerging themes in the decision-making process of patients considering amputation.

    PubMed

    Rassin, Michal; Tzevlin, Valeria; Malul, Einat; Harel, Shimrit; Shakhar, Hadar

    2012-06-01

    How patients make decisions about their future treatment has been sparsely study and with respect to limb amputation, a particularly difficult decision, not at all. An examination of this should furnish nurses vital knowledge about how patients come to the decision to give or refuse this consent. To reach as deep understanding as possible of how from the patients' point of view they reach the decision to consent to the amputation of a lower limb. The research was conducted in the qualitative method. Thirty lower-limb amputees (aged 32-88) took part in the study. In-depth interviews were held with the participants. The data were processed by means of content analysis. The main thematic categories identified were, in the chronological order of their appearance: 'The trail of torment leading to the decision to amputate', 'The turning point--taking the decision' "I just couldn't take any more pain" "We opt for life, we don't want to die". The more protracted and pain-filled the 'the trail of torment' the more mentally prepared patients were to give consent to amputation. Asked to look back on their choice, almost all interviewees had no regrets and even found virtues in it. The patients' decisions represented a mix of their grasp of the medical information supplied them by their doctors, their own personal values--opting for life prevailing over the desire for a whole body, and consideration for their family. The patients saw the decision-making process about amputation as a process of achieving consensus between themselves, their doctors and their family. PMID:22608176

  6. Personal decision-making processes for living related liver transplantation in children.

    PubMed

    Goldschmidt, Imeke; Migal, Katarina; Rückert, Norbert; van Dick, Rolf; Pfister, Eva Doreen; Becker, Thomas; Richter, Nicolas; Lehner, Frank; Baumann, Ulrich

    2015-02-01

    Living related liver transplantation (LRLT) is a valuable transplant option for children with end-stage liver disease who face long waiting times on regular waiting lists. The subjection of a healthy adult to a potentially life-threatening operation can raise issues of freedom of choice, fear, and family conflict for the potential donors. We examined attitudes, fears, and influencing factors in the decision-making process for living liver donation for children in order to identify factors to improve support for living liver donors in the future. In a retrospective, questionnaire-based survey of 93 adults evaluated for living liver donation between 1997 and 2010, 47 of whom actually proceeded to donation, we asked about attitudes, motivation, fears, influencing factors, and well-being during the LRLT evaluation process and during the donation period. Answers were recorded on Likert scales and compared with Pearson's rho correlation and the Mann-Whitney U test as appropriate. Although there was a strong sense of a lack of alternatives among the donors, the majority of the donors felt free in their decision to donate. Donors who were asked to donate for a relative who was not their own child appeared at higher risk of lacking support and of feeling coerced. Family and social support and good and empathic information about the donation process were identified as key factors for donor well-being. In conclusion, potential living liver donors need to have adequate, sufficient, and empathic information, and they need to be provided a supportive framework, including family support, in order to promote their well-being. Care needs to be taken in identifying and counseling potential donors at risk of feeling coerced into donation. PMID:25504770

  7. Flaws in the Decision-Making Process: Assessment and Acceptance in the Decision to Launch Flight 51-L.

    ERIC Educational Resources Information Center

    Renz, Mary Ann; Greg, John

    1988-01-01

    Argues that it was the failure of the decision-making process, rather than the mode of risk assessment, which led to the decision to launch the Space Shuttle Challenger. Identifies the phrasing of the decision question and a shift in the burden of proof as specific problems of the process. (MS)

  8. Distributed multisensor processing, decision making, and control under constrained resources for remote health and environmental monitoring

    NASA Astrophysics Data System (ADS)

    Talukder, Ashit; Sheikh, Tanwir; Chandramouli, Lavanya

    2004-04-01

    Previous field-deployable distributed sensing systems for health/biomedical applications and environmental sensing have been designed for data collection and data transmission at pre-set intervals, rather than for on-board processing These previous sensing systems lack autonomous capabilities, and have limited lifespans. We propose the use of an integrated machine learning architecture, with automated planning-scheduling and resource management capabilities that can be used for a variety of autonomous sensing applications with very limited computing, power, and bandwidth resources. We lay out general solutions for efficient processing in a multi-tiered (three-tier) machine learning framework that is suited for remote, mobile sensing systems. Novel dimensionality reduction techniques that are designed for classification are used to compress each individual sensor data and pass only relevant information to the mobile multisensor fusion module (second-tier). Statistical classifiers that are capable of handling missing/partial sensory data due to sensor failure or power loss are used to detect critical events and pass the information to the third tier (central server) for manual analysis and/or analysis by advanced pattern recognition techniques. Genetic optimisation algorithms are used to control the system in the presence of dynamic events, and also ensure that system requirements (i.e. minimum life of the system) are met. This tight integration of control optimisation and machine learning algorithms results in a highly efficient sensor network with intelligent decision making capabilities. The applicability of our technology in remote health monitoring and environmental monitoring is shown. Other uses of our solution are also discussed.

  9. What's Going On? Analysing Visual Data to Understand Context-Based Decision-Making Processes

    ERIC Educational Resources Information Center

    Johnson, Martin; Black, Beth

    2012-01-01

    This brief research report gives an overview of a visually based methodology that has recently been used to shed light on situated decision-making in a high stakes educational assessment environment. Looking carefully at the feedback interactions taking place between senior and less senior examiners, the project aim was to gain insight into the…

  10. Practical Activities that Focus on the Decision-Making Process. TEAL Occasional Papers, Vol. 2, 1978.

    ERIC Educational Resources Information Center

    Yildiz, Nancy

    This paper demonstrates how a diagram of a Safeway supermarket can be the vehicle for a language lesson based on Lawrence's cognitive categories (classification, definition, spatial order, chronological order, generalizations and specifics, and cause and effect). A wide variety of decision-making activities based on this diagram are described.…

  11. The Process of Occupational Decision Making: Patterns during the Transition to Adulthood.

    ERIC Educational Resources Information Center

    Mortimer, Jeylan T.; Zimmer-Gembeck, Melanie J.; Shanahan, Michael J.; Holmes, Mikki

    2002-01-01

    Interviews of 69 adults who had participated in the Youth Development Study as adolescents identified occupational decision-making themes: unfulfilled expectations, postponement of decisions, turning points, resources, and obstacles. Results suggest a need for changing and strengthening social policy especially related to career counseling.…

  12. Community College Presidents' Decision-Making Processes during a Potential Crisis

    ERIC Educational Resources Information Center

    Berry, Judith Kaye

    2013-01-01

    This case study addressed how community college presidents make decisions under conditions that can escalate to full-scale crises. The purpose of this study was to gather data to support the development of alternative models or refinement of existing models for crisis decision making on community college campuses, using an abbreviated…

  13. Physician Decision Making and Cardiac Risk: Effects of Knowledge, Risk Perception, Risk Tolerance, and Fuzzy Processing

    ERIC Educational Resources Information Center

    Reyna, Valerie F.; Lloyd, Farrell J.

    2006-01-01

    Despite training, professionals sometimes make serious errors in risky decision making. The authors investigated judgments and decisions for 9 hypothetical patients at 3 levels of cardiac risk, comparing student and physician groups varying in domain-specific knowledge. Decisions were examined regarding whether they deviated from guidelines, how…

  14. Sex Role Values in the Career Decision-Making Process. Final Report.

    ERIC Educational Resources Information Center

    Tittle, Carol Hehr

    Current career education curricula seems to neglect basic elements of career decision making for women. This criticism was addressed by first developing sets of values in the areas of marriage and parenthood and then examining the relationships of the values to educational, occupational, fertility, and labor force participation plans. Six hundred…

  15. Choosing a Major in Higher Education: Profiles of Students' Decision-Making Process

    ERIC Educational Resources Information Center

    Germeijs, Veerle; Luyckx, Koen; Notelaers, Guy; Goossens, Luc; Verschueren, Karine

    2012-01-01

    This study identified decision-making profiles of students who make a choice of a major in higher education. These profiles were examined in a sample of Belgian students at the end of Grade 12, when the educational system expects that these adolescents choose a specific major. Using latent class cluster analysis on adolescents' scores for coping…

  16. Career Decision Making: The Limits of Rationality and the Abundance of Non-Conscious Processes

    ERIC Educational Resources Information Center

    Krieshok, Thomas S.; Black, Michael D.; McKay, Robyn A.

    2009-01-01

    The terms of work have changed, with multiple transitions now characterizing the arc of a typical career. This article examines an ongoing shift in the area of vocational decision making, as it moves from a place where "it's all about the match" to one closer to "it's all about adapting to change". We review literatures on judgment and decision…

  17. Factors Influencing New Entrant Dairy Farmer's Decision-Making Process around Technology Adoption

    ERIC Educational Resources Information Center

    McDonald, Roberta; Heanue, Kevin; Pierce, Karina; Horan, Brendan

    2016-01-01

    Purpose: The aims of this paper are to (1) evaluate the main factors influencing grazing system technology adoption among new entrant (NE) dairy farmers within Europe and the Irish pasture-based dairy industry, and (2) to determine the extent to which economic factors influence decision-making around technology adoption and use among NEs to the…

  18. Headed for the Heartland: Decision Making Process of Community College Bound International Students

    ERIC Educational Resources Information Center

    Bohman, Eric

    2010-01-01

    Despite record growth in international student enrollment at U.S. community colleges, little is known regarding how the international students learn about--and ultimately decide to attend--community colleges. This research study identifies the decision making factors and explores the sources of information utilized by international students who…

  19. The Role of Emotional Intelligence in the Career Commitment and Decision-Making Process.

    ERIC Educational Resources Information Center

    Brown, Chris; George-Curran, Roberta; Smith, Marian L.

