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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. 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…

  17. 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…

  18. 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…

  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. 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…

  16. 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)

  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. 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…

  1. 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…

  2. 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…

  3. 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…

  4. 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…

  5. 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....

  6. 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....

  7. 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....

  8. 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....

  9. 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....

  10. 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…

  11. 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…

  12. 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,…

  13. 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…

  14. 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…

  15. 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…

  16. 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…

  17. 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.…

  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. 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

  7. 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.

  8. 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.

  9. 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

  10. 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

  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. 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.

  18. 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.

  19. 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

  20. 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

  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. 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

  15. 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.

  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

    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. 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

  20. 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

  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. 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

  15. 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

  16. 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

  17. 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

  18. 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

  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. 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…

  10. 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…

  11. 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…

  12. 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…

  13. 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…

  14. 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.…

  15. 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.…

  16. 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…

  17. 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…

  18. 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…

  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. 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…

  1. 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…

  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. 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…

  4. 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...

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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)…

  12. 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…

  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. [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

  16. 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.

  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 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

  19. 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

  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. 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

  12. 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.

  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 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

  20. 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

  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. 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…

  7. 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)

  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. 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.

  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. 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…

  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. 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…

  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. 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…

  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. 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…

  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

  11. Intensive care unit admission in chronic obstructive pulmonary disease: patient information and the physician’s decision-making process

    PubMed Central

    2014-01-01

    Introduction ICU admission is required in more than 25% of patients with chronic obstructive pulmonary disease (COPD) at some time during the course of the disease. However, only limited information is available on how physicians communicate with COPD patients about ICU admission. Methods COPD patients and relatives from 19 French ICUs were interviewed at ICU discharge about their knowledge of COPD. French pulmonologists self-reported their practices for informing and discussing intensive care treatment preferences with COPD patients. Finally, pulmonologists and ICU physicians reported barriers and facilitators for transfer of COPD patients to the ICU and to propose invasive mechanical ventilation. Results Self-report questionnaires were filled in by 126 COPD patients and 102 relatives, and 173 pulmonologists and 135 ICU physicians were interviewed. For 41% (n = 39) of patients and 54% (n = 51) of relatives, ICU admission had never been expected prior to admission. One half of patients were not routinely informed by their pulmonologist about possible ICU admission at some time during the course of COPD. Moreover, treatment options (that is, non-invasive ventilation, intubation and mechanical ventilation or tracheotomy) were not explained to COPD patients during regular pulmonologist visits. Pulmonologists and ICU physician have different perceptions of the decision-making process pertaining to ICU admission and intubation. Conclusions The information provided by pulmonologists to patients and families concerning the prognosis of COPD, the risks of ICU admission and specific care could be improved in order to deliver ICU care in accordance with the patient’s personal values and preferences. Given the discrepancies in the decision-making process between pulmonologists and intensivists, a more collaborative approach should probably be discussed. PMID:24898342

  12. Introduction of new technologies and decision making processes: a framework to adapt a Local Health Technology Decision Support Program for other local settings

    PubMed Central

    Poulin, Paule; Austen, Lea; Scott, Catherine M; Poulin, Michelle; Gall, Nadine; Seidel, Judy; Lafrenière, René

    2013-01-01

    Purpose Introducing new health technologies, including medical devices, into a local setting in a safe, effective, and transparent manner is a complex process, involving many disciplines and players within an organization. Decision making should be systematic, consistent, and transparent. It should involve translating and integrating scientific evidence, such as health technology assessment (HTA) reports, with context-sensitive evidence to develop recommendations on whether and under what conditions a new technology will be introduced. However, the development of a program to support such decision making can require considerable time and resources. An alternative is to adapt a preexisting program to the new setting. Materials and methods We describe a framework for adapting the Local HTA Decision Support Program, originally developed by the Department of Surgery and Surgical Services (Calgary, AB, Canada), for use by other departments. The framework consists of six steps: 1) development of a program review and adaptation manual, 2) education and readiness assessment of interested departments, 3) evaluation of the program by individual departments, 4) joint evaluation via retreats, 5) synthesis of feedback and program revision, and 6) evaluation of the adaptation process. Results Nine departments revised the Local HTA Decision Support Program and expressed strong satisfaction with the adaptation process. Key elements for success were identified. Conclusion Adaptation of a preexisting program may reduce duplication of effort, save resources, raise the health care providers’ awareness of HTA, and foster constructive stakeholder engagement, which enhances the legitimacy of evidence-informed recommendations for introducing new health technologies. We encourage others to use this framework for program adaptation and to report their experiences. PMID:24273415

  13. System and method for integrating hazard-based decision making tools and processes

    DOEpatents

    Hodgin, C. Reed

    2012-03-20

    A system and method for inputting, analyzing, and disseminating information necessary for identified decision-makers to respond to emergency situations. This system and method provides consistency and integration among multiple groups, and may be used for both initial consequence-based decisions and follow-on consequence-based decisions. The system and method in a preferred embodiment also provides tools for accessing and manipulating information that are appropriate for each decision-maker, in order to achieve more reasoned and timely consequence-based decisions. The invention includes processes for designing and implementing a system or method for responding to emergency situations.

  14. Design of an institutional decision-making process: the case of urban water management.

    PubMed

    Starkl, Markus; Brunner, Norbert; Flögl, Werner; Wimmer, Johann

    2009-02-01

    Urban water infrastructure expenditures cause a major financial burden to municipalities. In the opinion of many policy-makers, public funds may alleviate this burden and facilitate environmental policies. However, practice has shown that despite ambitious policies, funding often follows traditional cost-dominated thinking. In Austria, national policy-makers were interested in new guidelines for funding that increase the transparency of the planning, ensure the adequate treatment of ecological problems, and foster stakeholder involvement, but keep the process as simple as possible, and require minimal changes of the current guidelines. An interdisciplinary project team conducted such a study. Its outcome was tested in two pilot projects. Based on these experiences, policy-makers finally implemented the recommended guidelines for the funding of communal urban water infrastructure projects. A general observation about the policy-making process was a conservative attitude of policy-makers. They prefer simple constraints (precautionary principle) and flexible negotiations (delegation) to complex assessment and decision-aid methodologies. PMID:18474412

  15. To analyse a trace or not? Evaluating the decision-making process in the criminal investigation.

    PubMed

    Bitzer, Sonja; Ribaux, Olivier; Albertini, Nicola; Delémont, Olivier

    2016-05-01

    In order to broaden our knowledge and understanding of the decision steps in the criminal investigation process, we started by evaluating the decision to analyse a trace and the factors involved in this decision step. This decision step is embedded in the complete criminal investigation process, involving multiple decision and triaging steps. Considering robbery cases occurring in a geographic region during a 2-year-period, we have studied the factors influencing the decision to submit biological traces, directly sampled on the scene of the robbery or on collected objects, for analysis. The factors were categorised into five knowledge dimensions: strategic, immediate, physical, criminal and utility and decision tree analysis was carried out. Factors in each category played a role in the decision to analyse a biological trace. Interestingly, factors involving information available prior to the analysis are of importance, such as the fact that a positive result (a profile suitable for comparison) is already available in the case, or that a suspect has been identified through traditional police work before analysis. One factor that was taken into account, but was not significant, is the matrix of the trace. Hence, the decision to analyse a trace is not influenced by this variable. The decision to analyse a trace first is very complex and many of the tested variables were taken into account. The decisions are often made on a case-by-case basis. PMID:26942272

  16. Development of Energy Models for Production Systems and Processes to Inform Environmentally Benign Decision-Making

    NASA Astrophysics Data System (ADS)

    Diaz-Elsayed, Nancy

    Between 2008 and 2035 global energy demand is expected to grow by 53%. While most industry-level analyses of manufacturing in the United States (U.S.) have traditionally focused on high energy consumers such as the petroleum, chemical, paper, primary metal, and food sectors, the remaining sectors account for the majority of establishments in the U.S. Specifically, of the establishments participating in the Energy Information Administration's Manufacturing Energy Consumption Survey in 2006, the non-energy intensive" sectors still consumed 4*109 GJ of energy, i.e., one-quarter of the energy consumed by the manufacturing sectors, which is enough to power 98 million homes for a year. The increasing use of renewable energy sources and the introduction of energy-efficient technologies in manufacturing operations support the advancement towards a cleaner future, but having a good understanding of how the systems and processes function can reduce the environmental burden even further. To facilitate this, methods are developed to model the energy of manufacturing across three hierarchical levels: production equipment, factory operations, and industry; these methods are used to accurately assess the current state and provide effective recommendations to further reduce energy consumption. First, the energy consumption of production equipment is characterized to provide machine operators and product designers with viable methods to estimate the environmental impact of the manufacturing phase of a product. The energy model of production equipment is tested and found to have an average accuracy of 97% for a product requiring machining with a variable material removal rate profile. However, changing the use of production equipment alone will not result in an optimal solution since machines are part of a larger system. Which machines to use, how to schedule production runs while accounting for idle time, the design of the factory layout to facilitate production, and even the

  17. Identifying the processes underpinning anticipation and decision-making in a dynamic time-constrained task.

    PubMed

    Roca, André; Ford, Paul R; McRobert, Allistair P; Mark Williams, A

    2011-08-01

    A novel, representative task was used to examine skill-based differences in the perceptual and cognitive processes underlying performance on a dynamic, externally paced task. Skilled and less skilled soccer players were required to move and interact with life-size, action sequences involving 11 versus 11 soccer situations filmed from the perspective of a central defender in soccer. The ability of participants to anticipate the intentions of their opponents and to make decisions about how they should respond was measured across two separate experiments. In Experiment 1, visual search behaviors were examined using an eye-movement registration system. In Experiment 2, retrospective verbal reports of thinking were gathered from a new sample of skilled and less skilled participants. Skilled participants were more accurate than less skilled participants at anticipating the intentions of opponents and in deciding on an appropriate course of action. The skilled players employed a search strategy involving more fixations of shorter duration in a different sequential order and toward more disparate and informative locations in the display when compared with the less skilled counterparts. The skilled players generated a greater number of verbal report statements with a higher proportion of evaluation, prediction, and planning statements than the less skilled players, suggesting they employed more complex domain-specific memory representations to solve the task. Theoretical, methodological, and practical implications are discussed. PMID:21305386

  18. Using analytic hierarchy process approach in ontological multicriterial decision making - Preliminary considerations

    NASA Astrophysics Data System (ADS)

    Wasielewska, K.; Ganzha, M.

    2012-10-01

    In this paper we consider combining ontologically demarcated information with Saaty's Analytic Hierarchy Process (AHP) [1] for the multicriterial assessment of offers during contract negotiations. The context for the proposal is provided by the Agents in Grid project (AiG; [2]), which aims at development of an agent-based infrastructure for efficient resource management in the Grid. In the AiG project, software agents representing users can either (1) join a team and earn money, or (2) find a team to execute a job. Moreover, agents form teams, managers of which negotiate with clients and workers terms of potential collaboration. Here, ontologically described contracts (Service Level Agreements) are the results of autonomous multiround negotiations. Therefore, taking into account relatively complex nature of the negotiated contracts, multicriterial assessment of proposals plays a crucial role. The AHP method is based on pairwise comparisons of criteria and relies on the judgement of a panel of experts. It measures how well does an offer serve the objective of a decision maker. In this paper, we propose how the AHP method can be used to assess ontologically described contract proposals.

  19. 76 FR 58807 - An Assessment of Decision-Making Processes: Evaluation of Where Land Protection Planning Can...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... decision making. As part of a portfolio of adaptation strategies, land protection may become more important... climate change mitigation and adaptation. Dated: September 9, 2011. Darrell A. Winner, Acting...

  20. Shared decision making

    MedlinePlus

    ... Shared decision making to improve care and reduce costs. N Engl J Med . 2013 Jan 3;368(1):6-8. ... UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David ...

  1. Shared decision making

    MedlinePlus

    Shared decision making is when health care providers and patients work together to decide the best way to test ... you. The two of you will make a decision based on your provider's expertise and your values ...

  2. Application of an Informatics-Based Decision-Making Framework and Process to the Assessment of Radiation Safety in Nanotechnology

    DOE PAGESBeta

    Hoover, Mark D.; Myers, David S.; Cash, Leigh J.; Guilmette, Raymond A.; Kreyling, Wolfgang G.; Oberdörster, Günter; Smith, Rachel; Cassata, James R.; Boecker, Bruce B.; Grissom, Michael P.

    2015-01-01

    The National Council on Radiation Protection and Measurements (NCRP) has established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between approximately 1 and 100 nanometers, where unique phenomena enable novel applications. While the full report is in preparation, this article presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are alreadymore » present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.« less

  3. Application of an Informatics-Based Decision-Making Framework and Process to the Assessment of Radiation Safety in Nanotechnology

    SciTech Connect

    Hoover, Mark D.; Myers, David S.; Cash, Leigh J.; Guilmette, Raymond A.; Kreyling, Wolfgang G.; Oberdörster, Günter; Smith, Rachel; Cassata, James R.; Boecker, Bruce B.; Grissom, Michael P.

    2015-01-01

    The National Council on Radiation Protection and Measurements (NCRP) has established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between approximately 1 and 100 nanometers, where unique phenomena enable novel applications. While the full report is in preparation, this article presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are already present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.

  4. Curriculum Decision Making in TAFE.

    ERIC Educational Resources Information Center

    McBeath, Clare

    A study examined the decision-making stage in the curriculum development process in vocational programs throughout Australia. Data were collected from interviews from a network of persons currently involved in curriculum development and case studies of the curriculum development process in action at 16 vocational schools throughout Australia.…

  5. Assessment and limits of the existent seasonal forecasts as support for the decision making process in the Sahel

    NASA Astrophysics Data System (ADS)

    Bacci, Maurizio; Genesio, Lorenzo; di Vecchia, Andrea; Tarchiani, Vieri; Vignaroli, Patrizio

    2010-05-01

    production of new outputs translating climate forecast in impact forecast. The paper provides an assessment of the existing seasonal forecast products available for West African and highlighting the relevance of information for decision-making process. Moreover, it underlines the actual limits of the seasonal forecast products and the improvements needed to achieve more useful information for the end-user. The operational framework is the Food Crises Prevention Calendar (CPC) , which characterizes the crisis level in order to identify the appropriate information for decision makers in terms of timing, content and format. The study intend to differentiate Regional and National needs, evidencing that working at different scales is not only a resolution problem.

  6. Escharotomies, fasciotomies and carpal tunnel release in burn patients--review of the literature and presentation of an algorithm for surgical decision making.

    PubMed

    Piccolo, N S; Piccolo, M S; Piccolo, P D P; Piccolo-Daher, R; Piccolo, N D P; Piccolo, M T S

    2007-06-01

    Escharotomies are usually performed in patients with circumferential third degree burns of the extremities or anterior trunk. Fasciotomies are recommended for patients who sustained high voltage (or associated crush) injuries, with entrance or exit wounds in one or more extremities. Carpal tunnel release is practiced routinely in some services for cases of electrical injury. We have reviewed the literature which provides relatively little information as to when should these procedures actually be performed and what would happen if they were not done. We present a series of patients treated at our institution when an algorithm was used for surgical decision making as to when (or not) to operate (perform an escharotomy, a fasciotomy or a carpal tunnel release), based on clinical signs and monitoring alternatives, using the oximeter and the Doppler flowmeter. 13 938 burn patients were treated at our institution during the year of 2005. Of these, 571, with an average of 22.3 % TBSA, were treated as inpatients. Of these, 58 (10.3 %) had circumferential or electrical burns of one or more extremities. Patients were monitored hourly from admission and decision to operate was based on clinical signs and in absent or below 90 % oximetry, regardless of Doppler flow signs. 68 % were males, 6 (11.3 %) patients had immediate escharotomies, while 4 (7.5 %) had immediate fasciotomies. 2 of these patients were operated regardless of positive Doppler sign but no oximetry. All patients recovered oximetry over 90 % immediately after the operations. 3 patients had negative Doppler sign but oximetry > 90 % and were not operated. 3 patients had carpal tunnel releases based on oximetry < 90 % and symptoms of compression of the median nerve. Patients who were not operated fared well with no signs or symptoms of impairment of circulation or nerve damage up to their 3 and 6 months reevaluations. PMID:17602377

  7. Trust, regulatory processes and NICE decision-making: Appraising cost-effectiveness models through appraising people and systems.

    PubMed

    Brown, Patrick; Hashem, Ferhana; Calnan, Michael

    2016-02-01

    This article presents an ethnographic study of regulatory decision-making regarding the cost-effectiveness of expensive medicines at the National Institute for Health and Care Excellence (NICE) in England. We explored trust as one important mechanism by which problems of complexity and uncertainty were resolved. Existing studies note the salience of trust for regulatory decisions, by which the appraisal of people becomes a proxy for appraising technologies themselves. Although such (dis)trust in manufacturers was one important influence, we describe a more intricate web of (dis)trust relations also involving various expert advisors, fellow committee members and committee Chairs. Within these complex chains of relations, we found examples of both more blind-acquiescent and more critical-Investigative forms of trust as well as, at times, pronounced distrust. Difficulties in overcoming uncertainty through other means obliged trust in some contexts, although not in others. (Dis)trust was constructed through inferences involving abstract systems alongside actors' oral and written presentations-of-self. Systemic features and 'forced options' to trust indicate potential insidious processes of regulatory capture. PMID:26983173

  8. Cognitive flexibility in adolescence: neural and behavioral mechanisms of reward prediction error processing in adaptive decision making during development.

    PubMed

    Hauser, Tobias U; Iannaccone, Reto; Walitza, Susanne; Brandeis, Daniel; Brem, Silvia

    2015-01-01

    Adolescence is associated with quickly changing environmental demands which require excellent adaptive skills and high cognitive flexibility. Feedback-guided adaptive learning and cognitive flexibility are driven by reward prediction error (RPE) signals, which indicate the accuracy of expectations and can be estimated using computational models. Despite the importance of cognitive flexibility during adolescence, only little is known about how RPE processing in cognitive flexibility deviates between adolescence and adulthood. In this study, we investigated the developmental aspects of cognitive flexibility by means of computational models and functional magnetic resonance imaging (fMRI). We compared the neural and behavioral correlates of cognitive flexibility in healthy adolescents (12-16years) to adults performing a probabilistic reversal learning task. Using a modified risk-sensitive reinforcement learning model, we found that adolescents learned faster from negative RPEs than adults. The fMRI analysis revealed that within the RPE network, the adolescents had a significantly altered RPE-response in the anterior insula. This effect seemed to be mainly driven by increased responses to negative prediction errors. In summary, our findings indicate that decision making in adolescence goes beyond merely increased reward-seeking behavior and provides a developmental perspective to the behavioral and neural mechanisms underlying cognitive flexibility in the context of reinforcement learning. PMID:25234119

  9. Disparities in Water and Sewer Services in North Carolina: An Analysis of the Decision-Making Process

    PubMed Central

    Gibson, Jacqueline MacDonald

    2015-01-01

    Objectives. We examined the factors that affect access to municipal water and sewer service for unincorporated communities relying on wells and septic tanks. Methods. Using a multisite case study design, we conducted in-depth, semistructured interviews with 25 key informants from 3 unincorporated communities in Hoke, New Hanover, and Transylvania counties, North Carolina, July through September 2013. Interviewees included elected officials, health officials, utility providers, and community members. We coded the interviews in ATLAS.ti to identify common themes. Results. Financing for water and sewer service emerged as the predominant factor that influenced decisions to extend these services. Improved health emerged as a minor factor, suggesting that local officials may not place a high emphasis on the health benefits of extending public water and sewer services. Awareness of failed septic systems in communities can prompt city officials to extend sewer service to these areas; however, failed systems are often underreported. Conclusions. Understanding the health costs and benefits of water and sewer extension and integrating these findings into the local decision-making process may help address disparities in access to municipal services. PMID:26270307

  10. Factors influencing nurses' decision-making process on leaving in the peripheral intravascular catheter after 96 hours: a longitudinal study.

    PubMed

    Palese, Alvisa; Cassone, Andrea; Kulla, Annamaria; Dorigo, Sabrina; Magee, Jesse; Artico, Marco; Camero, Francesco; Cassin, Catia; Cialdella, Sandra; Floridia, Giuseppe; Nadlišek, Boris; Palcic, Annamaria; Valle, Giulia; Sclauzero, Paola

    2011-01-01

    The clinical and research debate on the peripheral intravascular (PIV) catheter length of stay in situ is ongoing. The principal aim of this study was to explore the factors behind a nurse's decision to leave a PIV in place for more than 96 hours. The study focused on 7 northern Italian hospitals in 2009. A consequent sample of 269 PIV catheters was included. Direct observation and interviews were adopted. The time of the expected PIV replacement was fixed at 96 hours after its positioning, in accordance with the international guideline. Several factors were taken into account in regard to replacement of the PIV catheters by nurses, ranging from analysis based on their own clinical experience with PIV complications and analysis of the patient's clinical situation to the critical analysis of their own work situation. This clinical decision-making process is valuable: leaving the PIV in place for more than 96 hours is a complex decision and not simply a guideline violation. PMID:21915006

  11. The FDA's decision-making process: isn't it time to temper the principle of protective paternalism?

    PubMed

    Brandt, Lawrence J

    2008-05-01

    The authors conducted a well-designed, multinational, large study of women younger than 65 yr of age with irritable bowel syndrome (IBS) with a mixed pattern of diarrhea and constipation (IBS-M) or constipation (IBS-C) and showed that a statistically greater percentage of patients in each group responded to tegaserod compared with patients treated with placebo. Practicality looms large, however, in that the Food and Drug Administration (FDA) disallowed the continued marketing of tegaserod because of cardiovascular safety concerns, and it now is only available under a restricted access program. The wisdom of this decision aside, it is disturbing that the FDA revealed a zero-tolerance for any significant risk of disease when a drug (e.g., tegaserod) was used for a nonlife-threatening condition; the FDA chose to neglect any potential benefit of significant improvement in quality of life, while at the same time allowing the continued availability of sildenifil for erectile dysfunction and other medications (e.g., rosiglitazone and nonsteroidal anti-inflammatory drugs [NSAIDs]), each with a far greater risk of cardiovascular complications. Whether tegaserod will be re-released and, if so, under what conditions, is yet to be determined, as is the question of whether the FDA will decide to allow a more transparent decision-making process with input from all interested parties affected by their decision. PMID:18477347

  12. Applying decision-making tools to national e-waste recycling policy: an example of Analytic Hierarchy Process.

    PubMed

    Lin, Chun-Hsu; Wen, Lihchyi; Tsai, Yue-Mi

    2010-05-01

    As policy making is in essence a process of discussion, decision-making tools have in many cases been proposed to resolve the differences of opinion among the different parties. In our project that sought to promote a country's performance in recycling, we used the Analytic Hierarchy Process (AHP) to evaluate the possibilities and determine the priority of the addition of new mandatory recycled waste, also referred to as Due Recycled Wastes, from candidate waste appliances. The evaluation process started with the collection of data based on telephone interviews and field investigations to understand the behavior of consumers as well as their overall opinions regarding the disposal of certain waste appliances. With the data serving as background information, the research team then implemented the Analytic Hierarchy Process using the information that formed an incomplete hierarchy structure in order to determine the priority for recycling. Since the number of objects to be evaluated exceeded the number that the AHP researchers had suggested, we reclassified the objects into four groups and added one more level of pair-wise comparisons, which substantially reduced the inconsistency in the judgment of the AHP participants. The project was found to serve as a flexible and achievable application of AHP to the environmental policy-making process. In addition, based on the project's outcomes derived from the project as a whole, the research team drew conclusions regarding the government's need to take back 15 of the items evaluated, and suggested instruments that could be used or recycling regulations that could be changed in the future. Further analysis on the top three items recommended by the results of the evaluation for recycling, namely, Compact Disks, Cellular Phones and Computer Keyboards, was then conducted to clarify their concrete feasibility. After the trial period for recycling ordered by the Taiwan Environmental Protection Administration, only Computer

  13. Experiences from active membership and participation in decision-making processes and age in moral reasoning and goal orientation of referees.

    PubMed

    Proios, Miltiadis; Doganis, George

    2003-02-01

    The purpose of the present study was to investigate the effect of experiences of active membership and participation in decision-making processes and age on moral reasoning and goal orientations of referees in sport. The sample consisted of 148 referees of whom 56 judged soccer, 55 basketball, and 37 handball. Their ages ranged from 17 to 50 years (M=36.6, SD=7.4). Of the total number of referees, 8.3% have no experiences from active membership and participation in decision-making processes in organizations (social, athletic, political), 53.1% were simply active members, and 38.6% were involved in decision-making in their respective organizations. A two-way multivariate analysis of variance showed an interaction between experiences and age on moral reasoning and goal orientation of referees. PMID:12705518

  14. Participation in Educational Decision Making.

    ERIC Educational Resources Information Center

    Lumley, Deborah D.

    1979-01-01

    The author suggests that teachers should be involved in the decision making process and that the administrator should structure meetings to generate such participation. Discussed are the National Group Technique (NGT) and the Delphi Technique as means of facilitating pooled judgments. (KC)

  15. Planning versus action: Different decision-making processes predict plans to change one's diet versus actual dietary behavior.

    PubMed

    Kiviniemi, Marc T; Brown-Kramer, Carolyn R

    2015-05-01

    Most health decision-making models posit that deciding to engage in a health behavior involves forming a behavioral intention which then leads to actual behavior. However, behavioral intentions and actual behavior may not be functionally equivalent. Two studies examined whether decision-making factors predicting dietary behaviors were the same as or distinct from those predicting intentions. Actual dietary behavior was proximally predicted by affective associations with the behavior. By contrast, behavioral intentions were predicted by cognitive beliefs about behaviors, with no contribution of affective associations. This dissociation has implications for understanding individual regulation of health behaviors and for behavior change interventions. PMID:25903243

  16. A method to assess how interactive water simulation tools influence transdisciplinary decision-making processes in water management

    NASA Astrophysics Data System (ADS)

    Leskens, Johannes

    2015-04-01

    In modern water management, often transdisciplinary work sessions are organized in which various stakeholders participate to jointly define problems, choose measures and divide responsibilities to take actions. Involved stakeholders are for example policy analysts or decision-makers from municipalities, water boards or provinces, representatives of pressure groups and researchers from knowledge institutes. Parallel to this increasing attention for transdisciplinary work sessions, we see a growing availability of interactive IT-tools that can be applied during these sessions. For example, dynamic flood risk maps have become recently available that allow users during a work sessions to instantaneously assess the impact of storm surges or dam breaches, displayed on digital maps. Other examples are serious games, realistic visualizations and participatory simulations. However, the question is if and how these interactive IT-tools contribute to better decision-making. To assess this, we take the process of knowledge construction during a work session as a measure for the quality of decision-making. Knowledge construction can be defined as the process in which ideas, perspectives and opinions of different stakeholders, all having their own expertise and experience, are confronted with each other and new shared meanings towards water management issues are created. We present an assessment method to monitor the process of knowledge construction during work sessions in water management in which interactive IT tools are being used. The assessment method is based on a literature review, focusing on studies in which knowledge construction was monitored in other contexts that water management. To test the applicability of the assessment method, we applied it during a multi-stakeholder work session in Westland, located in the southwest of the Netherlands. The discussions during the work session were observed by camera. All statements, expressed by the various members of a

  17. An Examination of the Career Development and Decision-Making Process of Female Division I Student-Athletes Attending a Mississippi Institution of Higher Learning

    ERIC Educational Resources Information Center

    Winstead, Jennifer

    2009-01-01

    The career development and decision-making process of student-athletes has been found to be a complex process (Brown, Glastetter-Fender, & Shelton, 2000; Lally & Kerr, 2005; and Sandstedt, Cox, Martens, Ward, Webber, & Ivey, 2004). Intertwined with issues not found within the general student population career development and decision-making…

  18. Decision Making in Action

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith; Statler, Irving C. (Technical Monitor)

    1994-01-01

    The importance of decision-making to safety in complex, dynamic environments like mission control centers and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. A similar observation has been made in nuclear power plants. Yet laboratory research on decision making has not proven especially helpful in improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multidimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication

  19. Processes and Factors Underlying Adolescent Males' Attitudes and Decision-Making in Relation to an Unplanned Pregnancy

    ERIC Educational Resources Information Center

    Condon, John T.; Corkindale, Carolyn J.; Russell, Alan; Quinlivan, Julie A.