    2003-01-01

    Measures of emotional intelligence, vocational exploration, and career decision-making self-efficacy (CDMSE) were completed by 288 college students. Emotional intelligence was positively related to CDMSE. Utilization of feelings and self-control factors were inversely related to vocational exploration and commitment. Gender was not a moderator of…

  20. Elementary Principal Decision-Making Process during Crisis Situations in One Northern New Jersey District

    ERIC Educational Resources Information Center

    Torley, Marilyn

    2011-01-01

    The purpose of this qualitative study was to investigate how school administrators respond during a crisis. Relevant research pertaining to crisis decision-making will be presented, focusing on the three steps of crisis decision theory (a) assessing the severity of the negative event (b) determining response options, and (c) evaluating response…

  1. A Mixed Methodological Analysis of the Role of Culture in the Clinical Decision-Making Process

    ERIC Educational Resources Information Center

    Hays, Danica G.; Prosek, Elizabeth A.; McLeod, Amy L.

    2010-01-01

    Even though literature indicates that particular cultural groups receive more severe diagnoses at disproportionate rates, there has been minimal research that addresses how culture interfaces specifically with clinical decision making. This mixed methodological study of 41 counselors indicated that cultural characteristics of both counselors and…

  2. A transdisciplinary approach to the decision-making process in extreme prematurity

    PubMed Central

    2014-01-01

    Background A wide range of dilemmas encountered in the health domain can be addressed more efficiently by a transdisciplinary approach. The complex context of extreme prematurity, which is raising important challenges for caregivers and parents, warrants such an approach. Methods In the present work, experts from various disciplinary fields, namely biomedical, epidemiology, psychology, ethics, and law, were enrolled to participate in a reflection. Gathering a group of experts could be very demanding, both in terms of time and resources, so we created a web-based discussion forum to facilitate the exchanges. The participants were mandated to solve two questions: “Which parameters should be considered before delivering survival care to a premature baby born at the threshold of viability?” and “Would it be acceptable to give different information to parents according to the sex of the baby considering that outcome differences exist between sexes?” Results The discussion forum was performed over a period of nine months and went through three phases: unidisciplinary, interdisciplinary and transdisciplinary, which required extensive discussions and the preparation of several written reports. Those steps were successfully achieved and the participants finally developed a consensual point of view regarding the initial questions. This discussion board also led to a concrete knowledge product, the publication of the popularized results as an electronic book. Conclusions We propose, with our transdisciplinary analysis, a relevant and innovative complement to existing guidelines regarding the decision-making process for premature infants born at the threshold of viability, with an emphasis on the respective responsabilities of the caregivers and the parents. PMID:25023324

  3. Education Leaders' Decision-Making Processes about Educational Facilities in a University Multiple Stakeholder Environment

    ERIC Educational Resources Information Center

    Kelting, Scott

    2011-01-01

    This research is a retrospective case study designed to document and analyze the process of decision-making by educational leaders and stakeholders at a four-year university. For this study, educational leaders and key stakeholders agreed to extensive interviews about the decisions made during the design, construction, and post-occupancy phases of…

  4. The Effects of Cognitive Process and Decision Making Training in Reading Experience on Meaningful Learning with Underachieving College Students

    ERIC Educational Resources Information Center

    Dean, Rebecca J.

    2010-01-01

    The ability of underprepared college students to read and learn from their reading is essential to their academic success and to their ability to persist towards completing their degree. The purposes of this study were to (a) assess the relationship between the cognitive processes of reading-based decision making and meaningful learning and (b)…

  5. The Decision-Making Processes of Early Childhood Teachers When Working with Children Experiencing Parental Separation and Divorce

    ERIC Educational Resources Information Center

    Mahony, L.; Lunn, J.; Petriwskyj, A.; Walsh, K.

    2015-01-01

    In this study, the pedagogical decision-making processes of 21 Australian early childhood teachers working with children experiencing parental separation and divorce were examined. Transcripts from interviews and a focus group with teachers were analysed using grounded theory methodology. The findings showed that as teachers interacted with young…

  6. Case Study: An Examination of the Decision Making Process for Selecting Simulations for an Online MBA Program

    ERIC Educational Resources Information Center

    Neely, Pat; Tucker, Jan

    2013-01-01

    Purpose: Simulations are designed as activities which imitate real world scenarios and are often used to teach and enhance skill building. The purpose of this case study is to examine the decision making process and outcomes of a faculty committee tasked with examining simulations in the marketplace to determine if the simulations could be used as…

  7. An Assessment of Decision-Making Processes: Evaluation of Where Land Protection Planning Can Incorporate Climate Change Information (Final Report)

    EPA Science Inventory

    This report, prepared by the Global Change Research Program (GCRP) in the National Center for Environmental Assessment (NCEA) of the Office of Research and Development (ORD) at the U.S. Environmental Protection Agency (EPA), is a review of decision-making processes of selected la...

  8. Adolescent Decision-Making Processes regarding University Entry: A Model Incorporating Cultural Orientation, Motivation and Occupational Variables

    ERIC Educational Resources Information Center

    Jung, Jae Yup

    2013-01-01

    This study tested a newly developed model of the cognitive decision-making processes of senior high school students related to university entry. The model incorporated variables derived from motivation theory (i.e. expectancy-value theory and the theory of reasoned action), literature on cultural orientation and occupational considerations. A…

  9. A Mixed Method Inquiry into the Perceptions of the Faculty Senate Concerning the Budget Decision-Making Process

    ERIC Educational Resources Information Center

    Higgins, Jeremy Keith

    2013-01-01

    Historically universities have been academically focused institutions; however, in recent years they have begun to resemble a corporate business. The purpose of this dissertation was to determine the faculty senate's perceptions of the budget decision-making process at a public institution of higher education in Texas. The institution under study…

  10. Modeling the Occupational/Career Decision-Making Processes of Intellectually Gifted Adolescents: A Competing Models Strategy

    ERIC Educational Resources Information Center

    Jung, Jae Yup

    2014-01-01

    This study developed and empirically tested two related models of the occupational/career decision-making processes of gifted adolescents using a competing models strategy. The two models that guided the study, which acknowledged cultural orientations, social influences from the family, occupational/career values, and characteristics of…

  11. An Ethnographic Study of the Decision-Making Processes and Leadership Behavior at the Schoolwide Level in Selected Secondary Schools.

    ERIC Educational Resources Information Center

    Dunstan, Jeffrey F.

    This study used field study methodology to identify and describe decision-making processes and leadership behavior at the school-wide level in secondary schools that individualize their educational programs. Indepth interviews, observations of groups and individuals, and analysis of documents were used to obtain the basic data. Two senior high…

  12. Examining the Underlying Values of Turkish and German Mathematics Teachers' Decision Making Processes in Group Studies

    ERIC Educational Resources Information Center

    Dede, Yuksel

    2013-01-01

    The purpose of this study was to explore the values underlying the decision-making processes in group studies for Turkish and German mathematics teachers. This study presented a small part of a wider study investigating German and Turkish mathematics teachers' and their students' values (Values in Mathematics Teaching in Turkey and…

  13. [Decision Making and Electrodermal Activity].

    PubMed

    Kobayakawa, Mutsutaka

    2016-08-01

    Decision making is aided by emotions. Bodily responses, such as sweating, heartbeat, and visceral sensation, are used to monitor the emotional state during decision making. Because decision making in dairy life is complicated and cognitively demanding, these bodily signals are thought to facilitate the decision making process by assigning positive or negative values for each of the behavioral options. The sweat response in a decision making task is measured by skin conductance response (SCR). SCR in decision making is divided into two categories: anticipatory SCR is observed before making decisions, and reward/punishment SCR is observed after the outcome of the decision is perceived. Brain lesion studies in human revealed that the amygdala and ventromedial prefrontal cortex are important in decision making. Patients with lesinon in the amygdala exhibit neither the anticipatory nor reward/punishment SCRs, while patients with the ventromedial prefrontal lesions have deficits only in the anticipatory SCRs. Decision making tasks and SCR analysis have contributed to reveal the implicit aspects of decision making. Further research is necessary for clarifying the role of explicit process of decision making and its relationship with the implicit process. PMID:27503819

  14. Integration of robotic surgery into routine practice and impacts on communication, collaboration, and decision making: a realist process evaluation protocol

    PubMed Central

    2014-01-01

    Background Robotic surgery offers many potential benefits for patients. While an increasing number of healthcare providers are purchasing surgical robots, there are reports that the technology is failing to be introduced into routine practice. Additionally, in robotic surgery, the surgeon is physically separated from the patient and the rest of the team, with the potential to negatively impact teamwork in the operating theatre. The aim of this study is to ascertain: how and under what circumstances robotic surgery is effectively introduced into routine practice; and how and under what circumstances robotic surgery impacts teamwork, communication and decision making, and subsequent patient outcomes. Methods and design We will undertake a process evaluation alongside a randomised controlled trial comparing laparoscopic and robotic surgery for the curative treatment of rectal cancer. Realist evaluation provides an overall framework for the study. The study will be in three phases. In Phase I, grey literature will be reviewed to identify stakeholders’ theories concerning how robotic surgery becomes embedded into surgical practice and its impacts. These theories will be refined and added to through interviews conducted across English hospitals that are using robotic surgery for rectal cancer resection with staff at different levels of the organisation, along with a review of documentation associated with the introduction of robotic surgery. In Phase II, a multi-site case study will be conducted across four English hospitals to test and refine the candidate theories. Data will be collected using multiple methods: the structured observation tool OTAS (Observational Teamwork Assessment for Surgery); video recordings of operations; ethnographic observation; and interviews. In Phase III, interviews will be conducted at the four case sites with staff representing a range of surgical disciplines, to assess the extent to which the results of Phase II are generalisable and to

  15. Imitation versus payoff: Duality of the decision-making process demonstrates criticality and consensus formation

    NASA Astrophysics Data System (ADS)

    Turalska, M.; West, B. J.

    2014-11-01

    We consider a dual model of decision making, in which an individual forms its opinion based on contrasting mechanisms of imitation and rational calculation. The decision-making model (DMM) implements imitating behavior by means of a network of coupled two-state master equations that undergoes a phase transition at a critical value of a control parameter. The evolutionary spatial game, being a generalization of the prisoner's dilemma game, is used to determine in objective fashion the cooperative or anticooperative strategy adopted by individuals. Interactions between two sources of dynamics increases the domain of initial states attracted to phase transition dynamics beyond that of the DMM network in isolation. Additionally, on average the influence of the DMM on the game increases the final observed fraction of cooperators in the system.

  16. [The impact of guidelines, standards and economic restrictions on clinical decision-making processes].

    PubMed

    Linden, Michael

    2004-05-01

    Guidelines aim at improving clinical decision-making. Contrary to textbooks and reviews that want to improve medical knowledge, guidelines try to influence medical behaviour. Scientific models of clinical decision-making such as the action theory and empirical data on the effects of guidelines suggest that guidelines will not always reach their goals but can instead even lead to a deterioration in the quality of medical care. Therefore there is a need for controlled clinical trials to investigate whether guideline-exposed physicians yield better patient outcomes than guideline-naïve physicians. Guidelines should only be regarded as evidence-based if their positive effects have been empirically demonstrated. PMID:15250387

  17. Toward theoretical understanding of the fertility preservation decision-making process: Examining information processing among young women with cancer

    PubMed Central

    Hershberger, Patricia E.; Finnegan, Lorna; Altfeld, Susan; Lake, Sara; Hirshfeld-Cytron, Jennifer

    2014-01-01

    Background Young women with cancer now face the complex decision about whether to undergo fertility preservation. Yet little is known about how these women process information involved in making this decision. Objective The purpose of this paper is to expand theoretical understanding of the decision-making process by examining aspects of information processing among young women diagnosed with cancer. Methods Using a grounded theory approach, 27 women with cancer participated in individual, semi-structured interviews. Data were coded and analyzed using constant-comparison techniques that were guided by five dimensions within the Contemplate phase of the decision-making process framework. Results In the first dimension, young women acquired information primarily from clinicians and Internet sources. Experiential information, often obtained from peers, occurred in the second dimension. Preferences and values were constructed in the third dimension as women acquired factual, moral, and ethical information. Women desired tailored, personalized information that was specific to their situation in the fourth dimension; however, women struggled with communicating these needs to clinicians. In the fifth dimension, women offered detailed descriptions of clinician behaviors that enhance or impede decisional debriefing. Conclusion Better understanding of theoretical underpinnings surrounding women’s information processes can facilitate decision support and improve clinical care. PMID:24552086

  18. Embedding health policy and systems research into decision-making processes in low- and middle-income countries.

    PubMed

    Koon, Adam D; Rao, Krishna D; Tran, Nhan T; Ghaffar, Abdul

    2013-01-01

    Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization's Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems. PMID:23924162

  19. Embedding health policy and systems research into decision-making processes in low- and middle-income countries

    PubMed Central

    2013-01-01

    Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization’s Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems. PMID:23924162

  20. Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania

    PubMed Central

    2012-01-01

    Background Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people’s needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual’s opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. Methods The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. Results The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Conclusions Existing challenges related to individuals’ influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in

  1. Shared clinical decision making

    PubMed Central

    AlHaqwi, Ali I.; AlDrees, Turki M.; AlRumayyan, Ahmad; AlFarhan, Ali I.; Alotaibi, Sultan S.; AlKhashan, Hesham I.; Badri, Motasim

    2015-01-01

    Objectives: To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia. Methods: This cross-sectional study was conducted in a major family practice center in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between March and May 2012. Multivariate multinomial regression models were fitted to identify factors associated with patients preferences. Results: The study included 236 participants. The most preferred decision-making style was shared decision-making (57%), followed by paternalistic (28%), and informed consumerism (14%). The preference for shared clinical decision making was significantly higher among male patients and those with higher level of education, whereas paternalism was significantly higher among older patients and those with chronic health conditions, and consumerism was significantly higher in younger age groups. In multivariate multinomial regression analysis, compared with the shared group, the consumerism group were more likely to be female [adjusted odds ratio (AOR) =2.87, 95% confidence interval [CI] 1.31-6.27, p=0.008] and non-dyslipidemic (AOR=2.90, 95% CI: 1.03-8.09, p=0.04), and the paternalism group were more likely to be older (AOR=1.03, 95% CI: 1.01-1.05, p=0.04), and female (AOR=2.47, 95% CI: 1.32-4.06, p=0.008). Conclusion: Preferences of patients for involvement in the clinical decision-making varied considerably. In our setting, underlying factors that influence these preferences identified in this study should be considered and tailored individually to achieve optimal treatment outcomes. PMID:26620990

  2. A functional difference in information processing between orbitofrontal cortex and ventral striatum during decision-making behaviour

    PubMed Central

    Stott, Jeffrey J.; Redish, A. David

    2014-01-01

    Both orbitofrontal cortex (OFC) and ventral striatum (vStr) have been identified as key structures that represent information about value in decision-making tasks. However, the dynamics of how this information is processed are not yet understood. We recorded ensembles of cells from OFC and vStr in rats engaged in the spatial adjusting delay-discounting task, a decision-making task that involves a trade-off between delay to and magnitude of reward. Ventral striatal neural activity signalled information about reward before the rat's decision, whereas such reward-related signals were absent in OFC until after the animal had committed to its decision. These data support models in which vStr is directly involved in action selection, but OFC processes decision-related information afterwards that can be used to compare the predicted and actual consequences of behaviour. PMID:25267815

  3. Data quality and processing for decision making: divergence between corporate strategy and manufacturing processes

    NASA Astrophysics Data System (ADS)

    McNeil, Ronald D.; Miele, Renato; Shaul, Dennis

    2000-10-01

    Information technology is driving improvements in manufacturing systems. Results are higher productivity and quality. However, corporate strategy is driven by a number of factors and includes data and pressure from multiple stakeholders, which includes employees, managers, executives, stockholders, boards, suppliers and customers. It is also driven by information about competitors and emerging technology. Much information is based on processing of data and the resulting biases of the processors. Thus, stakeholders can base inputs on faulty perceptions, which are not reality based. Prior to processing, data used may be inaccurate. Sources of data and information may include demographic reports, statistical analyses, intelligence reports (e.g., marketing data), technology and primary data collection. The reliability and validity of data as well as the management of sources and information is critical element to strategy formulation. The paper explores data collection, processing and analyses from secondary and primary sources, information generation and report presentation for strategy formulation and contrast this with data and information utilized to drive internal process such as manufacturing. The hypothesis is that internal process, such as manufacturing, are subordinate to corporate strategies. The impact of possible divergence in quality of decisions at the corporate level on IT driven, quality-manufacturing processes based on measurable outcomes is significant. Recommendations for IT improvements at the corporate strategy level are given.

  4. Social Networks Influence Hispanic College Women’s HPV Vaccine Uptake Decision-making Processes

    PubMed Central

    Stephens, Dionne P.; Thomas, Tami L.