    2006-01-01

    This research examined adolescent males' decision-making when confronted with a hypothetical unplanned pregnancy in a sexual partner. An innovative methodology, involving a computerized simulation game was utilized with 386 Australian males (mean age of 15 years). Data were gathered from responses made during the simulation, and questionnaires…

  20. Formal operational thinking: the role of cognitive-developmental processes in adolescent decision-making about pregnancy and contraception.

    PubMed

    Gordon, D E

    1990-07-01

    The role of formal operational thinking in adolescent decision-making about pregnancy and contraception is explored through an integration of the cognitive-developmental and pregnancy-contraception literatures. The ways in which cognitive-developmental change mechanisms initiate or hinder formal thinking on pregnancy-contraception are considered, and implications for counseling pregnant adolescents are discussed. PMID:2200271

  1. Retirement Satisfaction for Retirees and Their Spouses: Do Gender and the Retirement Decision-Making Process Matter?

    ERIC Educational Resources Information Center

    Smith, Deborah B.; Moen, Phyllis

    2004-01-01

    This study investigates factors related to retirees' and their spouses' individual and joint retirement satisfaction using decision-making theory and a life course perspective. The sample includes 421 retired respondents (ages 50 to 72) and spouses from the Cornell Retirement and Well-Being Study. Although 77% of retirees report retirement…

  2. Predicting individual differences in decision-making process from signature movement styles: an illustrative study of leaders

    PubMed Central

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

    2013-01-01

    There has been a surge of interest in examining the utility of methods for capturing individual differences in decision-making style. We illustrate the potential offered by Movement Pattern Analysis (MPA), an observational methodology that has been used in business and by the US Department of Defense to record body movements that provide predictive insight into individual differences in decision-making motivations and actions. Twelve military officers participated in an intensive 2-h interview that permitted detailed and fine-grained observation and coding of signature movements by trained practitioners using MPA. Three months later, these subjects completed four hypothetical decision-making tasks in which the amount of information sought out before coming to a decision, as well as the time spent on the tasks, were under the partial control of the subject. A composite MPA indicator of how a person allocates decision-making actions and motivations to balance both Assertion (exertion of tangible movement effort on the environment to make something occur) and Perspective (through movements that support shaping in the body to perceive and create a suitable viewpoint for action) was highly correlated with the total number of information draws and total response time—individuals high on Assertion reached for less information and had faster response times than those high on Perspective. Discussion focuses on the utility of using movement-based observational measures to capture individual differences in decision-making style and the implications for application in applied settings geared toward investigations of experienced leaders and world statesmen where individuality rules the day. PMID:24069012

  3. Designing for Decision Making

    ERIC Educational Resources Information Center

    Jonassen, David H.

    2012-01-01

    Decision making is the most common kind of problem solving. It is also an important component skill in other more ill-structured and complex kinds of problem solving, including policy problems and design problems. There are different kinds of decisions, including choices, acceptances, evaluations, and constructions. After describing the centrality…

  4. Quantitative Decision Making.

    ERIC Educational Resources Information Center

    Baldwin, Grover H.

    The use of quantitative decision making tools provides the decision maker with a range of alternatives among which to decide, permits acceptance and use of the optimal solution, and decreases risk. Training line administrators in the use of these tools can help school business officials obtain reliable information upon which to base district…

  5. Sustainability Based Decision Making

    EPA Science Inventory

    With sustainability as the “true north” for EPA research, a premium is placed on the ability to make decisions under highly complex and uncertain conditions. The primary challenge is reconciling disparate criteria toward credible and defensible decisions. Making decisions on on...

  6. Repeated Causal Decision Making

    ERIC Educational Resources Information Center

    Hagmayer, York; Meder, Bjorn

    2013-01-01

    Many of our decisions refer to actions that have a causal impact on the external environment. Such actions may not only allow for the mere learning of expected values or utilities but also for acquiring knowledge about the causal structure of our world. We used a repeated decision-making paradigm to examine what kind of knowledge people acquire in…

  7. Enhanced decision making through neuroscience

    NASA Astrophysics Data System (ADS)

    Szu, Harold; Jung, TP; Makeig, Scott

    2012-06-01

    We propose to enhance the decision making of pilot, co-pilot teams, over a range of vehicle platforms, with the aid of neuroscience. The goal is to optimize this collaborative decision making interplay in time-critical, stressful situations. We will research and measure human facial expressions, personality typing, and brainwave measurements to help answer questions related to optimum decision-making in group situations. Further, we propose to examine the nature of intuition in this decision making process. The brainwave measurements will be facilitated by a University of California, San Diego (UCSD) developed wireless Electroencephalography (EEG) sensing cap. We propose to measure brainwaves covering the whole head area with an electrode density of N=256, and yet keep within the limiting wireless bandwidth capability of m=32 readouts. This is possible because solving Independent Component Analysis (ICA) and finding the hidden brainwave sources allow us to concentrate selective measurements with an organized sparse source -->s sensing matrix [Φs], rather than the traditional purely random compressive sensing (CS) matrix[Φ].

  8. Decision Making in Educational Settings. Fastback 211.

    ERIC Educational Resources Information Center

    Sharman, Charles S.

    This booklet reviews decision-making, an important part of administrative processes, from the perspective of school teachers and other educators. The two most commonly used processes are the rational decision-making process (identify the problem, evaluate the problem, collect information, identify alternative solutions, select and implement…

  9. Teachers' Experiences with the Data-Driven Decision Making Process in Increasing Students' Reading Achievement in a Title I Elementary Public School

    ERIC Educational Resources Information Center

    Atkinson, Linton

    2015-01-01

    This paper is a research dissertation based on a qualitative case study conducted on Teachers' Experiences within a Data-Driven Decision Making (DDDM) process. The study site was a Title I elementary school in a large school district in Central Florida. Background information is given in relation to the need for research that was conducted on the…

  10. How They Decide: A Case Study Examining the Decision-Making Process for Keeping or Cutting Music in a K-12 Public School District

    ERIC Educational Resources Information Center

    Major, Marci L.

    2013-01-01

    This study was designed to examine the decision-making process for keeping or cutting the music program in one selected public school district. Lekbery School District, in the Detroit suburb of Lekbery, Michigan, had not made extreme cuts to the music program in over 10 years, nor had it specifically targeted the music program when budgets cuts…

  11. The Treatment Decision-Making Process: Age Differences in a Sample of Women Recently Diagnosed with Nonrecurrent Early-Stage Breast Cancer.

    ERIC Educational Resources Information Center

    Petrisek, Ann C.; Laliberte, Linda L.; Allen, Susan M.; Mor, Vincent

    1997-01-01

    Using retrospective, self-report data collected from women recently diagnosed with breast cancer (N=179), examines the influence of age differences in the treatment decision-making process. Findings indicate that older women were less likely than their younger counterparts to have desired participation in therapy selection or sought out medical…

  12. How They Decide: A Case Study Examining the Decision Making Process for Keeping or Cutting Music Education in a K-12 Public School District

    ERIC Educational Resources Information Center

    Major, Marci L.

    2010-01-01

    The purpose of this study was to examine and understand the decision making process for keeping or cutting music programs in one selected public school district. Berkley School District, in the Detroit suburb of Berkley, Michigan, has not made extreme cuts to the music program in over ten years, nor have they specifically targeted their music…

  13. Based on reception in general with bit-by-bit decision-making algorithm for signal processing in fiber optic telecommunication systems

    NASA Astrophysics Data System (ADS)

    Burdin, Vladimir A.; Kartashevsky, Vyacheslav G.; Grigorov, Igor V.

    2016-03-01

    This paper presents «reception in general with bit-by-bit decision-making» algorithm, which is the alternative to Viterbi algorithm. It is proposed to use it for fiber-optic transmission systems. It's features is compared with the Viterbi algorithm for digital signal processing in optical communication channels.

  14. Exploring the Decision-Making Process of Hispanic Adults to Pursue Citizenship in Siler City, North Carolina: A Narrative Analysis Using Photovoice

    ERIC Educational Resources Information Center

    Caye, Joanne Snyder

    2014-01-01

    The aim of this qualitative research study is to understand the decision-making process of Hispanic adults who have lived in the United States at least 15 years, have English as a second language, have less education than other recent immigrant waves, and have become citizens within the past four years. Narrative inquiry and photovoice were the…

  15. A Comparative Case Study of the Influence of Educational Governance Team Decision-Making Processes on District Climate and Student Achievement

    ERIC Educational Resources Information Center

    Thompson, Debra A.

    2010-01-01

    This study explored how the educational governance team, composed of the superintendent and school board, can, in their collaborative efforts and decision-making processes, influence school district climate and impact student achievement. Though in form and function, school boards have not changed much in their almost 200 years of existence,…

  16. Practice guidelines in the context of primary care, learning and usability in the physicians’ decision-making process – a qualitative study

    PubMed Central

    2014-01-01

    Background Decision-making is central for general practitioners (GP). Practice guidelines are important tools in this process but implementation of them in the complex context of primary care is a challenge. The purpose of this study was to explore how GPs approach, learn from and use practice guidelines in their day-to-day decision-making process in primary care. Method A qualitative approach using focus-group interviews was chosen in order to provide in-depth information. The participants were 22 GPs with a median of seven years of experience in primary care, representing seven primary healthcare centres in Stockholm, Sweden in 2011. The interviews focused on how the GPs use guidelines in their decision-making, factors that influence their decision how to approach these guidelines, and how they could encourage the learning process in routine practice. Data were analysed by qualitative content analysis. Meaning units were condensed and grouped in categories. After interpreting the content in the categories, themes were created. Results Three themes were conceptualized. The first theme emphasized to use guidelines by interactive contextualized dialogues. The categories underpinning this theme: 1. Feedback by peer-learning 2. Feedback by collaboration, mutual learning, and equality between specialties, identified important ways to achieve this learning dialogue. Confidence was central in the second theme, learning that establishes confidence to provide high quality care. Three aspects of confidence were identified in the categories of this theme: 1. Confidence by confirmation, 2. Confidence by reliability and 3. Confidence by evaluation of own results. In the third theme, learning by use of relevant evidence in the decision-making process, we identified two categories: 1. Design and lay-out visualizing the evidence 2. Accessibility adapted to the clinical decision-making process as prerequisites for using the practice guidelines. Conclusions Decision-making in

  17. Theoretical aspects and modelling of cellular decision making, cell killing and information-processing in photodynamic therapy of cancer

    PubMed Central

    2013-01-01

    Background The aim of this report is to provide a mathematical model of the mechanism for making binary fate decisions about cell death or survival, during and after Photodynamic Therapy (PDT) treatment, and to supply the logical design for this decision mechanism as an application of rate distortion theory to the biochemical processing of information by the physical system of a cell. Methods Based on system biology models of the molecular interactions involved in the PDT processes previously established, and regarding a cellular decision-making system as a noisy communication channel, we use rate distortion theory to design a time dependent Blahut-Arimoto algorithm where the input is a stimulus vector composed of the time dependent concentrations of three PDT related cell death signaling molecules and the output is a cell fate decision. The molecular concentrations are determined by a group of rate equations. The basic steps are: initialize the probability of the cell fate decision, compute the conditional probability distribution that minimizes the mutual information between input and output, compute the cell probability of cell fate decision that minimizes the mutual information and repeat the last two steps until the probabilities converge. Advance to the next discrete time point and repeat the process. Results Based on the model from communication theory described in this work, and assuming that the activation of the death signal processing occurs when any of the molecular stimulants increases higher than a predefined threshold (50% of the maximum concentrations), for 1800s of treatment, the cell undergoes necrosis within the first 30 minutes with probability range 90.0%-99.99% and in the case of repair/survival, it goes through apoptosis within 3-4 hours with probability range 90.00%-99.00%. Although, there is no experimental validation of the model at this moment, it reproduces some patterns of survival ratios of predicted experimental data. Conclusions

  18. Toward sustainability: a case study demonstrating transdisciplinary learning through the selection and use of indicators in a decision-making process.

    PubMed

    Stahl, Cynthia; Cimorelli, Alan; Mazzarella, Christine; Jenkins, Bill

    2011-07-01

    The purpose of this article is to use a case study example to demonstrate how a transparent, transdisciplinary approach to decision making allows the US Environmental Protection Agency Region III (USEPA Region III) to fulfill its decision-making responsibilities while taking critical steps toward engaging in sustainability discussions. The case study goals were to use information about environmental condition to inform staff and fiscal resource prioritization and allocation for the federal 2010 fiscal year. This article will use a select group of 3 indicators to show 1) that data are not the same as indicators, 2) the feasibility of using disparate data in the same analysis, and 3) specific discussions about indicators can lead to transdisciplinary learning, supporting more informed decision making. We show that, when used in a transdisciplinary learning process, these indicator lessons provide a stepping stone for organizations like USEPA Region III to consider sustainability as more than just a lofty, ethical concept. Instead, these kinds of organizations can more routinely and substantively address sustainability through a progression of individual decisions. We discuss how sustainability can be linked to decision making through a process that requires stakeholders to articulate and confront their values. In this process, selecting indicators and understanding what those choices imply regarding the issues that are highlighted and the population affected is part of the assessment of environmental condition, which is the focus of the case study. PMID:21309078

  19. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  20. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  1. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  2. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  3. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  4. Group performance and decision making.

    PubMed

    Kerr, Norbert L; Tindale, R Scott

    2004-01-01

    Theory and research on small group performance and decision making is reviewed. Recent trends in group performance research have found that process gains as well as losses are possible, and both are frequently explained by situational and procedural contexts that differentially affect motivation and resource coordination. Research has continued on classic topics (e.g., brainstorming, group goal setting, stress, and group performance) and relatively new areas (e.g., collective induction). Group decision making research has focused on preference combination for continuous response distributions and group information processing. New approaches (e.g., group-level signal detection) and traditional topics (e.g., groupthink) are discussed. New directions, such as nonlinear dynamic systems, evolutionary adaptation, and technological advances, should keep small group research vigorous well into the future. PMID:14744229

  5. Writing as decision-making

    NASA Technical Reports Server (NTRS)

    Souther, J. W.

    1981-01-01

    The need to teach informational writing as a decision-making process is discussed. Situational analysis, its relationship to decisions in writing, and the need for relevant assignments are considered. Teaching students to ask the right questions is covered. The need to teach writing responsiveness is described. Three steps to get started and four teaching techniques are described. The information needs of the 'expert' and the 'manager' are contrasted.

  6. Decision Making: Rational, Nonrational, and Irrational.

    ERIC Educational Resources Information Center

    Simon, Herbert A.

    1993-01-01

    Describes the current state of knowledge about human decision-making and problem-solving processes, explaining recent developments and their implications for management and management training. Rational goal-setting is the key to effective decision making and accomplishment. Bounded rationality is a realistic orientation, because the world is too…

  7. Decision Making: New Paradigm for Education.

    ERIC Educational Resources Information Center

    Wales, Charles E.; And Others

    1986-01-01

    Defines education's new paradigm as schooling based on decision making, the critical thinking skills serving it, and the knowledge base supporting it. Outlines a model decision-making process using a hypothetical breakfast problem; a late riser chooses goals, generates ideas, develops an action plan, and implements and evaluates it. (4 references)…

  8. The process of processing: exploring the validity of Neisser's perceptual cycle model with accounts from critical decision-making in the cockpit.

    PubMed

    Plant, Katherine L; Stanton, Neville A

    2015-01-01

    The perceptual cycle model (PCM) has been widely applied in ergonomics research in domains including road, rail and aviation. The PCM assumes that information processing occurs in a cyclical manner drawing on top-down and bottom-up influences to produce perceptual exploration and actions. However, the validity of the model has not been addressed. This paper explores the construct validity of the PCM in the context of aeronautical decision-making. The critical decision method was used to interview 20 helicopter pilots about critical decision-making. The data were qualitatively analysed using an established coding scheme, and composite PCMs for incident phases were constructed. It was found that the PCM provided a mutually exclusive and exhaustive classification of the information-processing cycles for dealing with critical incidents. However, a counter-cycle was also discovered which has been attributed to skill-based behaviour, characteristic of experts. The practical applications and future research questions are discussed. Practitioner Summary: This paper explores whether information processing, when dealing with critical incidents, occurs in the manner anticipated by the perceptual cycle model. In addition to the traditional processing cycle, a reciprocal counter-cycle was found. This research can be utilised by those who use the model as an accident analysis framework. PMID:25529547

  9. An ABC for decision making.

    PubMed

    Garcia, Luiz Henrique Costa; Ferreira, Bruna Cortez

    2015-01-01

    The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations. PMID:25987751

  10. An ABC for decision making*

    PubMed Central

    Garcia, Luiz Henrique Costa; Ferreira, Bruna Cortez

    2015-01-01

    The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations. PMID:25987751

  11. The Sweet-Home project: audio processing and decision making in smart home to improve well-being and reliance.

    PubMed

    Vacher, Michel; Chahuara, Pedro; Lecouteux, Benjamin; Istrate, Dan; Portet, Francois; Joubert, Thierry; Sehili, Mohamed; Meillon, Brigitte; Bonnefond, Nicolas; Fabre, Sébastien; Roux, Camille; Caffiau, Sybille

    2013-01-01

    The Sweet-Home project aims at providing audio-based interaction technology that lets the user have full control over their home environment, at detecting distress situations and at easing the social inclusion of the elderly and frail population. This paper presents an overview of the project focusing on the implemented techniques for speech and sound recognition as context-aware decision making with uncertainty. A user experiment in a smart home demonstrates the interest of this audio-based technology. PMID:24111430

  12. Acquisition and integration of low vision assistive devices: understanding the decision-making process of older adults with low vision.

    PubMed

    Copolillo, Al; Teitelman, Jodi L

    2005-01-01

    The purpose of this study was to describe how older adults with low vision make decisions to use low vision assistive devices (LVADs). Analysis of participants' narratives, from both group and individual interviews, revealed three topic areas affecting device use. Two are discussed in this paper: Experiences and Characteristics Leading to Successful LVAD Use Decision Making and Challenges to Successful LVAD Use Decision Making. The third, Adjustment to Low Vision Disability, is briefly discussed. Of particular importance to occupational therapy practitioners in the growing field of low vision rehabilitation was the value placed on low vision rehabilitation services to assist with acquiring devices and integrating them into daily routines. Occupational therapy services were highly regarded. Participants demonstrated the importance of becoming a part of a supportive network of people with low vision to gain access to information about resources. They emphasized the need for systems and policy changes to reduce barriers to making informed decisions about LVAD use. Results indicate that occupational therapists working in low vision can support clients by facilitating development of a support network, acting as liaisons between clients and other health practitioners, especially ophthalmologists, and encouraging policy development that supports barrier-free LVAD acquisition and use. These topics should be incorporated into continuing and entry-level education to prepare practitioners for leadership in the field of low vision rehabilitation. PMID:15969278

  13. Narrative message targets within the decision-making process to undergo screening colonoscopy among Latinos: a qualitative study.

    PubMed

    Hennelly, Marie Oliva; Sly, Jamilia R; Villagra, Cristina; Jandorf, Lina

    2015-06-01

    Colorectal cancer (CRC) is a preventable yet leading cause of cancer mortality among Latinos in the USA. Cultural targeting and narrative messaging are two strategies to increase the low screening colonoscopy rates among Latinos. This study identifies key messages for educational interventions aiming to increase screening colonoscopy used among Latinos and proposes a model to understand the relationship between factors involved in colonoscopy decision-making. Individual in-depth interviews were conducted with 12 Latino participants primarily of Puerto Rican descent on the topics of CRC knowledge, barriers and facilitators to colonoscopy use, and the use of narrative in colorectal health messaging. Knowledge about colorectal anatomy and the anesthesia component of colonoscopy procedure is low. Fear of procedure-related pain and fear of treatment-related burden following a cancer diagnosis are significant barriers to colonoscopy. Fear of disease-related suffering and death following a cancer diagnosis and fear of regret are strong facilitators and can be augmented by cancer narratives. Storytelling is commonly used in Latino culture and is an acceptable method to educate the Latino community about CRC screening via colonoscopy. Machismo is a unique barrier to colonoscopy for Latino men via homophobia and reluctance to seek healthcare. A preliminary model to understand factors in colonoscopy decision-making among Latinos is presented. Counseling practices and educational interventions that use culturally targeted narrative health messaging to mediate fears and increase colonoscopy knowledge may increase screening colonoscopy use among Latinos. PMID:25516413

  14. Pharmacoeconomics and formulary decision making.

    PubMed

    Sanchez, L A

    1996-01-01

    Pharmacoeconomic assessment of formulary actions has become increasingly common in local, national, and international formulary decision making. Tactics for managing medication use include formulary management and drug policies. Pharmacoeconomic data can provide support for these formulary decisions. For example, pharmacoeconomic data can support the inclusion or exclusion of a drug on or from the formulary and support practice guidelines that promote the most cost-effective or appropriate utilisation of pharmaceutical products. Various strategies can be used to incorporate pharmacoeconomics into formulary decision making. These include using published pharmacoeconomic studies and economic modelling techniques, and conducting local pharmacoeconomic research. Criteria for evaluating the pharmacoeconomic literature, suggestions for employing economic models, and suggested guidelines for conducting pharmacoeconomic projects are discussed. Although most formularies are viewed as cost-containment tools, formularies should not be a list of the 'cheapest' alternatives. Today's formulary should contain agents that optimise therapeutic outcomes while controlling cost. Pharmacoeconomic assessments of formulary decisions help to ensure that the agents promoted by our formularies yield the highest outcome per dollar spent. A discussion of the process for formulary action in a US hospital, the influence of pharmacoeconomics on US formularies, and strategies for incorporating pharmacoeconomics into formulary decision making are presented in this paper. PMID:10160112

  15. Reasoning, decision making and rationality.

    PubMed

    Evans, J S; Over, D E; Manktelow, K I

    1993-01-01

    It is argued that reasoning in the real world supports decision making and is aimed at the achievement of goals. A distinction is developed between two notions of rationality: rationality which is reasoning in such a way as to achieve one's goals--within cognitive constraints--and rationality which is reasoning by a process of logic. This dichotomy is related to the philosophical distinction between practical and theoretical reasoning. It is argued that logicality (rationality) does not provide a good basis for rationality and some psychological research on deductive reasoning is re-examined in this light. First, we review belief bias effects in syllogistic reasoning, and argue that the phenomena do not support the interpretations of irrationality that are often placed upon them. Second, we review and discuss recent studies of deontic reasoning in the Wason selection task, which demonstrate the decision making, and rational nature of reasoning in realistic contexts. The final section of the paper examines contemporary decision theory and shows how it fails, in comparable manner to formal logic, to provide an adequate model for assessing the rationality of human reasoning and decision making. PMID:8287673

  16. Somatic markers, working memory, and decision making.

    PubMed

    Hinson, John M; Jameson, Tina L; Whitney, Paul

    2002-12-01

    The somatic marker hypothesis formulated by Damasio (e.g., 1994; Damasio, Tranel, & Damasio, 1991) argues that affective reactions ordinarily guide and simplify decision making. Although originally intended to explain decision-making deficits in people with specific frontal lobe damage, the hypothesis also applies to decision-making problems in populations without brain injury. Subsequently, the gambling task was developed by Bechara (Bechara, Damasio, Damasio, & Anderson, 1994) as a diagnostic test of decision-making deficit in neurological populations. More recently, the gambling task has been used to explore implications of the somatic marker hypothesis, as well as to study suboptimal decision making in a variety of domains. We examined relations among gambling task decision making, working memory (WM) load, and somatic markers in a modified version of the gambling task. Increased WM load produced by secondary tasks led to poorer gambling performance. Declines in gambling performance were associated with the absence of the affective reactions that anticipate choice outcomes and guide future decision making. Our experiments provide evidence that WM processes contribute to the development of somatic markers. If WM functioning is taxed, somatic markers may not develop, and decision making may thereby suffer. PMID:12641178

  17. Joint federal research and development process to meet state and local needs. Part 1. Science and technology and political decision making

    SciTech Connect

    Wise, H F; Smith, L K; Einsweiler, R C; Jensen, D E

    1980-10-01

    This part of the handbook addresses the basic how to do it - how states and local governments can identify complex and cross-cutting issues and develop and manage scientific and technical resources in seeking policy solutions to such issues. The following subjects are discussed: background statement of the issue; the research/decision-making process; defining problems and identifying research components; research and decision-making strategies; how to identify existing knowledge or ongoing research in the area of policy concern; and managing multi-disciplinary research. The fourteen agencies involved in this effort include: US Departments of Energy, Agriculture, Transportation, Housing and Urban Development, Environmental Protection Agency, and National Science Foundation. (PSB)

  18. Subsurface characterization of groundwater contaminated by landfill leachate using microbial community profile data and a nonparametric decision-making process

    NASA Astrophysics Data System (ADS)

    Pearce, Andrea R.; Rizzo, Donna M.; Mouser, Paula J.