    2014-01-01

    This qualitative study was designed to assess current and preferred social networks that influence human papillomavirus (HPV) vaccine decision making in a sample of Hispanic college women. Individual, semi-structured interviews were conducted with 41 Hispanic college women attending a large southeastern Hispanic-serving institution. Television commercials and discussions with mothers were found to be the most influential social networks for current HPV vaccination beliefs. Internet sites, close family members, and healthcare providers’ communications were preferred social networks for HPV vaccine information. Perceived accessibility and sense of comfort influenced the order in which these social networks’ communications would be accepted. Findings suggest that Hispanic college women utilize specific social networks to gather information and make decisions about HPV vaccination. Continued efforts are needed to promote further understanding of the purpose of the HPV vaccine via these preferred sources of information. PMID:25599082

  5. Differences in ethical decision-making processes among nurses and doctors.

    PubMed

    Grundstein-Amado, R

    1992-02-01

    The study reports results of an inquiry into the different patterns of ethical decision making used by doctors and nurses. The findings of the study are that nurses and doctors act out of different values, motivations and expectations and that there is a communication gap between them. Nurses place the highest value on the 'caring' perspective, which entails responsiveness and sensitivity to the patients' wishes. In contrast, the doctors value above all the patients' rights and the scientific approach that implies a major concern with disease and its cure. The study suggests that there is a need for the development of a new foundation, based on common professional attributes of the two groups, to which both groups are committed. This would provide a joint point of reference from which the two professions can solve shared ethical problems and would remove communication barriers. PMID:1556321

  6. Preserving the Self: The Process of Decision Making About Hereditary Breast Cancer and Ovarian Cancer Risk Reduction

    PubMed Central

    Howard, A. Fuchsia; Balneaves, Lynda G.; Bottorff, Joan L.; Rodney, Patricia

    2016-01-01

    Women who carry BRCA1 or BRCA2 (BRCA1/2) gene mutations have up to an 88% lifetime risk of breast cancer and up to a 65% lifetime risk of ovarian cancer. Strategies to address these risks include cancer screening and risk-reducing surgery (i.e., mastectomy and salpingo-oophorectomy). We conducted a grounded theory study with 22 BRCA1/2 mutation-carrier women to understand how women make decisions about these risk-reducing strategies. Preserving the self was the overarching decision-making process evident in the participants’ descriptions. This process was shaped by contextual conditions including the characteristics of health services, the nature of hereditary breast and ovarian cancer risk-reduction decisions, gendered roles, and the women’s perceived proximity to cancer. The women engaged in five decision-making styles, and these were characterized by the use of specific decision-making approaches. These findings provide theoretical insights that could inform the provision of decisional support to BRCA1/2 carriers. PMID:20980697

  7. Shared decision making in transplantation: how patients see their role in the decision process of accepting a donor liver.

    PubMed

    Op den Dries, Sanna; Annema, Coby; Berg, Aad P van den; Ranchor, Adelita V; Porte, Robert J

    2014-09-01

    At the time of the organ offer for transplantation, donor-related risks such as disease transmission and graft failure are weighed against the patient's risk of remaining on the waiting list. The patient's commonly inactive role in decision making and the timing and extent of donor-specific risk information have been discussed in the medical literature. This is the first study revealing the opinions of liver patients on these issues. Forty patients listed for liver transplantation and 179 liver transplant patients participated in an anonymous questionnaire-based survey. The majority of the patients wanted to be informed about donor-related risks (59.8%-74.8%). The preferred timing for being informed about donor-related risks was the time of the organ offer for 53.3% of the patients. Among these patients, 79.8% wished to be involved in making the decision to accept or not accept a liver for transplantation, 10.6% wished to make the final decision alone, and only 9.6% did not want to be involved in the decision-making process. Implementing this knowledge through the standardization of the content, the manner of transfer, and the amount of information that we provide to our patients will improve opportunities for shared decision making at different time points during the transplant allocation process. This will enable us to provide the same opportunities and care to every patient on the waiting list. PMID:24863055

  8. Instruments to assess the perception of physicians in the decision-making process of specific clinical encounters: a systematic review

    PubMed Central

    Légaré, France; Moher, David; Elwyn, Glyn; LeBlanc, Annie; Gravel, Karine

    2007-01-01

    Background The measurement of processes and outcomes that reflect the complexity of the decision-making process within specific clinical encounters is an important area of research to pursue. A systematic review was conducted to identify instruments that assess the perception physicians have of the decision-making process within specific clinical encounters. Methods For every year available up until April 2007, PubMed, PsycINFO, Current Contents, Dissertation Abstracts and Sociological Abstracts were searched for original studies in English or French. Reference lists from retrieved studies were also consulted. Studies were included if they reported a self-administered instrument evaluating physicians' perceptions of the decision-making process within specific clinical encounters, contained sufficient description to permit critical appraisal and presented quantitative results based on administering the instrument. Two individuals independently assessed the eligibility of the instruments and abstracted information on their conceptual underpinnings, main evaluation domain, development, format, reliability, validity and responsiveness. They also assessed the quality of the studies that reported on the development of the instruments with a modified version of STARD. Results Out of 3431 records identified and screened for evaluation, 26 potentially relevant instruments were assessed; 11 met the inclusion criteria. Five instruments were published before 1995. Among those published after 1995, five offered a corresponding patient version. Overall, the main evaluation domains were: satisfaction with the clinical encounter (n = 2), mutual understanding between health professional and patient (n = 2), mental workload (n = 1), frustration with the clinical encounter (n = 1), nurse-physician collaboration (n = 1), perceptions of communication competence (n = 2), degree of comfort with a decision (n = 1) and information on medication (n = 1). For most instruments (n = 10), some

  9. Difficult Decisions: A Qualitative Exploration of the Statistical Decision Making Process from the Perspectives of Psychology Students and Academics

    PubMed Central

    Allen, Peter J.; Dorozenko, Kate P.; Roberts, Lynne D.

    2016-01-01

    Quantitative research methods are essential to the development of professional competence in psychology. They are also an area of weakness for many students. In particular, students are known to struggle with the skill of selecting quantitative analytical strategies appropriate for common research questions, hypotheses and data types. To begin understanding this apparent deficit, we presented nine psychology undergraduates (who had all completed at least one quantitative methods course) with brief research vignettes, and asked them to explicate the process they would follow to identify an appropriate statistical technique for each. Thematic analysis revealed that all participants found this task challenging, and even those who had completed several research methods courses struggled to articulate how they would approach the vignettes on more than a very superficial and intuitive level. While some students recognized that there is a systematic decision making process that can be followed, none could describe it clearly or completely. We then presented the same vignettes to 10 psychology academics with particular expertise in conducting research and/or research methods instruction. Predictably, these “experts” were able to describe a far more systematic, comprehensive, flexible, and nuanced approach to statistical decision making, which begins early in the research process, and pays consideration to multiple contextual factors. They were sensitive to the challenges that students experience when making statistical decisions, which they attributed partially to how research methods and statistics are commonly taught. This sensitivity was reflected in their pedagogic practices. When asked to consider the format and features of an aid that could facilitate the statistical decision making process, both groups expressed a preference for an accessible, comprehensive and reputable resource that follows a basic decision tree logic. For the academics in particular, this aid

  10. Interaction between assessment and instruction in science: A teacher's decision-making process

    NASA Astrophysics Data System (ADS)

    Brownstein, Erica Marie

    This study describes the interaction between assessment and instruction in a secondary science classroom. This research examines a chemistry teacher in an AP class in a midwestern urban setting interactively assessing his students and how knowledge gained during that assessment affected his instructional decision-making. The theoretical framework includes reflection-in-action, the zone of proximal development, and social constructivism. The primary question that guided the study was: What is the interaction between assessment and instruction in a science classroom? The three sub questions were: How does a teacher gain knowledge of students' thinking? How does a teacher use knowledge of his students' thinking in interactive instructional decisions? What are the components of his interactive instructional decisions? Participant observation of the classroom occurred over a four month period. The elicit interview technique was used immediately following class to discuss interactive instructional decisions with the teacher. Data sources included videotapes, interviews, field notes, classroom documents, intern journal, and member checking from which triangulation was possible. The goal was to examine and understand interactive decisions that had an impact on instruction. The results indicated that the students were in a safe, accepting environment and that student levels of understanding chemistry were indeterminate, low, medium, and high. Impacts on teacher decision making were pedagogical content knowledge, assessing context, and knowledge of the student. It was found that to gain knowledge of student thinking, the teacher listened, examined student work, asked questions, and made statements. Questions the teacher asked were to probe, lead, or clarify student knowledge. Statements the teacher made would clarify or restate student words. The teacher used his understanding of student knowledge to make instructional decisions by recognizing student knowledge, connecting

  11. Argument structure hierarchy system and method for facilitating analysis and decision-making processes

    DOEpatents

    Janssen, Terry

    2000-01-01

    A system and method for facilitating decision-making comprising a computer program causing linkage of data representing a plurality of argument structure units into a hierarchical argument structure. Each argument structure unit comprises data corresponding to a hypothesis and its corresponding counter-hypothesis, data corresponding to grounds that provide a basis for inference of the hypothesis or its corresponding counter-hypothesis, data corresponding to a warrant linking the grounds to the hypothesis or its corresponding counter-hypothesis, and data corresponding to backing that certifies the warrant. The hierarchical argument structure comprises a top level argument structure unit and a plurality of subordinate level argument structure units. Each of the plurality of subordinate argument structure units comprises at least a portion of the grounds of the argument structure unit to which it is subordinate. Program code located on each of a plurality of remote computers accepts input from one of a plurality of contributors. Each input comprises data corresponding to an argument structure unit in the hierarchical argument structure and supports the hypothesis or its corresponding counter-hypothesis. A second programming code is adapted to combine the inputs into a single hierarchical argument structure. A third computer program code is responsive to the second computer program code and is adapted to represent a degree of support for the hypothesis and its corresponding counter-hypothesis in the single hierarchical argument structure.