    2011-06-01

    Microbial biodiversity in groundwater and soil presents a unique opportunity for improving characterization and monitoring at sites with multiple contaminants, yet few computational methods use or incorporate these data because of their high dimensionality and variability. We present a systematic, nonparametric decision-making methodology to help characterize a water quality gradient in leachate-contaminated groundwater using only microbiological data for input. The data-driven methodology is based on clustering a set of molecular genetic-based microbial community profiles. Microbes were sampled from groundwater monitoring wells located within and around an aquifer contaminated with landfill leachate. We modified a self-organizing map (SOM) to weight the input variables by their relative importance and provide statistical guidance for classifying sample similarities. The methodology includes the following steps: (1) preprocessing the microbial data into a smaller number of independent variables using principal component analysis, (2) clustering the resulting principal component (PC) scores using a modified SOM capable of weighting the input PC scores by the percent variance explained by each score, and (3) using a nonparametric statistic to guide selection of appropriate groupings for management purposes. In this landfill leachate application, the weighted SOM assembles the microbial community data from monitoring wells into groupings believed to represent a gradient of site contamination that could aid in characterization and long-term monitoring decisions. Groupings based solely on microbial classifications are consistent with classifications of water quality from hydrochemical information. These microbial community profile data and improved decision-making strategy compliment traditional chemical groundwater analyses for delineating spatial zones of groundwater contamination.

  19. Aging and consumer decision making

    PubMed Central

    Carpenter, Stephanie M.; Yoon, Carolyn

    2013-01-01

    Research on consumer decision making and aging is especially important for fostering a better understanding of ways to maintain consumer satisfaction and high decision quality across the life span. We provide a review of extant research on the effects of normal aging on cognition and decision processes and how these age-related processes are influenced by task environment, meaningfulness of the task, and consumer expertise. We consider how research centered on these topics generates insights about changes in consumption decisions that occur with aging and identify a number of gaps and directions for future research. PMID:22360794

  20. Argumentation for Decision Making

    NASA Astrophysics Data System (ADS)

    Amgoud, Leila

    Decision making, often viewed as a form of reasoning toward action, has raised the interest of many scholars including economists, psychologists, and computer scientists for a long time. Any decision problem amounts to selecting the “best” or sufficiently “good” action(s) that are feasible among different alternatives, given some available information about the current state of the world and the consequences of potential actions. Available information may be incomplete or pervaded with uncertainty. Besides, the goodness of an action is judged by estimating how much its possible consequences fit the preferences of the decision maker. This agent is assumed to behave in a rational way [29] amgoud-woold, at least in the sense that his decisions should be as much as possible consistent with his preferences.

  1. Ethical issues in communication of diagnosis and end-of-life decision-making process in some of the Romanian Roma communities.

    PubMed

    Roman, Gabriel; Enache, Angela; Pârvu, Andrada; Gramma, Rodica; Moisa, Ştefana Maria; Dumitraş, Silvia; Ioan, Beatrice

    2013-08-01

    Medical communication in Western-oriented countries is dominated by concepts of shared decision-making and patient autonomy. In interactions with Roma patients, these behavioral patterns rarely seem to be achieved because the culture and ethnicity have often been shown as barriers in establishing an effective and satisfying doctor-patient relationship. The study aims to explore the Roma's beliefs and experiences related to autonomy and decision-making process in the case of a disease with poor prognosis. Forty-eight Roma people from two Romanian counties participated in semi-structured interviews, conducted by a research team from the University of Medicine and Pharmacy of Iasi. Participants were recruited among the chronically ill patients and caregivers. The Roma community opposes informing the terminal patients about their condition, the "silence conspiracy" being widely practiced. The family fully undertakes the right of decision making, thus minimizing the patient's autonomy. We identified ethical dilemmas concerning autonomy, lack of patients' real decision-making power, and paternalistic attitudes exerted firstly by the family and, on demand, by the physician. Instead, the Roma patient benefits from a very active support network, being accompanied at the hospital by numerous relatives. The patient's right to make autonomous decisions promoted in the Western countries and stipulated by the Romanian law has diminished value in the Roma community. For the Roma, the understanding of dignity is not simply individual and personal, but it is closely related to their cultural particularities. Ignoring their cultural values could create conflicts between healthcare providers and community. PMID:22752639

  2. Modelling decision-making by pilots

    NASA Technical Reports Server (NTRS)

    Patrick, Nicholas J. M.

    1993-01-01

    Our scientific goal is to understand the process of human decision-making. Specifically, a model of human decision-making in piloting modern commercial aircraft which prescribes optimal behavior, and against which we can measure human sub-optimality is sought. This model should help us understand such diverse aspects of piloting as strategic decision-making, and the implicit decisions involved in attention allocation. Our engineering goal is to provide design specifications for (1) better computer-based decision-aids, and (2) better training programs for the human pilot (or human decision-maker, DM).

  3. From Career Decision-Making Styles to Career Decision-Making Profiles: A Multidimensional Approach

    ERIC Educational Resources Information Center

    Gati, Itamar; Landman, Shiri; Davidovitch, Shlomit; Asulin-Peretz, Lisa; Gadassi, Reuma

    2010-01-01

    Previous research on individual differences in career decision-making processes has often focused on classifying individuals into a few types of decision-making "styles" based on the most dominant trait or characteristic of their approach to the decision process (e.g., rational, intuitive, dependent; Harren, 1979). In this research, an alternative…

  4. Political anticipation: observing and understanding global socio-economic trends with a view to guide the decision-making processes

    NASA Astrophysics Data System (ADS)

    Caillol, Marie-Hélène

    2012-01-01

    Political anticipation (PA), as practiced by Laboratoire Européen d'Anticipation Politique, is a method for improving the capacity to understand trends and forecast events with the aim of influencing events on a large or small scale. Our operational definition of anticipation is 'To foresee in order to act.' Intended to be efficient and of immediate use, PA is conceived as a decision-making tool for all types of decision-makers: politicians, economists, administrators, business leaders, private investors, educators, as well as heads of households. Everyone, in a professional or private role, makes important decisions (for employees, for business operations and commerce, for family, for investments, for jurisdictions, and for the country and economic zone, among other areas in which the polis is involved). Given the dynamics of reality in our times, every decision appears as a wager on the future. It is also related to the wish or desire to obtain the best outcome for risk assumed (which a wager entails) and the effort expended.

  5. Evidence-based process for decision-making in the analysis of legal demands for medicines in Brazil.

    PubMed

    Figueiredo, Tatiana Aragão; Osorio-de-Castro, Claudia Garcia Serpa; Pepe, Vera Lúcia Edais

    2013-11-01

    Legal actions have been playing a significant role as an alternative pathway to access to medicines in Brazil. These lawsuits demand medicines used in Primary Health Care as well as medicines that are still in clinical research and have not been market approved by the Brazilian National Agency for Sanitary Surveillance (ANVISA). The goal was to analyze medicines demanded through lawsuits brought to the judicial district which includes the city of Rio de Janeiro, Brazil, from July/2007 to June/2008. The medicines in 281 lawsuits were examined for their respective indications, classified according to their presence in publicly-funded lists, market approval by ANVISA, compliance with national clinical guidelines, existence of alternative therapies in lists and support of indication by scientific evidence. Six different categories were described, which are deemed useful to managers and the Judiciary in decision-making. The support of evidence is of utmost importance for medicines that are not included in public funding lists and also for those with no available therapeutic alternatives. PMID:25402244

  6. A Web-Based Tool to Support Shared Decision Making for People With a Psychotic Disorder: Randomized Controlled Trial and Process Evaluation

    PubMed Central

    Emerencia, Ando C; Boonstra, Nynke; Wunderink, Lex; de Jonge, Peter; Sytema, Sjoerd

    2013-01-01

    Background Mental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes. Objective This study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders. Methods The study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. Results In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions

  7. The role of economic evaluation in the decision-making process of family physicians: design and methods of a qualitative embedded multiple-case study

    PubMed Central

    Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

    2009-01-01

    Background A considerable amount of resource allocation decisions take place daily at the point of the clinical encounter; especially in primary care, where 80 percent of health problems are managed. Ignoring economic evaluation evidence in individual clinical decision-making may have a broad impact on the efficiency of health services. To date, almost all studies on the use of economic evaluation in decision-making used a quantitative approach, and few investigated decision-making at the clinical level. An important question is whether economic evaluations affect clinical practice. The project is an intervention research study designed to understand the role of economic evaluation in the decision-making process of family physicians (FPs). The contributions of the project will be from the perspective of Pierre Bourdieu's sociological theory. Methods/design A qualitative research strategy is proposed. We will conduct an embedded multiple-case study design. Ten case studies will be performed. The FPs will be the unit of analysis. The sampling strategies will be directed towards theoretical generalization. The 10 selected cases will be intended to reflect a diversity of FPs. There will be two embedded units of analysis: FPs (micro-level of analysis) and field of family medicine (macro-level of analysis). The division of the determinants of practice/behaviour into two groups, corresponding to the macro-structural level and the micro-individual level, is the basis for Bourdieu's mode of analysis. The sources of data collection for the micro-level analysis will be 10 life history interviews with FPs, documents and observational evidence. The sources of data collection for the macro-level analysis will be documents and 9 open-ended, focused interviews with key informants from medical associations and academic institutions. The analytic induction approach to data analysis will be used. A list of codes will be generated based on both the original framework and new themes

  8. The Impact of PPBS on Educational Decision Making

    ERIC Educational Resources Information Center

    Rajcic, John M.

    1976-01-01

    Attempts a brief analysis of the traditional decision-making process for budget preparation and the alternative, program planning, budgeting system (PPBS), in an effort to determine the effect of PPBS on the decision-making process for resource allocation and to answer the question of whether PPBS has improved decision-making processes. (Author/RK)

  9. [Decision making in cannabis users].

    PubMed

    Alameda Bailén, Jose Ramón; Paíno Quesada, Susana; Mogedas Valladares, Ana Isabel

    2012-01-01

    Several neuropsychological studies have shown that chronic cannabis users have cognitive impairments, including decision-making process. Therefore, this study aims to evaluate the process, through the somatic marker hypothesis in a sample of 41 cannabis users compared with a control group of equal size, and to analyze the influence of age, sex, education level, age of onset and amount of daily consumption. In order to do that, the software "Cartas" (similar to the Iowa Gambling Task), was used, implementing its two versions: normal and reverse. The results show significant differences between cannabis users and control group in the normal and reverse task execution. By block analysis, the control group obtained higher scores in the normal task execution, however, in the reverse task, the differences between groups are present in the initial task execution but not final task execution. None of the analyzed variables (age, sex ...) are significantly related to task performance. These results suggest the existence of alterations in the decision making process of consumers cannabis, which may relate to the difficulty in generating somatic markers, and not for insensitivity punishments insensitivity. PMID:22648319

  10. The decision-making process of genetically at-risk couples considering preimplantation genetic diagnosis: initial findings from a grounded theory study.

    PubMed

    Hershberger, Patricia E; Gallo, Agatha M; Kavanaugh, Karen; Olshansky, Ellen; Schwartz, Alan; Tur-Kaspa, Ilan

    2012-05-01

    Exponential growth in genomics has led to public and private initiatives worldwide that have dramatically increased the number of procreative couples who are aware of their ability to transmit genetic disorders to their future children. Understanding how couples process the meaning of being genetically at-risk for their procreative life lags far behind the advances in genomic and reproductive sciences. Moreover, society, policy makers, and clinicians are not aware of the experiences and nuances involved when modern couples are faced with using Preimplantation Genetic Diagnosis (PGD). The purpose of this study was to discover the decision-making process of genetically at-risk couples as they decide whether to use PGD to prevent the transmission of known single-gene or sex-linked genetic disorders to their children. A qualitative, grounded theory design guided the study in which 22 couples (44 individual partners) from the USA, who were actively considering PGD, participated. Couples were recruited from June 2009 to May 2010 from the Internet and from a large PGD center and a patient newsletter. In-depth semi-structured interviews were completed with each individual partner within the couple dyad, separate from their respective partner. We discovered that couples move through four phases (Identify, Contemplate, Resolve, Engage) of a complex, dynamic, and iterative decision-making process where multiple, sequential decisions are made. In the Identify phase, couples acknowledge the meaning of their at-risk status. Parenthood and reproductive options are explored in the Contemplate phase, where 41% of couples remained for up to 36 months before moving into the Resolve phase. In Resolve, one of three decisions about PGD use is reached, including: Accepting, Declining, or Oscillating. Actualizing decisions occur in the Engage phase. Awareness of the decision-making process among genetically at-risk couples provides foundational work for understanding critical processes

  11. Neurocognitive enhancement or impairment? A systematic meta-analysis of prescription stimulant effects on processing speed, decision-making, planning, and cognitive perseveration.

    PubMed

    Marraccini, Marisa E; Weyandt, Lisa L; Rossi, Joseph S; Gudmundsdottir, Bergljot Gyda

    2016-08-01

    Increasing numbers of adults, particularly college students, are misusing prescription stimulants primarily for cognitive/academic enhancement, so it is critical to explore whether empirical findings support neurocognitive benefits of prescription stimulants. Previous meta-analytic studies have supported small benefits from prescription stimulants for the cognitive domains of inhibitory control and memory; however, no meta-analytic studies have examined the effects on processing speed or the potential impairment on other domains of cognition, including planning, decision-making, and cognitive perseveration. Therefore, the present study conducted a meta-analysis of the available literature examining the effects of prescription stimulants on specific measures of processing speed, planning, decision-making, and cognitive perseveration among healthy adult populations. The meta-analysis results indicated a positive influence of prescription stimulant medication on processing speed accuracy, with an overall mean effect size of g = 0.282 (95% CI [0.077, 0.488]; n = 345). Neither improvements nor impairments were revealed for planning time, planning accuracy, advantageous decision-making, or cognitive perseveration; however, findings are limited by the small number of studies examining these outcomes. Findings support that prescription stimulant medication may indeed act as a neurocognitive enhancer for accuracy measures of processing speed without impeding other areas of cognition. Considering that adults are already engaging in illegal use of prescription stimulants for academic enhancement, as well as the potential for stimulant misuse to have serious side effects, the establishment of public policies informed by interdisciplinary research surrounding this issue, whether restrictive or liberal, is of critical importance. (PsycINFO Database Record PMID:27454675

  12. Optimization of the decision-making process for the selection of therapeutics to undergo clinical testing for spinal cord injury in the North American Clinical Trials Network.

    PubMed

    Guest, James; Harrop, James S; Aarabi, Bizhan; Grossman, Robert G; Fawcett, James W; Fehlings, Michael G; Tator, Charles H

    2012-09-01

    The North American Clinical Trials Network (NACTN) includes 9 clinical centers funded by the US Department of Defense and the Christopher Reeve Paralysis Foundation. Its purpose is to accelerate clinical testing of promising therapeutics in spinal cord injury (SCI) through the development of a robust interactive infrastructure. This structure includes key committees that serve to provide longitudinal guidance to the Network. These committees include the Executive, Data Management, and Neurological Outcome Assessments Committees, and the Therapeutic Selection Committee (TSC), which is the subject of this manuscript. The NACTN brings unique elements to the SCI field. The Network's stability is not restricted to a single clinical trial. Network members have diverse expertise and include experts in clinical care, clinical trial design and methodology, pharmacology, preclinical and clinical research, and advanced rehabilitation techniques. Frequent systematic communication is assigned a high value, as is democratic process, fairness and efficiency of decision making, and resource allocation. This article focuses on how decision making occurs within the TSC to rank alternative therapeutics according to 2 main variables: quality of the preclinical data set, and fit with the Network's aims and capabilities. This selection process is important because if the Network's resources are committed to a therapeutic, alternatives cannot be pursued. A proposed methodology includes a multicriteria decision analysis that uses a Multi-Attribute Global Inference of Quality matrix to quantify the process. To rank therapeutics, the TSC uses a series of consensus steps designed to reduce individual and group bias and limit subjectivity. Given the difficulties encountered by industry in completing clinical trials in SCI, stable collaborative not-for-profit consortia, such as the NACTN, may be essential to clinical progress in SCI. The evolution of the NACTN also offers substantial

  13. An Anti-Introspectivist View of Career Decision Making.

    ERIC Educational Resources Information Center

    Krieshok, Thomas S.

    1998-01-01

    Reviews 50 years of empirical literature on career decision making, summarizing 10 things the field knows "for sure." Presents an anti-introspectivist view of career decision making arguing that mental processing for decision making and behavior initiation is not performed at a conscious level and reflection on these processes may be detrimental…

  14. Intergroup Conflict and Rational Decision Making

    PubMed Central

    Martínez-Tur, Vicente; Peñarroja, Vicente; Serrano, Miguel A.; Hidalgo, Vanesa; Moliner, Carolina; Salvador, Alicia; Alacreu-Crespo, Adrián; Gracia, Esther; Molina, Agustín

    2014-01-01

    The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict –associated with indicators of the activation of negative feelings (negative affect state and heart rate)– has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making. PMID:25461384

  15. Principles and guidelines for the development of a science-based decision making process facilitating the implementation of the 3Rs by governmental regulators.

    PubMed

    Gauthier, Clément

    2002-01-01

    National government establishments, including regulatory agencies, are part of national science systems, which are a subset of larger national innovation systems. The forces that have influenced the basic roles of national government establishments in five countries over the past 10 yr are reviewed on the basis of a study commissioned by Industry Canada in 1999 for the Council of Science and Technology Advisors to the Canadian government. The most significant response among countries has been found to be the financial and managerial restructuring of government science and technology establishments driven by the push toward self-financing. Trends in the roles of government science and technology in six areas are also ranked, with increasing the health and safety of the nation, providing support to industry and participating in international cooperation occupying the first three positions. Potential ramifications of these trends on the implementation of the concept of replacement, reduction, and refinement (the 3Rs) in ensuring the ethical use of animals in regulatory testing are discussed. Science advice and its role in governmental decision making is reviewed on the basis of the 1999 Report of the Council of Science and Technology Advisors, Science Advice for Government Effectiveness. Six principles developed for the effective use of science advice in making regulatory decision have been adapted and are proposed with accompanying guidelines as a framework for the development of a science-based decision making process to facilitate the implementation of the 3Rs by governmental regulators. The proposed series of principles and guidelines are designed to reflect the rapidly evolving and complex context for government decision making, and to remain consistent across government departments and across nations. PMID:12388860

  16. Group Dynamics and Decision Making: Backcountry Recreationists in Avalanche Terrain

    ERIC Educational Resources Information Center

    Bright, Leslie Shay

    2010-01-01

    The purpose of this study was to describe and determine the prevalence of decision-making characteristics of recreational backcountry groups when making a decision of where to travel and ride in avalanche terrain from the perspective of individuals. Decision-making characteristics encompassed communication, decision-making processes, leadership,…

  17. Decision Making and Schools for the 70's.

    ERIC Educational Resources Information Center

    Pharis, William L.; And Others

    The authors of this volume divide their consideration of decision-making into three major areas: 1) a step-by-step analysis for a systematic decision-making process that has widespread application; 2) an explicit description of the legal and extralegal components of the current decision-making structure; and 3) a review of some changing concepts…

  18. Decision making in family medicine

    PubMed Central

    Labrecque, Michel; Ratté, Stéphane; Frémont, Pierre; Cauchon, Michel; Ouellet, Jérôme; Hogg, William; McGowan, Jessie; Gagnon, Marie-Pierre; Njoya, Merlin; Légaré, France

    2013-01-01

    Abstract Objective To compare the ability of users of 2 medical search engines, InfoClinique and the Trip database, to provide correct answers to clinical questions and to explore the perceived effects of the tools on the clinical decision-making process. Design Randomized trial. Setting Three family medicine units of the family medicine program of the Faculty of Medicine at Laval University in Quebec city, Que. Participants Fifteen second-year family medicine residents. Intervention Residents generated 30 structured questions about therapy or preventive treatment (2 questions per resident) based on clinical encounters. Using an Internet platform designed for the trial, each resident answered 20 of these questions (their own 2, plus 18 of the questions formulated by other residents, selected randomly) before and after searching for information with 1 of the 2 search engines. For each question, 5 residents were randomly assigned to begin their search with InfoClinique and 5 with the Trip database. Main outcome measures The ability of residents to provide correct answers to clinical questions using the search engines, as determined by third-party evaluation. After answering each question, participants completed a questionnaire to assess their perception of the engine’s effect on the decision-making process in clinical practice. Results Of 300 possible pairs of answers (1 answer before and 1 after the initial search), 254 (85%) were produced by 14 residents. Of these, 132 (52%) and 122 (48%) pairs of answers concerned questions that had been assigned an initial search with InfoClinique and the Trip database, respectively. Both engines produced an important and similar absolute increase in the proportion of correct answers after searching (26% to 62% for InfoClinique, for an increase of 36%; 24% to 63% for the Trip database, for an increase of 39%; P = .68). For all 30 clinical questions, at least 1 resident produced the correct answer after searching with either

  19. Decision Making and Health Education.

    ERIC Educational Resources Information Center

    Duryea, Elias J.

    1983-01-01

    A position statement is offered that clarifies the function, role, and emphasis of decision making within the field of health education, and a rationale that proposes that health decision-making efforts be limited to areas where evidence links a health behavior (i.e., smoking) to a health problem (i.e., lung cancer) is presented. (Author/CJ)

  20. Electronic Communication and Decision Making.

    ERIC Educational Resources Information Center

    Feldman, M. S.; Sarbaugh-Thompson, M.

    1996-01-01

    Electronic communication can either facilitate or sabotage decision-making contexts. This article formulates recommendations about when and how to use electronic communication to enhance decision making and describes various decision contexts. Solutions to communication problems such as groupthink, social deadlock, bureaucratic isolation from…

  1. The Influence of Future Command, Control, Communications, and Computers (C4) on Doctrine and the Operational Commander's Decision-Making Process

    NASA Technical Reports Server (NTRS)

    Mayer, Michael G.

    1996-01-01

    Future C4 systems will alter the traditional balance between force and information, having a profound influence on doctrine and the operational commander's decision making process. The Joint Staff's future vision of C4 is conceptualized in 'C4I for the Warrior' which envisions a joint C4I architecture providing timely sensor to shoot information direct to the warfighter. C4 system must manage and filter an overwhelming amount of information; deal with interoperability issues; overcome technological limitations; meet emerging security requirements; and protect against 'Information Warfare.' Severe budget constraints necessitate unified control of C4 systems under singular leadership for the common good of all the services. In addition, acquisition policy and procedures must be revamped to allow new technologies to be fielded quickly; and the commercial marketplace will become the preferred starting point for modernization. Flatter command structures are recommended in this environment where information is available instantaneously. New responsibilities for decision making at lower levels are created. Commanders will have to strike a balance between exerting greater control and allowing subordinates enough flexibility to maintain initiative. Clearly, the commander's intent remains the most important tool in striking this balance.

  2. Reclaiming their lives: The decision-making process in living liver donation – An interpretative phenomenological case study analysis of one couple

    PubMed Central

    McGregor, Lesley M.; Dickson, Adele; Flowers, Paul; Hayes, Peter C.; O’Carroll, Ronan E.

    2014-01-01

    Objectives: Adult-to-adult living liver donation (LLD) is a controversial procedure due to the risk to the healthy donor. The decision to proceed with LLD is an important, yet under-researched area. This study aims to explore the decision-making process of the donor and recipient independently, and within the donor–recipient dyad. Design: A longitudinal, qualitative analysis of the LLD decision from the perspective of a LLD donor–recipient dyad. Methods: In-depth interviews were conducted with the donor and recipient separately on three occasions: pre LLD, six weeks post and six months post LLD. Transcripts were subject to interpretative phenomenological analysis. Results: During the pre-LLD interviews, a series of intra- and interpersonal negotiations were reported as both the donor and recipient grappled to make a decision about LLD. Following the decision, the focus then centred on the consequences of the decision and making sense of unanticipated outcomes. By six months post LLD, both were able to reflect on adapting to the changes their decision had ultimately caused. Conclusions: This case study offers a unique insight into the risk assessment and decision-making demands of LLD and the results can help support future LLD candidates. PMID:24991986

  3. Decision making in xia2.

    PubMed

    Winter, Graeme; Lobley, Carina M C; Prince, Stephen M

    2013-07-01

    xia2 is an expert system for the automated reduction of macromolecular crystallography (MX) data employing well trusted existing software. The system can process a full MX data set consisting of one or more sequences of images at one or more wavelengths from images to structure-factor amplitudes with no user input. To achieve this many decisions are made, the rationale for which is described here. In addition, it is critical to support the testing of hypotheses and to allow feedback of results from later stages in the analysis to earlier points where decisions were made: the flexible framework employed by xia2 to support this feedback is summarized here. While the decision-making protocols described here were developed for xia2, they are equally applicable to interactive data reduction. PMID:23793152

  4. Roadmapping Process Improvements by Experience at the Idaho National Engineering and Environmental Laboratory High Level Waste Program and Synergistic Interfaces with Decision-Making

    SciTech Connect

    Murphy, James Anthony; Olson, Arlin Leland

    2001-02-01

    Six technology roadmaps were developed for various technologies under consideration for the treatment of sodium bearing liquid and calcine wastes. In the process of creating these roadmaps, a number of process improvements were identified for each of the formal roadmapping phases as described in the Department of Energy’s draft roadmapping guidance. The lessons learned, presented as beneficial improvements to the Idaho National Engineering and Environmental Laboratory (INEEL) High Level Waste Program, are proposed to be added to the draft guidance. Additionally, synergistic interfaces between the roadmapping and decision-making processes were observed and reported on. With these improvements, technology roadmapping has become an effective integration tool at the INEEL for planning technology development.

  5. Composite collective decision-making

    PubMed Central

    Czaczkes, Tomer J.; Czaczkes, Benjamin; Iglhaut, Carolin; Heinze, Jürgen

    2015-01-01

    Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms. PMID:26019155

  6. Composite collective decision-making.

    PubMed

    Czaczkes, Tomer J; Czaczkes, Benjamin; Iglhaut, Carolin; Heinze, Jürgen

    2015-06-22

    Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms. PMID:26019155

  7. The art of decision-making.

    PubMed

    Clancy, Thomas R

    2003-06-01

    As important as sound decision-making is, many executives neglect to utilize any formal decisionmaking process. As many executives know, making the wrong decision can be disastrous, if not career ending. In today's high-pressure, complex, and challenging healthcare environment, it makes sense to follow a tried and true process for making decisions. The author examines the traditional method of problem identification, setting objectives, listing alternatives and consequences, and selecting the best solution in the decision-making process as well as new research in this field. PMID:12796632

  8. Memory and decision making in the frontal cortex during visual motion processing for smooth pursuit eye movements.

    PubMed

    Shichinohe, Natsuko; Akao, Teppei; Kurkin, Sergei; Fukushima, Junko; Kaneko, Chris R S; Fukushima, Kikuro

    2009-06-11

    Cortical motor areas are thought to contribute "higher-order processing," but what that processing might include is unknown. Previous studies of the smooth pursuit-related discharge of supplementary eye field (SEF) neurons have not distinguished activity associated with the preparation for pursuit from discharge related to processing or memory of the target motion signals. Using a memory-based task designed to separate these components, we show that the SEF contains signals coding retinal image-slip-velocity, memory, and assessment of visual motion direction, the decision of whether to pursue, and the preparation for pursuit eye movements. Bilateral muscimol injection into SEF resulted in directional errors in smooth pursuit, errors of whether to pursue, and impairment of initial correct eye movements. These results suggest an important role for the SEF in memory and assessment of visual motion direction and the programming of appropriate pursuit eye movements. PMID:19524530

  9. How does the context and design of participatory decision-making processes affect their outcomes? Evidence from sustainable land management in global drylands.