  12. The decision-making process of workers in using sick time.

    PubMed

    Sandal, Candace L; Click, Elizabeth R; Dowling, Donna A; Guzik, Arlene

    2014-08-01

    The cost of employee absenteeism in the United States is significant in terms of sick pay, overtime costs, replacement personnel compensation, and lost productivity. Little is known about what workers consider when deciding to use sick time. Previous studies have examined work absence from an array of perspectives, including resulting work strain, job satisfaction, and job security, but absenteeism in the workplace has not been examined in terms of decision making. To scrutinize workers' decisions about using sick time, a descriptive pilot study was undertaken with a convenience sample (n = 94) of working college students. The responses to the survey revealed that the majority of the workers (73.4%) used sick time because they were too ill to work. These results are in direct opposition to previous research and suggest that workers may need education about preventing and managing minor illnesses before an absence is needed. Supporting and engaging employees and their significant others in healthy worker programs, regular surveillance examinations, and illness prevention strategies are wise investments in companies' financial futures. Future research should include a comparative study of worker absenteeism between worksites with occupational health nurses and those without nurses. PMID:25101929

  13. A Study of Secondary Students' Decision-Making Processes with Respect to Information Use, Particularly Students' Judgements of Relevance and Reliability

    ERIC Educational Resources Information Center

    Watson, Curtis L.

    2010-01-01

    This report details an ongoing investigation of the decision-making processes of a group of secondary school students in south-eastern Australia undertaking information search tasks. The study is situated in the field of information seeking and use, and, more broadly, in decision making. Research questions focus on students' decisions about the…

  14. A Retrospective Study Evaluating the Impact of Preoperative Breast MRI on Surgical Decision-Making in Young Patients (≤50 Years) with Invasive Breast Cancer

    PubMed Central

    Mukherjee, Som D.; Hodgson, Nicole; Lovrics, Peter J.; Dhamanaskar, Kavita; Minuk, Terry; Chambers, Shelley; Sussman, Jonathan

    2016-01-01

    INTRODUCTION Breast magnetic resonance imaging (MRI) is considered a more sensitive diagnostic test for detecting invasive breast cancer than mammography or breast ultrasound. Breast MRI may be particularly useful in younger premenopausal women with higher density breast tissue for differentiating between dense fibroglandular breast tissue and breast malignancies. The main objective of this study was to determine the impact of preoperative breast MRI on surgical decision-making in young women with breast cancer. METHODS A retrospective review of patients with newly diagnosed invasive breast cancer and age of ≤50 years was performed. All patients underwent physical examination, preoperative mammogram, breast ultrasound, and bilateral breast MRI. Two breast cancer surgeons reviewed the preoperative mammogram report, breast ultrasound report, and physical examination summary and were asked if they would recommend a lumpectomy, a quandrantectomy, or a mastectomy. A few weeks later, the two surgeons were shown the same information with the breast MRI report and were asked what type of surgery they would now recommend. In each case, MRI was classified by two adjudicators as having affected the surgical outcome in a positive, negative, or neutral fashion. A positive impact was defined as the situation where breast MRI detected additional disease that was not found on physical examination, mammogram, or breast ultrasound and led to an appropriate change in surgical management. A negative impact was defined as the situation where breast MRI led the surgeon to recommend more extensive surgery, with less extensive disease actually found at pathology. No impact was defined as the situation where MRI findings did not alter surgical recommendations or outcomes. RESULTS Of 37 patients whose charts were reviewed, five patients were deemed to be ineligible due to having received neoadjuvant chemotherapy, having previous breast implants, or having had their tumor fully excised

  15. Influence of the Preoperative Decision-Making Process on the Postoperative Outcome after Hysterectomy for Benign Uterine Pathologies

    PubMed Central

    Radosa, J. C.; Radosa, C. G.; Kastl, C.; Mavrova, R.; Gabriel, L.; Gräber, S.; Wagenpfeil, G.; Baum, S.; Hamza, A.; Joukhadar, R.; Juhasz-Böss, I.; Heimes, A.-S.; Meyberg-Solomayer, G.; Solomayer, E.-F.; Radosa, M. P.

    2016-01-01

    Introduction: The aim of this study was to assess whether the preoperative decision-making process might influence treatment success in premenopausal women undergoing hysterectomy for benign uterine pathologies Materials and Methods: All premenopausal women treated with hysterectomy for benign uterine pathologies between April 2011 and June 2013 at a tertiary university center were enrolled in this prospective observational cohort study. Five parameters of the preoperative decision-making process were assessed upon their correlation with postoperative quality of life, sexual function and patientsʼ satisfaction. These outcome measures were assessed for the pre- and postoperative (six months after surgery) status using two validated questionnaires (EQ-5D and “female sexual function index” (FSFI). Patientsʼ satisfaction with the postoperative outcome was assessed with a self-developed questionnaire. Results: 255 of 402 (63 %) patients completed the study. A correlation between the co-variables “interval between first counseling and decision to surgery”, “subjectively perceived quality of the preoperative counseling” and “certainty in the decision for the intervention” and postoperative outcomes were found. The co-variables “person mainly responsible for election of hysterectomy mode” and “discussion of decision for surgery with others” showed no influence on postoperative patients-reported outcomes. Conclusion: We found a correlation between certain parameters of the preoperative decision-making process and postoperative patient-reported sexual function, quality of life and patientsʼ satisfaction in premenopausal women undergoing hysterectomy for benign uterine pathologies. An optimization of these factors could contribute to an improvement in treatment outcomes. PMID:27134293

  16. The decision-making process for the fate of frozen embryos by Japanese infertile women: a qualitative study

    PubMed Central

    2012-01-01

    Background Previous studies have found that the decision-making process for stored unused frozen embryos involves much emotional burden influenced by socio-cultural factors. This study aims to ascertain how Japanese patients make a decision on the fate of their frozen embryos: whether to continue storage discard or donate to research. Methods Ten Japanese women who continued storage, 5 who discarded and 16 who donated to research were recruited from our infertility clinic. Tape-recorded interviews were transcribed and analyzed for emergent themes. Results A model of patients’ decision-making processes for the fate of frozen embryos was developed, with a common emergent theme, “coming to terms with infertility” resulting in either acceptance or postponing acceptance of their infertility. The model consisted of 5 steps: 1) the embryo-transfer moratorium was sustained, 2) the “Mottainai”- embryo and having another child were considered; 3) cost reasonability was taken into account; 4) partner’s opinion was confirmed to finally decide whether to continue or discontinue storage. Those discontinuing, then contemplated 5): the effect of donation. Great emotional conflict was expressed in the theme, steps 2, 4, and 5. Conclusions Patients’ 5 step decision-making process for the fate of frozen embryos was profoundly affected by various Japanese cultural values and moral standards. At the end of their decision, patients used culturally inherent values and standards to come to terms with their infertility. While there is much philosophical discussion on the moral status of the embryo worldwide, this study, with actual views of patients who own them, will make a significant contribution to empirical ethics from the practical viewpoint. PMID:22607034

  17. Decision Making and Communications Process Assessment of NASA Using Three Change Requests from the Space Launch System Program

    NASA Technical Reports Server (NTRS)

    Hicks, Karen Campbell

    2015-01-01

    This thesis investigated the communication and decision making process as part of the Systems Engineering practices at the NASA/Marshall Center to determine its level of effectiveness. Data was collected across three change requests to assess how decisions were made, how the decisions were communicated, and whether a process mattered in the formulation and dissemination of those decisions. Data results revealed the comprehensive decision making process for the technical change requests to be effective. Evidence revealed that the process was sufficiently tailored to accommodate the need of each individual technical change which promoted effective communication amongst the stakeholders in the formulation of the strategic decision recommendations elevated to upper management. However, data results also revealed the dissemination of the final decision and approval of the change requests from the higher organizational level down to all stakeholders was less effective. An establishment of a culmination meeting at the end of the change request decision process in which to close the communication loop with all entities would be beneficial.

  18. The role of citizen public-interest groups in the decision-making process of a science-intensive culture

    SciTech Connect

    Sinclair, M.P.

    1991-01-01

    This study explores how concerns about the environment have escalated in the past three decades from being peripheral to that of a mainstream social movement. Most environmental concerns stem from the deployment of technologies where technical expertise is essential to effective participation in the decision-making process. The manner in which the current policy for the disposal of low-level radioactive waste was devised and passed by Congress provides the information base through which the role of citizen groups in the decision-making process in a science-intensive culture is explored, as they seek to overcome the adverse environmental impacts and economic inequities of this Act. The actual process by which citizens have confronted this current flawed policy is described, which includes how technical expertise from various sources made the citizens' case credible and effective. Several existing and theoretical models of citizen participation are described. Recommendations and conclusions are presented briefly, and a recommended model based on the concept of sustainable development is proposed.

  19. Plastic neo-vaginal construction in Mayer-Rokitansky-Küster-Hauser syndrome: an expert opinion paper on the decision-making treatment process.

    PubMed

    Torres-de la Roche, Luz Angela; Devassy, Rajesh; Gopalakrishnan, Sreelatha; de Wilde, Maya Sophie; Herrmann, Anja; Larbig, Angelika; De Wilde, Rudy Leon

    2016-01-01

    Vaginal agenesis is a congenital anomaly that affects the life of one of each four thousand women around the world. There is a trend that patients request immediate surgical correction, instead of passive vaginal dilatation. Therefore a differentiated counselling should be provided. We present a comparative chart, based on published evidence, with aspect to the available techniques, which will facilitate the decision-making process in the clinical practice. From our point of view, the best results are achieved with techniques that combine the advantages of the minimal-invasive surgery with those derived of the use of peritoneum as covering tissue of the neovagina. Nevertheless there is a lack on interdisciplinary consensus about the best option to restore the physical and sexual quality of life. PMID:26904393

  20. Plastic neo-vaginal construction in Mayer-Rokitansky-Küster-Hauser syndrome: an expert opinion paper on the decision-making treatment process

    PubMed Central

    Torres-de la Roche, Luz Angela; Devassy, Rajesh; Gopalakrishnan, Sreelatha; de Wilde, Maya Sophie; Herrmann, Anja; Larbig, Angelika; De Wilde, Rudy Leon

    2016-01-01

    Vaginal agenesis is a congenital anomaly that affects the life of one of each four thousand women around the world. There is a trend that patients request immediate surgical correction, instead of passive vaginal dilatation. Therefore a differentiated counselling should be provided. We present a comparative chart, based on published evidence, with aspect to the available techniques, which will facilitate the decision-making process in the clinical practice. From our point of view, the best results are achieved with techniques that combine the advantages of the minimal-invasive surgery with those derived of the use of peritoneum as covering tissue of the neovagina. Nevertheless there is a lack on interdisciplinary consensus about the best option to restore the physical and sexual quality of life. PMID:26904393

  1. Fracture risk assessment: improved evaluation of vertebral integrity among metastatic cancer patients to aid in surgical decision-making

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Camp, Jon J.; Holmes, David R.; Huddleston, Paul M.; Lu, Lichun; Yaszemski, Michael J.; Robb, Richard A.

    2012-03-01

    Failure of the spine's structural integrity from metastatic disease can lead to both pain and neurologic deficit. Fractures that require treatment occur in over 30% of bony metastases. Our objective is to use computed tomography (CT) in conjunction with analytic techniques that have been previously developed to predict fracture risk in cancer patients with metastatic disease to the spine. Current clinical practice for cancer patients with spine metastasis often requires an empirical decision regarding spinal reconstructive surgery. Early image-based software systems used for CT analysis are time consuming and poorly suited for clinical application. The Biomedical Image Resource (BIR) at Mayo Clinic, Rochester has developed an image analysis computer program that calculates from CT scans, the residual load-bearing capacity in a vertebra with metastatic cancer. The Spine Cancer Assessment (SCA) program is built on a platform designed for clinical practice, with a workflow format that allows for rapid selection of patient CT exams, followed by guided image analysis tasks, resulting in a fracture risk report. The analysis features allow the surgeon to quickly isolate a single vertebra and obtain an immediate pre-surgical multiple parallel section composite beam fracture risk analysis based on algorithms developed at Mayo Clinic. The analysis software is undergoing clinical validation studies. We expect this approach will facilitate patient management and utilization of reliable guidelines for selecting among various treatment option based on fracture risk.

  2. The Lisbon new international airport: The story of a decision-making process and the role of Strategic Environmental Assessment

    SciTech Connect

    Partidario, Maria R.; Coutinho, Miguel

    2011-04-15

    This is the brief story of a decision process and the role of Strategic Environmental Assessment in government political decision-making. Following a prolonged, and agitated, decision process, initiated in the 1960s, the Government of Portugal in 2005 took the final decision to build the new international airport of Lisbon at the controversial location of Ota, 40 km north of Lisbon. The detailed project design and EIA were started. However this decision would change in 2007 due to the challenge raised by a private sponsored study that identified an alternative location for the airport at Campo de Tiro de Alcochete (CTA). This new site, which had never been considered as an option before, appeared to avoid many of the problems that caused public controversy at the Ota site. The Government, pressured by this challenge, promoted a strategic comparative assessment between the two sites. The result of this study was the choice of CTA as the preferred location. This paper discusses this radical change in the decision from a socio-political perspective. It will highlight the relevance of Strategic Environmental Assessment (SEA), and the strategic and constructive approach it enables in mega-project decision-making.

  3. Processing of decision-making and social threat in patients with history of suicidal attempt: A neuroimaging replication study.

    PubMed

    Olié, Emilie; Ding, Yang; Le Bars, Emmanuelle; de Champfleur, Nicolas Menjot; Mura, Thibault; Bonafé, Alain; Courtet, Philippe; Jollant, Fabrice

    2015-12-30

    Suicidal vulnerability has been related to impaired value-based decision-making and increased sensitivity to social threat, mediated by the prefrontal cortex. Using functional magnetic resonance imaging, we aimed at replicating these previous findings by measuring brain activation during the Iowa Gambling Task and an emotional faces viewing task. Participants comprised 15 euthymic suicide attempters (history of depression and suicidal behavior) who were compared with 23 euthymic patient controls (history of depression without suicidal history) and 35 healthy controls. The following five model-based regions of interest were investigated: the orbitofrontal cortex (OFC), ventrolateral prefrontal cortex (VLPFC), anterior cingulate cortex (ACC), medial (MPFC) and dorsal prefrontal cortex (DPFC). Suicide attempters relative to patient controls showed (1) increased response to angry vs. neutral faces in the left OFC and the VLPFC, as previously reported; (2) increased response to wins vs. losses in the right OFC, DPFC and ACC; (3) decreased response to risky vs. safe choices in the left DPFC; and (4) decreased response to sad vs. neutral faces in the right ACC. This study links impaired valuation processing (here for signals of social threat, sadness and reward) to prefrontal cortex dysfunction in suicide attempters. These long-term deficits may underlie the impaired decision-making and social difficulties found in suicide attempters. PMID:26483212

  4. An exploration of the decision-making processes at the point of referral to an Admiral Nurse team.

    PubMed

    Burton, J; Hope, K W

    2005-06-01

    The Admiral Nursing Service supports individuals caring for people with dementia. As a response to the high demand for one team's service, a temporary closure to referrals was agreed. This provided the impetus to explore the influence of nurses' decision making at the point of referral on demand for the service. The research questions addressed were: How do Admiral Nurses make decisions regarding referrals and What factors influence this decision-making process? Sixteen case studies were retrospectively reviewed through the auspices of a semi-structured interview aimed at identifying which factors influenced the nurses' acceptance or rejection of these referrals. Results indicated that the Admiral Nurses had a clearly identified focus in supporting the carers of people with dementia, but that the complexity of the carers situation which included the person with dementia was significant. However, the desire to fulfil a case-management role while attempting to provide a service that is of a specialist nature and of limited capacity generated tensions. The decision to offer a service to carers was consequently influenced not only by perceived need but also upon the nurses feeling professionally responsible for perceived gaps in service provision. PMID:15876244

  5. Propulsion Airframe Aeroacoustics Technology Evaluation and Selection Using a Multi-Attribute Decision Making Process and Non-Deterministic Design

    NASA Technical Reports Server (NTRS)

    Burg, Cecile M.; Hill, Geoffrey A.; Brown, Sherilyn A.; Geiselhart, Karl A.

    2004-01-01

    The Systems Analysis Branch at NASA Langley Research Center has investigated revolutionary Propulsion Airframe Aeroacoustics (PAA) technologies and configurations for a Blended-Wing-Body (BWB) type aircraft as part of its research for NASA s Quiet Aircraft Technology (QAT) Project. Within the context of the long-term NASA goal of reducing the perceived aircraft noise level by a factor of 4 relative to 1997 state of the art, major configuration changes in the propulsion airframe integration system were explored with noise as a primary design consideration. An initial down-select and assessment of candidate PAA technologies for the BWB was performed using a Multi-Attribute Decision Making (MADM) process consisting of organized brainstorming and decision-making tools. The assessments focused on what effect the PAA technologies had on both the overall noise level of the BWB and what effect they had on other major design considerations such as weight, performance and cost. A probabilistic systems analysis of the PAA configurations that presented the best noise reductions with the least negative impact on the system was then performed. Detailed results from the MADM study and the probabilistic systems analysis will be published in the near future.

  6. Values in Decision Making: The INVOLVE Model.

    ERIC Educational Resources Information Center

    Elfrink, Victoria L.; Coldwell, LuAnn Linson

    1993-01-01

    Describes the function of values and participatory decision making within the student affairs profession. Introduces a process model as a means of operationalizing values in the decision-making process and uses case studies to illustrate how the model can be used to improve student affairs professionals' decision making. (RJM)

  7. Facilitating Consensual Labor-Management Decision Making.

    ERIC Educational Resources Information Center

    Savage, Grant T.

    Facilitating consensual labor-management decision making may require interventions during, after, and before meetings. These interventions--including persuasion and mediation--may affect both the internal and the external processes of decision making. Communicative actions may help both the internal and the external decision making processes of a…

  8. Decision making: the neuroethological turn.

    PubMed

    Pearson, John M; Watson, Karli K; Platt, Michael L

    2014-06-01

    Neuroeconomics applies models from economics and psychology to inform neurobiological studies of choice. This approach has revealed neural signatures of concepts like value, risk, and ambiguity, which are known to influence decision making. Such observations have led theorists to hypothesize a single, unified decision process that mediates choice behavior via a common neural currency for outcomes like food, money, or social praise. In parallel, recent neuroethological studies of decision making have focused on natural behaviors like foraging, mate choice, and social interactions. These decisions strongly impact evolutionary fitness and thus are likely to have played a key role in shaping the neural circuits that mediate decision making. This approach has revealed a suite of computational motifs that appear to be shared across a wide variety of organisms. We argue that the existence of deep homologies in the neural circuits mediating choice may have profound implications for understanding human decision making in health and disease. PMID:24908481

  9. Decision making: the neuroethological turn

    PubMed Central

    Pearson, John M.; Watson, Karli K.; Platt, Michael L.