    NASA Astrophysics Data System (ADS)

    de Vente, Joris; Reed, Mark; Stringer, Lindsay; Valente, Sandra; Newig, Jens

    2014-05-01

    It is widely accepted that the design of participatory processes in environmental management needs to be adapted to local contexts. Yet, it is not clear which elements of process design are universal, making it difficult to design processes that deliver beneficial outcomes across different contexts. We used empirical evidence to analyse the extent to which context and process design can enable or impede stakeholder participation and facilitate beneficial environmental and social outcomes in a range of decision-making contexts where stakeholders are engaged in environmental management. To explore the role of national-scale context on the outcomes of participatory processes, we interviewed facilitators from a process that was replicated across 13 dryland study sites around the world, which focussed on selecting Sustainable Land Management (SLM) options in close collaboration with stakeholders. To explore the role of process design and local context, we interviewed participants and facilitators in 11 case studies in Spain and Portugal in which different process designs were used. Interview data were analysed using a combination of quantitative and qualitative approaches to characterise relationships between process design, context and process outcomes. The similarity of outcomes across the 13 international study sites suggested that the national socio-cultural context in which a participatory process is conducted has little impact on its outcomes. However, analysis of cases from Spain and Portugal showed that some aspects of local context may affect outcomes. Having said this, factors associated with process design and participant selection played a more significant role in influencing outcomes in both countries. Processes that led to more beneficial outcomes for the environment and/or participants were likely to include: the legitimate representation of stakeholders; professional facilitation including structured methods for eliciting and aggregating information and

  10. Modeling To Enhance Critical Thinking and Decision Making Skills Development in the Instructional Process: The Social Studies.

    ERIC Educational Resources Information Center

    Peters, Richard

    Students must be actively involved in the process of learning for it to have personal meaning and importance in their lives. Teachers must also become critical thinkers, creative individuals, and decision makers in order to create more challenging learning environments. Teachers need to blend structure and spontaneity into meaningful learning…

  11. Experiential and Contextual Factors That Shape Engineering Interest and Educational Decision-Making Processes among Female Students

    ERIC Educational Resources Information Center

    Swan, Amy

    2015-01-01

    This qualitative study explores the formation of educational and vocational goals among female first-year engineering students at two community colleges and one four-year institution, as well as contextual influences on this process. Participants' pathways to college are also explored, as well as their pathways into engineering. The findings…

  12. The Decision-Making Constraints and Processes of Grant Peer Review, and Their Effects on the Review Outcome.

    ERIC Educational Resources Information Center

    Langfeldt, Liv

    2001-01-01

    Questions how the review process affects the outcome of grant review. Considers the procedures of The Research Council of Norway which practices several different grant-review models and consequently is especially suited for explorations of the implications of different models. (Contains 24 references.) (Author/YDS)

  13. Health Impact Assessment (HIA) and EnviroAtlas: Integrating Ecosystem Services into the Decision-Making Process-Guide

    EPA Science Inventory

    This document was created to highlight the many ways that the U.S. EPA EnviroAtlas suite of ecosystem services tools can be used to aid in the Health Impact Assessment (HIA) process. Ecosystems provide numerous services and benefits to individuals, communities, businesses, and ot...

  14. When, where, why and with whom homeless women engage in risky sexual behaviors: A framework for understanding complex and varied decision-making processes

    PubMed Central

    Ryan, Gery W.; Stern, Stefanie A.; Hilton, Lara; Tucker, Joan S.; Kennedy, David P.; Golinelli, Daniela; Wenzel, Suzanne L.

    2010-01-01

    Impoverished women worldwide are at high risk for contracting HIV/AIDS. This study explores how homeless women make risky sex decisions and the role that alcohol and drugs play in this process. We analyze 56 in-depth qualitative descriptions of recent sexual episodes among 28 women living in shelters in Los Angeles, California, USA. The sample (age 18–63) was 46% African American, 21% Hispanic/Latina, and 21% white. Findings suggest that: (1) homeless women engage in multiple types of relationships and sexual behaviors; (2) emotion and attachment play critical roles in women’s risky sex choices; and (3) the role of alcohol and drugs on such choices varies across relationship commitment. Understanding the complexity of sexual decision-making among this population has implications for developing successful risk reduction interventions. PMID:20485467

  15. Reliability of the Path of the Sciatic Nerve, Congruence between Patients' History and Medical Imaging Evidence of Disc Herniation and Its Role in Surgical Decision Making

    PubMed Central

    Karimi Khouzani, Reza

    2015-01-01

    Study Design The prevalence of disc herniation is estimated to be about 100,000 new cases per year in France and disc herniation accounts for 25% to 30% of surgical activity in Departments of Neurosurgery. Classically, sciatica is expected to follow its specific dermatome-L5 or S1-. In clinical practice, we regularly encounter patients showing discrepancy between clinical sciatica and imaging findings. Purpose The aim of this paper is to review the medical concept and management of sciatica pain in patients showing this discrepancy. Overview of Literature To the best of our knowledge, this subject has not yet been discussed in the medical literature. Methods The medical records of 241 patients who were operated on for L5 or S1 sciatica caused by disc herniation were reviewed. Results We found an apparent clinicoradiological discrepancy between sciatica described by patients on one side and magnetic resonance imaging (MRI) finding on the other side in 27 (11.20%) patients. We did not find any other abnormalities in the preoperative and postoperative period. All of these patients underwent lumbar discectomy via posterior interlaminar approach. Three months after surgery, 25 patients (92.59%) had been totally relieved of sciatica pain. Two patients (7.41%) continued to experience sciatica in spite of the surgery. Conclusions The discrepancy between clinical sciatica and disc herniation level on MRI is not rare. Management of this discrepancy requires further investigation in order to avoid missing the diagnosis and treatment failure. PMID:25901230

  16. Re-engineering shared decision-making.

    PubMed

    Gillick, Muriel R

    2015-09-01

    Shared decision-making is widely accepted as the gold standard of clinical care. Numerous obstacles to achieving shared decision-making have been identified, including patient factors, physician factors and systemic factors. Until now, the paradigm is seldom successfully implemented in clinical practice, raising questions about the practicality of the process recommended for its use. A re-engineered model is proposed in which physicians elicit and prioritise patients' goals of care and then help translate those goals into treatment options, after clarifying the patient's underlying health status. Preliminary evidence suggests that each step of this revised process is feasible and that patients and physicians are comfortable with this strategy. Adoption of this model, after further testing, would allow the goal of shared decision-making to be realised. PMID:25926672

  17. Collaborative processes, research, and applications to improve drought-sensitive decision making in the Upper Colorado River Basin

    NASA Astrophysics Data System (ADS)

    Verdin, J. P.; Pulwarty, R. S.; Doesken, N. J.; Gillespie, M.; Werner, K.; Wilhelmi, O.; Lewis, M. E.; Darby, L. S.; McNutt, C. A.; Schmidt, M.; Redmond, K. T.

    2010-12-01

    The Upper Colorado River Basin (UCRB) is the focus of the first pilot regional drought early warning information system of the National Integrated Drought Information System (NIDIS). In partnership with resource managers from across the basin, a program of needs assessments, collaborative processes, research, and applications was designed and is being implemented. Priority actions involve the drought-sensitive decisions of large reservoir operators, water providers dependent on inter-basin transfers, and ecosystem managers. Identification of drought monitoring and forecasting needs has led to an ongoing UCRB drought monitoring process organized under the leadership of the Colorado state climatologist. Weekly webinars during spring runoff (monthly during the rest of the year) review the latest science, observations and forecasts for variables like streamflow, precipitation, temperature, snowpack, and reservoir storage. Research and applications projects support this collaborative process by developing new insights and tools for drought impact analyses. They include review and improvement of drought indices used in the UCRB, and new tools for making custom, locally-relevant indicators; spatial analysis of water demand in the basin; a low-flow impacts database, including environmental considerations; linkage of National Weather Service climate and hydrological modeling; a monitoring gaps assessment; and enhanced web access to drought information specific to the UCRB via the NIDIS portal. Lessons learned during 2010 will be applied during a second annual cycle in 2011 and then placed in the context of longer-term planning strategies. The findings of the pilot will provide the basis for the design of innovative and sustained practices in the UCRB, as well as expansion of the early warning system to include the Lower Colorado River Basin and to inform adaptation across multiple timescales. The UCRB effort highlights the role of pilot design and implementation as

  18. Inertia and Decision Making.

    PubMed

    Alós-Ferrer, Carlos; Hügelschäfer, Sabine; Li, Jiahui

    2016-01-01

    Decision inertia is the tendency to repeat previous choices independently of the outcome, which can give rise to perseveration in suboptimal choices. We investigate this tendency in probability-updating tasks. Study 1 shows that, whenever decision inertia conflicts with normatively optimal behavior (Bayesian updating), error rates are larger and decisions are slower. This is consistent with a dual-process view of decision inertia as an automatic process conflicting with a more rational, controlled one. We find evidence of decision inertia in both required and autonomous decisions, but the effect of inertia is more clear in the latter. Study 2 considers more complex decision situations where further conflict arises due to reinforcement processes. We find the same effects of decision inertia when reinforcement is aligned with Bayesian updating, but if the two latter processes conflict, the effects are limited to autonomous choices. Additionally, both studies show that the tendency to rely on decision inertia is positively associated with preference for consistency. PMID:26909061

  19. Inertia and Decision Making

    PubMed Central

    Alós-Ferrer, Carlos; Hügelschäfer, Sabine; Li, Jiahui

    2016-01-01

    Decision inertia is the tendency to repeat previous choices independently of the outcome, which can give rise to perseveration in suboptimal choices. We investigate this tendency in probability-updating tasks. Study 1 shows that, whenever decision inertia conflicts with normatively optimal behavior (Bayesian updating), error rates are larger and decisions are slower. This is consistent with a dual-process view of decision inertia as an automatic process conflicting with a more rational, controlled one. We find evidence of decision inertia in both required and autonomous decisions, but the effect of inertia is more clear in the latter. Study 2 considers more complex decision situations where further conflict arises due to reinforcement processes. We find the same effects of decision inertia when reinforcement is aligned with Bayesian updating, but if the two latter processes conflict, the effects are limited to autonomous choices. Additionally, both studies show that the tendency to rely on decision inertia is positively associated with preference for consistency. PMID:26909061

  20. Under the radar: how unexamined biases in decision-making processes in clinical interactions can contribute to health care disparities.

    PubMed

    Dovidio, John F; Fiske, Susan T

    2012-05-01

    Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities. Biases are complex but systematic, differing by racial/ethnic group and not limited to love-hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions. Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health. PMID:22420809

  1. Under the Radar: How Unexamined Biases in Decision-Making Processes in Clinical Interactions Can Contribute to Health Care Disparities

    PubMed Central

    Fiske, Susan T.

    2012-01-01

    Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities. Biases are complex but systematic, differing by racial/ethnic group and not limited to love–hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions. Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health. PMID:22420809

  2. An expert system supporting decision making process for sustainable groundwater use in main alluvial aquifers in Slovenia

    NASA Astrophysics Data System (ADS)

    Souvent, Petra; Vižintin, Goran; Celarc, Sašo; Čenčur Curk, Barbara

    2016-04-01

    The expert decision support system for groundwater management in the shallow alluvial aquifers was developed to assist the decision makers to quantify available groundwater for a given alluvial aquifer and provide additional information about quantity of groundwater available for water rights licensing. The system links numerical groundwater flow models with the water permits and concessions databases in a complex decision support system. Six regional stand-alone groundwater models are used in the process of the assessment of groundwater quantitative status as well as for assessing availability of groundwater resources during the period of maximum water consumption and minimum groundwater recharge. Model runs have been realized in a steady state and are calibrated to a medium-low hydrological field conditions, because water quantities for all already granted as well as to-be granted water rights have to be ensured in any time for several years. The major goal of the expert decision support system is therefore to provide control mechanisms in order to verify the water rights licensing for the sustainable use of groundwater resources. The system enables that the water quantity data from water permits and concessions in conjunction with the results of numerical groundwater modeling are used in the managing process of granting new water rights to users in terms of their long-term access to groundwater (sufficient quantity of groundwater) and in relation to the water rights of other users (co-impact of groundwater pumping). Also, groundwater access must be managed in such a way that it does not cause unacceptable local impacts (pumping must not lower the water level for more than 2/3 of water body in the medium-low hydrological conditions).

  3. Development of a Transparent Interactive Decision Interrogator to Facilitate the Decision-Making Process in Health Care

    PubMed Central

    Bujkiewicz, Sylwia; Jones, Hayley E.; Lai, Monica C.W.; Cooper, Nicola J.; Hawkins, Neil; Squires, Hazel; Abrams, Keith R.; Spiegelhalter, David J.; Sutton, Alex J.

    2011-01-01

    Background Decisions about the use of new technologies in health care are often based on complex economic models. Decision makers frequently make informal judgments about evidence, uncertainty, and the assumptions that underpin these models. Objectives Transparent interactive decision interrogator (TIDI) facilitates more formal critique of decision models by decision makers such as members of appraisal committees of the National Institute for Health and Clinical Excellence in the UK. By allowing them to run advanced statistical models under different scenarios in real time, TIDI can make the decision process more efficient and transparent, while avoiding limitations on pre-prepared analysis. Methods TIDI, programmed in Visual Basic for applications within Excel, provides an interface for controlling all components of a decision model developed in the appropriate software (e.g., meta-analysis in WinBUGS and the decision model in R) by linking software packages using RExcel and R2WinBUGS. TIDI's graphical controls allow the user to modify assumptions and to run the decision model, and results are returned to an Excel spreadsheet. A tool displaying tornado plots helps to evaluate the influence of individual parameters on the model outcomes, and an interactive meta-analysis module allows the user to select any combination of available studies, explore the impact of bias adjustment, and view results using forest plots. We demonstrate TIDI using an example of a decision model in antenatal care. Conclusion Use of TIDI during the NICE appraisal of tumor necrosis factor-alpha inhibitors (in psoriatic arthritis) successfully demonstrated its ability to facilitate critiques of the decision models by decision makers. PMID:21839417

  4. The involvement of the striatum in decision making.

    PubMed

    Goulet-Kennedy, Julie; Labbe, Sara; Fecteau, Shirley

    2016-03-01

    Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the degree of integration of both cognitive and neural substrates in order to further our understanding of decision-making skills. In terms of cognitive paradigms, there is a need to improve the ecological value of experimental tasks that assess decision making in various contexts and with rewards; this would help translate laboratory learnings into real-life benefits. In terms of neural substrates, the use of neuroimaging techniques helps characterize the neural networks associated with decision making; more recently, ways to modulate brain activity, such as in the prefrontal cortex and connected regions (eg, striatum), with noninvasive brain stimulation have also shed light on the neural and cognitive substrates of decision making. Together, these cognitive and neural approaches might be useful for patients with impaired decision-making skills. The drive behind this line of work is that decision-making abilities underlie important aspects of wellness, health, security, and financial and social choices in our daily lives. PMID:27069380

  5. The involvement of the striatum in decision making

    PubMed Central

    Goulet-Kennedy, Julie; Labbe, Sara; Fecteau, Shirley

    2016-01-01

    Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the degree of integration of both cognitive and neural substrates in order to further our understanding of decision-making skills. In terms of cognitive paradigms, there is a need to improve the ecological value of experimental tasks that assess decision making in various contexts and with rewards; this would help translate laboratory learnings into real-life benefits. In terms of neural substrates, the use of neuroimaging techniques helps characterize the neural networks associated with decision making; more recently, ways to modulate brain activity, such as in the prefrontal cortex and connected regions (eg, striatum), with noninvasive brain stimulation have also shed light on the neural and cognitive substrates of decision making. Together, these cognitive and neural approaches might be useful for patients with impaired decision-making skills. The drive behind this line of work is that decision-making abilities underlie important aspects of wellness, health, security, and financial and social choices in our daily lives. PMID:27069380

  6. Neuroethology of Decision-making

    PubMed Central

    Adams, Geoffrey K.; Watson, Karli K.; Pearson, John; Platt, Michael L.

    2012-01-01

    A neuroethological approach to decision-making considers the effect of evolutionary pressures on neural circuits mediating choice. In this view, decision systems are expected to enhance fitness with respect to the local environment, and particularly efficient solutions to specific problems should be conserved, expanded, and repurposed to solve other problems. Here, we discuss basic prerequisites for a variety of decision systems from this viewpoint. We focus on two of the best-studied and most widely represented decision problems. First, we examine patch leaving, a prototype of environmentally based switching between action patterns. Second, we consider social information seeking, a process resembling foraging with search costs. We argue that while the specific neural solutions to these problems sometimes differ across species, both the problems themselves and the algorithms instantiated by biological hardware are repeated widely throughout nature. The behavioral and mathematical study of ubiquitous decision processes like patch leaving and social information seeking thus provides a powerful new approach to uncovering the fundamental design structure of nervous systems. PMID:22902613

  7. Wildfire Decision Making Under Uncertainty

    NASA Astrophysics Data System (ADS)

    Thompson, M.

    2013-12-01

    Decisions relating to wildfire management are subject to multiple sources of uncertainty, and are made by a broad range of individuals, across a multitude of environmental and socioeconomic contexts. In this presentation I will review progress towards identification and characterization of uncertainties and how this information can support wildfire decision-making. First, I will review a typology of uncertainties common to wildfire management, highlighting some of the more salient sources of uncertainty and how they present challenges to assessing wildfire risk. This discussion will cover the expanding role of burn probability modeling, approaches for characterizing fire effects, and the role of multi-criteria decision analysis, and will provide illustrative examples of integrated wildfire risk assessment across a variety of planning scales. Second, I will describe a related uncertainty typology that focuses on the human dimensions of wildfire management, specifically addressing how social, psychological, and institutional factors may impair cost-effective risk mitigation. This discussion will encompass decision processes before, during, and after fire events, with a specific focus on active management of complex wildfire incidents. An improved ability to characterize uncertainties faced in wildfire management could lead to improved delivery of decision support, targeted communication strategies, and ultimately to improved wildfire management outcomes.

  8. How Do You Measure Shared Decision Making?

    ERIC Educational Resources Information Center

    Russell, John J.; And Others

    1992-01-01

    The Teacher Involvement and Participation Scale, version 2 (TIPS 2) helps schools assess eight dimensions of the decision-making process, including goals/vision/mission; facilitating procedures and structures; curriculum/instruction; budgeting; staffing; staff development; operations; and standards. This article explains additional applications…

  9. Greater than the Parts: Shared Decision Making.

    ERIC Educational Resources Information Center

    Jensen, Anabel L.

    1986-01-01

    The article describes the goals, rationale, structure of the shared decision-making model in effect at the Nueva Learning Center, a private elementary school for gifted and talented in Hillsborough, California. An example applying the model to class scheduling and 10 steps for facilitating the process are given. (Author/DB)

  10. Hospice Decision Making: Diagnosis Makes a Difference

    ERIC Educational Resources Information Center

    Waldrop, Deborah P.; Meeker, Mary Ann

    2012-01-01

    Purpose: This study explored the process of decision making about hospice enrollment and identified factors that influence the timing of that decision. Methods: This study employed an exploratory, descriptive, cross-sectional design and was conducted using qualitative methods. In-depth in-person semistructured interviews were conducted with 36…

  11. Assessing Adolescent Decision-Making Competence

    ERIC Educational Resources Information Center

    Fischhoff, Baruch

    2008-01-01

    Behavioral decision research offers a general approach to studying cognitive aspects of decision making, as well as a platform for studying their interplay with social and affective processes. Applied to any decision, behavioral decision research involves three interrelated tasks: (a) "normative" analysis, identifying the expected impacts of…

  12. Consumer Decision Making in a Global Context.

    ERIC Educational Resources Information Center

    Lusby, Linda A.

    This document examines the underlying rationale for the development of a global approach in consumer studies. The concept of consumer ethics is discussed and the consumer decision-making process is placed within an ecosystem perspective of the marketplace. The model developed introduces educators, marketers, and consumers to a more global…

  13. Identity development, intelligence structure, and interests: a cross-sectional study in a group of Italian adolescents during the decision-making process

    PubMed Central

    Pellerone, Monica; Passanisi, Alessia; Bellomo, Mario Filippo Paolo

    2015-01-01

    Background Forming one’s identity is thought to be the key developmental task of adolescence, but profound changes in personality traits also occur in this period. The negotiation of complex social settings, the creation of an integrated identity, and career choice are major tasks of adolescence. The adolescent, having to make choices for his or her future, has not only to consider his or her own aspirations and interests but also to possess a capacity for exploration and commitment; in fact, career commitments can be considered as a fit between the study or career that is chosen and personal values, skills, and preferences. Methods The objective of the study reported here was to investigate the role of identity on profile of interests; the relation between identity and decisional style; the correlation between identity, aptitudes, interests, and school performance; and the predictive variables to school success. The research involved 417 Italian students who live in Enna, a small city located in Sicily, Italy, aged 16–19 years (197 males and 220 females) in the fourth year (mean =17.2, standard deviation =0.52) and the fifth year (mean =18.2, standard deviation =0.64) of senior secondary school. The research lasted for one school year; the general group of participants consisted of 470 students, and although all participants agreed to be part of the research, there was a dropout rate of 11.28%. They completed the Ego Identity Process Questionnaire to measure their identity development, the Intelligence Structure Test to investigate aptitudes, the Self-Directed Search to value interests, and General Decision Making Style questionnaire to describe their individual decisional style. Results The data showed that high-school performance was positively associated with rational decision-making style and identity diffusion predicted the use of avoidant style. Interests were related to identity exploration; the differentiation of preferences was related to identity

  14. A system of system lenses for leadership decision-making.

    PubMed

    Cady, Phil

    2016-01-01

    The sheer volume and dynamics among system agents in healthcare makes decision-making a daunting task at all levels. Being clear about what leaders mean by "healthcare system" is critical in aligning system strategy and leadership decision-making. This article presents an emerging set of lenses (ideology and beliefs, rational and irrational information processing, interpersonal social dynamics, process and value creation, and context) to help frame leadership decision-making in healthcare systems. PMID:26656390

  15. Decision Making in the Airplane

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith; Shafto, Michael G. (Technical Monitor)

    1995-01-01

    The Importance of decision-making to safety in complex, dynamic environments like mission control centers, aviation, and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. Yet laboratory research on decision making has not proven especially helpful In improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multi-dimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that

  16. A Two-Layered Diffusion Model Traces the Dynamics of Information Processing in the Valuation-and-Choice Circuit of Decision Making

    PubMed Central

    2014-01-01

    A circuit of evaluation and selection of the alternatives is considered a reliable model in neurobiology. The prominent contributions of the literature to this topic are reported. In this study, valuation and choice of a decisional process during Two-Alternative Forced-Choice (TAFC) task are represented as a two-layered network of computational cells, where information accrual and processing progress in nonlinear diffusion dynamics. The evolution of the response-to-stimulus map is thus modeled by two linked diffusive modules (2LDM) representing the neuronal populations involved in the valuation-and-decision circuit of decision making. Diffusion models are naturally appropriate for describing accumulation of evidence over the time. This allows the computation of the response times (RTs) in valuation and choice, under the hypothesis of ex-Wald distribution. A nonlinear transfer function integrates the activities of the two layers. The input-output map based on the infomax principle makes the 2LDM consistent with the reinforcement learning approach. Results from simulated likelihood time series indicate that 2LDM may account for the activity-dependent modulatory component of effective connectivity between the neuronal populations. Rhythmic fluctuations of the estimate gain functions in the delta-beta bands also support the compatibility of 2LDM with the neurobiology of DM. PMID:25254039

  17. Weighing up the costs of seeking health care for dengue symptoms: a grounded theory study of backpackers' decision-making processes.