    2014-01-01

    Neuroeconomics applies models from economics and psychology to inform neurobiological studies of choice. This approach has revealed neural signatures of concepts like value, risk, and ambiguity, which are known to influence decision-making. Such observations have led theorists to hypothesize a single, unified decision process that mediates choice behavior via a common neural currency for outcomes like food, money, or social praise. In parallel, recent neuroethological studies of decision-making have focused on natural behaviors like foraging, mate choice, and social interactions. These decisions strongly impact evolutionary fitness and thus are likely to have played a key role in shaping the neural circuits that mediate decision-making. This approach has revealed a suite of computational motifs that appear to be shared across a wide variety of organisms. We argue that the existence of deep homologies in the neural circuits mediating choice may have profound implications for understanding human decision-making in health and disease. PMID:24908481

  10. Processing ambiguity in a linguistic context: decision-making difficulties in non-aphasic patients with behavioral variant frontotemporal degeneration

    PubMed Central

    Spotorno, Nicola; Healey, Meghan; McMillan, Corey T.; Rascovsky, Katya; Irwin, David J.; Clark, Robin; Grossman, Murray

    2015-01-01

    Some extent of ambiguity is ubiquitous in everyday conversations. For example, words have multiple meaning and very common pronouns, like “he” and “she” (anaphoric pronouns), have little meaning on their own and refer to a noun that has been previously introduced in the discourse. Ambiguity triggers a decision process that is not a subroutine of language processing but rather a more general domain resource. Therefore non-aphasic patients with limited decision-making capability can encounter severe limitation in language processing due to extra linguistic limitations. In the present study, we test patients with behavioral variant frontotemporal degeneration (bvFTD), focusing on anaphora as a paradigmatic example of ambiguity resolution in the linguistic domain. bvFTD is characterized by gray matter (GM) atrophy in prefrontal cortex, but relative sparing of peri-Sylvian cortex. A group of patients with parietal disease due to corticobasal syndrome (CBS) was also tested here in order to investigate the specific role of prefrontal cortex in the task employed in the current study. Participants were presented with a pair of sentences in which the first sentence contained two nouns while the second contained a pronoun. In the experimental (ambiguous) condition, both nouns are plausible referents of the pronoun, thus requiring decision-making resources. The results revealed that bvFTD patients are significantly less accurate than healthy seniors in identifying the correct referent of a pronoun in the ambiguous condition, although CBS patients were as accurate as healthy seniors. Imaging analyses related bvFTD patients’ performance to GM atrophy in ventromedial prefrontal cortex (vmPFC). These results suggest that bvFTD patients have difficulties in decision processes that involve the resolution of an ambiguity. PMID:26578928

  11. Processing ambiguity in a linguistic context: decision-making difficulties in non-aphasic patients with behavioral variant frontotemporal degeneration.

    PubMed

    Spotorno, Nicola; Healey, Meghan; McMillan, Corey T; Rascovsky, Katya; Irwin, David J; Clark, Robin; Grossman, Murray

    2015-01-01

    Some extent of ambiguity is ubiquitous in everyday conversations. For example, words have multiple meaning and very common pronouns, like "he" and "she" (anaphoric pronouns), have little meaning on their own and refer to a noun that has been previously introduced in the discourse. Ambiguity triggers a decision process that is not a subroutine of language processing but rather a more general domain resource. Therefore non-aphasic patients with limited decision-making capability can encounter severe limitation in language processing due to extra linguistic limitations. In the present study, we test patients with behavioral variant frontotemporal degeneration (bvFTD), focusing on anaphora as a paradigmatic example of ambiguity resolution in the linguistic domain. bvFTD is characterized by gray matter (GM) atrophy in prefrontal cortex, but relative sparing of peri-Sylvian cortex. A group of patients with parietal disease due to corticobasal syndrome (CBS) was also tested here in order to investigate the specific role of prefrontal cortex in the task employed in the current study. Participants were presented with a pair of sentences in which the first sentence contained two nouns while the second contained a pronoun. In the experimental (ambiguous) condition, both nouns are plausible referents of the pronoun, thus requiring decision-making resources. The results revealed that bvFTD patients are significantly less accurate than healthy seniors in identifying the correct referent of a pronoun in the ambiguous condition, although CBS patients were as accurate as healthy seniors. Imaging analyses related bvFTD patients' performance to GM atrophy in ventromedial prefrontal cortex (vmPFC). These results suggest that bvFTD patients have difficulties in decision processes that involve the resolution of an ambiguity. PMID:26578928

  12. Decision-making process of Kala Azar care: results from a qualitative study carried out in disease endemic areas of Nepal

    PubMed Central

    2013-01-01

    Background Analysis of consumer decision making in the health sector is a complex process of comparing feasible alternatives and evaluating the levels of satisfaction associated with the relevant options. This paper makes an attempt to understand how and why consumers make specific decisions, what motivates them to adopt a specific health intervention, and what features they find attractive in each of the options. Method The study used a descriptive-explanatory design to analyze the factors determining the choices of healthcare providers. Information was collected through focus group discussions and in-depth interviews. Results The results suggest that the decision making related to seeking healthcare for Kala Azar (KA) treatment is a complex, interactive process. Patients and family members follow a well-defined road map for decision making. The process of decision making starts from the recognition of healthcare needs and is then modified by a number of other factors, such as indigenous knowledge, healthcare alternatives, and available resources. Household and individual characteristics also play important roles in facilitating the process of decision making. The results from the group discussions and in-depth interviews are consistent with the idea that KA patients and family members follow the rational approach of weighing the costs against the benefits of using specific types of medical care. Conclusion The process of decision making related to seeking healthcare follows a complex set of steps and many of the potential factors affect the decision making in a non-linear fashion. Our analysis suggests that it is possible to derive a generalized road map of the decision-making process starting from the recognition of healthcare needs, and then modifying it to show the influences of indigenous knowledge, healthcare alternatives, and available resources. PMID:23849617

  13. Decision Making in Adults with ADHD

    ERIC Educational Resources Information Center

    Montyla, Timo; Still, Johanna; Gullberg, Stina; Del Missier, Fabio

    2012-01-01

    Objectives: This study examined decision-making competence in ADHD by using multiple decision tasks with varying demands on analytic versus affective processes. Methods: Adults with ADHD and healthy controls completed two tasks of analytic decision making, as measured by the Adult Decision-Making Competence (A-DMC) battery, and two affective…

  14. Impaired Decision Making in Adolescent Suicide Attempters

    ERIC Educational Resources Information Center

    Bridge, Jeffrey A.; McBee-Strayer, Sandra M.; Cannon, Elizabeth A.; Sheftall, Arielle H.; Reynolds, Brady; Campo, John V.; Pajer, Kathleen A.; Barbe, Remy P.; Brent, David A.

    2012-01-01

    Objective: Decision-making deficits have been linked to suicidal behavior in adults. However, it remains unclear whether impaired decision making plays a role in the etiopathogenesis of youth suicidal behavior. The purpose of this study was to examine decision-making processes in adolescent suicide attempters and never-suicidal comparison…

  15. The role of meteorological processes in the description of uncertainty for climate change decision-making

    NASA Astrophysics Data System (ADS)

    Briley, Laura J.; Ashley, Walker S.; Rood, Richard B.; Krmenec, Andrew

    2015-10-01

    Downscaled climate data are available at fine spatial scales making them desirable to local climate change practitioners. However, without a description of their uncertainty, practitioners cannot know if they provide quality information. We pose that part of the foundation for the description of uncertainty is an assessment of the ability of the underlying climate model to represent the meteorological or weather-scale processes. Here, we demonstrate an assessment of precipitation processes for the Great Lakes region using the Bias Corrected and Spatially Downscaled (BCSD) Coupled Model Intercomparison Project phase 3 (CMIP3) projections. A major weakness of the underlying models is their inability to simulate the effects of the Great Lakes, which is an important issue for most global climate models. There is also uncertainty among the models in the timing of transition between dominant precipitation processes going from the warm to cool season and vice versa. In addition, warm-season convective precipitation processes very greatly among the models. From the assessment, we discuss how process-based uncertainties in the models are inherited by the downscaled projections and how bias correction increases uncertainty in cases where precipitation processes are not well represented. Implications of these findings are presented for three regional examples: lake-effect snow, the spring seasonal transition, and summertime lake-effect precipitation.

  16. Pig farmers' perceptions, attitudes, influences and management of information in the decision-making process for disease control.