    PubMed

    Vajta, Bálint; Holberg, Mette; Mills, Jane; McBride, William J H

    2015-01-01

    Dengue fever, a mosquito-borne virus, is an ongoing public health issue in North Queensland. Importation of dengue fever by travellers visiting or returning to Australia can lead to epidemics. The mosquito can acquire the virus in the symptomatic viraemic phase, so timely recognition of cases is important to prevent epidemics. There is a gap in the literature about backpackers' knowledge of dengue fever and the decision-making process they use when considering utilising the Australian health-care system. This study uses grounded theory methods to construct a theory that explains the process backpackers use when seeking health care. Fifty semi-structured interviews with backpackers, hostel receptionists, travel agents and pharmacists were analysed, resulting in identification of a core category: 'weighing up the costs of seeking health care'. This core category has three subcategories: 'self-assessment of health status', 'wait-and-see' and 'seek direction'. Findings from this study identified key areas where health promotion material and increased access to health-care professionals could reduce the risk of backpackers spreading dengue fever. PMID:26509208

  18. The decision-making process leading to deep brain stimulation in men and women with parkinson’s disease – an interview study

    PubMed Central

    2014-01-01

    Background Deep brain stimulation (DBS) is an established treatment for patients with advanced parkinson’s disease (PD). Research shows that women are under-represented among patients undergoing DBS surgery. This may be due to gender-biased selection of patients, but patients’ wishes and attitudes may also contribute. This study investigated the decision making process to undergo DBS from the patient’s perspective, and explored any gender patterns in the participants’ decision-making. Methods All patients operated on with DBS for PD at the University Hospital of Northern Sweden between January 2002 and April 2010 were invited to an interview study. In this way 39 patients were recruited, 31 men and eight women. Three additional women, operated elsewhere, were recruited to acheive a more gender-balanced sample. In a mixed-method analysis, the interviews were analysed according to the constant comparison technique in grounded theory and descriptive statistics was used to present demographics and compare categories. Results Three different approaches to DBS were identified among the patients. ‘Taking own initiative’, included 48% of the patients and implied that the patients’ own initiatives and arguments had been crucial for having surgery. ‘Agreeing when offered’, and accepting DBS when suggested by doctors embraced 43%. The third approach, ‘Hesitating and waiting’ included < 10% of the patients. Most of the men were either ‘taking own initiative’ or ‘agreeing when offered’. The 11 women were evenly distributed in all three approaches. Among the interviewed, more women than men expressed strong fear of complications and more women consulted friends and relatives prior to deciding about DBS. Half of the patients had held a leadership position at work or in another organisation, and among patients ‘taking own initiative’ the proportion with leadership experiences was 80%. At time for surgery ten men but no woman were

  19. Teaching Rational Decision-Making.

    ERIC Educational Resources Information Center

    Woolever, Roberts

    1978-01-01

    Presented is an outline of a college course, "Education in American Society," that focused on teaching students rational decision-making skills while examining current issues in American Education. The outline is followed by student comments, reactions, and evaluations of the course. (JMD)

  20. Decision Making: The Underdeveloped Skill

    ERIC Educational Resources Information Center

    Phelps, Robert

    1974-01-01

    Business educators should give students specific training in a methodology which will enable them to make logical, systematic, and rational decisions. Kepner-Tregoe Analysis (KTA), a decision making model, is described and illustrated with an example of a student buying his first car. (SC)

  1. Ethical Decision Making: Basic Issues

    ERIC Educational Resources Information Center

    Bradley, Loretta J.; Hendricks, C. Bret

    2008-01-01

    Among counselors, ethical dilemmas occur often. Although ethical dilemmas are challenging, they can be solved by implementing a code of ethics and/or an ethical decision-making model. Using case studies, the authors illustrate how counselors can make informed, accurate decisions that are made to protect the welfare of the client. It also helps…

  2. Collective decision-making in microbes

    PubMed Central

    Ross-Gillespie, Adin; Kümmerli, Rolf

    2014-01-01

    Microbes are intensely social organisms that routinely cooperate and coordinate their activities to express elaborate population level phenotypes. Such coordination requires a process of collective decision-making, in which individuals detect and collate information not only from their physical environment, but also from their social environment, in order to arrive at an appropriately calibrated response. Here, we present a conceptual overview of collective decision-making as it applies to all group-living organisms; we introduce key concepts and principles developed in the context of animal and human group decisions; and we discuss, with appropriate examples, the applicability of each of these concepts in microbial contexts. In particular, we discuss the roles of information pooling, control skew, speed vs. accuracy trade-offs, local feedbacks, quorum thresholds, conflicts of interest, and the reliability of social information. We conclude that collective decision-making in microbes shares many features with collective decision-making in higher taxa, and we call for greater integration between this fledgling field and other allied areas of research, including in the humanities and the physical sciences. PMID:24624121

  3. Social Equity Decision Making: Narrative Explorations with Elementary Teachers

    ERIC Educational Resources Information Center

    Fuxa, Robin Lynn

    2012-01-01

    In this critical postmodern narrative study, I explore with my participants their decision making process/es around social equity issues (race, class, gender, social class, sexual identity, religion, etc.) in their teaching. The purpose of this study is to facilitate a closer examination of this important decision making process--when and how to…

  4. Health, Trust, or “Just Understood”: Explicit and Implicit Condom Decision-Making Processes Among Black, White, and Interracial Same-Sex Male Couples

    PubMed Central

    Campbell, Chadwick K.; Gómez, Anu Manchikanti; Dworkin, Shari; Wilson, Patrick A.; Grisham, Kirk; McReynolds, Jaih; Vielehr, Peter; Hoff, Colleen

    2013-01-01

    Among gay and bisexual men, primary partners are a leading source of HIV infection. Trust, intimacy, and advancements in HIV treatment may impact same-sex male couples’ decisions to engage in unprotected anal intercourse (UAI). This qualitative study explored how Black, White and interracial couples discussed, and made decisions regarding condoms. Qualitative interviews were conducted with 48 same-sex male couples in the New York and San Francisco metropolitan areas. Stratified purposive sampling was used to include Black (n = 16), White (n = 17), and interracial (Black-White) (n = 15) couples. Twenty-six couples were concordant HIV-negative and 22 were HIV-discordant. Interviews were recorded, transcribed, coded, and analyzed using a grounded theory approach. Some couples described explicit processes, which involved active discussion, while others described implicit processes, where condom-use decisions occurred without any explicit discussion. These processes also differed by race and HIV status. Black couples tended to report condom-use as “just understood.” White, HIV-discordant couples decided not to use condoms, with some identifying the HIV-positive partner’s suppressed viral load and high CD4 count as deciding factors. After an unplanned episode of UAI, White, HIV-negative couples tended to discontinue condom use while Black HIV-negative couples decided to revert to using condoms. HIV prevention efforts focused on same-sex, male couples must consider the explicit/implicit nature of condom decision-making processes. Understanding differences in these processes and considering relationship dynamics, across race and HIV status, can promote the development of innovative couple–level, HIV prevention interventions. PMID:23912774

  5. Patient decision making among older individuals with cancer.

    PubMed

    Strohschein, Fay J; Bergman, Howard; Carnevale, Franco A; Loiselle, Carmen G

    2011-07-01

    Patient decision making is an area of increasing inquiry. For older individuals experiencing cancer, variations in health and functional status, physiologic aspects of aging, and tension between quality and quantity of life present unique challenges to treatment-related decision making. We used the pragmatic utility method to analyze the concept of patient decision making in the context of older individuals with cancer. We first evaluated its maturity in existing literature and then posed analytical questions to clarify aspects found to be only partially mature. In this context, we found patient decision making to be an ongoing process, changing with time, reflecting individual and relational components, as well as analytical and emotional ones. Assumptions frequently associated with patient decision making were not consistent with the empirical literature. Careful attention to the multifaceted components of patient decision making among older individuals with cancer provides guidance for research, supportive interventions, and targeted follow-up care. PMID:21343431

  6. Considering Risk and Resilience in Decision-Making

    NASA Technical Reports Server (NTRS)

    Torres-Pomales, Wilfredo

    2015-01-01

    This paper examines the concepts of decision-making, risk analysis, uncertainty and resilience analysis. The relation between risk, vulnerability, and resilience is analyzed. The paper describes how complexity, uncertainty, and ambiguity are the most critical factors in the definition of the approach and criteria for decision-making. Uncertainty in its various forms is what limits our ability to offer definitive answers to questions about the outcomes of alternatives in a decision-making process. It is shown that, although resilience-informed decision-making would seem fundamentally different from risk-informed decision-making, this is not the case as resilience-analysis can be easily incorporated within existing analytic-deliberative decision-making frameworks.

  7. When Consensus Decision-Making Fails: A Case Study.

    ERIC Educational Resources Information Center

    Savage, Grant T.

    Habermas's theory of dialogue was used to evaluate the process of decision making that occurred in a labor-management committee's meeting to discuss flextime. The study attempted to determine why, at that meeting, the committee's consensus process of decision making failed. W.R. Bion's theory of unconscious group motives was also used to…

  8. [Medical decision making: some aspects].

    PubMed

    Steurer, J

    2004-09-22

    Three main aspects of medical decision making will be shortly described in this article. Comprehensible information is required to make decisions. The question is, how much information is needed to make decisions, and a third aspect in this article concerns the decision maker. Research in the field of information transfer has shown that medical information, as presented in most journals, is difficult to understand. According to the classic decision theory, decisions are taken after collecting all available information. More recent research in decision making proves the hypothesis that human beings are able to decide correctly with much less information than presumed earlier. In medicine the patient is the decision maker, and the primary task of physicians is to inform the patient about his health status and enable him to reach a conclusion. PMID:15500244

  9. An Assessment of Decision-Making Processes: The Feasibility of Incorporating Climate Change Information into Land Protection Planning (External Review Draft)

    EPA Science Inventory

    This report was 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). This draft report is a review of decision-making pro...

  10. Operationalizing Consumer Decision Making and Choice in the VR Process. Institute on Rehabilitation Issues (21st, Baltimore, Maryland, March 1995). Report from the Study Group.

    ERIC Educational Resources Information Center

    Fry, Ronald R., Ed.

    This document is the product of meetings of the Prime Study Group of the Institute on Rehabilitation Issues, whose mission was to: examine consumer choice and decision making in rehabilitation; review the legislation and consumer movements leading to greater consumer choice; identify the roles and responsibilities of the consumer, the counselor,…

  11. How to Implement the Ways of Knowing through the Realms of Meaning as an Ethical Decision-Making Process to Improve Academic Achievement--Ten Recommendations

    ERIC Educational Resources Information Center

    Skinner, Desiree A.; Kritsonis, William Allan

    2006-01-01

    "Values, purposes, and understandings are fragile achievements and give way all too readily to attitudes of futility, frustration, and doubt" (Kritsonis, 2007, pg. 7). Ethical decision-making is one way for school leaders to contribute to improving education. Effecting change is the duty of school principals; this may often come in making…

  12. Strategies for promoting ethical decision-making.

    PubMed

    Mysak, S

    1997-01-01

    The structured controversy as a strategy for helping the non-licensed caregiver make ethical decisions as well as develop critical thinking skills was an innovative teaching technique. Students in the Homecare/Special care aide program are essential providers of care to residents or clients in a special care facility or in a homecare setting. Theory and practice of ethical decision-making is not usually dealt with in the curriculum of the non-licensed caregiver. Implementation of this approach helped students learn theory and skills necessary when dealing with controversial issues in making ethical decisions. Thompson and Thompson's (1985) ten steps of bioethical decision-making were implemented to assist in the process. Structured controversy was defined and the process of implementing structured controversy outlined. A variety of ethical issues were presented based on the ethical principles of beneficence, justice, autonomy, truthfulness, confidentiality, and integrity (Yeo, 1991). Several definitions of critical thinking are presented. PMID:9136367

  13. Has Lean improved organizational decision making?

    PubMed

    Simons, Pascale; Benders, Jos; Bergs, Jochen; Marneffe, Wim; Vandijck, Dominique

    2016-06-13

    Purpose - Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization's decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization's decision-making context, making it more amenable for QI initiatives. Design/methodology/approach - In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings - Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications - Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value - Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI's sustainability. PMID:27256776

  14. The role of additional computed tomography in the decision-making process on the secondary prevention in patients after systemic cerebral thrombolysis

    PubMed Central

    Sobolewski, Piotr; Kozera, Grzegorz; Szczuchniak, Wiktor; Nyka, Walenty M

    2016-01-01

    Introduction Patients with ischemic stroke undergoing intravenous (iv)-thrombolysis are routinely controlled with computed tomography on the second day to assess stroke evolution and hemorrhagic transformation (HT). However, the benefits of an additional computed tomography (aCT) performed over the next days after iv-thrombolysis have not been determined. Methods We retrospectively screened 287 Caucasian patients with ischemic stroke who were consecutively treated with iv-thrombolysis from 2008 to 2012. The results of computed tomography performed on the second (control computed tomography) and seventh (aCT) day after iv-thrombolysis were compared in 274 patients (95.5%); 13 subjects (4.5%), who died before the seventh day from admission were excluded from the analysis. Results aCTs revealed a higher incidence of HT than control computed tomographies (14.2% vs 6.6%; P=0.003). Patients with HT in aCT showed higher median of National Institutes of Health Stroke Scale score on admission than those without HT (13.0 vs 10.0; P=0.01) and higher presence of ischemic changes >1/3 middle cerebral artery territory (66.7% vs 35.2%; P<0.01). Correlations between presence of HT in aCT and National Institutes of Health Stroke Scale score on admission (rpbi 0.15; P<0.01), and the ischemic changes >1/3 middle cerebral artery (phi=0.03) existed, and the presence of HT in aCT was associated with 3-month mortality (phi=0.03). Conclusion aCT after iv-thrombolysis enables higher detection of HT, which is related to higher 3-month mortality. Thus, patients with severe middle cerebral artery infarction may benefit from aCT in the decision-making process on the secondary prophylaxis. PMID:26730196

  15. How social cognition can inform social decision making.

    PubMed

    Lee, Victoria K; Harris, Lasana T

    2013-01-01

    Social decision-making is often complex, requiring the decision-maker to make inferences of others' mental states in addition to engaging traditional decision-making processes like valuation and reward processing. A growing body of research in neuroeconomics has examined decision-making involving social and non-social stimuli to explore activity in brain regions such as the striatum and prefrontal cortex, largely ignoring the power of the social context. Perhaps more complex processes may influence decision-making in social vs. non-social contexts. Years of social psychology and social neuroscience research have documented a multitude of processes (e.g., mental state inferences, impression formation, spontaneous trait inferences) that occur upon viewing another person. These processes rely on a network of brain regions including medial prefrontal cortex (MPFC), superior temporal sulcus (STS), temporal parietal junction, and precuneus among others. Undoubtedly, these social cognition processes affect social decision-making since mental state inferences occur spontaneously and automatically. Few studies have looked at how these social inference processes affect decision-making in a social context despite the capability of these inferences to serve as predictions that can guide future decision-making. Here we review and integrate the person perception and decision-making literatures to understand how social cognition can inform the study of social decision-making in a way that is consistent with both literatures. We identify gaps in both literatures-while behavioral economics largely ignores social processes that spontaneously occur upon viewing another person, social psychology has largely failed to talk about the implications of social cognition processes in an economic decision-making context-and examine the benefits of integrating social psychological theory with behavioral economic theory. PMID:24399928

  16. How social cognition can inform social decision making

    PubMed Central

    Lee, Victoria K.; Harris, Lasana T.

    2013-01-01

    Social decision-making is often complex, requiring the decision-maker to make inferences of others' mental states in addition to engaging traditional decision-making processes like valuation and reward processing. A growing body of research in neuroeconomics has examined decision-making involving social and non-social stimuli to explore activity in brain regions such as the striatum and prefrontal cortex, largely ignoring the power of the social context. Perhaps more complex processes may influence decision-making in social vs. non-social contexts. Years of social psychology and social neuroscience research have documented a multitude of processes (e.g., mental state inferences, impression formation, spontaneous trait inferences) that occur upon viewing another person. These processes rely on a network of brain regions including medial prefrontal cortex (MPFC), superior temporal sulcus (STS), temporal parietal junction, and precuneus among others. Undoubtedly, these social cognition processes affect social decision-making since mental state inferences occur spontaneously and automatically. Few studies have looked at how these social inference processes affect decision-making in a social context despite the capability of these inferences to serve as predictions that can guide future decision-making. Here we review and integrate the person perception and decision-making literatures to understand how social cognition can inform the study of social decision-making in a way that is consistent with both literatures. We identify gaps in both literatures—while behavioral economics largely ignores social processes that spontaneously occur upon viewing another person, social psychology has largely failed to talk about the implications of social cognition processes in an economic decision-making context—and examine the benefits of integrating social psychological theory with behavioral economic theory. PMID:24399928

  17. An Instructional System for Consumer Decision-Making: Teacher's Manual.

    ERIC Educational Resources Information Center

    Suchman, J. Richard; DiSario, Martha R.

    An instructional system is presented for building the competencies of adult basic education students in making consumer decisions, and offers a guide to teachers who wish to design their own decision-making problems for students. The first four chapters provide a brief introduction, discuss the rational consumer decision-making process and the…

  18. Stress in Decision-Making: Three Causes, Three Cures.

    ERIC Educational Resources Information Center

    Bates, Don

    This paper is a brief description of a conference presentation consisting of a 2.5-hour clinic session on decision-making. A motion picture, "The Making of a Decision," followed by a lively discussion, was used to illustrate the strenghts and weaknesses of administrators in their decision-making process. Presented in the film are three different…

  19. Personal Variables and Bias in Educational Decision-Making.

    ERIC Educational Resources Information Center

    Huebner, E. Scott; And Others

    1984-01-01

    Findings regarding the influence of four potential sources of bias (sex, socioeconimic status, race, physical attractiveness) upon decision-making stages of the assessment process are selectively reviewed. It is concluded that, though further research is needed, convincing evidence of bias in later stages of decision making has yet to be…

  20. Decision Technology Systems: A Vehicle to Consolidate Decision Making Support.

    ERIC Educational Resources Information Center

    Forgionne, Guisseppi A.

    1991-01-01

    Discussion of management decision making and the support needed to manage successfully highlights a Decision Technology System (DTS) that integrates other information systems. Topics discussed include computer information systems (CISs); knowledge gateways; the decision-making process; decision support systems (DSS); expert systems; and facility…

  1. Towards Ethical Decision-Making in Counselling Research.

    ERIC Educational Resources Information Center

    Robson, Maggie; Cook, Peter; Hunt, Kathy; Alred, Geof; Robson, Dave

    2000-01-01

    Explores the process of ethical decision-making in counseling research and examines to what extent decision-making is based on intuitive thinking. Reviews and considers several models of ethical problem solving. Argues that ethical decisions are reached through intuition, informed by ethical principles, codes of practice, and reference to the laws…

  2. Decision-Making Involvement of Individuals with Dementia

    ERIC Educational Resources Information Center

    Menne, Heather L.; Whitlatch, Carol J.

    2007-01-01

    Purpose: Research underscores how autonomy and decision-making involvement may help to enhance the quality of life of older adults; however, individuals with dementia are often excluded from decision making that is related to their daily functioning. In this study we use a modified version of the Stress Process Model to consider the stress process…

  3. "I'm Keeping Those There, Are You?": The Role of a New User Interface Paradigm--Separate Control of Shared Space (SCOSS)--in the Collaborative Decision-Making Process

    ERIC Educational Resources Information Center

    Kerawalla, Lucinda; Pearce, Darren; Yuill, Nicola; Luckin, Rosemary; Harris, Amanda

    2008-01-01

    We take a socio-cultural approach to comparing how dual control of a new user interface paradigm--Separate Control of Shared Space (SCOSS)--and dual control of a single user interface can work to mediate the collaborative decision-making process between pairs of children carrying out a multiple categorisation word task on a shared computer.…

  4. Zeno's paradox in decision-making.

    PubMed

    Yearsley, James M; Pothos, Emmanuel M

    2016-04-13

    Classical probability theory has been influential in modelling decision processes, despite empirical findings that have been persistently paradoxical from classical perspectives. For such findings, some researchers have been successfully pursuing decision models based on quantum theory (QT). One unique feature of QT is the collapse postulate, which entails that measurements (or in decision-making, judgements) reset the state to be consistent with the measured outcome. If there is quantum structure in cognition, then there has to be evidence for the collapse postulate. A striking, a prioriprediction, is that opinion change will be slowed down (under idealized conditions frozen) by continuous judgements. In physics, this is the quantum Zeno effect. We demonstrate a quantum Zeno effect in decision-making in humans and so provide evidence that advocates the use of quantum principles in decision theory, at least in some cases. PMID:27053743

  5. Involving the motor system in decision making.

    PubMed

    Wyss, Reto; König, Peter; Verschure, Paul F M J

    2004-02-01

    The control of behaviour is usually understood in terms of three distinct components: sensory processing, decision making and movement control. Recently, this view has been questioned on the basis of physiological and behavioural data, blurring the distinction between these three stages. This raises the question to what extent the motor system itself can contribute to the interpretation of behavioural situations. To investigate this question we use a neural model of sensory motor integration applied to a behaving mobile robot performing a navigation task. We show that the population response of the motor system provides a substrate for the categorization of behavioural situations. This categorization allows for the assessment of the complexity of a behavioural situation and regulates whether higher-level decision making is required to resolve behavioural conflicts. Our model lends credence to an emerging reconceptualization of behavioural control where the motor system can be considered as part of a high-level perceptual system. PMID:15101417

  6. [Decision-making and schizophrenia].

    PubMed

    Adida, M; Maurel, M; Kaladjian, A; Fakra, E; Lazerges, P; Da Fonseca, D; Belzeaux, R; Cermolacce, M; Azorin, J-M

    2011-12-01

    Abnormalities involving the prefrontal cortex (PFC) have long been postulated to underpin the pathophysiology of schizophrenia. Investigations of PFC integrity have focused mainly on the dorsolateral PFC (DLPFC) and abnormalities in this region have been extensively documented. However, defects in schizophrenia may extend to other prefrontal regions, including the ventromedial PFC (VMPFC), and evidence of VMPFC abnormalities comes from neuropathological, structural and functional studies. Patients with acquired brain injury to the VMPFC display profound disruption of social behaviour and poor judgment in their personal lives. The Iowa Gambling Task (IGT) was developed to assess decision-making in these neurological cases : it presents a series of 100 choices from four card decks that differ in the distribution of rewarding and punishing outcomes. Whilst healthy volunteers gradually develop a preference for the two "safe" decks over the course of the task, patients with VMPFC lesions maintain a preference for the two "risky" decks which are associated with high reinforcement in the short term, but significant long-term debt. Interestingly, damage to VMPFC may cause both poor performance on the IGT and lack of insight concerning the acquired personality modification. Recently, our group reported a trait-related decisionmaking impairment in the three phases of bipolar disorder. In a PET study, VMPFC dysfunction was shown in bipolar manic patients impaired on a decision-making task and an association between decision-making cognition and lack of insight was described in mania. A quantitative association between grey matter volume of VMPFC and memory impairment was previously reported in schizophrenia. Research suggests that lack of insight is a prevalent feature in schizophrenia patients, like auditory hallucinations, paranoid or bizarre delusions, and disorganized speech and thinking. Because schizophrenia is associated with significant social or occupational

  7. Better clinical decision making and reducing diagnostic error.

    PubMed

    Croskerry, P; Nimmo, G R

    2011-06-01

    A major amount of our time working in clinical practice involves thinking and decision making. Perhaps it is because decision making is such a commonplace activity that it is assumed we can all make effective decisions. However, this is not the case and the example of diagnostic error supports this assertion. Until quite recently there has been a general nihilism about the ability to change the way that we think, but it is now becoming accepted that if we can think about, and understand, our thinking processes we can improve our decision making, including diagnosis. In this paper we review the dual process model of decision making and highlight ways in which decision making can be improved through the application of this model to our day-to-day practice and by the adoption of de-biasing strategies and critical thinking. PMID:21677922

  8. Venture Capital Investment Selection Decision-making Base on Fuzzy Theory

    NASA Astrophysics Data System (ADS)

    Zhang, Xubo

    Venture capital investment decision-making is the most important issue in venture capital investment selection. There are higher uncertainty and complexity in venture capital investment decision-making process. This paper analysis these uncertain risk in venture capital investment decision-making base the previous studies. Attributed the venture capital candidate firms' select to fuzzy optimal decision-making. Build a risk-weight fuzzy optimal return model to avoid the decision-making risk. Get the optimal solution set.

  9. Simulation of human decision making

    DOEpatents

    Forsythe, J. Chris; Speed, Ann E.; Jordan, Sabina E.; Xavier, Patrick G.

    2008-05-06

    A method for computer emulation of human decision making defines a plurality of concepts related to a domain and a plurality of situations related to the domain, where each situation is a combination of at least two of the concepts. Each concept and situation is represented in the computer as an oscillator output, and each situation and concept oscillator output is distinguishable from all other oscillator outputs. Information is input to the computer representative of detected concepts, and the computer compares the detected concepts with the stored situations to determine if a situation has occurred.

  10. “I didn’t even know what I was looking for”: A qualitative study of the decision-making processes of Canadian medical tourists

    PubMed Central

    2012-01-01

    Background Medical tourism describes the private purchase and arrangement of medical care by patients across international borders. Increasing numbers of medical facilities in countries around the world are marketing their services to a receptive audience of international patients, a phenomenon that has largely been made possible by the growth of the Internet. The growth of the medical tourism industry has raised numerous concerns around patient safety and global health equity. In spite of these concerns, there is a lack of empirical research amongst medical tourism stakeholders. One such gap is a lack of engagement with medical tourists themselves, where there is currently little known about how medical tourists decide to access care abroad. We address this gap through examining aspects of Canadian medical tourists’ decision-making processes. Methods Semi-structured phone interviews were administered to 32 Canadians who had gone abroad as medical tourists. Interviews touched on motivations, assessment of risks, information seeking processes, and experiences at home and abroad. A thematic analysis of the interview transcripts followed. Results Three overarching themes emerged from the interviews: (1) information sources consulted; (2) motivations, considerations, and timing; and (3) personal and professional supports drawn upon. Patient testimonials and word of mouth connections amongst former medical tourists were accessed and relied upon more readily than the advice of family physicians. Neutral, third-party information sources were limited, which resulted in participants also relying on medical tourism facilitators and industry websites. Conclusions While Canadian medical tourists are often thought to be motivated by wait times for surgery, cost and availability of procedures were common primary and secondary motivations for participants, demonstrating that motivations are layered and dynamic. The findings of this analysis offer a number of important factors

  11. A brief history of decision making.

    PubMed

    Buchanan, Leigh; O'Connell, Andrew

    2006-01-01

    Sometime around the middle of the past century, telephone executive Chester Barnard imported the term decision making from public administration into the business world. There it began to replace narrower terms, like "resource allocation" and "policy making," shifting the way managers thought about their role from continuous, Hamlet-like deliberation toward a crisp series of conclusions reached and actions taken. Yet, decision making is, of course, a broad and ancient human pursuit, flowing back to a time when people sought guidance from the stars. From those earliest days, we have strived to invent better tools for the purpose, from the Hindu-Arabic systems for numbering and algebra, to Aristotle's systematic empiricism, to friar Occam's advances in logic, to Francis Bacon's inductive reasoning, to Descartes's application of the scientific method. A growing sophistication with managing risk, along with a nuanced understanding of human behavior and advances in technology that support and mimic cognitive processes, has improved decision making in many situations. Even so, the history of decision-making strategies--captured in this time line and examined in the four accompanying essays on risk, group dynamics, technology, and instinct--has not marched steadily toward perfect rationalism. Twentieth-century theorists showed that the costs of acquiring information lead executives to make do with only good-enough decisions. Worse, people decide against their own economic interests even when they know better. And in the absence of emotion, it's impossible to make any decisions at all. Erroneous framing, bounded awareness, excessive optimism: The debunking of Descartes's rational man threatens to swamp our confidence in our choices. Is it really surprising, then, that even as technology dramatically increases our access to information, Malcolm Gladwell extols the virtues of gut decisions made, literally, in the blink of an eye? PMID:16447367

  12. Dopaminergic Modulation of Risky Decision-Making

    PubMed Central

    Simon, Nicholas W.; Montgomery, Karienn S.; Beas, Blanca S.; Mitchell, Marci R.; LaSarge, Candi L.; Mendez, Ian A.; Bañuelos, Cristina; Vokes, Colin M.; Taylor, Aaron B.; Haberman, Rebecca P.; Bizon, Jennifer L.; Setlow, Barry

    2012-01-01

    Many psychiatric disorders are characterized by abnormal risky decision-making and dysregulated dopamine receptor expression. The current study was designed to determine how different dopamine receptor subtypes modulate risk-taking in young adult rats, using a “Risky Decision-making Task” that involves choices between small “safe” rewards and large “risky” rewards accompanied by adverse consequences. Rats showed considerable, stable individual differences in risk preference in the task, which were not related to multiple measures of reward motivation, anxiety, or pain sensitivity. Systemic activation of D2-like receptors robustly attenuated risk-taking, whereas drugs acting on D1-like receptors had no effect. Systemic amphetamine also reduced risk-taking, an effect which was attenuated by D2-like (but not D1-like) receptor blockade. Dopamine receptor mRNA expression was evaluated in a separate cohort of drug-naive rats characterized in the task. D1 mRNA expression in both nucleus accumbens shell and insular cortex was positively associated with risk-taking, while D2 mRNA expression in orbitofrontal and medial prefrontal cortex predicted risk preference in opposing nonlinear patterns. Additionally, lower levels of D2 mRNA in dorsal striatum were associated with greater risk-taking. These data strongly implicate dopamine signaling in prefrontal corticalstriatal circuitry in modulating decision-making processes involving integration of reward information with risks of adverse consequences. PMID:22131407

  13. Causal evidence for frontal cortex organization for perceptual decision making.

    PubMed

    Rahnev, Dobromir; Nee, Derek Evan; Riddle, Justin; Larson, Alina Sue; D'Esposito, Mark

    2016-05-24

    Although recent research has shown that the frontal cortex has a critical role in perceptual decision making, an overarching theory of frontal functional organization for perception has yet to emerge. Perceptual decision making is temporally organized such that it requires the processes of selection, criterion setting, and evaluation. We hypothesized that exploring this temporal structure would reveal a large-scale frontal organization for perception. A causal intervention with transcranial magnetic stimulation revealed clear specialization along the rostrocaudal axis such that the control of successive stages of perceptual decision making was selectively affected by perturbation of successively rostral areas. Simulations with a dynamic model of decision making suggested distinct computational contributions of each region. Finally, the emergent frontal gradient was further corroborated by functional MRI. These causal results provide an organizational principle for the role of frontal cortex in the control of perceptual decision making and suggest specific mechanistic contributions for its different subregions. PMID:27162349

  14. Causal evidence for frontal cortex organization for perceptual decision making

    PubMed Central

    Nee, Derek Evan; Riddle, Justin; Larson, Alina Sue; D’Esposito, Mark

    2016-01-01

    Although recent research has shown that the frontal cortex has a critical role in perceptual decision making, an overarching theory of frontal functional organization for perception has yet to emerge. Perceptual decision making is temporally organized such that it requires the processes of selection, criterion setting, and evaluation. We hypothesized that exploring this temporal structure would reveal a large-scale frontal organization for perception. A causal intervention with transcranial magnetic stimulation revealed clear specialization along the rostrocaudal axis such that the control of successive stages of perceptual decision making was selectively affected by perturbation of successively rostral areas. Simulations with a dynamic model of decision making suggested distinct computational contributions of each region. Finally, the emergent frontal gradient was further corroborated by functional MRI. These causal results provide an organizational principle for the role of frontal cortex in the control of perceptual decision making and suggest specific mechanistic contributions for its different subregions. PMID:27162349

  15. Couple Decision Making and Use of Cultural Scripts in Malawi

    PubMed Central

    Mbweza, Ellen; Norr, Kathleen F.; McElmurry, Beverly

    2011-01-01

    Purpose To examine the decision-making processes of husband and wife dyads in matrilineal and patrilineal marriage traditions of Malawi in the areas of money, food, pregnancy, contraception, and sexual relations. Methods Qualitative grounded theory using simultaneous interviews of 60 husbands and wives (30 couples). Data were analyzed according to the guidelines of simultaneous data collection and analysis. The analysis resulted in development of core categories and categories of decision-making process. Data matrixes were used to identify similarities and differences within couples and across cases. Findings Most couples reported using a mix of final decision-making approaches: husband-dominated, wife-dominated, and shared. Gender based and nongender based cultural scripts provided rationales for their approaches to decision making. Gender based cultural scripts (husband-dominant and wife-dominant) were used to justify decision-making approaches. Non-gender based cultural scripts (communicating openly, maintaining harmony, and children’s welfare) supported shared decision making. Gender based cultural scripts were used in decision making more often among couples from the district with a patrilineal marriage tradition and where the husband had less than secondary school education and was not formally employed. Conclusions Nongender based cultural scripts to encourage shared decision making can be used in designing culturally tailored reproductive health interventions for couples. Clinical Relevance Nurses who work with women and families should be aware of the variations that occur in actual couple decision-making approaches. Shared decision making can be used to encourage the involvement of men in reproductive health programs. PMID:18302586

  16. Decision making: rational or hedonic?

    PubMed Central

    Cabanac, Michel; Bonniot-Cabanac, Marie-Claude

    2007-01-01

    Three experiments studied the hedonicity of decision making. Participants rated their pleasure/displeasure while reading item-sentences describing political and social problems followed by different decisions (Questionnaire 1). Questionnaire 2 was multiple-choice, grouping the items from Questionnaire 1. In Experiment 1, participants answered Questionnaire 2 rapidly or slowly. Both groups selected what they had rated as pleasant, but the 'leisurely' group maximized pleasure less. In Experiment 2, participants selected the most rational responses. The selected behaviors were pleasant but less than spontaneous behaviors. In Experiment 3, Questionnaire 2 was presented once with items grouped by theme, and once with items shuffled. Participants maximized the pleasure of their decisions, but the items selected on Questionnaires 2 were different when presented in different order. All groups maximized pleasure equally in their decisions. These results support that decisions are made predominantly in the hedonic dimension of consciousness. PMID:17848195

  17. Crew decision making under stress

    NASA Technical Reports Server (NTRS)

    Orasanu, J.

    1992-01-01

    Flight crews must make decisions and take action when systems fail or emergencies arise during flight. These situations may involve high stress. Full-missiion flight simulation studies have shown that crews differ in how effectively they cope in these circumstances, judged by operational errors and crew coordination. The present study analyzed the problem solving and decision making strategies used by crews led by captains fitting three different personality profiles. Our goal was to identify more and less effective strategies that could serve as the basis for crew selection or training. Methods: Twelve 3-member B-727 crews flew a 5-leg mission simulated flight over 1 1/2 days. Two legs included 4 abnormal events that required decisions during high workload periods. Transcripts of videotapes were analyzed to describe decision making strategies. Crew performance (errors and coordination) was judged on-line and from videotapes by check airmen. Results: Based on a median split of crew performance errors, analyses to date indicate a difference in general strategy between crews who make more or less errors. Higher performance crews showed greater situational awareness - they responded quickly to cues and interpreted them appropriately. They requested more decision relevant information and took into account more constraints. Lower performing crews showed poorer situational awareness, planning, constraint sensitivity, and coordination. The major difference between higher and lower performing crews was that poorer crews made quick decisions and then collected information to confirm their decision. Conclusion: Differences in overall crew performance were associated with differences in situational awareness, information management, and decision strategy. Captain personality profiles were associated with these differences, a finding with implications for crew selection and training.

  18. Hypoplastic left heart syndrome: parent support for early decision making.

    PubMed

    Toebbe, Sarah; Yehle, Karen; Kirkpatrick, Jane; Coddington, Jennifer

    2013-01-01

    Hypoplastic left heart syndrome is a life threatening congenital cardiac anomaly. After a child has been diagnosed with hypoplastic left heart syndrome, parents must make life or death decisions within days of birth. Healthcare providers must provide appropriate education so that parents are able to make informed, timely decisions. Information regarding the diagnosis, treatment options, and parental decision making process for initial decision making for hypoplastic left heart syndrome are provided to guide nurses who work with these families. The challenging decision making process that parents must go through after diagnosis of hypoplastic left heart syndrome will be described. PMID:23246301

  19. Status of dual control theory. [stochastic decision making

    NASA Technical Reports Server (NTRS)

    Tse, E.

    1975-01-01

    Theoretical studies of decision making and stochastic processes are discussed. Several approaches are described for an improved performing control method. It is shown that control performance is highly dependent on the knowledge of the unknown parameters in the system.

  20. Decision-making Strategies and Performance among Seniors1

    PubMed Central

    Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael

    2011-01-01

    Using paper and pencil experiments administered in senior centers, we examine decision-making performance in multi-attribute decision problems. We differentiate the effects of declining cognitive performance and changing cognitive process on decision-making performance of seniors as they age. We find a significant decline in performance with age due to reduced reliance on common heuristics and increased decision-making randomness among our oldest subjects. However, we find that increasing the number of options in a decision problem increases the number of heuristics brought to the task. This challenges the choice overload view that people give up when confronted with too much choice. PMID:22408282

  1. Training for Aviation Decision Making: The Naturalistic Decision Making Perspective

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith; Shafto, Michael G. (Technical Monitor)

    1995-01-01

    This paper describes the implications of a naturalistic decision making (NDM) perspective for training air crews to make flight-related decisions. The implications are based on two types of analyses: (a) identification of distinctive features that serve as a basis for classifying a diverse set of decision events actually encountered by flight crews, and (b) performance strategies that distinguished more from less effective crews flying full-mission simulators, as well as performance analyses from NTSB accident investigations. Six training recommendations are offered: (1) Because of the diversity of decision situations, crews need to be aware that different strategies may be appropriate for different problems; (2) Given that situation assessment is essential to making a good decision, it is important to train specific content knowledge needed to recognize critical conditions, to assess risks and available time, and to develop strategies to verify or diagnose the problem; (3) Tendencies to oversimplify problems may be overcome by training to evaluate options in terms of goals, constraints, consequences, and prevailing conditions; (4) In order to provide the time to gather information and consider options, it is essential to manage the situation, which includes managing crew workload, prioritizing tasks, contingency planning, buying time (e.g., requesting holding or vectors), and using low workload periods to prepare for high workload; (5) Evaluating resource requirements ("What do I need?") and capabilities ("'What do I have?" ) are essential to making good decisions. Using resources to meet requirements may involve the cabin crew, ATC, dispatchers, and maintenance personnel; (6) Given that decisions must often be made under high risk, time pressure, and workload, train under realistic flight conditions to promote the development of robust decision skills.

  2. A Theory of Medical Decision Making and Health: Fuzzy Trace Theory

    PubMed Central

    Reyna, Valerie F.

    2008-01-01

    The tenets of fuzzy trace theory are summarized with respect to their relevance to health and medical decision making. Illustrations are given for HIV prevention, cardiovascular disease, surgical risk, genetic risk, and cancer prevention and control. A core idea of fuzzy trace theory is that people rely on the gist of information, its bottom-line meaning, as opposed to verbatim details in judgment and decision making. This idea explains why precise information (e.g., about risk) is not necessarily effective in encouraging prevention behaviors or in supporting medical decision making. People can get the facts right, and still not derive the proper meaning, which is key to informed decision making. Getting the gist is not sufficient, however. Retrieval (e.g., of health-related values) and processing interference brought on by thinking about nested or overlapping classes (e.g., in ratio concepts, such as probability) are also important. Theory-based interventions that work (and why they work) are presented, ranging from specific techniques aimed at enhancing representation, retrieval, and processing to a comprehensive intervention that integrates these components. PMID:19015287

  3. Decision-making mechanisms in the brain

    NASA Astrophysics Data System (ADS)

    Deco, Gustavo; Rolls, Edmund T.

    2007-02-01

    Behavioral, neurophysiological, and theoretical studies are converging to a common theory of decision-making that assumes an underlying diffusion process which integrates both the accumulation of perceptual and cognitive evidence for making the decision and motor choice in one unifying neural network. In particular, neuronal activity in the ventral premotor cortex (VPC) is related to decision-making while trained monkeys compare two mechanical vibrations applied sequentially to the tip of a finger to report which of the two stimuli have the higher frequency (Romo et al. 2004, Neuron 41: 165). In particular, neurons were found whose response depended only on the difference between the two applied frequencies, the sign of that difference being the determining factor for correct task performance. We describe an integrate-and-fire attractor model with realistic synaptic dynamics including AMPA, NMDA and GABA synapses which can reproduce the decision-making related response selectivity of VPC neurons during the comparison period of the task. Populations of neurons for each decision in the biased competition attractor receive a bias input that depends on the firing rates of neurons in the VPC that code for the two vibrotactile frequencies. It was found that if the connectivity parameters of the network are tuned, using mean-field techniques, so that the network has two possible stable stationary final attractors respectively related to the two possible decisions, then the firing rate of the neurons in whichever attractor wins reflects the sign of the difference in the frequencies being compared but not the absolute frequencies. Thus Weber's law for frequency comparison is not encoded by the firing rate of the neurons in these attractors. An analysis of the nonstationary evolution of the dynamics of the network model shows that Weber's law is implemented in the probability of transition from the initial spontaneous firing state to one of the two possible attractor states

  4. Factors influencing dental decision making.

    PubMed

    Grembowski, D; Milgrom, P; Fiset, L

    1988-01-01

    In clinical decision making, dentists routinely choose between alternative treatments such as crown vs amalgam/composite buildup, root canal vs extraction, fixed bridge vs removable partial denture, and prophylaxis vs subgingival curettage or periodontal scaling. A number of technical and patient factors can influence dentists' choice of treatment in these situations; however, little is known about their relative importance. To address this issue, a list of technical (e.g., periodontal status and caries rate) and patient (e.g., cost and patient preference) factors possibly influencing choice of treatment was developed for each pair of services. Responding to a mail questionnaire, 156 general dentists in Washington State listed the top three factors influencing their choice of service in each pair. Results revealed that dentists took different factors into account in choosing among alternative treatments. Technical factors dominated over patient concerns; only about 33 percent of the dentists considered patient factors important in choosing alternative therapies. The latter group was less preventively oriented, were solo practitioners, worked longer hours, and had lower prices. Results suggest patients may have little influence on prescriptions of therapy among experienced general dentists. PMID:3045303

  5. Incorporating environmental justice into environmental decision making

    SciTech Connect

    Wolfe, A.K.; Vogt, D.P.; Hwang, Ho-Ling

    1995-07-01

    Executive Order 12898, signed on February 11, 1994, broadly states that federal activities, programs, and policies should not produce disproportionately high and adverse impacts on minority and low-income populations. Moreover, the Order indicates that these populations should not be denied the benefits of, or excluded from participation in, these activities, programs, and policies. Because a presidential memorandum accompanying the order said that National Environmental Policy Act (NEPA) documents should begin to address environmental justice immediately, much attention has been paid to assessment-related issues. Also important, a topic that appears to have received relatively little attention, is how decision makers should be expected to use information about environmental justice in their decision making. This paper discusses issues surrounding the use of environmental justice information in the decision-making process by focusing on the following five main topics: (1) the importance, or weight, attached to environmental justice within larger decision-making contexts; (2) the potential tension between localized environmental justice issues and regional or national issues and needs; (3) the use of environmental justice information to develop (perhaps in concert with affected minority and low-income communities) appropriate mitigation strategies, or to establish conditions under which activities, programs, and policies may be accepted locally; (4) the general implications of shifting the distribution of broadly defined risks, costs, and benefits among different population groups; and (5) the implications of implementing environmental justice on an individual, ad hoc basis rather than within a larger environmental justice framework. This paper raises the issues and discusses the implications of alternative approaches to them.

  6. Decision-Making Theories and Career Assessment: A Psychometric Evaluation of the Decision Making Inventory

    ERIC Educational Resources Information Center

    Hardin, Erin E.; Leong, Frederick T. L.

    2004-01-01

    To address criticisms that the empirical literature on assessment of career decision making has tended to lack a theoretical base, the present study explored the relevance of a general theory of decision making to career decision making by assessing the psychometric properties of the Decision Making Inventory (DMI), designed to measure Johnson's…

  7. Mentalizing in economic decision-making.

    PubMed

    Polezzi, David; Daum, Irene; Rubaltelli, Enrico; Lotto, Lorella; Civai, Claudia; Sartori, Giuseppe; Rumiati, Rino

    2008-07-19

    In the Ultimatum Game, participants typically reject monetary offers they consider unfair even if the alternative is to gain no money at all. In the present study, ERPs were recorded while subjects processed different offers of a proposer. In addition to clearly fair and unfair offers, mid-value offers which cannot be easily classified as fair or unfair and therefore involve more elaborate decision making were analyzed. A fast initial distinction between fair and other kinds of offers was reflected by amplitude of the feedback related negativity (FRN). Mid-value offers were associated with longer RTs, and a larger N350 amplitude. In addition, source analyses revealed a specific involvement of the superior temporal gyrus and the inferior parietal lobule during processing of mid-value offers compared to offers categorized clearly as fair or unfair, suggesting a contribution of mentalizing about the intention of the proposer to the decision making process. Taken together, the present findings support the idea that economic decisions are significantly affected by non-rational factors, trying to narrow the gap between formal theory and the real decisional behaviour. PMID:18406476

  8. The Role of Science in Advising the Decision Making Process: A Pathway for Building Effective Climate Change Mitigation Policies in Mexico at the Local Level.

    PubMed

    Barraza, Roberto; Velazquez-Angulo, Gilberto; Flores-Tavizón, Edith; Romero-González, Jaime; Huertas-Cardozo, José Ignacio

    2016-01-01

    This study examines a pathway for building urban climate change mitigation policies by presenting a multi-dimensional and transdisciplinary approach in which technical, economic, environmental, social, and political dimensions interact. Now, more than ever, the gap between science and policymaking needs to be bridged; this will enable judicious choices to be made in regarding energy and climate change mitigation strategies, leading to positive social impacts, in particular for the populations at-risk at the local level. Through a case study in Juarez, Chihuahua, Mexico, we propose a multidimensional and transdisciplinary approach with the role of scientist as policy advisers to improve the role of science in decision-making on mitigation policies at the local level in Mexico. PMID:27128933

  9. The Role of Science in Advising the Decision Making Process: A Pathway for Building Effective Climate Change Mitigation Policies in Mexico at the Local Level

    PubMed Central

    Barraza, Roberto; Velazquez-Angulo, Gilberto; Flores-Tavizón, Edith; Romero-González, Jaime; Huertas-Cardozo, José Ignacio

    2016-01-01

    This study examines a pathway for building urban climate change mitigation policies by presenting a multi-dimensional and transdisciplinary approach in which technical, economic, environmental, social, and political dimensions interact. Now, more than ever, the gap between science and policymaking needs to be bridged; this will enable judicious choices to be made in regarding energy and climate change mitigation strategies, leading to positive social impacts, in particular for the populations at-risk at the local level. Through a case study in Juarez, Chihuahua, Mexico, we propose a multidimensional and transdisciplinary approach with the role of scientist as policy advisers to improve the role of science in decision-making on mitigation policies at the local level in Mexico. PMID:27128933

  10. Instructional decision making of high school science teachers

    NASA Astrophysics Data System (ADS)

    Carver, Jeffrey S.

    The instructional decision-making processes of high school science teachers have not been well established in the literature. Several models for decision-making do exist in other teaching disciplines, business, computer game programming, nursing, and some fields of science. A model that incorporates differences in science teaching that is consistent with constructivist theory as opposed to conventional science teaching is useful in the current climate of standards-based instruction that includes an inquiry-based approach to teaching science. This study focuses on three aspects of the decision-making process. First, it defines what factors, both internal and external, influence high school science teacher decision-making. Second, those factors are analyzed further to determine what instructional decision-making processes are articulated or demonstrated by the participants. Third, by analyzing the types of decisions that are made in the classroom, the classroom learning environments established as a result of those instructional decisions are studied for similarities and differences between conventional and constructivist models. While the decision-making process for each of these teachers was not clearly articulated by the teachers themselves, the patterns that establish the process were clearly exhibited by the teachers. It was also clear that the classroom learning environments that were established were, at least in part, established as a result of the instructional decisions that were made in planning and implementation of instruction. Patterns of instructional decision-making were different for each teacher as a result of primary instructional goals that were different for each teacher. There were similarities between teachers who exhibited more constructivist epistemological tendencies as well as similarities between teachers who exhibited a more conventional epistemology. While the decisions that will result from these two camps may be different, the six step

  11. Phenotyping, endotyping and clinical decision-making.

    PubMed

    Fokkens, W J

    2016-06-01

    We have exiting times in the treatment of chronic rhinosinusitis (CRS). The last year has brought us a number of new ideas and publications to help in decision-making in daily practice. In the first issue of this year, Claire Hopkins and co-authors identified the most important outcomes for patients, public and practitioners that should be evaluated in studies on health interventions for CRS. In this issue of the journal, a group of experts tried to define appropriateness criteria for endoscopic sinus surgery during management of uncomplicated adult chronic rhinosinusitis. Appropriate indications for endoscopic sinus surgery (ESS) are currently poorly defined and the lack of clear surgical indications for ESS likely contributes to the large geographic variation in surgical rates. Using the Delphi method a total of 624 clinical scenarios (half CRSsNP and half CRSwNP) were ranked. The study clearly states that this group of experts indicates that ESS can only be indicated after medical treatment has failed with patients still having significant symptoms (SNOT-22 over 20) and at least some abnormalities at CT scan. PMID:27236249

  12. Decision making in bipolar disorder: a cognitive modeling approach.

    PubMed

    Yechiam, Eldad; Hayden, Elizabeth P; Bodkins, Misty; O'Donnell, Brian F; Hetrick, William P

    2008-11-30

    A formal modeling approach was used to characterize decision-making processes in bipolar disorder. Decision making was examined in 28 bipolar patients (14 acute and 14 remitted) and 25 controls using the Iowa Gambling Task (Bechara et al., 1994), a decision-making task used for assessing cognitive impulsivity. To disentangle motivational and cognitive aspects of decision-making processes, we applied a formal cognitive model to the performance on the Iowa Gambling Task. The model has three parameters: The relative impact of rewards and punishments on evaluations, the impact of recent and past payoffs, and the degree of choice consistency. The results indicated that acute bipolar patients were characterized by low choice consistency, or a tendency to make erratic choices. Low choice consistency improved the prediction of acute bipolar disorder beyond that provided by cognitive functioning and self-report measures of personality and temperament. PMID:18848361

  13. Collaborative decision making for sustainable development

    SciTech Connect

    Kinsley, M.J.

    1995-12-31

    For many years, economic development has mean industrial recruitment where business-at-any-cost was preached by a small elite, where civic discord replaced civic discussion, where families made more money but had less to spend, where residents learned to lock their doors, where communities changed from the unique to commonplace and a thousand towns looked alike. But now, scores of communities are saying no to old, worn-out approaches to development and embracing a new kind of development that respects the community and the environment. Created collaboratively by people from all walks of community life, this new approach is called sustainable community economic development. Though new, sustainable development is based on traditional values of stewardship and working together. Its principles are powerful in their simplicity. Its lessons enrich community decision making. This paper describes these principles and lessons. It introduces a community decision-making process that applies them and suggests the kinds of results you can expect from such a process in your town.

  14. Improving Adolescent Judgment and Decision Making.

    PubMed

    Dansereau, Donald F; Knight, Danica K; Flynn, Patrick M

    2013-01-01

    Human judgment and decision making (JDM) has substantial room for improvement, especially among adolescents. Increased technological and social complexity "ups the ante" for developing impactful JDM interventions and aids. Current explanatory advances in this field emphasize dual processing models that incorporate both experiential and analytic processing systems. According to these models, judgment and decisions based on the experiential system are rapid and stem from automatic reference to previously stored episodes. Those based on the analytic system are viewed as slower and consciously developed. These models also hypothesize that metacognitive (self-monitoring) activities embedded in the analytic system influence how and when the two systems are used. What is not included in these models is the development of an intersection between the two systems. Because such an intersection is strongly suggested by memory and educational research as the basis of wisdom/expertise, the present paper describes an Integrated Judgment and Decision-Making Model (IJDM) that incorporates this component. Wisdom/expertise is hypothesized to contain a collection of schematic structures that can emerge from the accumulation of similar episodes or repeated analytic practice. As will be argued, in comparisons to dual system models, the addition of this component provides a broader basis for selecting and designing interventions to improve adolescent JDM. Its development also has implications for generally enhancing cognitive interventions by adopting principles from athletic training to create automated, expert behaviors. PMID:24391350

  15. Naturalistic Decision Making For Power System Operators

    SciTech Connect

    Greitzer, Frank L.; Podmore, Robin; Robinson, Marck; Ey, Pamela

    2009-06-23

    Abstract: Motivation -- As indicated by the Blackout of 2003, the North American interconnected electric system is vulnerable to cascading outages and widespread blackouts. Investigations of large scale outages often attribute the causes to the three T’s: Trees, Training and Tools. A systematic approach has been developed to document and understand the mental processes that an expert power system operator uses when making critical decisions. The approach has been developed and refined as part of a capability demonstration of a high-fidelity real-time power system simulator under normal and emergency conditions. To examine naturalistic decision making (NDM) processes, transcripts of operator-to-operator conversations are analyzed to reveal and assess NDM-based performance criteria. Findings/Design -- The results of the study indicate that we can map the Situation Awareness Level of the operators at each point in the scenario. We can also identify clearly what mental models and mental simulations are being performed at different points in the scenario. As a result of this research we expect that we can identify improved training methods and improved analytical and visualization tools for power system operators. Originality/Value -- The research applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message -- The NDM approach provides an ideal framework for systematic training management and mitigation to accelerate learning in team-based training scenarios with high-fidelity power grid simulators.

  16. Key role of social work in effective communication and conflict resolution process: Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and shared medical decision making at the end of life.

    PubMed

    Bomba, Patricia A; Morrissey, Mary Beth; Leven, David C

    2011-01-01

    In this article, the authors review the development of the Medical Orders for Life-Sustaining Treatment (MOLST) Program and recent landmark legislation in New York State in the context of advance care planning and shared medical decision making at the end of life. Social workers are central health care professionals in working with patients, families, practitioners, health care agents, and surrogates in the health systems and in the communication and conflict resolution process that is integral to health care decision making. The critical importance of ethics and end-of-life training and education for social workers is also addressed. Data from a pilot study evaluating interdisciplinary ethics training on legal and ethical content in communication and conflict resolution skills in health care decision making are reported. Recommendations are made for research on education and training of social workers, and investigation of the role and influence of systems in shaping social work involvement in end-of-life and palliative care. PMID:21391078

  17. Naturalistic Decision Making for Power System Operators

    SciTech Connect

    Greitzer, Frank L.; Podmore, Robin; Robinson, Marck; Ey, Pamela

    2010-02-01

    Motivation – Investigations of large-scale outages in the North American interconnected electric system often attribute the causes to three T’s: Trees, Training and Tools. To document and understand the mental processes used by expert operators when making critical decisions, a naturalistic decision making (NDM) model was developed. Transcripts of conversations were analyzed to reveal and assess NDM-based performance criteria. Findings/Design – An item analysis indicated that the operators’ Situation Awareness Levels, mental models, and mental simulations can be mapped at different points in the training scenario. This may identify improved training methods or analytical/ visualization tools. Originality/Value – This study applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message – The NDM approach provides a viable framework for systematic training management to accelerate learning in simulator-based training scenarios for power system operators and teams.

  18. Multistable binary decision making on networks

    NASA Astrophysics Data System (ADS)

    Lucas, Andrew; Lee, Ching Hua

    2013-03-01

    We propose a simple model for a binary decision making process on a graph, motivated by modeling social decision making with cooperative individuals. The model is similar to a random field Ising model or fiber bundle model, but with key differences in behavior on heterogeneous networks. For many types of disorder and interactions between the nodes, we predict with mean field theory discontinuous phase transitions that are largely independent of network structure. We show how these phase transitions can also be understood by studying microscopic avalanches and describe how network structure enhances fluctuations in the distribution of avalanches. We suggest theoretically the existence of a “glassy” spectrum of equilibria associated with a typical phase, even on infinite graphs, so long as the first moment of the degree distribution is finite. This behavior implies that the model is robust against noise below a certain scale and also that phase transitions can switch from discontinuous to continuous on networks with too few edges. Numerical simulations suggest that our theory is accurate.