    PubMed

    Alarcon, Pablo; Wieland, Barbara; Mateus, Ana L P; Dewberry, Chris

    2014-10-01

    The objectives of this study were (1) to explore the factors involved in the decision-making process used by pig farmers for disease control and (2) to investigate pig farmers' attitudes and perceptions about different information sources relating to disease control. In 2011 a qualitative study involving 20 face-to-face interviews with English pig farmers was conducted. The questionnaire was composed of three parts. The first part required farmers to identify two diseases they had experienced and which were difficult to recognize and/or control. They were asked to report how the disease problem was recognized, how the need for control was decided, and what affected the choice of control approach. For the latter, a structure related to the Theory of Planned Behaviour was used. Their verbal responses were classified as associated with: (1) attitude and beliefs, (2) subjective norms, or (3) perceived behavioural control (PBC). In the second part, five key sources of information for disease control (Defra, BPEX, research from academia, internet and veterinarians) and the factors related to barriers to knowledge were investigated. Interviews were recorded and transcribed. A qualitative analysis of the text of the interview transcripts was carried out using templates. Drivers for disease control were 'pig mortality', 'feeling of entering in an economically critical situation', 'animal welfare' and 'feeling of despair'. Veterinarians were perceived by several participating farmers as the most trusted information source on disease control. However, in particular non-sustainable situations, other producers, and especially experiences from abroad, seemed to considerably influence the farmers' decision-making. 'Lack of knowledge', 'farm structure and management barriers' and 'economic constrains' were identified in relation to PBC. Several negative themes, such as 'lack of communication', 'not knowing where to look', and 'information bias' were associated with research from

  17. Influences in the Decision-Making Process for Careers as a Speech-Language Pathologist or an Audiologist.

    ERIC Educational Resources Information Center

    Brodsky, Martin B.; Cooke, Paul A.

    2000-01-01

    Students and professionals (N=297) in speech-language pathology and audiology were surveyed about career decision making. Decision-making factors were similar across both professions, with personal factors being the most influential. Employment and education factors were also critical. Early course work also played a significant role. (Author/MKA)

  18. Safety, risk and mental health: decision-making processes prescribed by Australian mental health legislation.

    PubMed

    Smith-Merry, Jennifer; Caple, Andrew

    2014-03-01

    Adverse events in mental health care occur frequently and cause significant distress for those who experience them, derailing treatment and sometimes leading to death. These events are clustered around particular aspects of care and treatment and are therefore avoidable if practices in these areas are strengthened. The research reported in this article takes as its starting point coronial recommendations made in relation to mental health. We report on those points and processes in treatment and discharge where coronial recommendations are most frequently made. We then examine the legislative requirements around these points and processes in three Australian States. We find that the key areas that need to be strengthened to avoid adverse events are assessment processes, communication and information transfer, documentation, planning and training. We make recommendations for improvements in these key areas. PMID:24804534

  19. Some implications of the technology assessment function for the effective public decision-making process

    NASA Technical Reports Server (NTRS)

    Mayo, L. H.

    1971-01-01

    A preliminary provisional assessment of the prospects for the establishment of an adequate technology assessment function and the implications of the assessment function for the public decision process are presented. Effects of the technology assessment function on each phase of the public decision process and briefly explored. Significant implications during the next decade are projected with respect to the following phases: invention and development of alternative means (technological configurations); evaluation, selection and promotion of preferred courses of action; and modification of statutory scheme or social action program as an outcome of continuing monitoring and appraisal.

  20. Remote Sensing: A valuable tool in the Forest Service decision making process. [in Utah

    NASA Technical Reports Server (NTRS)

    Stanton, F. L.

    1975-01-01

    Forest Service studies for integrating remotely sensed data into existing information systems highlight a need to: (1) re-examine present methods of collecting and organizing data, (2) develop an integrated information system for rapidly processing and interpreting data, (3) apply existing technological tools in new ways, and (4) provide accurate and timely information for making right management decisions. The Forest Service developed an integrated information system using remote sensors, microdensitometers, computer hardware and software, and interactive accessories. Their efforts substantially reduce the time it takes for collecting and processing data.

  1. Parallel Process and Isomorphism: A Model for Decision Making in the Supervisory Triad

    ERIC Educational Resources Information Center

    Koltz, Rebecca L.; Odegard, Melissa A.; Feit, Stephen S.; Provost, Kent; Smith, Travis

    2012-01-01

    Parallel process and isomorphism are two supervisory concepts that are often discussed independently but rarely discussed in connection with each other. These two concepts, philosophically, have different historical roots, as well as different implications for interventions with regard to the supervisory triad. The authors examine the difference…

  2. Towards Understanding the Negotiation and Decision-Making Process of Withdrawal from College: A Qualitative Approach

    ERIC Educational Resources Information Center

    Irwin, Mary Ann

    2010-01-01

    This qualitative research project focused on the interviews of 27 low socio-economic students at a research university in the southwestern United States. The students had already withdrawn from the university or were in the process of withdrawing. The study seeks to provide increased understanding of how students negotiate the decision-making…

  3. Some implications of the technology assessment function for the effective public decision making process

    NASA Technical Reports Server (NTRS)

    Mayo, L. H.

    1975-01-01

    A study was undertaken to analyze ways in which the institutionalization of the assessment function can affect the following phases of the public decision process: problem perception, problem definition, data assembly, invention of alternatives, evaluation of options, authorization, implementation, operation, appraisal, and modification.

  4. Micromanaging Death: Process Preferences, Values, and Goals in End-of-Life Medical Decision Making

    ERIC Educational Resources Information Center

    Hawkins, Nikki Ayers; Ditto, Peter H.; Danks, Joseph H.; Smucker, William D.

    2005-01-01

    Purpose: This study examined patients' and surrogates' attitudes about using advance directives to manage end-of-life medical care. It also explored process preferences, or how patients want decisions to be made. Design and Methods: Data come from the third wave of the Advance Directives, Values Assessment, and Communication Enhancement project, a…

  5. An Examination of the Decision-Making Process Used by Designers in Multiple Disciplines

    ERIC Educational Resources Information Center

    Stefaniak, Jill E.; Tracey, Monica W.

    2014-01-01

    Design-thinking is an inductive and participatory process in which designers are required to manage constraints, generate solutions, and follow project timelines in order to complete project goals. The researchers used this exploration study to look at how designers in various disciplinary fields approach design projects. Designers were asked to…

  6. Small Employer Decision-Making with Australia's New Apprenticeship System: Process-Oriented Research.

    ERIC Educational Resources Information Center

    Rowlands, Bruce; Chappell, Clive

    2002-01-01

    A qualitative study examined 18 small and medium-sized business owners' decision to adopt or reject Australia's new apprenticeship system. Participation was based on three interconnected processes: psychological commitment, financial justification, and operational choice. Contextual elements in the internal and external environment influenced…

  7. Dual Processes in Decision Making and Developmental Neuroscience: A Fuzzy-Trace Model

    ERIC Educational Resources Information Center

    Reyna, Valerie F.; Brainerd, Charles J.

    2011-01-01

    From Piaget to the present, traditional and dual-process theories have predicted improvement in reasoning from childhood to adulthood, and improvement has been observed. However, developmental reversals--that reasoning biases emerge with development--have also been observed in a growing list of paradigms. We explain how fuzzy-trace theory predicts…

  8. Due Process and Higher Education: A Systemic Approach to Fair Decision Making. ERIC Digest.

    ERIC Educational Resources Information Center

    Stevens, Ed

    University officials and faculty are frequently required to make decisions based on interpretations of disputed facts. By applying the concept of due process within the context of higher education, they can meet legal challenges of contract and constitutional law and the pedagogical demand for justice. To guide their efforts, decision makers can…

  9. On diffusion processes with variable drift rates as models for decision making during learning

    NASA Astrophysics Data System (ADS)

    Eckhoff, P.; Holmes, P.; Law, C.; Connolly, P. M.; Gold, J. I.

    2008-01-01

    We investigate Ornstein Uhlenbeck and diffusion processes with variable drift rates as models of evidence accumulation in a visual discrimination task. We derive power-law and exponential drift-rate models and characterize how parameters of these models affect the psychometric function describing performance accuracy as a function of stimulus strength and viewing time. We fit the models to psychophysical data from monkeys learning the task to identify parameters that best capture performance as it improves with training. The most informative parameter was the overall drift rate describing the signal-to-noise ratio of the sensory evidence used to form the decision, which increased steadily with training. In contrast, secondary parameters describing the time course of the drift during motion viewing did not exhibit steady trends. The results indicate that relatively simple versions of the diffusion model can fit behavior over the course of training, thereby giving a quantitative account of learning effects on the underlying decision process.

  10. Deontological and utilitarian inclinations in moral decision making: a process dissociation approach.

    PubMed

    Conway, Paul; Gawronski, Bertram

    2013-02-01

    Dual-process theories of moral judgment suggest that responses to moral dilemmas are guided by two moral principles: the principle of deontology states that the morality of an action depends on the intrinsic nature of the action (e.g., harming others is wrong regardless of its consequences); the principle of utilitarianism implies that the morality of an action is determined by its consequences (e.g., harming others is acceptable if it increases the well-being of a greater number of people). Despite the proposed independence of the moral inclinations reflecting these principles, previous work has relied on operationalizations in which stronger inclinations of one kind imply weaker inclinations of the other kind. The current research applied Jacoby's (1991) process dissociation procedure to independently quantify the strength of deontological and utilitarian inclinations within individuals. Study 1 confirmed the usefulness of process dissociation for capturing individual differences in deontological and utilitarian inclinations, revealing positive correlations of both inclinations to moral identity. Moreover, deontological inclinations were uniquely related to empathic concern, perspective-taking, and religiosity, whereas utilitarian inclinations were uniquely related to need for cognition. Study 2 demonstrated that cognitive load selectively reduced utilitarian inclinations, with deontological inclinations being unaffected. In Study 3, a manipulation designed to enhance empathy increased deontological inclinations, with utilitarian inclinations being unaffected. These findings provide evidence for the independent contributions of deontological and utilitarian inclinations to moral judgments, resolving many theoretical ambiguities implied by previous research. PMID:23276267