  19. Informed Consent in Decision-Making in Pediatric Practice.

    PubMed

    Katz, Aviva L; Webb, Sally A

    2016-08-01

    Informed consent should be seen as an essential part of health care practice; parental permission and childhood assent is an active process that engages patients, both adults and children, in their health care. Pediatric practice is unique in that developmental maturation allows, over time, for increasing inclusion of the child's and adolescent's opinion in medical decision-making in clinical practice and research. This technical report, which accompanies the policy statement "Informed Consent in Decision-Making in Pediatric Practice" was written to provide a broader background on the nature of informed consent, surrogate decision-making in pediatric practice, information on child and adolescent decision-making, and special issues in adolescent informed consent, assent, and refusal. It is anticipated that this information will help provide support for the recommendations included in the policy statement. PMID:27456510

  20. Decision making and co-operation between stakeholders within the process of sick leave. A case study in a Danish municipality.

    PubMed

    Johansen, Kristina; Andersen, John Sahl; Mikkelsen, Sigurd; Lynge, Elsebeth

    2011-01-01

    The study addresses how recent reforms of the Sickness Benefit Act in Denmark are put into practice. A single case study embedded with five subunits of analysis based on "real life" cases has been conducted in a Danish municipality. Five "sick-listed" citizens and their respective municipal case manager and general practitioner (GP) were interviewed. Two key persons within the municipality were interviewed as background informants. The GPs and case managers ability to co-operate was hampered by lack of time, frequent staff turnover, lack of financial resources, and low accessibility. The motivation for co-operation was low due to low status of social medical issues, lack of feedback and lack of trust. The co-operation was characterized by sequential task integration. The stakeholders encountered difficulties when reciprocal task integration was needed. The decision making was affected by legal constraints and conflicting paradigms of key stakeholders. Rather than forcing co-operation, policymakers should increase the stakeholders' abilities and improve the conditions that create the low level of trust and hamper the willingness to co-operate. PMID:20795840

  1. Aeromedical decision making: from principles to practice.

    PubMed

    Navathe, Pooshan; Drane, Michael; Preitner, Claude

    2014-05-01

    While there is literature which describes aeromedical decision making (ADM), there is not much which describes a process identifying the steps to be taken in arriving at such decisions. A five-step algorithm is proposed to clarify the ADM process. The five steps are: 1) determine the likelihood of a clinically significant event from the health condition; 2) determine the likelihood of an undesirable aviation event from the health condition; 3) determine the acceptability of the combined risks (#1 and #2); 4) determine the risk level after clinical intervention for the health condition; and 5) determine the risk level after operational restrictions for the health condition. There are several factors which can affect the various steps in the algorithm, such as uncertainty, difficulty in generalization, power and "fit" of the studies, etc. Notwithstanding these issues, the algorithm serves a useful purpose in providing a pathway for ADM. PMID:24834574

  2. Incorporating patients' preferences into medical decision making.

    PubMed

    Fraenkel, Liana

    2013-02-01

    Current models of care emphasize the importance of including patients' values in the decision-making process. This is particularly important for decisions for which there are few data supporting a clear strategy or treatment choice. Constructing preferences for complex decisions requires that patients be able to consider multiple trade-offs between specific risks and benefits. Several marketing research techniques have been recently applied to heath care settings to facilitate this process. Most can be programmed to generate patients' preferences or priorities, which can then be used to improve patient-physician communication. In this article, we will describe some of the currently available approaches that have been successfully used in the health care setting. We provide case examples to illustrate the potential value of adopting each of these approaches in clinical practice. PMID:23132890

  3. Practice Makes Perfect: Prospective Teachers Develop Skills in Decision-Making.

    ERIC Educational Resources Information Center

    John, Martha Tyler; Norton, Robert

    Preservice teachers must develop decision making skills and feel comfortable with decision making processes. Prospective teachers at MidAmerican Nazarene College (MNU), Kansas, are involved in a research based output system called the Decision-Making Packet (DMP). DMP's are units of study that allow students choice and require their pupils to take…

  4. Career Decision-Making Characteristics of Primary Education Students in Greece

    ERIC Educational Resources Information Center

    Sidiropoulou-Dimakakou, Despina; Mylonas, Kostas; Argyropoulou, Katerina; Drosos, Nikos

    2013-01-01

    The present study aims at investigating career decision-making process of 6th grade students with the use of the Childhood Career Decision-Making Questionnaire (CCDMQ). CCDMQ offers scores for the following three decision-making dimensions: (a) "Concerns/fears regarding career future", (b) "Investment ?n decision-making…

  5. An STS Case Study about Students' Decision Making on the Waste Issue.

    ERIC Educational Resources Information Center

    Kortland, Koos

    1996-01-01

    Assesses students' existing and developing decision-making ability against the background of a normative model of the decision making process. Results indicate that after a unit on household packaging waste the students' arguments about a decision making situation improved in terms of validity and clarity of the criteria used. Contains 16…

  6. Decision-Making in Child Welfare: A Self Instructional Manual. Publication No. 12.

    ERIC Educational Resources Information Center

    Campbell, Margaret M., Ed.; And Others

    Information on the process of decision-making, hints on how to function in team decision-making, and materials on how to prepare clients for decision-making in team meetings for the beginning level child welfare worker are provided in this self-instructional manual. Techniques are discussed for improving the quality of decisions made by the…

  7. Between Safety and Risk: A Model for Outdoor Adventure Decision Making.

    ERIC Educational Resources Information Center

    Boyes, Michael A.; O'Hare, David

    2003-01-01

    Decision making by outdoor adventure educators revolves around balancing risk and competence. A model of outdoor adventure decision making is presented that draws on naturalistic decision-making processes and emphasizes the importance of situational recognition and prior experience. Leaders draw key information from the natural environment,…

  8. Decision-making in diabetes mellitus type 1.

    PubMed

    Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B

    2013-01-01

    Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include "hypoglycemia unawareness" and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease. PMID:23487192

  9. Decision-making models of Finnish nurses and public health nurses.

    PubMed

    Lauri, S; Salanterä, S

    1995-03-01

    This study described nursing decision-making models and variables related to these models. For this purpose a 56-item Likert-type questionnaire was constructed according to the Dreyfus model of skill acquisition as applied to nursing by Benner and information processing theory. The target group consisted of 100 registered nurses working in inpatient clinics and 100 public health nurses working in preventive health care. The decision-making variables explored were nurses' experience, education and knowledge as well as the nature of the nursing task and context. The results revealed four different types of decision-making: (a) unquestioning/questioning decision-making, (b) creative-diversive decision-making, (c) patient/nurse-oriented decision-making, and (d) rule- and situation-based decision-making. The most important factors related to decision-making were experience and the nature of the nursing task and context. PMID:7745207

  10. Delay discounting without decision-making: medial prefrontal cortex and amygdala activations reflect immediacy processing and correlate with impulsivity and anxious-depressive traits

    PubMed Central

    Ludwig, Vera U.; Nüsser, Corinna; Goschke, Thomas; Wittfoth-Schardt, Dina; Wiers, Corinde E.; Erk, Susanne; Schott, Björn H.; Walter, Henrik

    2015-01-01

    Humans value rewards less when these are delivered in the future as opposed to immediately, a phenomenon referred to as delay discounting. While delay discounting has been studied during the anticipation of rewards and in the context of intertemporal decision-making, little is known about its neural correlates in the outcome phase (during reward delivery) and their relation to personality. Personality traits that have been associated with increased delay discounting include impulsivity and, potentially, anxious-depressive traits. Here we performed functional magnetic resonance imaging (fMRI) in 72 healthy participants while they carried out a monetary incentive delay (MID) task with a delay manipulation. In sixty percent of the experimental trials, participants won rewards that differed in magnitude (0.05€, 0.50€ or 1€) and delay until delivery (immediately, 10 days, or 100 days). A factor analysis on questionnaires yielded two factors reflecting Impulsivity and Anxiety/Depression, which we used to examine potential relationships between personality and delay discounting. When winning a reward, medial prefrontal cortex (mPFC) activation was higher for immediate compared to delayed rewards. Moreover, amygdala activation correlated with reward magnitude for immediate but not for delayed rewards. Amygdala activation to winning immediate rewards was higher in more impulsive participants, while mPFC activation to winning immediate rewards was higher in more anxious-depressed participants. Our results uncover neural correlates of delay discounting during reward delivery, and suggest that impulsivity and subclinical anxious-depressive traits are related to stronger neural responses for winning immediate relative to delayed rewards. PMID:26578910

  11. Influence of framing on medical decision making

    PubMed Central

    Gong, Jingjing; Zhang, Yan; Feng, Jun; Huang, Yonghua; Wei, Yazhou; Zhang, Weiwei

    2013-01-01

    Numerous studies have demonstrated the robustness of the framing effect in a variety of contexts, especially in medical decision making. Unfortunately, research is still inconsistent as to how so many variables impact framing effects in medical decision making. Additionally, much attention should be paid to the framing effect not only in hypothetical scenarios but also in clinical experience. PMID:27034630

  12. Decision-Making Strategies for College Students

    ERIC Educational Resources Information Center

    Morey, Janis T.; Dansereau, Donald F.

    2010-01-01

    College students' decision making is often less than optimal and sometimes leads to negative consequences. The effectiveness of two strategies for improving student decision making--node-link mapping and social perspective taking (SPT)--are examined. Participants using SPT were significantly better able to evaluate decision options and develop…

  13. Entrustment Decision Making in Clinical Training.

    PubMed

    Ten Cate, Olle; Hart, Danielle; Ankel, Felix; Busari, Jamiu; Englander, Robert; Glasgow, Nicholas; Holmboe, Eric; Iobst, William; Lovell, Elise; Snell, Linda S; Touchie, Claire; Van Melle, Elaine; Wycliffe-Jones, Keith

    2016-02-01

    The decision to trust a medical trainee with the critical responsibility to care for a patient is fundamental to clinical training. When carefully and deliberately made, such decisions can serve as significant stimuli for learning and also shape the assessment of trainees. Holding back entrustment decisions too much may hamper the trainee's development toward unsupervised practice. When carelessly made, however, they jeopardize patient safety. Entrustment decision-making processes, therefore, deserve careful analysis.Members (including the authors) of the International Competency-Based Medical Education Collaborative conducted a content analysis of the entrustment decision-making process in health care training during a two-day summit in September 2013 and subsequently reviewed the pertinent literature to arrive at a description of the critical features of this process, which informs this article.The authors discuss theoretical backgrounds and terminology of trust and entrustment in the clinical workplace. The competency-based movement and the introduction of entrustable professional activities force educators to rethink the grounds for assessment in the workplace. Anticipating a decision to grant autonomy at a designated level of supervision appears to align better with health care practice than do most current assessment practices. The authors distinguish different modes of trust and entrustment decisions and elaborate five categories, each with related factors, that determine when decisions to trust trainees are made: the trainee, supervisor, situation, task, and the relationship between trainee and supervisor. The authors' aim in this article is to lay a theoretical foundation for a new approach to workplace training and assessment. PMID:26630606

  14. The decision-making process for senior cancer patients: treatment allocation of older women with operable breast cancer in the UK

    PubMed Central

    Morgan, Jenna L.; Richards, Paul; Zaman, Osama; Ward, Sue; Collins, Karen; Robinson, Thompson; Cheung, Kwok-Leung; Audisio, Riccardo A.; Reed, Malcolm W.; Wyld, Lynda

    2015-01-01

    Objective Up to 40% of women over 70 years with primary operable breast cancer in the UK are treated with primary endocrine therapy (PET) as an alternative to surgery. A variety of factors are important in determining treatment for older breast cancer patients. This study aimed to identify the patient and tumor factors associated with treatment allocation in this population. Methods Prospectively collected data on treatment received (surgery vs. PET) were analysed with multivariable logistic regression using the variables age, modified Charlson Comorbidity Index (CCI), activities of daily living (ADL) score, Mini-Mental State Examination (MMSE) score, HER2 status, tumour size, grade and nodal status. Results Data were available for 1,122 cancers in 1,098 patients recruited between February 2013 and June 2015 from 51 UK hospitals. About 78% of the population were treated surgically, with the remainder being treated with PET. Increasing patient age at diagnosis, increasing CCI score, large tumor size (5 cm or more) and dependence in one or more ADL categories were all strongly associated with non-surgical treatment (P<0.05). Conclusion Increasing comorbidity, large tumor size and reduced functional ability are associated with reduced likelihood of surgical treatment of breast cancer in older patients. However, age itself remains a significant factor for non-surgical treatment; reinforcing the need for evidence-based guidelines. PMID:26779368

  15. Shared Decision Making: Through the Patient's Eyes.

    PubMed

    Klassa, Patricia J; Dendrinos, Susan; Penn, Annette; Radke, Judith

    2016-01-01

    Birth is an intimate moment in a woman's life, and healthcare providers play a pivotal role in pregnant women having safe and memorable birth experiences. Utilizing the shared decision-making model during the prenatal period involves listening to the voices of identified high-risk patients and giving them options for care during labor and birth. "Through the Patient's Eyes" is an innovative program that evolved from the care planning process for these identified high-risk obstetric patients who are invited back postpartum to describe to the team birth through "their" eyes. Through this program, the team learned that compassionate care comes from truly listening to pregnant women and their families and that nurses play a pivotal role as educators and advocates. Sharing birth stories with the staff who cared for them not only had a positive effect on the staff but also many women described profound healing afterward. PMID:27465455

  16. How expert advice influences decision making.

    PubMed

    Meshi, Dar; Biele, Guido; Korn, Christoph W; Heekeren, Hauke R

    2012-01-01

    People often use expert advice when making decisions in our society, but how we are influenced by this advice has yet to be understood. To address this, using functional magnetic resonance imaging, we provided expert and novice advice to participants during an estimation task. Participants reported that they valued expert advice more than novice advice, and activity in the ventral striatum correlated with this valuation, even before decisions with the advice were made. When using advice, participants compared their initial opinion to their advisor's opinion. This comparison, termed the "opinion difference", influenced advice utilization and was represented in reward-sensitive brain regions. Finally, the left lateral orbitofrontal cortex integrated both the size of the opinion difference and the advisor's level of expertise, and average activity in this area correlated with mean advice utilization across participants. Taken together, these findings provide neural evidence for how advice engenders behavioral change during the decision-making process. PMID:23185425

  17. How Expert Advice Influences Decision Making

    PubMed Central

    Meshi, Dar; Biele, Guido; Korn, Christoph W.; Heekeren, Hauke R.

    2012-01-01

    People often use expert advice when making decisions in our society, but how we are influenced by this advice has yet to be understood. To address this, using functional magnetic resonance imaging, we provided expert and novice advice to participants during an estimation task. Participants reported that they valued expert advice more than novice advice, and activity in the ventral striatum correlated with this valuation, even before decisions with the advice were made. When using advice, participants compared their initial opinion to their advisor’s opinion. This comparison, termed the “opinion difference”, influenced advice utilization and was represented in reward-sensitive brain regions. Finally, the left lateral orbitofrontal cortex integrated both the size of the opinion difference and the advisor’s level of expertise, and average activity in this area correlated with mean advice utilization across participants. Taken together, these findings provide neural evidence for how advice engenders behavioral change during the decision-making process. PMID:23185425

  18. Quality of decision making and group norms.

    PubMed

    Postmes, T; Spears, R; Cihangir, S

    2001-06-01

    Two studies investigated the impact of group norms for maintaining consensus versus norms for critical thought on group decisions in a modification of the biased sampling paradigm (G. Stasser & W. Titus, 1985). Both studies showed that critical norms improved the quality of decisions, whereas consensus norms did not. This effect appeared to be mediated by the perceived value of shared and unshared information: Consensus norm groups valued shared information more highly than critical groups did, and valence was a good predictor of decision outcome. In addition, the 2nd study showed that the group norm manipulation has no impact on individual decisions, consistent with the assumption that this is a group effect. Results suggest that the content of group norms is an important factor influencing the quality of group decision-making processes and that the content of group norms may be related to the group's proneness for groupthink. PMID:11414374

  19. Distributed decision-making for space operations

    NASA Technical Reports Server (NTRS)

    Hornstein, Rhoda Shaller; Gardner, J. A.; Willoughby, J. K.

    1990-01-01

    A programmatic and technical perspective in the context of future space applications is presented, that includes some of the management challenges that arise as the decision-making process becomes increasingly more decentralized. Three challenges are discussed: (1) the degree to which the planners must communicate with each other and with those who are seeking space operations resources, (2) the collection, management, employment and dissemination of the information needed to make decisions, and (3) the challenges connected with schedule integration. The technical perspective presented leads to recommended adaptations to the normal scheduling algorithms that retain the 'degrees of freedom' in the planning result. It is shown that these adaptations are specific technical responses to the programmatic challenges discussed.

  20. Survey of the Definition of Fetal Viability and the Availability, Indications, and Decision Making Processes for Post-Viability Termination of Pregnancy for Fetal Abnormalities and Health Conditions in Canada.

    PubMed

    Hull, Danna; Davies, Gregory; Armour, Christine M

    2016-06-01

    The purpose of this study was to explore the definition of fetal viability and the availability, indications, and decision making processes for post-viability termination of pregnancy for fetal abnormalities and health conditions in Canada. An online survey of members of the Canadian Association of Genetic Counsellors, the Canadian College of Medical Geneticists, and the Canadian Society for Maternal-Fetal Medicine who provide direct counselling to, or management of, prenatal patients in Canada (total sample size 815). Results of this study showed that the majority of respondents indicated that their centre will offer post-viability termination of pregnancy (98/123; 80 %). Sixty-seven percent (68/101) of respondents reported the definition of fetal viability to be 24 weeks' gestation. Most respondents reported that a collaborative decision making process was used to determine if post-viability termination of pregnancy would be offered (136/170; 80 %). For conditions presumed to be lethal/likely lethal, the majority of respondents would "sometimes" or "always" offer post-viability termination of pregnancy, whereas for conditions presumed to have a mild effect, the majority of respondents would "rarely" or "never" offer post-viability termination of pregnancy. Ninety percent (77/86) of respondents reported that perinatal hospice is offered as an alternative to termination of pregnancy. In conclusion, this study suggests that although post-viability termination is available in many provinces in Canada, variation in the definition of fetal viability and indications appear to exist. While these variations may lead to unequal access to post-viability termination of pregnancy across Canada, they might also represent the complexity of the decision making process and the importance of examining individual factors to ensure that the most appropriate decision is made in each case. PMID:26536885

  1. Examining Decision-Making Regarding Environmental Information

    SciTech Connect

    Marble, Julie Lynne; Medema, Heather Dawne; Hill, Susan Gardiner

    2001-10-01

    Eight participants were asked to view a computer-based multimedia presentation on an environmental phenomenon. Participants were asked to play a role as a senior aide to a national legislator. In this role, they were told that the legislator had asked them to review a multimedia presentation regarding the hypoxic zone phenomenon in the Gulf of Mexico. Their task in assuming the role of a senior aide was to decide how important a problem this issue was to the United States as a whole, and the proportion of the legislator’s research budget that should be devoted to study of the problem. The presentation was divided into 7 segments, each containing some new information not contained in the previous segments. After viewing each segment, participants were asked to indicate how close they were to making a decision and how certain they were that their current opinion would be their final decision. After indicating their current state of decision-making, participants were interviewed regarding the factors affecting their decision-making. Of interest was the process by which participants moved toward a decision. This experiment revealed a number of possible directions for future research. There appeared to be two approaches to decision-making: Some decision-makers moved steadily toward a decision, and occasionally reversed decisions after viewing information, while others abruptly reached a decision after a certain time period spent reviewing the information. Although the difference in estimates of distance to decisions did not differ statistically for these two groups, that difference was reflected in the participants’ estimates of confidence that their current opinion would be their final decision. The interviews revealed that the primary difference between these two groups was in their trade-offs between willingness to spend time in information search and the acquisition of new information. Participants who were less confident about their final decision, tended to be

  2. Public involvement in science and decision making.

    PubMed

    Till, J E; Meyer, K R

    2001-04-01

    commitments encountered when making scientific decisions in a public forum. Although the process was time consuming for the scientists responsible for the calculations, a more technically defensible as well as publicly acceptable soil action level emerged. The technical approach developed during the project has been recommended for use as a decision-making tool for cleanup of the site. PMID:11281205

  3. Nationwide survey to evaluate the decision-making process in euthanasia requests in Belgium: do specifically trained 2nd physicians improve quality of consultation?

    PubMed Central

    2014-01-01

    competencies and tasks of consulting physicians may additionally incite improvement. Irrespective of whether euthanasia is a legal practice within a country, similar services may prove useful to also improve quality of consultations in various other difficult end-of-life decision-making situations. PMID:25030375

  4. Primum Non Nocere: is shared decision-making the answer?

    PubMed

    Santhirapala, Ramai; Moonesinghe, Ramani

    2016-01-01

    Surgical ambition is rising, with the Royal College of Surgeons reporting an increase in the number of procedures by a million over the past decade (Royal College of Surgeons. Surgery and the NHS in Numbers. Available from https://www.rcseng.ac.uk). Underpinning, this is a rapidly growing population, especially those in the over 85 age group, coupled with rising perioperative expertise; options for surgery are now present where conditions were once managed conservatively. Matching the right patient to the right procedure has never been so pertinent (Bader, Am Soc Anesthesiol 78(6), 2014). At the heart of these increasingly complex decisions, which may prove fatal or result in serious morbidity, lies the aspiration of shared decision-making (SDM) (Glance et al., N Engl J Med 370:1379-81, 2014). Shared decision-making is a patient-centred approach taking into account the beliefs, preferences and views of the patient as an expert in what is right for them, supported by clinicians who are the experts in diagnostics and valid therapeutic options (Coulter and Collins, Making shared decision-making a reality: no decision about me, without me, 2011). It has been described as the pinnacle of patient-centred care (Barry et al., N Engl J Med 366:780-1, 2012). In this commentary, we explore further the concept of shared decision-making, supported by a recent article which highlights critical deficits in current perioperative practice (Ankuda et al., Patient Educ Couns 94(3):328-33, 2014). This article was chosen for the purposes of this commentary as it is a large study across several surgical specialties investigating preoperative shared decision-making, and to our knowledge, the only of this kind. PMID:27313845

  5. A framework for automated decision making and problem solving

    NASA Technical Reports Server (NTRS)

    Heer, E.

    1980-01-01

    Problems can be subdivided into two main categories: well structured problems and ill structured problems. The first require routine repetitive decisions which are generally amenable to programmable decision processes. The second require novel nonprogrammable decision processes. The decision making processes can be subdivided into those representative of those done by humans and those done by machine. Many of such decision processes require a combination of humans d machines. Automated decision making and problem solving technologies are expected to have their greatest potential impact in the space program.

  6. Interference effects of categorization on decision making.

    PubMed

    Wang, Zheng; Busemeyer, Jerome R

    2016-05-01

    Many decision making tasks in life involve a categorization process, but the effects of categorization on subsequent decision making has rarely been studied. This issue was explored in three experiments (N=721), in which participants were shown a face stimulus on each trial and performed variations of categorization-decision tasks. On C-D trials, they categorized the stimulus and then made an action decision; on X-D trials, they were told the category and then made an action decision; on D-alone trials, they only made an action decision. An interference effect emerged in some of the conditions, such that the probability of an action on the D-alone trials (i.e., when there was no explicit categorization before the decision) differed from the total probability of the same action on the C-D or X-D trials (i.e., when there was explicit categorization before the decision). Interference effects are important because they indicate a violation of the classical law of total probability, which is assumed by many cognitive models. Across all three experiments, a complex pattern of interference effects systematically occurred for different types of stimuli and for different types of categorization-decision tasks. These interference effects present a challenge for traditional cognitive models, such as Markov and signal detection models, but a quantum cognition model, called the belief-action entanglement (BAE) model, predicted that these results could occur. The BAE model employs the quantum principles of superposition and entanglement to explain the psychological mechanisms underlying the puzzling interference effects. The model can be applied to many important and practical categorization-decision situations in life. PMID:26896726

  7. Influence of branding on preference-based decision making.

    PubMed

    Philiastides, Marios G; Ratcliff, Roger

    2013-07-01

    Branding has become one of the most important determinants of consumer choices. Intriguingly, the psychological mechanisms of how branding influences decision making remain elusive. In the research reported here, we used a preference-based decision-making task and computational modeling to identify which internal components of processing are affected by branding. We found that a process of noisy temporal integration of subjective value information can model preference-based choices reliably and that branding biases are explained by changes in the rate of the integration process itself. This result suggests that branding information and subjective preference are integrated into a single source of evidence in the decision-making process, thereby altering choice behavior. PMID:23696199

  8. Combining disparate data for decision making

    NASA Astrophysics Data System (ADS)

    Gettings, M. E.

    2010-12-01

    variables such as water use, environmental quality measures (visual and geochemical), deposit quality, rate of development, and commodity price combine in complex ways to yield frequently counter-intuitive results. By varying the interaction strengths linking the variables, insight into the complex interactions of the system can be gained. An example using agent-based modeling is a model designed to test the hypothesis that new valley fever fungus sites could be established from existing sites by wind transport of fungal spores. The variables include layers simulating precipitation, temperature, soil moisture, and soil chemistry based on historical climate records and studies of known valley fever habitat. Numerous agent-based model runs show that the system is self organizing to the extent that there will be new sites established by wind transport over decadal scales. Possibility theory provides a framework for gaining insight into the interaction of known or suspected variables in a complex system. Once the data layers are quantified into possibility functions, varying hypotheses of the relative importance of variables and processes can be obtained by repeated combinations with varying weights. This permits an evaluation of the effects of various data layers, their uncertainties, and biases from the layers, all of which improve the objectivity of decision making.

  9. Embodied Choice: How Action Influences Perceptual Decision Making

    PubMed Central

    Lepora, Nathan F.; Pezzulo, Giovanni

    2015-01-01

    Embodied Choice considers action performance as a proper part of the decision making process rather than merely as a means to report the decision. The central statement of embodied choice is the existence of bidirectional influences between action and decisions. This implies that for a decision expressed by an action, the action dynamics and its constraints (e.g. current trajectory and kinematics) influence the decision making process. Here we use a perceptual decision making task to compare three types of model: a serial decision-then-action model, a parallel decision-and-action model, and an embodied choice model where the action feeds back into the decision making. The embodied model incorporates two key mechanisms that together are lacking in the other models: action preparation and commitment. First, action preparation strategies alleviate delays in enacting a choice but also modify decision termination. Second, action dynamics change the prospects and create a commitment effect to the initially preferred choice. Our results show that these two mechanisms make embodied choice models better suited to combine decision and action appropriately to achieve suitably fast and accurate responses, as usually required in ecologically valid situations. Moreover, embodied choice models with these mechanisms give a better account of trajectory tracking experiments during decision making. In conclusion, the embodied choice framework offers a combined theory of decision and action that gives a clear case that embodied phenomena such as the dynamics of actions can have a causal influence on central cognition. PMID:25849349

  10. Computer Graphics and Administrative Decision-Making.

    ERIC Educational Resources Information Center

    Yost, Michael

    1984-01-01

    Reduction in prices now makes it possible for almost any institution to use computer graphics for administrative decision making and research. Current and potential uses of computer graphics in these two areas are discussed. (JN)

  11. [Aeromedical Decision-Making in Psychiatry].

    PubMed

    Weber, F

    2016-09-01

    This paper reviews aeromedical decision-making in psychiatry. It explains the "one-percent rule", the general medical criteria for fitness for flying and how they are applied to psychiatric disorders. PMID:27607071

  12. Characterization of Ambiguity in Decision Making

    ERIC Educational Resources Information Center

    Yates, J. Frank; Zukowski, Lisa G.

    1976-01-01

    Describes a psychology experiment that investigated the effect of ambiguity on human decision-making behavior. (Available from Behavioral Science, University of Louisville, P.O. Box 1055, Louisville, KY 40201; $3.50 single copy.) (JG)

  13. Acute Stress Modulates Risk Taking in Financial Decision Making

    PubMed Central

    Porcelli, Anthony J.; Delgado, Mauricio R.

    2016-01-01

    People’s decisions are often susceptible to various demands exerted by the environment, leading to stressful conditions. Although a goal for researchers is to elucidate stress-coping mechanisms to facilitate decision-making processes, it is important to first understand the interaction between the state created by a stressful environment and how decisions are performed in such environments. The objective of this experiment was to probe the impact of exposure to acute stress on financial decision-making and examine the particular influence of stress on decisions with a positive or negative valence. Participants’ choices exhibited a stronger reflection effect when participants were under stress than when they were in the no-stress control phase. This suggests that stress modulates risk taking, potentially exacerbating behavioral bias in subsequent decision making. Consistent with dual-process approaches, decision makers fall back on automatized reactions to risk under the influence of disruptive stress. PMID:19207694

  14. The thinking doctor: clinical decision making in contemporary medicine.

    PubMed

    Trimble, Michael; Hamilton, Paul

    2016-08-01

    Diagnostic errors are responsible for a significant number of adverse events. Logical reasoning and good decision-making skills are key factors in reducing such errors, but little emphasis has traditionally been placed on how these thought processes occur, and how errors could be minimised. In this article, we explore key cognitive ideas that underpin clinical decision making and suggest that by employing some simple strategies, physicians might be better able to understand how they make decisions and how the process might be optimised. PMID:27481378

  15. Leadership of risk decision making in a complex, technology organization: The deliberative decision making model

    NASA Astrophysics Data System (ADS)

    Flaming, Susan C.

    2007-12-01

    The continuing saga of satellite technology development is as much a story of successful risk management as of innovative engineering. How do program leaders on complex, technology projects manage high stakes risks that threaten business success and satellite performance? This grounded theory study of risk decision making portrays decision leadership practices at one communication satellite company. Integrated product team (IPT) leaders of multi-million dollar programs were interviewed and observed to develop an extensive description of the leadership skills required to navigate organizational influences and drive challenging risk decisions to closure. Based on the study's findings the researcher proposes a new decision making model, Deliberative Decision Making, to describe the program leaders' cognitive and organizational leadership practices. This Deliberative Model extends the insights of prominent decision making models including the rational (or classical) and the naturalistic and qualifies claims made by bounded rationality theory. The Deliberative Model describes how leaders proactively engage resources to play a variety of decision leadership roles. The Model incorporates six distinct types of leadership decision activities, undertaken in varying sequence based on the challenges posed by specific risks. Novel features of the Deliberative Decision Model include: an inventory of leadership methods for managing task challenges, potential stakeholder bias and debates; four types of leadership meta-decisions that guide decision processes, and aligned organizational culture. Both supporting and constraining organizational influences were observed as leaders managed major risks, requiring active leadership on the most difficult decisions. Although the company's engineering culture emphasized the importance of data-based decisions, the uncertainties intrinsic to satellite risks required expert engineering judgment to be exercised throughout. An investigation into

  16. Environmental Decision Making and Information Technology: Issues Assessment

    SciTech Connect

    Barg, S.; Fletcher, T.; Mechling, J.; Tonn, B.; Turner, R.

    1999-05-01

    This report presents a summary of the Information Technology and Environmental Decision Making Workshop that was held at Harvard University, October 1-3, 1998. Over sixty participants from across the US took part in discussions that focused on the current practice of using information technology to support environmental decision making and on future considerations of information technology development, information policies, and data quality issues in this area. Current practice is focusing on geographic information systems and visualization tools, Internet applications, and data warehousing. In addition, numerous organizations are developing environmental enterprise systems to integrate environmental information resources. Plaguing these efforts are issues of data quality (and public trust), system design, and organizational change. In the future, much effort needs to focus on building community-based environmental decision-making systems and processes, which will be a challenge given that exactly what needs to be developed is largely unknown and that environmental decision making in this arena has been characterized by a high level of conflict. Experimentation and evaluation are needed to contribute to efficient and effective learning about how best to use information technology to improve environmental decision making.

  17. Reduced model-based decision-making in schizophrenia.

    PubMed

    Culbreth, Adam J; Westbrook, Andrew; Daw, Nathaniel D; Botvinick, Matthew; Barch, Deanna M

    2016-08-01

    Individuals with schizophrenia have a diminished ability to use reward history to adaptively guide behavior. However, tasks traditionally used to assess such deficits often rely on multiple cognitive and neural processes, leaving etiology unresolved. In the current study, we adopted recent computational formalisms of reinforcement learning to distinguish between model-based and model-free decision-making in hopes of specifying mechanisms associated with reinforcement-learning dysfunction in schizophrenia. Under this framework, decision-making is model-free to the extent that it relies solely on prior reward history, and model-based if it relies on prospective information such as motivational state, future consequences, and the likelihood of obtaining various outcomes. Model-based and model-free decision-making was assessed in 33 schizophrenia patients and 30 controls using a 2-stage 2-alternative forced choice task previously demonstrated to discern individual differences in reliance on the 2 forms of reinforcement-learning. We show that, compared with controls, schizophrenia patients demonstrate decreased reliance on model-based decision-making. Further, parameter estimates of model-based behavior correlate positively with IQ and working memory measures, suggesting that model-based deficits seen in schizophrenia may be partially explained by higher-order cognitive deficits. These findings demonstrate specific reinforcement-learning and decision-making deficits and thereby provide valuable insights for understanding disordered behavior in schizophrenia. (PsycINFO Database Record PMID:27175984

  18. Studying Collective Human Decision Making and Creativity with Evolutionary Computation.

    PubMed

    Sayama, Hiroki; Dionne, Shelley D

    2015-01-01

    We report a summary of our interdisciplinary research project "Evolutionary Perspective on Collective Decision Making" that was conducted through close collaboration between computational, organizational, and social scientists at Binghamton University. We redefined collective human decision making and creativity as evolution of ecologies of ideas, where populations of ideas evolve via continual applications of evolutionary operators such as reproduction, recombination, mutation, selection, and migration of ideas, each conducted by participating humans. Based on this evolutionary perspective, we generated hypotheses about collective human decision making, using agent-based computer simulations. The hypotheses were then tested through several experiments with real human subjects. Throughout this project, we utilized evolutionary computation (EC) in non-traditional ways-(1) as a theoretical framework for reinterpreting the dynamics of idea generation and selection, (2) as a computational simulation model of collective human decision-making processes, and (3) as a research tool for collecting high-resolution experimental data on actual collaborative design and decision making from human subjects. We believe our work demonstrates untapped potential of EC for interdisciplinary research involving human and social dynamics. PMID:26280078

  19. Patients’ decision making in total knee arthroplasty

    PubMed Central

    Barlow, T.; Griffin, D.; Barlow, D.; Realpe, A.

    2015-01-01

    Objectives A patient-centred approach, usually achieved through shared decision making, has the potential to help improve decision making around knee arthroplasty surgery. However, such an approach requires an understanding of the factors involved in patient decision making. This review’s objective is to systematically examine the qualitative literature surrounding patients’ decision making in knee arthroplasty. Methods A systematic literature review using Medline and Embase was conducted to identify qualitative studies that examined patients’ decision making around knee arthroplasty. An aggregated account of what is known about patients’ decision making in knee arthroplasties is provided. Results Seven studies with 234 participants in interviews or focus groups are included. Ten themes are replicated across studies, namely: expectations of surgery; coping mechanisms; relationship with clinician; fear; pain; function; psychological implications; social network; previous experience of surgery; and conflict in opinions. Conclusions This review is helpful in not only directing future research to areas that are not understood, or require confirmation, but also in highlighting areas that future interventions could address. These include those aimed at delivering information, which are likely to affect the satisfaction rate, demand, and use of knee arthroplasties. Cite this article: Bone Joint Res 2015;4;163–169. PMID:26450640

  20. Modeling Hospital Discharge and Placement Decision Making: Whither the Elderly.

    ERIC Educational Resources Information Center

    Clark, William F.; Pelham, Anabel O.

    This paper examines the hospital discharge decision making process for elderly patients, based on observations of the operations of a long term care agency, the California Multipurpose Senior Services Project. The analysis is divided into four components: actors, factors, processes, and strategy critique. The first section discusses the major…

  1. The problem of consciousness in habitual decision making.

    PubMed

    Bernacer, Javier; Balderas, Gloria; Martinez-Valbuena, Ivan; Pastor, Maria A; Murillo, Jose Ignacio

    2014-02-01

    Newell & Shanks (N&S) carry out an extremely sharp and static distinction between conscious and unconscious decisions, ignoring a process that dynamically transfers decisions and actions between the conscious and unconscious domains of the mind: habitual decision making. We propose a new categorisation and discuss the main characteristics of this process from a philosophical and neuroscientific perspective. PMID:24461349

  2. Mental Workload as a Key Factor in Clinical Decision Making

    ERIC Educational Resources Information Center

    Byrne, Aidan

    2013-01-01

    The decision making process is central to the practice of a clinician and has traditionally been described in terms of the hypothetico-deductive model. More recently, models adapted from cognitive psychology, such as the dual process and script theories have proved useful in explaining patterns of practice not consistent with purely cognitive…

  3. A Social Constructivism Model of Ethical Decision Making in Counseling.

    ERIC Educational Resources Information Center

    Cottone, R. Rocco

    2001-01-01

    Examines social constructivism as an intellectual movement in the mental health field that directs a social consensual interpretation of reality. Presents a social constructivism approach to counseling which redefines the ethical decision-making process as an interactive rather than individual or intrapsychic process. Explores how the process…

  4. The anatomy of clinical decision-making in multidisciplinary cancer meetings

    PubMed Central

    Soukup, Tayana; Petrides, Konstantinos V.; Lamb, Benjamin W.; Sarkar, Somita; Arora, Sonal; Shah, Sujay; Darzi, Ara; Green, James S. A.; Sevdalis, Nick

    2016-01-01

    Abstract In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable. The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision. This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons. We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis. The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = −0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001). Hawthorne effect is the main limitation of the study. The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient profile and contributions to case review by all core

  5. Shared Decision Making for Routine Infant Circumcision: A Pilot Study

    PubMed Central

    Mitchell, Teri M.; Beal, Claudia

    2015-01-01

    ABSTRACT It is important that expectant parents receive accurate information about the benefits and risks of circumcision as well as the benefits and risks of having an intact foreskin when making a decision about routine infant circumcision (RIC). A pilot study was conducted using the shared decision making (SDM) conceptual model to guide expectant parents through a 3-phase decision-making program about RIC as part of their childbirth education class. The participants showed a high level of preparedness following each of the 3 phases. Preparedness score were highest for those who decided to keep their expected sons’ penises natural. This SDM program was an effective way of guiding expectant parents through the decision-making process for RIC. PMID:26834440

  6. Neural basis of quasi-rational decision making.

    PubMed

    Lee, Daeyeol

    2006-04-01

    Standard economic theories conceive homo economicus as a rational decision maker capable of maximizing utility. In reality, however, people tend to approximate optimal decision-making strategies through a collection of heuristic routines. Some of these routines are driven by emotional processes, and others are adjusted iteratively through experience. In addition, routines specialized for social decision making, such as inference about the mental states of other decision makers, might share their origins and neural mechanisms with the ability to simulate or imagine outcomes expected from alternative actions that an individual can take. A recent surge of collaborations across economics, psychology and neuroscience has provided new insights into how such multiple elements of decision making interact in the brain. PMID:16531040

  7. Incorporating affective bias in models of human decision making

    NASA Technical Reports Server (NTRS)

    Nygren, Thomas E.

    1991-01-01

    Research on human decision making has traditionally focused on how people actually make decisions, how good their decisions are, and how their decisions can be improved. Recent research suggests that this model is inadequate. Affective as well as cognitive components drive the way information about relevant outcomes and events is perceived, integrated, and used in the decision making process. The affective components include how the individual frames outcomes as good or bad, whether the individual anticipates regret in a decision situation, the affective mood state of the individual, and the psychological stress level anticipated or experienced in the decision situation. A focus of the current work has been to propose empirical studies that will attempt to examine in more detail the relationships between the latter two critical affective influences (mood state and stress) on decision making behavior.

  8. Analytical group decision making in natural resources: Methodology and application

    USGS Publications Warehouse

    Schmoldt, D.L.; Peterson, D.L.

    2000-01-01

    Group decision making is becoming increasingly important in natural resource management and associated scientific applications, because multiple values are treated coincidentally in time and space, multiple resource specialists are needed, and multiple stakeholders must be included in the decision process. Decades of social science research on decision making in groups have provided insights into the impediments to effective group processes and on techniques that can be applied in a group context. Nevertheless, little integration and few applications of these results have occurred in resource management decision processes, where formal groups are integral, either directly or indirectly. A group decision-making methodology is introduced as an effective approach for temporary, formal groups (e.g., workshops). It combines the following three components: (1) brainstorming to generate ideas; (2) the analytic hierarchy process to produce judgments, manage conflict, enable consensus, and plan for implementation; and (3) a discussion template (straw document). Resulting numerical assessments of alternative decision priorities can be analyzed statistically to indicate where group member agreement occurs and where priority values are significantly different. An application of this group process to fire research program development in a workshop setting indicates that the process helps focus group deliberations; mitigates groupthink, nondecision, and social loafing pitfalls; encourages individual interaction; identifies irrational judgments; and provides a large amount of useful quantitative information about group preferences. This approach can help facilitate scientific assessments and other decision-making processes in resource management.

  9. Better environmental decision making - recent progress and future trends.

    PubMed

    Pollard, S J T; Davies, G J; Coley, F; Lemon, M

    2008-08-01

    Recent trends in risk-based decision making are reviewed in relation to novel developments in comparative risk analysis, strategic risk analysis, weight of evidence frameworks, and participative decision making. Delivery of these innovations must take account of organisational capabilities in risk management and the institutional culture that implements decision on risk. We stress the importance of managing risk knowledge within organisations, and emphasise the use of core criteria for effective risk-based decisions by reference to decision process, implementation and the security of strategic added value. PMID:18774589

  10. Systematic behavior research for understanding consumer decision making.

    PubMed

    Lin, Chin-Feng

    2009-05-01

    This study incorporates means-end chain (MEC) theory and dynamic programming for understanding the implications of consumer decision making. The conceptual framework of this study can help programmers design information systems for analyzing consumption behaviors. Such analyses will provide marketers with meaningful information for formulating marketing strategies. The main contributions of this article are as follows: (1) to enable researchers to obtain information for consumer cognitive hierarchies utilizing an information system, (2) to enhance the functions of traditional MEC methodology and provide an integrated method for analyzing consumption information, and (3) to construct an information system for analyzing consumer decision-making processes. PMID:19363181

  11. Decision-making based on emotional images.

    PubMed

    Katahira, Kentaro; Fujimura, Tomomi; Okanoya, Kazuo; Okada, Masato

    2011-01-01

    The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants' choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward, the "reward value" of the decision outcome, which guided the update of value for each choice, is unknown beforehand. To estimate the reward value of emotional pictures from participants' choice data, we used reinforcement learning models that have successfully been used in previous studies for modeling value-based decision making. Consequently, we found that the estimated reward value was asymmetric between positive and negative pictures. The negative reward value of negative pictures (relative to neutral pictures) was larger in magnitude than the positive reward value of positive pictures. This asymmetry was not observed in valence for an individual picture, which was rated by the participants regarding the emotion experienced upon viewing it. These results suggest that there may be a difference between experienced emotion and the effect of the experienced emotion on subsequent behavior. Our experimental and computational paradigm provides a novel way for quantifying how and what aspects of emotional events affect human behavior. The present study is a first step toward relating a large amount of knowledge in emotion science and in taking computational approaches to value-based decision making. PMID:22059086

  12. Shared Problem Models and Crew Decision Making

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith; Statler, Irving C. (Technical Monitor)

    1994-01-01

    The importance of crew decision making to aviation safety has been well established through NTSB accident analyses: Crew judgment and decision making have been cited as causes or contributing factors in over half of all accidents in commercial air transport, general aviation, and military aviation. Yet the bulk of research on decision making has not proven helpful in improving the quality of decisions in the cockpit. One reason is that traditional analytic decision models are inappropriate to the dynamic complex nature of cockpit decision making and do not accurately describe what expert human decision makers do when they make decisions. A new model of dynamic naturalistic decision making is offered that may prove more useful for training or aiding cockpit decision making. Based on analyses of crew performance in full-mission simulation and National Transportation Safety Board accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation and reflect the crew's metacognitive skill. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking in response to a problem. This presentation will examine the relation between communication that serves to build performance. Implications of these findings for crew training will be discussed.

  13. Fifty Years of College Choice: Social, Political and Institutional Influences on the Decision-Making Process. New Agenda Series. Volume 5, Number 3

    ERIC Educational Resources Information Center

    Kinzie, Jillian; Palmer, Megan; Hayek, John; Hossler, Don; Jacob, Stacy A.; Cummings, Heather

    2004-01-01

    The college-choice process is complex and affects many high school students, family members and public policy-makers, as well as institutions of higher education. This report provides an overview of the college-choice process for traditional-age students and examines how it has evolved during the last half of the 20th century. Material from the…

  14. Pleasure in decision-making situations

    PubMed Central

    Cabanac, Michel; Guillaume, Jacqueline; Balasko, Marta; Fleury, Adriana

    2002-01-01

    Background This study explores the role of pleasure in decision making. Results In Experiment 1, 12 subjects were presented with a questionnaire containing 46 items taken from the literature. Twenty-three items described a situation where a decision should be made and ended with a suggested solution. The other items served as filler items. The subjects were requested not to make a decision but to rate the pleasure or displeasure they experienced when reading the situation described in the item. The subjects' ratings were then compared to the decisions on the same situations made by the other subjects of the studies published by other workers. The ratings of pleasure/displeasure given by our subjects correlated significantly with the choices published by other authors. This result satisfies a necessary condition for pleasure to be the key of the decision making process in theoretical situations. In Experiment 2, a new group of 12 subjects rated their experience of pleasure/displeasure when reading various versions of 50 situations taken from daily life where an ethical decision had to be made (Questionnaire I) including 200 items. This was followed by a multiple-choice test with the 50 situations (Questionnaire II) using the same 200 items and offering the various behaviors. Subjects tended to choose ethical and unethical responses corresponding to their highest pleasure rating within each problem. In all cases the subjects' behavior was higher than chance level, and thus, followed the trend to maximize pleasure. In Experiment 3, 12 subjects reading 50 mathematical short problems followed by correct and incorrect versions of the answer to the problem (Questionnaire III), including 200 items. This was followed by a multiple-choice mathematical test with the 50 problems (Questionnaire IV) using the same 200 items and offering the correct and incorrect answers. In questionnaire IV, subjects tended to choose correct as well as incorrect responses corresponding to their

  15. Neural substrates of approach-avoidance conflict decision-making

    PubMed Central

    Aupperle, Robin L.; Melrose, Andrew J.; Francisco, Alex; Paulus, Martin P.; Stein, Murray B.

    2014-01-01

    Animal approach-avoidance conflict paradigms have been used extensively to operationalize anxiety, quantify the effects of anxiolytic agents, and probe the neural basis of fear and anxiety. Results from human neuroimaging studies support that a frontal-striatal-amygdala neural circuitry is important for approach-avoidance learning. However, the neural basis of decision-making is much less clear in this context. Thus, we combined a recently developed human approach-avoidance paradigm with functional magnetic resonance imaging (fMRI) to identify neural substrates underlying approach-avoidance conflict decision-making. Fifteen healthy adults completed the approach-avoidance conflict (AAC) paradigm during fMRI. Analyses of variance were used to compare conflict to non-conflict (avoid-threat and approach-reward) conditions and to compare level of reward points offered during the decision phase. Trial-by-trial amplitude modulation analyses were used to delineate brain areas underlying decision-making in the context of approach/avoidance behavior. Conflict trials as compared to the non-conflict trials elicited greater activation within bilateral anterior cingulate cortex (ACC), anterior insula, and caudate, as well as right dorsolateral prefrontal cortex. Right caudate and lateral PFC activation was modulated by level of reward offered. Individuals who showed greater caudate activation exhibited less approach behavior. On a trial-by-trial basis, greater right lateral PFC activation related to less approach behavior. Taken together, results suggest that the degree of activation within prefrontal-striatal-insula circuitry determines the degree of approach versus avoidance decision-making. Moreover, the degree of caudate and lateral PFC activation is related to individual differences in approach-avoidance decision-making. Therefore, the AAC paradigm is ideally suited to probe anxiety-related processing differences during approach-avoidance decision-making. PMID:25224633

  16. Transparency in Evidence Evaluation And Formulary Decision-Making

    PubMed Central

    Dean, Bonnie B.; Ko, Kelly J.; Graff, Jennifer S.; Localio, A. Russell; Wade, Rolin; Dubois, Robert W.

    2013-01-01

    Objective: Establishing a better understanding of the relationship between evidence evaluation and formulary decision-making has important implications for patients, payers, and providers. The goal of our study was to develop and test a structured approach to evidence evaluation to increase clarity, consistency, and transparency in formulary decision-making. Study Design: The study comprised three phases. First, an expert panel identified key constructs to formulary decision-making and created an evidence-assessment tool. Second, with the use of a balanced incomplete block design, the tool was validated by a large group of decision-makers. Third, the tool was pilot-tested in a real-world P&T committee environment. Methods: An expert panel identified key factors associated with formulary access by rating the level of access that they would give a drug in various hypothetical scenarios. These findings were used to formulate an evidence-assessment tool that was externally validated by surveying a larger sample of decision-makers. Last, the tool was pilot-tested in a real-world environment where P&T committees used it to review new drugs. Results: Survey responses indicated that a structured approach in the formulary decision-making process could yield greater clarity, consistency, and transparency in decision-making; however, pilot-testing of the structured tool in a real-world P&T committee environment highlighted some of the limitations of our structured approach. Conclusion: Although a structured approach to formulary decision-making is beneficial for patients, health care providers, and other stakeholders, this benefit was not realized in a real-world environment. A method to improve clarity, consistency, and transparency is still needed. PMID:24222979

  17. Tools to support evidence-informed public health decision making

    PubMed Central

    2014-01-01

    Background Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. Methods As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Results Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the ‘actionable message(s)’ from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing

  18. Shared decision making in endocrinology: present and future directions.

    PubMed

    Rodriguez-Gutierrez, Rene; Gionfriddo, Michael R; Ospina, Naykky Singh; Maraka, Spyridoula; Tamhane, Shrikant; Montori, Victor M; Brito, Juan P

    2016-08-01

    In medicine and endocrinology, there are few clinical circumstances in which clinicians can accurately predict what is best for their patients. As a result, patients and clinicians frequently have to make decisions about which there is uncertainty. Uncertainty results from limitations in the research evidence, unclear patient preferences, or an inability to predict how treatments will fit into patients' daily lives. The work that patients and clinicians do together to address the patient's situation and engage in a deliberative dialogue about reasonable treatment options is often called shared decision making. Decision aids are evidence-based tools that facilitate this process. Shared decision making is a patient-centred approach in which clinicians share information about the benefits, harms, and burden of different reasonable diagnostic and treatment options, and patients explain what matters to them in view of their particular values, preferences, and personal context. Beyond the ethical argument in support of this approach, decision aids have been shown to improve patients' knowledge about the available options, accuracy of risk estimates, and decisional comfort. Decision aids also promote patient participation in the decision-making process. Despite accumulating evidence from clinical trials, policy support, and expert recommendations in endocrinology practice guidelines, shared decision making is still not routinely implemented in endocrine practice. Additional work is needed to enrich the number of available tools and to implement them in practice workflows. Also, although the evidence from randomised controlled trials favours the use of this shared decision making in other settings, populations, and illnesses, the effect of this approach has been studied in a few endocrine disorders. Future pragmatic trials are needed to explore the effect and feasibility of shared decision making implementation into routine endocrinology and primary care practice. With the

  19. The Effect of Previsit Education in Breast Cancer Patients: A Study of a Shared-decision-making Tool.

    PubMed

    Serpico, Victoria; Liepert, Amy E; Boucher, Kenneth; Fouts, Diane L; Anderson, Layla; Pell, Joyce; Neumayer, Leigh

    2016-03-01

    To enhance shared decision-making for patients with breast cancer, we developed an evidence-based educational breast cancer video (BCV) providing an overview of breast cancer biology, prognostic indicators, and surgical treatment options while introducing health care choice. By providing patients access to a BCV with information necessary to make informed surgical decisions before seeing a surgeon, we aimed to increase patient participation in the decision-making process, while decreasing distress. Patients with a new diagnosis of breast cancer were provided a link to the BCV. Group 1 participated in online pre- and postvideo questionnaires, with the BCV embedded in between. The questionnaires evaluated self-reported baseline knowledge of breast cancer and perceived distress related to the diagnosis. Changes in self-reported responses were analyzed using the Wilcoxon matched pairs test. Group 2 received a survey collecting demographics, decision-making information, and perceptions of the BCV at the time of clinic visit before meeting the surgeon. Group 1 included 69 subjects with 62 per cent reporting improved knowledge and 30 per cent reporting reduced distress in regard to their breast cancer diagnosis. Group 2 included 87 subjects; 94 to 98 per cent felt the BCV provided information and stimulated thoughts and questions to assist in breast cancer treatment decision-making. The BCV was positively received by participants and feasible to implement into clinical practice. Evidence-based media tools improve knowledge and reduce distress in patients with a new diagnosis of breast cancer as well as contributing to the shared decision-making process. PMID:27099063

  20. Cognitive reflection vs. calculation in decision making

    PubMed Central

    Sinayev, Aleksandr; Peters, Ellen

    2015-01-01

    Scores on the three-item Cognitive Reflection Test (CRT) have been linked with dual-system theory and normative decision making (Frederick, 2005). In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT's ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes); Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1) or calculated using proportions (Studies 1 and 2). These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead. PMID:25999877